254 
they continue for many years free from the 
disposition to become so, yet if they remain 
until the period of the cessation of menstruation 
they sometimes assume a new and malignant 
action.” The breast is not exempted from the 
deposit of either cartilaginous or ossific matter, 
and tumours of this character are occasionally 
developed in its substance. 
The breast is oceasionally enlarged by hyper- 
ae of the adipose tissue. A tumour of 
this kind, removed by Sir Astley Cooper, is 
reserved in the Museum of St. Thomas’s 
ospital, which weighed 14 lbs.100z. The 
whole structure of the mamma also has been 
found hypertrophied and the breasts enormously 
increased in dimensions without being appa- 
rently the subject of any disease. That all- 
pervading poison of some constitutions—the 
scrofulous tubercular matter—does not leave 
the mamma exempt from its influence. Sir 
Astley says that these tumours “ can only be 
distinguished from the simple chronic inflam- 
mation of the breast by the absence of tender- 
ness, and by the existence of other diseases of 
a similar kind in the absorbent glands of other 
parts of the body.” They produce no danger- 
ous effects, and do not degenerate into malig- 
nancy. 
“The breast is liable to become irritable 
without any distinct or perceptible swelling, as 
well as to form an irritable tumour composed 
of a structure unlike that of the gland itself, 
and which therefore appears to be of a specific 
growth.” When the complaint affects the 
glandular structure of the breast, there is scarcely 
any perceptible swelling, but one or more of 
its lobes becomes exquisitely tender to the 
touch, and if it be handled the pain sometimes 
continues for several hours.” ‘ There is no 
external mark of inflammation, as the skin 
remains undiscoloured.” Besides this irrita- 
ble and painful state of a whole or part of the 
breast, a tumour sometimes is found distinctly 
circumscribed, highly sensitive to the touch, 
acutely painful at intervals, more especially 
rior to menstruation, very moveable, often not 
arger than a pea, seldom exceeding the size of 
a marble; generally one only exists, but in 
other cases there are several similar swellings.” 
“ Although they continue for years they vary 
but little in size. I have never seen them 
suppurate. kw sometimes spontaneously 
cease to be painful, and sometimes disappear 
without any obvious cause. Upon dissection 
they are found to be composed of a solid and 
semi-transparent substance, with fibres inter- 
woven with it, but without any regular distri- 
bution, and I have not been able to trace any 
large filament of a nerve into them.” “The 
pain with which this tumour is accompanied, its 
tenderness to the slightest touch or to pressure 
of any kind, the suffering which succeeds ex- 
amination, distinguish it from the hydatic, the 
chronic mammary tumour, and the scirrhous 
and fungous tubercle.” 
The malignant or incurable diseases of the 
breast may be classed under two heads, scirrhous 
carcinoma or cancer, and fungus hematodes. 
Scirrhus has been again subdivided into 
MAMMARY GLANDS. 
genera by different authors, some in relation te 
their external ap ces and situation, other 
in accordance with their internal structun 
Dr. Benedict, Professor in the Universit, y 
Breslau,* in giving the following arrangeme 
has rather pursued the former plan :—1st. © 
taneous cancer. 2d. True scirrhus; co 
ing of—1. Nodulated scirrhus; 2. 
scirrhus; 3. Bladder scirrhus. 
Miiller, in his late work on cancer, which’ 
been translated by Dr. West, describes” 
different kinds of carcinoma to which the bre 
in common with other organs, is liable, not 
reference to their seat whether cutaneous 
glandular, but in accordance with their intin 
structure; and to scirrhus, medullary saree 
carcinoma alveolare, and carcinoma melano 
of former authors, has added carcinoma reti 
lare and fasciculatum. To these we shall ret 
a little further on, dwelling previously o1 
form of cancer which is not very common 
highly important in a practical point of 
to the surgeon. 
“ Cutaneous cancer of the breast,” says 
Benedict, p. 39, “ deserves to be particuli 
noticed, because most surgeons frequently | 
found it with the common cancer, from 
it, however, materially differs. It never s 
in the substance of the organ, but al 
solely in the surface of the skin, n 
probably from fat and adipose glands of 
same. Its form is similar to that of cam 
the face and eyelids, and arises in the : 
way. At first there is nothing but a little 
wart, or hard little spot somewhere upon 
skin of the breast. This place begins grad 
to redden and then passes into a stage of 
tion. The swelling which has edges | 
a hard base spreads out, increasing bol 
depth and width so as to advance from the s 
into the substance of the gland, not pas: 
far, and only very gradually destroying 
breast. The glands of the axilla are 
attacked so early as in carcinoma of the g 
itself, and the hectic fever which ulti 
destroys the patient developes itself 
much longer period. . 
Mr. Travers (Med. Chir. Trans. vol. x 
also describes this cutaneous cancer in the 
lowing words: “ There is a cancerous tu 
of the skin which appears upon the 
in other parts, connected with a 
change in the texture of the skin. The 
of the skin is, I believe, primary. It 
of a brawning induration with extension of 
areole, a coarseness such as this 
sents when viewed through a ry 
which gives it a resemblance to pig's § 
Isolated tubercles of various sizes appear at 
siderable distances apart: the texture of 
subjacent cellular membrane is enormo 
thickened and has a cartilaginous hardness; 
the’ breast when the skin undergoes this chat 
upon that organ is early and immoveably fi 
the chest.” I have drawings of two cases of 
kind: one which occurred in the practic 
“ 
’ 
Ae 
or 
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oe 
¥ 
* Bemerkungen iiber die Krankheiten der rust 
und Achsel-Driisen. Breslau, 1825, 4to. p. 4 
