General surgical pathology and therapeutics, in fifty lectures : a text-book for students and physicians / by Theodor Billroth : translated from the fourth German edition with the special permission of the author, by Charles E. Hackley.

Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: General surgical pathology and therapeutics, in fifty lectures : a text-book for students and physicians / by Theodor Billroth : translated from the fourth German edition with the special permission of the author, by Charles E. Hackley. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    appear late; still, there are exceptions to this rule. In cancer of the breast the localization of the secondary tumors is very regular, as already stated; the pleura, liver, and bones, are the most frequent seats of metastatic tumors. The varying course of cancer of the breast renders it very diffi- cult, indeed almost impossible, to compare the result of early or late operations with those cases that run their course without operation ; even the age of the patient causes great diiferences: in old persons, the disease almost always runs a slower course than in young ones; numerous entirely unknown influences come in play. The most ex- perienced surgeons have given very different opinions about operating, some declaring that the course of the disease is hastened by ojieration, others that it is retarded. The statistical tables that have been pub- lished aid little in solving this question, because cases of all sorts are thrown together in them; to obtain a correct result from them, tbe cases must first be separated on certain principles. But what good would this do ? It would always be a question, in each case, whether we should aid the patient by an operation or not. The tumors 'vvill almost always return in the cicatrix, in its vicinity or in the neighbor- ing lymphatic glands, because they are usually operated on too late / the patients will then die of metastatic tumors, if they are not carried off sooner by suppuration, haemorrhage, or acute disease. How much does the patient suffer from the tumor ? What danger does it induce locally ? These are the first urgent questions. But I am anticipating by considering here the treatment, which we propose studying more Fio. 148. Exrension of a cancorons tumor into the fattv tissne nliont o Ivmphnlic gland. Alcohol propa- rntion. Mnguifled 350 tllametera. attentively at the end of this section on cancerous diseases. Exami- nation of the enlarged lymphatic glands, which partly adhere together, shows that the smaller are more succulent and vascular than normal;