Certainly,  the  opinion  that  epithelial  cancer  is  thoroughly  curable  by
operation,  and  is  altogether  a  much  less  mahgnant  disease  than  the
other  varieties  of  cancer,  is  due  in  great  part  to  warty  growths  and
ulcers  having  been  considered  cancerous  which  were  not  so.  To  the
naked  eye  and  during  life,  the  two  diseases  may  be  very  much  alike  ;
but  the  diiFerence  in  their  respective  minute  structures  is  clear,  and  in-
dicates essential  difference  of  nature.
'  The  growths  described  by  some  of  the  German  pathologists,  by  the  name  of
destructive  papillary  tumour  of  the  skin,  are  doubtless  the  same  as  these  ulcerating
warty  growths.
728  EPITHELIAL  CANCER.
LECTURE  XXXir.
EPITHELIAL    CANCEK.
PAET   II. — I'ATHOLOGT.
Among  all  the  cancers,  the  epithelial  present  the  general  or  constitu-
tional features  of  malignant  disease  in  the  least  intense  form.  They
commence  at  the  latest  average  period  of  life  ;  they  appear  to  be  most
dependent  upon  local  conditions  ;  they  are  least  prone  to  multiplication
in  internal  organs.  And  yet  I  believe  that  in  a  large  survey  of  them,
none  of  the  features  of  malignant  disease,  as  exemplified  in  the  scirrhous
and  medullary  cancers,  will  be  found  wanting  :  the  difference  is  one  of
degree,  not  of  kind.
(a.)  A  large  majority  of  the  cases  of  epithelial  cancers  occur  in
males.  In  105  cases,  affecting  parts  common  to  both  sexes,  86  were  in
men  and  19  in  women.  In  the  cases  affecting  the  sexual  organs  them-
selves, I  think  the  proportion  is  nearly  equal ;  unless  we  reckon  the
scrotal  soot-cancers,  which  for  obvious  reasons,  we  should  more  properly
exclude.
(6.)  A  few  cases  are  on  record,  transmitted  from  book  to  book,  in
which  what  were  probably  epithelial  cancers  occurred  before  adult  life.
