The surgeon's vade mecum : a manual of modern surgery / by Robert Druitt.

  • Robert Druitt
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: The surgeon's vade mecum : a manual of modern surgery / by Robert Druitt. Source: Wellcome Collection.

    12/894 page 8
    illustrated with an engraving, are somewhat abridged from the Letters from Madras/' The chapter on tumours has been very extensively revised with the assistance of Mr. Parker, surgical registrar to the London Hospital, and assistant surgeon to the East London Hospital for Children, who supplied the new engravings of each kind of tumour. I may observe that, ever since the introduction of the microscope as a general means of diagnosis, a conflict has been maintained as to the nature of the worst tumours. Some of the more enthusiastic microscopists adopted what we may Call a substantial, or material, view. They taught that the malignity of some tumours was due to th^ presence of a special substance, called the cancer cell, of un- known origin and alien nature, which invaded, supplanted, and destroyed the natural tissue of the affected organ, and produced the ten kinds of mischief which are enumerated at p. 83, as the signs of malignity. Others, on the contrary—especially those who take the view of things which the Greeks call empirical, and we call practical—refused to acknowledge any specific structure as exclusively cancerous, and looked upon malignity as functional— as a perverted mode of growth, which might infest any tissue in any organ, and, starting thence, be propagated over the whole economy;—the real difference being, not structure, but mode of growth. Most cancers are now believed to be overgrowths of epithelium which penetrates, infiltrates, and devours the neigh- bouring tissues beyond its normal range. Hence has arisen a curious change in the use of terms; whereas very lately the microscopists contended that epithelioma (of the lower lip, for instance) was not cancer, because no new strange and foreign structure was found in it, but only normal epithelium in a state of overgrowth, so now pathologists are inclined to consider all cancer of secreting glands as epithelioma. In the large variety of sarcomatous tumours, they see the same tendency to overgrowth and infiltration of the embryonic elements of areolar tissue as is witnessed in the epi- thelial class of cancers. The student will notice Mr. Parker's classification of malignant tumours, according to the nature of the tissue of which they are exaggerations, and may indulge in the hope that a few more years of patient labour will furnish us with consistent and harmonious views of this once mysterious class of diseases. I have also to record my obligations to Mr. Parker, who served as surgeon in the Prussian wars of 1866 and 1870, for much infor- mation on the subject of gun-shot wounds; and it will be seen that
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