Imatges de pàgina

creasing our stock of knowledge, or furnishing us with any means of combating the evil. The work, however, turns out to be something like the Alchemist's search after the Philosopher's Stone, whereby many things were found which were never sought for; since the whole drift of our author's reasonings tends to prove, that there is no such thing as Cancer of the breast; at least, that there is nothing peculiar in Cancer, but what arises merely from the nature of the parts attacked with inflammation and ulceration. In his endeavours to establish this doctrine, if he is unsuccessful in his object, he has conferred a very great obligation on the profession, by pointing out and drawing their attention to those numerous cases of indurated mammæ which the routine practitioner heedlessly pronounces to be of a schirrhous or cancerous nature, and either advises extirpation, or sows the seeds of alarm and misery in the patient's mind, thereby greatly aggravating the original disease, which, by soothing treatment and mild yet judicious applications, might have been entirely removed. In showing, therefore, how much may be done by medicine and regimen for the removal of tumours which are suspected to be schirrhous, Dr. Rodman has given us a more useful book, than any which could have been written by the ablest practitioner on Cancer itself.

We must be allowed to observe, in limine, that although Dr. Rodman is perpetually railing against theorists and men of genius, there is scarcely a page of his own work which does not contain theoretical speculations, which in most instances are palpably obscure, we had almost said unintelligible, and conveyed in the most unhappy, the most uncouth, and often the most ridiculous language. Mixed up with these defects and blemishes, we can clearly discover genuine good sense, acuteness of observation, and judicious practice; circumstances which amply compensate for the imperfections alluded to, and which we point out as independent and unbiassed Reviewers, for the sake of the author himself, who will doubtless profit by the honest and disinterested advice here with offered.

The work, though formally divided into chapters, is so singularly devoid of method or arrangement, that it almost bids defiance to any attempt at analysis. By a careful perusal indeed of its contents, we could, from the impression on our memory, convey to our readers a very just conception of our author's opinions and practice, in our own words; and to this plan we shall be forced to resort, in most instances, during the present critique.

The first chapter, “ The feeble structure of the female constitution," conveys to us, with endless circumlocution and obscurity of language, the knowledge of a fact which is familiar to all medical men of reflection and observation, but which is little attended to by the host of routine practitioners; namely, that in both sexes, but particularly in the female, certain affections of the mind have a powerful influence in deranging the functions of the body, more especially the functions of the digestive organs.

“ There is an affection,” says our author, “ with which females are afflicted, appearing next to that of an inherent or universal disease among them, and this is a state of the stomach whereby digestion of food is often imperfectly performed; and during such a state, the bowels are usually constipated. The effects resulting from both of these occurrences upon all the system, are indubitably hurtful.”p.7.

This is true; and it might also have been remarked, that disordered states of the digestive organs arising from other causes than mental emotions, produce and aggravate that fickleness of mind and irritability of temper, which in their turn re-act on the corporeal functions. So intimate, in short, is the sympathy or connection between mind and matter, in these cases, that it is generally impossible to say where the malady originally commenced.

In the second chapter Dr. Rodman treats of the “disposition of mammary glands, and origination of tumours.” After remarking on the complicated and vascular texture of the female breast, he thus proceeds to account for the "origination of tumours.”

“Even in the best of health, each gland, to a certain extent, swells and subsides frequently, from the quantity of fluids which enter the vessels at one time and leave them at ano. ther, so that their contents are often varying in bulk. This variety of contents arises from several causes, but one is the power of uterine influence, by which, at the catamenial periods, fluids are injected into the vessels more abundantly than at the times intervening. And during such a state, it is very usual for partial obstructions to occur, and small knots to form in the body of the breast, without exciting troublesome feel. ings, or requiring any extraordinary attention. Knots of this kind are generally of short duration, and being customary, exist many times unnoticed.” p. 17.

If this be the case in health, our author asserts that it is still more so in disease, and in fact, that mental commotions and corporeal ailments augment, if they do not occasion the generality of mammary enlargements. Two of the principal external causes of the origination of tumours in the female breast are long pressure and sudden violence. Of the former, tight lacing is the most prominent and dangerous, since, as it acts gradually, and the feelings from it are not severe for some time, it meets with less attention.

“ But this leads me," says Dr. Rodman,“ to notice what I have already mentioned, that the mammary vessels, even when healthy, are naturally subject to a state of periodical plethora; a state which is afflictive only when the body is diseased and irritable. Now, if weakness and irritability of the frame, catamenial excitation, and diseased turgidity and tenderness of the breast, in consequence of pressure, be all experienced at the same time, the individual is greatly disordered, and becomes one of those vexatious cases, wherein Mr. Abernethy says, the mammary gland seems to be a nidus for carcinomatous action." p. 21, 22.

