TUMOURS. 



of hemorrhage, and they are very eafily feparated from the 

 furrounding parts. The detachment of the tumour, how- 

 ever, may be more difficult when there have been previous 

 attacks of inflammation in the part. An adipofe tumour, 

 even when large, may continue a great many years without 

 producing any material inconvenience, provided no compli- 

 cation attend the difcafe. The fweUing may grow with 

 more or lefs rapidity, or remain flationary ; but it has never 

 been obferved to difappear fpontancoufly ; and every means 

 which has been hitherto tried with a view of difperfnig it, 

 has proved ineifeftual. The only method of cure confiils in 

 cutting away every part of fuch a fwelling, which ought to 

 be done before the difeafed mafs is of very large fize. 



Of fame other Kinds of Sarcomatous Tumours — It is ex- 

 tremely difficult to name and defcribe, clearly and unobjec- 

 tionably, all the different varieties of farcoma. Mr. Aber- 

 nethy has propofed naming them according to their anato- 

 mical ftrufture, or their fuppofed refemblance in texture to 

 particular organs. Thus he adopts the terms common vafcu- 

 lar, OT organized farcoma ; adipofe farcoma, which we have 

 already defcribed ; pancreatic farcoma ; cjiftic farcoma ; maf- 

 toid or mammary farcoma ; tuberculated farcoma ; medullary 

 farcoma f &c. 



Under the title of common vafcular, or organized far- 

 coma, Mr. Abernethy comprehends all tumours which ap- 

 pear to be compofed of the gelatinous part of the blood, 

 rendered more or lefs vafcular by the growth of veffels 

 through it, without having any diltinguiffiing peculiarity of 

 llru(&ure. Mr. Abernethy conceives that this kind of or- 

 ganization in tumours is the moil iimple, and, perhaps, 

 may always precede other defcriptions of ftrudlure. Vaf- 

 cular farcoma not only makes its appearance as a tumour, 

 which is altogether extraneous in regard to the original con- 

 formation of the body, it alfo enlarges natural parts, efpe- 

 cially the teilis, mamma, and abforbent glands. 



When this fort of fwelling has attained a confiderable 

 fize, the fuperficial veins become quite varicofe. If left to 

 itfelf, the tumour generally grows till the (liin is fo diftended, 

 that it ulcerates and expofes the new-formed fubftance, 

 which floughs and falls out. 



In this manner the difeafe might be got rid of ; but fuch 

 are the conftitutional irritation attending it, and the fetor and 

 frightful appearance of the part, that the furgeon generally 

 waits no longer, but removes the whole mafs of the difeafe 

 with his knife. 



Pancreatic farcoma is the name which Mr. Abernethy 

 applies to thofe flefhy tumours which refemble the pancreas 

 in ilrufture. The fubllance of which they confift is com- 

 pofed of irregularly-fhaped maffes, connected together by a 

 fibrous kind of texture. This fpecies of farcoma is fome- 

 times formed diftinftly in the cellular fubftance ; but moft^ 

 commonly occurs in the female breaft, perhaps originating 

 in the lymphatic glands. The tumour increafes (lowly, and 

 generally has little tendency to inflame and fuppurate. The 

 morbid ftrufture in queftion frequently takes place in the 

 breaft, a little above, and on that fide of the nipple which is 

 next to the arm. In general the difeafe is chronic, and does 

 not involve the neighbouring abforbent glands. But, in a 

 few inftances, this fpecies of farcoma, when fituated in the 

 breaft, deviates from its ordinary indolent nature, and occa- 

 fions fevere, lancinating pain, an inflammatory ftate of the 

 integuments, and an adhefion of them to the tumour, the 

 axillary glands alfo becoming enlarged. Pancreatic farcoma 

 is fometimes fo irritable a difeafe, that Mr. Abernethy 

 thinks it may frequently be confidered as bad as cancer. 

 When the glands in the axilla become affefted, one generally 

 firft fwells, and is e.xtremely tender and painful ; afterwards 



the pain abates, and it remains indurated ; another then be- 

 comes affefted, and runs through the fame courfe. 



