What is commonly held to he fungus haematodes, is a luxuriant vascular growth, mischievous, both from its liability to occasional hemorrhage, and from its tendency to exhaust the constitution by the habitual hemorrhage consequent upon its ulceration. Some deem it curable by removal with the knife, whilst others maintain that it invariably recurs either at the same spot or elsewhere, and that it is of cancerous nature. Some even fancy, that not only does it return in its primitive form, but that it may be replaced by another form of cancer, namely, the medullary or encephaloid.

1 The author has since modified his opinions respecting these, so-called "cavernous textures." Abandoning the ground of their development out of a solid blastema through partial resorption, he now regards their stroma as nearly identical with that of cancerous structures, both in its elementary constitution, and in the fact of the same dendritic excrescences springing from its septa, and growing into its chamberlets. The affinity of these tumors to cancer, the author considers further established by their not unfrequent concurrence in the same organ (the liver, for instance) with cancerous tumors.

Incipient cavernous tumors do not, it is asserted, present any anastomosis whatever with the venous system. The anastomosis is established only at a later period through the mediation of very minute venous offshoots. It is not made clear, however, in what manner this communication is brought about. (See Rokitansky " fiber die Entwickelung der Krebs-geruste." Sitzungs-berichte der Kais. Akad. der Wissenschaften, Marz, 1852.) - Ed.

Our own opinion respecting the occurrence of fungus haematodes, is to this effect:

1. It is incontestable that highly developed, bleeding, ulcerating telangiectases, as also cavernous textures, are frequently mistaken for fungus haematodes. applies still more forcibly to a highly vascular, bleeding, ulcerating, blood-turgid medullary carcinoma. Nay, we have often seen a tumor, as fungus haematodes, resolve itself in the dead subject, after collapse of the bloodvessels had taken place, into a medullary carcinoma.

2. We are convinced of the existence of new growths almost wholly made up of bloodvessels; we even regard it as likely that the so-termed telangiectases (both congenital and adventitious) are, for the most part, new growths of bloodvessels.

The question with respect to such luxuriations of bloodvessels is, what is it that determines their (innocent or malignant) character? We believe this to reside, not in the bloodvessel growth, but in the remaining, namely, the intervascular, portion of a common blastema; just as in the malignant osteoid, not the bone-luxuriation, but the adjacent, soft heterologous parenchyma, determines its cancerous nature. Scanty as is the proportion of this intervascular heterologous substance to the bloodvessel growth, the former merits, in this sense, the most ample consideration, and however important bloodvessel luxuriation in itself may be, the term fungus haematodes designates but a secondary feature of the entire new growth, a modification, through accidental excess of vascularity, of a new growth well-marked, only imperfectly examined. The designation vascularized areolar tissue or vascularized cancerous formation, would be both more philosophical and more practical.

Hence the benign or malignant character of a new growth associated with excessive vascularity would, in such cases, be primitive.

Can the benign new growth of this kind become malignant? It can hardly be doubted that vascular tumors may accidentally become the nidus of a malignant new growth, just as may any natural organ rich in bloodvessels.

Another kind of consecutive degradation to malignancy is also conceivable, although for the present little more than hypothetical.

To explain our meaning it will be necessary to enter upon a little further discussion.

Bloodvessel luxuriations represent, when the anastomoses with the old vessels are completed, a new vascular apparatus complete within itself, a repetition, so to speak, of the portal system.

The anastomoses might be of such a character as to attach solely either to the arterial or to the venous system. Van der Kolk considers this proved, maintaining that medullary carcinoma belongs exclusively to the arterial, and another new growth, which he denominates fungus haematodes, to the venous system alone.

A vascular apparatus of this kind not being conceivable without interchange of matter, it might be not unreasonably inferred -

1. That the products of such a process would differ according to the arterial or to the venous nature of the blood circulating in the tumor, and that the products would be more especially anomalous where blood, previously rendered venous, has to permeate a secondary system of capillaries. In both cases the circulation must needs become torpid, and prone to undergo stases.

2. That the crasis of the general circulation must suffer a change, more especially in the second case.

In such wise, vascular luxuriations might indeed be imagined to pass into malignant new growths, the product, namely, of their interchange of matter constituting a malignant blastema.

The new formation of lymphatics has been demonstrated by Van der Kolk in adventitious membranes and in cancers.