PAPILLOMATA. 453 



in vertical sections through the ulcers described above, appear- 

 ances which I may be allowed provisionally to regard as due to an 

 eruption of miliary granulations. For in these ulcers of the larynx 

 and epiglottis, we very frequently meet with spheroidal clusters 

 of cells, situated well below the surface, in the midst of con- 

 nective tissue which is still intact. These deposits resemble a 

 single gland-acinus in size ; when soaked in carmine solution, 

 they absorb the colouring-matter far more greedily at their 

 edges than towards their centre, a fact which points to a globular 

 mode of grouping, and reminds us ver}^ forcibl}^ of the behaviour 

 of miliary tubercles under the same conditions. These tubercles, 

 indeed, are so sparingly disseminated, the}^ appear so very insig- 

 nificant in comparison with the inflammatory infiltration of the 

 ulcerated surface itself, that I would only regard them as a 

 pledge of the connexion of the morbid changes with constitu- 

 tional tuberculosis. At most, they could only be raised to the 

 dignity of permanent inflammatory irritants, and so made re- 

 sponsible for the obstinacy and proneness to recur which is so 

 especially marked in these catarrhal inflammations. 



The occurrence of true miliary tubercles on the minute 

 bronchi, in the neighbourhood of so-called tuberculous cavities, 

 will be discussed in the chapter devoted to the respiratory 

 organs. 



d. Tumours. 

 1. Papillomata. 



§ 391. Papillomata of the mucous membrane must be care- 

 fully distinguished from those tuberous and polypoid elevations 

 of the mucous surface which are due to glandular hypertrophy 

 and dilatation. They exhibit many varieties of external form 

 and situation. 



a. On the mucous lining of the oral cavity, in the vagina, 

 just within the anus, in a word, on the transitional semi- 

 mucous surfaces, we find the papillary types of the skin but 

 little modified. Instead of the ordinary wart we have roundish, 

 sessile, berry-like bodies, attached to the gums or the inner 

 surface of the cheeks ; they are very similar to condylomata, 

 differing only in the greater toughness of their epithelial cover- 



