Ag 
MAMMARY GLANDS. 
mal or globular. Cellulous hydatids are sim- 
ple bags containing fluid. ‘The breast gra- 
dually swells,” says Sir A. Cooper,* “and in 
the beginning is entirely free from pain or 
tenderness; it becomes hard, and no fluctu- 
ation can then be discovered in it; it con- 
tinues slowly growing for months and even 
years, sometimes acquiring very considerable 
magnitude, the largest I, have seen having 
weighed nine pounds; but in other cases, al- 
though the bosom was quite filled with these 
bags, yet it never exceeded twice the size of 
the other breast.” After a time fluctuation 
Tay be felt and the cutaneous veins enlarge, 
—————————e 
but the breast continues free from pain and the 
constitution does not suffer. The tumour is 
moveable and pendulous, in some cases in- 
volving the whole gland, in others only a small 
portion. 
** When the swelling,+ and the breast in 
which it is situated, are examined, it is found, 
upon a careful dissection, that the interstices 
_of the glandular structure itself, and the ten- 
_ dinous and cellular tissue connecting it, are in 
cll ie 
a great measure filled with fibrous matter, 
poured out by a peculiar species of chronic 
inflammation, but in some instances a bag is 
formed into which a serous, or glairy, or some- 
times a mucous fluid is secreted, according to 
the degree of inflammation attending it, and 
this fluid, from its viscidity and from the solid 
effusion which surrounds, as well as from the 
cyst being a perfect bag, cannot escape into 
the surrounding tissues; but by its quantity, 
its pressure, and by the gradual yielding of the 
bag, it becomes of a very considerable size ; 
and yast numbers of these cysts are found to 
_ occupy each part of the breast, producing and 
_ Supporting a continued but slow irritation, and 
occasioning an effusion of fibrous matter, by 
which the breast forms an immense tumour 
_ consisting of solid and fluid matter. Within 
these bags of fluid, hydatids hang by small 
stalks.” ‘The size of these cells varies from 
the head of a pin to that of a musket-ball.” 
“ When the tumour requires removal for this 
disease, it is necessary to take away all the 
hardened and swollen parts of the breast, for 
they have cysts, or cells, formed in them; and 
_ if any cyst be suffered to remain, it will still 
_ continue to grow, and the remaining part of 
the breast to form an hydatid tumour. The 
_ great solace to the patient in this disease is, 
i 
2 
. 
that as it does not contaminate other structures, 
there is no danger of its extending by absorp- 
tion, of its producing any complaint beyond 
the breast, or of its affecting other parts of the 
_ body; nor have I seen it seated in both breasts 
at the same time.” 
Sir B. Brodie} has pointed out an important 
feature in the development of certain cysts in 
the breast, which are different from the true 
hydatid. This consists in the generation of a 
morbid growth or excrescence from their in- 
terior, which becoming organized sometimes 
__.™ Iilustrations of the Diseases of the Breast, by 
Sir A. Cooper, 1829. Part i. p. 21. 
+ Page 22, op. cit. 
_ £ Medical Gazette, Feb. 21, 1840. 
253 
entirely fills the cyst so as to convert it into a 
solid tumour, which ultimately protrudes ex- 
ternally as a fungous growth, afid presents a 
new and formidable appearance. “ In this 
last stage of the disease,* it is evident that 
spreading ulceration, sloughing and hemor- 
rhage, the usual results of an ulcer occurring 
in a diseased structure, must ensue, and that 
no remedy is likely to be ofany service to the 
patient, except the removal of the affected 
parts by surgical operation.” The operation is 
not recommended in the early stages of the 
disease, as these cysts sometimes become ab- 
sorbed previously to the development of the 
fibrous tissue. As the disease is merely local 
the operation is wholly unattended with danger. 
The term by which Sir B. Brodie designates 
these tumours is that of “ sero cystic tumour 
of the breast.”’ It appears probable that the 
bladder scirrhus of Dr. Benedict is nothing 
more than this form of hydatid disease. 
“ The third species of hydatidt+ which is 
found in the breast is the animal or globular, 
and which consists of a bag containing a fluid, 
which has no vascular connection with the 
surrounding parts; and it produces within its 
interior a multitude of bags similar. to itself. 
It is in fact a true entozoon similar in every 
respect to that found in the brain of sheep and 
in many other organs of the human frame.” 
“* When one of these hydatids,”} says Sir 
A. Cooper, “ is produced in the breast, an in- 
flammation is excited by it, and a wall of 
fibrine surrounds it, it feels hard, and from the 
small size of the hydatid a fluctuation cannot 
be discovered; but as the hydatid grows, 
although the quantity of solid matter increases, 
yet as the fluid in the hydatid becomes more 
abundant, a fluctuation in the centre of the 
tumour may be ultimately perceived.” 
The disease is not malignant, and if a sim- 
ple puncture and evacuation of its contents 
should not prove effectual in dispersing it, may 
be removed without danger. 
The chronic mammary tumour occurs early 
in life and unconnected with any diseased state 
of constitution. ‘ It grows,” according to 
Cooper, “ from the surface of the breast rather 
than from its interior, and it therefore generally 
appears to be very superficial, excepting if it 
spring from the posterior surface of the breast, 
when it is deep-seated and its peculiar features 
are less easily discriminated.” These tumours 
are unconnected with the glandular structure of 
the breast. Dr. Warren§ relates a case in which 
he removed one of these tumours from a young 
woman, who four years after the operation 
nursed an infant from the same breast. They 
are extremely moveable, frequently begin with- 
out pain, and continue many years without 
exciting any uneasiness. They vary in size, 
have a lobulated character, and are invested in 
a fibrous membrane. “ Although these tumours 
are not in their commencement malignant, and 
* Page 842, loc. cit. 
+ Page 45, op. cit. 
t Loc. cit. page 48. 
Surgical Observations on Tumours, Boston, 
1837, p. 211. 
