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JUDGES: DANIEL LEWIS, A.M., M.D., New York, President of the New York

State Board of Heaith; Professor of Special Surgery, New York Post-Graduate Medical School; Surgeon to the Skin and Cancer Hospital; Editor o!" The Medical

Review of Reviews." CHARLES A. L. REED, A.M., M.D., Cincinnati, Ex-President

American Medical Association; Ex-Presideat American Association of Obstetricians

and Gynaecologists; Feliow British Gynsecological Society. JOHN EDWIN RHODES, A.M., M.D., Chicago, Associate Pro

fessor Diseases of the Chest, Throat and Nose, Rush Medical College; Former Professor of Physical Diagnosis and Clinical Medicine, Northwestern University Woman's Medical College.

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Vol. XXIV.

NASHVILLE, JULY, 1902.

No. 7.

Original Communications.

THE ETIOLOGY AND PATHOLOGY OF MALIGNANT

TUMORS.*

BY WILLIAM KRAU88, M.D., MEMPHIS, TENN.

This subject is entirely too great to be handled successfully in a ten-minute paper, and it will be necessary to confine ourselves to a very few points in the most recent literature, which is becoming daily more voluminous. Unfortunately, investigators in the parasitology and transmissibility of malignant tumors have arrived at some very contradictory results, and their claims are met by the adherents of the autogenetic theory by citing the very facts upon which the parasitologists lean. Andrews has collected 7,881 cases of primary carcinoma, all of which were upon exposed surfacesi. e., subject to infection; but it might be claimed by the irritationists that this is the best evidence of their mechanical (traumatic) origin. Briefly, all the arguments of the one side may be

*Read before the Medical Society of the State of Tennessee, at Memphis,

April 9, 1902.

used by the other--viz., physiologic resistance, heredity, location, trauma, locus minoris resistentiæ, homologous character of cells, etc.

Among the most noteworthy recent works of the parasitologists the foremost is the very classic article by Gaylord in the June (1901) number of the American Journal of the Medical Sciences. What has struck the present speaker most forcibly is the apparent harmonizing of the most discordant points of other investigators, as shown by a profusion of most perfect photomicrographs, showing bodies very like some I have photographed from section in stock in my private collection. Gaylord makes the statement that carcinoma is a parasitic disease due to a protozoön which he has found in all cases of cancer examined by his method, and reproduced the same therewith in experiment animals. Hektan, who in à review of the progress of pathology in Progressive Medicine in March, 1902, briefly alludes to all recent observations made in this line, says the whole structure of Gaylord crumbles because he has failed to cultivate the organism artificially and made his inoculation with an unfiltered ascitic fluid which might have contained proliferating epithelia.

I think Hekton's critique too severe, because Gaylord specifically states that he used the sedimented fluid, and his photomicrographs seem to show that the carcinoma in the lung of his guinea pig is derived from the epithelia of the bronchi and air sacs, and is, therefore, homologous to the guinea pig, and not to the man from whom the fluid was taken. This is the strongest refutation of the autogenetic theory, for the favorite peg upon which the autogenetists have hung their arguments is that metastases were of cells homologous to the original site. The bodies (protozoa) were also found in the blood, spleen, and enlarged lymph glands of the experiment animals; and Gaylord is certain that the young forms of his parasite are identical in morphology and tingibility with Plimmer's bodies and Russell's fuchsine bodies, and he further shows that this is only a stage in the development of the parasite, which seems to explain why these were not uniformly present in all carcinomata. Schüller's parasites are said by Gaylord to be identical with his also.

Gaylord is not the discoverer of this protozoön. Virchow long ago called attention to bodies in cancer cells analogous to the pro tozoa in molluscum contagiosum, the physaliphora. Pfeiffer, in 1888, found protozoa, sporozoa, and microsporidia in a case of carcinosis. One of the strongest arguments made against the etio

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