Volume 1

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

  • Hutchinson, Jonathan, Sir, 1828-1913.
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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    LEEDS 4<WEST-Rin(N?-. MEDICO-CHIRURCtCAL oGOIETT PLATES XLVIII AND XLIX. CONGENITAL COCCYGEAL TUMOUR. Infants are occasionally born with tumours in the neighhour- hood of the coccyx, which have nothing in common with spina bifida and have no connection whatever with the theca of the spine. They are, in fact, placed much lower down than the usual position of spina hifida. The latter almost always affects the upper part of the sacrum, whilst the tumours, of which I now speak, originate between the eoccyx and rectum, and bulging backwards displace and surround these structures. There is a strong superficial resemblance, however, between a large spina hifida and a large coccygeal tumour, and mistakes in diagnosis leading to errors in practice have resulted. These congenital growths in the coccygeal region are by no means all of the same kind. Some, as in the case which these portraits illustrate, consist of a lohulated fihro-cystic mass, others contain fewer cysts or none, whilst a quite distinct group is characterised by the presence of parts of another foetus. My own experience would have led me to the belief that those depending upon super- foetation are much less common than the hhro-cystic ones; hut this does not appear to he the opinion of all. Tlie tumour in all its forms is rare; and it has not fallen to the lot of any surgeon to observe many cases, nor are many detailed records of such to he found in surgieal literature. The best summary of our knowledge respecting them with which I am acquainted is that given by Mr. Holmes in his work on ‘ Diseases of Children.’ The cases present us with some interesting pathological problems, and they are also of considerable importanee in respect to the question of surgical treatment. The patient from whom these portraits were taken was a female child, originally under the eare of Dr. Reilly, of Victoria Park, hut who at six weeks old was admitted by my colleague Dr. Stephen Mackenzie at the London Hospital, and by him kindly transferred to my charge. She remained in the hospital about six weeks, and died at the age of three months. I had not ventured to attempt the removal of the tumour, being deterred in part l)y its very large size and dangerous position, and in part by