Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

    102/864 page 86
    with epithelium; their walls become thickened by fibroid changes ; and the natural secretion is altered by inspissa- tion or by exudation from the cyst-wall. Thrte forms are described—1, atheromatous or sebaceous cysts, due to the dilatation of the sebaceous glands; 2, mucous cysts formed by the dilatation of mucous glands ; and 3, cysts produced'by the distention of special ducts, as the salivary, lacteal, hepatic, and renal ducts, and tubules of the testicle. (1.) Atheromaious or sehaccous cysts occur mostly on the scalp or face, but may be met with on any part of the body, and are often multiple. They do not contain hair- folb'cles, papillae, or other skin elements, thereby differing from the dermoid cysts which they otherwise resemble. Those on the scalp are sometimes hereditary._ Signs.— They form smooth lens-shaped, semi-fluctuating, move- able swellings, often adherent to the skin. They may be distinguished from a fatty tumoru-by not slipping from under the finger on pressing the edge of tbe swelling, and from an abcess by the absence of signs of inflammation. A small black pimctuni, the obstructed orifice of the sebaceous follicle, may moreover, be discovered on the surface. Secomlary changes.—I. They may become in- flamed and break down into an abscess. 2. One part may give wav, and the sebaceous matter exude, become har- dened, and be pushed up from below, and take the form of a horny growth. 3. Granulations may s]n-ing up from the intciior of the cyst, and exude as a fungatmg mass resembling an epithelioma. 4. They may degenerate into an epithelioma. .3. Theirwalls may undergo calcification, rrfa/.i/u'j/f.—They may be removed by—1. Ilissection. 2. Splitting them, squeezing out the sebaceous matter, and seizing the cyst-wall w'ith forceps and pulling it out. Care should be taken not to leave any of the wall behind, or a troublesome sinus will remain. 3. Dilating the orifice with a probe, and squeezing out the contents. They are apt, however, to refill Avhen emptied in this way, unless the cyst-wall is also squeezed out or suflicient m- llanimatiou is set up to destroy it. , . ) Mui-ona rysts are formed by the dilatation of mucous glands. ^ They occur in the lips, mouth, labia, and other situations where mucous glands exist. In themoutli they constitute one fonn of raimhr. The so-called dropsy of the antrum is generally believed to be duo to the dila- tation of one of the mucous glands of the lining mem-
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