CAROINOMATA. 459 



surface itself is covered with shreds of tissue, which float when 

 a stream of water is poured over tliem. They are the remains 

 of the cancer- stroma, which resist destruction longer than the 

 cancer-cells. They now become detached, principally owing to 

 the action of the gastric juice, and so give rise to those patho- 

 gnomonic hsemorrhages in which the blood escapes a drop at a 

 time, coagulates forthwith, and assumes a brownish-black tint ; 

 innumerable particles of this altered blood giving the contents 

 of the stomach — the vomited matters — the appearance usually 

 described as resembling coffee-grounds, chocolate, &c. On 

 examining a vertical section through the thickened border of the 

 ulcer, we see how, on the sound side, the glandular layer of the 

 mucous membrane is stretched by the tumour, how over the 

 most prominent part of the raised border its thickness is sud- 

 denly reduced, the glands being as it were compressed at both 

 ends, and the contiguous ones forced asunder. At last the 

 mucosa proper is only represented by an interrupted chain of 

 wasted glands ; between which and the muscular coat, the entire 

 thickness of the cancerous mass, which may attain from four to 

 six lines, intervenes. On the other side of the boundary, the 

 transition to ulceration is effected by fatty degeneration of the 

 cancer-cells. Even the unarmed eye can detect the yellow dots 

 and striae of the decaying cancer-tissue, and trace them all 

 round the floor and borders of the ulcer. The disintegration 

 itself may be hastened by the action of the gastric juice upon the 

 necrobiotic tissue ; at least the process is usually more sluggish 

 in the precisely analogous affections of the uterus, urinary 

 bladder, &c. 



The course of the scirrhus ventricnli is very different. This 

 variety of cancer is far slower in its rate of growth ; starting 

 from the lesser curvature, its favourite place of origin, it suc- 

 ceeds for the most part in extending round the entire circum- 

 ference of the stomach. The submucous and mucous layers are 

 converted into a white, fibroid band, from two to three lines 

 thick, which, wdien the girdle is complete, gives the middle of 

 the stomach the appearance of a rigid tube from one to two 

 inches in diameter, to which the fundus is attached like a loose 

 bag. The microscope shows a very marked resemblance between 

 the arrangement of the epithelial elements and that of glandular 

 epithelium. Not that the cells and cell-nests are either very 



