[ 62 ] 
The close resemblance to hepatic cells of the cells of the growth the; 
absence of any alveolar structure and the non-implication of the glands are 
all in favour of an Adenoma rather than of a true Carcinoma. The growth 
clinically is Malignant to a high degree. 
Classified according to the nature of the growth as determined by 
microscopic examination. There were Adeno carcinoma or Malignant 
adenoma, 5 in each case of the Liver. Carcinoma, 2. One of stomach and 
one of the pancreas. Sarcoma, 1. Granuloma of the Stomach, 2. 
The Adeno-carcinoma of the liver is certainly the commonest malignant 
growth here. Three similar specimens in addition to these mentioned have 
been sent to me, and most of the Medical practitioners know of other cases.i 
Sarcoma is more common than my figures would indicate. I have received 
in addition a specimen of Fibrosarcoma of the male breast from Dr. 
McClosky. An enormous mass weighing 40 lbs. was removed by an 
Assistant Surgeon at Kwala Kubu from the abdomen at a post-mortem 
examination and was sent to me by Dr. Delmege. This tumour did not 
involve the abdominal viscera and appears to have been omental in origin. 
It was lobulated, contained much fat and several irregular cysts containing 
blood or altered blood and varied greatly in appearance in different parts. 
In parts the structure myxomatous and in others it was more the type of a 
spindle celled sarcoma. I here were in other places strands of dense fibrous 
tissue and of imperfectly formed cartilage. There was no ossification. It 
was one of the mixed sarcomatous abdominal growths and had been steadily 
increasing in size for some months. 
1 he two cases called “ granuloma ” are of a type new to me. In both 
the mucous membrane of stomach was extensively involved. The mass of 
the growth was imperfectly cicatrised and superficial ulcerated in places. The 
edge of the growth was raised slightly nodular and sharply defined from the 
unaffected mucous membrane. I he cicatricial tissue was hard and inelastic 
so that the stomach retained its shape when removed from the body. There 
was no deep extension of the growth. The glands were not involved and 
there were no secondary growths in other parts of the body. In one of the 
cases the whole of the mucous membrane of the stomach was involved and 
the growing edge extended into the oesophagus and duodenum respectively. 
In the second the pyloric half of the stomach alone was involved. 
Microscopically the grow r th was a round celled mass with outlying' 
smaller masses not sharply defined. These scattered portions of the growth 
were found in the cicatricial tissue and in advance of the growing edge: 
which was entirely composed of the grow T th. 
No tubercle or other bacilli were found in the depths of the growth and 
there was no evidence of syphilis. 
Specimens of Peritoneal Malignant growth in a dog and in a fowl were: 
sent to me by Mr. Ford. In both cases the growths were extensive and 
were sarcomatious in structure. 
General Conclusions .—Our main knowledge of diseases is of those 
imported into the States and of indigenous diseases as they affect imported 
races. 
Effective quarantine combined with notification of infective diseases and! 
local action are the main points on which to rely against the further impor-| 
tation of disease. In certain cases the effect of other measures should be tol 
render conditions unsuitable for the spread of disease if imported. Amongst! 
such measures a water supply free from chance of contamination will hinder) 
