The principles of surgery . tooplain; often neutralizing the results of operations otherwise most pro-mising. And the liability to such a perverted state of system mustalways be borne in mind, in reference to treatment and a still more formidable diathesis is found occasionally to occur;productive not of neuralgic pains but of neuromatous tumors, through-out the whole body; as in the remarkable cases related by Mr. Smith ofDublin. Such general disease is manifestly hopeless, under any treatment. PAINFUL TUBERCLE. 553 Painful_ Tubercle.—This is often termed also Subcutaneous; its
The principles of surgery . tooplain; often neutralizing the results of operations otherwise most pro-mising. And the liability to such a perverted state of system mustalways be borne in mind, in reference to treatment and a still more formidable diathesis is found occasionally to occur;productive not of neuralgic pains but of neuromatous tumors, through-out the whole body; as in the remarkable cases related by Mr. Smith ofDublin. Such general disease is manifestly hopeless, under any treatment. PAINFUL TUBERCLE. 553 Painful_ Tubercle.—This is often termed also Subcutaneous; its mostfrequent site being the areolar tissue, immediately beneath the skin;and sometimes the integument also seems to be partially , however, it is found in the intermuscular areolar size seldom exceeds that of a pea or bean; and is often less thaneither. The structure appears very similar to that of the neuroma ;but often more dense; and sometimes containing points, if not actually Fig. Painful subcutaneous tubercle, on the fore-arm.—Smith. bloody, at least of a blood-like appearance. This last condition, how-ever, may be accidental; the result of external injury. And probablyit is so; for the structure, in all other respects, seems to be simple andbenign. Another difference from the neuroma is, that whereas in thelatter the nervous fibres are very apparent, here the fibrous matterseems to be mainly, if not wholly, a new production. No nervoustrunk is continuous with the mass; only the minute terminal branchesare capable of being traced into it. The tumor is very movable;gliding under the finger. But it is intolerant of the slightest pressure;intense pain being produced thereby. The pain sometimes assumes theform of paroxysms; induced by the slightest external influence, andsometimes of spontaneous origin. More frequently than the neuroma,it has been associated with hysteria; but, usually, the general health isless disordered than in neu
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