Soranus gives a full account of scirrhous breast distinct from the cancerous. He states that when the whole breast is scirrhous and adheres to the chest, the excision of the sound parts from the diseased ought not to be attempted; but when only the extremity of the breast, or only the half of it is hardened, he approves of amputation without burning, there being no danger of bleeding in this case as in cancer. (66.) SECT. XLVI.—ON MALE BREASTS RESEMBLING THE FEMALE. As at the season of puberty the breasts of females swell up, so in like manner those of the males also swell to a certain extent; but for the most part they subside again. In some cases, however, having acquired a beginning they go on increasing, owing to the formation of fat below. Wherefore, as this deformity has the reproach of effeminacy, it is proper to operate upon it. Having, therefore, made a lunated incision below the breast, and dissected away the skin, we unite the parts by sutures. But if, as in women, the breast incline downward, owing perhaps to its magnitude, we make in it two lunated incisions, meeting together at the extremities, so that the smaller may be comprehended by the larger, and dissecting away the intermediate skin, and removing the fat, we use sutures in like manner. But if, through mistake, we should cut away too little, we must again remove what is redundant, and apply the remedies for fresh wounds. * * * * * COMMENTARY. The description given by Albucasis is so like our author’s that there can be no doubt of its being borrowed from him. When there is a great redundance of fat and flesh, he directs us to make two lunated incisions, the larger comprehending the smaller, and having dissected away the intermediate skin to unite the edges by sutures. (Chirurg. ii, 47.) Haly Abbas repeats the same description in almost the same words. (Pract. ix, 40.) Rhases recommends the operation upon the authority of Antyllus and our author. (Contin. xiv.) SECT. XLVII.—ON BURNING OVER THE LIVER. If the pain be attended with weight in those who have abscess in the liver, it is an indication that the fleshy part of the liver is affected; but if the pain be acute the matter is rather in the coats, and we must burn the part thus:—Having strongly heated slender, knobbed cauteries, we apply them a little above the loins at the extremity of the liver, making an eschar. But having burnt the whole skin and reached the coat we must evacuate the pus: after the discharge of which, having used lentils and honey, with the applications from honied water, and things of an incarnative nature, we have afterwards recourse to epulotics. * * * * * COMMENTARY. In cases of hepatitis, which do not yield to the usual remedies, the author of one of the Hippocratic treatises advises us to burn the side with spindles of boxwood dipped in oil, or with fungi. (De Morbis Internis.)