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
It is unnecessary to say that the modern classification of morbid
growths owes its foundation and a large part of its superstructure to
Virchow, whose classic work, _Die Krankhaften Geschwülste_, showed the
direction which future investigators were to pursue and the nature of
the discoveries likely to result.
The tumor represents the result of the growth of a tissue or tissues
which are like or resemble those which form the normal constituents of
the body. Although a new formation is present, it is composed of
tissues lying within the possibilities of the individual. A new
formation of feathers, as Virchow suggests, is beyond the productive
powers of human tissues, though within those of feathered animals. A
goose can produce a tumor containing feathers, not one in which hairs
are found; in the human species tumors containing hairs may occur, not
those, however, in which feathers are present. Although the cells of
the tumors of man may deviate in their appearances from the cells of
normal tissues, this deviation is never so extreme that their analogue
cannot be met with in some part of the body.
As the normal tissues originate from pre-existing tissues, so the
pathological tissues of the tumor grow only from the antecedent
tissues. The matrix from which the tumor arises is a normal tissue.
There is produced from it, as a neoplasm, either a tissue which
follows the type of the maternal tissue, a homologous tumor, or one
which deviates in type from that of the matrix, a heterologous growth.
Although the latter differs in its composition from that of the
matrix, it does not vary essentially from a like tissue to be found
elsewhere in the body. It occurs where it does not belong either in
place, time, or quantity. The homologous tumor appears rather as a
hypertrophy of the tissue from which it arises, and the line between
this variety of growth and a simple hypertrophy is often purely
arbitrary.
Although tumors, in the more limited sense, are solid, fleshy masses,
the new formation of tissues may result in the presence of a tumor
within which is a cavity with various contents. Such a cavity is not a
mere hole, but has a distinct wall of connective tissue lined with
epithelium or endothelium. A distinction is thus drawn between cysts
and growths--one which is of daily importance in the practice of
medicine--and Virchow's oncology includes the consideration of the two
varieties of tumors.
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