PATHOLOGY 
176 
the fpine on the lame fide; pale countenance; general 
debility. Three varieties are noted. 
a. P. coaflum ; from infar&ion. Chiefly after obfti- 
nate remittents or intermittents in organs weakened by 
previous intemperance; the ablorbents being hence 
doubly debilitated. 
P. fcirrhofum ; affuming a feirrhous charafter. On 
the death of a woman it was found to weigh thirty-three 
pounds, and to fill nearly the whole of the abdomen. 
The complaint lafted feventeen years before the patient 
died, during nearly the whole of which Ihe purfued her 
itfual avocations. Sauvages. —Three times its natural 
fize. Buillie, Morb. Anat. Fafc. vi. pi. 3.—Contained 
fifteen pints of pus. FUJI. de l'Acad, des Sciences, 1753.— 
The entire vifcus has often been extirpated without in¬ 
jury. 
7. P. cartilaginofum : the coats of the fpleen converted 
into a cartilaginous fubftance. Baillie, Morb. Anat. 
Fafc. vi. pi. 1. 
3. Parabyfma pancreaticum : hard elongated tumour, 
running tranfverfely in the epigaftric region; dyfpepfy; 
general languor. Here are two varieties. 
a. P. coa&um; from infarftion. Buillie, Morb. Anat. 
pi. vii. fig. 1.—Torpitude produced by the ftimulus of 
tobacco, almoft inceflantly chewed or fmoked for many 
years; fatal. Darwin. 
( 3 . P. calculofum ; accompanied with white calculous 
concretions. Buillie ut fup. fig. 2, 3, 4. 
The pancreas occafionally aflumes a feirrhous ftrudfture. 
It is delcribed as remarkable for the little general diftur- 
bance of the fyftem ; the fixed and burning pain at the 
pit of the flomach, exceflively increaled by the preflu re 
of the diftended flomach ; fo much fo indeed, that, 
though the appetite is often good, the patient is com¬ 
pelled to induce vomiting after eating, to lull the pain. 
The bent pofture, as taking oft' compreflion, is likewife 
preferred. Coflive ftate of the bowels much increales the 
pain, by producing the like preffure on the difeafed vi(- 
cera. The palliative treatment is therefore obvious. 
4. Parabyfma melentericum: indurated and irregular 
mafs of tumours below the flomach, yielding to the pref- 
fure of the hand; pale bloated countenance ; atrophy; 
the appetite at the fame time feldom diminilhed, often 
voracious. There are fix varieties. 
а. P. lielminthicum ; accompanied with hydatids or 
worms. 
jS. P. ftrumofum ; accompanied with fcrophula. See 
Marafnius, in this article. 
y. P. fcirrhofum ; accompanied with feirrhus. 
б. P. fareomaticum ; accompanied with farcomatous 
excrefcences. 
e P. fleatomatofum ; accompanied with fteatomatous 
excrefcences. In one inftance, the tumour weighed 
40 lbs. Nov. Act. Nut. Cur. vol. i. 
if. P. fungofum ; accompanied with fungous excref¬ 
cences. 
The above varieties are from Sauvages, who has been 
copied by Cullen. The tumours are often very large, 
and conglobated : and at times accompanied with 
cyfts filled with a limpid fluid. In one inftance thefe 
amounted to twenty of various fixes, one as large as a 
child’s head, fix as large as the fift, and the reft refem- 
bling hens’ and pigeons’ eggs. Hence the whole abdo¬ 
men is in fame cafes fo generally tumefied as to give a 
j'emblance of pregnancy. This is particularly the cafe 
with the laft variety; and as the appetite, ftate of the 
bowels and bladder, are often unaffected, there is not 
unfrequently feme difficulty in determining the nature 
of the difeafe. See Sauv. in loco ; as alfo the writings of 
Welfch, Trincavelli, Morgagni, and Rioiarii, who have 
made collections of extraordinary cafes ; and compare 
Cruikfhank on the Anatomy of the abforbing Veffels, p. 
j 15. 2d edit. 4to. 
5. Parabyfma inteftinale: the tumour hard and circum- 
fcribed ; round or elongated; moveable upon the pref¬ 
fure of both hands; irregular deje&ions 5 obftinate vo¬ 
miting ; pyrexy; and for the moll part emaciation. Two 
varieties. 
а. P. conglomeratum; cohefive, and conglomerated. 
