LECTURE XX. 



patients died anaemic, and yet no trace of any cancerous 

 infiltration of the base of the growth or of the villi ex- 

 isted, but the tumour was quite a simple papillary one, a 

 benignant formation, which on the surface of the skin 

 could easily have been removed by the knife or ligature, 

 but which, owing to its concealed position, was in these 

 cases attended with a series of phenomena, which during 

 life it seemed impossible to refer to anything else than a 

 really malignant new formation. 



Just the same is the case with the much-discussed 

 cauliflower-tumours, as they are seen on the surface of the 

 genital organs, both in man and woman. In men, these 

 papillary tumours, which proceed from the prepuce and 

 surround the corona glandis, are for the most part covered 

 by a very thick layer of epidermis, so that, when they 

 ulcerate, they yield but a very trifling amount of secre- 

 tion. In women, on the contrary, the tumour being 

 seated on the neck of the uterus a very vascular part, 

 provided with a thin stratum of epithelium, and natu- 

 rally beset with a thick layer of numerous and large 

 papillae for the most part very early occasions abun- 

 dant transudations and occasionally haemorrhagical exu- 

 dations of a fluid, like water in which raw meat has been 

 soaked, or really red and bloody. In these cases there 

 frequently exists doubts as to the nature of the disease. 

 I myself was present when a very renowned surgeon 

 came to Dieffenbach's operating room, just as that ope- 

 rator had amputated a penis on account of a " carcinoma " 

 and when the stranger afterwards declared it to have 

 been a simple condyloma. On the other hand I have 

 examined cases, in which growths of this sort had been 

 doctored about for years as if they had been syphilitic 

 condylomata, because the external appearance is so ex- 

 tremely analogous, and it is so extremely difficult to dis- 

 cover a criterion by which it can be accurately determined 



