SOFT CANCER. 445 



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

 as fungus-hsematodes, cephaloma, encephaloma, encephaloid, 

 carcinoma medullare, medullary fungus, medullary sarcoma, 

 &c. It is found in the glands, in the inter-muscular struc- 

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

 in the bones and periosteum. — (See Photo-lithograph, Plate 

 IV., Pig. 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, which may be taken 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 tlie 

 pectoralis magnus and serratus maguus muscles. But though 

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

 are round or oval, and readily adapt themselves to surrounding 

 parts. They grow deeply in loose areolar spaces, but their 

 boundaries are more superficial where the surrounding struc- 

 tures are firm. The parts around the lobes are not usually 

 infiltrated, as each lobe is surrounded by a more or less distinct 

 capsule, which seems not only to enclose each individual lobe, 

 but to extend over and involve the whole tumour. This is 

 easily separated from the surrounding structures, and when cut 

 into allows its contents to protrude, or, when very soft, to ooze 



