ON METASTASIS m 



the body to the central neural textures of the nervous 

 system, and, therefore, we hold that the whole series of 

 such untoward events is due to, and determined by, the 

 existence of circulatory channels and facilities along which 

 the rheumatic virus and toxins are transferred from the one 

 to the other of the involved areas. In other words, we 

 hold that in such cases the materies morbi is in the mean- 

 time located in the external fibre-muscular developments 

 of the body, whence it is usually eliminated by the lym- 

 phatics and other excretory provisions, but which, in such 

 instances, have for the time being become occluded from 

 some cause, and so have necessitated the escape of the 

 rheumatic materies morbi, with its containing toxic culture 

 and toxins, along the other lines of least resistance, which 

 here are the intra-neurilemmar spaces of the proximal 

 motor nervature connected with the involved musculature, 

 into the cerebro-spinal cavity, where its neuro-cerebral 

 toxic qualities are immediately, and with almost uni- 

 versally fatal effects, demonstrated. 



In like manner the metastasis of gout is observed when 

 an external manifestation of that disease gives place to, or 

 is immediately followed by, an acute gastric attack, in 

 which case the sequence of the metastatic events are 

 retirement, or regurgitation, of the gouty materies morbi 

 from its external seat, its invasion of the cerebro-spinal 

 lymph cavity, and its ejection through the pneumogastric 

 neurilemmar lymph inter-spaces into the gastric terminal 

 extensions of these nerve trunks and related non-nervous 

 structures. 



Many other instances of metastasis might be mentioned, 

 but these may suffice to prove that it is still necessary for 

 us to retain the term as absolutely required to express and 

 describe a pathological occurrence which is not uncommon, 

 and which it would be difficult to define by any other term 

 or combination of words. 



