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Show qr "removes. there is no such thing as the conversion of diseaSe: Mr. Pearson expresses himself thus: " Writers have indeed said much about certain tumours changing their nature, and assuming a new character: but I strongly suspect, that the doctrine of the mutation of diseases into each other, stands upon a very uncertain foundation. Improper treatment may without doubt crasperate diseases, and render a complaint. which appeared to be mild and tractable, dangerous or de~ structive; but to aggravate the symptoms, and to change the form of the disease, are things that ought not to be confounded. 22,? or rnir‘ouns: I do not ailirm, that a breast which has been the seat. of a mammary abscess, or a gland that has been affected by scrophula, may not become cancerous; for they might have suffered from this disease, had no previous complaint existed; but these morbid alterations generate no greater pro- pensity to the cancer, than if the parts had always retained their natural condition." I cannot entirely agree with this opinion. I conceive that a part deprived of its natural ac- tion, is in a certain measure thrown out of the governance of the general (economy, and is left a prey to irregular action, to disease. When a gland is injured by a blow, and the inflammation has gone high; if the natural structure and (economy be deranged, permanent disease follows the subsid ing of the mere inflammation. So we see that there is a period of life when the breast and womb become useless, and the influence of the system is no longer felt upon them ; then disease fixes on them. I am not able to give any other explanation of the cancerous affections of the womb and mamma being so frequent at the turn of life. By pushing this discussion a little further I am led to conclude, that dis- em is not the effect of circumstance, and impression, but that there is a latent tendency to certain diseases, which take place in the absence of the controul of the healthy action. 0f the extirpation of tumours by the knife. Tumours of glands are cut out, as being likely to propagate a malignant disease ; as apt to increase and press upon important places, Before we think of using the knife, we must consider well whether the tumour be simply scirrhous, or if it be of the nature of a carcinoma; or whether a capsule has been fornied which marks the limit of the diseased action, or the sur‘ rounding parts be imperceptibly assimulat ed into the disease. In carcinoma, Mr. Hunter observed a disposition in the sur= rounding parts prior to the actual occurrence of disease in them. This remark, says Mr. Abernethy, is ratified by daily‘ experience, and has led to the following rule of practice ; that a surgeon ought not to be contented with removing merely the indurated, or actually diseased part, but that he should take away some portion of the surrounding substance. The simpler statement I fancy to be, that long before the eye can discover diseased texture in the substance, the action is propagated which must necessarily precede this effect. However that may be, it is particularly necessary to exa~ mine the edges of a tumour which has been cut out, and to me that there is none of the peculiar texture of the tumour terminating abruptly on the edge, as if out through. For example, the character of carcinoma, as exhibited on dissection, is in the condensed cellular membrane, which has a very pe. culiar appearance of irregular diverging streaks of a whiter colour, in the darker substance of the tumour ; now if these membranous bands have reached into the cellular texture which has been left after the tumour is cut off, the disease will inevitably return, and grow with a rapid progress. The tumour is, therefore, to be held in reference to the wound, and where these bands are found to terminate abruptly, or here in tire tumour there are any hardness and irregularity, or pulpy matter, or substance which does not appear of the natural texture, the corresponding part of the wound is to be examined, and the remaining disease extirpated. We must ever remember, that if tumours possessing malignity are only partially extirpated, they resent the injury offered to them, and resume a worse aspect than befme. If we are to operate on a tumour which has its seat in a gland, and if it be a mere scirrhns, there is a circumstance. which if Ilu» '15 the eye, or throat : or lastly, from mere unseemliness. .; l Hanna-'4.- 1 , 22i3 ‘ 1 V.» ;""TT'TWTii'I WON! ' morn U- |