Iconograms : a collection of colored plates illustrating interesting surgical conditions / explanatory text, with special reference to diagnosis and treatment, by Faxton E. Gardner.

Gardner, Faxton E. (Faxton Eugene), 1878-

Date:: [1913]

Credit: Iconograms : a collection of colored plates illustrating interesting surgical conditions / explanatory text, with special reference to diagnosis and treatment, by Faxton E. Gardner. 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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$aud his pupils, it has liecii coiisiikTi'il as a pnrasyiihiliti<; keratosis— that is, an affection of sypliilitic orit/iu. Iml, not (if syphilitic nature— devfloiiinn inulor tlic cornhiiHMl iiitluciirc df syphilis and tol)acco. Tlii.v view is iiiiw liclil li\ liic iiiajmily (if sypliilologers. A third opinion contends that IIh'ic aic Iwi. kinds dl' Iciicoijlastic lesions: first, genuine leiicophihin. liypi'ikcratosi.v of unkiiovvn origin, hut having nothing to do with syi)liilis; second, pseudo-lciicoplakia, much more frequent, which is the so-called i)arasyphilitic leucoi)]alva of syphilologers. Tiiis tliird ojiinion seems tlie most rational, but, practically, tlie ]ioint is not of nnich iini)ortance, l)ecause, he it pseudo- leucoplakia or genuine leucoplakia, all these patches of hyperkera- tosis have an unfortunate tendency to undergo malignant epithelial degeneration. In fact, cancer is the natural outcome of leucoplakia of long standing; and lingual leucoplakia is found in the antecedents of one-half of the cases of lingual cari-iiKniia. The surface of the patch, at first smooth and painless, after a time becomes fissured, especially after excessive smoking, and the lesion becomes deeper and sometimes exceedingly painful. The treatment of leucoplakia consists in the avoidance of tobacco, alcohol aud spicy food, and in the removal of patches, either with the knife or with the thermo or galvano-cautery. This is possible only when the patches ai-e not too extensive. Simple cauterizations which do not destroy the leucoplakia patch are worse than useless, because they merely irritate and tend to promote malignant degenera- tion, without being able to cure. Besides leucoplakia, jagged carious molar teeth also act as ex- citing causes of cancer of the tongue, which explains the almost exclusive occurrence of cancer in the posterior part of the side of the tongue. Lingual carcinoma appears in two forms, according as it arises from the superficial miicnus membrane or from the fjlandular epifkeUu)n. The first form rosemlilcs a flat cutaneous carcinoma and soon gives rise to a small ulcer with hard, raised edges (Fig. 7, right half), the fissured surface of which has a yellowish or dirty-brown appear- ance. Although the carcinoma is only superficial, the .submaxillary glands are soon affected, owing to the alnindant l>nii)hatii's of the tongue. Deep carcinoma begins as iiard nodules over which the mucous memlirane remains intact for a long time. After the breaking down of the nodules and destruction of the mucous membrane, an extensive crateriform ulcer is formed with hard, irregular edges aud deep^$