PATHOLOGY. 23L 
fwells like the milder kind, and is at firft fcarcely diftin- 
guilhable from it, but by its attacking in advanced life, 
and in females about the periodical change. It is not 
painful, and advances flowly to fuppuration. If the 
latter can be prevented by leeches, cooling applications, 
&c. the inconvenience, for many years, is not confider- 
able; but, when it fuppurates, the pus is feldom lauda¬ 
ble, and the patient loon finks from the difcharge. In 
this cafe, bark, hemlock, and the whole tribe of poifons, 
have been tried in vain. The wound enlarges, the Houghs 
become deeper, till the conftitution is completely under¬ 
mined, and gradually finks. The fcirrhous parotids may 
be extirpated, (though this is one of the mod difficult 
operations in furgery;) but the malignant fink deeper, 
and will not admit of the operation, which is always 
dangerous from the numerous large veffels in the neigh¬ 
bourhood. 
5. Phlegmone mammae, abfcefs of the breaft : tumour 
feated in the breaft; pale-red; hardilh; in irregular 
clufters; pain pricking and acute; fuppuration quick 
and copious. Here alio we have two varieties. 
a. Violens: from fevere prefl'ure or blow. 
(3. La&antium, milk-abfcefs : from redundancy of 
milk. Both varieties are charafterifed by tumefaction, 
tenfion, heat, rednefs, and pain; fometimes in both 
breafts, but molt commonly in one. Pyrexia generally 
attends the difeafe. It is fometimes very quickly formed, 
and in general without any thing preceding to Ihow it; 
but now and then a flight Ihivering is the forerunner. 
This difeafe terminates either in refolution or fuppura¬ 
tion. If left to itfelf, it generally terminates in i'uppu- 
ration. But it is often of long continuance; it is very 
painful, but feldom fatal, unlefs when abfolutely neg¬ 
lected. The termination of the difeale by gangrene is 
feldom to be apprehended ; at leaft few, if any', have feen 
the difeafe terminate in this way. 
As to the firft variety, during the inflammatory ftage, 
cold lotions, purging, See. may be had recourfe to. In 
the fuppurating ftage, the fame treatment is required as 
in the var. ( 3 , or milk-abfcefs. This latter may in ge¬ 
neral be prevented by an immediate application of the 
infant to the breafts after delivery, or at leaft before they 
are turgid with milk. When pus is actually formed, a 
foft warm poultice, compofed of bread and water, or of 
a decoCtion of poppies and linfeed meal, ftiould be con- 
ftantly kept upon the part, and renewed every three or 
four hours; at the fame time carefully fufpending the 
enlarged breaft, with an handkerchief fpread under it, 
and tied behind the neck. It is very rarely proper to 
make any artificial opening in thefe abfeeffes : they ftiould 
be permitted to burft of themfelves, and be poulticed as 
long as the hardnefs or inflammation continues. During 
this painful period, the child muft be fuckled by the 
healthy breaft; for it rarely happens that the milk is 
pure during a ftate of inflammation, or that the mother 
can bear her child’s attempt to draw the nipple. 
During the fuppurating procefs, the dietetic regulations 
laid down under Dyfpepfia muft be rigoroufly enforced. 
The local application muft vary with the appearance of 
the ulcer when it heals ; and the adminiftration of 
remedies will alfo be regulated by the fame criterion. See 
Parturition, vpl. xviii. p. 71a, 13. 
6. Phlegmone bubo : tumour feated in a conglobate 
gland ; reddifii ; hard ; diffufe ; not eafily fuppurating ; 
opening with a callous edge. Divided into, 
a. Simplex : unconnected with any conftitutional or 
foreign poifon. 
| 3 . Virulentus: produced by fpecific virus, or con¬ 
nected with conftitutional affeCtion. The glands moltly 
infeCted are thofe of the inguen and axilla. This laft va¬ 
riety is found chiefly in lues and peftis. Often cured by 
vomits after fuppuration has advanced. 
The firft variety will require the fame treatment dur¬ 
ing its inflammatory ftage as phlegmon in other parts, 
and the fame during the fuppurating ftage as common 
Yol. XIX. No. 1299. 
abfcefs. The fecond variety, being fymptomatic of other 
difeafes, will properly be treated under thofe heads. 
