192 
ROBERT FORMAD. 
the first and in addition tend to recur after removal and spread 
to other parts, by metastasis or direct invasion, secondary 
particles carried through the circulation or the lymphatic 
channels. 
These two groups of tumors have each their own peculiari¬ 
ties, which can be summed up as follows : Benign.—Have a cap¬ 
sule ; are homologous ; usually poor in blood vessels ; no metas¬ 
tasis ; generally multiple ; may grow very large ; ulcer if exists 
only superficially in the skin-lipoma; do not recur; never kill 
except mechanically ; no cachexia. Malignant.—Have no cap¬ 
sule ; are heterologous ; usually soft and juicy ; rich in blood 
vessels ; give metastasis ; generally single primarly except spin¬ 
dle-cell sarcoma which, may be multiple; primary always 
small; secondary may grow large ; often ulcerates tumors itself 
being involved do recur; kill by destruction of tissue and 
metastasis ; show cachexia—progressive emaciation from lack 
of nutrition. The malignant tumors are represented by the 
various forms of cancer and sarcomas ; all the rest are benign, 
with the exception of the myxoma, which may be either. 
CLASSIFICATION BY SHAPE. 
1. Uniform swelling : Goitre lymphoma Glioma. 
2. Nodes growing centrally (all the benign grow below the 
surface): Fibroma, myoma, lipoma, chondroma, neuroma, etc. 
3. Nodes by infiltration sending roots : All malignant tumors, 
sarcoma and cancer. 
4. Desquamation : Ichthyesis. 
5. Flat tabular swelling: Benign angioma, lymphoma, 
kiliod, malignant epithelioma, squamous and cylindrical. 
6. Hemispherical growth : Multiple fibroma and spindle-cell 
sarcoma. 
7. Tuber : Chondroma, osteoma, chondroma. 
8. Papilla: Horns, corns, chondyloma (pointed). 
9. Fungus rich in color and not covered by skin: Telan- 
giastatic sarcoma and carcinoma. 
10. Polyp or pedunculated growth : Myoma, soft fibroma, 
adenoma. 
