Cancer clinically considered / by John Bland-Sutton.

  • Sir John Bland-Sutton, 1st Baronet
Date:
1909
Catalogue details

Licence: Public Domain Mark

Credit: Cancer clinically considered / by John Bland-Sutton. Source: Wellcome Collection.

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    the large intestine is a common disease, and the liability of its mucous membrane to become cancerous increases from the caecum to the rectum. Thus cancer is thrice as common in the terminal two feet of the large gut (sigmoid flexure and rectum) than in the remainder of the colon, and if care be taken to discriminate between hyperplastic tuberculous disease of the bowel and cancer the disproportion will be found even greater. Of the initial and early stages of cancer of the colon we know nothing ; the disease has no special sympto¬ matology, and causes no pain until it lias so narrowed the lumen of the gut that the intestinal contents (faeces) are hindered from passing; then the patient suffers from intestinal obstruction, and seeks advice, and, in many instances, when the cancer reaches this stage, unless surgical help is quickly forthcoming, the patient will succumb from perforation of the caecum, or the colon above the stricture. The character of the disease in the early stages is unknown, for it grows unsuspected and unrecognised, and in an absolutely painless manner until the lumen of the colon is too narrow to allow faeces to pass, then pain is the sequence; even then the disease remains undetected often for many months. In the colon cancer appears in its final stages in two forms. It may be massive and exuberant, the cancerous mass blocking up the bowel. The other form is the more insidious, for the cancerous growth may resemble the small contracting nodule so often present in the breast. When cancer attacks the colon it spreads around it in a circular manner; in the contracting form it will narrow its lumen until the colon appears as if a piece of cord had been tied tightly around it. I have long held the opinion that in these extreme contracting forms of cancer of the gut we have, as I endeavoured to explain to you in connection with the