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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    proper cells, it may also in part be due to transformation of the elements of the normal tissues, similar to the primary transformation out of which the carcinoma had its origin. And there was always doubt regarding the origin of the stroma or framework of carcinoma. A few years ago, I think Ribbert first maintained, from the examination of much earlier specimens of carcinoma of the skin than had previously been submitted to pathologists, that the microscopic anatomy of continuous sections of these early growths does not support the theory of the derivation of carcinoma from the extension downwards of the normal pro- cesses of the epidermis. The very youngest carcinoma of the skin consists of cells which resemble in many respects the cells of the epidermis, and which may lie in contact with the processes of the epidermis, but which cannot be shown to be derived from the cells of the epidermis. On the contrary, the cells of the carcinoma may invade the processes of the epidermis, may change their shape by pressure, and may lead to their destruction, but the carcinoma cells are neither trans- formed into normal cells, nor can they be shown to be derived from the normal cells. This view is now held by many pathologists, and is maintained by our Director, Dr. Bashford, and his assistant, Dr. Murray. To illustrate it I have copied drawings and diagrams of Ribbert and Borrmann for car- cinoma of the skin, and of Bashford for carcinoma of the tongue.* The second modification is even more important, and it also is supported by the observations of our research: that the growth of carcinoma depends on the growth and repro- duction of its own proper cells, and does not depend on transformation of the neighbouring cells into carcinoma cells. Our Director confirms this view from the examination of carcinoma of different varieties in different parts of the body. There is no transformation of the normal cells of the adjacent parts, whether these be squamous or columnar or spheroidal. They may be thrust aside by the carcinoma cells, or undermined, or atrophied, or actually destroyed, but they are not transformed. The growth of the disease is due to the multiplication of its own proper elements. There is a third matter on which our Director has been working and has made authoritative statement: the origin of the stroma or framework of carcinoma. This has frequently been discussed; but our pathologists have watched its development day by day in carcinoma which has been inoculated. They tell us that it is derived from the con- nective tissue of the part in which the carcinoma grows, and does not depend on transformation of the carcinoma cells. Whether the stroma is formed as a result of “ irritation ” pro- duced by the presence and progress of the disease ; whether it is disposed and arranged in this manner or in that manner in obedience to an influence exercised by the carcinoma cells, as was suggested many years ago by Ballance and Shattock,3 I do not know. * In this connexion it is very interesting to study the third plate of Thiersch’s atlas, which is intended to show the origin of cancer of the skin from the processes of the epidermis. Two of the figures show precisely the same relation of the growth to the surface epithelium as that which is exhibited in Ribbert and Borrmann’s drawings, and might be used for their purpose. But it either had escaped the observation of Thiersch or had been differently interpreted by him.