Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: to enable us to make a diagnosis; the patient, a physician, complaining only of pain in the left iliac fossa, and of occasional passages of blood with the faeces. The autopsy revealed an annular cancerous stricture in the sigmoid flexure. All of these cases illustrate the general rule that complete obstruction is only liable to occur when the stricture is high up, and that it may then occur very early and with very slight premonition. In many old cases near the anus it is surprising to see how many years life will be prolonged with the gut almost completely closed. The explanation is purely a mechanical one?with a stricture high up in the movable portion of the bowel, the force applied in the effort of defecation merely bends the gut upon itself and increases the obstruction by adding a flexure to the stricture. On the other hand, in disease low down, where the rectum is firmly held in place by bony points, all the force of the expulsive movement is brought to bear in a direct line with the orifice, and small, ribbon-like masses of solid faeces are driven through the opening as long as any opening remains. This is the ex- plantion of tape-like stools as a symptom of stricture. They are only seen when the disease is near the anus, and they are often caused by a spasmodic action of the sphincter where there is no organic stricture. Stricture of the rectum, whether cancerous or benign, left to its own course, ends fatally, either by obstruction or by exhausting the sufferer's powers. After a few years these patients sink into a miserable condition, worn out bj' constant rectal tenesmus, by chronic inestinal obstruction, and by degeneration of the kidneys. The only attempt at a cure nature is ever known to have made was in the case of Talma, where an intestinal anastomosis was e...