a blastema, or basis substance, more or less advanced in fibre-development, in which very various forms of cell-growth are imbedded. Of the latter, it is utterly impossible to give any general account, except to correct the common idea that they are of fusiform shape, they may be bare Fig. 79. Portion of the section from a carcinomatous tumor of the breast; consisting of fibrous tissue and cysts, inclosing cancer-cells and granules. A compound granular corpuscle is also visible. Fig. 80. Another portion of the same section treated with acetic acid. The fibrous tissue is rendered more transparent, and elongated nuclei are visible scattered through it. The nuclei of the cancer-cells are unchanged, while their walls are transparent. A compound granular corpuscle is seen at the upper part of the figure. Fig. 81 Cancer-cells from the cream-like juice squeezed from the tumor. Numerous granules, and a compound granular cell, are seen. Fig. 82. The same, after the addition of acetic acid.-From Bennett. nuclei, cells of most various aspect, vesicles; granular globules; with these oil and diffused granulous matter are mingled in varying quantity. Glomeruli are often seen in fattily degenerating, or in inflamed parts; and parent cells, containing a secondary generation, are occasionally present. The disposition of the fibres is very various, sometimes parallel Fig. 83. Dense fibrous and elastic tissue, in which cancer-cells are infiltrated from cancer of rectum. Fig. 85. The same, after the addition of acetic acid.-From Bennett. to each other, sometimes radiating, often crossing at right or acute angles. An alveolar arrangement sometimes exists; it proceeds, according to Rokitansky, from the development of the parent cell. Scirrhus yields some gelatin on boiling; less albumen and oil, but more saline matter, are contained in it than in encephaloid. The growth of scirrhus is slow, the more so in proportion as its fibrous element predominates; it may then exist long without inducing the constitutional cachexia, or reproducing itself in any distant part, or even affecting the lymphatic glands. The most common seats of scirrhus are the female breast, the pyloric extremity of the stomach, the rectum; it is usually the original formation in these or in other parts; but gives rise to secondary encephaloid growths. A tumor of this kind does not, even when most defined, possess a true cyst; often, it extends itself by infiltration among adjacent tissues. It rarely attains a large size, it is not often seen so large as an orange. Various names have been given to some peculiar appearances occasionally presented by scirrhous tumors; of these, we shall only mention the napiform, applied to certain tumors whose cut surface presents a number of concentric lines, resembling those seen in the interior of a turnip; and the apinoid, or reticulated, in which spots or streaks of an opaque oily matter are apparent upon a grayish field, and thus occasion the appearance of separate patches, or of a network. It is ascertained that this latter condition indicates a commencing fatty change. The surface of an ulcerating cancer is irregular, of a grayish or faint reddish aspect, covered with a thin watery sanies, or with a layer of sloughing detritus; the margin of the surrounding skin is commonly elevated and everted. Colloid cancer, the next variety we notice, is also called alveolar; other cancers may present more or less of an alveolar arrangement, but it never constitutes the prominent feature of their structure. The walls of the alveoli consist of a fibroid tissue, sometimes extremely delicate and translucent, sometimes, and especially in the deeper layers, strong and firm. The contained loculi vary in size from that of a grain of sand to that of a pea; they are round or oval; occasionally adjacent ones communicate together by solution of the interposed wall. The jelly-like substance in their cavities is of a greenish yellow, semi-transparent, and clammy; "it yields no gelatin on boiling, but seems to consist of a peculiar substance, identical with that naturally occurring in the cavities of the thyroid, and in some cysts. Cells, nucleated and non-nucleated, caudate, and fusiform, nuclei, and elementary granules, occur in this substance, and, under circumstances probably connected with softening changes, granule-cells, and fat-molecules. Endogenous production of the cells within parent-cells is sometimes observed. Colloid may present itself as a distinct solitary tumor," or may infiltrate the tissues which it infests, when it occurs on serous membranes; there are often small scattered nodules of the growth in the vicinity of the larger. Rokitansky mentions the two following varieties of colloid: (1.) The contents of the loculi increase, so that their septa are in great measure atrophied and lost, and the mass presents the aspect of a tremulous jelly. (2.) The superficial alveoli enlarge considerably, and attain a prodigious size. The favorite habitat of colloid is the stomach and omentum; it also occurs in the ovaries, the bones, the kidneys, the uterus, and the spleen. Its growth is often rapid, and it may attain a very large size, exceeding that of a cocoa-nut. The contents of the alveoli are sometimes of pearly aspect, probably from the presence of cholesteatomatous matter. Cruveilhier has described an areolar pultaceous variety, in