Polypus
POLYPUS, is a morbid growth attached to the interior of one or other of the mucous canals, by a more or less narrow pedicle. Polypi occur most frequently near the orifices of external communication of the mucous canals, as in the uterus, the fauces, the larynx, aud the nose. A description of those that grow in the last of these situations may serve for all.
Polypi of the nose are of four kinds, which are named respectively, vesicular, gelatinous, fibrous, and malignant. Vesicular polypi are grey or yellowish transparent vesicles, containing a clear watery fluid with a little mucus; they uro very soft, easily break down when they are pressed, and are liable to considerable increase of size when the evaporation from them is decreased in damp weather. They appear to consist of enlarged mucous follicles. Gelatinous polypi are more solid growths, consisting of dull white masses attached to the mucous membrane of the nose, and themselves covered by a fine but rather tough membrane. They seem composed of an excessive growth of the mucous membrane infiltrated with fluid, and having a few fibres running through its substance. Fibrous polypi are still more solid growths; they consist of a dense fibrous and vascular tissue, which it is often difficult to cut through, and which is sometimes converted into bone. They are usually intimately connected with the deeper parts of the mucous membrane. Malignant polypi are growths of a cancerous nature from the mucous membrane, which have received the name of polypi rather from having the same situation as the preceding than from their similarity of form. They may assume the characters of simple or scirrhous cancer, but more commonly they have those of the soft or medullary variety [cancer] which is frequently called funyus hx'inatodes.
The common symptoms cf all polypi of the nose are that the patient is unable to breathe through the nostril in which they are placed, and has a nasal voice; there is usually a discharge of watery mucus, a loss of smell, and a diminution of the power of taste. If situated far back in the nose, they may cause deafness or obstruct the swallowing of food. They even render .the breathing difficult. The soiler liinils seldom produce worse effects than these, for then growth is restrained by the linn tissues of tho nostrils; but the two last and firm varieties will continue to increase, expanding the bones and other tissues of the nostrils and face into huge and hideous swellings, and producing death either by their ulceration, or by their pressure on the vessels of the brain, or on the brain itself through the base of the skull.
The most usual situation of polypi is in Ihe upper and back parts of the nostrils; and almost always on the outer wall, the septum being very rarely affected. In their increase they mould themselves to the form of the passages of tho nose, and at last pro'.rude either forwards through the anterior openings or backwards into the fauces.
The growth of vesicular polypi is usually connected With a generally disordered state of the health. They seldom require to be removed by operation; the patient should take mild alterative and tonic medicines with purgatives, and lotions containing alum or sulphate of zinc, or some equally powerful astringent, should he frequently injected into the nostrils. Wheu the polypi are thus destroyed, ointment containing nitrate of mercury, or savin? powder, or some other sliaaulant, should be rubbed on the membrane whore they were seated. Gelatinous polypi are not usually benefited by the preceding plan of treatment; although after their removal it is very useful to prevent them from growing again. They must be pulled from their attachment by forceps, which should have rough blades, and, if possible, be placed around the pedicle of the growth, and withdrawn with a kind of twisting motion. All the i ii 'I:'
polypi being thus removed, the mucus membrane should havo some powerfuHy tts*ringentlotion;t)r oiatmont applied to it. The fibrous polypi -usually require a rnure difficult operation for their removal; when they can be withdrawn by the forceps, it is only with much difficulty, from their being seated fur back in the nostrils, and With some violence and danger of hemorrhage. In some cases a lignture may bo tied round the base of such a polypus so as to make it slough off; in others they must be cut out with the- knife or scissars. The choice of these operations must be made according to the circumstances of each case. After their removal, the same means should be adopted to prevent thoir return as in the preceding cases. The malignant growths in the nose, like those in other parts of the body, where their early and complete removal cannot certainly be accomplished, had better be treated only by palliative measures.
Note - this article incorporates content from The Penny Cyclopaedia of the Society for the Diffusion of Useful Knowledge (1840)
