An Account of a Person Deceased of a Scirrhous Tumor in His Breast. By Mr Tho. Greenhill, Surgeon

III. An Account of a Person deceased of a Scirrhoue Tumor in his Breast. By Mr Tho. Greenhill, Surgeon. Mr J. D. departed this Life the first of this instant, and was supposed to dye of a Consump- tion, forasmuch as 14 months before he had been violently seized with an Inflammation of his Lungs, accompanied with a sharp Fever, Difficulty of Breathing, Cough, acute Stitches, and Pleuritick Pains, with a spitting Blood, &c. He was bled largely in the beginning; and often repeated it during his Sickness, continually taking such proper Remedies, as were prescribed him. But notwithstanding about Easter, there appeared a Tumour on the Breast Bone, Pap, and Pectoral Muscle, of the Left Side, with a fulness under the Axilla: From whence there was conjectured to be a collection of Purulent Matter in the Cavity of the Thorax, and that the Sternum was foul. The first from the aforesaid Tumors, and his spitting a bloody and purulent Matter, and the latter from the rising and inequality of that Part. But opening him the third of this month, I found his Case very different and surprizing, which several judicious persons that attended him in his sickness, and were present when he was opened, can testify. For so soon as I had divided and removed the common teguments of the Thorax, I found, instead of a rising of the Bone with Cariosity, only an oblong tumor, about four fingers in length, and two in breadth, and a proportionate thickness, weighing about 3 ounces, it extended itself perpendicularly, on the superficies of that part of the Sternum, which joyns with the Cartilago Ensiformis. I separated it with my Knife, easily, from the Breast-bone, and found it to be of that sort of Wens or encisted Tumors called Atheroma, containing a pappy substance like sodden Barley. Next appeared a very large tumor on the Left side of the Thorax; covering the whole Pap and Pectoral Muscles forwards, with a fulness under the Axilla of the same Arm. Then opening the Thorax, I found the same Tumor comprehending the Intercostals, Deltoides, Subclavian, and Subscapular Muscles, and the whole Axillary and Mamillary Glands, which being obstructed, and its Vessels replete with a creamy pappy Matter, more thick and white than the former, there was produced such an induration of the atorsaid Glands and Muscles, which compose the upper part of the Breast, that it may more properly be esteemed a Schirrous. The same tumor on the outside of the Breast was somewhat bigger than ones Hand, extending itself from the Clavicle to the lower part of the Pap; and laterally from the Basis of the Muscle quite under the Arm-pit. Internally it possessed a third part of the Cavity of the Breast, crowding the Left Lobe of the Lungs to the Right Side, and in its upper part firmly growing to it; which it likewise did every way to the Intercostal Muscles. It was about the bigness of a Penny Loaf; and the whole Tumor being considered together, might reasonably be allowed to weigh between 3 and 4 pounds, which being cut into, there ouzed out of it, like an expressed Sponge, a great quantity of thick, white and pappy Matter: And what is more particularly remarkable, there was form'd a large Sink or Pelvis, in the middle of the Axillary Gland, which contained a thinner and discolour'd Matter, and had a free Communication to the Vessels of the Lungs in the upper part of it, where I told you before it was united; and from hence it was that he generally found ease when he had somewhat emptied it by large expectorations, and that he could so exactly perceive, when any thin Rheums or Matter Matter flowed to the part: And it was here only that the Lungs were black and replete with stagnated Blood, and some Globules of the aforesaid Matter in its Vessiculae. The rest of the Lungs were pretty clear from any Ulcers or Matter, but of a Sublivid Colour, and strictly adhered on both sides to the Pleura, but particularly on the Left side, all about the Schirrous Tumor. The Vessica Fellis or Gall Bladder was full of Stones, of the bignets of a Runcival Pea, and consisted most of odd Angles, and were formed of a thick Viscous Sediment of Gall (which we found in it) from an obstruction of its Vessels, or Jaundice, which he had some years before: They were in number 22, some triangular, quadrangular, quincuncial, &c. There was nothing more remarkable, besides a Marasmus of the External parts, the washing of the Gall, and emptiness of all the Viscera and Blood Vessels in general.