Page:Cyclopaedia, Chambers - Supplement, Volume 2.djvu/692

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' ft fchirrus or cancer by delay. The plafler of diachylon, with (he gums, or fome other fuch ripening plafter is to be applied forthwith ; and with all convenient fpeed the proper cata- plafms are to be ufed, to digeft the matter ; thefe are to be ap- plied hot to the breafts, and very frequently renewed, keep- ing them on with large comprefles and boltters, the better to retain the heat. The Tumor, when the matter is ripe, will by this means either break of itfelf, or elfe it mull: be opened by the fcalpel, the incifion being always made in the lower part of the breaft ; and after the matter is all discharged, the wound is to be -clean-fed with the common digeftives, incarned with tiie farcotic, and healed with the balfam of Peru, or fome other fuch vulnerary balfam. But where the fuppura- tion has run very deep, the wound mull be warned by means ofafyringe, with vulnerary decoctions; and to prevent the opening from clofing, before the bottom is healed, and filled tip with new flefli, a fort of tent of fcraped lint mull be intro- duced, which may be fhortened at every drefling, as the wound fills up, and at length wholly laid afide. Heifier's Surgery, p. 187.

Encyfted Tumors, Tumors arifing in different parts of the body, but contained in certain membranous coats : Thefe are Sometimes harder, Sometimes fofter, of a palifh colour, and ufually attended with little pain. Thefe Tumors arife from obstructions either in the glands, or in the adipofe membrane, more efpecially about the face and neck, where they occalion great deformity.

The membranous coat with which thefe Tumors are inverted, is often of a considerable thicknefs, and is ufually the coat of the difordered gland, or fome of the adipofe ceils. At their

■ beginning they are ufually very (mail and moveable ; but en- creafmg by flow degrees, they grow Sometimes to an enor-

■ mous bulk.

The confiftence of fome of thefe Tumors is foft and fluctuating, and of others more hard and firm. They are of all Shapes and lizes, and fome of them become hard as a callus, and im- moveable, while others are, for the generality, foft and moveable.

They are distinguished according to the confiftence of their contents ; fome are called atheromata, from their contents refembling pafte, others, which have them of the confiftence of honey, are called meliceres ; but if they are of a fatty fub-

• fiance, like fuet or lard, they are called Jieatomata. If they happen in a gland which becomes indurated, they are called

• fchirrousi and laftly, when they are of a flefhy confidence, they are called farcomata. Some of thefe Tumors have been found alfo full of hair.

They arc diftinguifhed by others according to the places where they are Situated. Thofe Seated under the Scalp are called talpa, teftudo, or lupla. Thofe in the neck, Jlrwnes or fcro- pbula ; and thofe in the hands and feet, especially if among the tendons, are called ganglions.

There is no general method for the cure of them ; but the Surgeon, according to their different circumftances, attempts this by diScuflion, Suppuration, or extirpation. Heifer's Sur- gery, p. 323. Fungous Tumours, in Surgery, are a Sort of Swellings much approaching to the nature of the oedema, and are often difor- ders of very bad confequence.

• Thefe are Tumors of a limb, taking their rife at the joint ; they look pale, are void of heat and pain, eafily'yield to the

• preflure of the fingers, hut rife again inStantly on removing the finger, leaving no pit or imprefuon behind ; tho' no joint of the upper or lower limbs can be Said to be Secure from this diforder, yet the knees are ever moft Subject to it, and that becaufe they abound in fat and glandular bodies, which are concealed among the ligaments and tendons. It is what we commonly know by the name of white Swellings or fcrophu-

■ ious Turners in the joints, and isoffeveral Species; Sor Some Tumors of this kind are larger, fome Smaller, fome fofter,

. fome harder ; and with regard to the State of the infpiffated fluid, Some are more, Some lefs glutinous. The noxious humours are ufually Situated without the joint, and are, in that caSe, properly what we are here treating of. But in fome they are collected and retained in the joint itfelf, as the Serum is contained in the tefticle in an hydrocele. This laft diforder is not improperly to be called a dropSy oS the joint ; and this may be commonly distinguished from the external fungous Tumors of the joints, by the inlargement which appears all ■ round the joint ; whereas the fungous Tumor is ufually Situated more on one or the other Side of it. The proximate cauSe of thefe 7 "umors is, doubtleSs, thevifci- dity of the ferum about the ligaments of the joints, which is apt to Stagnate after the ligaments have received any confidera- ble violence from a fall or a blow. The Tumor Sometimes

■ riSes in the external parts, Sometimes in the articulation it- felf, by which the ligaments being weakened, the part Iofes

- its natural motion ; and when the nerves or blood-veffels are greatly prefled upon by the Tumor, the pans below are ufually

- deprived of nourishment; and while the joint, by degrees, becomes greatly enlarged, the parts below it diminifh and

• vvafte.

