A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
History
A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
Medicine -- Practice
The seat of the tumor is of importance mainly on account of the
vascular supply of a part and the more spongy or yielding nature of
certain regions. That the more abundant the nutrition of certain
regions of the body, the more favorable the opportunities for growth,
may be admitted without question. The spongy nature of tissues implies
a predominance of cavities over solid constituents. These cavities are
lined by surfaces which represent, on the one hand, the walls of
lymph-spaces, on the other the free surfaces of the body exposed to
the air, as the mucous or cutaneous surfaces and the pulmonary
surface. The rapidity of growth in the direction of the least
resistance is amply shown in the projection of tumors above the
surface of serous membranes and the frequent presence of fungoid
excrescences in various parts of the body.
The growth of tumors extends in all directions, but a distinction has
long been drawn between the concentric or interstitial manner of
growth and the excentric or infiltrating form. This distinction is
based upon the presence of a sharply defined limitation of
pathological and normal tissues or upon the absence of such a
limitation. Such a distinction is merely of relative importance, as
certain tumors may grow in both ways. This is best observed in those
bulging superficial tumors whose base is irregularly extended into the
continuous healthy tissues.
The concentric variety of growth includes those tumors which have
commonly been described as encapsulated, and which are capable of
ready enucleation from their surroundings in virtue of a thin layer of
loose connective tissue lying between the tumor and the contiguous
tissue. Such a capsule represents the matrix, the pia mater, in which
lie the blood-vessels going to and coming from the tumor, and is often
nothing else than the distended and hyperplastic fibrous tissue
remaining after the absorption of the muscular fibres or gland-cells
from the tissues surrounding the morbid growth.
The excentric, peripheral, or infiltrating extension of the tumor
takes place when the surrounding parts are invaded by the active
elements of which the tumor is composed. The amoeboid property of the
cells of certain tumors is well known, and the possibility is
admissible that the indifferent cells of the body, so often
accumulated at the periphery of the growth, become impregnated with a
formative function by the constituents of the tumor. Such amoeboid and
wandering cells represent a means through which the growth of the
tumor may become extended in its vicinity as well as in more remote
parts of the body.
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