. Cyclopædia of obstetrics and gynecology. of a cancerous nature, was held, thematter was a very simple one; but as we now no longer believe in thisdogma, only an exact, anatomical, differential diagnosis can decide. Unfortunately I cannot offer anything to aid in the diagnosis. Inthe anatomical examinations which I have made on this subject, sufficientanalyses with modern methods have always shown it to be carcinoma. Iwas very much disposed to doubt the existence of a chronic mastitis ending 36 DISEASES OF THE FEMALE MAMMARY GLANDS. with cicatricial shrinking (though I did not entirely disbel
. Cyclopædia of obstetrics and gynecology. of a cancerous nature, was held, thematter was a very simple one; but as we now no longer believe in thisdogma, only an exact, anatomical, differential diagnosis can decide. Unfortunately I cannot offer anything to aid in the diagnosis. Inthe anatomical examinations which I have made on this subject, sufficientanalyses with modern methods have always shown it to be carcinoma. Iwas very much disposed to doubt the existence of a chronic mastitis ending 36 DISEASES OF THE FEMALE MAMMARY GLANDS. with cicatricial shrinking (though I did not entirely disbelieve in it), whena short time ago I had a patient in whom there was a condition of theleft breast which was without doubt what I had until then sought for invain. A. M. W., a farmers wife; 45 years old, always healthy; alwaysmenstruated regularly; had borne nine children, the first fifteen years,the last two and one-half years ago. She had nursed all the children atboth breasts, usually for sixteen months, and had never had a bad Fig. 11.—Shrivelling of the Left Breast from Chronic JIastitis, without Suppuration. (Unfortunately no mention was made in the history as to Avhether men-struation had ceased at the time or not.) Wliil e nursing her youngest child,which was born November 3, 1878, she noticed that a spot as large as anut and above the nipple of the left breast was becoming hard; this in-duration constantly increased, particularly after the cessation of formed and gradually the gland atrophied, as shown in theillustration. The riglit breast, which was well-developed, remained abso-lutely unchanged. There had been no pain during the whole process. ciirOnio mastitis. 37 and even at tliis time palpation was not painful. The axillary glandscould not be felt. The atrophied gland was freely movable over the pec-toral is major muscle: its consistence Avas that of a moderately firm cicatrixthough not so firm as a scirrhus. There were no indurate
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