PRODUCTS, ADVENTITIOUS. 



123 



Growths, as a class, varies in the different 

 parts of organs. Thus the pyloric end of the 

 stomach suffers more frequently than the rest 

 of the organ ; the epididymis than the body of 

 the testis. 



(c.) Certain organs, and certain parts of 

 organs, have an excess of tendency to the 

 formation of certain special Growths. Thus 

 the uterus, the mamma, the stomach, the 

 liver, are peculiarly prone to cancerous, as 

 distinguished from other forms of growth ; 

 the bones are the chosen seat of enchondroma. 

 And, again, cancer does not form indifferently 

 in all parts of the uterus, but tends especially 

 to invade its neck ; while fibrous tumours 

 affect a preference for the body of the organ. 

 The large intestine is a tolerably common seat 

 of cancer ; the small is very rarely implicated. 



(d.) Growths of different kinds exhibit dif- 

 ferent degrees of compatibility as co-existences 

 in the same body. Some Growths, as Cystoma 

 and Carcinoma, are sufficiently prone to 

 appear in the same individual; others, as 

 Fibroma and Carcinoma, are rare co-exist- 

 ences; none are actually incompatible, either 

 as unconnected co-existences, or as develop- 

 ments in each other.* 



Sex influences the site of Growths. The 

 renal organs of the male suffer more fre- 

 quently than those of the female ; the con- 

 verse is true of the genital organs. In like 

 manner, age has its influence. But on the 

 whole, the causes of these peculiarities of 

 seat are unfathomed. 



A Growth having once been developed, 

 may pursue an anatomical (or better, topo- 

 graphical) course, of three different kinds. 

 First, it may remain solitary and alone till the 

 death of the individual in whom it exists, no 

 other organ or tissue than that originally af- 

 fected becoming involved by similar disease. 

 This is frequently observed in the case of 

 enchondroma and of cystoid tumours, occa- 

 sionally of fibrous, and even of cancerous 

 Growths. 



Or, secondly, a morbid mass originates in 

 some particular site, whence it seems to spread 

 as from a centre to a multitude of parts ; the 

 latter are said to be the subject of secondary 

 Growths. The mechanism of this propagation 

 differs according as parts adjacent to or dis- 

 tant from the primary formation are the con- 

 secutive sufferers. (I.) When circumjacent 

 tissues become the seat of secondary develop- 

 ment, this is either the result : first, of pro- 



* It is true we have never ourselves seen cancer 

 within the substance of a fibrous tumour ; but there 

 is no a priori motive for disbelieving the possibility 

 of such localization, and competent persons affirm 

 they have seen examples of it. Although tubercle 

 is not, properly speaking, a growth, it may be well 

 to observe here (as we first showed eight years ago), 

 that this product and cancer rarely co-exist. Among 

 104 cases of death from cancer, there were but seven 

 in which the anatomical character of phthisis was 

 present. The age at which the two diseases are 

 most prevalent will, to some extent, but not wholly, 

 explain this result. (See Nat. and Treatment of 

 Cancer, p. 185.) On the other hand, the diseases 

 by no means absolutely exclude each other ; cancer 

 and tubercle may form in the same organ. 



gressive and direct infiltration of those tissues 

 by the morbid matter; or next, of infiltration 

 spreading to those tissues through the me- 

 dium of the proceeds of common inflam- 

 mation (induration-matter) previously depo- 

 sited among them, in some instances effecting 

 adhesions between parts not actually adherent 

 to each other in the natural state ; or, lastly, 

 possibly of infiltration arising in some unex- 

 plained way, through the influence of a part 

 simply placed in juxtaposition, and not con- 

 tinuous (either naturally or accidentally) with 

 the tissues primarily affected. These modes 

 of secondary implication are exemplified by 

 cancer alone. (2.) The formation of second- 

 ary Growths in distant organs, where an effect 

 of pre-existing disease elsewhere, seems only 

 intelligible as a result of transmission by the 

 lymphatic or vascular systems. Cancerous, 

 and perhaps fibrous tumours, give rise through 

 both these routes, to secondary development. 

 As respects the lymphatic glands in commu- 

 nication with a cancerous mass, they may 

 themselves become cancerous, while the ves- 

 sels leading to them are either filled with 

 morbid matter of the same kind, or perfectly 

 free from all anatomical change. Now when 

 the tubes are themselves loaded with cancer- 

 ous substance, and are, for example, traceable 

 so loaded even to the thoracic duct (A. 

 Cooper ; Hourmann), without any evidence 

 existing of the matter being a product of their 

 own tissue, the implication of the lymphatic 

 system, is evidently the result of absorption. 

 But when (as is more commonly the fact) 

 the cancerous state of the glands is unasso- 

 ciated with similar contamination of the con- 

 necting tubes, it is not thus so plainly and sa- 

 tisfactorily explicable. Still it is probable that 

 in the majority of cases the principle is even 

 here the same ; but that the mode in which 

 stagnation of absorbed particles takes place 

 differs. In other instances it is possible that 

 cancerous development in the glands may be 

 effected as in an independent and original 

 centre of production, and not through a pro- 

 cess of absorption or other direct mode cf 

 influence of pre-existing Growths. These no- 

 tions are put hypothetically ; but they appear to 

 me more likely to be well founded than those 

 usually tendered. Nevertheless if contamina- 

 tion be admitted to arise as a result of absorp- 

 tion in some instances, the inference appears 

 necessary, that it shall occur in all cases ; inas- 

 much as a process of nutrition, accomplished 

 in the usual way, is constantly going forward 

 in morbid Growths. Now, as matter of fact, 

 such contamination does not always ensue, 

 and, above all, does not commence from the 

 earliest period of evolution of the previous 

 growth. Here seems to lie a serious objection 

 to the doctrine of lymphatic absorption. But 

 the absorption is only thus shown to be of a 

 kind which we may, for convenience sake, call 

 unproductive; and which may be assimilated 

 to that taking place from abscesses, in cases 

 where no pus, with its sum of natural proper- 

 ties, finds its way into the circulation. That 

 the pus-corpuscles undergo, in such cases, dis- 



