PATHOLOGY. 
embraces modifications of dyfpeptic treatment obvious 
enough. The bowels are to be kept regular; and the 
hepatic fecretion excited, if depraved in quality or defi¬ 
cient in quantity. For opening the bowels, the mildeft 
purgatives only mull be ufed, irritation of the mucous 
membrane being feduloufly avoided; for irritating ca¬ 
thartics aggravate the difeafe. According to the condi¬ 
tion it happens to be in, the ftomach will require to be 
excited by gentian, fteel, and aromatics; or, on the con¬ 
trary, to have its morbid fecretions corredled by fedatives 
and alkalies. The diet will be regulated by the fame cri¬ 
terion. In moft cafes folid animal food may be allowed ; 
but this of courfe will depend on the powers of digeftion, 
fince, if the food be not properly digelted, little mull be 
taken, and that reduced to a pulpy confidence. If mor¬ 
bid growths are large, and their continuance dangerous, 
much may be effected towards their difcuflion by extreme 
abltinence, and the exhibition of finall dofes of antirno- 
nials daily. The external treatment of fcrofulous tu¬ 
mours, ulcers, &c. is obvious. Little, in the majority 
of cafes, need be done. If they put on an inflammatory 
appearance, the ufual means for the reduction of inflam¬ 
mation is to be put in force ; if they are indolent, flight 
irritants, or, as the cafe demands, counter-irritants, mull 
be reforted to. The treatment of fcrophulous ulcers 
and abfcefles will receive further notice under the article 
Surgery. 
2. Struma mefenferica: afFedling the mefenteric glands; 
countenance pale; appetite infirm ; abdomen tumid ; ex¬ 
crements ufually peculiarly fetid. 
The nature of this fpecies of fcrofula is pretty evident. 
The application of irritating matter to the termination 
of the mefenteric abl'orbents is the primary caufe. This 
irritant is either improper food, or food undigefted in con- 
fequence of dyfpepfia. The irritation on the oral extre¬ 
mities of the abforbents caufes an inflammation of their 
vefl'els, which is communicated to their glands ; the in¬ 
flammation deftroys in a great nleafure the abforbing pro¬ 
perty of the vefl'els ; and, when the inflammation termi¬ 
nates in depofition of morbid matter, as tubercles, &c. 
thofe properties are entirely loll; confequently the fup- 
ply of chyle to the blood is flopped, emaciation and de¬ 
bility follow, and the patient dies. The detail of fymp- 
toms is fufficiently full in Dr. Good’s definition. As to 
the treatment of the malady, this is to remove the exci¬ 
ting caufes ; under which plan, during its early ftages, 
the difeafe may be removed. Gentle dofes of calomel, 
althelmintics, wholefome diet, and the other meafures 
ufed in the treatment of difeafes arifing from gaftric, 
bilious, or inteflinal, irritation, are to he adopted. In the 
latter flages of the difeafe, extreme abltinence appears to 
be the only means capable of arrefting the depofition of 
tuberculous matter. Dr. Uwins has related a cafe, in 
which very minute dofes of digitalis, we believe one 
drop, gradually increafed, effedled a cure. Moft pradli- 
tioners trull to fmall dofes of calomel and opium. 
The fymptoms of this complaint are very fimilar to 
what Dr. Gregory has called u fcrofulous inflammation 
of the peritoneum.” It is very nearly the fame com¬ 
plaint, except that the irritation does not feem to be de¬ 
rived from the inteftines. The treatment of this latter 
difeafe, with the addition of occafional bliftering, is the 
fame as in the Struma mefenterica. 
' ^ 
Genus VII. Carcinus, [from y.apy.mo;, cancer, a crab ; 
on account of the cancriformor crab-like ramifications of 
the dark diftended veins of the tumour.] Cancer. Ge¬ 
neric charafters—A fcirrhous livid tumour, interfered 
with firm wliitifli divergent bands, chiefly of the fecer- 
nent glands ; pains acute and lancinating, often propa¬ 
gated to other parts; terminating in a fetid and ichorous 
ulcer. Dr. Good makes but one fpecies. 
Carcinus vulgaris : tumour burning, knotty, with dark 
cancrifortn varices ; ulcer, with thick livid retorted lips. 
^ A hard unequal tumour that is indolent, and with- 
Yol. XIX. No. 1304. 
