SHORT PAPERS 



DR. CARL BECK, Professor of Surgery in the New York Post-graduate Medical 

 School, and Chairman of the Section of Surgery, presented an interesting technical 

 paper " On the Technic of Urethral Dislocation in Hypospadias and in Other 

 Defects and Injuries of the Urethra." 



PROFESSOR JOHANNES ORTH, of the University of Berlin, presented the follow- 

 ing short paper on "The Morphology of Cancer and the Parasitic Etiology." 



GENTLEMEN, In answer to the request of your president, Dr. Carl Beck, I 

 address you to-day concerning Carcinomatous tumors. I can tell you nothing 

 new, but perhaps it will have a certain interest for you to hear the views of a 

 pathologist who agrees in general with the greater number of German patho- 

 logists in regard to two questions which read : 



I. What are the morphologic characteristics of cancer? 



II. What is the present position of the question of its parasitic etiology? 



As regards the first question there can be no doubt that the characteristic and 

 determining elements are the cancer cells, and the cancer cells are nothing else 

 than epithelial cells. They are epithelial cells not only as regards their structure 

 but as regards the character of their protoplasm and their nuclei. Not only 

 epithelial as regards their biologic activities, they are also epithelial as regards 

 their origin. 



There is no metaplasia of connective tissue, or other cells into epithelial cells, 

 into cancer cells. Of course one sort of epithelium can change into another, 

 cylinder cells into squamous epithelium, squamous cells into cylinder cells, but 

 an epithelial cancer cell is never formed from a connective tissue cell. 



In primary cancers the fact of the direct origin of cancer cells from preformed 

 epithelium is, however, difficult to prove, as the growth of a cancer is not the 

 same, nor is its primary origin. I, indeed, believe that there are cancers in which 

 the conversion of preformed epithelial cells into cancer cells proceeds continu- 

 ously in the surrounding tissues at the edge of the primary tumor, that there are 

 multicentric cancers, not only in the sense that at the same time cancerous trans- 

 formation occurs in numerous neighboring places, but also in the sense that one 

 place becomes carcinomatous later than another. I realize, however, that many 

 cancers are unicentric, that they originate from a single cell complex and possess 

 only interstitial, no appositional growth. Previously we assumed without proof 

 a cancerous transformation of preformed epithelium wherever epithelial and 

 cancer cells came into contact. That such a view is not permissible has been justly 

 pointed out by Ribbert; as it is possible that cancerous epithelium has grown 

 against preformed epithelium and secondarily displaced this; but we cannot go 

 so far as to explain the relation of cancer cells with normal epithelium which we 

 find at the edge or in the immediate neighborhood of a cancer in this way, although 

 we can often show positively in serial sections that an isolated growth of pre- 

 formed cells occurs in which the quality of the cells show a certain variation from 

 the appearance of the mother cells. That in such cases a special sort of karyo- 

 mitosis occurs, similar to the mitosis of a fertilized ovum, I have not been able 



