256 
“In proportion as the malignant fungus is 
recent and of small din:ensions, is the diffi- 
culty of diagnosis from the hydatid cyst, for 
the fungus, as I have before said, ordinarily 
commences on the interior of a cyst containing 
a fluid, from the vascular lining of which it 
hangs like a fringe, and it is common to find 
more than one, often several contiguous cysts, 
in the early stage of the disease. As the fungi 
grow, the cysts burst and are blended in the 
same mass. From this account it will appear 
that there is sufficient analogy between the 
hydatid and fungoid disease in its incipient 
state to require more aids to diagnosis than 
those derived from manual examination. We 
sometimes meet with puzzling analogies in 
these diseases.” 
“ The relation of medullary sarcoma,” says 
Miiller, “ to scirrhus or carcinoma simplex is 
displayed by the fact that after amputation of a 
scirrhous breast, real fungoid tumours may oc- 
cur in other parts, as many observations of Zaup- 
taft, Cruveilhier, and others abundantly shew. 
This affinity is further illustrated by microscopic 
examination, which shews that many structures 
comprehended under the generic term of fungus 
medullaris differ greatly from each other, and 
have nothing in common but the softness of 
their texture.” Miiller therefore employs the 
term fungus medullaris “ as a collective name 
for different forms or stages of developement 
of soft cancer, which undergo imperceptible 
transitions into each other.” The following are 
the varieties for a knowledge of the minutize 
of which we must refer our readers to the 
original. 
“1. Carcinoma medullare, abounding in 
roundish formative globules which make u 
the greater part of the medullary mass, chesigh 
intersected by a delicate fibrous net-work. 
“ 2. Carcinoma medullare, with an exceed- 
ingly soft cerebriform base composed of pale 
elliptical bodies without caudate appendages. 
* 3. Carcinoma medullare, with caudate or 
spindle-shaped corpuscules. 
“ Carcinoma fasciculatum (syn. hyacinum.) 
—Among the structures commonly included 
under the name fungus medullaris, are some 
altogether fibrous in their texture, and which 
correspond with other forms of that disease 
only in the softness of their tissue. The 
fibrous structure of these growths is immedi- 
ately evident on breaking or dividing them ; 
when torn they do not crumble, but are readily 
rent in the direction of the fibres. If ex- 
amined under a microscope they display nei- 
ther the cellular globules of other varieties of 
carcinoma, nor the caudate corpuscules, which 
give a fibrous appearance to some forms of fun- 
gus medullaris.” 
Mr. Travers, in the paper previously referred 
to, says that “ certain anomalous morbid 
changes, as large fungous excrescences and 
deep cavernous fetid ulcers, are now and then 
the sequele of tumours in the female breast 
which are in a loose and slovenly classification 
termed cancerous. They are not so; but they 
are almost as incapable of being conducted 
to a curative termination as if they were; their 
MAMMARY GLANDS. 
ferns said to affect the 
ing remarkable for its slowness and fr 
from pain.” He also describes an excor 
of the integument around the nipple g ul 
extending over the breast, accompanied by 
ichorous exudation which remains in the sai 
incurable state many years, and ultimate 
throws up a broad toad-stool fungus exquis 
irritable and much disposed to bleed. 
neither the glands nor health.” mm 
Melanosis or black cancer has been met ¥ 
in the breast, but we believe never as a prim 
disease, the breast having been attacked s 
sequently to other tissues. Breschet, in 
treatise on this disease, gives a representa 
7 
of it in this organ. There is a preparation 
it in the museum of Bartholomew's He 
It is considered by Miiller as “ merely a 
of cancerous degeneration, and termin: 
the same way as other forms of carcinoma.” 
“« Microscopic examination,” says Mil 
“ detects two forms of melanotic st 
In both instances the basis of the structure 
formed of a fibrous network, the stroma of 
lanosis, within the meshes of which the m 
noid matter is deposited. This matter is gt 
rally composed of cells, filled with 
or blackish green granules. These cells 
and always continue to be free, never becom 
coherent. Their forms are very various. Mi 
indeed most, are round, oval, or i 
some are elongated; a few actually caud 
terminating at one or both extremities m 
point or ina fibril. Still more rarely the 
present several points. They are real pigm 
cells.” This author discovered in one of 
larger cells a nucleus with its nucleolus, | 
dependently of the pigment granules. 
cannot conclude this article more satisfactor 
than by quoting from the same accurate ¢ 
server, Mr. Travers, of whose observatior 
have already so fully availed ourselves. 
“ No description can comprehend all 
varieties of tumour to which this organ is li 
nor does any share of experience enable 
nicest observation to suggest an infallib 
to their nature. We have sometimes 6 
manipulation to depend upon, which is an 
imperfectly cultivated by scientific surge 
Cases now and then arise about which 
most accurate observers are liable to er 
True it is this does not frequently hap 
the distinction between innocent and malig 
growths. The several species of innocent 
mours already enumerated may all be di 
guished from scirrhus with comparatively 
difficulty; but if any doubt exists we m 
consider the age, habits, and circumstance 
the patient. For example, we should asee 
if marks of scrofula are present; if the uter 
functions are regular and healthy; if the 
mour can be referred to violence in the ee 
mencement, which from the exposed situatt 
of the organ is far from uncommon; if m 
than one lump exists in the same breast; 
both breasts are infected; if painful, the ch 
racter of the pain; if any absorbent glands 
altered in the neighbourhood and how. 
many cases of breast tumour are in the recol- 
. 
te 
