420 MUCOUS MEMBHANliS. 



and consistency ; it exhibits in addition, fibrous bands of a milk- 

 Avliite colour, radiating from the root of the polypus to its 

 periphery, as well as mucous cysts of considerable size, which 

 feel hard and elastic before they are cut open. Microscopic 

 examination shows, first, a continuous layer of columnar epithe- 

 lium investing the outer surface of the polypus. The main bulk 

 of the tumour is made up of hypertrophied glands ; we find 

 tubes whose walls frequently bulge outwards to a variable depth, 

 and which terminate in clusters of fully -developed gland-follicles. 

 The tubes are lined with well-formed columnar epithelium ; and 

 filled with concentrically laminated masses of viscid mucus. 

 Besides the mucous glands, we find a certain amount of soft 

 connective tissue, rich in cells, which is dense and fibrous only 

 in the pedicle and the bands which radiate from it. The pedicle 

 is chiefly made up of the afferent and efferent vessels ; no nerves 

 have hitherto been found in it. We may accordingly take it for 

 granted that mucous polypi originate in a circumscribed hyper- 

 trophy of the mucous membrane, which mainly involves its 

 glandular elements. The mucous lining of the nasal fossae is 

 their favourite seat ; next comes the mucous membrane of the 

 uterus. More rarely they spring from the small and great 

 intestines, the larynx and respiratory passages, the female 

 urethra, the external meatus, the sinuses of the upper jaw and 

 frontal bone. 



§ 360. Chronic catarrh exerts a very singular influence upon 

 the DUCTLESS GLANDS of the mucous membrane ; and this in- 

 fluence is closely connected with the chronicity of the disease. 

 It is only in the tonsils that a true hypertrophy, strictly 

 analogous to the simple hypertrophic alterations considered 

 above, is caused by repeated acute congestion of the pharyngeal 

 mucous membrane. It consists in an equable and uniform 

 overgrowth of all the histological elements of the follicles ; of 

 the reticulum, the vessels, the lymph-paths and the cells. The 

 individual follicles may become from three to five times larger 

 than normal. The size and shape of the entire tonsil undergo a 

 corresponding alteration. It forms a globular and often pedun- 

 culated tumour, which may project so far into the pharynx as 

 even to interfere with the breathing. Its surface is smooth ; 

 even those depressions are effaced which correspond to the 

 orifices of the little crypts round which the follicles are grouped. 



