File:The principles and practice of surgery (1916) (14763839002).jpg

Identifier: principlespracti1916warr (find matches)
Title: The principles and practice of surgery
Year: 1916 (1910s)
Authors: Warren, Richard, 1876-
Subjects: Surgery Surgery
Publisher: Philadelphia : Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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s and, asit is often found in children with definite signs of tuberculosis, is sometimesknown as strumous lip, but it is seldom a tuberculous condition. A similar condition follows the cracked lips of congenital or acquiredsecondary syphilis, or may be due to gummatous lymphatic obstruction;in the the treatment is specific. Congenital macrocheilia appears to be a condition of lymphangiomaof the lip and can be improved by excision of a wedge-shaped portion. In addition to the primary and secondary manifestations of syphilisalready mentioned (p. 372, also Fig. 118) gummata may also occur here, 374 A TEXTBOOK OF SURGERY and arc distinguished from epithelioma by their punched-out appearance,less induration, greater vascularity, and absence of enlarged, hard lymph-glands; in doubtful cases a portion of the edge should be subjected tomicroscopical examination. New Growths of the Lips. Capillary and cavernous nsevi are common. Retention cysts from blocking of mucous glands are found as small
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1ig. 118. Syphilitic chancres of the upper and lower lips ; note also the enlarge-ment of the submaxillary and submental lymph-nodes.(Kindly lent by Dr. Gilbert Scott.) translucent swellings on the inner side of the lip : removal of the outer wallof the cyst suffices for cure. ( a x<er a xd Allied Conditions. Leukoplakia, or patches of thickenedepithelium resting on a basis of hypertrophicd papilla?, are found insidethe lips and cheeks just as they are on the tongue. These may persistunchanged for years, but in many instances are the originating point ofsquamous-celled cancer, and hence are best removed. Warty growths may start in patches of leucoplakia or independentlyof these. From well-defined cancer they may be distinguished by the wantof surrounding infiltration and of glandular enlargement; but from earlycancer, in which these points are slight, diagnosis may be impossible, andhence all warts should be removed at once and examined microscopically,and should the condition prov

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