opposition. When we compare the treatment of the Bar and of our own profession, we cannot but be struck with the enormous distinction which a minister makes between those who can and those who cannot brawl for the purposes of party. Is it ever to be thus ?

I. ON THE NATURE AND

CANCER AND OF THOSE MORBID GROWTHS WHICH MAY BE CONFOUNDED WITH IT. By J. Müller, M. D. Professor of Anatomy and Physiology in the University of Berlin, &c. Translated from the German, with Notes, by Charles West, M. D. Graduate in Medicine of the University of Berlin. Illustrated with numerous Steel Plates and Wood Engravings. Part I. Sherwood and Co. London, 1840.

II. CYCLOPEDIA OF PRACTICAL SURGERY, Part VI.-CANCER. By W. H. Walshe, M.D.

IN the last number of this Journal we took up the work whose title stands first at the head of this article, and introduced to our readers that part of it, which treats of Carcinoma. We now turn to the second division of it, appropriated to some of those morbid growths which may be confounded with Carcinoma-Enchondroma-Adipose Tumors-and Compound Cystoid and Cystosarcomatous Growths.

I. OF CARTILAGINOUS TUMORS, OR ENCHONDROMA.

M. Müller remarks, that the term Chondroid has been applied to many morbid structures which differ essentially from cartilage. He proposes to describe under the name of Enchondroma, or Chondroma-true chondroid growths possessed of the characters to be described.

1. General Description of Enchondroma.

"Enchondroma," says M. Müller, "is a fungoid growth proceeding from bones, or from soft parts, as, for instance, from glands, and curable by amputation. It forms a spheroidal, not lobulated tumor, which equals or even exceeds the size of the fist. When it appears in soft parts, it is furnished with a thin covering, resembling cellular tissue; in the bones, where its occurrence is more frequent, it retains the periosteum as its investing membrane. This disease presents itself as a soft expansion of the bone, developed either within its interior, or more rarely, from its periphery. In the former case it is covered not only by the periosteum, but also by the bone itself, which is sometimes expanded to an extreme thinness. In some instances, indeed, this bony shell is not entire, and its only remains are a few thin isolated bony lamine on the surface of the tumor. When the growth springs from the circumference of the bone it does not necessarily have any osseous investment. The articular surfaces of the bones are usually but very little altered by this disease, often they are not at all affected, and

even in instances where the phalanx of the finger has been converted into a round tumor as large as an orange, the articular surfaces are in most cases unchanged in structure, and maintain their proper position. How great soever may be the expansion of the bone, the disease seldom advances beyond the articular surface, and if two neighbouring phalanges of a finger form this expansion, the two tumors very rarely become confounded with each other. The occurrence of anchylosis also is unusual, though it took place in a case of enchondroma described by Mery.

The parts covering the enchondroma generally remain unaltered, notwithstanding the large size to which the tumor may attain. This circumstance, together with the slow, painless development of the tumor, and its existence for ten or twenty years without producing any injurious effect on the constitution, sufficiently prove its benignant character. The contents of the tumor are soft: when it is developed in or on the bones small spiculæ of osseous matter are usually intermixed with its tissue, although their presence is not constant. The parenchyma of the growth usually displays, when divided, two different constituents, distinguishable with the naked eye; the one a fibro-membranous sub. stance, the other grey, pellucid, and resembling cartilage or very firm jelly. The fibro-membranous part, which is but seldom absent, forms cells both large and small, some equalling or even exceeding the size of a pea; and the larger cells often containing smaller ones in their cavity. Within these cells is contained the other substance, which is grey, somewhat pellucid, differing from cartilage in being more soft, and more nearly resembling in consistence the soft hyaloid cartilage of cartilaginous fishes: in some instances, indeed, it is not firmer than very firm jelly. These masses are easily removed from the cells, and are then found to be very friable. Like the hyaloid cartilages of cartilaginous fishes, this substance preserves its pellucid character in alcohol. The intervention of membranous structures connects the transparent cartilaginous masses, and imparts to enchondroma a conglomerated appearance, which does not occur in any other form of exostosis. The slight inequalities which may be seen on the surface of an enchondromatous tumor indicate this conglomerated structure of its interior." 99.

The fibro-membranous part, proceeds our author, appears, under the microscope, to be composed of an interweaving of transparent fibres; the hyaloid mass, however, so closely resembles cartilage, as to suggest to the author the name he has applied to this form of tumor. Real cartilage, even that of the cartilaginous fishes, contains, scattered through its substance, oval or round semi-transparent cartilage corpuscules,* and cells containing granules, or smaller cellules; and precisely such microscopic corpuscules are contained in the hyaloid mass. But, how similar soever to cartilage the hyaloid mass may appear, when viewed by the naked eye, or by the aid of a microscope, yet the fibro-membranous capsules or cells which usually intersect the whole of the tumor distinguish its texture from that of true cartilage. These membranous structures contain blood-vessels.

