CANCEROUS TUMORS. 23 



in the cicatrix and destroj-cd tlie patient.* Tlie secondaiy 

 grovvtlis liad no doubtful anatomy. Billrotli-j- insists on tlie 

 imiDortance of an early removal of such growths and points out 

 their proneness to undergo a cancerous transformation if they 

 are permitted to remain, and to recur with cancerous charac- 

 teristics if they are removed too late ; while acknowledging 

 the justice of his observations I am disposed to go even still 

 farther in my appreciation of their relation to ordinary cancers. 



I next draw your attention to some views from a case of 

 cancer of the left breast, removed in March, 1871. The 

 patient was about forty-five years old, and the tumor had been 

 growing a little over a year, having first made its appearance 

 shortly after an injury to the breast received by falling against 

 the corner of a table. It had attained about the size of a 

 hen's egg at the time of removal. Eighteen months after the 

 operation the patient was still apparently in good health. 



In this case portions of the growth presented the ordinary 

 anatomy of scirrhus of the breast, but other portions were in a 

 condition very similar to that described in the last case, except 

 that many of the gland vesicles were dilated into cysts. In 

 numerous places the same milk-duct led to groups of vesicles 

 apparently belonging to the same lobule, some of which were 

 nearly normal, while others had undergone the cystic transfor- 

 mation. Both normal vesicles and cj^sts were pushed apart 

 by a luxuriant connective tissue, infiltrated with small cells. 

 (Five photographs, Nos. 37 to 41, shown.) 



Such a growth would be called cysto-sarcoma if the whole 

 tumor had the structure represented in these photographs, 

 but a large part of it had the ordinary anatomy of scirrhus, 

 and I call attention to the significance of the association of tlie 

 two lesions in the same breast. 



The transformation of some of the vesicles of the mammary 



*Loc. cit., vol. 39, p. 331. 

 tQp. cif.,p. 606. 



