and Laboratory Methods. 1181 



lymph-spaces can be directly traced, or when the tumor is found in places, such 

 as bones and lymph-nodes, where epithelium is lacking, and the structure of the 

 tumor corresponds to that of undoubted endotheliomata. Braun did not fulfill 

 these requirements of Krompecher. He based his diagnosis on the difference of 

 structure as compared with ordinary epidermoid carcinomata ; on the absence of 

 epithelial pearls ; and especially on the lack of any connection between the tumor 

 and the skin. 



Krompecher studied thirty-three cases. The tumors occurred on various 

 parts of the body. By means of serial sections, he demonstrated the connection 

 of these tumors with the surface epithelium, thus proving their epithelial origin. 

 The striking feature of these tumors is their microscopic structure. While the 

 epidermoid cancer is composed of the cylindrical cells of the stratum Malpighii, 

 and of polygonal prickle cells, which by cornification give rise to epithelial pearls, 

 the group of tumors under consideration is distinguished by the fact that only 

 the cylindrical layer of the stratum Malpighii proHferates. The cells retain their 

 embryonic character. The tumor consists of nests of high cylindrical cells, which 

 stain intensely. There is no formation of epithelial pearls. j. h. p. 



Wright, J. H. A Case of Multiple Myeloma. ^^.j ^^ defines multiple myeloma as a 

 Irans. Assoc. Am. Phys. 15: 137, 1900. , ° f j 



primary neoplasm of the bone marrow, 



affecting chiefly the sternum, the ribs, the vertebrae, and the skull ; the substance 

 of the bone being more or less extensively replaced by the tumor tissue. The 

 affection was first recognized by von Rustizky in 1873. It is a rare condition. 

 Less than twenty cases have been reported. The association of albumosuria 

 with multiple myeloma is an interesting feature, and an aid in diagnosis. In the 

 case studied by the writer, the tissues were hardened in Zenker's fluid and in 

 Flemming's solution. The sections were stained in various ways, but eosin and 

 Unna's alkaline methylen blue solution, and fuchsin, either alone or in combina- 

 tion with aurantia, were found most satisfactory. 



The tumor is chiefly made up of small cells closely crowded together. Most 

 of the cells have all the appearances of plasma cells, except that the cytoplasm 

 does not in all cases show a marked affinity for methylen blue, as does the 

 typical plasma cell. Wright holds that these cells are plasma cells, and their 

 deviations from the type of the parent cell are quite analagous to those seen in 

 the cells of other neoplasms. 



The author found that plasma cells are a normal constituent of the red mar- 

 row, and he concludes that the tumor arose from an abnormal proliferation of 

 these cells. Hence his case of multiple myeloma is to be regarded as a neoplasm 

 originating not in the red marrow cells collectively, but in only one of the varie- 

 ties of the cells of the red marrow, namely, the plasma cells. j. h. p. 



