Reproduction
Object numberRCSHC/P 192
Scientific nameHomo sapiens
CollectionHunterian
CategoryWet preparations
Object namerectum, Carcinoma, Cancer and Fungated Sores, Mounted wet tissue
DescriptionA rectum showing the effects of both haemorrhoids and bowel cancer.
The patient in this case was Thomas Thurlow (1737-1791), the Bishop of Durham. Thurlow had suffered from some time from a bowel complaint which he initially thought was the result of piles. He consulted John Hunter after a number of other physicians and surgeons had failed to provide him with a satisfactory diagnosis. Hunter successfully identified the tumour through rectal examination but recognised that it was incurable. Thurlow died ten months later.
The original preparation was marked 'Cancerous Rectum. Late Bishop of Durham' on the lid in the hand of Robert Haynes, who was Hunter's assistant in 1791.
Production date 1791
Preparator
Owner/user
Patient/subject
Surgeon/clinician
Surgeon/clinician
Surgeon/clinician
Surgeon/clinician
presented
Physical Location
Location
Not on public display: contact museum for access conditions
Physical Information
Physical descriptionWet preparation of tissue mounted in a circular glass jar with glass lid. Dimensions: 234mm h x 139mm d.
Materialglass (material)
Dimensions
whole height: 234 mm
whole diameter: 139 mm
whole weight: 3296 g
whole diameter: 139 mm
whole weight: 3296 g
Bibliography
SourceProger 1966-1972
Vol. 1, pages 116-9.
NotesText taken from Stanley & Paget (1846-9), and Paget (1882-5).
TranscriptThe rectum of a patient of whose case Mr Hunter left the following record [entry follows as for Hunter Casebooks, 589-91].
SourceHunter Casebooks
Cases & Dissections, No. 58, pages 589-91.
NotesThe Case of the Bishop of Durham (Thomas Thurlow 1737-1791). (Also in Proger 1966-72).
TranscriptHis Lordship had, about ten years ago, the piles, for which he took Ward's Paste, and was cured. Near ten years after (probably about the year 1790), he was taken with a complaint in the anus; blood and slime came away with his stools which often passed with great difficulty, especially when costive, and often attended with considerable pain in the part. The loss of blood was so considerable at last as to appear in his countenance. In the summer, 1790, he became extremely debilitated, loss of appetite, want of rest, quick pulse, and his legs began to swell. Dr. Blane attended him, and Dr. Warren was called in. As the symptoms attending the stools expressed considerable disease somewhere in the gut, and as the pain expressed it to be the rectum, it was proposed that he should be examined, and Mr. Earle was applied to, who examined him with the finger, but could not find anything uncommon. I was next sent for (I think, in August) and immediately, upon introducing my finger up the rectum, near three inches, I felt a rising, forming a ridge, which went round the gut obliquely, like a ring, was harder or firmer in consistence than the other parts; over which I could just pass my finger.
This was so familiar a feel to me, that I at once pronounced it to be what is commonly called a cancer. Opiate and cicuta clysters were given to keep the parts in as easy a state as possible; and such food and medicines as the effects of the disease had on the constitution were thought proper for, without attempting a cure were administered, and the disease went on.
Dr. Hugh Smith was called in, and when I told him what I felt upon examination, and what my opinion was of what I did feel, he then gave up hope of being able to do any good. However, upon a supposition that I might be deceived, and as he had seen great good from mercury in diseases of the rectum, in what he conceived to be pile-cases, he ordered Ward's White Drops; but, after a short trial, it disagreed with his stomach, and he left it off for that time. Upon leaving off this medicine he became rather easier, less blood and slime came away, and the swelling in his legs abated; but as he was then taking nothing, no particular stress was laid upon it by himself or friends, and, as I did not suppose it possible for him to get well, no stress was laid on it by me. This, however, lasted about ten days; and it was this time when the family were importuned to have Taylor the cattle-doctor to attend him, and I was asked to examine this doctor, to see whether it was likely he should do mischief or not. Upon examination it appeared to me that his medicines could do no harm, and he sent his medicines, which I was desired by the family to apply according to the account or mode given by Taylor. This was done accordingly, and now great attention was paid to the ease or abatement of the symptoms; which still continuing, the mind of the patient, as well as those of his friends, forgot the former ten days and dated the time of ease from the application of Taylor's medicines.
