i 



SOFT CANCER. 421 



taining small separate cavities or cysts filled with the colloid 

 substance. 



(2.) Medullary Cancer is developed in the form of circum- 

 scribed tumours or infiltrations. The case from which the 

 specimen seen in Photo-lithograph, Plate IV., Fig. 4, was taken, 

 presented both varieties, the circumscribed, as well as the in- 

 filtrated form, in the mammary region ; infiltrations only in the 

 submaxillary space, and one w^ell-defined circumscribed tumour 

 (that represented in the figure), weighing four pounds, upon the 

 outer side of the thigh. 



Many names have been given to this variety of cancer, such 

 as fungus-hsematodes, cephaloma, encephaloma, encephaloid, car- 

 cinoma medullare, medullary fungus, medullary sarcoma, &c. It 

 is found in the glands, in the inter-muscular structures, in the 

 penis, scrotum, the orbit, submaxillary space, and in the bones 

 and periosteum. — (See Photo-lithograph, Plate IV., Fig. 6.) 



Medullary cancer may present itself as one tumour ; but when 

 cut into, it will be found, as a rule, to be made up of several 

 smaller ones, enclosed in a distinct wall or boundary; or its 

 multiple character may be defined by external examination. To 

 the touch it presents a peculiar soft elastic feel of the slow fluc- 

 tuation of some thick liquid, w^hich may be mistaken for pus or 

 serum by an inexperienced examiner. The veins over the tumour 

 are congested ; the skin retains its natural appearance for a long 

 time; but eventually becomes tense and painful, the pain 

 being referable to the tension of the nerves and surrounding 

 tissues — the tumour itself not being sensitive — and then 

 ulcerates and bleeds. Ulceration does not take place very 

 readily; but when it occurs, a fungous growth soon appears, 

 and much of the brain-like matter of which the tumour is 

 composed, along with much blood, is discharged. A separable 

 medullary cancer may, as a whole, present a very irregular sur- 

 face, having a tendency to extend in the direction of the inter- 

 muscular spaces, as in one case where I found it in the walls of 

 the abdomen. In this instance the tumour was almost of a 

 triangular shape, with its base turned backwards, extending for 

 about fourteen inches under the panniculus carnosus, and 

 adapting itself to the form of the spaces existing between the 

 pectoralis magnus and serratus magnus muscles. But though 

 the mass may be irregular in the aggregate, its component lobes 

 are round or oval, and readily adapt themselves to surrounding 



