On the structure of cancerous tumors and the mode in which adjacent parts are invaded / by J.J. Woodward.

  • Joseph Janvier Woodward
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: On the structure of cancerous tumors and the mode in which adjacent parts are invaded / by J.J. Woodward. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    40/48 page 34
    from the primary disease? On the other hand if a tumor be extirpated which does not possess the anatomy of cancer; in which no proper cancer cylinders have been formed ; as for ex- ample in the first case of mammary tumor to which I alluded this evening, can we be sure that the growth would not have ultimately acquired the cancerous anatomy if it had been let alone? Can we be sure that it will not, in spite of its timely extirpation, recur and prove fatal? A proper discussion of these important questions, based upon a consideration of all the evidence, would require much time and thought and be a work of no small labor and diffi- culty. Of course it cannot be undertaken in the present lecture. Nevertheless it may not be amiss to state that the general tenor of surgical experience would seem to give a negative answer to both these important questions. With re- gard to the first, the'negative answer is the justification of the operation of extirpation, still so generally resorted to, and the motive for urging operative interference as early as pos- sible. It implies a more or less confident belief in the local significance of the primary lesion, and it is not inconsistent with the circumstance that practicalby the majority of tumors, which on extirpation prove to have the anatomy of cancer, do in fact recur, for the incomplete extirpation of marginal por- tions of the primary growth, or the existence already at the time of the operation of small secondary growths in distant organs, will sufficiently account for this result, without any more violent supposition. On the other hand the negative answer to the second question might have been anticipated on purely anatomical grounds, since it would seem that in every cancer there must be a period when the small-celled infiltration of the connective tissue, and perhaps some increase in the number of the epithe- lial elements of any glandular part involved, is all that has taken place, and whenever this process commences simultane-
    digitised image 1
    digitised image 2
    digitised image 3