Taylor was now informed of what had been done; he went on for about two months, taking occasionally opium as much as the symptoms seemed to require; so that opium was not objected to as interfering with his medicine. The ointment introduced into the anus was now left off, and only the sacrum and loins rubbed with a liquid, which appeared to be oil of origanum dissolved in spirit of wine, and this he went on with for many months. All this time the accounts we had of his health were that he was better, sometimes that he was cured, &c.
Most of this time his appetite was certainly better, slept better, his excrements passed easier, less blood and slime, although there was often a great deal of both. With all these accounts of his recovery, yet he did not get flesh, although he and they were in hopes that he did; for the confirmation of which his barber applied to, who thought it was necessary he should say he thought his cheeks plumper. He became so weak at last as to be hardly able to sit, and fell off his night-table and bruised himself; and about eight or ten days after he died, which was in May 1791about ten months after I saw him. Of the appearances upon entering the Body of the Bishop of Durham.
On examining the contents of the abdomen the whole viscera, or contents of that cavity were perfectly sound; but the parts below, contained in the Pelvis, where the Symptoms were when living, viz the last bowel, was in a diseased state.
The whole inner surface of that bowel, from within an inch of the external parts to about five inches up, made one broad ulcer, terminating in a ridge below, as also at the upper part; and the Ulcer between these two ridges was ragged and spongy.
On that surface of the Gut next to the bladder the gut was intirely gone; being ulcerated away; and the bladder on that side exposed. And it had likewise ulcerated higher up the gut where there was no natural union of parts; and of course would have communicated with the cavity of the belly, is some adhesions had not taken place above, which prevented the contents of the Bowels getting into that cavity: which would have proved fatal in a very short time.
The surrounding parts of this Ulcer were hard, or what is commonly called Callous:- almost as hard as gristle, by which means the gut was firmly attached to the surrounding parts.
These appearances were the only diseased parts [ones], for in other respects I never saw one more free from disease. That they had increased is evident, for when I examined his Lordship last, the lower edge of the ulcer was near three inches high, but now it was hardly an inch; and we may suppose the upper ridge also went higher.
His Lordship at first, as has been observed, had great difficulty in passing his Stools, which was owing to these two ridges being nearer to each other, and higher or thicker, but as ulceration went on, or as it spread, these parts were removed; so that the intestines here, instead of being contracted as at first, was now enlarged: so that the contents of the bowels came away more easily; which was very conducive to his Lordship's ease. As there were no lymphatic glands diseases, how far was this Disease to be reckoned a Cancer?
SourceClift 1830 Part 1
NotesCatalogue number 855
TranscriptThe rectum of a gentleman in a very diseased state laid open. [The patient about ten years before had been afflicted with piles, but had been cured. A year before his death he was attacked with disease of the rectum, which occasioned great pain and difficultly in voiding the contents, which were accompanied by much blood and slime; and he became exceedingly debilitated. On examination, some months after the commencement, a hard ridge was felt about three inches above the anus, passing obliquely round the gut. In May 1791, after various ineffectual modes of treatment, the patient died. On an examination after death it was found that the rectum, from within an inch of the anus to about five inches above it, made one broad ragged ulcer terminating in a ridge both above and below. On the side next to the bladder, the intestine had been destroyed by ulceration; and a communication with the cavity of the abdomen would have been formed, had it not been for some adhesions, which prevented the escape of the contents of the bowel into the cavity. The surrounding parts of the ulcer were hard, or what is commonly called scirrhous; almost as dense as gristle. Mr Hunter concludes by asking, "As there were not any lymphatic glands affected, how far was this disease to be accounted a cancer?"
SourceClift 1830-1831
TranscriptCancerous Rectum. Late Bishop of Durham. Written on, by Robt. Haynes.
