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ABSCESS IN AN ENLARGED PROSTATE AND IN BOTH KIDNEYS.
97 Thomas
G--, aged sixty,
was
admitted
on
the 14th of
after death.-Body well nourished. healthy. The spleen was pulpy. The pelves of both kidneys were dilated and vascular; the corAutopsy,
were
sixteen hours
March, 1863, into Luke ward, under Mr. Hilton, with urinary The thoraoic organs
were
due to enlargement of the prostate. Soon after he sank into a typhoid state, as if the kidneys had become in- tical part was increased in thiokness, and both organs were volved, and died on the 13th of April. sprinkled with minute abscesses. The walls of the bladder Autopsy, twenty hours after death.-The body was wasted. hypertrophied and fasciculated. The prostate was enThe ureters and pelves of kidneys were greatly dilated. On larged. and contained an abscess. the right side the pelvis was as large as the kidney, and the ureter as capacious as the small intestine. When opened a milky fluid poured out, bat the mucous membrane was not MIDDLESEX HOSPITAL. much altered in character. Both kidneys were wasted, and ABSTRACT OF NOTES OF FIFTY CASES OF CANCER OF the section showed numerous white lines, as if an inflammatory THE BREAST product were thrown out in their tissue. Their capsules were firmly adherent to the tissues around, so that they could not (Under the care of Mr. T. W. NUNN.) be extracted with the organs themselves. They were also (Concluded from page 39.) irregular on the surface, and the cortex was wasted. Bladder much hypertrophied; the muscular bands of great size and very GROUP VI. prominent. The middle lobe of the prostate was enlarged OF TWO YEARS’ DURATION. CASES to the size of a chesnut, and projected into the interior of the bladder. CASE 33.-Caroline P-, aged forty-five. Dec. 3rd, J860 : The nipple of the left breast has disappeared by ulceration. ST. GEORGE’S HOSPITAL. The whole gland is more or less solidified, but especially at its STRICTURE OF URETHRA; ABSCESS BEHIND PROSTATE; inner and lower portion. The disease has existed two years; SACCULATED BLADDER. there is axillary enlargement and swelling of the arm; the suffering is intense. care of the Mr. PRESCOTT (Under HEWETT.) Jan. 7th, 1861.-The lower deposit has ulcerated; pains ex. JA1BIES P-, aged fifty-six, admitted April 23rd, 1862, with tend over all the limbs. the history of stricture of many years’ standing. The urine April 19th, 1861.-Since last report the patient has been was passed in a very small stream-in fact, sometimes dribbling suffering almost without intermission. The entire gland is away. It was very thick, alkaline, containing a large amount hardened, and is superficially ulcerated at many points. The of ropy mucus, and presenting under the microscope an im- patient died shortly after this date. CASE 34.-Hannah P-, from Gloucestershire, aged forty. mense quantity of triple phosphates. Attempts were made to Has two round, tense, red, shining, pass an instrument, but without avail, as the urethra was in an eight. Jan. 3rd, 1861 : tumours between the nipple and lower border of protuberant a irritable bled much time and condition, every exceedingly the right breast, the centres of which have excavated ulceracatheter was passed. About a week before his death he was tions. She first noticed a lump, the size of a bean, two years seized with a severe attack of rigors, followed by pain and and a half ago, which gradually increased. About five weeks swelling in the perineum ; he had almost total suppression of since she was seized with shivering and sickness, with pain urine, and became rapidly jaundiced. Large amounts of stimu- over all the body. From that date the excavation has more lants were given him, but without avail; the rigors continued rapidly progressed. The painfulness varies much, and its accession was very gradual. unabated, and he died from exhaustion on the lst of July. Autopsy, thÙ’tyfow’ 7aours after death.-There was a conSept. 21st.-Reported to have returned to the country, and siderable wound in the scrotum, which, however, did not open to have increased much in size, while the breast has been getting into the urethra. The aorta was dilated just above the cardiac worse and worse. The patient’s family history is somewhat interesting. The valves ; about the first part of the arch was a quantity of soft atheroma between the inner and middle coats of the vessel. father was living, aged seventy-four; mother died of "dropsy," The liver contained a few patches of fatty degeneration. The aged sixty; maternal aunt died of cancer of the breast; fathers right kidney was enlarged and softened at many points; aunt died of the same affection; first cousin died of cancer of through its structure were minute abscesses : these were about the womb, and a sister died of ovarian dropsy. as large as peas. The left kidney was atrophied, and the pelvis CASE 35.-Eliz. H-, aged fifty-nine, from Wiltshire. dilated; it contained no abscesses. Both ureters were pervious, June 10th, 1861 : Has a small tumour above the nipple in the and slightly injected; the right more so than the left. A large left which has existed during eighteen months. No breast, circumscribed abscess lay between the prostate and the bowel; further report. this was about the size of a tennis ball. The bladder was CASE 36.