form in the uterus and in the bones. The case which he relates of cancer alveolaire pultacé, of the skull is very remarkable, and the representation he gives of it is very interesting. The diseased bones were the frontal, the ethmoid, the inferior turbinated bones, and the vomer. The morbid growth extended both outwards and inwards, and had attacked the mucous membrane of the nose, and the dura mater." 52.

M. Boutin Limousineau analysed the yellow matter from the cells, and found that it contained casiene. A somewhat similar structure was observed by M. Müller in a breast removed by M. Dieffenbach.

"The author obtained the following results* from microscopic examination of carcinoma alveolare of the stomach. If the smaller cells are looked at under the microscope, they are found to contain encased within them many still smaller cellules, which in their turn include others of yet more diminutive size. In the smaller cells the darkish yellow parietal nucleus is distinctly evident. Many cells, likewise, contain mere nuclei, free within their cavity, as cystoblasts from which new cells are to be afterwards developed. The walls of the largest cells are distinctly fibrous, and their fibres run from one cell to another. Twice the author observed rod-shaped crystals in the jelly-like matter of preparations which had been kept in spirit; and on another occasion he saw spindle-shaped corpuscules in the jelly from a cancer alveolaris of the breast.

The history of the development of carcinoma alveolare corresponds exactly to that of the primitive formation of cartilage and of the chorda dorsalis, as described by Schwann. The young cells are produced from cystoblasts, or nuclei developed in the interior of the parent cell; and although the parent cell continues to increase in size, these young cellules by degrees fills up its cavity. At length the walls of the young cells come in contact with each other, and they form together with the parent cell, within which they are encased, one compound cell. Thus, the process of development goes on, till the larger cells on the internal wall of the stomach burst, and pour their jelly-like contents into its cavity.

The fibres forming the walls of the largest cells constitute a nidus within which younger generations of cells are developed. In order, however, to observe the manner in which the cells are encased one within the other, and the relation they bear to their nuclei, it is necessary to examine them in an earlier stage, and before their walls have begun to be split up into fibres.

The main point distinguishing carcinoma alveolare from carcinoma reticulare and carcinoma simplex seems to be, that, in the former the cells continue to grow, and their walls become adherent to each other, while this progressive development and mutual cohesion do not take place in the delicate cellular globules of the two latter forms of cancer."

54.

Carcinoma Melanodes.

M. Müller starts by observing, that melanosis is merely a variety of cancerous degeneration, for it terminates in the same way as carcinoma, and is frequently combined with other species of it.

Carcinoma melanodes is generally lobulated, whether it forms the whole of a morbid growth, or is merely interspersed through the substance of some

*"A short notice of them appeared in an article by Schwann, in Froriep's Not. 1838, Januar. No. 3.

other form of cancer. When it appears in the substance of an organ, it formis masses more or less completely insolated.

66

In

Microscopic examination detects two forms of melanotic structure. both instances the basis of the structure is formed of a fibrous network, the stroma of melanosis, within the meshes of which the melanoid matter is deposited. This matter is generally composed of cells, filled with yellowish or blackish granules. These cells are, and always continue to be free, never becoming coherent. Their forms are very various. Many, indeed most, are round, oval, or irregular; some are elongated; a few actually caudate, terminating at one or both extremities in a point, or in a fibril. Still more rarely the cells present several points. They are real pigment cells:* some of them are of a palish yellow color, others darker, while the interior of others is stained of a dark brown by the granular pigment they contain. It was but seldom, and then only with difficulty, that the author succeeded in detecting, in one of the larger cells, a nucleus with its nucleolus, independently of the pigment granules. The diameter of the cells varies greatly; the largest are more than 0.00108 of an English inch in diameter; while smaller ones had a diameter of 0.00105, 0.00095, 0.00073, 0.00045, 0.00039, or even less, of an English inch." 56.

It has not been ascertained whether the increase in number of the pigment cells depends on the production of fresh ones within the parent cell, or whether new cells are formed external to the old ones.

The pigment globules, continues M. Müller, when very small, display that molecular motion common to all very minute parts, even to the globules of the pigmentum nigrum of the eye. The pigment globules are seen not merely within the cavities of the pigment cells, but also strewn between them, and it is only in the case of these free lobules that the molecular motion is observed. The existence of free pigment granules, external to the cells, is perhaps to be attributed to the bursting of the cells and the extravasation of their contents. Many pigment cells are much smaller than others; probably they are young cells which have been set free by the bursting of the older and larger cells, or possibly they may have been forined external to them. Moreover, many cells, and especially many caudate corpuscules, are of so pale a color, as apparently to be quite destitute of pigment.