M. Müller has seen many specimens of enchondroma both in Germany and England. The bones are the most frequent seat of it. In only four out of thirty-six cases, was it found occupying the soft parts. In all of these four cases the parts affected were glandular structures, namely, in one

* “These bodies were first observed by Professor Purkinje, in human cartilage, and were described by him in a dissertation by Deutsch, De penitiori ossium structura observationes, Vratisl, 1834."

instance the parotid gland, in another the mammary gland, and in the remaining two the testicle. The bones most subject to this disease are the metacarpal bones and the fingers: in fact, five-sixths of the cases of enchondroma in the bones have occurred in those parts. Three cases were observed in the leg, one only in the thigh, one in the os ilium, one in the basis of the skull, and one in the ribs.

2. Different Forms of Enchondroma in the Bones.

Enchondroma affects two forms-one, the more common, a central one, developed in the interior of the bone, and accompanied with expansion of the osseous shell-the other, on the surface of the bone, unattended by expansion of the bony shell.

A. Enchondroma of the Bones with Osseous Shell.-This is by far the more frequent form in the smaller cylindrical bones, in the metacarpal and metatarsal bones, and in the phalanges of the hand and foot. The first changes are softening of the spongy substance in the interior of the bone, the place of which is occupied by the soft mass of enchondroma. While this process is going on, the shell of the bone becomes dilated, as though from the action of some internal force. This distention, however, can be the result only of some change in the nutritive process, for the attenuated shell does not break, but long maintains its perfect continuity. In proportion as the old bone is destroyed, new bone is deposited on the surface of the tumor, and thus the shell of the bone is the subject of a constant alteration. The progressive growth of the new substance in the interior of the bone dissolves here and there the continuity of the bony shell; and in course of time this shell is reduced to a few thin isolated laminæ on the surface of the tumor, which still retains its smoothness, and spheroidal shape.

It seems dubious whether Sir A. Cooper has described this form of enchondroma under the head of cartilaginous exostosis of the medullary membrane. M. Müller, however, expressly cautions us against confounding fibrous tumor from the interior of the bone with enchondroma.

B. Enchondroma of the Bones, without Osseous Shell.-In some bones in which the spongy tissue predominates, enchondroma occasionally becomes developed from their exterior without being invested with a bony shell-as from the pelvis, cranial bones, and ribs. The tumor is, in these instances, less regularly spheroidal, and its surface less smooth, displaying an agglomeration of rounded bodies, some larger than a pea, others smaller, which are cells containing a soft, grey, cartilaginous mass. The whole tumor is made up of a conglomeration of such cells. The preparation in the museum of the College of Surgeons, in London, labelled, "cartilaginous tumor formed on a man's ribs," is of this nature. The museum of Saint Bartholomew's Hospital contains (Morbid Preparations, eighteenth series, No. 14) a specimen of enchondroma of the basis of the skull. In the museum of the Middlesex Hospital is an immense mass growing from the inner surface of the ilium, which presented the structure of enchondroma.

The larger cylindrical bones are also sometimes liable to the exogenous form of enchondroma, especially if that growth is developed in parts where

the spongy structure abounds, as in the upper end of the tibia. In such a case, the tumor may be destitute of osseous shell. A preparation of this sort (Morbid Preparations, first series, No. 41) is contained in the museum of Saint Bartholomew's Hospital.

The museum of Guy's Hospital contains a preparation, numbered in the catalogue 666*, and called an osteo-sarcoma. It is an enchondromatous growth, without a bony shell. Sometimes this growth appears on the leg, encased within a bony shell, at least the examination of two dried preparations in the museum at Berlin seems to warrant this conclusion. In some rare cases of enchondroma of the phalanges of the finger, the tumor is destitute of bony shell, as may be seen in two preparations of enchondroma, in the museum of Guy's Hospital. M. Müller thinks it evident that what Sir A. Cooper describes as cartilaginous exostosis between the periosteum and bone is only ordinary external osseous exostosis with cartilaginous animal basis.

3. Microscopic Examination of Enchondroma.

The minute structure of enchondroma corresponds exactly with that of cartilage, and all that the employment of high magnifying powers has brought to light with regard to the latter substance, has been confirmed by examination of the former. But it resembles more the cartilage in the embryo than in the adult. In most cases cells with nuclei only are seen; the presence of secondary cells is more rare. Usually the cells are in close contact with each other, and there is no sign of development of intercellular substance, though, in a few cases, a clear substance may be distinguished between the cells. Here and there bundles of fibres are visible.

