CANCER OR CARCINOMA.* In this sub-order we place as a genus the product Carcinoma, containing three species — encephaloid or soft, scirrhus or hard, and colloid or jelly-like, Carcinoma. " The union of these three morbid structures," as we have dsewhere observed, " into a distinct genus, is, in truth, not a mere nosologicai artifice: it is manifest that the formations, to which I thus apply the generic term cancer, possess characters entitling them to be grouped to gether, and separated from all others to the generation of' which the organism is ex posed. They agree anatomically, for they are all composed of elements forming a combina tion without its counterpart, either in other adventitious products or in the natural struc tures: they agree chemically, for...they are ail distinguished by the vast predominance of protein-compounds in their fabric ; they agree physiologically, for they all possess in them selves the power of growth and of extending by infiltrating surrounding tissues, and so producing an appearance of assimilating to their proper substance the most heterogene ous materials,—an inherent tendencyto de struction, and the faculty of local reproduc tion; they agree pathologically, for 'they all tend to affect simultaneously or consecutively various organs in the body, and produce that tlepraved state of the constitution known as the cancerous cachexia." But, on the other hand, these three structures are not one and the same ab initio, as is contended by some writers: each may- be developed in the others ; but encephaloid stands apart from its co-spe cies by containing true cancer-elements in greatest abundance, and in the purest and most unadulterated form, — scirrhus derives speciality from its lavish supply of fibre,— colloid from an unimitated condition of gela tinousness. And, again, we maintain that the three products are not mere varieties, —they are actual species, because each of them, as just stated, has its own constant structural attribute.* The ultimate elements met with in cancer ous Growths are of three kinds,— essential, almost essential, and merely contingent.
(a) The essential elements are granules, cells, fibres, blastema, and vessels. Granules exist to vai ions ampunts in all varieties of cancer ; average -f.0*5-6 of an inch in diameter, and either float free, or are seated within cells, or upon or between fibres. They are composed of a protein-substance, or of fat. The cells of cancer are spherical or imperfectly caudate. The spherical variety (sometimes oval or discoid) measuring, on an average, about Th-o- of an inch, may reach only thew-616u of an inch, or, on the other hand, attain the diameter of 10,-w of an inch, in diameter. The
cells of small dimensions are particularly to be seen in scirrhus, where endogenous cell production is rare ; the bulky class in colloid cancer, where they stand in the relation of parent-cells to a contained progeny of sub cells. The thickness and transparency of the cell-wall vary ; it is sometimes collapsed, sometimes full and tense ; almost always colourless. The caudate variety of cell exhi bits itself under two forms : first, that of an irregularly branched corpuscle, flaying in its interior a spherical cell, itself provided in turn with a nucleus or even containing nucleated. sub-cells ((fig. '98) ; secondly, that of the fusiform cell seen in sarcomatous Growths (seefig. 93, p. 127), and in exudation-matter undergoing development into pseudo-fibrous tissue. The first form of caudate cell is scat tered in an isolated manner through the growth ; the second may accumulate in fasei culated bundles, so as to simulate fibre. (See fig. 93, p. 127.) The contents of cells are a cer tain fluid, granules, nuclei, and sub-cells. Gra nules are abundant in the cells, more especially, of scirrhus. The nucleus of the cancer-cell is an oval, flattened, parietal, comparatively opaque body, generally speaking of large size in pro portion to its cell, and often exhibiting a furrow on its surface or indentation at its edge, (see fig. 6, a. of the author's work on Cancer), a condition preparatory to its split ting into two. Each nucleus is supplied with one, two, or, it may be, so many as four minute bright corpuscles— its nucleoli, which in turn probably contain sub-nucleoli. When a nu cleus splits in the manner referred to, the resultant bodies may be fairly regarded as sub cells,— they are manifestly hollow, granular, and themselves nucleated.* The diameter of the nucleus varies between the .5300 and idoo of an inch, averaging 3.11,:rn of an inch. Fthrt exist under different forms in cancer. First, delicate, non-adherent broken fibrils occur in most specimens. Secondly, true fibrous tissue occurs in the loculus-walls of colloid, and forms the stroma of scirrhus. Thirdly, exces sively delicate, almost transparent fibres exist in a special variety of soft cancer, the fasciculate. The unevolved blastenta of a cancerous growth varies in quantity, and is perfectly fluid, or somewhat viscid. Particles of amorphous substance, gelatinising under acetic acid, may sometimes be found associated with it. The vessels of cancer are either those of the natural structure affected, or are actual new forma tions; they are exceedingly.abundant or very few in number. The veins are frequently plugged with cancerous matter, so as to pre vent them from being injected.