Remarks on a treatise on the rectum [by James Syme].

  • Cockburn, Archibald William, 1814-1862.
Date:
[1838?]
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on a treatise on the rectum [by James Syme]. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    is due to this Mr. Craig for discovering the polypus ; — although, as it was a large pendulous tumour, we confess we see no great proof of skill or extraordinary powers of discovery in feeling what could not be overlooked. In stricture of the rectum, combined with fistula in ano, Professor Syme says, that the sinus does not, as has been alleged, open into the gut above the contracted part, but holds its usual position near the anus. We previously denied that the internal fistulous aperture had any settled and unchanging spot for its appearance — and we once more deny the statement. In stricture of the rectum combined with fistula, the internal aperture is above the constricted part. If consistency in a bad cause is praiseworthy, we certainly grant Pro- fessor Syme his full share of commendation. He next comes to treat of malignant stricture of the rectum. He commences with a contradiction as to the situation of the disease: he tells us that it generally occurs in the same part of the gut as the simple stricture. We turn to the simple stricture, and find that it is situated very near the lower extremity of the rectum, a little within the sphincter, between two or three inches from the anus ; but in his second page, upon cancer of the rectum, we are told that it more frequently leaves the coats of the intestine free, for an inch or two within the sphincter. We are first told it is within the sphincter; next, that the coats of the intestine within the sphincter are free! After a description of the symptoms of this disease, he proceeds to its treatment; and we are at once informed with marvellous brevity — and, considering the state his feelings were in when he wrote this sentence, with wonderful composure — that the situation of the di- seased part forbids any prospect of benefit from removal by the knife or any other means. His chapter ends with announcing, that of late the lower part of the rectum has been excised in this city; and he ushers in the annunciation of this fact with most impressive assurances of its veracity, being possessed of the idea that the horror of the entertained supposition would do entirely away with the reality of the fact. We sincerely hope our readers will not be quite led away by the extreme sensibility displayed by Professor James Syme, but will dismiss from their minds the prejudiced nonsense he has written. Many cases of scbirro-contracted rectum come under our notice, in which the disease, even although it encircle the whole gut, is confined to the lower part of the rectum, not extending beyond two or three inches from the anus ; and in such a case, knowledge of surgery, and the experience of practice, show the perfect possi- bility of removing the disease by excising the affected part. The operation is not very difficult of performance, and the haemorrhage attending it can always be commanded: it is a painful operation, but a lingering death from a daily extending cancer of the rectum is less easily endured. We should hardly condescend to notice some remarks of Professor Syme's upon this operation; but knowing tlieni to proceed from ig- norance, we pardon them. He says, that from excision the patient can derive no benefit, and must have an impulse given to the morbid