Morgagn. de Sed. et Cauf. Morb. tom. ii. In this cafe the 
tumour lay fenfible to fight, of a circular fhape between 
the enfiform appendix and navel. On diffeCtion, the 
ileum and adjoining portion of thejejunum were retrac¬ 
ted upwards, coacervated, and firmly adhefive. 
( 9 . P. farcomatofum. Fantoni. Obf. Med. feleCh ii. 
In this cafe the tumour, of an oblong fhape, lay below 
the left hypochondrium inclining to the epigaftrium, 
prominent, with unequal hardnefs. On diffeClion, every 
other part being found healthy, the colon, under the fto- 
mach, and towards the left fide, for the length of the palm 
of the hand, appeared clofely indurated, diftended, and 
loaded with a flefliy fibrous peculiarly-thickened tumour, 
which contracted its diameter. 
б. Parabyfma omentale; the tumour indurated and 
diffufed ; frequently fpreading over the whole of the ab¬ 
dominal region ; dyfpncea ; emaciation. This fpecies is 
ufually of a mixed kind : infarCled; feirrhous; glandu¬ 
lar; and cartilaginous. It has been found of various 
extent and magnitude ; from a weight of five pounds to 
twenty, twenty-five, thirty, and in one inftance (Greg. 
Hurftii. Prob. 10. dec. vi.) fifty-fix pounds, occupying 
the whole capacity of the belly. In one cafe, the hard¬ 
nefs was almoft ftony-. Panarol. Pentec. iii. obf. 10. In 
another, offeous, the weight thirteen pounds: Mongin, 
Hilt, de 1 ’Acad. des Sciences, 1732. In a third, loaded 
with many thoufand glandules ; in a fourth, accompa¬ 
nied with excruciating pains, the weight fixteen pounds : 
lluxh. Phil. Tranf. vol. vii. 
7. Parabyfma complicatum : the belly hard, elevated, 
and diftended as though pregnant, and often fuppofed to 
be fo; yet more or lefs knotty and unequal; the breath¬ 
ing feldom impeded ; for the moft part, acute pain, nau- 
fea, obftinate vomiting, and third. (Phyfconia polyf- 
planchna. Sauv. Cull. Phyfconia vifeeraiis. Auc. Far.) 
The fymptoms of this fpecies, Dr. Good obferves, mull 
vary according to the organs affefted, and the nature 
and extent of the difeafe. The enlargement is generally 
found to be farcomatous, feirrhous, hydatidous, oradi- 
pofe. The liver is in moft cafes more or lefs concerned ; 
fometimes in connexion w-ith the fpleen, fometimes with 
the mefentery, fometimes with the ftomach orinteftines, 
and fometimes with all together. Hildanus found the 
liver fo enlarged as to pafs beyond the falfe ribs of the 
left fide, with the fpleen equally enlarged, and fixed 
to the hepatic lobe. Cent. ii. Obf. 43.— Huldenreich, 
in a woman of forty-five years of age, found the liver 
feirrhous, weighing fourteen pounds, with a flelhy 
excrefcence in the mefentery of the fize of a child’s head ; 
Mifcel. Nat. Cur. ann. vi. and vii. Jaundice accompanied 
this cafe.— Bartholine mentions a woman of elegant 
form, in the flower of her age, attacked with another va¬ 
riety of this difeafe, which at length deftroyed her : when 
all the inteftines, liver, fpleen, and every adjoining vif¬ 
cus, w'ere found intermixed, and buried in fat; the liver 
being at the fame time enlarged and feirrhous, and filling 
both hypochondria; the ftomach thickened, and cartila¬ 
ginous. Cent. ii.—Coiter found the whole of thefe organs 
adhering together, and filled with cyfts of different fizes 
diftended with a limpid fluid; he reckoned more than, 
fourfeore : the organs themfelves were exhaufted and 
dry. ObJ'. Anat. p. 117. See alfo the works of De Haen 
and Boerhaave for remarkable diffe&ions of the fame 
kind. 
Recent refearches feem to prove in a very convincing 
manner, that, however different the matter contained in 
abdominal tumours, they have a common origin in tu¬ 
bercles, or, as fome fay, in hydatids. We (hall not enter 
into this fpeculation now ; but, as it is of importance to 
diftinguifh the earlieft approaches of a diforder which gra¬ 
dually involves the whole of the liver, peritoneum, in- 
teftines 3 
