Lectures on nutrition, hypertrophy, and atrophy : delivered in the Theatre of the Royal College of Surgeons, May 1847 / by James Paget ; reported by William S. Kirkes.

  • Paget, James, Sir, 1814-1899.
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on nutrition, hypertrophy, and atrophy : delivered in the Theatre of the Royal College of Surgeons, May 1847 / by James Paget ; reported by William S. Kirkes. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    longing to the part, or are healthy perfect tissues, however highly organised the part enlarged may be. And this at once distin- guishes them from the direct products of a morbid process, for a highly organised tissue is very rarely, indeed, formed in a diseased process. Such an instance, however, I have now to meution ; and in this a tissue is produced by disease, which appears to be even more highly organised, and is of more complex structure, than that in whish it is formed. The case I refer to is that of ovarian cysts. These, you know, often contain fatty matter or tissue, hair and teeth, and other organised structures, either attached to thin walls, as if growing from them, or lying loose in their cavities. But, till Dr. Kohl- rausch* examined them with the micro- scope, it was not, I think, known that the fat and hair are produced in a truly cu- taneous structure growing on the inner sur- face of the cyst. In thisf, and in other specimens, I have had opportunity of veri- fying his observations, and of finding, as he describes, that (as in the diagram) the pro- minent substance in which the hair grows is really a piece of skin, having a well orga- nised, tcugh, and thin layer, like the firm outer layer of cutis ; that this rests on true * Muller's Archiv, 1843, page 365. t Prepar. 164a, in the College Museum: de- scribed at page 69 of the Pathological Catalogue, vol. i. Other portions of the same cyst are pre- served in preparations 165a and 165b. adipose tissue, arranged like the subcuta- neous fat of the common integument; and that the cutis thus formed is covered by well-organised epidermis, and contains em- bedded in it hair-follicles and sebaceous glands as well formed as on the proper integument. He adds, that it also contains sweat glands: but these I have not seen. This specimen existed in part of a very large multilocular cyst, the other divisions of which contained some fatty matter and loose hair; others, various fluids : others, secondary and tertiary cysts. And this is commonly the case ; the cysts are so large when they come to be examined, that we cannot tell their origiu. But here is one*, a virgin ovary, with a cyst, the small size of which, as well as the structure of its walls, and the mode in which they are connected with the sur- rounding substance of the ovary, leave no doubt that it is a simply enlarged Graafian vesicle. Yet it contains a small mass of fat, exactly resembling the subcutaneous fat, with its tough fibro-cellular partitions. So, then, we may conclude concerning these cysts, that they are Graafian vesicles, enlarged and diseased, and yet retaining that marvellous formative energy which, even independent of impregnation, and under only morbid excitement, can produce in them well-formed tissues, which may bring to perfection growths imbedded in them. * From the Pathological Museum of the Col- lege of Surgeons.