Day 017 - 25 Jul 94 - Page 45


     
     1        because the stool bulk and the frequency of stool
              production was greater in the Bantus.  He suggested
     2        perhaps that the fibre encouraged the progress of the
              bowel motions through the bowel more quickly and therefore
     3        did not allow possible carcinogens contained within the
              feces to act on the bowel wall for such a long time, as in
     4        typically constipated western people who produce stools of
              relatively small bulk.
     5
              However, that theory, even though this is another study
     6        which suggests that it may be a factor, this situation
              remains a theory.  It has never been conclusively proven
     7        that fibre by itself is a protective factor in bowel
              cancer.
     8
         Q.   Can it confidently be postulated, if it does have a
     9        protective effect, what are the carcinogens against which
              dietary fibre may be protective?
    10        A.  Right.  The bowel acids and other factors produced in
              the bowel which are responsible for the digestion of food
    11        and then subsequently are acted upon by bacteria which
              normally exist  in our bowels.  These are the substances
    12        which have been thought to be possibly related to the
              development of tumours and that by diluting these or
    13        encouraging the passage of the feces through the bowel
              more rapidly allows them only to act with the bowel lining
    14        for a relatively short period of time, or reduces the
              concentration of them acting against the bowel lining.
    15
         Q.   Can we move forward from 1978 some 12 years to 1990 and
    16        look at a chapter from a textbook, which you find at tab
              14 of the file.  The chapter is number 40 or section in
    17        the book, Epithelial Tumours, and explain to us the
              meaning of "epithelial".  What is this textbook from which
    18        this passage is taken?
              A.  The book is called Gastroentestinal(?) Pathology.
    19        Basil Moreson(?) is the principal author of this chapter.
              He is an accepted world figure in bowel pathology.
    20
         Q.   So does it follow from that that we in this court, who are
    21        laymen in this field, should treat what he says with a
              degree of respect?
    22        A.  Certainly.  Most doctors treat ----
 
    23   Q.   I was going to ask you -- do you treat what he says with a
              degree of respect?
    24        A.  Undoubtedly.  He is now retired, but he has been for
              many years one of the leading figures in large bowel
    25        pathology.
  
    26   Q.   As I say, the chapter is headed Malignant Epithelial 
              Tumours.  There is a section on adenocarcinoma.  Is he 
    27        English, Mr. Morson?
              A.  Yes, he worked for many years at St. Marks Hospital
    28        here in London, a hospital which specialises in disease of
              the colon and rectum.
    29
         Q.   Then there is a section on epidemiology, the relation
    30        between anatomical silent epidemiology.  Then on page 598
              a section in the right-hand column headed: Aetiology and

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