The Goulstonian Lectures on the Origin and Relations of New Growths
Authors: J. F. Payne
Journal: BMJ (1874)

L1 CLURIE I.M1 R. PitESD1)1E N i,-The title of the course of lectures vhich I shall have the honiour of deli\erirjg before you is one so wide and comprehensive, that I mnust endeaxour to (lehie somewhat more precisely the lilmlits of the subject.The term tumotur, which was, I suppose, the one first applied to the structures w hich I have callecl new growths, had once, it is needless to say, a very wside raiige of meaning, and een in modern tiimes has been used with conisiderable laxity.WNitlh the ancients, for instance, before iniflammation had been conceived of as an abstract process, the phlegmon or inflammatory swelling xx as put in the same category as wlhat we shouild noxv call a caincer; nor wvas it then possible to separate from this class swellings produced by any cause w hatever.So w%vide a conception wvould, of course, at the present day be practically useless, and is accepted by nio one.Buit even in the most important work yet devoted to this subject, Virchox's great treatise on tumours, the corresponldinlg German term is taken in a very comprehensive sense.Virchow includes inl his wvork, for inistance, all kinds of cysts, even hydrocele, as wvell as the products of tubercular and syphilitic diseases.WNithout any initen- tioIn of fully dliscussinig the proper definition of the wvord tumour or nexv groxxth, I still feel it necessary to mark out clearly the subject of the following lectures, and wxill therefore just say, by xvay of preliminiary, that my remailks wvill be confined to those tumours which may be fairly described as new groxvths, omitting mere enlargements of parts already existing, anid the products of inflammation, xvhether acute or chronic, and omitting also the consideration of syphilitic and tubercular products, as being more niearly allied to inflammation.What we include, then, are nearly what Virchow distinguishes as pseudo-plasmen or true growths (Gexvichse).The group thuts limiiited includes all nexv formations, in the form of a more or less circumscribedc mass, of substance resembling the simple tissues of the body, or immature stages of them ; it includes also those productions knox,vn as cancers, and various growths nearly allied to these, known as sarcomatous tumours.Among the simple tissue-tumours, I recognise fibrous (fibroma), mllucous (myxoma), fatty (lipoma), cartilaginous (enchondroma), osseous (osteoma), vascular (angioma), muscular (myoma), nervous (neuroma), glandular (adeinoma), and lymphatic (lymphoma and lymphangioma).Under cancers, I incltude epithelial canicer or epithelioma ; and, under -sarcomatous tumriours, several forms xvhich approximate to simple groxvths.Finally, there are comi-binations of the forms just mentioned.I shall not attempt to define the class thus made up, except by simple enumera- tion.The characters of the smaller groups are tolerably well marked, and no practical difficulty need arise in knowving what kind of objects it is intended to discuss.The chief fact which all these structures have in common is the fact of growxth or inicrease, ancl, moreover, of a groxvth xhich appears to be, in a certain senise, inidepenident of that of the body, as if the tumour had some separate life of its own.So strongly did this impress the older