The effects of external violence occasioning tumours in the female breast need not be dwelt upon, nor those indurations resulting from milk abcesses, or milk gorged in the breasts from early weaning. But it is useful to bear in mind, that under all these circumstances, the application of cold is singularly powerful in producing swelled lymphatics, or lacteals thickened and tense like small cords, with numbers of bulky or clustered glands dispersed over several parts in the body of the breast. It is generally at these times, when the breast is suffering from affections of cold, that shooting pains occasion so much alarm to the patient. The second section, or remainder of this chapter, entitled “ Probable affections,” is entirely filled with unintelligible theory, while our author is every where exclaiming against genius and speculation!

The third chapter, on “The locality of mammary disease arising from affections of the mind,” is more interesting, and exhibits our author in a favourable view. He very justly observes, that a large class of females " disregard the concerns of health, as though it were unworthy of esteem," till it is lost, or till some painful affection (especially a mammary one) rouses their attention, and then life seems highly precious, and they are all alarm for its safety! Our author asserts and we have reason to believe his assertion, that when the mind of a female is rendered anxious by, and her attention drawn to, any painful sensation in the mamma, the local affection is so much under the influence of mental agitation, that it is almost instantaneously aggravated thereby, and continues to fluctuate according to the state of the mind as well as of the body, throughout the disease. He justly observes also, that there is a peculiar sympathy which reigns amongst females respecting cancer in the breast, that causes the most afflictive sensations of alarm, when any friend or acquaintance is distressed with a mammary tumour named cancer. The idea of a lingering and painful disease, or a terrible operation, preys upon their minds.

“ Hence, the lively conception of sufferings from the mammæ of others, affects these organs in themselves, by their attention resting upon them, which, in progress of time, occasions a painful plethora of a similar part.” p. 57.

Though this may be termed a fanciful doctrine, we believe it to be founded in fact, and it points to useful hints in the method of treatment. This supposition explains the fact of mammary affections being more active in some districts than in others; and also why, as practitioners have often remarked, an unusual number of females apply for medical advice respecting diseased breasts immediately after the amputation of a cancerous mamma in the neighbourhood. It may also explain why the disease has even been considered hereditary, since it is natural to suppose, that the daughter who has long witnessed the sufferings of a cancerous parent may be easily led to conclude, that every pang in her own breast is only a prelude to what her mother endured from cancer of the same organ.

Dr. Rodman brings forward cases illustrative of this sympathetic affection of the breast, which are sufficiently convincing, but we deem it unnecessary to quote any of them.

In the fourth chapter our author endeavours to show, that on real criterion of schirrhous tumours exists; and, in short, that all tumours may become what is termed cancerous, if neglected or mismanaged, the whole phenomena being the result of inflammation, preceded, in general, by local plethora, and mental or corporeal disorder.

“When such a state of inflammation is repeatedly occasioned, the small glandular bodies around the tumour continue to harden, and adhering to its surface, become part of its body. The morbid production depends upon the frequency, and also upon the continuance of the inflammatory process, both for its bulk and for its figure. The hardness results likewise from similar causes; and as for the arrangement of fibrous texture, in the internal structure of a diseased mass, it seems to occur in consequence of various degrees of the inflammatory process, by which, taking place while the body is afflicted with different degrees of indisposition, may be viewed as almost sufficient to produce an endless variety.” p. 81.

Now, although we are unable to offer any explanation of that singular“ arrangement of fibrous texture,” which distinguishes cancer, or rather schirrhus, and from which it probably derived its name, yet we believe that few medical men will consider the elucidation of our author as at all satisfactory. The ligamentous bands which issue from the nucleus of the tumour, like radii from a centre, are not what might be expected from successive and various degrees of inflammation, for in the latter case they would be like the layers of an onion, or circling round, instead of issuing from a common centre. But it is time to leave theory and return to practical points.

The fifth chapter is entitled “ The Influence of Cold.”

After some judicious remarks on the delicacy and susceptibility of the female constitution, Dr. Rodman proceeds thus:

“ It has already been seen, that indigestion is a very common and hurtful complaint among the sex. Every thing, therefore, which has a tendency to this complaint, tends infallibly to increase the disposition to disease. If they be over-heated and fatigued, then for some time exposed in this state to a current of cold air, or other cold medium, the sense of immediate injury may, perhaps, be trifling; yet sickness at stomach, and an unhealthy colour of the excretions, are apt to come on the following day. Not only so, but a considerable languor of body,

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