Tumors of the abdominal walls / by Edward J. Ill.

  • Ill, Edward J.
Date:
[1892]
Catalogue details

Licence: Public Domain Mark

Credit: Tumors of the abdominal walls / by Edward J. Ill. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    38/38 page 36
    the under surface of the ribs, doing a plastic operation, and closed the surfaces. The wound healed kindly; the patient left the hospital August 7, 1891; has made a good recovery, and remains well up to the present time. In giving me more the particulars of his case, he states that in the spring of 1888 a lump appeared at the upper side of the old scar and grew rapidly for a short time, looked red and in- flamed, was sore and pained him much. He poulticed it with figs steeped in new milk, and in about two months’ time it disappeared. After the operation in March, 1889, when the wound was nearly healed, another lump began growing on his right breast. When about the size of a large bean he showed it to Dr. Pearl, who suggested that they keep watch of it, and if it continued to grow he would remove it; but this one disappeared without any treatment whatever. Dr. Ill (closing the discussion).—Dr. McMurtry has remarked as to the extreme rarity of carcinoma of the navel. I can say that I have collected twenty-one cases of carcinoma of the umbilicus, from which I have excluded three as probably of another nature, which makes eighteen. This collection extends so far back as 1827. I have seen but one case. It is extremely rare. As to Dr. Reed’s remarks, it seems to me that the differential diag- nosis ought always to be attempted. I do not believe that we ought to cut down upon a tumor without having exhausted all means for a diagnosis. Those who are teachers are under obligations to their students to endeavor to make such a differential diagnosis. I do not say we can always reach it, but it is better to do so. As to the incision that Dr. Reed speaks of, I do not think he means it for a simple lipoma or a fatty .hernia. In the portion of the paper relating to tumors of the umbilicus I have suggested an elliptical excision as the best. For a fatty hernia a simple, plain incision, extended to any size you like, will give you all the room necessary for the removal of such a growth. There seems to be a little misapprehension as to how the free fibro- lipoma of Virchow is formed in the abdominal cavity. (Here Dr. Ill explained by means of the blackboard how this tumor is formed.) As it grows it pushes the peritoneum in front of it, and the constant movement of the intestines up and down will gradually produce a neck until the tumor is torn off. The President has spoken of the melanotic tumor of the abdominal skin. I have in the course of my paper stated the fact that sarcomata of the skin of the abdomen are usually melanotic, and their return after extirpation is almost inevitable if of a melanotic type. I desire to thank the Fellows for the kind reception accorded my paper.
    digitised image 1
    digitised image 2
    digitised image 3