A contribution to the surgical pathology of sero-sanguineous cysts in the neck and axilla / by John Birkett.

  • Birkett, John, 1815-1904.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: A contribution to the surgical pathology of sero-sanguineous cysts in the neck and axilla / by John Birkett. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    6/24 (page 4)
    between the nipple and shoulder. The integuments were not affected. It slowly increased and, four years after first observing it, a puncture was made, and about three fourths of a pint of colourless fluid removed. The cyst refilled, and in February, 1859, about the same quantity of serum as above described was withdrawn. Neither of these operations was followed by any constitutional disturbance. The fluid again collected, and when I next examined the case the following conditions existed. There was a large swelling occupying the right axilla, extending forwards to the mammilla, and backwards between the scapula and thorax. It was easily pressed in every direction, and, when the arm was brought against the side of the chest, the swelling bulged forwards and backwards. The wall of the cyst was not very tense, so that its thickness could be determined by nipping it up between the finger and thumb. The wavy, vibratory movement of a circumscribed collection of fluid was visible and palpable throughout the swelling, when its surface was gently tapped with the fingers. The translucency of the swelling was very apparent. The patient never experienced any pain in the part. It was easily ascer- tained that the cyst extended beneath the pectoral muscle in front, and between the scapula and the thorax behind. Above it reached the clavicle, between which bone and the tumour the axillary vessels and nerves were situated. 1st Operation, October, 1860.—I performed paracentesis of the cyst, and removed about twelve ounces of amber- coloured, clear fluid in which laminse of eholestearine floated. Heat coagulated it into a solid mass. A second very small cyst was felt above and attached to the collapsed one. 2nd Operation, September, 1861.—At this date the swelling being inconveniently large, I removed about three ounces and a half of serum possessing the characters above described. When the cyst was collapsed, I could feel a solid mass in the armpit. On this account I delayed injecting the cyst with tincture of iodine, the treatment I had pro- posed to adopt.