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Before leaving this subject, we mention a marvelous operation performed by Billroth on a married woman of twenty-nine, after her sixth pregnancy. This noted operator performed, synchronously, double ovariotomy and resections of portions of the bladder and ileum, for a large medullary carcinomatous growth of the ovary, with surrounding involvement.
If carcinomatous disease is to be rooted out, its mode of spread by means of the lymph vessels must be borne in mind, and as this occurs at an early stage, and is not evident on examination, a wide area must be included in the operation.
Percy and Stokes have observed phosphorescence in a carcinomatous ulcer. There is a description of a Zulu boy exhibited in Edinburgh in 1882 whose body was so charged with electricity that he could impart a shock to any of his patrons. He was about six-and-a-half years of age, bright, happy, and spoke English thoroughly well.
La Tribune Medicale for January 16, 1895, gives an abstract of Langenbuch's contribution upon total extirpation of the stomach. Three patients were treated, of whom two died. In the first case, on opening the abdominal cavity the stomach was found very much contracted, presenting extensive carcinomatous infiltration on its posterior surface.
Poulet quotes two curious cases: in one a pregnant woman was examined by a doctor who diagnosticated carcinomatous degeneration of the neck of the uterus.
Penrose, assisted by Baldy, has performed this operation after excision of an inch of the left ureter for carcinomatous involvement.
This will always retain its place in operative surgery as a palliative and life-saving operation for carcinomatous stenosis of the lower part of the colon, and in cases of carcinoma of the rectum in which operation is not feasible.
Kennedy mentions an instance in which the tumor appeared as extremely tender tubercles. Tietze describes a woman of twenty-seven who exhibited a marked type of plexiform neurofibroma. The growth was simply excised and recovery was promptly effected. Carcinomatous growths, if left to themselves, make formidable devastations of the parts which they affect.
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