soft, clear, tremulous, like jelly, scantily supplied with vessels. In structure it presents, in different specimens, varying proportions of fibres, white or elastic, of celloid particles, elementary granules, and fibrillating blastema. In other instances the structure is more firm and resistent, of lobulated aspect, consisting of white filamentous tissue, intermingled with caudate nuclei and cells. In others, again, the intercell substance is firmer, more stiff and amorphous, so that the structure approaches that of enchondroma. Some sarcomatous tumors present a not very distant resemblance to the conglomerate gland structure, their mass dividing into lobes and lobules. To such, the name of pancreatic sarcoma has probably been applied. It is, however, pretty certain, that the same kind of structural arrangement exists in some cancerous growths. M. Lebert has examined sarcomatous tumors very carefully, and designates them as fibro-plastic. By this term, he seems to imply that they constitute a transition stage towards fibrous tumors; and the excellent detailed descriptions he gives of their structure, are, on the whole, confirmative of the same view. Nuclei, circular, and elongated cells, and fibres, make up the chief part of their structure-the fusiform cells being generally the most numerous. It is to be regretted that the tumors he examined were not tested, so as to ascertain whether gelatin could be obtained from them in quantity. If this had been the case, their fibrous character would have been decided. Among the tumors we have ourselves examined, those which seem to deserve best the name of sarcoma, as being unlike either to fibrous and carcinomatous growths, are certain enlarged lymphatic glands, whose structure consisted of multitudes of nuclei, set in a fibroid stromal substance. With these we should class certain separate tumors, entirely new formations, which are rather soft or lax, of a whitish gray or light pinkish color, either smooth on the surface or lobulated, so as to resemble the pancreas. In structure, these are found to consist of myriads of nuclear, with a few celloid, particles, and some trace of fibroid stroma mingled with a large proportion of faintly granulous matter, and more or less oily. These tumors contain notable quantities of gelatin and protein. Generally, we should conceive that a growth, consisting of cells or of nuclei, set in a non-fibrillated homogeneous blastema, would not yield gelatin, but albumen; while one which consisted of fusiform cells or fibres, would have more or less completely undergone the chemical change which an albuminous blastema experiences in passing into the state of gelatinous fibre. The former, we should, therefore, consider to be properly termed a sarcoma, i. e. a simple growth, of like composition to flesh, or the albuminous blastema, effused from the blood, not having attained in its development any very special structural character. In proportion as it passed into the condition of a fibrous tumor, it would lose its sarcomatous character. Cyst formation, combined with sarcoma, constitutes cysto-sarcoma. This is said by Rokitansky to occur in three forms: (1) simple cysto-sarcoma; (2) cysto-sarcoma proliferum, in which young cysts grow on the inner surface of the parent, and are either sessile or pedunculated; (3) cysto-sarcoma phillodes, distinguished by a growth of vascular, laminated, or watery or cauliflower-like excrescences projecting into the interior of the cyst. The structure of these growths

is sometimes more fibrous, sometimes more similar to that of gland tissue. In both cases, the foliated terminal portions are invested by a distinct limitary membrane, within which an epithelium is sometimes discernible. Cysto-sarcomata mostly occur in the female breast and in the ovary.

CANCEROUS TUMORS.

In attempting to give a sketch of cancerous or malignant tumors, we think the best plan will be to take a typical specimen, which presents all the characters of the genus strongly developed, and to point out what these characters are. We shall afterwards notice the several species, and endeavor to show how the distinguishing features gradually become effaced, until the formation, as often happens, is, or appears, almost identical with those of a benignant nature. A tumor, of the species called encephaloid, is certainly the napadelyna of cancer. It is of rapid growth, often attaining in a short time a very large size. Its

Fig. 67.

