The Annular Stricture, which in the first instance is unattached, may, as the cancer advances, become fixed in a similar manner at the point of its original development, or at different parts at a distance from this point, either by cellular tissue, or by a fusion of the carcinomatous tissues. The propulsion of the intestinal contents will, in that case, be impeded to a greater degree than in simple dislocation, and the more so, the greater the dislocation itself, the more acute the angle of inflection, and the more firm the adhesions are.

The intestine lying above the diseased portion is found affected to a various extent, and commonly in proportion to the amount of contraction, by active dilatation, i. e., dilatation accompanied by hypertrophy of the muscular coat. The parietes of this section of the intestine are occasionally found very much thickened and indurated; the muscular coat presents a yellow discoloration and is friable, the cellular layers are infiltrated with a gelatinous medullary substance, the mucous membrane is thinned and resembles a serous membrane, and the contents of the intestine accumulate to a considerable extent above the affected point. The portion of intestine which lies below the cancerous mass is more or less permanently contracted and empty.

In considering the metamorphosis of intestinal scirrhus, we have adverted to its terminations; it commonly ends fatally with symptoms of intestinal inflammation and ileus.

Cancerous ulceration, more frequently than any other variety of ulceration, gives rise to communications between the affected portion of intestine and neighboring cavities and passages, and more especially with the rectum.

Intestinal carcinoma often occurs in the isolated form, but it is not unfrequently complicated with cancer of the stomach, the liver, the lymphatic glands, and the bones, with osteomalacia, and universal cancerous cachexia.

There are certain ulcers which occur only in the large intestine, and especially in the sigmoid flexure and the rectum, and are nearly allied to cancer, and particularly to cutaneous cancer. They are generally solitary, but there may be two, three, or four at a time. They invariably give rise to intense pain, and appear etiologically connected with an abuse of ardent spirits. Although in many respects analogous to the ulcers hitherto considered, they offer distinctive characters. They are invariably zonular and have a callous base, upon which occasionally a discolored, brownish, grumous discharge is visible, and they are surrounded, by a thick, tumid, spongy, carneous, and irregularly-sinuous margin of mucous membrane. They generally cause a diminution of the capacity of the intestine, though not to any considerable degree. A further investigation into their nature still remains a desideratum.