In some specimens of melanosis, the author discovered no pigment cells, but all the pigment globules appeared to be free, and dispersed through the meshes of a fibrous tissue. He thinks it probable, that, in these instances, the formative organs of the pigment granules were dissolved, for the latter are always contained in cells.

Carcinoma Medullare.

M. Müller adopts the opinion generally entertained in this country that

A short notice by the author, of the caudate corpuscules in melanosis appeared in Müller's Archiv. 1837, Heft. v. p. 466. Anmerkung. The author likewise made some observations on the pigment cells of melanoid structures in ■ postscript to Schwann's third paper, in Froriep's Not. 1838, April.

fungus hæmatodes and medullary sarcoma are only different designations for accidental varieties of the same structure.

The soft cancer, of the consistence of the brain or of the placenta, may have not merely a whitish or yellowish white color, similar to that of the cerebral substance, or a blood-red hue like the placenta, but it is subject to many other variations of color; and sometimes the same morbid growth will exhibit all varieties of hue in different parts of its sub

stance.

These fungoid growths are highly vascular, but they present, in addition, a medullary mass composed of globules or other corpuscules, and a tissue made up of delicate fibres, in the meshes of which the medullary portion of the growth is contained.

"When perfectly free from other matters, the medullary part of these growths presents a whitish or greyish white color. If a portion of fungus medullaris is cut in pieces and squeezed under, water, the medullary corpuscules, which are very easily soluble, impart to the water a milky hue, more or less tinged with blood. The intensity of the red color of fungus medullaris depends on the relative proportion of blood vessels which it contains; but the bloody patches which are sometimes interspersed through the substance of the structure are in part produced by the effusion of blood into the meshes of its tissue. The brownish hue which the ulcerated surface of fungoid growths presents, is probably produced by decomposed blood.

The external form of fungus medullaris is often lobulated; its appearance when cut or broken varies greatly; sometimes it shews no trace of any definite arrangement of fibres, while, at other times, fibres are indistinctly seen either running parallel to each other, or intersecting each other irregularly, and in some instances displaying a radiated or tufted arrangement. In few cases, however, is this fibrous structure very distinct, for the morbid growth may easily be torn in other directions than in that in which the fibres seem to run; and irregular pieces may often be broken off, though it is not possible to tear off a regular tuft of fibres." 60.

Fungus medullaris usually forms large tumors, but, in some few instances, it presents itself in the shape of a great number of very small ones. It occurs at all ages, and in every organ and vascular tissue. When it appears on the surface of the tubular or flat bones, it receives a slight support from a peculiar skeleton formed of very delicate aciculæ or lamine of bone, which, proceeding in a radiated manner from the surface of the bone, penetrate into the interior of the soft tumor. Yet Sir A. Cooper successfully amputated a limb affected with a fungous exostos's containing such spicula. If fungus medullaris has its seat in the interior of a bone, not merely does it fill up the cavity of that bone, but induces a state of atrophy in the oss‹ous tissue, and reduces the substance of the bone to a mere shell, so that the slightest cause suffices to produce fracture. It rarely happens that the boue is distended in a spherical manner by medullary fungus in its interior.

The relation of medullary sarcoma to carcinoma simplex is shown by the fact that, after extirpation of a scirrhous breast fungoid growths not unfrequently follow.

"This affinity is likewise further illustrated by microscopic examination, which shows that many structures comprehended under the generic term of fungus medullaris differ greatly from each other, and have nothing in common

but the softness of their texture. Several forms, which present no external differences from others, approach very nearly in structure to the most consistent species of cancer, carcinoma simplex, and contain similar cells or formative globules; the softness of their texture being produced by the presence of a great number of these globules distributed through a very delicate tissue. On the other hand, we have seen that carcinoma reticulare, a form of cancer which presents a very peculiar structure, varies in consistence from that of the hardest scirrhus, to that of fungus medullaris. Further, there are varieties of fungus medullaris, the exterior of which presents nothing peculiar or different from other forms, but which shew a great particularity on microscopic examination, appearing then to be formed in a great measure of caudate or spindle-shaped bodies, or of cells, the development of which has been arrested, while in the intermediate state between cells and fibres. At first, cne might be tempted to separate this form from the rest, under the name of carcinoma closteroides; but more extended investigations prove that this division would be unwarrantable, for cases are met with in which, although the medullary part of the morbid structure is composed principally of formative globules without caudate appendages, yet caudate bodies do occur in greater or less number among the round corpuscules. It will hereafter be seen that this variety of internal structure is met with also in the case of innocent albuminous sarcoma, which is sometimes composed of cells, while at other times, it consists of caudate and spindle-shaped corpuscules so arranged as to produce the appearance of an imperfectly fibrous structure."

