On Prison and Workhouse Dietaries
Authors: E. Lankester
Journal: BMJ (1867)

3So 7'HE BRITISHI MkEDICAL 7OURNAL.(NoV.2, 1867.far fromiusual, and, as a conseqiuience, the probabilities of the case tend towards that of innocenyc.Should the tumour have gradually assumncd a globular form, the quiestion of chronic suppuration may be enter- tained; andL1, shiould fluettuationi ie detected, though indistinctly, the na- ture of the discaie will have become tolerably certain.In these cases, an exploratory l)unctulre withi a grooved nee(lle becomes of incalculable value.Withouit it, errors in dliagnosis will be made; for chironic absces.se.s have niot unfrequently been cut into, and breasts have even been removed, utnder the mistaken notion that cancerous (lisease existecd.I the fi)ollowing cases, such an error in diagnosis might have been made, hiad too muchi confi(lence been p!aced in certain symptoms, or too little attention beenl lpaid to the history of thle disease; and, as such, are de- serving of stuldy.CASIE 1. 7'unior;-in Br-ea sirhnutitinur se.-ionts Diseas.e:C/ironzic A4sc,ss, ard A'-overy,.-E.F., aged 32, came unlfer Iny care oni April 2nd, 1867, wvith a ttunour in her right breast of nine months' growth, of the size of ain orangc, and enlarge(d axillary glands.The tumour had been of slow growth for eight monthis; but for the last few weeks its increase had been rapi(d.It had given rise to little pain.The nip)ple was slightly retracted, and lhad discharged for the early months a watery fluid, but for the last the discharge had ceased.She was a married woman, the inother of four children, the youngest being two.She had never stuckledl with the affecte(d breast, as the nipple hiad been too tender.T'he dia,nosis of this case was not clear.The tumiour w.as somsewvhat globular and(t elastic; antl thus the cystic nature of the disease was slightly in(dicated1.The history of the case pointed towa(lds a chlrollic abscess.Tnd(ler these circumstances, an exploratory pl1netle was de- manide1d.Pus escapcd.I1'e abscess was fairly opened, eight ounces of pups escaping.By June 6th slhe wvas declared well.C%sm.: i./,ronic Ind aiora/jo qfAxilla:y Lobe qfRi;rhi Breast, uwit/h contract,-sl NiAple anld Enlarey Axi.'/n,y Glands.-Emnma G., aged 30 came in(ler iliv care April i Stlh, 1867, with a ' tumonour in the outer half of the right breast of nine Years' duIration, a retracted nipple, and i enlar,e(d axillar-glands."The tumouir was evidenitlv an infiltrating uone, and involved the axillary half of the glantd.Bly the local symptonis alone, the tiaue diagnosis of the case would have beeni difficult, if not im- l)ossible; for the symptoms presemit were precisely thosc whiclh are met wvith in a cancer.T'he age of thc patiemit (30), and the (luration of the (isease (nine yearA), however, militate(d a-aiinst this view; an(l, wheni we founld that she wvas a married womzan, the mother of six children; that shc hadl never suickle(d fromii that breast, on accouint of tile contracted nipple;, andi that the lump) in thla breast had appeared after her first con- finement,-the tric natuire of the case was revealedl.B3y treatmenciit, all these syml)toms subsided; andi on Junc 6thi she was well.( To be concltuded.)OBSTETRIC MEMORANDA.UNIDFR this hleade v shall fiom timiie to time, as materials conie to han(l fromii correspodl(lents, pul)lish recor(is of cases remarkable in them- selves, or ilLu.trating points of initerest in obstetric psractice, theirapCUtic or manipulative.WNe shlall p)robably in this way preserve from oblivion the notes of vciy nany usefiul am I instructive occurrenlces in private .Practice, for the great obntetric experientie is tlat-for the nmost part hiitherto unwritten -of the great body of general p)racdiLioners throughout Gireat Btritaini.WN'e will onily ask those w-ho may forward cases for record to relate the:u with the utmost brevity, atnd cqually to condeinse any appended renmark,;.CASE; OF INTRAUTE,RINE' ABISCESS.iBy JOll-N TAYLOR, E sq., Ticehiuirst.HI.S., age(l 17,