338 THE POPULAR SCIENCE MONTHLY. 



are considered: 1, The relative frequency of malignant and be- 

 nign tumors ; 2, the liability of the transformation of benign into 

 malignant tumors; 3, the impropriety of delaying operative in- 

 terference ; and 4, the advantages of early operations. 



1. The testimony of careful observors tends to show that the 

 malignant tumors exceed the benign in frequency, and also that 

 many malignant tumors remain stationary and seemingly harm- 

 less for one, two, six, eight years, and even for longer periods, 

 then increase rapidly, and soon contaminate the system. (Then 

 follow technical and statistical considerations in substantiation 

 of these propositions.) Twenty-four per cent of all cancerous 

 tumors affect the breast. Benign tumors of the breast are most 

 frequent before the age of forty, and cancerous tumors of the 

 breast are most frequent after the age of forty. Cancerous tumors 

 are very much more frequent in the female than in the male sex. 

 The discrimination of malignant and benign tumors at the bed- 

 side is often so difficult that surgeons are justified in advising im- 

 mediate extirpation and in relying upon the microscope to insure 

 the diagnosis and establish the prognosis. 



2. The liability to the transformation of benign into malignant 

 tumors has long been recognized, but the histological demonstra- 

 tion of the phenomenon is modern. It has happened that some 

 tumors have been excised during their transition from the benign 

 to the malignant type, and that this metamorphic process has 

 been verified by careful microscopical examination of different 

 parts of the growths. But so far it has not been possible to de- 

 termine the precise time of the beginning of the transformation. 

 Warts, moles, and other benign growths upon the face or body 

 have been observed to undergo cancerous metamorphosis many 

 years after their appearance. Fibrous and fatty tumors are often 

 transformed into malignant tumors. So long as a tumor retains 

 a comparatively high degree of organization it remains benign ; 

 but when its constituent tissues are disturbed, there is apt to be 

 an accession of tissues of a low grade of organization and the 

 tumor becomes malignant ; the lower the organization the greater 

 the malignity. 



3. In stating the reasons why he believes it improper and un- 

 wise to delay operative measures for the cure of tumors, the 

 author discusses the methods of general and local treatment em- 

 ployed. He considers some of them delusive, and others directly 

 harmful, particularly the escharotics, which he thinks should be 

 condemned. The anciently promulgated precept, that so long as 

 a tumor is causing no apparent mischief and shows no disposition 

 to increase in size it should not be disturbed, is still regarded by 

 many as conservative, and commonly followed to the letter in the 

 management of tumors. In accordance with the light thrown of 