291 
out any difcoloration in the Ikin, is called'a fcirrhus ; but, 
when an itching is perceived in it, which is follow'ed by 
a pricking, (hooting, or lancinating^ pain, and a change 
of colour in the fkin, it is ufually denominated a cancer. 
It generally is fmall in the beginning, and increafes gra¬ 
dually; but, though the Ikin changes to a red or livid 
appearance, and the ftate of the tumour from an indo¬ 
lent to a painful one, it is fometimes very difficult to fay 
when the fcirrhus really becomes a cancer, the progrefs 
being quick or flow according to concurring caufes. 
When the tumour is attended with a peculiar kind of 
burning fnooting pains, and the ikin hath acquired the 
duikv purple or livid hue, it may then be deemed the ma¬ 
lignant fcirrhus, or confirmed cancer. Mr. Pearfon fur¬ 
ther adds, when thus far advanced in women’s breafts, 
the tumour fometimes increafes fpeedily to a great fize, 
having a knotty unequal furface, more glands becoming 
obftrufted, the nipple finks in, turgid vefl'els are confpi- 
cuous, ramifying around, and refembling a crab’s 
clav.'s. Thefe are the character:flics of an occult cancer 
on the external parts; and we may fufpedl the exiftence 
of one internally, when fuch pain and heat as hath been 
defcribed fucceedin parts where the patient hath before 
been fenfible of weight and preffure, attended with obtufe 
pain. A cancerous tumour never melts down in fuppu- 
ration like an inflammatory one; but, when it is ready to 
break open, efpecially in the breaft, it generally becomes 
prominent in fome minute point, attended with an increafe 
of the peculiar kind of burning fliooting pain, felt be¬ 
fore at intervals in a lefs degree, and deeper in the body 
of the gland. In the prominent part of the tumour, in 
this ftate, a corroding ichor fometimes tranfudes through 
the fkin, foon forming an ulcer ; at other times a confi- 
derable quantity of a thin lymphatic fluid, tinged with 
blood from eroded vefl'els, is found in it. Ulcers of the 
cancerous nature difcharge a thin fetid acrid fanies, which 
corrodes the parts, having thick dark-coloured retorted 
lips; and fungous excrefcences frequently rife from thefe 
ulcers, notwithftanding the corrofivenefs of the difcharge. 
In this ftate they are often attended with excruciating, 
ungent, lancinating, burning,pains; and fometimes with 
leeding. 
Though a fcirrhus may truly be deemed a cancer as 
foon as pain is perceived in it, yet every painful tumour 
is not a cancer; nor is it always eafy to fay whether a 
cancer is the diforder or not; irregular hard lumps may 
be perceived in the breaft ; but on examining the other 
breaft, where no uneafinefs is perceived, the fame kind 
of tumours are fometimes found, which renders the di- 
agnoftic uncertain. Yet, in every cafe after the ceflTa- 
tion of catamenia, hard unequal tumours in the bread 
are fufpicious ; nor, though without pain, are they to be 
fuppofed indolent or innoxious. Barren women, old 
maids, and thofe who mifmenftruate, are chiefly the fub- 
jedls of cancer. 
The nature of cancer is unknown. It has long been 
difputed, whether it was. a general difeafe, a portion of 
the fluids determined by different caufes to the aftedled 
part, or whether any accident to the organ difeafed altered 
its former habits, fo as to produce a poifonous corrofive 
fluid inftead of the ufual falutary one. We regard it as 
local; and in this opinion many of the bell practitioners 
of the prefent day, among whom are Mr. Abernethy and 
Dr. Baillie, concur. All its fymptoms imprefs the notion 
that it is a local inflammation, as far as regards the vaf- 
cularfyftem, in which the feceryients, from hereditary 
predifpofition (which we cannot admit to exift in the 
blood), or from other at prefen t unknown caufes, lofe their 
natural functions, and acquire a faculty of fecreting a 
new and peculiar poifon. This a 61 ion of the fecernents 
is fo exceflive, that no known agents are capable of con¬ 
trolling it. The arguments adduced in favour'of the 
general origin of the difeafe are thefe ; that it is heredi¬ 
tary, and often met with in the fame family. This can 
be no argument in favor of it, were it not prefumed that 
4 F hereditary 
