SYNCYTIOMA MALIGNUM 329 



perfect histological evidence as it is possible to possess that at 

 least one group of primary malignant tumours of the uterus a 

 group, I may add, presenting " exquisite " or " eminent " 

 malignant properties consists of the aberrant growth of foetal 

 cells within the maternal organism. 



This vie^ of the foetal nature of the cells of the deciduoma 

 malignum was, I need scarce say, violently opposed for many 

 years by an important section of pathologists ; but now Mar- 

 chand, whose opinion cannot be passed over, has been forced 

 to accept the view : in short, no other view is possible at the 

 present time. The typical deciduoma is a syncytioma or chorio- 

 epithelioma malignum. I greatly doubt whether any committee 

 of the London Obstetrical Society could be found in these latter 

 days to report, as one reported only five years ago, that a group 

 of specimens of this form of tumour was of connective tissue 

 origin, and so sarcomatous. 



Can we explain this most remarkable form of neoplasm by 

 any parasitic theory ? To do this it is obvious that we must start 

 from the assumption that micro-parasites, in some way or other, 

 exalt the already existing invasive properties of the syncytial 

 cells, so that now they invade and infiltrate to an excessive 

 extent. That must be the starting-point. 



For myself I am perfectly prepared to accept this much, 

 namely, that parasites and their products are capable of stimulat- 

 ing cell growth. I see that in his recent Milroy Lectures Mr. C. 

 Powell White discovers a poorly defended spot in my argument 

 published last year, 1 in that there I make this same admission, 

 while simultaneously I lay down that the vegetative and pro- 

 liferative activities of the cell are inherent, the functional activi- 

 ties set up by stimulation from without. Upon first consideration 

 the objection appears valid. Further consideration, I think, 

 shows that it does not hold. We can imagine stimuli leading 

 to building-up anabolic processes in the cell, processes which, 

 under ordinary conditions, are preparatory to functional and 

 katabolic processes, which, in the absence of circumstances 

 favouring katabolism, favour cell proliferation. Now, in con- 

 nexion with this very form of tumour we are considering, it is 

 not a little interesting to note that the growth does not occur in 

 the placenta during the period of pregnancy, during the period, 

 1 [Vide p. 288.] 



