[110] Of this nature was probably the ulcer mentioned by Mr. Wiseman, at least if we may judge from his very short description: “It had eat deep into her left breast, and was fixed to the ribs, but not with much pain. In progress of time, the lips inverted, and united, as it were, and lay covered with a crusty scab; the humour in the mean while spent itself upon the nerves, &c. She lived long, and, in her latter age, tolerably healthful.” Chirurg. Treatises, Vol. I. p. 165. [111] Extirpation is the only certain cure of this disease; and it is at all times the quickest and the best; but, by eschoritics, we may sometimes procure cicatrization, at least if the gland have shrunk, and most of its substance been destroyed. This disease may attack the uterus, and is very apt to be confounded with cancer; nor is it easy to distinguish them, as the parts are unseen. There is never much enlargement. The ulcer is pretty smooth, and the margins circular, hard, and glabrous. The pain is not very considerable. The discharge is thin, copious, and of a yellowish colour, but seldom bloody, unless when the disease has continued very long. The spongoid inflammation has been considered as cancerous by those who have seen it; but the distinction betwixt the two is sufficiently obvious: The one begins with a spongy elastic tumor, the other with a firm hard lump. Scrophula may be mistaken for cancer, when it appears in one of the secretory glands, such as the breasts; at least as long as it remains without ulceration. But the tumor generally enlarges more rapidly than cancerous tumors, at least such as are not very painful. It is pretty soft and doughy, the pain is inconsiderable, and we may generally perceive the marks of a scrophulous habit. When ulceration takes place, the opening is, for some time, sinous, and the matter discharged is curdy, and without fœtor. When the ulceration extends along the skin, it has not the fungous appearance of cancer, but the aspect of a scrophulous sore, and the gland below appears sloughy. The pain is not very considerable, and is not the burning kind. Scrophulous inflammation may also attack the uterus, bladder, and any of the internal organs. The uterus and bladder become thickened, and contain abscesses in different parts, which point on the surface of these viscera. They are filled with a thick white cheesy-looking matter; and when they burst, they produce ulcers, with a foul surface, and having the margins notched, and lying for a considerable way over the disk of the sore.