Page images
[graphic][merged small]

Papillary adeno-sarcoma of rectum, 240 diam.; stroma, highly embryonic; this section rather thick. Notice similar white bodies in other acini. The area with ring around it is more highly magnified in Plate II.

[graphic][merged small][merged small][merged small]

A portion of Plate I., more highly magnified; protoplasmic bodies in nuclear area of epithelial layer. The "Plimmer Bodies" are the swelled elements. Next in size are the round cells; then the oval epithelial nuclei. a, Connective tissue round cells. b, One of the three large protoplasmic bodies. C, Epithelial nuclei. d, One of the small free granules.

logical relation of these bodies to the growth is made on the ground that all parasitic tumefactions are inflammatory, even the coccidia disease in the liver of rabbits, which results later in inflammatory tissue. Paget refers to analogy of morbid growths upon trees, the result of inoculation by insects or deposition of their ova; and here the question of inflammatory origin again presents itself. Allan J. Smith, in a paper before the Pan-American Medical Congress in 1893, shows drawings presenting all the forms shown by Gaylord. Schüller has been observing similar bodies for two years, and says the best zoölogic and botanic authorities in Berlin have been unable to decide their nature. He has made successful inoculation experiments. Roswell Park says Schüller's bodies are like Gaylord's, but Schüller himself denies this. Sjöbring claims to have successfully cultivated an organism of a coccidian nature, resembling Russell's bodies, and from these he has produced tumors in white mice. Leopold and y. Leyden insist upon the mycelioid character of the bodies found by them, but all observers find their parasites in the same location-at the growing margin and in general carcinosis-a fact which is significant. Regarding Sanfelice's saccharomyces neoformans, Gaylord has made and inoculated cultures of this, and, like others, has never produced anything but granulomata or mesotheliomatous growths, and has never reproduced in the experiment animals (nor has Sanfelice) anything resembling Plimmer's or Russell's bodies; and Gaylord says they bear no etiologic relation to cancer whatever. It must be admitted that to positively prove the parasitic origin of a disease the parasite must be inoculated from a subculture, and it must produce the same disease in the experiment animal; but the plasmodium was accepted as the cause of malaria ten years before it was demonstrated in the stomachs of mosquitoes, and it seems that too much zeal is displayed in the effort to discredit the discoveries so far made. Furthermore, Gaylord always finds embryonic forms in the blood of cachectics, and has succeeded in inoculating animals therewith.

Abnormal cell proliferation is said to be evidence of the autogenetic theory,yet non-cancerous epithelial cells refuse to multiplyin abnormal situations; and, in fact, all the arguments of the opposition are far more flimsy than the ones they condemn. It is more likely that the parasite, invading the cell, arrests its further development and deprives it of practically all the functions except that of reproduction. Many interesting theories are advanced along this line, but we have no time to stop to consider these. Adami calls attention to the fact that if the parasitic theory of cancer is proved we are in a quandary as to the cause of benign and semimalignant growths, since the histologic line of demarcation is by no means sharp. This is exemplified by the photomicrograph (Plates I. and II.) which I here show you. The growth was from a person, aged 20, who had had rectal papilloma protruding into the lumen and showing no tendency to invade the deeper tissues and which had been repeatedly removed. There is nothing in the epithelial arrangement to suggest malignancy; but the stroma is very embryonic, showing no definite (mature) basement membrane. The nuclear region of the epithelial lining shows numerous large bodies which are spheric, like plasma cells, and are apparently small mucous cysts; but some of them contain from one to four highlystained small bodies, about the size of Plimmer's bodies, or smaller than round cells. I am not prepared to say what they really are, as, indeed, I would not insist that this papilloma is malignant, though this is my opinion.

Plate III. is from a cancer of the kidney, and the enlarged picture, Plate IV., shows epithelia completely studded with small bodies of varying size and some free ones which were displaced by dismounting the section for restaining for the photograph.

In the few malignant epithelial growths I have had the opportunity to examine since the publication of Gaylord's article I have found in the cleared alcohol teasings pictures that I never dreamed existed in carcinoma, and it would be a great comfort to know that they could be relied upon for diagnosis. I present a slide of scrapings from a mammary cancer, showing reddish bodies of varying size, which are not fat, because some were treated with ether without affecting them. They are uninfluenced by osmic peroxide. I have not yet tried Sudan III. cn them. Everything presented in connection with this paper is from stock slides and unfavorable for demonstration. The sections are too thick to make good photographs, nor were they stained with this object.

I think we are at least justified now in discarding the old idea of non-communicability—another example of the harm done by the dogmatic ignorance of medical men, as in the case of leprosy and other transmissible diseases, just because we could not produce immediate results by simple contact with the infected indi

[graphic][merged small]

Cancer of kidney, showing the ". Plimmer Bodies” within epithelial cells. Note differtnt sizes of the minute spheric bodies in the clear spaces-x 240 13 obj. 7 feet, in ocular.

[graphic][ocr errors][subsumed][subsumed]

Some cells from Plate III., enlarged, showing bodies resembling Russell's and Plimmer's—x720. a, Size of red cell for comparison.

« PreviousContinue »