132 



PRODUCTS, ADVENTITIOUS. 



pure character is rarely observed however. 

 The tendency to inflammation is extremely 

 slight, inherently, in these formations ; when it 

 occurs, it arises as a secondary consequence of 

 their mechanical action on surrounding parts. 

 This action produces various derangements of 

 function of those parts, which are followed 

 in them hy irritative action, eventually spread- 

 ing to the adventitious mass. The proof is, 

 that growths so seated as not to lead to irri- 

 tation of adjoining textures (sub-peritoneal 

 pedunculated uterine tumours, for example) 

 never, so far as our own observation and all 

 recorded experience goes, become the seat of 

 inflammation. We do not, however, mean to 

 deny that in tumours of soft texture and 

 abundantly vascular, an intrinsic process of in- 

 flammation may not possibly arise. Sphacelus 

 may be the result of the former kind of inflam- 

 mation ; but this change, according to our ob- 

 servation, very rarely occurs with its ordinary 

 anatomical characters. 



Melanic colouring matter is sometimes de- 

 posited in abundance in these growths. Dr. 

 Carswell (Elementary Forms of Dis. Melano- 

 ma, pi. l*JSg' iv.) has figured a very beautiful 

 and characteristic specimen of this kind. 



The softer species of fibrous mass has in 

 the uterus been sometimes found to contain 

 steatomatous matter and hair. 



Krull has given a rough sketch of a uterine 

 fibrous tumour, the central part of which con- 

 tained vessels, some of them capable of ad- 

 mitting a pen, and said to present somewhat 

 the characters of " erectile tissue" a term 

 very vaguely used. 



Different notions have been held as to the 

 possibility of fibrous tumours " becoming can- 

 cerous." The difficulty in deciding this ques- 

 tion has arisen from the total want of definite 

 meaning in the minds of authors as to what 

 constitutes "becoming cancerous." If the 

 phrase be applied in the manner which seems 

 the only rational and sound one, that is, to 

 parts, whether adventitious or not, in which the 

 development of one or the other of three species 

 of cancerous formation occurs, the perplexity 

 of the question vanishes at once. The growth 

 of cancerous substance in fibrous tumours is, 

 in truth, at the least, materially more rare than 

 in any natural vascularized tissue. We have 

 never ourselves seen a particle of true scirrhus, 

 encephaloid or colloid, in the interior of a 

 fibrous tumour proper. The assertion of Du- 

 puytren and certain of his copyists, that 

 fibrous tumours frequently become carcino- 

 matous, is easily explained : they confound 

 the fungative and intractable sores sometimes 

 arising on the uterine surface and adjoining 

 sub-mucous fibrous tumour, with cancerous 

 disease applying the term, with a vagueness 

 subversive of all correctness in morbid ana- 

 tomy and in pathology, to every sore resist- 

 ing treatment and affecting the constitution by 

 its discharge and irritative agency. As well 

 might they call the fungating sore, produced 

 in the tongue or cheek by a carious tooth, a 

 cancer. 



The total expulsion of fibrous tumours from 



the body, is a phenomenon of less uncommon 

 occurrence, than is usually supposed. It is 

 effected while the mass possesses its original 

 fibrous constitution, or after its conversion 

 into earthy matter : the process in the latter 

 case is much simpler than in the former, as 

 the organic connections of the mass have 

 been gradually destroyed in the manner already 

 referred to ; it is likewise of much more fre- 

 quent occurrence. While yet fibrous, the 

 growth may be expelled as a single mass or 

 piecemeal; more rarely in the former way. 

 The conditions necessary for its accomplish- 

 ment are, that it should be separated from its 

 connections, and, this once effected, that it 

 should be so seated as to drop from the body 

 spontaneously, or be under the influence of 

 some expelling force. In the case of the 

 uterus, the expulsive efforts of the organ lead 

 to the removal of the masses (especially if 

 seated under the mucous membrane) at a 

 much earlier period, than their mere anato- 

 mical state would lead us to expect. The 

 museum of University College contains a 

 portion of fibrous tumour, expelled from the 

 uterus in this manner ; submitted to micro- 

 scopical examination, we found it composed of 

 precisely the elements already described. 



The constitution of these growths would 

 lead us to expect their local reproduction, if 

 partially removed. Observation confirms this 

 view. Cruveilhier describes, from the prac- 

 tice of Dupuytren, a case of fibrous tumour 

 growing from the interior of the body of the 

 lower maxilla, in which reproduction took 

 place twice after imperfect removal with the 

 knife. 



The simple tissues in which fibrous tu- 

 mours are observed are : the cellular ; the 

 fibrous ; rarely, if ever, the osseous properly 

 so called ; the nervous. The compound 

 tissues and organs in which they are more or 

 less frequently developed are : the bones, 

 in immediate connection with the endosteum, 

 or more especially the periosteum; the sub- 

 mucous tissue of the pharynx, more rarely of 

 the oesophagus, of the stomach and intestines ; 

 the subperitoneal tissue; the submucous tis- 

 sue of the larynx, the nares, the frontal and 

 sphenoid sinuses ; the sub-pleural tissue ; the 

 arterial tissue ; the ovaries ; the Fallopian 

 tubes ; the uterus ; the vagina ; the mamma; 

 the testicle ; the dura mater in its subjacent 

 cellular tissue ; the nerves ; the thyroid gland ; 

 the thymus gland. Of these various parts, the 

 uterus, dura mater, ovary, and mamma suffer, 

 especially the two former, with incomparably 

 the greatest frequency. A single one, or 

 several fibrous tumours may exist in the same 

 body. Usually numerous, for example, when 

 affecting the dura mater; they are commonly 

 single in the bones. Their coexistence in 

 several distinct organs is extremely rare. 



ENCHONDROMA. 



Enchondroma (from eyxovSpoz, cartilagi- 

 nous,} is the name recently proposed by 

 Miiller for a species of cartilaginous growth, 

 not unknown to previous observers, but by 