which the loculi contain an opaque, yellowish, tallow-like matter, having the chemical constitution of casein. we believe, with Rokitansky, to be a condition in which fatty transformation of the gelatinous matter is taking place analogous to that noticed in reticular scirrhus. Colloid may exist combined with scirrhus, and also with encephaloid; in the latter case, the superficial loculi become occupied by soft encephaloid matter. The malignant This character is less marked in colloid than in the other kinds of cancer; it does not induce such marked cachexia, does not reproduce itself in distant parts, does not contaminate the lymphatic glands, and is less prone to softening and decay, or to inflammation and saniation. Epithelial cancer seems only recently to have been admitted among the varieties of this disease; it is not mentioned by Dr. Walshe in his elaborate work, and yet its cancerous nature in many cases is unequivocal and strongly marked. It occurs almost solely on tegumentary or mucous surfaces, the lips and cheeks are among the parts most commonly affected by it. Rokitansky mentions having once observed it in the liver, and Dr. Bennett has met with it as a secondary growth in the Fig. 88. lymphatic glands. On mucous surfaces it appears as a cauliflower-like growth, of a more or less red tint from vascular injection, of various degrees of consistency, and easily separated into parts by press ure. On the general tegument, its appearance is most often that of a low, tolerably well-defined tumor, of hard feel, having an irregular nodulated surface, covered with minute watery papillæ; when ulceration and softening take place, the surface becomes injected, a watery and serous discharge is poured out, and gradual destruction of the part proceeds. In structure, these tumors essentially consist of an alteration of the integument, the corium and subcutaneous Epithelial cancer. d. Cancer-cells Appearance of section of cancerous tumor of the cheek. a. Epidermic scales and fusiform corpuscles on the external surface. b. Group of epidermic scales. c. Fibro-elastic tissue of the dermis. infiltrated into the fibrous tissue, and filling up the loculi of dermis. (From Bennett.) areolar tissue being converted into a fibroid substance, the papillæ greatly hypertrophied, as well as the epithelium resting upon them. In the last specimen we examined, which was from the lower lip, a vertical section displayed an external whitish layer, about one-third inch thick, marked by vertical striæ, and resting upon some areolar tissue, fat, and muscle. Its surface showed but slight traces of subdivision. Its extent in depth appeared to be most accurately limited by the lower margin of the whitish striated layer, but, upon examination, the areolar tissue immediately subjacent, and for some depth, was found thoroughly infiltrated with nuclei and granular matter. Sections of the altered integument showed papillary elevations, completely overwhelmed and blended together by an enormous growth of scaly epithelium, which, in some parts, showed a tendency to fatty change, and here and there the capsulating arrangement mentioned below. If glands exist in the part affected, their epithelium may also accumulate within their canals, and thus add to the size of the tumor. One peculiarity is very commonly observable in the arrangement of the cells of epithelial cancer, which does not seem to occur in other growths; this is, that here and there the scaly particles are arranged in lamellæ around a central circular space, which appears to be a largish cell, containing a younger cell-growth. The malignant character of epithelial cancer is manifested in its extending from the superficial textures first involved to the deeper seated, even to the bones; the laryngeal cartilages have often been involved by it. It seems, however, to have less tendency to contaminate the lymphatic glands, and the system generally, than other varieties of cancer. Rokitansky describes a variety of cancer, which he calls villous, from its consisting of a kind of delicate fibrous stalk branching at its end into villous processes, with somewhat bulbous terminations. These contain encephaloid substance, and are extremely vascular. Hemorrhage often takes place spontaneously from them, and is easily excited by the slightest lesion. The only specimen at all corresponding to this which we have examined, was one of cauliflower excrescence of the uterus: it was not in a suitable state for accurate Fig. 90. Epithelial cancer-four of the loculi are shown, and some of the flattened cells, one of which is curved, having probably been arranged round a loculus. investigation, but we saw that it consisted in great measure of large vessels, covered with a thick layer of lowly organized cell-growth. Rokitansky mentions a case of this kind, in which the growth sprang from an evidently encephaloid base. A cystic growth sometimes occurs in combination with one or other of the species of cancer, chiefly with encephaloid: the cysts may be simple or compound. The cysto-carcinomatous growth is usually of large size. There may be, probably, other varieties of cancerous tumors, or, to put it otherwise, tumors possessing more or less of cancerousness; but we have now sketched the outline of the principal forms that are usually met with, and we feel convinced that it is far more important |