Carcinoma is a parasitic disease : being the Bradshaw lecture delivered before the Royal College of Surgeons of England / by Henry T. Butlin.

  • Butlin, Henry Trentham, Sir, 1845-1912.
Date:
1905
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Licence: In copyright

Credit: Carcinoma is a parasitic disease : being the Bradshaw lecture delivered before the Royal College of Surgeons of England / by Henry T. Butlin. 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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    along them of the multiplying cells of the tumour, which have gained access to them at some point where the walls are weak or broken. The frequent occurrence of secondary masses in glands, and lungs, and liver, and in other organs and tissues; each mass composed of cells so like in shape and character to those of which the primary tumour is made up, that there is no doubt of their source, so like that the nature of the primary disease may often be determined with- out fail from an examination of the secondary growths. The occasional occurrence of tumours in the lungs due to the detachment of small masses of cells which are carried in the air stream, and deposited in the smallest bronchi, and which are composed of cells precisely similar to those of the primary disease —All these phenomena are at once clear to us. We can understand not only why these secondary growths occur, but, in a manner, why they fail to occur. The condi- tions are not favourable to the activity and multiplication of the cell. And, bearing in mind the tenacity of life with which the cell is endowed, we may assume that although the condi- tions are not for the moment favourable to the active life of the cell, they are yet not so unfavourable as to destroy it, and that it may lie dormant in the parts to which it has gained access during long periods of time, until the conditions become more favourable, when it resumes its activity, and multiplies as if it still formed part of the original tu mour. Thus we can understand why the occurrence of secondary tumours in the glands and other organs is sometimes so long deferred. We can appreciate something of the conditiors on which depend very late occurrences of carcinoma in glands and other organs which take place years after the suc- cessful removal of the primary disease, and which have always been a puzzle to us. During those long years the cells have probably lain dormant, not dead, but sleeping, until what we are pleased to call “ some chance ” awakens them from their torpor, puts new life into them, and enables them to prosper and multiply exceedingly. More than once I have seen carcinoma thus lighted up in glands long after it ought naturally to have occurred, and just when we were beginning to hope that all danger was at an end; once by exposure of the side of the neck to a cold draught during several hours, and more than once by an attack of in- flammation of a salivary gland, within or in the immediate neighbourhood of which the lymphatic glands were placed. We can understand why our operations fail and why they succeed. Tne surrounding tissues are already widely infil- trated by the parasite in the one case, and we have not cut beyond it; or it has already gained access to some gland or distant organ. In the other case, it is less vigorous and active, and having gained but a poor foothold on the tissues of the host, has been easily and effectively removed. The action of destructive agents is just as intelligible: it is a question of complete destruction. As certain tissues and organs of the host receive the wander- ing cells coldly, as if they would only harbour them and give them shelter, so we may assume that there are tissues and organs of the host which are not suited to the support of the cell, and which never can be rendered suitable ; and that there are other tissues and organs which are only suitable at certain times and under certain conditions. And, as these