CYSTIC GROWTHS 47 



according to the structural character of the part or parts 

 affected, the vasculatures implicated, and the degree and 

 extent of the pathological changes effected ; but in most 

 are displayed, to some degree, the classic or Celsian tumour 

 or swelling, and, it may be, dolor, or pain, with a varying 

 number of other subjective signs determined by the 

 mechanical and other effects of the pathological changes 

 produced, locally and generally. The character and 

 amount of the swelling varies indefinitely, usually within 

 certain structural visceral limits, but is always the most 

 pathognomonic symptom, as it has been the one which 

 has given rise to the generic name of tumour. Pain is 

 also a very variable quantity, as observed in the origin 

 and progress of tumours, and is evoked very often by 

 merely mechanical causes, such as pressure on and stretch- 

 ing of nerve structures, or by direct implication of these 

 in the matrix of the tumour, with stasis of the nervine 

 circulations, complete or partial. The character of the 

 pain is somewhat tell-tale, however, and sometimes very 

 plainly reveals what structures are implicated directly in 

 the pathological process, and what parts are indirectly or 

 reflexly involved in the neural nexus amid pain " storms" ; 

 the sympathetic nervature from this point of view 

 yielding information, more especially from distant internal 

 parts, of the most valuable character to the diagnostician. 

 Moreover, pains emanating distinctly from the systemic 

 nervous system are usually strangely contrasted to those 

 of the purely sympathetic or the mixed or dual class, and 

 proclaim themselves, as a rule, within the matrix of the 

 cutaneous envelope of the body, being referred to or 

 realised at some portion or portions of that structure by 

 the sensorium. Besides, it is found that a series of sen- 

 sations, varying from a desire to sneeze, through the many 

 degrees of pruritus to acute pain, are found to locate 

 themselves with the precision of cause and effect at and 

 around the areas engaged in the function of cerebro-spinal 

 lymph excretion, i.e. in the Schneiderian mucosa, in the 

 pharyngeal mucosa, in the peri- and endo-anal structures, 

 and at the orifices of the individual and grouped sweat 

 glands, or in reality wherever that fluid is eliminated from 

 the body. 



