118 



PRODUCTS, ADVENTITIOUS. 



5. DIPHTHERITIC DEPOSIT. 



The inflammatory action giving rise to the 

 deposits which we include under the title 

 Diphtheritic (A(^>0epr), a membrane), is cer- 

 tainly of special kind, though the intimate 

 nature of its peculiarity is yet undiscovered. 

 These deposits form on the tegumentary sur- 

 faces, mucous and cutaneous. 



(a.) White Thrush (Muguet of the French). 

 The matter of white thrush forms on the 

 mucous membrane of the mouth, fauces, aeso- 

 phagus, and nasal passages, in patches of 

 milky colour, cheesy consistence, variable size, 

 and irregular form. Adhering closely to the 

 mucous surface when first exuded, it gradu- 

 ally becomes more and more easily separable ; 

 if artificially removed, the subjacent surface 

 looks slightly hollowed and somewhat raw, 

 but is not abraded. 



The microscope exhibits molecules ; cells 

 of oval, spherical, or elongated form, with 

 or without nuclei ; epithelium cells, in more 

 or less abundance ; and fibrils. These fibrils, 

 almost transparent, of delicate and sharply- 

 defined outline, of cylindrical form, gene- 

 rally uniform in thickness, but sometimes 

 swollen irregularly, and occasionally bifur- 

 cated, are not affected by water, acetic or 

 nitric acids, or alkalies, but dissolve in sul- 

 phuric acid. Hence it appears obvious that 

 this substance is in part entophytic ; but it is 

 only secondarily so, the rapid development 

 of fungi depending on the constitutional state, 

 or, perhaps, upon the chemical condition, of the 

 local secretions. The smallest cells are pro- 

 bably sporules. 



There is no structural difference between 

 the matter existing in the white thrush of 

 children, and that appearing on the mucous 

 membrane of the mouth in adults towards the 

 close of lingering chronic diseases, especially 

 phthisis. But it has appeared to us from 

 numerous observations, that it is less prone to 

 become entophytic. 



(b.) We have examined with some care 

 the white material of cheesy consistence which 

 forms, in certain states of the constitution, 

 on blistered surfaces, kept open by irritant 

 ointments, and find no particular difference 

 between it t;nd the similar produce of mucous 

 membrane. Entophytic formation occurs here. 



ORDER II. GROWTHS. 



1. Growths possess texture which differs 

 in physical characters from all natural tissues, 

 the arrangement of their septa and loculi 

 being, among other things, distinctive of 

 themselves. They differ, further, from natural 

 structures, in a total deficiency of modelling 

 faculty; they enlarge in all directions indiffer- 

 ently, careless, as it were, of the mechanical 

 mischiefs their presence may inflict. They are 

 composed of evanescent vegetating cells, in- 

 capable of propagation by artificial inoculation 

 into the tissues of the individual producing 

 them. 



2. The existence of structure in the 

 order Growths is apparent on superficial in- 



spection. And there is one unfailing charac- 

 teristic of this structure, as displayed to the 

 naked eye ; it consists of a stroma and an in- 

 terstitial matter occupying its meshes. This , 

 which is the most striking peculiarity on the 

 surface of some tumours (enchondroma, col- 

 loid cancer), is much less evident in others 

 (milt-like variety of encephaloid, many spe- 

 cimens of simple scirrhus) ; but in these latter 

 it is clearly disclosed by slight maceration. 

 And the want of a clear definition at first 

 of stromal and interstitial parts depends, 

 not on their non-existence, but on the more 

 than ordinary similarity in phvsical characters 

 of both. Generally speaking, in truth, there 

 is a very obvious difference in this respect : 

 the stroma of fully developed colloid has the 

 aspect of cellule-fibrous membrane, opaque 

 and close ; its interstitial matter all the out- 

 ward appearances of a jelly-like substance ; in 

 enchondroma, the interstitial matter, resem- 

 bling jelly of a different tint, is enclosed in a 

 stroma, in many cases formed of laminae of 

 bone. But, on the other hand, in some cases 

 (as those referred to), there is no such obvious 

 difference in the visible character of the two 

 divisions, as they may be called, of the growth. 

 In yet other cases, again, the outward cha- 

 racters of the stromal and interstitial parts 

 differ in colour, transparency, density, tenacity, 

 when roughly examined, and yet their intimate 

 constitution is almost identical ; this is the 

 case in fibrous tumours. 



In the majority of Growths, the stromal 

 substance encloses spaces inclining to the 

 spherical form, a form most distinct in en- 

 chondroma, colloid cancer, and fibrous tu- 

 mours ; only imperfectly seen in encephaloid ; 

 almost completely absent in simple scirrhus 

 and in erectile growths. The manner in 

 which the sphericity of the loculi is produced 

 will be considered further on. 



Another element of Growths, which is vi- 

 sible to the naked eye, or may be rendered 

 so by means of injection, is blood-vessel. 

 In varying proportions all Growths possess 

 vessels, which may be limited to their stromal 

 substance, or permeate both stromal and 

 intrastromal substances. These vessels are 

 in part those of the textures invaded, by 

 the new formation, in part adventitious pro- 

 ducts. 



Lymphatic vessels and nerves are occa- 

 sonally found within the area of a Growth ; 

 but there is no evidence that they are ever 

 of new formation. 



3. The ultimate essential elements of 

 tumours are granules, molecules, cells, free 

 nuclei, and fibrils. With these elements are 

 accidentally associated Precipitates, Deposits, 

 Exudation-Products, and certain of the sim- 

 pler Pseudo-Tissues. 



(.) The elementary granule is spherical in 

 shape, flattened or amorphous; averages in 

 size T trozm tn f an mcn 5 an d is seated in the 

 interior of cells, or on the surface of fibres, or 

 is free. The molecule is too minute for mea- 

 surement. 



(b.) Some portion of the substance of all 



