In the 7 eases which showed digestive disturbances subsequent to operation, the length of intestine removed, with 2 exceptions, was over 200 centimetres (6 feet inches). The 1-I which showed no untoward symptoms lost less than :3)0 centimetres, with one exception in which 205 centimetres were removed. From these statistics the author con cludes that 200 centimetres, or le,s than one-third of the total length of the in testine, is the danger-limit. Children stand extensive resections better than adults; and the loss of intestine is more serious the nearer one approaches the stomach. Alexander Blityney (Brit. Med. Jour., Nov. 16, 1001).
Tumors of the Intestine.—An abso lutely certain diagnosis of a tumor of the intestine is usually quite impos sible at an early stage of its develop ment. Hence, as malignant growths within the peritoneal cavity involve im portant structures so rapidly and so early, an exploratory operation should be immediately resorted to in any case of intestinal disturbance in which there is rapidly developing cachexia which leads to the suspicion of a malignant growth.
Resection of the growth, if possible, is always the operation of choice, but, in case it has progressed too far, entero anastomosis or the establishment of an artificial anus may be considered.
Syphilitic tumors give rise to the same symptoms as other new growths, and the diagnosis would depend upon the history and observation of the general constitu tional symptoms of syphilis.
Intestinal tuberculosis, through ulcer ation, inflammatory thickening, and con traction, gives rise to symptoms similar to those produced by new growths. Young persons are more commonly affected, and frequent attacks of colic are quite characteristic. The ileo-cmcal region is most commonly affected. The disease leads frequently to perforation and acute suppurative peritonitis or to the forma tion of a fistula. The clinical picture of tuberculosis in the ileo-cieeal region often resembles that of recurrent ap pendicitis or that of a tumor in this region.