On the operative surgery of malignant disease / by Henry T. Butlin ; with the co-operation of James Berry (The thyroid) W. Bruce Clarke (The kidney) Alban Doran (The ovary and uterus) Percy Furnivall (The stomach, intestine, and rectum) Walter Jessop (The eye) H.J. Waring (The liver and gall-bladder).

  • Sir Henry Butlin, 1st Baronet
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: On the operative surgery of malignant disease / by Henry T. Butlin ; with the co-operation of James Berry (The thyroid) W. Bruce Clarke (The kidney) Alban Doran (The ovary and uterus) Percy Furnivall (The stomach, intestine, and rectum) Walter Jessop (The eye) H.J. Waring (The liver and gall-bladder). Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    to affect the lower end. They pursue a slower course than the sub-periosteal tumours of the tibia, grow more slowly, have no tendency to affect the groin glands, apparently only seldom become generalised, and, in truth, are generally less malignant than the corresponding varieties of sarcoma of sub-periosteal origin of the same bone. They may attain a very large size and may destroy the upper end of the bone and make their way into the joint. The centra] tumours of the Fibula also affect its upper end, and appear to be less malignant than the corresponding tumours of sub-periosteal origin. But the number of cases which has been collected is so small that it would not be right to draw from them very decided conclusions. The Humerus is almost always affected at its upper end, and a tumour is produced which gives to the shoulder much the form of a leg of mutton. There is a wide difference in the course of these and of the sub-periosteal tumours ; for whereas the latter are very malignant and very rapidly fatal, the central tumours are of much slower growth, are not disposed to involve the surrounding structures, and have apparently no marked tendency to become disseminated. The instances of generalisation appear to be for the most part instances of multiple sarcomas, rather than of dissemination proceeding from a single primary growth. The central tumours usually affect older subjects than the tumours of sub-periosteal origin. The central sarcomas of the Radius and Ulna almost invari- ably affect the lower end of the bone. They exhibit a modified malignancy, not tending to affect the lymphatic glands, or to produce secondary growths in the organs and tissues. They usually grow slowly, and are for a long period enclosed in the interior of the affected bone. Central tumours of the Clavicle are very rare, and little can be said with regard to the course they pursue. The account of the central tumour of the Scapula is included in that of the sub-periosteal tumours. Methods of Operation.—In considering and estimating the various methods of dealing with the sarcomas of central origin, it must be borne in mind that there is great difference in the relation which the tumour bears to the bone in many instances. Some of the growths are enclosed in cavities in the interior of the bones, which are smooth-walled, clearly defined,