-Eliz. H-, aged fifty-five. June 12th, 1862: dilated and hypertrophied. The walls were excavated b3 several pouches as large as chesnuts; these were lined witt Has a contracting scirrhous mass, the size of a small orange, below and to the outer side of the nipple of right breast, which mucous membrane, which had been projected between th< fasciculi. The orifices of the pouches were so minute as to bE was discovered one year since. The nipple is so retracted as to almost imperceptible. The urethra was slightly narrowed fo; be hidden. She suffers much from pain; is liable to rheumatism in the leit ankle. The arm does not swell. a short distance, commencing two inches in front of the bulb Dec. 1st.—The axilla examined carefully to-day. There is The mucous membrane was here thick and rough; there was : no enlargement. false passage to the left of the median line in the membranou April, 1863.-Patient cheerful. The disease has made but part, where also was considerable irregularity. little progress. ABSCESS IN AN ENLARGED PROSTATE AND IN BOTH KIDNEYS. May 28th, 1863.-About the same. CASE 37. -Mary H-, aged forty-two. June 12th, 1862 : (Under the care of Mr. POLLOCK.) Has a tumour of the right breast, with enlargement of the The notes of the following case are condensed from the report axillary glands. Disease commenced one year since. She is of Mr. Woodhouse Braine. thin, and has suffered from hemoptysis or from haematemesis, Charles B-, aged fifty-four, admitted February 4th, 1863. and has been under the care of Dr. Chorley at the St. MaryleAbout nine months ago he perceived that his stream of urine bone Dispensary for the complaint. She suffers much pain in began to get smaller, and for the last few months he has had the breast. incontinence of urine, accompanied with aching pain in the! July 27tb.-Breast has been very painful, but has not inregion of the bladder. A catheter was passed after he had, asI creased in size. he thought, emptied his bladder, and about half a pint of urinei Oct. 23rd.-Has been in the country for some weeks; breast drawn off, showing that he had enlarged prostate. A few daysabout the same. after admission he had increase of lumbar pains, with rigors, Feb. 5th, 1863.-Several pea-like nodules have made their and his tongue became dry and brown. At this time he mani- appearance around the tumour. feated much disinclination to move or talk, and he becamei March 5th.-Disease spreading. 26th.-Nodules inflamed. drowsy. On the following day the drowsiness much increased, the breathing became stertorous, with subsultus, and he died ont April 4th. —Numerous nodules have invaded the breast of the 10th February, at ten r.M. the opposite side within the last fortnight.
symptoms
(OUT-PATIENTS).
.
.
.
’
-
,
G--, aged sixty,
was
admitted
on
the 14th of
after death.-Body well nourished. healthy. The spleen was pulpy. The pelves of both kidneys were dilated and vascular; the corAutopsy,
were
sixteen hours
March, 1863, into Luke ward, under Mr. Hilton, with urinary The thoraoic organs
were
due to enlargement of the prostate. Soon after he sank into a typhoid state, as if the kidneys had become in- tical part was increased in thiokness, and both organs were volved, and died on the 13th of April. sprinkled with minute abscesses. The walls of the bladder Autopsy, twenty hours after death.-The body was wasted. hypertrophied and fasciculated. The prostate was enThe ureters and pelves of kidneys were greatly dilated. On larged. and contained an abscess. the right side the pelvis was as large as the kidney, and the ureter as capacious as the small intestine. When opened a milky fluid poured out, bat the mucous membrane was not MIDDLESEX HOSPITAL. much altered in character. Both kidneys were wasted, and ABSTRACT OF NOTES OF FIFTY CASES OF CANCER OF the section showed numerous white lines, as if an inflammatory THE BREAST product were thrown out in their tissue. Their capsules were firmly adherent to the tissues around, so that they could not (Under the care of Mr. T. W. NUNN.) be extracted with the organs themselves. They were also (Concluded from page 39.) irregular on the surface, and the cortex was wasted. Bladder much hypertrophied; the muscular bands of great size and very GROUP VI. prominent. The middle lobe of the prostate was enlarged OF TWO YEARS’ DURATION. CASES to the size of a chesnut, and projected into the interior of the bladder. CASE 33.-Caroline P-, aged forty-five. Dec. 3rd, J860 : The nipple of the left breast has disappeared by ulceration. ST. GEORGE’S HOSPITAL. The whole gland is more or less solidified, but especially at its STRICTURE OF URETHRA; ABSCESS BEHIND PROSTATE; inner and lower portion. The disease has existed two years; SACCULATED BLADDER. there is axillary enlargement and swelling of the arm; the suffering is intense. care of the Mr. PRESCOTT (Under HEWETT.) Jan. 7th, 1861.-The lower deposit has ulcerated; pains ex. JA1BIES P-, aged fifty-six, admitted April 23rd, 1862, with tend over all the limbs. the history of stricture of many years’ standing. The urine April 19th, 1861.-Since last report the patient has been was passed in a very small stream-in fact, sometimes dribbling suffering almost without intermission. The entire gland is away. It was very thick, alkaline, containing a large amount hardened, and is superficially ulcerated at many points. The of ropy mucus, and presenting under the microscope an im- patient died shortly after this date. CASE 34.