63.

M. Müller accordingly employs the term fungus medullaris collectively for different forms or stages of development of soft cancer; referring to this genus the following varieties:—

1. Carcinoma medullare, abounding in roundish formative globules which make up the greater part of the medullary mass, though intersected by a delicate fibrous network. These formative globules, M. Müller regards as very similar to those of common cancer, and to those which constitute the grey mass of carcinoma reticulare: a few points, or very minute granules, were often all that could be detected in their interior, but frequently, on making use of a high magnifying power, a nucleus may be seen just as in other forms of carcinoma. The size of these globules is about the same as in common cancer, though it presents great varieties.

2. Carcinoma medull re, with an exceedingly soft cerebriform base, composed of pale, elliptical bodies, without caudate appendages. The author is acquainted with but one specimen, which he can refer to this class: it was a case of cerebriform fungus medullaris of the foot, and of the interior of the tarsal bones. With the exception of the vessels which were distributed to the diseased ma s, its substance was almost entirely formed of uniform ellipsoidal corpuscules, which cohered but very slightly with each other. These corpuscules had a very pale hue when looked at under the microscope; they were one-and-a-half or twice as large as the red particles of the blood, and equalled them in breadth. The author in no instance observed a fibril proceeding from these bodies, nor did he ever see a single nucleus or a young cellule in their interior. A few very minute points were all

that could be detected by the highest magnifying powers.

3. Carcinoma medullare, with caudate or spindle-shaped corpuscules. Sometimes, on tearing a piece of this kind of fungus medullaris, the torn surface will present a resemblance to a fibrous structure. This appearance is owing to several of the caudate corpuscules being arranged in one direc

tion; as was observed in a case related by Valentin. The author has seen a similar structure in several sp cimens of fungus medullaris; sometimes interspersed in the midst of round, formative globules, at other times forming the greater part of the growth.

M. Müller goes on to state:-"According to the direction in which the caudate corpuscules are disposed, a radiated appearance is sometimes produced, at other times the structure seems more tufted, while, in other instances the direction of the corpuscules is so various, that the tumor does not display the slightest trace of fibrous texture. It is, indeed, not always easy (even when the caudate bodies are so disposed as to occasion a fibrous appearance) to tear the growth into tufts of fibres, although irregular portions of it may be broken off very readily. Frequently, however, the caudate corpuscules are arranged with great regularity. Their interior presents the appearance already described, namely, it contains ither a granular substance without any evident nucleus, or a nucleus with one or more nucleoli may be more or less distinctly seen. These corpuscules are prolonged at one or both sides, and in some rare instances at more than two sides, into fibrils of different length. They are cells, the dev lopment of which has been arrested in the stage of transition from cells to fibres."

M. Müller observes that, since so many fibrous tissues in the embryo are formed from caudate cells, there is evidently nothing extraordinary in the occurrence of caud te corpuscules in morbid growths of very different physiological tendencies; in the innocent, as well as in the malignant; and, consequently, no inferences can be drawn from their presence with regard to the character of the structure in which they occur. The only guide, he says, which remains is afforded by the tendency of cancer to interfere with the natural structure of surrounding parts, while those formations which are of a benignant nature leave the neighbouring healthy tissues unalt red. The caudate corpuscules being formed from round cells, the occasional coexistence of round cells with nuclei, and of caudate corpuscules in the same medullary fungus, is not surprising. In all cases of medullary sarcoma fat is present in the shape of fat globules which are free, and not enclosed in cells.

Some structures ranked as fungus medullaris, though soft, are fibrous in their texture. This is evident on breaking or dividing them.

"If examined under the microscope, they display neither the cellular globules of other varieties of carcinoma, nor the caudate corpuscules which give a fibrous appearance to some forms of fungus medullaris. The fibres often have a tufted arrangement, running in a divergent course from a common centre; in which case the masses may be rent into radiated bundles, the apex of which is directed towards their point of insertion, their base towards the uneven surface of the tumor. Or, some of these tufts of fibres are arranged in one way, some in another, large masses of fibres forming but one tuft, while in other places they are divided into many; and all of these bundles of fibres are intertwined with each other, as is seen on attempting to tear their tissue. In this case, the tumor very frequently forms lobules of various sizes, both externally and in its interior. Between the lobules are membranous septa, from some one of which a tuft of fibres springs, and, after running for some distance, curves over, and