1905.] On the Cytology of Malignant Growths. 



337 



observations seem to throw light on those matters. We are fully aware that 

 in pursuing such a course, we lay ourselves open to the charge of incom- 

 pleteness, and of unduly neglecting the views of others. But an attempt to 

 deal at all adequately with the vast literature that has grown up around the 

 subject of cancer would involve a very lengthy, and probably not a corre- 

 spondingly fruitful, discussion. 



We further propose to confine ourselves to a consideration of carcinomata, 

 and we do not intend to deal with sarcomata at this juncture, since we have 

 enjoyed far fewer opportunities of examining growths of this class with 

 anything approaching to completeness. On the other hand, we have been 

 fortunate in securing a large number of carcinomata of very different ages, 

 for which we are indebted to the kindness of several London Surgeons and 

 others. We also desire especially to acknowledge our indebtedness to the 

 Committee of the Imperial Cancer Kesearch Fund for a grant in aid of our 

 investigations. 



We have been able to study extremely early stages in cases of cancers of 

 the rectum, scrotum, penis, lip and tongue. A similarity in all essential 

 features was plainly apparent in the history of the cellular evolution of each of 

 these growths respectively. It will, therefore, be sufficient for the purpose of 

 this paper, and it will also conduce to brevity, if we continue our account, 

 especially to one of them, merely premising that it represents a type to which 

 the rest really conform in all essential details of interest in the present 

 connection. "We will, therefore, select as our chief example a very early case 

 of rectal epithelioma. This was not only a very young, but also a very 

 actively proliferating growth, and it was preserved immediately after excision 

 (see Plate 8, fig. 1. This is also to be compared with Plate 9, fig. 2, which 

 illustrates a young growth of epithelioma of the penis). 



For the sake of clearness it will be useful to give a short preliminary 

 description of the mucous and subjacent layers of a healthy rectum as they 

 appear under high magnification. The boundary of the lumen of the gut is 

 composed of a large celled columnar epithelium, the elements of which are 

 generally set one row deep upon the basement membrane. The latter is 

 formed from the connective tissue and other elements of the submucous layer. 

 All over the interior surface of the intestine the mucous epithelium is 

 produced outwards into folds that bound correspondingly finger-like cavities, 

 the latter forming the so-called crypts of Lieberkukn. As seen during 

 ordinary states of activity, the epithelium is composed of elongated cells, 

 each consisting of a mass of granular protoplasm in which a large nucleus is 

 situated. The position of the latter in the cell is subject to individual 

 variations. Amongst these resting cells are others in which the cytoplasm 



