Chest complications in abdominal disease : a study in diagnosis : the first Hunterian lecture of the Hunterian Society session 1901-2 / by J. Mitchell Bruce, M.A., L.L.D., M.D., F.R.C.P.

  • Bruce, J. Mitchell (John Mitchell), 1846-1929
Date:
1902
Catalogue details

Licence: In copyright

Credit: Chest complications in abdominal disease : a study in diagnosis : the first Hunterian lecture of the Hunterian Society session 1901-2 / by J. Mitchell Bruce, M.A., L.L.D., M.D., F.R.C.P. Source: Wellcome Collection.

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    probable, that some cases recorded as examples of primary tubal cancer were instances of cancer of the endometrium extending into the uterine ends of the tubes, there is now a large body of carefully prepared evidence to prove that cancer may arise primarily in the tubal mucous membrane. The subject is one which must be considered here, for the signs of the disease are those exhibited by cancer of the body of the uterus, namely irregular hasmorrhages at, or more frequently subsequent to the menopause. I am also of opinion that in cases where the uterus has been dilated for diagnostic purposes, where the signs strongly indicated cancer of the body of the uterus and no disease was found on examination and the haemorrhage continued, in some of those cases there may have been cancer in the Fallopian tube (p. 35). Primary cancer of the tube is very malignant, and gives bad remote results to operative treatment even when the uterus has been removed with the tubes. Certainly it seems that it is better not to remove the uterus, but we await with patience the results of more experience. Deciduoma malignum (chorion-epithelioma). — This dreadful disease for which complete extirpation of the uterus is at present the only available remedy, may be described in the phraseology so familiar to zoologists as “ a species new to science,” it is “ newer ” than cancer of the Fallopian tube. Very few examples have been observed in England, and most of our knowledge con¬ cerning its pathology and clinical characters we owe to German workers. The most complete account of this disease accessible to British surgeons is an admirable paper furnished by Dr. John H. Teacher to the f Transactions of the Obstetrical Society/ London, 1903, which contains a tabular statement of the results of operative treatment of the disease, the result of an analysis of 188 recorded cases. His opinion may be given in his own words : “ It seems reasonable to conclude that operation offers a fair chance of recovery, and, further, that it may be done with some prospect of success in the face of the gravest signs of