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The nature of ileus and the clinical problem it poses are discussed. A consideration of the previous multiplicity of treatments is presented. The concepts behind the present mode of treatment are outlined. This consists of removing the sympathetic inhibition of the alimentary tract in the condition and potentiating or supplementing tone. Case histories are presented to illustrate the use of the drugs suggested, and the indications for therapy are discussed. The mistaken concept that the gut is “paralysed” in ileus should be finally abandoned.

EDITORIAL COMMENT These observations in the cat show that the stomach has a high level of extrinsic, and a low level of intrinsic, cholinergic control, but this is reversed in the small intestine. Similar studies are clearly needed in man to provide us with logical tests for the management of motility disorders.

The present study was undertaken in order to discover whether patients with breast cancer in large breasts experienced a delay in the detection of their cancer due to the bulk of the breast and consequently presented with more advanced tumours compared with women with small breasts. Mastectomy specimens were weighed and their dimensions measured, in particular recording breast mass and breast thickness (anterior‐posterior depth). Tumour diameter, the number of involved lymph nodes and the oestrogen and progesterone receptor levels were measured as prognostic indices. Although there was no difference in receptor status of tumours from large and small breasts, on presentation, patients with big breasts had larger tumours and more involved lymph nodes than women with small breasts, whether breast size was assessed by weight or thickness. Women with large breasts may therefore be expected to fare worse than those with small breasts.

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