A manual of the practice of surgery / by W. Fairlie Clarke.

  • Clarke, W. Fairlie (William Fairlie), 1833-1884.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: A manual of the practice of surgery / by W. Fairlie Clarke. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    pain. But if it is allowed to remain, it involves the skin and ulcerates; and the result is an intractable sore, which has somethin<:r of a malitrnant aspect. The only remedy is removal. If circumstances permit, the tumor should be thoroughly extirpated. If it is attached to bone a resection, or perhaps even an amputation, will generally be requisite. BONY TUMORS. A deposit of osseous matter having more or less the characters of true bone, sometimes takes place in the substance of fibrous or other tumors. Again, an enchondroma sometimes becomes developed into bone. But it is more common to meet with osseous tumors springing directly from bone (exostosis). Such growths occur under two conditions—either they are dense in texture, like ivory; or they are composed of cancellated tissue. They will be more fully considered hereafter when we come to speak of the diseases of bones. THE CANCERS—CARCINOMATA. We come now to that group of malignant diseases which is distin- guished by the name Cancer or Carcinoma, and which includes four varie- ties—Scirrhous, Encephaloid, Epithelioma, and Colloid. The cancers are new formations of an epithelial type, and consist of cells, compacted together without any intercellular substance and lying in the spaces of a fibrous stroma. They are heterologous, that is to sa^-, the elements are alien to the situation in which they are found, and they present in a high degree the clinical marks of malignancy—/. c, they in- vade the surrounding structures, they impair the general health, they are apt to return after removal, and they give rise to secondary dejDosits in various j^arts of the body. The cells that are met with in cancers vary much, for they represent all the varieties of epithelium, both when it is fully developed and while it is in process of formation. But if the tumor is examined at a spot where the cells are fully formed, but have not yet begun to undergo re- trogressive changes, it will be found that they are like the epithelium of the part in which the growth originated. Thus the cells may be large or small, regular or irregular in outline. They may be round, or oval, or pyriform, or caudate—the exact shape depending much upon the degree of pressure to which the elements of the growth have been subjected. Some are simple; others are compound, and contain two or three com- plete cells within them, with nuclei and nucleoli. When degenerative changes have commenced—and such changes are very common in morbid growths of this kind—the cells are often loaded with oil-globules and granular matter. All the cancers, inasmuch as they are apt to affect the organs of digestion and assimilation, are sometimes attended by the leaden hue, the emaciation, and the deep dejection to which the older writers gave the name of the cancerous cachexia. But in truth there is no cachexia peculiar to cancer. Some persons suffering from this complaint present a very healthy appearance; while, on the other hand, many patients