-Hannah P-, from Gloucestershire, aged forty. mense quantity of triple phosphates. Attempts were made to Has two round, tense, red, shining, pass an instrument, but without avail, as the urethra was in an eight. Jan. 3rd, 1861 : tumours between the nipple and lower border of protuberant a irritable bled much time and condition, every exceedingly the right breast, the centres of which have excavated ulceracatheter was passed. About a week before his death he was tions. She first noticed a lump, the size of a bean, two years seized with a severe attack of rigors, followed by pain and and a half ago, which gradually increased. About five weeks swelling in the perineum ; he had almost total suppression of since she was seized with shivering and sickness, with pain urine, and became rapidly jaundiced. Large amounts of stimu- over all the body. From that date the excavation has more lants were given him, but without avail; the rigors continued rapidly progressed. The painfulness varies much, and its accession was very gradual. unabated, and he died from exhaustion on the lst of July. Autopsy, thÙ’tyfow’ 7aours after death.-There was a conSept. 21st.-Reported to have returned to the country, and siderable wound in the scrotum, which, however, did not open to have increased much in size, while the breast has been getting into the urethra. The aorta was dilated just above the cardiac worse and worse. The patient’s family history is somewhat interesting. The valves ; about the first part of the arch was a quantity of soft atheroma between the inner and middle coats of the vessel. father was living, aged seventy-four; mother died of "dropsy," The liver contained a few patches of fatty degeneration. The aged sixty; maternal aunt died of cancer of the breast; fathers right kidney was enlarged and softened at many points; aunt died of the same affection; first cousin died of cancer of through its structure were minute abscesses : these were about the womb, and a sister died of ovarian dropsy. as large as peas. The left kidney was atrophied, and the pelvis CASE 35.-Eliz. H-, aged fifty-nine, from Wiltshire. dilated; it contained no abscesses. Both ureters were pervious, June 10th, 1861 : Has a small tumour above the nipple in the and slightly injected; the right more so than the left. A large left which has existed during eighteen months. No breast, circumscribed abscess lay between the prostate and the bowel; further report. this was about the size of a tennis ball. The bladder was CASE 36.-Eliz. H-, aged fifty-five. June 12th, 1862: dilated and hypertrophied. The walls were excavated b3 several pouches as large as chesnuts; these were lined witt Has a contracting scirrhous mass, the size of a small orange, below and to the outer side of the nipple of right breast, which mucous membrane, which had been projected between th< fasciculi. The orifices of the pouches were so minute as to bE was discovered one year since. The nipple is so retracted as to almost imperceptible. The urethra was slightly narrowed fo; be hidden. She suffers much from pain; is liable to rheumatism in the leit ankle. The arm does not swell. a short distance, commencing two inches in front of the bulb Dec. 1st.—The axilla examined carefully to-day. There is The mucous membrane was here thick and rough; there was : no enlargement. false passage to the left of the median line in the membranou April, 1863.-Patient cheerful. The disease has made but part, where also was considerable irregularity. little progress. ABSCESS IN AN ENLARGED PROSTATE AND IN BOTH KIDNEYS. May 28th, 1863.-About the same. CASE 37. -Mary H-, aged forty-two. June 12th, 1862 : (Under the care of Mr. POLLOCK.) Has a tumour of the right breast, with enlargement of the The notes of the following case are condensed from the report axillary glands. Disease commenced one year since. She is of Mr. Woodhouse Braine. thin, and has suffered from hemoptysis or from haematemesis, Charles B-, aged fifty-four, admitted February 4th, 1863. and has been under the care of Dr. Chorley at the St. MaryleAbout nine months ago he perceived that his stream of urine bone Dispensary for the complaint. She suffers much pain in began to get smaller, and for the last few months he has had the breast. incontinence of urine, accompanied with aching pain in the! July 27tb.-Breast has been very painful, but has not inregion of the bladder. A catheter was passed after he had, asI creased in size. he thought, emptied his bladder, and about half a pint of urinei Oct. 23rd.-Has been in the country for some weeks; breast drawn off, showing that he had enlarged prostate. A few daysabout the same. after admission he had increase of lumbar pains, with rigors, Feb. 5th, 1863.-Several pea-like nodules have made their and his tongue became dry and brown. At this time he mani- appearance around the tumour. feated much disinclination to move or talk, and he becamei March 5th.-Disease spreading. 26th.-Nodules inflamed. drowsy. On the following day the drowsiness much increased, the breathing became stertorous, with subsultus, and he died ont April 4th. —Numerous nodules have invaded the breast of the 10th February, at ten r.M. the opposite side within the last fortnight.
symptoms
(OUT-PATIENTS).
.
.
.
’
-
,