SYNCYTIOMA MALIGNUM 329 



perfect histological evidence as it is possible to possess that at 

 least one group of primary malignant tumours of the uterus — a 

 group, I may add, presenting " exquisite " or " eminent " 

 malignant properties — consists of the aberrant growth of foetal 

 cells within the maternal organism. 



This view of the foetal nature of the cells of the deciduoma 

 malignum was, I need scarce say, violently opposed for many 

 years by an important section of pathologists ; but now Mar- 

 chand, whose opinion cannot be passed over, has been forced 

 to accept the view : in short, no other view is possible at the 

 present time. The typical deciduoma is a syncytioma or chorio- 

 epithelioma malignum. I greatly doubt whether any committee 

 of the London Obstetrical Society could be found in these latter 

 days to report, as one reported only five years ago, that a group 

 of specimens of this form of tumour was of connective tissue 

 origin, and so sarcomatous. 



Can we explain this most remarkable form of neoplasm by 

 any parasitic theory ? To do this it is obvious that we must start 

 from the assumption that micro-parasites, in some way or other, 

 exalt the already existing invasive properties of the syncytial 

 cells, so that now they invade and infiltrate to an excessive 

 extent. That must be the starting-point. 



For myself I am perfectly prepared to accept this much, 

 namely, that parasites and their products are capable of stimulat- 

 ing cell growth. I see that in his recent Milroy Lectures Mr. C. 

 Powell White discovers a poorly defended spot in my argument 

 published last year, 1 in that there I make this same admission, 

 while simultaneously I lay down that the vegetative and pro- 

 liferative activities of the cell are inherent, the functional activi- 

 ties set up by stimulation from without. Upon first consideration 

 the objection appears valid. Further consideration, I think, 

 shows that it does not hold. We can imagine stimuli leading 

 to building-up — anabolic — processes in the cell, processes which, 

 under ordinary conditions, are preparatory to functional and 

 katabolic processes, which, in the absence of circumstances 

 favouring katabolism, favour cell proliferation. Now, in con- 

 nexion with this very form of tumour we are considering, it is 

 not a little interesting to note that the growth does not occur in 

 the placenta during the period of pregnancy, during the period, 



1 [Vide p. 288.] 