Thofe farcomatous tumours which contain cytts or cell?, 

 Mr. Abernethy diftinguifties by the term cyflic. The difeafe 

 fometimes occurs as a diftinft fwelling ; but it is more com- 

 monly obferved in the tefticle and ovary. The cyfts are very 

 vafcular, fo that they admit of being made quite red with an 

 anatomical injeftion. They generally contain a ferous fluid ; 

 but fometimes a cafeous fubftance. Mr. Abernethy be- 

 lieves that this fpecies of farcoma is peculiarly intraftable 

 when fituated in the tefticle. 



The majloid or niammary farcoma is fo named from its re- 

 femblance to the mammary gland in ftrufture. Mr. Aber- 

 nethy has not frequently feen this kind of tumour, and his 

 attention was called to the nature of the difeafe by a cafe, iu 

 which a fwelling, partaking of the above ftrudlure, and 

 about as large as an orange, was removed from the front of 

 the thigh. The wound feemed at firft difpofed to heal ; but 

 it afterwards degenerated into a malignant ulcer, which in 

 about two months proved fatal. As this fort of tumour is 

 gradually loft in the furrounding parts, which probably re- 

 tain a difpofition to affume a fimilar morbid alteration, Mr. 

 Abernethy very judicioufly recommends a more exteniive 

 removal of them than was praftifed in the foregoing 

 example. 



Tuberculated farcoma is the name propofed by Mr. Aber- 

 nethy for thofe flefliy fwellings which confift of an aggrega- 

 tion of fmall, roundifti tumours, of various fizes and colours, 

 connetled together by a kind of cellular fubftance. This 

 gentleman has principally feen the difeafe in the lymphatic 

 glands of the neck. The tumours ulcerated, became pain- 

 ful fores, and ultimately deftroyed the patients. Mr. Aber- 

 nethy regards the tuberculatfd farcoma as an incurable 

 and fatal difeafe ; though, fortunately, its occurrence is 

 unfrequent. 



Medullary farcoma is the term applied by Mr. Abernethy 

 to a mahgnant and dangerous kind of tumour, vrhich refembles 

 in its ftrufture and appearance the medullary fubftance of the 

 brain. It is often feen affeding the teftis, and has been 

 termed tliefoft cancer of that part. Many furgeons conlider 

 this affeftion and the fungus hsmatodes as the fame : we do 

 not therefore deem it neceffary to offer here any remarks in 

 addition to thofe already dehvered on the latter difcafe in an- 

 other article. See Fungus. 



Treatment of Tumours — Surgeons not only remain ignorant 

 of thofe particular caufes which produce the commencement 

 of the growth of the various defcriptions of fatty, flefhy, 

 indolent tumours ; they alfo know no effectual means by 

 which the progrefs of the difeafe can be ftopped, and the 

 patient freed from the inconveniences of continually bearing 

 about with him a mafs of redundant matter, which, in a chronic 

 ftate, is both a deformity and an oppreffion ; and in an in- 

 flamed or ulcerated ftate, is a fource of fevere pain, and 

 even of fatal mifchief. It has been conjeftured that topical 

 bleeding and cold apphcations would check the growth of in- 

 dolent tumours ; but experience teaches us to place no de- 

 pendence upon the plan. Mercurial friftions, eleftricity, 

 bhfters, and local ftimulants, have alfo been repeatedly 

 tried, with a view of exciting the aftion of the abforbents, 

 and difperfing the fwelhng. Thefe methods, however, are 

 not recommended by many examples of fuccefs ; and they 

 are attended with fome rifle of irritating the tumour, with- 

 out leffening it, in which cafe the difeafe fometimes changes 

 from an indolent quiet form to an irritable ftate, in which it 

 inflames, enlarges, ulcerates, emits fungi, and alTumes a 

 charafter as dangerous and intraAable as that of cancer itfelf. 

 Whenever a fweUing is fufpefted of being either a mammary, 



6 tuber- 



