On the operative surgery of malignant disease / by Henry T. Butlin.

  • Sir Henry Butlin, 1st Baronet
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: On the operative surgery of malignant disease / by Henry T. Butlin. 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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    Del ii be clearly understood 1 have not been speaking different varieties of cancer, or comparing a medullary with a withering scirrhous cancer, but have been speaking of what may Lied the ordinary hard cancer of the breast. Between the tumours which pursue bo widely different a course not even a microscopic difference can be distinguished. Now, these cancers of slow course and less malignancy are not sufficiently recognized in their relation to the operative surgery of malignanl disease, yel they explain a curious exception to one of tin.' greatest laws which we have hitherto formulated for the surgery of cancer. That THE BARLIEB \ < am I:i; [S BEHOVED 90 MUCH THE MORE LIKKI.V D3 THE OPERATION TO BE PERMANENTLY SUOl ES8F1 I. is a general law to which almost every surgeon will assent. Yet it is nevertheless true that some of the most successful operations are those in which the removal of the disease has for some reason been deferred until it has been in existence for a much 1< period than would cover the whole course of most cases of the same variety of cancer in that part of the body. Many of the chapters offer examples of these apparent exceptions t<> the advan- tages of early operation, and particularly the chapters i u the Breast, the Penis, the Lower Lip. Such cases might 1-. and have been, I doubt not, often employed as an argument in favour of deferred operations. But, seen in their true light, they are merely evidences of very modified malignancy of individual tumours. Ead the same tumours been removed at an earlier period, as brilliant results would have been produced by less formidable operations. Every week of delay has increased the danger of the contraction of serious adhesions, of affection of the Lymphatic glands, and of the formation of Beoondary growths. Such cases as these afford the best prospect of permanent so from an operation, and yel I have known the advice given that, the course of the disease being so slow and the annoyance produced by the tumour so small, an operation was not desirable, and that, so Far from being useful, it might set up more rapid growth and actually lend to the very catastrophe it is intended to avert. On a knowledge Of these eases I shall venture to formulate a proposition to the efl'ecl thai whin LONG DURATTOS 01 \ MALIG- NANT TUMOUR ES ASSOCIATED Willi VERV. BLOW PROGRESS, SMALL SIZE, ABSENCE OF SERIOUS ADHESIONS, ABSENCE OP APFECTIO]