Carcinoma of the bladder / by Gilbert Barling.

  • Barling, Harry Gilbert, 1855-1940.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Carcinoma of the bladder / by Gilbert Barling. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    found that many of them run their full course without contami- nating the glands at all, or if infection does occur, it is very tardy. For determining the frequency of local extension and of secondary infection only 26 cases of epithelioma are available, no complete post mortem being recorded in the others. In only three of these is there mention of extension to neighbouring parts, once to the vena cava and twice to the tissues of the pelvis, no further particulars being given. In eleven cases out of twenty-six, or in about 42 per cent, secondary deposits were found either in the lymphatic glands or in some distant part of the body, but it is curious that in only one instance were glandular and general infections associated. Possibly, however, more careful examinations in the future will shew glandular infection to be more frequent, as has been demonstrated in epithelioma of other parts of the body when attention has been specially directed to this point. The glands were infected in six cases as follows—three times the lumbar, twice the aortic, once the iliac as well as the aortic, and once the abdominal. General infection occurred also six times, thrice in one or both kidneys, once in the lungs and liver (the lumbar glands being also involved), once in the lung only, and once in the radius only. How long elapses before second- ary infection occurs after the growths have once started is to some extent conjectural, but it is almost certain that it does not happen until a late period Symptoms may point to the existence of an epithelioma for two to three years or even longer, and yet a careful post mortem reveals neither glandular nor general contamination. It is equally true that alter a few months symptoms only, both forms of secondary invasion may be found, but it is quite certain that a growth may exist and arrive at considerable magnitude without any clinical evidence of its presence, so that it would be misleading to date the origin of all tumours from the commencement of symptoms, and equally misleading to conclude that secondary invasion may occur in a few months. What is the average time epithelioma of the bladder exists