CAUCINOMATA. 181 



development of the open glands. In both cases alike, we have 

 aggregates of epithelial cells projecting in the form of tap- 

 shaped processes or cords from the under surface of the epi- 

 thelium, and boring their way between the fibrous bundles 

 of the connective tissue. Phenomena of active fission are also 

 seen to take place in the elementary constituents of these cellu- 

 lar aggregates; two leading features therefore are undeniably 

 common to the morbid process and the normal development of 

 glands. Nevertheless the view which makes the development of 

 cancer consist in a lawless and irregular counterfeit of the normal 

 growth of glands Qiet^radenie of the French) is only legitimate 

 within certain limits. After having devoted so much time and 

 space in former chapters to the consideration of the normal 

 growth of epithelium, it would be unfortunate indeed were we 

 now to sacrifice the fruit of those considerations, by a premature 

 attempt at systematisation. Indeed, as regards cancerous disease 

 of open glands, special stress must be laid on the fact that every 

 imaginable intermediate stage exists between simple glandular 

 hypertrophy and glandular cancer. Of late years, our know- 

 ledge of these transitional forms has been much extended, and 

 the term adenoma has been proposed for a tumour which is 

 neither simple hypertrophy nor yet cancer. Such at least is the 

 most commonly received acceptation of the word ; some authors 

 raising the denotation cf the term in the scale, while others lower 

 it, the former placing it nearer to hypertrophy, the latter to 

 carcinoma ; and that an^r such shifting should be possible affords 

 conclusive proof of the existence of a graduated scale between 

 the two extremes of simple hypertrophy and cancer. 



A general appreciation of those cancers which spring from 

 the epidermis or the epitlelial covering of mucous membranes is 

 far more difficult. Here too the hyperplastic and carcinomatous 

 conditions are unmistakeably correlated. It is matter of experi- 

 ence, e.g. that those circumscribed hypertrophies of the skin which 

 we call warts and papillonata, ai'e capable of passing into epi- 

 thelial cancer. The transtion, as regards its purely anatomical 

 features, takes place as follows : — The hypertrophy of the papillae 

 occasions a more or less eonsiderable dislocation of the plane 

 along which the epitheliun and the connective tissue are in 

 contact. The steep sides of the overgrown or newly-formed 

 papillse bound deep fissure-like depressions. Accordingly the 



