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Show 222 "vii-my rim 1 or rumouns. the growth of a steatome in the marrow of the bone, in which the bone enlarging becomes a shell to the fatty tumour, until perhaps the softer substance bursts through the boneas. The term osteo-sarcomatous describes that softening and enlarge. ment of a bone in which the tumour exhibits a mixture of soft and bony matter and softer fleshy substance. But the in this Opinion much to ponder on and to admire. The matter in which the action resides, is the result of disease; the disease varies in its nature; the structure of that matter, so formed, slightly deviating, must affect the action residing in it; and that action having no doubt the character of all de- action of the vessels, the nature of these tumours, partakes of existence may be undoubtedly varied and modified. Thus it appears to me that new diseases are formed in many of the individual tumours, though they are not propagated: a correct general classification may no doubt be expected from a great variety. Indeed the term STEATOM gives us an improper idea of the common fatty tumour of the body, which is a diseased acretion of fat nourished by vessels, and often without a cyst, or much to distinguish them from the common fat but their inordinate growth. It is not in vindication of the imperfection of this sketch of a classification of tumours that I venture to throw out a doubt of a possibility of making a perfect catalogue and a description of them. Without boasting of how much I have seen, I may assert that I have seen a distracting multiplicity in the character of tumours. I have seen lately, and expect often to see, tumours which bear no accurate resemblance to such as I have seen before, or such as I find described. Tumours are not like animals, each proceeding from a stock, and bearing the mark of that origin. They are not like the diseases of the natural body, which, in similar circumstances is always similarly affected. But, to use the words of Mr. Abernethy, they are edifices which are built up by diseased actions, and in which these diseased actions reside. There is * In the greatest enlargement of a bone it often occurs, that What appears like an immense bone is but a shell. ‘Vhen the bony matter is absorbed on one side of a bone, we see it accumulated on the other ; when wasting with« f'fl"";‘ 'VVW"-'¢I-- . N< ,2. . -. 'll‘flfl" 223 or rumours. out, accumulated within 3 in short, when there are the most decided ravages of disease the bone is strangely disfigured, but still the mass of earthy matter remains nearly the same. In considering this disease ofarteo-steatoma, or of the cases which I have seen, when the tumour of aneurism, and the formation of bone went on together ; it appears, that the bony matter forms a shell as long as the original quantity of matter is not exhausted ; at last , however, the growth of the original tumour becoming too large, the thin shell of bone is absorbed over the most prominent part of the tumour, and die tumour seems to burst through. viations from nature, viz. a less definite and circumscribed careful observation, but I think it will ever be liable to de- rangement by the observation of individual cases, OF THE TREATMENT OF TUMOURS. Of a snvcllcd gland. It is only by the continuance and ob-« stinacy of a tumour in resisting remedies, that we know it to have such a peculiarity of action, as to afford little hopes of its resolving. In the beginning of every tumour, therefore, much the same practice may be pursued; and I shall state What is right to be done, under the idea that we still hope that it is merely a gland accidentally swelled; and where the diminution of the action may be followed by the decrease of size, and the restoration of its natural function. When a patient comes to us with a sWelled lymphatic gland we first consider the probabilty there is of its being in consequence of some irritation in the course of the absorb- ents ; or we attend to the probability of its being scrophulous and constitutional. If we find it a solitary swelling of a lymphatic gland, for example, in the neck, we take into consideration its seat, and the course of the vessels ; there is, perhaps, a scabby eruption about the roots of the hair, a gum- boil, ulcerated sore throat, discharge from the nose, &c. If there should not be one, but many glands swelled, and indu~ rated, we must look to the age and constitution, and not com. mit the error of treating wholly as a local disease that which has its origin in the prevailing tendency of the system. . 1-. ._‘1 H "'n-Tw-w-e‘ , , ‘ . Vlthl 'MOSE‘iI‘ M |
