A system of surgery : pathological, diagnostic, therapeutic, and operative . remedy is early and free excision; but under opposite circum-stances, or, when it coexists in other parts, or is extensively diffused throughthe cutaneous and areolar tissues, all interference of the kind should be avoided,as likely to accelerate the fatal crisis. 13. SCIRRHUS. Scirrhus of the cutaneous tissue is also exceedingly uncommon ; it is, however,occasionally met with in various parts of the body, particularly the face, forearms,and hands. It generally begins in the form of a whitish, milky, or leucoid spot,c
A system of surgery : pathological, diagnostic, therapeutic, and operative . remedy is early and free excision; but under opposite circum-stances, or, when it coexists in other parts, or is extensively diffused throughthe cutaneous and areolar tissues, all interference of the kind should be avoided,as likely to accelerate the fatal crisis. 13. SCIRRHUS. Scirrhus of the cutaneous tissue is also exceedingly uncommon ; it is, however,occasionally met with in various parts of the body, particularly the face, forearms,and hands. It generally begins in the form of a whitish, milky, or leucoid spot,commonly a little elevated above the surrounding level, but now and then appa-rently somewhat depressed, of a dense, firm consistence, more or less rough, andcompletely inlaid in the substance of the skin. Large vessels frequently extendacross the affected parts, the redness contrasting strikingly with the whitenessof the intervening surface. Movable at first, the tumor gradually contracts adhe-sions, and, in time, involves the subcutaneous cellular substance. If a section. 592 DISEASES OF THE SKIN AND CELLULAR TISSUE. chap, i, be made, it will be found to be traversed by white lines, and to yield, on pressure,a small quantity of lactescent fluid. Although the progress of this aifection is usually slow, its tendency ultimatelyis to disintegration and decay, the resulting ulcer having an irregular, jaggedappearance, with everted edges, and a foul bottom, the discharge being of asanious or ichorous nature. More or less pain, of a sharp, lancinating character,generally attends. As the morbid action proceeds, new leucoid spots are oftensuperadded to those already existing ; the health gradually gives way, and thepatient finally dies exhausted, though commonly not until carcinomatous diseasehas developed itself in some of the internal organs, particularly the lungs, pleura,and liver. Occasionally the affected parts assume a true encephaloid character,and in this way a tumor of consid
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