M. Lebert on Cancer.—M. Lebert, the author of the well-known
work on Cancer, lately read a paper before the Surgical Society of Paris,
on Fibro-plastic Tumors. Thg principal facts and conclusions brought
forward by M. Lebert are the following :—
1.	Fibro-plastic tumors are composed of a cellular texture of new
formation, similar to that seen in embryonic life. Fibro-plastic tissue
may have an inflammatory origin, it may be the result of hypertrophy,
or arise quite spontaneously.
2.	Fibro-plastic tumors are made up of a soft lobulated tissue, of a
pinkish yellow; or else of a firmer texture, of a pale hue, and more ho-
mogenous ; or, finally, of a mixture of a gelatiniform substance with
the two structures just mentioned. These tumors are situated in the
skin, or the subcutaneous areolar tissue; they may be buried in the depth
of the muscular masses of a limb, especially the thigh; or else they
may spring up in bone, a favorite seat being the jaws; or finally, they
may grow upon the meninges.
3.	Fibro-plastic tumors present the same characters in man and in
domestic animals.
4.	The Fibro-plastic texture, which owes its origin to inflammation,
has a marked tendency to fibrous transformation; it is often met with in
protracted inflammations, of which it is at the same time the support
and the produce.
5.	Fibro-plastic tumors present either a smooth or lobulated surface,
and are either globular or flattened, according to their seat, and in cases
of hypertrophy they assume the shape of the affected organ. They are
generally free and well-defined; but when springing from bone they are
sessile, and look like excrescences.
6.	These tumors may become very large, both in glandular organs
and when seated on limbs, especially when they contain much gelatini-
form tissue. They are generally surrounded by a fibro-cellular envelope.
When a section is made in a recent case the liquid obtained is clear and
transparent; but it is sometimes thick and dull, when flocculi or entire
lobuli are suspended in it. Besides the textures above mentioned, there
is sometimes found in the tumors a substance of pale yellow, and quite
dull; sometimes calcareous concretions are found, or else osseous radia-
tions, when the disease begun in the periosteum.
7.	Under the microscope, cells with small, rounded, or ovoid nuclei
are seen, and all the forms intermediate between the cell and common
fibre, especially a great many narrow fusiform bodies; the nucleoli are
always very small. There are also perceived original cells with com-
pound nuclei rolled up together, and sometimes fusiform nuclei which
then constitute fibro-plastic masses.
8.	As regards neighboring textures, fibro-plastic tumors grow like
fibrous tumors, as they press upon these textures without taking then-
place; whilst cancerous tumors substitute themselves in neighboring
parts. Fibro-plastic tumors follow, as to their growth, the following
development:—There is first a local deposit; the increase is then slow,
but soonjoecomes rapid; phlegmasia takes place ; then comes haemorrhage,
partial calcification, softening, the formation of cysts, partial ossification,
ulceration, and then, in exceptional cases, sloughing.
9.	Both sexes are obnoxious to these tumors; they are seen at all
ages, but they arise more frequently between thirty-five and fifty years.
10.	Recurrence after operation takes place, especially in autogeneous
tumors, and has not been observed in fibro-plastic hypertrophy; recur-
rence is not observed, as in cancer, to arise in distant organs, though it
is often caused by an incomplete operation. Notwithstanding the occa-
sional pertinacity of fibro-plastic tumors to recur in the cicatrix, they
are not found to injure the general health. In very rare cases a kind
of fibro-plastic diathesis becomes established; this fact has, however,
been observed with fibrous, adipose, neuromatous, and melanotic tumors.
11.	Singleness and a strictly local nature have been observed as a
rule in fibro-plastic tumors. This fact is proved by twenty-six carefully
conducted autopsies of cases in which the disease had reached its natu-
ral termination, and also by a considerable number of perfect and per-
manent cures after operation; whilst no such cures are known to exist
respecting true cancer.
12.	Fibro-plastic tumors have a much more chronic character than
cancerous tumors; and save a few cases of very rapid growth, it may be
said that fibro-plastic tumors, when they become fatal, last rather more
than between five and ten years; whilst the natural duration of cancer
is from two to two years and a half. Cases have even been known, and
are not rare, in which fibro-plastic tumors have lasted twenty years and
more, without much inconvenience. It should, however, be mentioned
that these tumors, after a very slow progress, have rapidly assumed a
very serious character.
13.	Pain is very rarely acute and permanent, and is mostly, as in
other tumors, of a neuralgic kind. Functional disturbance depends
principally on the seat of the tumor. The general health, in the great
majority of cases, remains undisturbed, except in the very rare cases of
general fibro-plastic infection, or those in which the local affection has
ended in extensive ulceration.
14.	The prognosis of fibro-plastic tumors is much more favorable than
that of cancer. Curability is the rule. The fibro-plastic texture of in-
flammatory origin is the more likely to be benign the more it shows a
tendency to assume a fibrous character. The prognosis is, in fibro-plastic
hypertrophy, likewise favorable. In fact these tumors constitute a local
affection little or not at all likely to recur, which can only become dan-
gerous in so far as its seat, extent, or amount of ulceration arc con-
cerned. Kelis is likewise an affection of a simple kind, (see “ Mirror
of Hospitals,” The Lancet, vol. ii., 1852, p. 567,) notwithstanding its
pertinacity regarding recurrence in the cicatrix after operation. Fibro-
plastic tumors of spontaneous origin are very likely to recur after ex-
cision, when they are situated on the tegumentary surface, under the
skin, or in the bones. The surgeon should always bear in mind the
possibility of general infection, only, however, as an occasional occur-
rence, but not as a probability. Fibroplastic tumors seated in the me-
ninges destroy the patient by interfering with the functions of the
brain, though remaining all the while a perfectly local affection.
15.	The treatment of these tumors should begin with the prolonged
use of preparations of iodine, when the origin is of a syphilitic nature,
or when the tumor is simply owing to hypertrophy. W hen an operation
is necessary, it should consist, as a rule, of complete extirpation; strong
caustics should be tried with superficial tumors of small dimension.
Operations in such cases should always be performed boldly, whether
the knife be carried into soft parts, or whether the affection be
seated in bone. Amputation should be performed when the tumor is
situate in the depth of the limb and the former sends prolongations into
parts where dissection is difficult.
Autoplasty should be used to substitute healthy tissue to cicatrices
likely to favor recurrence, in operations of a moderate ex tent,and when the
tumor is seated on the surface. The actual cautery is necessary when
superficial tumors are too extensive to admit of autoplasty.
It is finally advisable to use iodine after operations, as a prophylactic
means against recurrence of general infection.—London Lancet.