7. Phlegmone .phimotica, phimofis and paraphimofis : 
tumour feated in the prepuce; diffufe; obtufely pain¬ 
ful; imprifoning the glans, or ftrangling it by retraCfion. 
a. Tncarcerans: the prepuce protraCfed, and imprifon¬ 
ing the glans. Numerous fubjeCls are born with a con¬ 
traction of the aperture of the prepuce; and the cafe is 
then called a natural or congenital phimofis. Sometimes, 
in adults, and particularly in old perfons, the prepuce 
contracts fo much, without any evident caufe, that its 
cavity becomes filled with urine during the aCt of mak¬ 
ing water, and great pain is the confequence. In cafes 
where the opening is exceedingly fmall, and the diforder 
is either congenital, or has occurred without obvious in¬ 
flammation, it is by no means an uncommon circum- 
ftance for calculi to be formed under the prepi ce. 
Thefe fometimes refemble in fliape the glans, on which, 
as it were, they are moulded. When the phymofis is 
congenital, and has exifted a long while, it frequently 
happens that, in confequence of inflammation, adhelions 
have taken place between the glans and the prepuce; and, 
in this event, it may not always be in the power of the 
furgeon to effeCt a cure. The poflibility of doing fo 
muft depend, in a great meafure, upon the extent and 
firmnefs of the adhelions. According to Richerand, it 
is feldom practicable to deftroy them after the patient has 
attained the age of puberty. 
No operation ought to be praCtifed on children for the 
natural phimofis, unlefs prefling inconvenience ftiould 
immediately arife from the malformation. The conftric- 
tion generally goes off, as fuch fubje&s approach the 
adult ftate. For the mode of performing the operation 
when neceffary, fee Surgery. For the treatment of the 
difeafe, and alfo the other variety, ( 3 , ftrangulans, or 
paraphimofisy in which the prepuce is retraCled and 
ftrangling the glans, fee Lues of this article. 
Genus III. Phyma, [Gr. a tubercle, from (pvu , to 
break or gulh out.] Boil, carbuncle, &c. Generic cha¬ 
racters—ImperfeClly-fuppurative, cutaneous or fubcu- 
taneous tumour ; the abfcefs thickened, and indurated 
at the edge; often with a core in the middle. There are 
fourfpecies, though Dr. Good has numbered them as if 
one were omitted. 
1. Phyma hordeolum, the ftye : tumour feated in the 
verge of the eye-lid; granular, hard, reddifli, fore to 
the touch ; fuppuration confined to the point. This is 
generally produced by indigeftion. Ple.nck affirms that 
he knew' a man who uniformly had a ftye after drinking 
ardent fpirit. He points out the following refemblance 
between a ftye and a boil : “ Eft tuberculum inflamma- 
torium, parvo furunculoJimile,m margine palpebrarum.” 
See Surgery. 
2. Phyma farunculus, the boil: tumour common to 
the furface; deep-red ; hard, circumfcribed, acutely 
tender to the touch ; fuppurating with a central core. 
See Surgery. 
3. Phyma fycofis: tumour excrefcent, flelhy, fig- 
fliaped, darkifh-red, fprouting from the hairy part of the 
head or face; gregarious; often coalefcing; difcharge 
partial and fanious. 
Dr- Bateman has deferibed the Sycofis to confift of “ an 
eruption of inflamed but not very hard tubercles, oc¬ 
curring on the- bearded portion of the face and on the 
fcalp, in adults, and ufually cluftering together in irre¬ 
gular patches.” Some difference takes place in the ap¬ 
pearance and progrefs of the eruption, when it is feated 
in the chin and in the fcalp. Hence it is divided into 
two varieties. 
ce. Sycofis barbae, (S. menti, Bateman.) The turnout- 
hard, roundifti, pea-lized ; feated in the beard; com¬ 
monly in clufters; occafionally confluent, and fpreading 
from ear to ear ; difcharge fmall and gelatinous, beard 
matted. See Plate I. fig. 1. 
3 & According 
