30 THE TONER LECTURES. 



same difficulties which we encountered in the case of cancer of 

 the breast. 



The first series of illustrations is drawn from a case of cancer 

 of the pylorus, taken from a man aged thirtj^-eight, who died 

 in Providence Hospital, in March, 1871. (Medical Section, 

 Army Medical Museum, No. 1079.) The growth assumed the 

 form of a moderate carcinomatous thickening of the walls of 

 the stomach for several inches around the pyloric orifice ; the 

 inner surface of the diseased part presenting a superficial area 

 of ulceration near the pylorus, while on the exterior an irreg- 

 ular mass, about an inch in diameter, invaded the gastro- 

 hcpatic omentum. 



Sections taken from the marginal portions of this carcinoma- 

 tous thickening showed numerous branching and anastomos- 

 ing cancer cylinders in the submucous connective tissue, which, 

 iDctween the cylinders, was infiltrated with numerous small cells, 

 the infiltration being most luxuriant just below the mucous 

 membrane. These cylinders in the submucous tissue were 

 continuous with other larger ones in the muscular coat and the 

 submucous adipose tissue. In all of them the pei'ipheral cells 

 were columnar in character, and bore a coarse resemblance to 

 the columnar epithelium of the tubular glands of the stomach ; 

 but within these columnar cells, the cylinders were completely 

 filled with polygonal irregular cells, and none of them, as 

 I thought, had any interior free space or lumen ; simply as 

 the cells of the interior were not Aery firmly interadherent 

 they readily fell out of their places from the larger cylinders 

 when thin sections were made, and thus the appearance of 

 tubes lined by an epithelium was simulated. I cannot but note 

 also that the general form and arrangement of the cylinders 

 in the muscular coat, at least, were strikingl}'^ similar to what 

 injections teach us of the mode in which the Ij-mphatic net- 

 work is distributed in this region. (Six photographs, Nos. 59 

 to G4, shov.n.) 



