MALIGNANCY 55 



obviously due to the inhibiting action of the blood-stream 

 and the catalysts it carries. 



If these conclusions are of any weight, and it is allowed 

 that malignancy is a failure of developmental machinery, 

 we are impelled to ask if there is any one gland in the 

 human body, for instance, which, on the principles of 

 interactions between epithelium and connective tissue, 

 may be more to blame than another. The thyroid is 

 suspect since it is frequently in a morbid condition in 

 malignant states ; but no proof has been adduced of its 

 responsibility. There are, moreover, much greater 

 reasons for suspecting another gland, directly responsible 

 for definite under- or overgrowth, such as the pituitary 

 body, since its direct connection with bone development 

 is now admitted on all hands. But if the pituitary can 

 determine infantilism, gigantism, and acromegaly b3? over- 

 growth or failure of bone-growth, and growth in all tissues 

 generally, it is hardly extravagant to suggest that it may 

 be directly responsible for bone sarcomas. If this is true 

 we might then call sarcoma of the bones " local explosive 

 osteomegalies." If there is such a thing as anarchy 

 among the osteoblasts and osteoclasts, in which each under 

 abnormal stimulation functioned regardless of normal 

 inhibitions, we should expect such phenomena as we 

 see in femoral sarcoma. It is at least a possible explana- 

 tion to suggest that the deadly character of such a sarcoma 

 is due to a breakdown in a bone exposed, perhaps, to 

 greater single stresses than any in the body. But if the 

 pituitary can influence one form of connective tissue, 

 however highly specialized, it may equally influence 

 other forms. From one point of view, the beginnings 

 of all late sarcomas, not only those of bone, might be 

 regarded as cases of overdone repair, while those of early 



