CARCINOMATA. 463 



commonly in its p3'loric part ; indeed it is often localised on the 

 fold of mucous membrane which separates the stomach from the 

 duodenum. In this region it gives rise in succession, to a flat 

 tuberous elevation, a fungoid tumour with a broad base, and 

 finally a polypus ; the latter is often quite spherical, larger than 

 a pigeon's egg, with a relatively short pedicle. In this its final 

 form, the tumour is admirably fitted to block up the duodenal 

 canal, and so, i.e. by hindering the introduction and digestion 

 of food, to cause acute marasmus ending in death, unless the 

 growth is speedily softened and broken up. When this occurs, a 

 smooth excavation is left, in whose edges the further extension 

 of the growth may be traced. And here it is closely related to 

 that adenoma of the alimentary tract which I have described 

 more fully in § 171. 



§ 401. In the lower divisions of the digestive tube, w^e have 

 a soft glandular cancer of the colon, which tends to produce 

 zonular ulcerations with a fibroid and therefore firmly-contracted 

 base, and so to cause stricture of the bowel with its conse- 

 quences. In the same region w^e find a superficial adenoma — 

 a variety w^hich is also met wdth in the rectum {Klehs, Ley den). 

 Squamous epitheliomata of the rectum immediately above the 

 anus, frequently attain a very considerable size as cauliflower 

 growths, before thej^ start from the mccous follicles to invade 

 the deeper parts (§ 166, note 2). 



§ 402. The uterus exhibits a greater liability to cancerous 

 disease than any other part of the urogenital tract (if we class 

 cancroid of the penis among tumours of the skin). A good half 

 of all the cases of so-called uterine cancer are epitheliomata. 

 These originate either from the mucous lining of the cervix or 

 from the portio vaginalis ; in either case, it is long before the 

 boundary-line betW' een the portio vaginalis and the canal of the 

 cervix is overstepped. Cancroid of the portio vaginalis very 

 commonly originates as a soft papilloma, or cauliflower growth ; 

 the transition to deeper parts being effected, as in papillomata 

 of the skin, by the dislocation of the epithelial boundary into 

 the subepithelial connective tissue. Epithelial cancer may give 

 rise to very extensive lesions in the uterus. The muscular coat 

 offers most resistance. When this has given way, the lax areolar 

 tissue between the organs of the true pelvis offers a most favour- 

 able soil for the luxuriant extension of the morbid growth. We 



