122 



PRODUCTS, ADVENTITIOUS. 



the fatty (rational enough, chemically con- 

 sidered,) fails pathologically. Growths of very 

 opposite tendencies and attributes are to be 

 found in the same chemical class ; thus the 

 most deleterious forms of cancer are albu- 

 minous, while sarcoma (per se most innocent) 

 is the same in its chemical basis. 



(a.) In the albuminous growth the other 

 forms of protein are frequently present as 

 essential ingredients ; the term growth of 

 protein-basis appears therefore more strictly 

 applicable. A matter said to be allied to 

 ptyalin has been found in this class. Con- 

 tinued ebullition scarcely furnishes a trace of 

 gelatin ; and when some such trace does 

 appear, is probably derived from natural 

 gelatinous textures accidentally connected 

 with the morbid mass. 



(b.) Growths of the gelatinous class are 

 almost completely reduced to jelly by boiling. 

 The gelatin yielded is either of the common 

 species, as in fibroma, or of the variety known 

 as chondrin, and first detected by Miiller in 

 enchondrorna. 



(c.) In the fatty class, the fatty matter is 

 chemically the same as that of ordinary 

 adipose tissue (e. g. in lipoma) ; or it is more 

 or less closely allied to cholesterin (e. g. 

 in cholesteatoma). 



The fatty particles which exist in almost 

 all Growths, even of the albuminous kind, 

 and which do not form the essential part of 

 the mass, are not contained in cells, as in 

 true fatty Growths, but exist in the various 

 forms enumerated in a former passage. 



Carbonates, hydrochlorates, and phosphates 

 of the alkalies and earths are the inorganic 

 salts most commonly and largely associated 

 with the animal constituents of growth. 



6. The PATHOLOGY of Growths em- 

 braces the subjects, first, of the morbid changes 

 arising in, or in immediate connection with, 

 those formations ; and, secondly, of the va- 

 rious conditions of the system which precede, 

 accompany, and follow their evolution. Their 

 pathology may, in other words, be regarded as 

 local and general. 



(a.) Local. Under the head of physiology 

 we have considered briefly the various changes 

 arising in Growths, as essential phenomena of 

 their complete development ; and which, 

 however they may be regarded as morbid in 

 respect of the system generally, are, on the 

 part of the adventitious mass in which they 

 take place, evidences of natural progress. 

 But there are numerous changes occasionally 

 occurring in Growths, that are actually morbid 

 in essence in relation to the substance of the 

 new product itself; and others of a similar 

 character which are produced in the sur- 

 rounding tissues. These two classes of 

 changes (which can only be glanced at here) 

 constitute the materials of the Local Patho- 

 logy of Growths. 



1. The changes observable in the substance 

 of Growths, and which signify a departure 

 from the regular process of evolution, are : 

 congestion ; infiltration with blood or with 

 serosity ; haemorrhage, and in consequence of 



these states, various forms of discolouration ; 

 inflammation ; mortification ; and the deposi- 

 tion within or upon them of some adventitious 

 material foreign to their nature. In fact, the 

 chief morbid changes occurring in the natural 

 structures may arise in these formations. 



2. The effects produced by Growths on 

 surrounding tissues are mechanical arid vital. 



The mechanical variety comprises detrusion 

 and various other displacements; condensa- 

 tion ; discolouration ; infiltration ; blocking up 

 of cavities ; interference with the motion of 

 fluids, &c. 



The detrusion produced by Growths may 

 be simple, expansive, or causing peduncula- 

 tion, a peculiarity observed when certain 

 Growths, endued with little or no tendency 

 to infiltrate the parts around, originate be- 

 tween a mucous or serous surface, and a 

 hard, resisting tissue. And this for obvious 

 reasons; with the progress of their enlargement 

 the distention they induce does not equably 

 affect all surrounding parts (because the re- 

 sistance of these is unequal), but acts espe- 

 cially upon the least resisting structures. As 

 they enlarge, they carry these structures be- 

 fore them, until themselves eventually pro- 

 trude sufficiently from their precise seat of 

 origin to leave a sort of process of the mem- 

 brane they push before them, acting as a stalk 

 of attachment to the place of their original 

 connection. 



A growth thus pedunculated is practically 

 known as a Polypus, a term extremely injudi- 

 cious, as it leads the observer to neglect the 

 important matter of the nature of the tumour, 

 and to regard a mere accident of shape as an 

 essential feature. 



The vital effects are rarefaction ; condensa- 

 tion; atrophy; hypertrophy; inflammation, 

 with its results adhesion, softening, indura- 

 tion, ulceration, mortification, perforation, 

 effusion of blood, enlargement of vessels, &c.; 

 and, most important of all, infiltration of the 

 surrounding tissues with matter similar to 

 that composing the new growth. This last 

 effect occurs (as we believe) in connection 

 with no growth except cancer, and constituting 

 one of the most evident pathological and 

 nosological distinctions between cancerous 

 and other allied formations, will be presently 

 examined. 



7. The nature of this work will not admit 

 of any extended observations on the general 

 Pathology of Growths, but some prominent 

 facts can scarcely be passed over in silence. 



The conditions of localization of Growths are 

 curious, and for the most part inexplicable. 

 The following propositions may be laid down 

 concerning them : 



(.) The tendency to become the seat of 

 Growths, as a class, varies greatly in the dif- 

 ferent tissues and organs. Thus, while cel- 

 lular tissue is their peculiarly favourite site, 

 fibrous texture but rarely affords them a nidus. 

 Again, the mamma, the ovary, the uterus, 

 are frequent, the lungs and brain much less 

 common, sufferers. 



(b.) The tendency to become the seat of 



