PRODUCTS, ADVENTITIOUS. 



125 



lieve that any mode of association of cell and 

 fibril (at least any mode now known and un- 

 derstood) can be considered distinctive of 

 carcinoma. On the other hand, we believe 

 that Growths of evil tendency have a manner 

 peculiar to themselves (ascertainable by 

 naked-eye observation) of accumulating in 

 the tissues. We refer to accumulation by 

 infiltration. The nature of infiltration is easily 

 explained. The elementary molecules of the 

 morbid matter, instead of accumulating round 

 a central point equally in all directions, and 

 pushing aside the tissues amid which they are 

 deposited, spread between the primary ele- 

 ments of those tissues on every side. In 

 proportion as this extension of the morbid 

 matter is accomplished, interference with the 

 healthy process of nutrition takes place. 

 The effete particles of the natural tissues 

 cease to be replaced by similar ones ; and an 

 appearance of conversion (" transformation " 

 or " degeneration ") of a natural into a mor- 

 bid structure is worked out. But if the 

 nature of the phenomenon be simple, its cause 

 is obscure. Why it should occur (as we 

 conceive it does) in the instance of cancer 

 alone, and why peculiarities so important as 

 those of cancer, in respect of general influence 

 on the system, should appear to hang upon 

 the existence of a local pathological attribute, 

 in nowise remarkable, strictly considered per 

 se, is a difficulty which facts are wanting to 

 explain away. Speculatively, as we have 

 formerly said, " we must look elsewhere for 

 an explanation of the evils practically con- 

 nected with infiltration, than to the mere 

 physical phenomenon itself, in a word, we 

 must seek elsewhere some condition of which 

 the process is but a consequence or invo- 

 lution. But the natural place to look for this 

 condition is in the tissues themselves, which 

 undergo infiltration ; and in these in some 

 special morbid change within them must 

 reside the source and origin of the process. 

 And this view is confirmed by the fact, that 

 there is nothing in the mode of vegetation of 

 cancer itself to explain why it alone, among 

 vegetating new formations, should possess the 

 power of infiltrating the natural tissues." 



We are aware that the property of infil- 

 tration has been ascribed to other Growths 

 besides cancer; that fibrous tumours have, 

 for instance, been said to affect circumjacent 

 tissues in this manner. But we are per- 

 suaded, from close examination of such al- 

 leged cases, that infiltration with common 

 plastic matter (the produce of inflammation 

 arising from irritating pressure on the part of 

 the tumour) has been mistaken for infiltration 

 with substance identical with that of the 

 fibrous growth ; and that the distinction is 

 nosologically sound. 



On the grounds just set forth, we propose 

 to divide the order Growths into two sub- 

 orders the NON-INFILTRATING and the 

 INFILTRATING. 



SUB-ORDER I. NON-INFILTRATING 



GROWTHS. 



The genera in this sub-order may be ar- 

 ranged according to chemical composition 

 the protein compounds, fat and gelatin, being 

 severally the predominant element. 



OF PROTEIN-BASIS. 

 1. H.EMATOMA. 



Blood effused into the tissues may be either 

 (a) absorbed wholly or partially, or (b) not 

 absorbed. 



(a) 1. If the blood be absorbed wholly, no 

 vestige of the haemorrhage may ultimately be 

 traceable, even in the condition of the tissue 

 amid which it occurred ; or (as is more com- 

 mon) even after the total removal of the blood- 

 elements, some slight puckering, changed den- 

 sity, or changed position of the proper texture 

 of the organ (of the brain, for instance) re- 

 veals the fact that haemorrhage has occurred. 

 In either case, blood has escaped from the 

 vessels without leaving even the potential ele- 

 ments of a growth behind it. 2. Partial ab- 

 sorption acts commonly upon the watery and 

 colouring matters of the blood, the fibrin alone 

 remaining : this fibrin (fibnnous haematoma, 

 from a'/juarw/xa, blood-tumour), may form a 

 single mass, as is usual in the parenchymata, 

 or several fragmentary parcels, as happens 

 generally in the serous cavities. Partial ab- 

 sorption, in a class of rarer cases, acts first 

 upon the fibrin ; the effused blood becomes 

 more thin and aqueous, and sometimes (spread- 

 ing by infiltration and endosmosis amid the 

 surrounding textures) is thence eventually 

 absorbed : here no residue, referrible to the 

 present head, remains behind. 



(6) When not absorbed, blood either (1) ex- 

 cites inflammation and its consequences ; or (2) 

 remains stationary in a fluid condition; or (3) 

 assumes the characters of dark grumous semi- 

 coagula ; or (4) undergoing inspissation from 

 deprivation of its watery parts, a firm co- 

 agulum, growing daily more solid, remains be- 

 hind : in this last instance we have a coloured 

 haematoma. 



A haematoma is then a fibrinous mass, 

 coloured or not, arising from haemorrhage. 



Before us (Univ. Coll. Mus.) lies a colour- 

 less haematoma of the spinal menmges in the 

 cervical region, the result of a blow. Its size 

 is that of a walnut ; it is of pale straw-colour, 

 homogeneous on superficial view, but finely 

 granular when closely inspected. Haematoma 

 may, however, be coarsely loculated ; the 

 wails of the loculi being solid, the contents 

 more or less fluid, or gelatiniform-looking. 

 Such tumours (while unchanged in characters) 

 exhibit microscopically the qualities of fibrin, 

 fibrils gelatinizing with acetic acid, amor- 

 phous fragments, granules, and molecules. 

 Their colour varies ; it may be of deep yellow, 

 somewhat buff, tint, and commonly is so, in 

 the spleen and kidney, for instance. Their 

 chemical reactions are those of fibrin. 



The surface of a haematoma is smooth ; a 

 coating of epithelial structure, rapidly form- 



