On follicular disease of the scalp / by James F. Goodhart.

  • Goodhart, James Frederic, 1845-1916.
Date:
[1870]
Catalogue details

Licence: Public Domain Mark

Credit: On follicular disease of the scalp / by James F. Goodhart. 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.

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    cases before us certain sebaceous tumours, in some instances after a long period of quiescent existence and at the declining period of life, begin to increase in an active manner. It may not be that they put on at once all the characters of infecting tumours, yet, inasmuch as at a critical period they become active in their development, that fact alone should cause them to be regarded with suspicion. The daily practice of surgery does but confirm in other regions this relation between the age of the patient and the character of the tumour. The period of life at which the disease occurs is, it seems to me, the one great point which influences surgeons in the diagnosis between inno- cent and malignant tumours. Take, for example, those of the female breast. If a patient comes under notice, past middle age, Avith a nodule which has as yet none of the features of an in- filtrating growth, yet a surgeon will be very cautious in pro- nouncing it of an innocent nature. Or, again, an infiltration of the breast is under consideration, unaccompanied by any glan- dular enlargement, and perhaps Avith a definite history of in- jury. Again, he will lean towards cancer in the old jDatient, while, without doubt, in younger life the question of chronic inflammation would be discussed and a more hopeful prognosis given. Thus, it will be seen that sebaceous tumours, with their stage of fungating disease, lead up to the old question of a special cancerous diathesis. Let it not be understood that such a wide subject is about to be argued out here ; only proceeding from these special cases it Avill be well to see what suggestions they off'er on the more general question. Now, if it be true that certain individuals may exist for years Avith an apparently innocent tumoiu-, and suddenly, at a certain period of life, such tumour may begin to grow and, perhaps, to infiltrate neighbouring structures, it is diflicult to explain in such instances the diathesis of later life apart from tliat of its earlier stages. If ultimately a cancer why not ahvays a cancer, sup- posing a special tendency to that disease to exist, and yet the earlier stages of these groAvths could not be designated as such. The proposition, then, Avhich such cases seem to suggest is this, that the tendency to infiltrating and recurrent grOAVths is de- pendent rather upon the element of age than upon a particular constitutional taint. This is not to say that cancer, using the