PRODUCTS, ADVENTITIOUS, 



98 



and rectum, and more rarely about the eyelids, 

 scalp, neck, and prepuce. The matter itself 

 is homogeneous, but differs in consistence in 

 different parts of the cyst it may be almost 

 fluid in some. Dr. Lever * describes a cyst 

 between the uterus and vagina which gave out 

 a quantity of fluid matter, when punctured, 

 that looked like "dripping" when cold. In 

 ovarian cysts steatoma is frequently associated 

 with hair. . 



(D.) Cholestericfats. Plates of cholesterin t 

 are frequently found in the fluid of hydrocele 

 and of cysts of the thyroid gland. _Rayer J 

 found them in a cyst of the kidney, in a sub- 

 ject whose aorta contained several small tu- 

 mours a little above the bifurcation, seated 

 under the lining membrane, and composed in 

 great part of cholesteric scales. In a female 

 who lately died in our wards with obstructed 

 bowels from stricture of the rectum, a large 

 cyst lying behind the right psoas muscle con- 

 tained cholesterin in atheromatous-looking 

 patches on the inner surface of its wall : here 

 it was undergoing calcification. 



Cholesterin has been found in scales among 

 pus of an abscess near a carious tooth || , and of 

 an abscess near an anchylosed joint.H In such 

 cases it disappears from the secreted matters 

 before suppuration ceases. 



Cholesterin occurs occasionally in various 

 morbid growths, for example, in the different 

 varieties of cancer. 



Closely allied to (if not sometimes identical 

 with) cholesterin in chemical constitution, is 

 a fatty product, for which the name of cholc- 

 stcatoma has recently been proposed by Miiller. 

 This substance occurs in the forms of (1) tu- 

 mours ; (2) granules ; (3) patches ; (4-) scales. 



(]). Tumours composed of this material are 

 commonly of the consistence of tallow ; firmer 

 than the brain when found in that organ. 

 They are not lobulated, but frequently mam- 

 millated on the surface ; uneven, with a gene- 

 ral tendency to roundness ; surrounded with a 

 capsule of delicate fibrous structure ; varying 

 in size from a walnut to the clenched fist and 

 upwards. Of sixteen recorded cases the brain 

 was the seat of the tumour in seven ; the bones 

 in three ; the utero-rectal cellular tissue in 

 two ; subcutaneous cysts in three ; a large 

 cysto-sarcoma of the breast in one. 



The interior of the mass has a shining white 

 and semi-transparent aspect, either generally 

 or in some spots only, while in others the white 

 colour is dull. Miiller found that the substance 

 shrinks and becomes yellowish by desiccation. 

 All who have observed it describe it as com- 

 posed of delicate laminae, for the most part 



* Med. Chir. Trans, vol. xxiii. 



f Becquerel and llodier affirm that the proportion 



arranged concentrically, and easily separated : 

 it is completely extra-vascular. 



The laminae and the matter interposed be- 

 tween them possess different structures. (.) 

 The lamina; consist of superimposed strata of 

 cells, rendered pentagonal, hexagonal, or 

 polvgonal, by lateral mutual pressure, resem- 

 bling, except in size (they are only halt as 

 large, averaging a diameter of .00081 of an 

 inch), the cells pf sheep's fat (fg. 91) ; easily 



Fig. 91. 



of cholesterin in the blood increases in persons of 

 both sexes from the age of forty to fifty: hence, 

 perhaps, the greater frequency of separation of this 

 fat in old people. 



1 Maladies des Reins, t. iii. p. 541. 



*5 See also Christison, Ed. Med. and Surg. Jovtrn. 

 vol. xxxii. p. 278. 



|| Caventou, Journ. de Pharmacie, t. xi. p. 4G3. 

 18-25. 



f Nasse, Midler's Arcliiv, 1840, Heft. iii. S. 267. 



Poh/qonal cells of clioksteatoma magnified 290 times. 

 (After Muller.) 



separated from each other, transparent and 

 pale; possessing neither nucleus nor central 

 granules, and admitted to be hollow, rather 

 from the analogy of sheep's fat, than proved 

 to be so by observation. The substance form- 

 ing the cells is distinct in its nature from fat, 

 as" it is neither dissolved nor deprived of its 

 laminated appearance by boiling alcohol. (/;.) 

 The inter-laminar matter consists of crystals 

 tabular and lamellar. The tabular are in 

 greatest abundance ; generally short, broad, 

 and rectangular, but frequently narrow and 

 riband-like, and probably composed of pure 

 cholesterin (which appears under the micro- 

 scope in the form of rhombic tables), as acids 

 and alkalies do not affect them. 



The lamellar crystals look hke aciculag of 

 stearin from their being gathered into bundles ; 

 but when deposited from their aethereal secre- 

 tion they are distinctly lamellar, and pointed 

 at both ends. 



(2.) Granules. We agree with Miiller in 

 believing that the pearly looking globules 

 described by Cruveilhier in a cancerous growth 

 of the testicle* were very probably composed 

 of cholesteatomatous matter. 



(3.) Patches. Dupuytren observed patches 

 of this substance on the surface of a urinary 

 fistula ; Muller a stratum of it covering a can- 

 cerous ulcer of the mamma. 



(4.) Scales. The fluid of hydrocele and of 

 tumours of the thyroid gland frequently con- 

 tains scales of a pearly looking matter, some- 

 times collected abundantly at the most de- 

 pendent part of the cavity. This matter, 

 commonly believed to consist of cholesterin, 

 is not always so composed. Dr. Bostockf 

 found it essentially different from adipocere 

 and from cholesterin, not soluble in water or 

 in alcohol, but partially so in aether, and in- 

 capable of saponification by potash. Muller 

 found the alcoholic or aethereal solution of 

 the tuberiform variety yielded no oil on eva- 

 poration, but a fine granular fat, probably 

 stearin, with lanceolate lamellar crystals, 



* An. Path. livr. v. tab. i. fig. 2. 

 t Med. Chir. Trans, vol. xv. p. 158. 



