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
