Some comments and discussion on the paper "The etiology of tumors", read before the Pathological Society of Philadelphia, April 28, 1881 / by H.F. Formad.

  • Formad, H. F. (Henry F.), 1847-1892.
Date:
[1881?]
Catalogue details

Licence: Public Domain Mark

Credit: Some comments and discussion on the paper "The etiology of tumors", read before the Pathological Society of Philadelphia, April 28, 1881 / by H.F. Formad. Source: Wellcome Collection.

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    This, however, does not prove anything for the etiology of primary tumors. It has been shown that if a cock’s spur be transplanted from the leg to the comb it will often grow excessively; another most perfect parallel to transplantations of tumors we have in skin-grafting and in plastic surgery. Other observers, again, impressed with Cohnheim’s idea that tumors arise only from misplaced (heterotopic) cells or tis¬ sues, experimented as follows : ist. Particles of tissues taken from adult animals were introduced into the circula¬ tion and into the interior of organs, but they failed to grow and were ultimately absorbed. 2d. Foetal tissues (particles of embryo¬ nal cartilage, etc.) were similarly trans¬ planted, and they grew and developed to moderate-sized tissue-masses (tumors). Through these results Cohnheim’s prop¬ osition that tumors arise only from mis¬ placed embryonal cells was regarded as proven. But this was too hasty a conclusion, and it appears also that those experiments were conducted very carelessly, as the results could not be confirmed. The exhaustive experiments which Henry Wile made in the pathological laboratory of the University of Pennsylvania (partly quoted in my monograph and partly not published yet) positively prove that trans¬ planted adult tissues grow as well as foetal ones, and never became absorbed in care¬ fully-executed experiments. The results of these experiments surely indicate con¬ clusions far different from those which were derived from the experiments performed in the Leipsic laboratory. As the embryonal theory of Cohnheim depended upon the results of the latter experiments for its main support, it no longer can be regarded as proven, and all the much-dwelt-upon deductions therefrom are wholly unwar¬ rantable. INFLAMMATION AS THE SUPREME CAUSE. Allow me now to review the arguments in favor of, and the proofs for, an inflam¬ matory origin of tumors, as brought for¬ ward in my paper. These are of three kinds: ist, proofs by analogy; 2d, clin¬ ical and statistical proofs ; and 3d, micro¬ scopical proofs. 1. The close analogy of tumors and in¬ flammatory products is strongly in favor of our proposition. Careful study and comparison have shown that no line of distinction can be drawn between true tumors and chronic inflammatory products; in fact, many of the latter are recognized as true tumors. The criterion of true tumors is regarded to-be their tendency to permanency in con¬ tradistinction to inflammatory products, which tend to disappear. The cases col¬ lected and the views of reliable observers recorded in my monograph show this to be incorrect. It has been proven that tumors occasionally heal and disappear. On the other hand, it is well known that only acute inflammatory products tend to dis¬ appear, while many chronic ones never do disappear, and that the symptoms and cause of the latter are frequently less obvious than in the case of tumors. The connective tissue which, in prolifer¬ ating, constitutes the main bulk of ele¬ phantiasis and of the cirrhosis of organs and a good many other pathological tis¬ sues outside of tumors, never disappears.. Virchow properly considers elephantiasis Arabum and soft fibroma morphologically and etiologically identical, and in the same sense he does not admit any difference be¬ tween the connective tissue of an advanced cirrhosis of organs and that of a diffused fibroma. In fact, we are only in the habit of calling a proliferation of connective tissue in the mamma an intercanalicular fibroma, because the connective tissue af¬ fects an external part, while a similar affec¬ tion of the liver or kidney we term an inflammatory one—a cirrhosis. Why should we make such a distinction ? Gummata, tubercles (tyromata), lupus, the well-established products of inflamma¬ tion, are unquestionably true tumors. Lucke observed that sarcomata in young individuals occasionally grow as rapidly as acute abscesses, and have been frequently mistaken for the latter. Tissues which are most liable to be the seat of inflammation are also the most common seat of tumors. Again, those tis¬ sues which do not participate in active inflammatory processes (ganglionic and striated muscular tissue) seldom or never give rise to tumors. The extensive and careful statistics of Dr. D’Espine, of Geneva, show that the os uteri and the stomach are the most frequent seats of primary cancer, and they are also distinguished for their remarkable liabil¬ ity to catarrhs. Virchow has repeatedly