"The size of the cells," continues M. Müller, “exceeds several times that of the red particles of human blood. The nuclei, which have a diameter of 0.00032 to 0.00042 of an English inch, are sometimes round, at other times oval or irregularly elongated. The nucleus appears somewhat flattened, but its form is often very irregular. In addition to the nuclei, corpuscules are seen here and there, of an irregular form, furnished with spiculated appendages, often of considerable length, and similar to the spiculated osseous corpuscules described by the author. Occasionally these spiculæ extend over a whole cell, or even further. In most instances, enchondroma remains stationary at that stage of development which cartilage attains in the embryo, and presents an almost entirely cellular structure. A very firm and hard cartilaginous tumor of the testicle, however, which once came under the author's notice, showed a very high degree of developinent in the intracellular cartilaginous mass, and closely resembled the natural appearance of those cartilages in which the cellular structure is not per

manent. 109.

4. Chemical Analyses of Enchondroma.

A. Enchondroma of the Bones-If, says M. Müller, portions of enchondroma of an osseous structure are boiled for ten or eighteen hours, they yield a considerable quantity of gelatine, which forms a jelly immediately on cooling, but differs completely in its chemical characters from ordinary gelatine, or colla; while it coincides exactly with the peculiar gelatine which the author has discovered in cartilage, and to which he has applied the name

of chondrine. The author detected it first in enchondroma, afterwards in the permanent cartilages. M. Müller proceeds to offer a description of these two sorts of gelatine.

1. Colla, common glue, the gelatine obtained from tendons, membranes, bones. The characters of this kind of gelatine are well known, and it is also a fact familiar to all, that isinglass differs from ordinary gelatine, or glue, only in being more soluble in alcohol. Its behaviour to the common chemical reagents we need not stop to consider.

This kind of gelatine is extracted, by boiling, from the skin of man or of beasts, from tendon, from fibro-cartilage, from the inter-articular cartilages, from cellular tissue, serous membranes, and from the cartilages of bones after they are ossified; but is not obtained from the permanent cartilages, nor from those of the bones previously to their ossification. The same kind of gelatine was likewise obtained by boiling from enchondroma of the parotid gland: enchondroma of the bones, however, and of the testicle, became resolved by long boiling into cartilage gelatine, or chondrine.

2. Cartilage gelatine, chondrine.-This matter exists in the permanent cartilages, with the exception of the tendino-fibrous cartilages; in the cartilages of the larynx, in those of the ribs, and of the joints, and in the cornea; all of which yield it if boiled for ten, fifteen, or eighteen hours, and become wholly converted into it if boiled for a sufficiently long time. A concentrated solution of chondrine is less coloured than a solution of common glue. A solution of it, like a solution of common glue, solidifies in cooling, and forms a clear jelly; if evaporated to dryness, the matter is less brown than ordinary glue. Though chondrine is capable of forming a jelly, though it swells up when moistened with cold water, and is dissolved by hot water, just like ordinary gelatine, and though infusion of gall nuts, chlorine, alcohol, and corrosive sublimate produce the same results with both, yet the former is differently affected by alum, by sulphate of alumina, by acetic acid, acetate of lead, and sulphate of iron. All these matters precipitate chondrine, while they do not produce the slightest effect on ordinary gelatine. These precipitates are not soluble either in hot or in cold water, though they may be dissolved by an excess of the solutions of alum or of sulphate of alumina, which ought therefore to be added only drop by drop to any fluid from which it is wished entirely to separate the chondrine. Evaporation of the filtered fluid will shew when the chondrine has been entirely separated; for the fluid then ceases to gelatinize, and, indeed, contains only a minimum of animal matter. Hence it is evident that the presence of chondrine is the cause of the gelatinization of a solution of permanent cartilage, and that chondrine is not contained in it in addition to gelatine, as a sort of subsidiary constituent. We have not space for the elaborate account of the chemical properties of chondrine furnished by M. Müller, nor for the distinctions between it and caseine. Nor can we pur sue our author in his hypotheses on the exact relation between colla and chondrine, and on the causes of their differences. It is certainly true, as he remarks, that among the most remarkable chemical changes which any tissue undergoes, are those which ossification produces in the cartilages of bones. According to the author's observations, cartilage becomes changed during this process from chondrine into gelatine, and this metamorphosis takes place alike in healthy and in morbid ossification. The cartilages of