638 THOMAS R. BROWN AND JOHN H. KING 



The Neoplastic Enteropathies 



(a) Carcinoma of the Intestines. 



1. Carcinoma of the rectum. 



2. Carcinoma of the colon sigmoideum. 



3. Carcinoma of the intcstinum cecum. 



4. Carcinoma of the duodenum. 



(b) Sarcoma and Lymphosarcoma of the Intestines. 



(c) Polyposis Intestinalis. 



Carcinoma of the duodenum is rare and the descending loop is most often 

 involved. When the tumor occurs in the suprapapillary form,' the clin- 

 ical picture resembles pyloric stenosis. The most frequent site of car- 

 cinomatous growth in the large intestines is the rectum, and then in order 

 of frequency the sigmoid, the hepatic and splenic flexures and the 

 cecum. 



The chief metabolic disturbance caused by cancer of the intestines is 

 cachexia. There has been a great deal of discussion as to whether the 

 cancerous tissue itself exerts a specific effect on the body metabolism by 

 means of a specific toxin, or whether the cachexia results entirely from 

 diminished intake of food, secondary disease in organs which play an 

 important part in metabolism, and increased bacterial activity. 



Secondary secretory, motor and absorptive disturbances can explain 

 many of the component parts in the picture of cachexia. 



(1) Malnutrition and weakness, from insufficient intake of food. 



(2) Stagnation and decomposition, from mechanical obstruction. 



(3) Anemia, from malnutrition and hemorrhage. 



(4) Insufficient absorption of food, from either cancerous degeneration 

 of important digestive organs or from secondary disease of the intestinal 

 mucous membrane. 



.Cancerous tissue contains an autolytic ferment which is capable of 

 digesting body tissue, and this has been suggested as the specific toxic 

 agent in cancer. The proof is still wanting. 



Differences in the variety of cancer as adenocarcinoma, medullary, 

 scirrhous and colloid carcinoma show no qualitative differences in their 

 effect on the body metabolism. The speed of growth, their localization, 

 and the character and site of their metastases determine the rapidity 

 of the cachexia, rather than any inherent differences in the tumors 

 themselves. , 



Acidosis of varying degrees may accompany the cachexia of cancer 

 of the intestines. It depends upon starvation for its production and is 

 not a specific effect of the cancer itself. 



Metastases and invasion to other organs of the body may add new 

 components to the picture, dependent upon the organs involved. Should 



