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suspected there was a communication between it and the Œsophagus. I proposed the opening of it to my Brother, who was a young man, unexperienced and timid; he discovered fears on that account, and desired me to open it; I readily complied with his request, not having the least doubt upon my mind, as to the propriety of such a step: I made a moderate opening, at which was discharged a tea-cup of ichorous matter exceedingly fetid; and upon introducing a probe, it passed into the Œfcphagus, without any interruption, fully confirming our opinion.
The matter was of such a corrosive nature, that it immediately turned the probe of a copper color. The dressings afterwards were superficial, in the common manner, after injecting a little warm Jamaritan balsam with an ivory syringe. By opening the tumor, and this gentle treatment, the patient's pains were greatly mitigated, he swallowed soft food with ease, and his life was rendered, though not comfortable, much more tolerable; but his constitution was so much impaired, that notwithstanding all possible care, as drinking ass's milk, &c. he languished and died tabid about a year after. A
A Poor man about the same age, and In a declining state also, lately asked my advice, in a case similar to this, which I represented, at his request, to the Surgeon he intended to employ; giving an account of the preceding, in order to engage his attention the more; but leaving Norwich soon after, I did not hear the event.
A cancerous breast of an enormous size extirpated, and the wound healed.
Septemberthe nth, 1755.
T N a consultation held on the case of Mrs. D. of P. a woman remarkably corpulent, yet very active and temperate, it was unanimously agreed, that she had no other chance for relief than by losing her breast; which was about a yard in circumference, not yet fixed, but threatened immediate ulceration.
Under these discouraging circumstances, we cou'd not urge the operation; but the week following;, at her own desire, I performed it, Mr. Layman of Diss, an eminent Surgeon, and the Surgeon whose patient she had long been, assisting me. The operation did not prove tedious, considering the magnitude of the breast, nor did any thing material occur in it.
The skin of the whole breast was affected to such a 'degree, that we durst not attempt to preserve so much of it as we wou'd willingly have done; and the membrana adiposa was near five inches thick towards the Axilla.
We examined the principal distempered gland, suspended in a bloody fluid, which also appeared of a lymphatic nature, by inspissating with a moderate degree of heat. The cyst which contained the fluid, was formed of the capsula of the gland, the gland itself remaining in a Jcirrhous state; out of which an excrescence was grown, resembling the head of a colly-flower, as represented in PI. 7. Upon cutting into the body of the gland, which was like the gizzard of a turkey, we observed some vessels varicous, others ruptured, and many coagula of blood, such, we suppose, as the Ancients called Atra Bills, and looked upon to be the eiiicient cause of Cancers.
The wound healed very kindly, without any bad accident supervening, and was perfectly cicatrized in little more than three months, by the great care of the Surgeon
whose whose patient she had been before; and she enjoyed good health for about a year after.
December the 28th, 1756, I was again desired to meet her Surgeon in ordinary, on account of an indolent tumor which extended uniformly over the whole scapula on the other side, and measured three feet and eight inches in circumference, without the breast, or glands in the Axilla, being the least affected; yet I looked upon it as an appearance of the old leaven, and therefore advised no application, only to have it well supported, and that all possible care shou'd be taken to prevent its breaking; plainly foreseeing, that under such a circumstance, her case wou'd be still more deplorable.
Before her death, which happened on April the 2d, 1757, the tumor was much increaled; she lived but a short time after it -broke, and that in the utmost misery, without any ease, but what was procured by opiates: the discharge was immensely great, and the matter not only excessively offensive in smell, but the effluvia proceeding from it were so virulent, as to affect