PRODUCTS, ADVENTITIOUS. 



Growths seem to exercise a very distinct in- 

 fluence on the structural character of the 

 mass as visible to the naked eye. The locular 

 aspect of their divided surfaces, for instance, 

 we fully believe to be dependent on such 

 influence. In the case of Growths enlarging 

 on the endogenous plan, it is obvious that the 

 juxtaposition of successive round cells within 

 a containing or parent cell must cause this to 

 retain its spherical outline, until it has en- 

 larged sufficiently to become visible with the 

 naked eye ; and further, that if several of 

 these enlarged ceils be placed round a common 

 centre and beside each other, the general form 

 of the area they cover must be spherical. 

 And so we find that it is precisely in enchon- 

 droma and in colloid cancer, distinctly en- 

 dogenous formations, that sphericity is most 

 decided. The thickening and fibrous depo- 

 sition, which take place both in the walls of 

 enlarged cells and in the intercell substance, 

 contribute further to the deceptive appear- 

 ance of encysted structure. In masses which 

 enlarge on the exogenous plan, the spherical 

 character in the loculi is much less apparent. 

 In scirrhus, and in many specimens of ence- 

 phaloid, it is not to be clearly descried ; the pre- 

 dominance of straightly-fibrous arrangement 

 of the stroma, produced by the presence of 

 real fibrous tissue, of fusiform corpuscles, 

 &c., accounts for this. But even in Growths 

 of this class, the original rounded form of the 

 elementary constituents tends to impress upon 

 their larger divisions, as these do upon the 

 entire mass, the spherical shape. Accidental 

 circumstances, of course, are liable to affect 

 this ; but the internal locular arrangement of 

 fibrous tumours shows that those circum- 

 stances may be only partially effectual. 



The locular character (under the title of 

 "encysted") has been put forward as an 

 evidence of "malignity" on the part of the 

 structure exhibiting it. Experience proves 

 the notion to be untenable. Sphericity of the 

 loculi is most obvious in enchondroma, one 

 of the most intrinsically innocent Growths 

 known ; such sphericity is, on the other hand, 

 totally, or almost totally, wanting in scirrhus 

 and many specimens of encephaloid. Again, 

 the least deleterious form of cancer col- 

 loid, exhibits it in an especial manner; and, 

 though modified, it is evident in those pecu- 

 liarly benignant structures (considered in their 

 essence) fibrous tumours. 



The decay of Growths is preceded by soften- 

 ing of their substance ; this softening, indeed, 

 by its increase actually constitutes their de- 

 cay. The change is effected by infiltration of 

 serosity, interstitial haemorrhage, by satura- 

 tion with inflammation-products and by gan- 

 grene, either of inflammatory or simply 

 mechanical origin. Or, there is an important 

 class of cases, in which the softening of 

 Growths seems analagous to that undergone 

 by stagnating fibrin, and probably depends on 

 chemical decomposition. 



The removal o$ Growths (fibrous, cancerous, 

 and others,) is sometimes effected by a spon- 

 taneous process, commonly comprising at- 



121 



tenuation and rupture, or ulceration of the 

 investing natural tissues, and gradual liquefac- 

 tion of the morbid matter, which is poured 

 through the opening ; or, in less common 

 cases, consisting of sphacelus, whereby the 

 mass, in whole or in part, is separated from 

 its connections. 



Cicatrisation of the ulcerated surfaces of 

 Growths is occasionally witnessed. We have 

 ourselves seen this change occur on the proper 

 surface of formations possessing all the cha- 

 racters of scirrhus. 



Growths of all descriptions are liable, when 

 removed spontaneously or by art, to be repro- 

 duced in the spot they previously occupied, 

 if the removal have not been absolutely com- 

 plete. The particles left behind act as at- 

 tractive forces for new blastema convertible 

 into cells, similar to those of which themselves 

 are composed. This mode of reproduction (as 

 it is erroneously called, for it is nothing more 

 than enlargement, facilitated by removal of 

 pressure of pre-existing substance) occurs 

 with Growths of all kinds, cancerous, sarcoma- 

 tous, fibrous, fatty, enchondromatous, erect- 

 ile, &c. But it would appear that in some 

 cases of surgical removal, when the whole 

 mass has, as is presumed, been extirpated, a 

 new growth vegetates in its place. The dif- 

 ference of the cases is often rather apparent 

 than real : we have distinctly found the ger- 

 rnina of cancer in tissue, reputed healthy, 

 surrounding a cancerous mass ; and it is 

 manifest that such germina, though invisible 

 to the naked eye, may, quite as readily as a 

 fragment of diseased tissue of even consider- 

 able size, act as the efficient agents of new 

 development. When, independently of this 

 mode of generation, the disease returns in the 

 seat of its former growth, the occurrence 

 must depend upon the continuance of that 

 depraved state of the blood which is fitted to 

 supply the necessary blastema, and likewise, 

 possibly, upon some peculiar state of vessels 

 of the part favouring its exudation here rather 

 than elsewhere. 



In other cases, hardly has a growth been 

 removed from one place, when a mass of the 

 same kind appears in some distant and appa- 

 rently unconnected part of the body : this 

 occurrence, which is especially observed in the 

 case of cancer, is termed its " distant repro- 

 duction," and is explicable in two ways. The 

 newly discovered growth may have existed 

 previously to the extirpation of the old one, 

 and having simply acquired additional activity, 

 so become obvious, after that extirpation. Or 

 the new growth may really have first appeared 

 subsequently to the removal of the old (this 

 we believe to be rare) : in this case the simple 

 explanation is that the vitiated state of the 

 blood, proper for the supply of the neces- 

 sary blastema, continues ; and this blastema is 

 poured out in some other part of the frame, 

 the original tumour no longer existing to 

 attract its deposition within or around itself. 



5. The chemical study of Growths is yet in 

 its infancy. Mailer's division into three chemi- 

 cal classes, the albuminous, the gelatinous, and 



