Hxmorrhage into the substance of the growth is a condition occasionally observed. Andral has noticed it, and we have seen a tumour containing a clot of considerable size.
Numerous small cavities are occasionally observed in these masses filled with red, and manifestly bloody, serosity ; doebtless blood in an altered condition. These accumulations saturate and disintegrate eventually much of the solid substance.
Like all vascular structures, these growths are occasionally seized with inflammation — the hard variety much less frequently than the soft. This occurrence may be announced by severe local and general symptoms, increased by the participation of the surrounding tissues. The products of inflammation exuded into the substance soften and disintegrate it ; pus of pure character is rarely observed however. The tendency to inflammation is extremely slight, inherently, in these formations ; when it occurs, it arises as a secondary consequence of their mechanical action on surrounding parts. This action produces various derangements of function of those parts, which are followed in them by irritative action, eventually spread ing to the adventitious mass. The proof is, that growths so seated as not to lead to irri tation of adjoining textures (sub-peritoueal pedunculated uterine tumours, for example) never, so far as our own observation and all recorded experience goes, become the seat of inflammation. We do not, however, mean to deny that in tumours of soft texture and abundantly vascular, an intrinsic process of in flammation may not possibly arise. Sphacel us may be the result of the former kind of inflam mation ; but this change, according to our ob servation, very rarely occurs with its ordinary anatotnical characters.
Melanie colouring matter is sometimes de posited in abundance in these growths. Dr. Carswell (Elementary Forins of Dis. Melano ma, pl. 1.fig. iv.) has figured a very beautiful and characteristic specimen of this kind.
The softer species of fibrous mass has in the uterus been sometimes found to contain steatomatous matter and hair.
Krull has given a rough sketch of a uterine fibrous tumour, the central part of which con tained vessels, some of them capable of ad mitting a pen, and said to present somewhat the characters or " erectile tissue"—a term very' vaguely used. - Different notions have been held as to the possibility of fibrous tumours "becoming can cerous." The difficulty in deciding this ques tion has arisen from the total want of definite meaning in the minds of authors as to what constitutes " becoming cancerous." If the phrase be applied in the manner which seems the only rational and sound one, that is, to parts, whether adventitious or not, in which the development of one Or the other of three species of cancerous formation occurs, the perplexity of the question vanishes at once. The growth of cancerous substance in fibrous tumours is, in truth, at the least, materially more rare than in any natural vascularized tissue. We have never ourselves seen a particle of true scirrhus, encephaloid or colloid, in the interior of a fibrous tumourproper. The assertion of Du puytren and certain of his copy ists, that fibrous tumours frequently become carcino matous, is easily explained : they confound the fungative and intractable sores sometimes arising on the uterine surface and adjoining sub-mucous fibrous tumour, with cancerous disease—applying the term, with a vagueness subversive of all correctness in morbid ana tomy and in pathology, to every sore resist ing treatment and affecting the constitution by its discharge and irritative agency. As well
might they call the fungating sore, produced in the tongue or cheek by a carious tooth, a cancer.
The total expulsion of fibrous tumours from the body, is a phenomenon of less uncommon occurrence, than is usually supposed. It is effected while the mass possesses its original fibrous constitution, or after its conversion into earthy matter : the process in the latter case is much simpler than in the former, as the organic connections of the mass have been gradually destroyed in the manner already referred to; it is likewise of much more fre quent occurrence. While yet fibrous, the growth may be expelled as a single mass or piecemeal; more rarely in the former way. The conditions necessary for its accomplish ment are, that it should be separated from its connections, and, this once effected, that it should be so seated as to drop from the body spontaneously, or be under the influence of some expelling force. In the case of the uterus, the expulsive efforts of the organ lead to the removal of the masses (especially if seated under the mucous membrane) at a much earlier period, than their mere anato mical state would lead us to expect. The museum of University College contains a portion of fibrous tumour, expelled from the uterus in this manner ; submitted to micro scopical examination, we found it composed of precisely' the elements already described.
The constitution of these growths would lead us to expect their local reproduction, if partially removed. Observation confirms this view. Cruveilhier describes, from the prac tice of Dupuy tren, a case of fibrous tumour growing from the interior of the body of the lower maxilla, in which reproduction took place twice after imperfect removal with the knife.
The simple tissues in which fibrous tu mours are observed are : the cellular ; the fibrous ; rarely, if ever, the osseous properly so called ; the nervous. The compound tissues and organs in which they are more or less frequently developed are : — the bones, in immediate connection with the endosteum, or more especially the periosteum; the sub mucous tissue of the pharynx, more rarely of the cesophagus, of the stomach and intestines; the subperitoneal tissue; the submucous tis sue of the larynx, the nares, the frontal and sphenoid sinuses ; the sub-pleural tissue ; the arterial tissue ; the ovaries; the Fallopian tubes ; the uterus ; the vagina ; the mamma ; the testicle ; the dura mater in its subjacent cellular tissue; the nerves ; the thyroid gland; the thymus gland. Of these various parts, the uterus, dura mater, ovary, and maunna suffer, especially the two former, with incomparably the greatest frequency,. A single one, or several fibrous tumours may exist in the same body. Usually numerous, for example. when affecting the dura mater; they are commonly single in the bones. Their coexistence in several distinct organs is extremely rare.