416 MUCOUS MEMBRANES. 



tissue witli corpuscular elements (fig. 121, h). All these cells 

 must be removed before the mucous membrane can be said to 

 have returned entirely to its normal state. Some of them 

 undergo fatty degeneration ; others may be taken up by the 

 lymphatics. But weeks may elapse before this is effected ; and 

 during the interval, the mucous membrane offers a dimhiished 

 capacity of resistance to fresh sources of irritation. For the 

 irritability of an organ is proportional to the number of elements 

 susceptible of irritation, -svliich it contains. This is not always 

 sufficiently remembered either by the physician or his patient. 

 The latter is in much the same position as a person whose 

 mucous membranes are predisposed to catarrhal inflammation 

 by a passive hypera3mia. There is always a risk lest the catarrh 

 should return on the slightest provocation, and that in exactly 

 the same part which it has apparently forsaken. The relapse is 

 usually more obstinate than the primary disease ; the vulner- 

 ability of the mucous membrane, and the consequent risk of a 

 fresh relapse, increases and lasts for a longer time after every 

 recurrence of the inflammation. Every relapse adds to the 

 number of cells in the connective tissue of the mucosa ; the 

 epithelium too, and the glandular apparatus, come gradually to 

 take part in the chronic thickening ; the mucous membrane 

 becomes hypertrophied. Hypertrophy, viewed in this light, is 

 therefore a result of catarrh ; it may also be regarded as a 

 structural cause which predisposes to catarrh, inasmuch as the 

 phenomena which, when taken together, constitute catarrh — sc. 

 hyperaemia, swelling, hy2:)er-secretion — have already reached a 

 certain pitch, at which they have become stationary ; so that a 

 very trifling provocation suffices to raise them to the level of 

 catarrhal inflammation. (Chronic catarrh.) 



§ 356. Let us now consider the anatomical factors of 



HYPERTROPHY OF THE MUCOUS MEMBRANES OUC by OUC. 



a. The overgrowth of the connective tissue is particularly 

 striking where (as in the gastric mucous membrane) its amount 

 is normally insignificant, where it is a mere cement, holding the 

 closely - packed tubular glands together. The narrow septa 

 between the glandular orifices, as the most superficial locality of 

 this cement, are often the theatre of a very luxuriant overgrowth 

 of young connective tissue; they form villous and lamellar 

 elevations, to a heiccht of one line above the mucous surface, 



