Excision of the eyeball in cases of melanosis, medullary carcinoma, and carcinoma : with remarks / by J. Argyll Robertson.

  • Robertson, J. Argyll.
Date:
1844
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Credit: Excision of the eyeball in cases of melanosis, medullary carcinoma, and carcinoma : with remarks / by J. Argyll Robertson. Source: Wellcome Collection.

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    one presenting tlie chai'acters of carcinoma fasciculatum, and situated within the eyeball, the other of medullary sarcoma with spherical cells, situated between the sclerotic and conjunc- tiva,—the one patient being fifty-six, the other sixty years of age. The operations for the cure of such cases have been so uni- versally unsuccessful that 1 would have been disposed to think that I had been deceived as to the true character of the affec- tion in these two instances of a successful result, were it not that the diseased structures were minutely examined by so distin- guished a pathologist and careful observer as Mr Goodsir, and that the cases diifored from almost all those on record, in occmnnng in individuals somewhat advanced in life, instead of in infancy. Is it possible that when carcinoma shows itself at an early period of life, it indicates in a higher degree a constitutional taint and less of a local origin ? I must, in conclusion, express my deep obhgations to my friend Mr John Goodsir, the distinguished conservator of the University Museum, for examining and submitting to the microscope the various preparations, and to my talented colleague Dr Skae, lecturer on anatomy, for the beautiful plates by which the subject is illustrated. Diagnosis. ENCEPHALOID. sciRRHus (as in common cancer of mamma.) MELANOSIS. Of consisteuce of brain in thin cellular septa. Of an opaque white colour. Numerous minute vessels. Consists of globules and caudate corpusoules. May hecome of enormous bulk. ■Often of rapid growth. Oftun interstitial effusion of blood. Not disposed to form adhesions to surrounding parts. When subcutaneous, the skin is distended and stretched, and gives way usually by simple ulceration. After ulceration, rapid progress, and often large fungous growths, and frequently he- morrhiigo. This species of carcinoma most f requently met with in infancy and youth. liiabln to be propagated through the absorbent organs. Of firm consistence in cellulo- fibrous septa. Semi-transparent bluish-yellow colour. Sparingly supplied with blood- vessels. Nuclear cells. No caudate cor- puscules. Seldom of large size. Progress generally slow. Rarely interstitial hemorrhage. Becomes firmly connected with sm-roiuiding parts. The skin becomes puckered and assumes the cancerous ulce- ration. After ulceration progress not so rapid, ,and seldom profuse hemorrhage, provided it does not assinne the eucephaloid structiu-c. Most connnon in advanced life. Even more liable to be propa- gated through the absorbent (U'gans. Of soft consistence in thin cellu- lar septa. Black or sepia colour. No blood-vessels have been traced. Pigment cells—round, oval, or irregular, and sometimes cau- date. They attain a large size. Growth of variable rapidity. Never interstitial hemorrhage. Not disposed to form adhesions to surrounding parts. | The skin becomes stretched and i distended, and yields by simple | ulceration. i After ulceration progress of tumour more rapid—no he- morrhage. 1 Usually about or after middle ago. No tendency to be propagated, through the absorbent or;giui8. j EXPLANATION OF FIGURES. Figs. 8, 9, 10, and 11, nil refer to the case of Elizalietli Willinmson, ivt. eight,—disease, medullary ciircinomn in the interior of the cyehall. Fig. 8 shows the appearance of the disease in its early stage, when the humours