Reviews of Books

1839 The Lancet  
408 did not, generally, produce much irritation, but, in the course of a fortnight, it had great stimulating power. Blistering the part and keeping the blisters open, in some instances, had answered the same purpose. In one case, in which a lady had a tumour in the breast, of the size of a small orange, blistering for six weeks effected a cure. He believed that in the advanced stages of these cases, excrescences occasionally grew from the inner membrane of the cysts. Sir A. Cooper had given a
more » ... ooper had given a drawing of one of these cases, in which the excrescences resembled bunches of red and white grapes. In the case of a lady who was under his, Sir Benjamin's, care, twelve months since, he had punctured a tumour consisting of a single cyst, and evacuated the fluid ; the tumour again formed; it was then freely laid open; it became much inflamed; suppuration took place, and a cure was effected. After a time, however, a portion of a fungous growth appeared at the cicatrix of the wound. The breast was removed, and the cvst found to contain excrescences resembling bunches of red and white grapes. He was convinced that, originally, this cyst merely contained serous fluid. Mr. ARNOTT, ill a case in which the cyst i was as large as a walnut, had laid it open, evacuated a quantity of serum, and taken out a fungous growth arising from the inner membrane; severe inflammation followed, and a cure was effected. He had seen other cases of the disease which formed the subject of the paper, besides the one which the author had alluded to as coming under his (Mr. A.'s) care. In one case the tumour was situated under the angle of the jaw in a child. He was not aware whether the tumour consisted of many cysts or not. He made an incision into it, which he subsequently enlarged, and pushed a piece of lint into the wound ; inflammation ' , took place, and a cure was effected In one case he had found a transparent substance at the bottom of the cyst, which proved, on removal, to consist of a number of separate cysts, in close contact with each other, but filled with fluid. Operations, in these -cases, should be carefully performed, as the disease sometimes, as in his own case, proceeded to the deeper-seated parts. Mr. HAWKINS concurred in the great necessity of caution in the removal of the tumours which formed the subject of his paper. In the fatal case which he had alluded to the disease had implicated the Neighbouring vessels, and had proceeded even down to the spine. Regarding the presence of excrescences in tumours, they were found also in cysts containing a simply serous fluid; in oncystpd tumours from en-' larged sebaceous follicles; and it was not uncommon to find projecting growths in ovarian tumours. Sir B. BuoDiE believed that many breasts had been removed under the impression that they were affected with malignant disease, when, in fact, these excrescences only were present. Mr. LLOYD thought that the excrescences in question formed an essential part of the disease. In a case of tumour which he had removed from the breast of a woman who had been affected with the disease for seventeen or eighteen years, the tumour consisted of a number of cysts,varying in size from a pea to a walnut. In every one of these cysts was an excrescence, resembling either a white or a red raspberry, together with more or less of fluid, varying in colour and consistence, in the different cysts. In another case, in which the disease had only existed four years, the woman was married, but had had no children. In this case the same appearances were observed. Some of the cysts were evidently connected with the nipple, for when the breast was squeezed some of the contents of the tumour flowed out. He had seen tumours of a similar description in the groin. Regarding the removal of these tumours by stimulants, he had, in the case of a lady, who had six or seven tumours in the breast, ordered her to apply a lotion, consisting of muriate of ammonia, spirit, and acetic acid, and in a few weeks the disease was removed. the subject of the disease in question, is the son of a bargeman, and it is probable, from the high wages earned by his father, that he is better nourished than the greater number of the children of the poor. He was under the immediate care of Mr. Bayley, of Odiham, who was unable to discover anything in his diet to explain the occurrence of the remarkable form of disease under which he laboured. The author visited the patient, in company with Mr. Barry, of Farnham, on the 29th of January last, at which time three of his limbs, the left leg and both arms, were in an advanced stage of destruction by dry gangrene. Three days before his first visit the right forearm had been amputated by nature at the elbow.joint, but the slough had ex. tended above the joint, where a second attempt at amputation was in progress. The foot of the left leg was completely removed just above the ankle-joint, between the epiphyses and the shafts of the tibia and 6!mfa, leaving the extremities of the bones exposed. On the rightfoot the phalanges of the second and third toes had been removed. The aaathor learned from the mother of the child that the disease had begun in the month of August last, both his feet becoming
doi:10.1016/s0140-6736(02)99991-5 fatcat:jeyprgil5vbtrbk35ip2divosy