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Page 19
The traumatic[2] theory. There is much in favor of this. In a certain
number of cases tumors do develop at the site of injuries. The
coincidence of injury and tumor is apt to be overestimated because of
the strong tendency to connect succeeding events. Tumors are not most
common on those parts of the body which are most exposed to injury.
They are rare, for instance, on the hands and feet, and very rarely do
they appear at the site of wounds caused by surgical operations. For
those tumors which develop in intra-uterine life it is difficult to
assign injury as a cause. There does, however, seem to be a relation
between tumors and injuries of a certain character. The natives of
Cashmere use in winter for purposes of heat a small charcoal stove
which they bind on the front of the body; burns often result and
tumors not infrequently develop at the site of such burns. Injuries of
tissue which are produced by the X-ray not infrequently result in
tumor formation and years may elapse between the receipt of the injury
and the development of the tumor. These X-ray injuries are of a
peculiar character, their nature but imperfectly understood, and the
injured tissues seem to have lost the capacity for perfect repair.
In regard to the possible action of both injuries and parasites in
causing tumors, the possibility that their effects on different
individuals may not be the same must be considered. In addition to the
trauma or the parasite which may be considered as extrinsic factors,
there may be conditions of the body, intrinsic factors, which favor
their action in tumor development. The peculiar tissue growth within
the uterus called decidua, which occurs normally in pregnancy and
serves to fasten the developing ovum to the inner lining of the
uterus, may be produced experimentally. This growth depends upon two
factors, an internal secretion derived from the ovary and the
introduction into the uterus of a foreign body of some sort; in the
case of pregnancy the developing embryo acts as the foreign body. It
is not impossible that some variation in the complex relations which
determine normal growth may be one factor, possibly the most
important, in tumor formation.
Another theory is that the tumor is the result of imperfect embryonic
development. The development of the child from the ovum is the result
of a continued formation and differentiation of cells. A cell mass is
first produced, and the cells in this differentiate into three layers
called ectoderm, entoderm and mesoderm, from which the external and
internal surfaces and the enclosed tissues respectively develop, and
the different organs are produced by growth of the cells of certain
areas of these layers. The embryonic theory assumes that in the course
of embryonic development not all the cell material destined for the
formation of individual organs is used up for this purpose, that
certain of the embryonic cells become enclosed in the developing
organs, they retain the embryonic capacity for growth and tumors arise
from them. There is no doubt that something like this does take place.
There is a relation between malformations due to imperfect development
of the embryo and tumors, the two conditions occurring together too
frequently to be regarded as mere coincidence. Also tumors may occur
in parts of the body in which there is no tissue capable of forming
structures which may be present in the tumors. The theory, however, is
not adequate, but it may be among the factors.
The problems concerned in the nature and cause of tumors are the most
important in medicine at the present time. No other form of disease
causes a similar amount of suffering and anxiety, which often extends
over years and makes a terrible drain on the sympathy and resources of
the family. The only efficient treatment for tumors at the present
time is removal by surgical operation, and the success of the
operation is in direct ratio to the age of the tumor, the time which
elapses from its beginning development. It is of the utmost importance
that this should be generally recognized, and the facts relating to
tumors become general knowledge. Tumors form one of the most common
causes of death (after the age of thirty-five one in every ten
individuals dies of tumor); medical and surgical resources are, in
many cases, powerless to afford relief and the tumor stands as a bar
to the attainment of the utopia represented by a happy and comfortable
old age, and a quiet passing. Every possible resource should be placed
at the disposal of the scientific investigation of the subject, for
with knowledge will come power to relieve.
FOOTNOTES:
[1] By cachexia is understood a condition of malnutrition and
emaciation which is usually accompanied by a pale sallow color of the
skin.
[2] By trauma is understood a wound or injury of any sort.
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