. Tumours, innocent and malignant; their clinical characters and appropriate treatment. Fig. 169.—Caucer of the gall-bladder in section. {Micsetim of the Middlesex Hospital.) Infection of epithelium causes it to multiply: this is ex-emplified in the gall-bladder. Its mucous membrane undernormal conditions contains few glands, but, when it is chroni-cally inflamed, mucous glands become abundant and of largesize. In cases of fistulte between gall-bladder and intestinethe mucous membrane becomes thick and resembles that ofthe intestine. These mucous glands are important, for theyare the chief sou
. Tumours, innocent and malignant; their clinical characters and appropriate treatment. Fig. 169.—Caucer of the gall-bladder in section. {Micsetim of the Middlesex Hospital.) Infection of epithelium causes it to multiply: this is ex-emplified in the gall-bladder. Its mucous membrane undernormal conditions contains few glands, but, when it is chroni-cally inflamed, mucous glands become abundant and of largesize. In cases of fistulte between gall-bladder and intestinethe mucous membrane becomes thick and resembles that ofthe intestine. These mucous glands are important, for theyare the chief sources of the calcium found in mixed biliary GANGER OF THE BILE-DUCT 351 concretions. It is undeniable that gall-stones are a commoncomplication of cancer of the gall-bladder, and many writershave maintained that they are the cause of the cancerouschange. I have never accepted this opinion, preferring tobelieve that the pathological conditions of the epitheliumlining the gall-bladder, which cause it to produce cholesterin. Fis 170.—Cancerous and calculous gall-bladder in section, showing the manner inwhich the liver is infiltrated. {2Iuseuiii of St. Bartholomeivs Hospital.) in abundance, increase its vulnerability to the micro-parasiteof cancer. The relations of gall-stones to cancer vary a great deal ;in some the walls of the gall-bladder are greatly thickenedand the calculi are nested together in the centre of the other cases the gall-bladder is filled with a semi-pultaceousmass of soft white growth, and the gall-stones are irregularly 352 EPITHELIAL TUMOUES distributed through it. In other instances the cancerouswalls of the gall-bladder are thick, tough, and firmly con-tracted on a set of gall-stones which completely fill it; yet
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