of  the  mucous  membrane  of  the  stomach  or  rectum)  the  cancer  usually
ulcerates  widely  with  the  tissue  it  affects,  and  herein  imitates  more  nearly
the  characters  of  the  ulceration  in  scirrhous  and  epithelial  cancers.
Through  the  constantly  deepening  cachexia,  with  which  the  increase
in  the  medullary  cancers  is  usually  commensurate,  and  which  is  aug-
mented by  the  various  influences  of  the  local  disease,  the  usual  course
of  the  medullary  cancer  is  uniformly  towards  death ;  and  rapidly  thither,
even  when  the  grovfth  does  not  involve  parts  necessary  to  life.  And
yet,  as  Rokitansky  has  observed,^  there  is  no  form  of  cancer  in  which
spontaneous  natural  processes  of  healing  so  often  occur.  Doubtless
nearly  all  the  reputed  cases  of  the  cure  of  cancer  have  been  erroneously

'  Li  Series  xxxv.  No.  60,  in  the  Museum  of  St.  Bartholomew's,  is  a  large  medullary
tumour  whicli  had  grown  in  the  subcutaneous  tissue  of  the  back,  and,  after  the  skin
over  it  had  ulcerated,  was  in  one  mass  squeezed  out  through  the  opening,  while  the
patient  was  endeavouring  to  raise  herself  in  bed.
"  Loc.  cit.  p.  375.
DEGENERATION.  685

SO  regarded  ;  yet  instances  may  be  easily  gathered  of  at  least  temporary
cure  ;  and  these  are  important  in  relation  to  the  general  pathology  of
cancer,  since  they  afford  the  best  examples  of  the  effects  of  its  degener-
ations and  diseases.'

The  degenerations  of  medullary  cancer  are  chiefly  three  :  withering,
fatty,  and  calcareous  degeneration.  Its  chief  diseases  are  equal  in  num-
ber :  hasmorrhage  or  apoplexy,  suppuration,  and  sloughing.
A  medullary  cancer  may  gradually  decrease,  becoming  harder,  as  if
by  shrivelling  and  condensing,  and  at  length  may  completely  disappear.
I  have  mentioned  such  cases  at  p.  675  ;  and  I  have  seen  the  same
happen  after  partial  removal  of  cancers.
