On the origin of cancer / by Alexander Ogston.

  • Ogston, Alexander, 1844-1929.
Date:
[1873]
Catalogue details

Licence: Public Domain Mark

Credit: On the origin of cancer / by Alexander Ogston. Source: Wellcome Collection.

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    nearer the mucous than the cutaneous surface, immediately external to the buccinator muscle'; and, though more distinctly felt from the mucous than from the cutaneous surface, it was more intimately connected with the latter, the mucous membrane being’ loose and displaceable over it, while the skin, although capable of being grasped from the outside independently of the tumour, was felt to be connected with it by a certain amount of induration. The tumour produced a distinct increase of thickness in the part where it was situated, being visible as a prominence on the cheek when looked at obliquely. The skin over the prominence had a faint bluish-red tint, and appeared to the naked eye slightly altered in texture. The glands in front of the ear and beneath the horizontal ramus of the jaw were of natural size. The suspicious history and appearance of the tumour induced us to decide upon its removal, and on the 5th December 1872, she was placed under the influence of ether, and the growth, along with the skin and tissues included between two elliptical incisions directed from before backwards, dissected out and removed. The portion of the buccinator muscle with which it was in contact was removed along with it, but the buccal mucous membrane was not opened, so that the wound communicated only with the cutaneous aspect of the cheek. The supervention of sickness, from her having inadvertently partaken of food prior to the operation, caused some delay in controlling the haemorrhage from three arteries which had been divided ; but these were eventually secured by torsion, and the wound was closed by five silk sutures. On the third day the sutures were removed, the wound was found quite healed upon the fifth day, and she made a very good recovery. On the lltli January 1873, the tumour had recurred in the same situation. It was again removed on the 17th January, and no recurrence is observable up to the present date. Microscopic Examination.—The tumour was hardened in dilute chromic acid, and afterwards sections through its whole extent, including the skin, were examined before and after being tinted in solution of carmine. It proved to be an example of true carcinoma, with a large predominance of the groups of cancer-cells and a relatively small proportion of the connective tissue trabeculae. Examined under a low power, the nucleus of the growth (sec Plate, g) was seated immediately external to the fibres of the buccinator muscle (A, h), and although pretty well circumscribed, was found to have invaded the connective tissue in its vicinity, causing a certain amount of disappearance of the fat-cells (/') filling the alveoli, wherever the invasion had advanced so as to be decidedly evident. Its connexion with the skin was produced by dense connective tissue with cancerous cellular proliferation and pronounced disappearance of the fatty alveoli, so that the low power exhibited one principal and several subordinate bands of indurated and infiltrated connective tissue passing directly between tumour