Edinburgh Medical Journal, Vol. 21: Containing the Monthly Journal of Medicine and the Edinburgh Medical and Surgical Journal; Part 2, January to June, 1876 (Classic Reprint)

Excerpt from Edinburgh Medical Journal, Vol. 21: Containing the Monthly Journal of Medicine and the Edinburgh Medical and Surgical Journal; Part 2, January to June, 1876

Of a sarcomatous growth. In addition, there is disturbance in the functions Of neighbouring organs differing in degree in different cases according to the Size and situation of the neoplasm and its bed. Sooner or later the repeated losses Of blood or the continued drain Of watery discharge begin to tell on the patient's general health; and when the disease has advanced towards its final stages, it usually develops in the sufferer a condition of general cacheria.

The physical examination Of a patient with such a train Of symptoms would discover some degree of uterine enlargement, varying according to the size of the morbid mass occupying its interior. It is rarely SO large as to form an abdominal tumour, ex cept where we have to do with a myo-sarcoma, or a fibroid tumour undergoing sarcomatous degeneration, when we may find a supra pubic mass Of considerable dimensions, with the vascular bruit and other characteristics Of such growths. Where the growth springs from the cervix, or the uterus has become inverted, a polypoidal body will be felt occupying the vagina. The uterus, though en larged, remains freely movable, unless the tumour be so great as to cause some impaction in the pelvis, or inflammatory adhesions have formed among the pelvic organs - conditions which are both comparatively rare in the true sarcoma. The sound will pass without difficulty into the interior of the uterus, and detect the extent Of increase of the cavity and the presence Of a foreign body in which bleeding is easily excited. But it is only when the canal is dilated with a tent - and, as I have shown, the textures are so soft and expansible that a single good-sized sponge-tent may suffice for the dilatation - that the size, consistence, and attach ments of the new growth can be discovered, and that a fragment of it can be Obtained for microscopical investigation. It is in this way alone that an exact diagnosis can be made out.

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