GLANDULAR CAHCINOMATA. 101 



sarcomatous stroma. Its trabeculse are made up of the charac- 

 teristic spindle-shaped cells, and are often so thick, that if we 

 purposely take our section from the denser parts of the tumour, 

 we may have to prosecute our search through several times the 

 diameter of the microscopic field, before we come upon a deposit 

 of cancer-cells. 



As regards malignity, this tumour also takes its place with 

 soft glandular cancer. It is worth mentioning that it may grow 

 to a colossal size. Kidnevs have been met with weio-hinp- ten, 

 and testicles weighing fourteen pounds. 



§ 158. Hard cancer (simple carcinoma, scirrhus, connective- 

 tissue cancer) differs from the two foregoing varieties by struc- 

 tural and evolutional peculiarities of such moment, that many of 

 my fellow-workers will be most unwilling to admit it to a place 

 among glandular cancers at all. As the epithet I have chosen 

 indicates, it is essentially distinguished from those morbid growths 

 which are akin to it by the greater firmness of its texture. 

 The consistency of a cancer depends on the quantitative ratio 

 between the cellular infiltration on the one hand, and the stroma 

 on the other. Hard cancer owes its greater density to the tra- 

 beculse of its stroma being thicker, and the interstices for the 

 cancer-juice smaller, than they are in the soft form of glandular 

 cancer. And yet its hardness varies within certain limits ; its 

 degree being regulated partly by its age and the period of its 

 development, partly by local idiosyncracies. Some hard glandular 

 cancers are of such density throughout that great violence is 

 required to tear them ; they creak under the scalpel (durities 

 eburnea; scirrhus). These cancers are white and glistening; 

 the microscope shows them to be made up of a dense, finely- 

 fibrous connective tissue, which contains the nests of cancer- 

 cells in a comparatively small number of fissures and alveoli. 



More commonly we find softer and harder portions included 

 in the same tumour, and that in a certain definite order ; a hard, 

 central nucleus being env^eloped by a peripheral zone of rela- 

 tively softer — sometimes positively soft — consistency. . Examina- 

 tion with the unaided eye alone is enough to make us suspect 

 some connexion between this arrano;ement and the relative ag-e 

 of the central and peripheral parts. The outermost layer of the 

 tumour (which always occurs in an exquisitely nodular form) 

 consists of a zone of extremely minute, reddish-grey foci, which 



