Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    or columuar when derived from a mucmis membrane, splieroidal when derived from a gland. The alveoli in ■which the cells are contained are by many I'egarded as the lymjjhatic spaces natural to the affected tissue dilated by the invading epithelium. They communicate with one another, forming a kind of cavernous tissue through- out the growth. The stroma siu'rounding the spaces at first consists of the connective or other tissue of the in- vaded parts, infiltrated moi-e or less with small round cells. This small-cell infiltration is ascribed to the irrita- tion of the epithelial invasion, and from it is believed to be later derived the fibrous tissue constituting the dense stroma of some forms of carcinoma. The blood-vessels, which run in the stroma, are numerous in the more rajiidly gi'owing tumours, and esjaecially in the circiunferential parts, but are much fewer in number in the more chi'onic forms, and in the central parts of the latter may be obliterated by the growth of the fibrous tissiie. Hence the frequency with which fatty de- generation of the cells, and breaking down [ulceration) of the older parts of the tumour occur. In the softer or rapidly growing forms, in which the stroma is scanty, and the sup]3ort that the vessels receive from it is consequently but slight, hiemorrhages are frequent. Carcinomata have no capsule, grow by endogenous cell division and continued invasion of the surrounding tissues, and, sooner or later, bri^ak down and ulcerate. They implicate the nearest lym])hatic glands, and finally become dis- seminated. At first the general health is usually but little affected; but later, partly owing to local iilcera- tion and partly to the dissemination of the growth, a con- dition known as cancerous cachexia sets in, the skin becoming sallow and of a peculiar earthy colour, tho face careworn and anxious, and the body emaciated. Tho strength fails, and the patient at length dies of ex- haustion, induced by the general interference with nutrition, local ulceration, hiemorrhages, pain, and mental anxiety. Varikties ok CAUCiNo^rA. — The carcinomata are divided mto two great classes (1) The <icinom or sphe- roidal-cAled; and (2) the epithelial. The acinous, or spheroidal-celled, are further divided into («) the h,ird spheroidal-celled, (/;) the soft spheroidal-celled, and {c) the colloid carcimmia, which is probablv a degenerated con- dition of either of the former. 2. The epithelial arc sub-
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