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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    the bre Bt, bo the groin glands in connection with cancer of the penis, the vulva, and vagina The hich have led to it are those in which, within a few weeks or months of the remova the primary disease, the neighbouring lymphatic glands have become enlarged and cancerous without any recurrence of the primary disease. That such cases do occur there can I- no question, bnl their number and importance have been Is iterated. It has been assumed, and probably correctly assumed, thai the lymphatic glands, in such cases, were ah affected with cancer al the time of the removal of the primary disease, but that they had not then attained a sufficiently size to 1' distinguished through the overlying tissues. In so far, therefore, as it is not possible in every instance to 1- Bure of the condition of the lymphatic glands, it is well to remoi the glands which can be discovered at the time of the remova] of such primary cancers as are habitually associated with glandular affection. If they are diseased, the sooner they are removed the better; if they arc not diseased, at least little or no harm is done. Up to the present time, no evidence has been brought forward in favour of this practice which carries conviction with it. I am not aware of any statistics which arc so arranged as to plac advantages clearly before the profession. 1 know well the statistics of (iross and Banks in reference to operations on the breast, and the paper of Gusseubauer, on the development of secondary glandular tumours, in the second volume of the Z&Uschrift fur Hefflmnde (p. 17), and other tables and papers on the subject. And 1 have been astonished to sec the large number of instances in which Gussenbauer discovered cancerous affection of the glands in association with primary cancer of the lip, and to compare the results of his minute examination with the results of actual practice. Actual practice and what may be termed experiment on the human subject teach us that the most Buccessful operations for the removal of cancer are those which an- performed for cancer of the Lower lip: thai the prospect of cure by operation is about 50 per cent, when the operation is performed before there is any visible or palpable enlargement of lie- -binds. The glands have not been removed in th because they have nol been obviously diseased. And ye1 Gusseubauer has found microscopic evidence of cancerous affection in no fewer than t went v-nine 6u1 of thirty-tWO Cases, and