37 



Series A. 



Entire large bowel involved (except extreme lower part of rectum).. 87 



Lesions confined to caecum and ascending colon 5 



Lesions confined to transverse colon .., 1 



Lesions confined to descending colon, sigmoid, and rectum 



Xot recorded 7 



Total 100 



Appendix ulcerated (with large intestine) G 



Ileum ulcerated (with large intestine) 2 



Sebies B. 



Entire large bowel involved 72 



CiBcum and ascending colon 18 



Descending colon, sigmoid, and rectiun 9 



Tranverse colon 1 



Total 100 



Appendix involved (with large intestine) 8 



Ileum involved (with large intestine) 5 



The variations shown in the two series, and those in literature 

 as well, perhaps, may be at least partly explained. The factors to 

 be considered are the duration of the disease at the time of death, 

 the kind of treatment, its duration, and the stage of the disease in 

 which the patient was when treatment was commenced. 



If we take the Johns Hopkins Hospital series as an example, we 

 may be reasonably sure that the majority, if not all, of them were 

 treated by irrigations per reetmn, as in our cases of Series B. 

 A rational consequence of this might be that in many cases the 

 lower lesions in the bowel had healed, and at autopsy only those 

 that were inaccessible to treatment or which irrigations had not 

 reached would be seen. This undoubtedly accounts, in part, for 

 the variations manifested in our series and this dissimilarity would 

 undoubtedly be more prominent had a larger number been properly, 

 consistently, and persistently treated. 



The duration of the disease at the time of death is unquestionably 

 an exceedingly important factor in untreated cases and in those in 

 which irrigation has been neglected. It may be said that without 

 treatment the greater the duration of the disease the more exten- 

 sive is the distribution of the lesions. 



For the reason indicated above and for other obvious ones it may 

 1)0 said that tbe findings at necropsy can not be taken as a guide to 



