CATARRH. — HYPERTROPRY. 417 



wlicn they may be recognised even with the naked eye. 

 The overgrowth of the connective tissue however — both in its 

 microscopical and naked-eye effects — is thrown very much into 

 tlie background by the overgrowth of the glands ; one is prone 

 to forget that the connective tissue which invests the enlarged 

 glands, which forms the pedicle of a polypus, &c. , is itself, in the 

 main, a new formation. 



h. The EPITHELIAL LINING of the hypertrophied mucous 

 membrane is quite as continuous as in the healthy state. Hence 

 we may assume that it increases in a horizontal plane, so as to 

 keep pace with the increased area of the mucous membrane 

 itself. It appears, moreover, to adhere more firmly than usual 

 to the connective tissue ; for without showing the least breach in 

 its continuity — without e.g. the loss of a single columnar cell 

 from the respiratory mucous membrane — it allows the passage, 

 not only of considerable quantities of transuded fluid, but also of 

 great numbers of young cells, which migrate from the deeper 

 parts to the surface, where they mingle with the secretion as pus 

 and mucus-corpuscles. 



c. The increase in bulk of the open glands is usually re- 

 garded as a functional hypertrophy. Just as the bulk of a 

 muscle increases by exercise, so are the glands supposed to grow 

 in consequence of continued over-secretion. In opposition to 

 this view, I would lay more stress upon the retention of secreted 

 matters, and the passive distension of the glands which ensues. 

 The overgrowth of the subepithelial layer of connective tissue 

 may very plausibly be regarded as a mechanical obstacle to the 

 escape of the secretions. It may compress, narrow, dislocate, 

 occlude the eff'erent duct, while the body of the gland, especially 

 when situated in the submucous connective tissue, underneath, 

 the mucous membrane, may increase in size unchecked. I must 

 not be understood to reduce the glandular hypertrophy to simple 

 dilatation. In the majority of hypertrophied glands we can 

 readily see an elongation or twisting of the tubuli, an increase 

 in the number of acini, as well as a luxuriant cell-growth both 

 within and around the glands. But none the less do I mark, 

 tliat the tubes and acini of the hypertrophied glands are in- 

 variably wider, and contain a larger accumulation of secreted 

 matter than they ought to do ; and I look for the stimulus which 

 causes the morbid growth, in a centrifugal pressure of the 



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