Polypes, a name applied in pathology to various morbid growths projecting into the mucous cavities and passages, having their origin either in or beneath these membranes. These growths or excrescences may be in the vicinity of the natural openings of the body, as in the nasal fossae and rectum, and therefore within the sight and reach of the surgeon; or interior, as in the uterus, bladder, etc, inaccessible to his eye and very often to his instruments. They are usually single, sometimes multiple; their extent is very variable, according to their time and freedom of growth, and their surface may be inflamed or ulcerated. There are two principal forms: the pediculated, with a more or less long and narrow neck, as in the nasal passages; or sessile, in which the morbid mass simply raises the tegumentary membrane. Some are easily crushed, others are very hard. In the soft, mucous, or vesicular polypus, the appearance is semi-transparent, gelatinous, consisting of a mass of areolar tissue, containing an albuminous fluid, covered by a thin adherent membrane; it sometimes contains vesicles; the vessels are few and fine.
Themselves insensible, these tumors give trouble only by their volume, rarely cause haemorrhage, irritation, inflammation, or any grave symptom, and do not degenerate into malignant disease; they are also hygrometrical, growing larger in damp weather; nothing positive is known as to their causes. A more solid form consists of a concrete, grayish albumen, enclosed in areolar tissue, covered by a slightly vascular membrane. In the spongy polypus the tissue is soft, red, vascular, often giving rise to troublesome bleeding, and prone to undergo cancerous degeneration. The fibrous polypus may acquire a considerable size, and is generally pear-shaped, though sometimes of very strange forms;, it is tabulated, smooth, and firm, except when subsequently softened and ulcerated; itself insensible, it may cause pain by pressure on surrounding parts; when softened or gangrenous, it may lead to bleeding or to offensive discharges equally exhausting. The fleshy polypus is vascular, painful, and prone to degeneration; the cartilaginous forms may undergo more or less osseous transformation. Polypus is generally a product of the hypertrophy of some one or more of the anatomical elements of the tissue from which it takes its origin.
These tumors impede the functions of the organs with which they are connected; impairing smell and taste when in the nasal cavities, in the pharynx interfering with swallowing in the auditory meatus with hearing, in the larynx with the respiration and the voice; in the rectum with defecation, in the bladder with the excretion of urine, and in the uterus with reproduction. The treatment consists of local applications for drying up or destroying the growth; or of excision, tearing off, laceration, seton, compression, ligature, and similar applications of modern surgery. In the nose the common form of the polypus is the gelatinous, and its favorite attachment the turbinated bones; its presence is indicated by a constant stuffed feeling as from a cold in the head, increased in damp weather; it may generally be brought into view by forcing air through the affected nostril, while the other is closed; there are sometimes more than one, and they are very liable to return when removed; if allowed to remain, the increasing size blocks up the nostril and displaces the septum, producing often great deformity on the cheek and about the eye; it is generally twisted off from its narrow peduncle by forceps. The hydatid, cancerous, and fungoid polypi admit only of palliative treatment.
Uterine polypus is generally pear-shaped and attached by a narrow neck; the symptoms are those of uterine irritation, such as dragging pains, menorrhagia, and fetid dis charges; it is generally removed by ligature. In other polypi near the external openings of the body the principles of treatment are the same; in the internal forms the diagnosis is obscure, and the treatment simply palliative.