Encephaloid-The first and the last three of the sets are from the liver, the second is from a bone, and the third from the vertebral column. The great difference of the cell forms is very apparent.

aspect, resembling very closely that of the medullary cerebral structure, has obtained for it the name just mentioned, as well as others of similar import-medullary sarcoma, medullary fungus. Its color is an opaque white, often, however, varied in parts by patches of deep red, from vascular injection or hemorrhage. Its consistence is often so soft, that it seems semi-fluid, and gives the sensation of fluctuation. In structure, it appears on section often almost homogeneous, sometimes with a locular or fibrous arrangement. Microscopic examination shows that the main mass consists of celloid particles and cells, contained in a sparing quantity of filamentous tissue, which forms a kind of stroma. Such a tumor is seldom solitary, but coexists with other similar ones in the same and in different organs. If extirpated, it is sure to return,

and probably diffuse itself more widely than before. It poisons the lymphatic current passing from it, and induces growths of like nature

in the glands which that current traverses. It affects the general system with a peculiar cachexia, marked by languor, emaciation, debility,

and a sallow complexion. It is very apt to infiltrate adjacent textures with its own substance, and, by absorbing their nourishment for itself, to occasion their atrophy; and, lastly, it tends, when exposed, to break

down by a kind of decay, and to pour out profuse, exhausting discharges of serous, sanious, or bloody fluid. Such is cancer in its most malignant form. Of the above-mentioned characters, those which seem to us most nearly pathognomonic, are the tendency to infiltrate adjoining parts, to affect the glands traversed by the issuing lymph-current, to reproduce similar growths in distant parts, and to return after removal. If these

Figs. 70, 71, 72. Cancer-cells before and after the addition of acetic acid, also the structure of the reticulatum from encephaloma of the testicle.

Figs. 73, 74. Young cancer-cells before and after the addition of acetic acid.

four characters are decidedly exhibited by any tumor, there can be scarce any doubt of its malignant nature. It is to be remarked that all these characteristics are dynamic and not structural. They result from the invisible qualities of the new formation; its mode of vegetation, dis

semination, and reproduction, not from any peculiarity of form or arrangement of its particles. Whatever these might be, a tumor, which behaved as we have just described, would proclaim its cancerous nature.

This point we shall illustrate further on. We now proceed to speak of the other varieties of cancer; first, however, noticing the sub-varieties of encephaloid. The name mastoid is given to a kind of firm growth, which is thought to resemble on section the boiled udder of the cow. That of solanoid (potato-like) designates other hard cancers, resembling that vegetable when sliced. Dr. Walshe says they are a pale yellowish, of unctuous crisp look, and almost homogeneous. Milt-like has evidently reference to a soft, pale growth, containing scarce any blood. The surface of a section of Nephroid cancer presents a resemblance to that of a kidney, owing to the peculiar arrangement of its fibres, which are themselves of a delicate gelatinous transparency, so that Rokitansky calls the growth hyaline cancer. The term Hæmatoid expresses a much more important feature than any of the preceding, as it implies that the growth is unusually vascular, is the seat of excessive development of vessels, and perhaps of blood, and is prone to pour out those alarming hemorrhages which often cause fatal exhaustion. When the hæmatoid character is strongly marked, the name of Fungus Hæmatodes is applicable. Melanoid cancer is, in the great majority of cases, encephaloid structure, with the addition of black pigment. The cell-growth of

encephaloid may consist of large free nuclei, of caudate cell-particles, of granulous globules much like those of pus, but unaltered by acetic acid, of cells of most various shapes, often irregularly caudate, and of pellucid vesicles. All these may be mingled in various proportion, or some may constitute the chief mass of a growth. The annexed cut, page 187, exhibits cell structures of various kinds; and for more minute details we must refer to the trustworthy descriptions of Mr. Paget, page 368, vol. ii., of his published lectures.

Scirrhus or hard cancer commonly appears as a knotty, or uneven, pretty distinctly limited, very hard (stony) tumor. Its surface or section is of a bluish or grayish white, and often presents a peculiar glossiness; scarce any trace of vessels is ordinarily visible, except in spots, which are inflamed and softening. The adjacent tissues, especially the skin, when the growth is subcutaneous, are more or less involved, and drawn inwards towards the tumor. In structure, it consists essentially of