Volume 1

The works of John Hunter / edited by James F. Palmer.

Date:
1835-37
Catalogue details

Licence: Public Domain Mark

Credit: The works of John Hunter / edited by James F. Palmer. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    LECTURES ON THE of the surrounding parts; so that if we remove the tumour in this con- dition, the glands in the breast will probably inflame and sometimes sup- purate, although often these effects are not cancerous. When inflamed, the tumour increases very fast, but the sympathy is very slow, which is common in many diseases. When distant parts, not in the line of the absorbents, are affected, it would appear that such parts are very slow in taking on the diseased action, although the disposition has been formed, for we frequently see that they do not take on an active form for some years after. In those cases where there is absorption of coagulable lymph, it becomes a question whether the lymph is cancerous, or whether the affection is only sympathetic: most probably it is the last. The last two forms of the disease are generally very slow, which circumstance makes them dangerous, as it cannot be ascertained when parts are really affected with the disease, which often necessitates a second operation, it being necessary to remove all the parts which have undergone the dis- position, although the inflammation or tumour itself is circumscribed. The predisposing Causes of Cancer are three in number, viz. age, parts, and hereditary disposition; perhaps climate also has considerable effect, though not itself a predisposing cause. The cancerous age is from forty to sixty in both sexes, though it may occur sooner or later in certain cases. The testicle, for instance, often becomes cancerous at twenty or thirty ; but then not from the disposition of the parts alone, but from accident*. Cancer has been supposed to be in young people’s eyes; therefore it is most probable that the breast is less subject to it at this age, and other parts are not so much confined to age in this dis- ease. WTe often see tumours in the breast at thirty, and probably some of them are cancerous, although scrofula is more to be sus- pected. When cancer occurs in the breast of women under forty, it is more rapid in its progress than when the patient is older, and also more extensive; remote sympathy likewise takes place more readily in them than in the old, so that the operation succeeds better in the latter on this account. However, we seldom find it in the young or very old ; although of the two it is most frequent in the latter. When it occurs in the young, does it not show a very strong disposition for the disease, and therefore more danger, from a greater likelihood of its returning ? * [The distinction between the various forms of medullary disease and cancer was not well understood in the time of Hunter, and consequently he has classed together several diseases which modern pathologists have very properly separated. It is unques- tionably true that cancer may exhibit itself before the age of forty, and fungus liaema- todes after that period: still, as a general rule this does not happen, nor is there any individual fact more characteristic of the difference of these diseases than the different periods of life at which they respectively occur.]