112 The Minute Anatomy of Two Cases of Cancer. 
far these disadvantages counterbalance its advantages. I place the 
two prints side by side, and should be glad to hear comments on 
then* respective merits. 
I may add that the prints of the edition of these two plates are 
not so uniform as the Woodbury prints above alluded to. Some 
are much darker, some much lighter than the standard desired. I 
cannot say, however, that this irregularity ls as great as is usually 
the case with silver prints. In cost the Albertype prints, paper 
included, were rather cheaper than the unmounted Woodbury 
prints. 
In selecting a subject for this report, which it is to be hoped 
may be regarded as the first of a series of short essays on morbid 
growths, I determined upon a case of multiple carcinoma, consecu- 
tive to the ablation of a primary cancer of the female breast. With 
this I have associated a brief description of a primary mammary 
tumour of similar structure. 
The microscopical anatomy of these growths appeared of interest 
in connection with the recent study of Koester on the development 
of carcinoma and sarcoma.* 
Koester has been led to the opinion that carcinomatous growths 
very frequently have their origin in a proliferation of the endothelium 
of the lymphatics of the parts involved, and that this transforma- 
tion plays probably a great part in the development of most cancers 
and sarcomas. His work, so far as published, is confined to the 
examination of epithelial cancer of the skin, and alveolar colloid of 
the stomach (alveolarer Gallertkrebs des Magens), and he has post- 
poned for future parts the detailed examination of other varieties. 
His views have been received with much favour in various quarters ; 
I may especially mention Rindfleisch, as having given prominence 
to them in the last edition of his text-book.f I shall have occasion 
to refer further to the views of Koester in the sequel. 
The following is briefly the history of the case selected for con- 
sideration : — 
Case. Martha J. H , a widow, forty-three years old, who 
had resided for twenty years in the District of Columbia, most of 
the time in East and South Washington, where she had frequently 
suffered from intermittent fever, first noticed a tumour in her right 
breast in June, 1865. The whole mammary gland was removed 
November 23, 1866, by Professor Johnson Eliot. The tumour, 
which had attained the size of a hen’s egg, was hard, uneven, and 
somewhat painful. No microscopical examination was made. 
The patient speedily recovered from the operation, but never 
* 1 Die Entwicklung der Carcinome und Sarcoine,’ von Dr. Karl Koester 
Erste Abtheilung. Wurzburg, 1869. 
t ‘ A Text-book of Pathological Histology.’ By Dr. Edward Rindfleisch. 
American translation. Philadelphia, Lindsay and Blakiston, 1872. 
