MARTIN — DISCUSSION ON CARCINOMA. 



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that in the formor the results arc always irritative, inHaimnatory and 

 destructive, in the \f*^\ r purely prolitVirntive. To these views, how- 

 ever, can be opposed the autliority of e(|nally eapalih^ patholo<^ists, 

 who insist on the neoplastic nature of such niala<li(!s even as fcuhercu- 

 losis. The bacilli once havinj]f found a restinj; place nianifitst their 

 presence at once by a new jjrowth of cells, i\w tubercle, and only sub- 

 sequently do we get degekierative chan{j;es. It is praetically the same 

 in many other diseases, such as leprosy, where the earliest evidence of 

 the presence of bacilli in the vessels is manifesteri not by an inHam- 

 mp.l/ion, but by a hyperplasia of the neij^hboiu'in^' tissues. As a result 

 of the hyperplasia true tumours form chieHy in connection with nerve 

 endings, while degenerative processes may be (piite absent. Hut a yet 

 more striking analogy between cancer ami infective proccisses is seen 

 in actinomycosis. It is true that heie an irritation is .set up by the 

 advent of the fungus, but on the otlier hand so great is the prolifei'a- 

 tion of cells and bone formation in the jaw that before its parasitic 

 nature was understood, its structure was looked on as being that of 

 an osteo-sarcoma. 1^'rom tlie primary seat m<'tatases can spi-eatl to 

 any part of the body, the first evidence of their presence in the 

 newly-infected region being a multiplication of cells in the vicinity. 

 But whereas it may be argued that in these in.stances the inHamma- 

 tory conditions are primary, there are tumours formed by parasites 

 where no sign of irritation exists. Such is the case in typhoi' fever. 

 The lymphomata sometimes founil cm the serous coats of the intes- 

 tines, in the liver and elsewhere, are essentially neoplasms induced by 

 the action of the typhoid germ. 



In passing I would refer also to Hodgkin's disease, now classed by 

 most pathologists among the infective maladies, for ther<', too, non- 

 intiammatory neoplasms likewise occur. 



But there are examples approaching still nearer to our subject, 

 inasmuch as it is evident that in some instances an animal parasite 

 (i. e., one more nearly allied to the supposed parasite of cancer~> can 

 induce a hyperplasia of cells, a true tumour not running the ordinary 

 course of inflammation. In chronic malaria the almost constant result 

 of the parasitic infection is to produce in the spleen an enonnous over- 

 growth in itfl essential cells and the fibrous stroma surrounding them. 



It would seem, then, from what has been said, that parasites are 

 quite capable of inducing overgrowths of tissue purely hyperplastic 

 in character. 



And further, it is known, that in some at least of the infectious 

 disebses the parasites select chiefly certain cells for their habitat dur- 

 ing a part at least of their life history. In malaria the blood cells 



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