504 TUMORS. 



hands and the feet, as a point of departure, from which it gradu- 

 ally invades large portions of the surface of the body, in some 

 cases so rapidly that inflammatory symptoms are observed with 

 the formation of every new nodule. In such cases, the secondary 

 tumors in internal organs are either white or pigmented. The 

 patients die showing the symptoms of exhaustion (cachexia, 

 marasmus) or of septicaemia, in consequence of extensive gan- 

 grene of the tumors. Mucous or colloid degeneration may also 

 occur, and this change renders the tumor much less malignant. 



In the growth of myeloma, muscle- and nerve-tissue are trans- 

 formed into medullary tissue. If the tumor has originated in a 

 glandular organ, the epithelia are also converted into medullary 

 plastids, and glands are either completely destroyed or partly 

 enlarged, and even newly formed. In the latter cases, peculiar 

 cauliflower-like vegetations are produced within the gland, owing 

 to the encroachment of the myeloma tissue. Under these condi- 

 tions, cysts are very common occurrences f. i., in cysto-mye- 

 loma of the female breast or the ovary. 



THE CHANGES OF EPITHELIA PRODUCED BY GROWTH OF MYELOMA. 

 BY RUDOLPH TAUSZKY, OF NEW YORK.* 



It is known that myelomatous growths, which have originated either in 

 the cutaneous or subcutaneous tissue, and also those which appear in tissues 

 more deeply situated, as they approach the surface, sometimes produce ulcer- 

 ative processes in the integument. This always becomes attenuated before 

 the ulcerative process, often accompanied with inflammatory symptoms, 

 begins. After a certain time a loss of substance is observed at the most 

 prominent point of the tumor, which gradually enlarges ; and at its base the 

 tumor is seen as a reddish, slightly nodular, or even smooth mass. The ulcer 

 produces, as a rule, a relatively small quantity of pus. Clinically, this is a 

 valuable diagnostic symptom of myeloma. Cancer invariably gives rise to an 

 uJcerative process in the skin, and the ulcers thus produced present uneven, 

 nodular, and irregularly granulating surfaces, yielding pus or ichor. 



The question now arises: What histological changes take place in the 

 wasting process of the epidermis ? Of course, with the customary expression 

 of "fading or dying" of the epithelium only a clinical fact is recognized, and 

 the cause must be sought for in anatomical changes. At the same time, the 

 question may be answered : What changes does the epithelium of glandular 

 organs undergo when myeloma appears in them ? 



The literature of the morbid growths under consideration gives no satisfac- 

 tory explanation of the question. I therefore examined a number of myelo- 



* Abstract from Dr, Rud, Tauszky's essay : " Ueber die durch Sarcomwucherung be- 

 dingten Veranderungen des Epithels." Sitzunsber. d. Kais. Akademie d. Wissensch. in Wien. 

 Bd. Ixxiii. The term " sarcoma" is changed into "myeloma," and that of "protoplasm " into 

 "bioplasson." 



