522 LECTURE XX. 



clei, so that from twelve to twenty-four or thirty are 

 contained in one cell, in which case, however, the nuclei 

 are always small and have a homogeneous and somewhat 

 shining appearance. 



This structure, which in its development is compara- 

 tively most nearly related to pus, inasmuch as it has the 

 smallest nuclei and relatively the smallest cells, is distin- 

 guished from all the more highly organized forms of can- 

 cer, cancroid and sarcoma, by the circumstance, that 

 these contain large, voluminous, nay often gigantic cor- 

 puscles with highly developed nuclei and nucleoli. Tu- 

 bercle, on the contrary, is always a pitiful production, a 

 new-formation from its very outset miserable. From its 

 very commencement it is, like other new-formations, not 

 unfrequently pervaded by vessels, but when it enlarges, 

 its many little cells throng so closely together, that the 

 vessels gradually become completely impervious and only 

 the larger ones, which merely traverse the tubercle, re- 

 main intact. Generally fatty degeneration sets in very 

 early in the centre of the knot (granule), where the oldest 

 cells lie (Fig. 140), but usually does not become com- 

 plete. Then every trace of fluid disappears, the corpus- 

 cles begin to shrivel, the centre becomes yellow and 

 opaque, and a yellowish spot is seen in the middle of the 

 grey translucent granule. This is the commencement of 

 the cheesy metamorphosis which subsequently characterizes 

 the tubercle. This change advances from cell to cell far- 

 ther and farther outwards, and it not unfrequently hap- 

 pens that the whole granule is gradually involved in it. 



Now, the reason why I think that the name of tuber- 

 cle must be specially retained for this formation as being 

 extremely characteristic of it, is this that the tubercle- 

 granule never attains any considerable size, and that a 

 tuber never arises out of it. Those which are wont to be 

 termed large tubercles, and attain the size of a walnut, or 



