OCR Text |
Show or removes. or re HOURS. using this unintelligible language if we will but acknowledge our ignorance. What governs the constitution of the part in health unites it by adhesion, or circumscribes the new formed A tumour, on the contrary, is a circumscribed swelling, with new modification of the structureés, which arises in con- granulations when it is cut, or injured, so that they rise to the surface, but no further. There is no necessity, nay, there is no foundation for supposing, that an alteration in structure, or in the action of the part, (further than in degree,) is necessary to its closing when cut, to its restoration when injured. When we reflect that every part in its natural state is continually changing, not for a day remaining ac~ tually the same in all its parts, but that absorption and depo‘ sition are going forward perpetually, while the external character and form, the internal structure and the very constitution of the part remain the same, need we seek for any other explanation of the healing and the restitution of a part injur: 'Mgflq.‘ {no-9"». v.92,- er» . "I ed than the continuance of the same uniform influence, the same action of vessels ? A silent and imperceptible influence preserves the part during the necessary changes from youth to age; by violence this influence becomes apparent, which is owing to the demonstrable nature of its effects, not to the change of its action. ""6 cannot judge of the action of vessels but by their effects; when we see that the tendency of increased action is to the restitution of the frame to its origin al and perfect state, we must consider the action as natural ; as still influenced by the same principle which originally formed it, and by which, during a course of changes, it was preserved. These considerations, I hope, will lead us to adhere to the definition of tumour given by other surgical pathologists. " W:- o‘UFK'fc-ffi-n, p.. , . We shall be enabled to distinguish betwixt mere tumefaction and confirmed tumour, while, I hope, we shall be led to a rational principle of practice. A swelling is a mere consequence of over-action in vessels where yet there is no change or modification ; in this case the mere reduction of the strength and activity of the part will be followed by the reduction of the tuiuefaction. 20! sequence of a specific action ; does not spontaneously disappear ; and will not subside by the mere subtraction of blood, or diminution of activity in the vessels. A tumour is often superadded to the natural body, but is constituted sometimes by the preternatural augmentation of a part; for example, of a gland, in consequence of a specific change, and increased activity of the vessels of the part. In illustration of what I have here delivered I venture to add this example : "When a man breaks his leg I conceive it is . ., I ‘xqr'r-Inrv :: , 206 healed, not by a new action, not by a stimulus of necessity, which implies the residence of an intelligent principle, but by the continuance of that uniform influence which brought it from cartilage to bone, which prescribed the form of the bone, which preserved its form whilst its particles were changing daily. Those operations we did not see : neither the destruction, nor the renovation of the parts ; but now we see the renovation because the destruction and injury were palpable ; and this, not from the change of action, but from the change of circumstances. When, however, the new bone is not level with the old, when it is different in structure and redundant, * On the term tumour, the following observations of Mr. Pearson are most pertinent: "Chirurgical writers have generally enumerated tumour as an essential symptom of the scirrhus ; and it is very true, that this disease is often accompanied with an increase of bulk in the part affected. From long and careful observation I am however induced to think, that an addition to the quantity of matter, is rather an accidental, than a necessary consequence, of the presence of this peculiar affection. "'hen the breast is the seat of a scirrhus, the altered partis hard, perhaps unequal in its figure, and definite ; but these symptoms are not always connected with an actual increase in the dimensions of the breast : on the contrary, the true icirrhus is frequently accompanied with a contraction, and diminutionot bulk, a retraction of the nipple, and a puckered state of the skin. The irritation produced by an indurated substance lying in the breast, Will very often cause a determination of blood to that organ, and a consequent enlargement ot'it ; but I consider this as an inflammatory state of the Surfoundmg parts, excited by the scirrlius acting as a remote cause, and by no means essential to the original complaint. » e-H W0M 7' M09917 |