Lectures on tumours, delivered in the theatre of the Royal College of Surgeons of England / by James Paget, F.R.S.
- James Paget
- Date:
- 1851
Licence: Public Domain Mark
Credit: Lectures on tumours, delivered in the theatre of the Royal College of Surgeons of England / by James Paget, F.R.S. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
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![LECTURE v.—Part L Fibrous tumours—Their distinction jrom the corresponding outgrowths —General form, connections, investments, and struc- ture of fibrous tumours—Microscopic characters in different specimens—com- binations with muscular and elastic tis- sues, and ivith bone—Formation of cysts, and deposit of lims-salts, constiluting the ^^fibro-cystic and fibro-calcareons tu- mours— /Jisintegration and O'her dis- eases. Particular illustrations of fibrous tumours groining on tendinous or fibrous tissues— /71 the subcutaneous tissue— Tn or upon periosteum and bone—In or about the jaws—In the lobules of the ears—Sum- mary of observations, TsE name of fibrous tumour appeal's the best, among tlie sixteen or more, by which different writers liave described the tumours whose chief characteristic is their likeness to tlic natural fibrous or tendinous tissue of the body. This, at least, seems the best for a general designation ; and to those among them whicli are constructed of more tlian one elementary tissvie we may give such names as fibro-muscidar, fibro- elastic, fibro-calcareous, &c. Tlie most frequent and notorious exam- ples of tlio species ai-o the fibrous tumoiu-s, or fibrous bodies, of tlie uterus ; the hard, flesliy tubercle of tlie uterus, as it was described by Dr. Baillie. From these, chiefly, the general characters of the species may be described. First, the usual distinction must be drawn between the tumom's and the out- growths of the same structure. The uterus presents examples of both. The fibrons uterine polypi, more properly so called, are continuous outgrowths of and from the substance of the uterus ; the mucous mem- brane, and tlie muscular and fibrous tissues of the uterus, growing, in variety of ])ro- portions, into its cavity and that of the vagina. Tlie fibrous tumours, as dis- tinguished from these, are discontinuous growtlis of similar tissue, in or near, not of, the substance of the uterus.* * The distinct on is expressed hy M. Cruveil- • ler (Anatomic I'fitliolo-iqiic) by the terms corps fibreux implanf^^s, und corps fihieiix lion nnplant<:-s ; but the corps til)rcux of tlie brpiist, which were described bv liim, iind hd to the renowned discussion at the I'rench AciuhMny 0 Medicin,., wore, for the most part, mammary fflamlular tumours, and nearly solidihcd pro- liferous cysts. 1 The distinction is often difiicult to make during hfe; for the pendulous, polypoid, and narrow-stemmed outgrowth may be imitated, in all its external characters, by a tumour growing near the surface of the uterus, and projecting into its cavity, with a gradually thinning investment of its muscular and mucous tissues. On dissec- tion, however, the continuity of the polypus or outgrowth, and the discontinuity of the tumour, may generally be discerned, even in specimens which, like two in the museum of St. Bartholomew's Hospital, aiv, in ex- ternal appearance, exactly alike* Similar differences exist among vv-hat are classed together as fibrous tumours of bone or periosteum: some, as we shall see, arc tumours ; some are outgrowths, and the line of distinction cannot be weU drawn. The fibrous tumom*s, of which alone I shall at present speak, appear to have a na- tural tendency towards a spherical or oval shape, with a smooth or supcrfieially lobed surface ; but from these marks tliey often deviate, in adaptation to mutual pressiu'e or the dilferent resistances of surrounding parts. When, for example, a fibrous tu- mour is pendulous, its more dependent portion usually grows most, and it tends fi'om the spheroidal to the pyriform shape ; or when one grows into a cavity, it is apt to assume the shape of that cavity, what- ever it may be, or else to become deeply lobed. Such varieties as these vfre often vseen in the fibrous tumours of the upper jaw, according as they grow uito the an- trum or project into the cavity of the mouth; and greater diversities occur among many specimens of the fibrous tu- mours and polypi of the uterus. The fibrous tumours have usually a com- plete fibro-cellular capsule; and ii^tlie ute- rine walls this is sometimes peculiarly dry and loose, so that when one cuts on the tumour, it, almost of itself, escapes from its cavity or bed. So, too, are covered the fibrous tumours in the subcutaneous tissue and the nerves, and those parts of the fibrous tumours and outgi-owths from bones which are in contact with other tissues than those from which they spring. To the touch, the fibrous tumours ai-o usually very firm, often extremely so ; they may even be as hard and ineom- * Series xxxli., Nob. 12 and 34.](https://iiif.wellcomecollection.org/image/b21475398_0047.jp2/full/800%2C/0/default.jpg)
