dered necessary. To succeed, in however small a degree, in clearing up that confusion would be a sufficient reward to me for any pains which have been bestowed upon this work, but a far higher object has been in my mind throughout. Hitherto our modes of treatment of Cancer have been confessedly unsatisfactory; and so long as our ignorance of the pathology of the disease prevented us from being able to suggest a reliable prognosis in most cases, the results of the various remedies from time to time proposed could not possibly be fairly weighed; for when a remedy appeared to be successful, there always remained a doubt as to the nature of the tumour treated, and, consequently, of the share of the remedy in its removal. Of course it is not suggested that our difficulties in this regard are as yet in any great degree overcome. Much patient experimental research is before us, ere the truth of the recent views of the local nature of Cancer, as opposed to the notion of a specific blood disease like syphilis, can be either established or refuted. But we have assuredly made great advances in the right direction; and it is not too much to hope that, as accuracy in diagnosis advances, rational and successful treatment may follow in its wake. I am glad to take this opportunity of thanking the Council of the Pathological Society of London for permission to insert in the present work many of the drawings which I originally prepared in illustration of observations recorded in the Pathological Transactions.' HENRY ARNOTT. May 30th, 1872. CONTENTS. Introductory-Necessity for an Anatomical rather than a Clinical Classi- fication of Tumours-The Degrees of Malignancy met with-Local Recurrence-Lymphatic Gland Infection-General Dispersion; various Importance of Examination of Thin Sections--Simplest method by which such Sections may be prepared, stained, and mounted--Value of Scrapings for diagnostic purposes, illustrated by Sketches of CARCINOMA-The diagnostic value of "Cancer Cells"-Definition of Car- cinoma-Its Minute Structure-Stroma-Cells. The stages of Deve- CARCINOMA (continued).-Microscopic Appearances modified by Tissue affected, as Muscle, Bone, &c.-Villous Cancer-Hæmatoid Cancer, or SARCOMA (continued).-Glioma; its Clinical Characters of Malignancy and Microscopical Structure-Melanotic, Osteoid, and other varieties of PRACTICAL SUMMARY.-The Prognostic and Therapeutical Value of the accurate Diagnosis of the Varieties of Cancer-The relative Value in this Differential Diagnosis, of Family History, Age of Patient, Cachexia, Lymphatic Gland Involvement, Adhesion by Infiltration, Pain, and Rapidity of Growth of the Tumour-Table showing these DESCRIPTION OF THE PLATES. With one exception (Plate IV, fig. 2) all the drawings in these plates are from microscopical sections magnified 220 diameters, i. e. viewed with a Powell and Lealand's objective and low eye-piece. PLATE I. -inch FIG. 1.—A thin section from a scirrhous carcinoma of bone. The drawing shows the fibroid stroma with elongated meshes, the cells of an epithelial type, and the absence of visible intercellular material, which are characteristic of carcinoma. At one point the stroma has given way, and some of the cells have escaped. The irregular shape of the cells, with the uniform large oval nuclei and bright nucleoli, are well seen in this section. FIG. 2. Another section from the same tumour, showing the same fibroid stroma (d) and cells (c), but in addition a spicule of bone (a), probably of new formation, containing lacunal cells (6) with rudimentary canaliculi. FIG. 3.-From an ossifying sarcoma of the spindle-cell type. In this portion of the tumour the spindle cells have given place to a smaller round- and oval-cell structure (b), from which the lacunal cells of the new bone (a) are apparently derived. FIG. 4.-A thin section from the edge of the same spindlecell (b) sarcoma, showing the considerable admixture of cells of other shapes (c) not unfrequently met with, and also showing how the muscular fibres (a, a) in the vicinity of the new growth are invaded by it. The genuine infiltration of normal tissues is here as well marked as it is in any carcinoma. The arrangement of the cells, however, the amount of visible substance separating them, and the absence of any fibroid stroma, sufficiently distinguish this growth from carcinoma as shown. in fig. 1. |
