SYPHILITIC INFILTRATION OF THE MAMMA. MASTITIS.
That different forms of syphilides may extend over the skin of the mamma is self-evident, and in themselves they have nothing to do with disease of the mammary gland. The presence of syphilitic ulcers of the nipple has already been mentioned. That gummata occur in the mam mary gland has only recently been proved. Hennig describes a case, in which an autopsy was made: "A woman, 55 years old, was bedridden for four years on account of syphilitic ulceration of the bones of the knee. The mammary glands were of medium size and unchanged in their acinous parts. Between the lactiferous ducts, which were somewhat pushed aside, in the middle of each gland, though a little towards the anterior surface, there was a gumma, inches long, wide, and on the right side, on the left, .07 inches thick. The right was somewhat internal to and below the nipple, and was caseous in the middle, on both sides projected centrifugally flat nodules, bounded peripherally by a pale reddish-brown, somewhat jelly like on the left, oedematous tissue-structure, by which the whole new growth appeared somewhat hilly. Superficially it occupied perhaps a
third part of the extent of the gland." From this description, without microscopical examination, it cannot be Bait' that it was necessarily a .syphiloma which was seen; it might have been scirrhus, which is, at times, oilateral in old women. Among the cases reported by Ambrosoli Med. Bahama Lombardia, S.V., T. III. No. 36, 1864), one was in a young man the two others in young women, 19 and 24 years of age. Both of the latter had constitutional syphilis, had swellings in the anterior parts of the right mamma, which disappeared under the use of mercury. The cases cited by Hennig and Virchow from Sauvages, Marin, Biercher and Follin, show nothing special as to the nature of the disease. Samuel Gross mentions Maisonneuve and V erneuil as observers of syphiloma of the breast, but without quoting any of their observations. Erichsen and many other experienced surgeons and gynecologists do not mention syphilis of the mamma at all. We must at least wait for further observations before we can form a clear picture of this affection.