A MIRROR OF HOSPITAL PRACTICE. UNUSUAL SITUATION OF SEBACEOUS CYSTS IN THE SOLE OF THE FOOT. * By Surgeon-Major L.
Cameron,
M.
D.,
Civil Surgeon, Bacliergunge,. stated in books on anatomy that sebaceous absent from tlie skin of the palm of the hand and sole of the foot; and in Strieker's Histology it is stated in addition that they are absent from the dorsi of the third phalanges and glans penis. In 1875, in the Police Hospital at Burrisaul, I examined a constable who had been sent in from an outpost with an intractable ulcer in the sole of the foot. His body was well nourished, and he had no constitutional taint. The ulcer measured f" in diameter. Its margins, composed of the tissues of the skin, were raw, red, smooth and healthy looking. Its base was occupied by a brownish coloured inert-looking membrane, which, when unfolded by means of a probe, was found to be comparatively insensitive and to present a smooth glistening secreting surface on the side towards the exterior. It was removed by avulsion ; and the ulcer, which hitherto had resisted treatment, healed quickly. The portion of membrane removed had the character of the cyst of a vein : it consisted only of a portion of the original cyst?the remainder (exterior portion) had been lost in the process of ulceration : it was dense and thick. Having a free outlet, it contained no mass of fatty pultaceous secretion, but looked and felt greasy. The history was of a small painless swelling in the sole ; of its gradual enlargement ; of its becoming painful; of its bursting, and finally of the formation of the ulcer. In 1877 a man, strong and healthy, came to the Dispensary at Gya complaining of lameness, pain and swelling in the sole of the left foot. On examination a dense resisting cyst, of the size of a marble, was found under the skin on the plantar aspect of the fifth metatarsal bone. The skin over it was red, painful and adherent. It had been blistered and subjected to other kinds of treatment. Recollection of the constable's case at once occurred, and it was apparent that this was an earlier stage of the same thing. This was confirmed by incision and avulsion of the cyst. It was an ordinary enlarged sebaceous cyst, and the contents were, as usual, pultaceous fatty matter. It had caused much pain and lameness, as in the case of the constable, for a lengthened period. JSurrisal, 29th March 1880. It is
glands
*
generally
We
are
are
indebted for this
case
to tlie
Surgeon-General for Bengal.
Cameron,
M.
D.,
Civil Surgeon, Bacliergunge,. stated in books on anatomy that sebaceous absent from tlie skin of the palm of the hand and sole of the foot; and in Strieker's Histology it is stated in addition that they are absent from the dorsi of the third phalanges and glans penis. In 1875, in the Police Hospital at Burrisaul, I examined a constable who had been sent in from an outpost with an intractable ulcer in the sole of the foot. His body was well nourished, and he had no constitutional taint. The ulcer measured f" in diameter. Its margins, composed of the tissues of the skin, were raw, red, smooth and healthy looking. Its base was occupied by a brownish coloured inert-looking membrane, which, when unfolded by means of a probe, was found to be comparatively insensitive and to present a smooth glistening secreting surface on the side towards the exterior. It was removed by avulsion ; and the ulcer, which hitherto had resisted treatment, healed quickly. The portion of membrane removed had the character of the cyst of a vein : it consisted only of a portion of the original cyst?the remainder (exterior portion) had been lost in the process of ulceration : it was dense and thick. Having a free outlet, it contained no mass of fatty pultaceous secretion, but looked and felt greasy. The history was of a small painless swelling in the sole ; of its gradual enlargement ; of its becoming painful; of its bursting, and finally of the formation of the ulcer. In 1877 a man, strong and healthy, came to the Dispensary at Gya complaining of lameness, pain and swelling in the sole of the left foot. On examination a dense resisting cyst, of the size of a marble, was found under the skin on the plantar aspect of the fifth metatarsal bone. The skin over it was red, painful and adherent. It had been blistered and subjected to other kinds of treatment. Recollection of the constable's case at once occurred, and it was apparent that this was an earlier stage of the same thing. This was confirmed by incision and avulsion of the cyst. It was an ordinary enlarged sebaceous cyst, and the contents were, as usual, pultaceous fatty matter. It had caused much pain and lameness, as in the case of the constable, for a lengthened period. JSurrisal, 29th March 1880. It is
glands
*
generally
We
are
are
indebted for this
case
to tlie
Surgeon-General for Bengal.
