TUMORS. 475 



of epithelial and connective tissue, such as papilloma and ade- 

 noma. 



u Another series of tumors, on the contrary, called malig- 

 nant, have a deleterious influence upon the constitution of the 

 patient. They grow rapidly, are painful, liable to ulceration, 

 recur very often after extirpation, and produce secondary tumors 

 in internal organs. For the differentiation of these growths we 

 are greatly indebted to R. Virchow. He first cleared up the fact 

 that some of these tumors are formations of connective tissue 

 in its undeveloped embryonal or medullary condition, for which 

 he used the rather unsuitable denomination i sarcoma'; while 

 others are combinations of epithelium and connective tissue 

 the so-called cancer forms. A third variety of tumors exhibits 

 intermediate stages between these two kinds, and they represent 

 what is termed, in a popular expression, suspicious tumors, such 

 as myxo-, fibro-, chondro-, osteo-sarcoma, etc. These, upon their 

 first appearance, do not impair the constitution of the patient ; 

 but gradually, or after repeated extirpations, or rather trials of 

 extirpation, become decidedly malignant. 



" The study of the minute anatomy of tumors, in its present 

 condition, is as yet far from being satisfactory. Still, if the ques- 

 tion should be raised, whether microscopy has advanced so far 

 as to give a thorough decision of the benign, suspicious, or 

 malignant nature of a tumor, the answer, doubtless, will be a 

 hearty yes, it has. 



" There are but very few points worthy of consideration as to 

 the nature of a tumor. The more of a basis-substance of the above 

 description is present, the smaller, therefore, the amount of free bio- 

 plasson bodies, the surer it is that the new growth is of a benign 

 nature. On the contrary, the smaller the amount of basis-substance, 

 the larger the relative number of bioplasson bodies, the more cer- 

 tainly does the tumor belong to a malignant type. The very worst 

 tumors glio-sarcoma, round-cell-sarcoma, and medullary cancer 

 exhibit a trifling amount of fibrous connective tissue. The 

 difference mentioned, namely, is true, not only for sarcoma, but 

 also for cancer. The more the connective tissue prevails, in 

 comparison with the epithelial formations, the less malignant is 

 its course, the more we are entitled to term it a l scirrhus ' ; 

 while in the fast-growing and rapidly killing medullary cancers, 

 the frame of connective tissue bearing the blood-vessels is very 

 small, and the epithelia are ill-developed viz. : remain in their 

 medullary or embryonal condition. 



