The breast: its anomalies, its diseases, and their treatment

1917·35.8 MB·English

by  Deaver, John B. (John Blair), 1855-1931

HarvardMedicalLibrary
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THE BREAST:
ITS ANOMALIES, ITS DISEASES,
AND THEIR
TREATMENT
DEAVER AND MCFARLAND
Digitized by the Internet Arciiive
in 2010 with funding from
Open Knowledge Commons and Harvard Medical School
http://www.archive.org/details/breastitsanomaliOOdeav
THE BREAST:
ITS ANOMALIES, ITS DISEASES,
AND THEIR
TREATMENT
BY
JOHN B. DEAVER, M. D., LL. D., Sc. D.,
PROFESSOROFTHEPRACTICEOFSURGERY,UNIVERSITYOFPENNSYLVANIA;SURGEON-IN-CHIEFTOTHE
GERMANHOSPIIAI,;VISITINGSURGEONTOTHEHOSPITALOFTHEUNIVERSITYOFPENNSYLVANIA;
CONSULTINGSURGEONTOTHEGERMANTOWNHOSPITAL,THEPHILADELPHIAGENERALHOSPITAL,
SAINTAGNESHOSPITAL,ANDMOUNTSINAIHOSPITAL,PHILADELPHIA,PENN'a.
AND
JOSEPH McFARLAND, M. D., Sc. D.,
PROFESSOROFPATHOLOGYANDBACTERIOLOGYINTHEMEDICALDEPARTMENTOFT
OFPENNSYLVANIA; PATHOLOGIST TO THE PHILADELPHIA GENERALHOSPITAL;
FELLOWOFTHECOLLEGEOFPHYSICIANS,PHILADELPHIA, ETC.
ASSISTED BY
J. LEON HERMAN, B. S., M. D.,
ASSISTANT SURGEON TO THE METHODIST HOSPITAL OF PHILADELPHIA; INSTRUCTOR[iN ANATOMY,
MEDICALSCHOOLOFTHEUNIVERSITYOFPENNSYLVANIA'
WITH 8 COLORED PLATES AND
277 ILLUSTRATIONS IN TEXT
PHILADELPHIA
P. BLAKISTON'S SON & CO.
1012 WALNUT STREET
Copyright, 1917, by P. Blakiston's Son & Co.
PREFACE ^Rd^r:
^
Inpresentingthisbooktotheprofession,itsauthors(havebeenmovedbytwoprime
considerations:first, theirnportanceofcollectingindividualexperienceinorder that de-
ductionsandgeneralizationsmayfollow, and, second, thedisseminationof knownfacts
ofvitalimportanceinthetreatmentof themalignantdiseasesofthebreast._)
However much we may deplore the fact that the essential cause of the neoplastic
diseasesremainsunknown,andourinability,intheabsenceofthatknowledge,toprevent
suchdiseases,therearecertainresponsibilitiesarisingfromwhatwedoknowbutdonot
properly utilize. The critical examination of the results of any large series of cases
cannotbutproduceaprofoundimpressionandlead to thedistressingrealizationof the
fact,thatwe,asaprofession,arefarfromthescientificapplicationofmuchoftheknowl-
edgealreadyatourdisposal.
Wereweproperlyalivetothesituationasitexiststo-day,adeathfromexternalcancer
wouldbe theexceptionratherthantheruleanditwouldbeuniversallyrecognizedand
admittedthattotemporizewithasuspicionofmalignantdiseaseis criminal.
Anyone acquainted with the excellent treatises of Velpeau, Cooper, John Rodman,
Birkett, Billroth, Bryant, Williams, Binaud and Braquehaye, Sheild, Handley, W. L.
Rodman and others willrealizehow muchalllaterstudentsofthesubjectowetothese
authors; adebtwhichwefreelyacknowledge.
ThesectionsonpathologyreflectthepersonalviewsofDr.McFarland,andarebased
upon the study of 575 cases, which are not the same as those from which the surgi-
calstatisticsarecompiled. Thelatterarederivedfrom the German HospitalofPhila-
delphia, where approximately 1000 records of surgical breast cases were at our dis-
posal, though unfortunately many of them were too incomplete to permit utilization
in detail. W^ehave, however, been able tokeep a sufficient numberof operative cases
underobservation, tolearnthatwehaveestabhshednohigh-watermarkinthe cureof
malignantdisease ofthebreast;wecannotevenlayclaimto asgreatsuccessashasbeen
claimedbysomeofourcontemporaries.
HaditnotbeenfortheindefatigablelaborsofDr. J.LeonHermanthisbook would
not now be existing. We desire, therefore, especially to acknowledge his part in the
workand our obhgations to him. We also wish very particularly to acknowledge our
indebtedness to Dr. Pfahlerfor his contributionupon"The Non-OperativeTreatment
of Cancer," and to Dr. A. D. Whiting for the preparation of the index.
Welikewisedesiretoexpressourthankstomanywhohavecontributedtothe value
ofthebookinwaysthatonlytheauthorscanthoroughlyappreciate. Wemake special
acknowledgment of the courtesy and promptness of Dr. Halsted of Johns Hopkins
University and of Dr. J. Collins Warren of Harvard University, in responding to our
request for assistance in thepreparation of the chapter on "The Operative Treatment
of Carcinoma," aphase of our subject with which the names of these gentlemen must
everbeassociated.
Wemustmentionwithpraisethe translationofmanypapersinforeignjournalsby
MissA. M. Jastrow, and the numerousoriginal drawingsbyMr. CharlesF. Bauer.