A system of surgery : theoretical and practical . xtent as may render itimpossible to assign the particular growth underexamination to any definite class. And so againsome growths which superficially appear papillo-matous may have firm fibrous bases. And, further,the condylomata of syphilis, the thickened eleva-tions of phthisis, and the small protuberances re-sulting from localised chronic inflammation insome cases can hardly be distinguished from whatmore properly, perhaps, ought to be regarded as new growths in the strictest acceptation of theterm. A very interesting specimen was almost acc
A system of surgery : theoretical and practical . xtent as may render itimpossible to assign the particular growth underexamination to any definite class. And so againsome growths which superficially appear papillo-matous may have firm fibrous bases. And, further,the condylomata of syphilis, the thickened eleva-tions of phthisis, and the small protuberances re-sulting from localised chronic inflammation insome cases can hardly be distinguished from whatmore properly, perhaps, ought to be regarded as new growths in the strictest acceptation of theterm. A very interesting specimen was almost accident-ally met with some short time since in the post-mortem room at Guys Hospital, in which there wasextroversion of the mucous membrane of the leftventricle of the larynx. Fig. 154 conveys a somewhatfeeble idea of the appearance presented. The extro-verted mucous membrane could be easily replacedin its proper position ; and when this was done there was nothing abnormal in theappearance of the larynx. The patient had had no laryngeal symptoms.*. Malignant Tumours of Larynx. Cancerous growths in the larynx are for the most part epitheliomatous in charac-ter ; but instances of medullary cancer affecting the larynx are not wanting. Scir-rhous cancer is still more rare. Epithelioma of the larynx generally commences on the pharyngeal aspect of themucous membrane covering the arytenoid or cricoid cartilages, and subsequentlyinvades the interior of the larynx. But in some instances it commences inside ; andin such cases, as a rule, it first appears on the ventricular bands or on the mucousmembrane of the posterior and lower part of the larynx over or near the internalsurface of the cricoid cartilage, in the form of small irregular nodules, whichgradually increase in size and soon ulcerate. The distinctive features of advancedepithelioma of the larynx, as seen by aid of the laryngoscope, have been alreadydescribed (see p. 682). ^ See Transactions of Royal Med. Chir. Sac. vol. xlvii. 1
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