Licence: Public Domain Mark
Credit: Lectures on the diseases of women / by Charles West. Source: Wellcome Collection.
Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.
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![ceive as smooth a polish at tlie hands of the lapidary as any f];eo- logical specimen. The growths which proceed from the outer surface of the womb, where nutrition is usually the least active, are those in which this change most commonly takes place. Still the rule is by no means without exception, as a tumour projecting into the cavity of the womb sometimes undergoes this alteration, and beino; at length expelled from the uterus, constitutes the so-called osseous concretions,' the origin and nature of which were once a puzzle to observers. It is, I imagine, almost superfluous to say that these tumours contain none of the elements of true bone, that the change which takes place in them is unaccompanied by the formation of. bone cartilage; that in short it is due to a chemical rather than to a physiological process, and like the so-called ossification of the arteries, is an evidence of enfeebled vitality, not of active nutrition.^ The only other question of importance concerning the pathology of fibrous tumours of the uterus, is that of their relation to malignant disease, and the possibility of their degeneration into carcinomatous structures. Nothing but the imperfect means of observation pos- sessed in former days would have allowed this question to remain so long undecided; but while hard cancer was believed to be a com- mon form of uterine disease, and every induration of the cervix was regarded as scirrhous, it is not surprising that hard tumours should have been believed to be at least of kindred nature. It may, how- ever, be now positively asserted that no such degeneration of a fibrous tumour ever takes place ; and further, that though fibrous tumours do not exclude carcinoma, they are yet not associated together with any special frequency.'' Fibrous tumours are generally regarded, and I believe with truth, as the most frequent of all organic diseases of the womb, though I cannot pretend to state the fact numerically, for the reasons which have been already referred to as vitiating the statistics of hospital practice. Strange as it seems, too, the results of post-mortem ex- aminations are conflicting; on the one hand Ave have the statement on Bayle's authority, that every fifth woman, after the age of thirty- ' There are some good drawings illustrative of these changes in fibrous tumours in Hooper's Morbid Anatomy of the Human Uterus, 4to., London, 1832, plate vii. ^ See on this subject the remarks of Professor Bidder at p. 42 of Walter's Disserta- tion, who believes in the occasional presence of true bone ; while Henle also, Allge- meine Anatomie, p. 809, states that he has discovered cartilage corpuscles in them; a statement which Vogel, in Wagner's Handbuch der Physiologie, vol. i. p. 823, does not corroborate. * Dr. Lee, in his Clinical Reports of Uterine and Ovarian Diseases, relates one case of the coexistence of a calcareous fibrous tumour and malignant ulceration of the uterine cavity, p. 176, Case V.; and one case of the presence of the two has come under my own notice. Cbiari's figures, indeed, would lead to the belief that fibrous tumours of the womb are associated with a special liability to malignant disease, since in twenty-five examinations of patients suffering from them, two presented also cancer of the womb, one cancer of the mamma and lung and six cancers of other organs, op. oil., p. 404. I know of no other data, however, which would lead to tho same conclusion. 15](https://iiif.wellcomecollection.org/image/b21197374_0211.jp2/full/800%2C/0/default.jpg)
