Surgery, a practical treatise with special reference to treatment / by C.W. Mansell Moullin ; assisted by various writers on special subjects.

  • Mansell-Moullin, C. W. (Charles William), 1851-1940
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Surgery, a practical treatise with special reference to treatment / by C.W. Mansell Moullin ; assisted by various writers on special subjects. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    3. Involution cysts accomi)anyin^ the atrophy of senility in each particular organ antl observed in the breast. I have also shown that spermatocele may be produced by the same i)rocess.* (^/) Cysts of the (iraafian follicles at times resemble retention cysts, in that they are preventetl from rupturing by adhesions, the result of jteri-ovaritis. (^•) Cysts formed by cutting oft of portions of blood-vessels are rare, and are found in connection with veins, especially the internal saphena ; one case has come under my own observation. Virchow records an example in connection with the internal jugular vein. A case of cystic dilatation of the lymphatic vessels of each groin, in a youth aged twenty, has been described by Trelat. The swellings had existed six years. (/) Cysts formed around extravasations of blood, foreign bodies, and para- sites, are practically of the same nature, the encapsulation being due to the for- mation and organization of granulation tissue. In illustration of the first I may allude to a very large and distinctly defined blood-cyst of the scrotum, which I described. It followed a kick and had existed sixteen years. Ijutlin has ])ointed out that many cysts formerly described as blood-cysts were probably soft sarcomata into which profuse extravasation of blood had occurred (Jiemorrhagic sarcoma). Proliferous Cysts.—Many cysts, especially those of glandular organs and mucous membranes, may become the seat of solid growths, which spring from their inner surface. They occur frequently in cysts of the lacteal ducts, and the disease then constitutes the true sero-cxstic disease of Brodie. The intra-cystic growths are softish and papillary on the surface. Under the microscope they usually show i)apill?e, between which gland-like tubules, either rectilinear or tortuous, extend downward and give to the mass the appearance of an adenoma with scanty intercellular substance. Such cysts are usually innocent, but at times the growth is cancerous and infiltrates the surrounding tissues ; it then constitutes the disease described as villous cancer. Proliferous or papillary cysts are also common in the hilum of the ovary and broad ligament. They have essentially the same structure, being composed of tubular glands lined with columnar or cuneiform epithelium, and their surface is more or less distinctly papillary. They secrete mucus freely. Such papillary and adenomatous intra-cystic growths are homologous to warts on the integument. II. CONGENITAL CYSTS. Cysts originating in persistent rudiments of foetal structures and congenital cysts. I. Cysts formed in the Remains of the Wolffian Duct and Body in the Female.—The.se were first systematically described by Dr. Coblentz in Virchow's Archil', Bd. 5, 1881. In ruminants and some other mammals the whole of the Wolftian body and duct persists. But in the human female only the anterior or sexual portion is normally present; it lies in the broad ligament, being known as the parovarium or organ of Rosenmiiller. It consists of twelve or fifteen narrow, vertical tubes about half an inch in length, which radiate upward from the hilum of the ovary to join a horizontal tube running nearly parallel with the Fallopian tube. These vertical tubes represent the anterior or sexual segment of the Wolffian body; a few similar tubes are in rare instances found between these and the uterus, and are remnants of the posterior non-sexual segment. The horizontal tube, known as Gartner's duct, is the duct of the same organ ; it pa.sses from the broad ligament into the side wall of the uterus, down which it courses into the anterior wall of the vagina, where it is usually lost. Wolffian remains also extend into the tissue of the hilum of the ovary, and in horizontal sections of that organ are seen as tortuous rods or columns of epithelium. This portion of the gland * See Catalogue of St. Bartliolomew's Hospital Museum, Nos. 2807 and 2808.
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