Identifier: systemofsurgeryt02holm (find matches)
Title: A system of surgery : theoretical and practical
Year: 1883 (1880s)
Authors: Holmes, Timothy, 1825-1907 Hulke, J. W. (John Whitaker), 1830-1895
Subjects: Surgery Surgical Procedures, Operative
Publisher: New York : W. Wood
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ion of the white patches. Iii those cases where cancerfollowed on leucoplakia seen by the author, this ulceration usually preceded themalignant degeneration, and the latter appeared on the whole rather slower inits advance towards infiltration of the surrounding structures and glands thanepithelioma stalling in other ways (see p. 592). When all this malignant change is about to take place, or whether it is going tobegin at all in any given case, are points which cannot be determined positively asyet from any known premonitory signs. It can only be said that the condition isalways a suspicious one, and to be regarded with anxiety whenever it exists,especially if it be accompanied by ulceration. The latter complication, indeed, mustbe looked upon as constituting the affection a most grave one, which should be dealtwith by free and early excision, if it be found that there is any induration presentwith it. Fig. 134.—Section of a portion of Tongue affected with Leucoplakia. 1) fx d : It
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re, small-celled graniiTatioR representing the extidatiou at the boundary line of the epitbelium ; b, thickened epitheliumof the pla(xue proper ; c, cell-proliferation in the papilla body most evident at the tip. To the right of o for a con-siderable way all the papilla bodies of the mucous layer are seen to have been destroyed; rf, vessel in the coriumaround which for the most part the small-celled infiltration has taken place; e, granulation-cells in the corium ;/, mucous glands with proliferation in parts ; h, relatively normal epithelium, with perfectly sound papillie. This disease, frequently noticed dxiring the last fifty years, was supposed by itsearlier observer to be the result of syphilis (Babington Wallace). Other writersdescribed it as connected with or part of a general ichthyosis, only most marked onthe skin (Pkimbe, Alibert,- Rayer®). Later on it was recognised by Buzenet^ andUUmann in 1858 as a condition independent of skin affections and of syphilis, and asprobably p

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