The early recognition of carcinoma of the cervix / by Hunter Robb.

  • Robb, Hunter, 1863-1940.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: The early recognition of carcinoma of the cervix / by Hunter Robb. 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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    tory of cancer who presents a laceration of the cervix, no matter of how slight a grade, should present herself to a competent physician about every six months in order that the cervix may be carefully inspected ; (4) every woman over thirty-three years of age who has borne a child at any time during her life should be advised to submit to an exami- nation, and she should be guided by the physician’s statements about the condition of the cervix as to whether it is advisable for her, even in the absence of symptoms, to present herself at stated intervals in the future for further examinations. If these rules were followed, the physician would at least have the opportunity of diagnosing the disease in its incipient stage and while it is still curable. Now as to the making of this diagnosis certain in the incipient stage, it is very hard in many cases where the growth is confined strictly to the cervix and the mobility of the uterus is rot interfered with to distinguish this form of malignant disease from a harmless eversion of the lips or ectropion. When we sec an elevated area differing a little in color from the sound mucous membrane and tend- ing to bleed freely upon the slightest touch, we should look upon it with grave suspicion, and if it feels hard and nodular, and upon a second or third examination at shoit intervals shows a tendency to extend, it should be removed without delay. Yet in our anxiety to guard against all possible danger we should not be too anxious to submit our patient to a serious operation, and, fortunately, we now have within our reach the means of clinching our diagnosis. The microscopical examination of scrapings from the uterine and cervical canal is by no means so satisfactory as was at first hoped. One might think that this w'ould be an easy way of deciding whether malignant disease existed or not. We now know that it is possible to have an increase in the number and size of the glands and even the presence of more than one layer of epithelium without any coexist- ing malignant disease. And it is only when we have certain proof that the subjacent tissues have been invaded by the epithelial ele- ments that we can be sure of our diagnosis. In the same way, when the suspicious condition is limited to the vaginal portion of the cervix, it is of but little value to merely scrape off a portion of the superficial tissue. But we need not confine our- selves to this procedure, for with the help of cocaine we are now able, without giving the patient any pain worth mentioning, to excise a portion of the deep-lying tissues ; from this sections can be made and examined under the microscope, and, if any signs of malignancy are