In order to render the cure oS recent and milder Tumors, of

• this-'kind, the more eufy, by [difperfing remedies, it will be

proper to rub the disordered part with warm cloths every rJby# fomenting it afterwards with tartarized Spirit of wine ; and this method is to be carefully purfued, till the natural Strength and form of the limb are reftored. Purmannus's fomentation is excellent for this purpofe. It is made of Six ounces of roch- alum, an ounce and half of Roman vitriol, and two handfuls of fage leaves, boiled in a quart of herring-pickle, mixed with a pint of the Sharpen; vinegar ; it is to boil together Sor about half an hour, and then to be ufed as the before-mentioned. When the tumours begin to difperfe, and the parts to reco- ver their Strength, it will be a great forwarding of the cure, to foment the limb well fcveral times every day with tartarized. Spirit of wine, or with the foetid oil of tartar, laying the ban- dages carefully on every time afterwards, to defend it from the injuries of the external air, of which it is very Sufceprible : And laftly, the following is an application by which many of thefe Tumors have been perfectly and happily cured. Take litharge half a pound, bole armen'ic an ounce, maftic and myrrh of each half an ounce, white wine vinegar a pint; mix thefe together, and let them boil for a quarter of an hour, and let coarSe linnen rags be dipped in this liquor, or fine ones often doubled, and applied morning and night in bed to the part ; and at the fame time the patient is not to omit the pro- per internal remedies, which are the attcnuants and Sudori- fics.

But if the Tumor be of long Standing, and will not give way to any of thefe remedies, all the hope left is to make an incifion into the dependant part of it, taking great care to avoid wounding the ligaments or tendons of the joint ; and by this means the Stagnating Serum, if contained in one cavity, is in- ftantly evacuated, and if it be lodged in Several different cells, it will yet make its efcape through the fame orifice in the Space of a few days. Before the incifion is made, in this cafe, the Tumor Should be pulled down as low as may be with the ringers, and a tight bandage made above to retain it in that Situation ; by this means the moft convenient part for the in- cifion to be made in will He fair, and when the opening is made, the ferum will readily burft forth like blood on the opening a vein, or lymph in the tapping for the hydrocele or afcites. When this is done, if any Tumor Still remains, the part is to be drefled with diachylon or oxycroceum piasters, and wafhed with lime-water or Spirit oS wine. By continu- ing the applications, what remains infpiflated in the Tumor will entirely difperfe. When the limb is reftored to its natural Shape, the wound is to he healed with vulnerary balfams, di- ligently avoiding the ufe of fatty or oily medicines, as they are hurtful to the tendons and ligaments, with which thofe parts abound. If the Serum, contained in the Tumor, is So glutinous that it cannct difcharge itfelf for want of fluidity, throw up attenuating injections at every drefling. The belt for this purpofe are thofe prepared from a decoction of agri- mony, birth wort, or ladies mantle, mixed with honey, in which rofemary or celandine have been infufed. Notwith- standing that Such of thefe Tumors as are opened by the knife are Sooneft difcharged and healed, yet fome furgeons prefer the application of cauftic medicines to the knife, difcharging the ferum upon the falling off of the efchar. In either cafe it would be'propcr to warm and invigorate the ligaments and tendons, efpecially when the diSorder falls upon the knee, by the uSe oS Some nervous ointment, or aromatic Spirit. It too frequently happens, however, that after the wound has been cauterized, the infpiflated ferum having been firft ever So carefully evacuated, that there will be a frefh collection of a vitiated fluid in the part. In order to prevent therefore ait accident of this kind, let the patient be kept in a Strict courfe of purging, Sudorific and attenuating medicines, and the wound be kept open with tents, cleanfing it thoroughly every- day, by throwing up an injection, Such as has been before directed. It may be proper alfo Sometimes to inject iime- Water, and afterwards to cover up the part with a warm pla- fter, or foment it with fome liquor of the fame intention. It is, however, finally to be obferved, that it is not every fun- gous Tumor of the joints that can be opened with fafety ; for if the Tumor is of a very long Standing, hard, or of a very large fize, or the patient is of an infirm weakly habit of body, the knife muft not be thought of, as it would occaSion difbrders worSe than the firft ; to wit, caries, fiftulas, and gangrene. Heijier\ Surgery, p. 285.

We have an account of a very extraordinary Tumor in the knee of a perfon, whofe leg was taken off by Mr. Peirce at Bath. The leg and foot weighed Sixty- nine pounds. See Phil. TranS. N°. 452. Sett. 4. Windy Tumors. TheSe Tumors are formed by the air inclofed under Some membrane, which is dilated more or leSs by that air, according to its quantity, and from within which it cannot efcape, at leaft not of a certain time.

Thefe Tumors are uSually round, circumfcribed, or determi- nate, and if they are Struck with a finger, they give a found like that of a blown bladder. They have no particular feat in any part of the body, but almoft every part is more or lefs liable to them. The great difficulty in accounting for thefe Tumors, is to Say

- how the air comes to be collected there ; but the moft proba-

- : ble cauSe Seems to be the collecting together of a quantity of a

3 fluid