Tumours formed by the enlargement of glands are frequently productive
of dangerous consequences. If situated in the neck, they may render
breathing and deglutition extremely difficult, and in the event of
their suppurating, the purulent matter may be discharged into the
trachea or gullet; fatal results have followed the giving way of an
abscess into the former canal. The breathing is also seriously impeded
by enlargement of the bronchial glands, by the pressure of which
the lungs may be much condensed, and unfitted for their functions.
The immediate effect of enlargement of the mesenteric glands, is
interruption to the passage of the chyle, and a consequent decline of
the powers of life. Such tumours in the abdomen have been mistaken for
enlargement of the liver, spleen, ovarium, &c., and the most noxious
treatment employed.
Inflammatory glandular enlargements terminate either in resolution, in
delitescence, or in suppuration; sometimes in death of the part. When
the tumour, after having attained a certain size, gradually disappears,
it is said to be resolved; when, however, it is rapidly discussed, it
terminates in delitescence; the difference between the terms being
the same as when used to express the corresponding terminations of
inflammatory swelling in general.
Suppuration is by far the most usual termination, and the matter is
frequently evacuated through numerous small apertures, exposing the
gland denuded and prominent in the middle of the chasm; in such cases,
the gland proves the source of much irritation, and must be destroyed,
otherwise the cure is extremely tedious.
Though inflamed and swelled lymphatic glands very generally disappear
by suppuration, it is to be remarked that the conglomerate glands,
though often violently inflamed, seldom, if ever, have pus formed in
them; in mumps, for instance, the action often runs very high, yet
abscess of the parotid is rare. The submaxillary salivary glands are
often supposed and said to be inflamed and enlarged; the conglobate
glands superficial to them are in such cases only affected.
Collections of pus in the lymphatic glands or cellular substance, in
patients of a weak constitution, (whether naturally or in consequence
of disease,) are attended with little or no pain, or inflammatory
action; and although it is probable that inflammation does precede the
formation of such purulent depôts, still it is generally so slight
as not to attract the attention of the patient or his attendant. The
sensation is dull and uneasy, rather than painful; and, even after the
accumulation of a considerable quantity of purulent matter, redness of
the surface and pointing do not occur till a late period. The contained
matter is thin, flaky, and of a brownish colour. The collections often
attain a very great size, and, if improperly treated, terminate in the
formation of numerous and extensive sinuses.
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