138 



PRODUCTS, ADVENTITIOUS. 



tumour may present to the naked eye the cha- 

 racters of encephaloid, be the seat of interstitial 

 haemorrhage, affect the communicating lymph- 

 atic glands, run in all respects the course of 

 cancer, and nevertheless contain no cells but 

 such as are nndistinguishable, in the present 

 state of knowledge, from common exudation- 

 cells. (4.) Nay more, while a primary 

 " malignant" tumour contains these cells 

 alone, the lymphatic glands secondarily af- 

 fected may contain compound nucleated cells, 

 spherical and shapelessly-caudate.* (5.) The 

 granular and imperfectly nucleated cell of 

 scirrhus is valueless as an evidence of cancer. 

 (6.) The true fusiform cell (j%. 93) is an 

 adventitious formation when it occurs in 

 cancer, and has no diagnostic signification. 

 (7.) The association of fibre and cell-structure, 

 which will distinguish scirrhus from fibrous 

 tumour, may be totally wanting in encepha- 

 loid, and exists in sarcoma and enchondroma. 

 (8.) If fat be associated in large quantity with 

 fibre and cell-structure, the certainty that 

 cancer is present becomes great, but not ab- 

 solute. 



The property of infiltration, which serves 

 well, as we have shown (p. 125), to distinguish 

 cancer from otlicr growths nosologically, fails 

 practically in the distinction of tumours gene- 

 rally, because a true cancer is not necessarily 

 infiltrated, and because tubercle and exuda- 

 tion-matter may be infiltrated. In ultimate 

 analysis the single character least likely to 

 deceive is this : if a tumour be cancerous, it 

 will yield on pressure an opaque, whitish 

 (milky or creamy-looking) albuminous fluid f ; 

 if it be not cancerous, it will not yield a fluid 

 of these qualities. 



ORDER III. PSEUDO-TISSUES. 



The blastema from which Pseudo-Tissues 

 are evolved is commonly known as coagulable 

 lymph, itself nothing more than liquor san- 

 guinis slightly modified in nature, and in the 

 proportion of its elements (the modification 

 consisting in excess of fibrin, it comes from 

 hyperinotic blood, and in the presence of 

 gelatin, Mulder), and like it composed of 

 water, fibrin, albumen, fat and salts. Pro- 

 duced by exudation from the vessels, homo- 

 geneous and amorphous, this fluid soon be- 

 comes the seat of cell-formation, the cell 

 being that already described as the com- 

 pound granule corpuscle. The fibrin it con- 

 tains coagulates into patches or flakes of 

 yellowish grey colour, semi-transparent, amor- 

 phous to the naked eye, but fibrillar (in 

 parallel fasciculated rows) under the micro- 

 scope, the cells (and abundant granules) ap- 

 pearing set in or upon the fibrils. Ha-matin, 



* Mr. Ellis has recently ascertained this fact in 

 examining a testicle, and communicating lymphatic 

 glands. 



f We have found this the fact even with cancers 

 of excessive transparency and wateriness of look. 

 (See Op. cit. p. 17.) Colloid cancer is compara- 

 tively poor in this land of fluid ; but fortunately its 

 other characters unfailingly identify it. 



or entire blood-disks may appear, and pus 

 corpuscles be produced, amid these coagula. 



Now the issue of this exudation-matter 

 (which seems regulated rather by the consti- 

 tutional state than by its own nature) may be 

 of two kinds. Either a permanent material 

 sui generis (which, for want of a better name, 

 we will call Induration-matter') is produced ; 

 or a structure resembling some one or other 

 of the natural adult tissues is evolved. The 

 former result signifies a lower plastic power 

 than the latter : the necessity of active con- 

 gestion for the production of either is more 

 than doubtful. 



INDURATION-MATTER. 



Coagulable lymph, destined to remain in 

 the condition of induration-matter, becomes 

 more and more opaque and solid, and acquires 

 an imperfect fibrous character (as Mr. Gul- 

 liver first showed) from simple condensation 

 of the original fibrillated fibrin, and indepen- 

 dently of cell-formation. The fibres become 

 thicker, and run more flexuously, as the 

 consistence increases, a change probably 

 caused by contraction from removal of water. 



The properties of induration-matter vary 

 greatly. Of greyish, yellowish, or white co- 

 lour ; opaque ; fragile and cheesy in consistence, 

 or firm as nbro-cartilage ; of trifling, or of 

 extreme tenacity ; rarely crisp, and generally 

 distinctly tough ; commonly elastic; in its firm- 

 est condition creaking on incision ; occurring 

 in the forms of membranous kyers, more or 

 less perfect sacs, nodules, patches (plane, puc- 

 kered, cupulated, or convex), points, granules, 

 wart-like bodies, or altogether, amorphous ; 

 essentially of protein-basis, yet yielding gela- 

 tin in a certain proportion, prone to contain 

 fat (granular or cholesteric), and often becom- 

 ing the seat of saline (ossiform) deposits ; 

 induration-matter is perfectly similar to none 

 of the natural textures. As it hardens, its 

 texture densely and closely set, often acquires 

 a chondroid appearance without containing a 

 particle of true cartilage ; it is imperfectly 

 (or not at all) vascular. Microscopically it 

 is found to be unprovided with prolific cells ; 

 nor are the few cells it may contain, nucleated 

 as a general fact. It is rendered pale by acetic 

 acid. 



Induration-matter is endowed to a remark- 

 able degree with the property of slow con- 

 traction, a property which renders its 

 presence most beneficial or most baneful. It 

 is this property, on the one hand, which in the 

 process or cicatrisation by granulation, reduces 

 within reasonable limits the surface of the 

 largest wounds ; while on the other, it may 

 cause painful deformity, as in the instance of 

 burns, or actually cause death, as in the 

 instance of healing intestinal ulcers.* 



Presenting itself wherever vessels exist, and 

 entering non-vascular textures by imbibition; 



* The cure of ulcers of the small intestine in 

 continued fever and in phthisis, and of the large 

 bowel in chronic inflammation, has more than once 

 proved the cause of fatal stricture. 



