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. The breast: its anomalies, its diseases, and their treatment . s, brownish fluid is discharged. It represents the products ofnecrosis and its escape continues until a deep ragged ulcer is formed and cicatrization 244 THE BREAST begins. As the lesion is apt to be centrally situated, the nipple is not infrequently de-stroyed and in severe cases almost the entire breast may become slowly transformedinto a malodorous slough closely simulating a broken-down malignant tumor as in theremarkable very destructive gumma reported by Bryant (Diseases of the Breast,1867, p. 73). He reports the case of a
. The breast: its anomalies, its diseases, and their treatment . s, brownish fluid is discharged. It represents the products ofnecrosis and its escape continues until a deep ragged ulcer is formed and cicatrization 244 THE BREAST begins. As the lesion is apt to be centrally situated, the nipple is not infrequently de-stroyed and in severe cases almost the entire breast may become slowly transformedinto a malodorous slough closely simulating a broken-down malignant tumor as in theremarkable very destructive gumma reported by Bryant (Diseases of the Breast,1867, p. 73). He reports the case of a woman with an induration of the upper half of the left breast that had beencoming on for 8 or 10 months. In August, 1869, the skin on the lesion was natural. In addition to themammary induration she had a lesion over the frontal bone. In October, 1869, the skin had becomebossy and there were external signs of inflammation—heat, redness and fluctuation. In March,1870, the breast had become as large as a cocoanut, the skin over it was ulcerating, and the gland. Fig. 113.—Gumma of the breasts with other tertiary lesions of syphilis. (Porter.) tissue seen through the opening looked dead and presented a yellow wash-leathern aspect so character-istic of syphilis. In September, 1870, the whole mass sloughed and fell as a putrid mass into a basinleaving a clear granulating surface. On November 10, 1870, the woman was well. Actual gangrene may occur as in Robinsons case (Medical Times and GazetteLondon, 1864, II, 261). A less frequent manifestation of tertiary syphilis is diffusesyphilitic mastitis. Fundamentally the process is similar to gumma, but instead of theforce of the infection concentrating at a single focus and effecting complete destruction,it occurs at many tiny scattered foci, and distributing its force over considerable tissue,loses its extremely destructive character. The result is a subacute inflammatory dis-turbance without resemblance to tumor, without ulceration,
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectbreast, bookyear1917