Volume 1

Illustrations of clinical surgery .. / with descriptive letterpress by Jonathan Hutchinson.

  • Jonathan Hutchinson
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: Illustrations of clinical surgery .. / with descriptive letterpress by Jonathan Hutchinson. Source: Wellcome Collection.

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

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    epithelium, and where the seetion is peneilled to remove them, no trace can he seen of the adenoid reticulum of lymphatic growths. Of course the cysts in this tumour are true embryonic formations, as their perfect linings show.” With the greatest possible respect for the results of histological examination, wliich my friends have so kindly placed at my disposal, I cannot help feeling some doubt whether the growth in this case would have followed the course, either of sarcoma or carcinoma. There was no evidence of tendency to infect either the glandular system or the viscera, and could it have been safely removed, it is, perhaps, not improbable that the child would have remained without recurrence. The facts are, however, but very scanty as yet on which to base such an opinion. We know neither the history nor the results of microscopic examination in similar cases. It is, however, not common for congenital tumours to prove malignant in their course. As regards treatment, we ought, I think, to assume that these tumours are innocent, and if their removal by excision appear practicable, it should he attempted. It may be a question of some importance as to the age at which the operation should be per- formed, and in deciding this the surgeon will be guided by the state of health of the infant. If the health he well kept up, it will be better to wait awhile, unless, indeed, the tumour be growing. A Case of Spina Bifida with Hydrocephalus. This woodcut does not properly belong to the subject under discussion, hut I introduce it here in order to show the contrast as to position between a spina bifida and a coccygeal tumour. It will he seen that the tumour, a sacral spina bifida, does not project over the anal region in any degree, hut rises up in the hack. I have seen cases of spina bifida in which the tumour passed more or less under one buttock, but never any in which the coccyx was con- cealed or the growth overhung the rectum. This portrait is valuable because it demonstrates the connection between spina bifida and hydrocephalus. This association, as I pointed out many years ago, is very common, and is probably due to the fact that the central canal of the cord remains pervious, thus allowing of communication between the ventricles and the sub-arachnoid spaces of the cauda equina. In many cases of spina bifida, but especially in these, pressure on the spinal cyst will produce brain symptoms, the fluid passing freely up into the skull. It is, of course, possible that this may be
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