have found douches with alum (5 per cent.) very effective to stop the bleeding. Against the extensive polypusis intestinalis our treatment is quite powerless (Schneider).
2. Cysts of the Epithelial Structures These are most frequently observed as dcrmoid cysts (see Congenital Affections). Cysts of the embryonal clefts and ducts have also been described (see Branehial Cysts).
Cystic dilatation of the pelvis of the kidney with compression of the parenchyma (hydronephrosis) also belongs here. For the symp tomatology of hydronephrosis and cystic kidney see Langstein, vol. iv. For the extirpation we employ the same technic as for nephrectomy.
Retention cysts of the glands are met with h atheromota, and they are caused by occlusion of the sebaceous glands or their ducts. It is not always easy to diagnose these from dermoid cysts. The typical location of these latter at the edge of the orbit near the primordial clefts makes their nature clear. Atheromata are frequently adherent to the skin, while this is usually movable over dernwids. At times we can make a diagnosis only with the microscope. The epithelial lining of the does not contain any papilla) while the capsule of the der mold cysts contains all the parts of the skin.
Treatment consists in total removal of the bag, because remnants of this may give rise to recurrences.
Retention Cysts of the Mucous Glands.—These are best known as ran ale, and are found in the mouth underneath the tongue. Here they are usually formed through occlusion of the duet of the sublingual glands, more rarely through the oc clusion of mucous glands. They appear as thin-walled translucent cysts of slow growth which may lift up the tongue. Their content con sists of a clear sticky liquid.
Treatment has to consist in their radical extirpation. Should this be impossible, then we remove the anterior wall and sew the pos terior wall to the mucous mem brane, thus preventing new forma tion of the cyst. No other mode of treatment will prevent recurrences.
3. Carcinoma This type of tumor is rare in children.
They are seen most frequently as cancer of the kidney, and Karew sky claims that childhood is pre disposed to this to some extent.
Usually we observe mixed tu mors of the kidney, embryonal glandular tumors, which it is difficult to arrange in any one group of tumors (Dodenein, Birch-Hirschfeld) (Fig. 197).
They are observed almost exclusively in children and then only during the first few years of life. They grow very rapidly and can be recognized quite early as large tumors which we can feel through the abdominal wall. The results of their extirpation are bail, because the children are brought to the surgeon only when the neoplasm is too large to be removed. According to Brims the mortality is 30 per cent., and about 10 per cent. were well for one year after the operation.
Closely related to these tumors are those mixed tumors which develop at the pelvic end of the embryonal structure, and arc there known as teratoid mixed tumors or as teratomata. These "sacral tumors" may be formed of the three germinal layers and may grow through bones and soft parts like malignant tumors, or they may remain cystic, and then grow to considerable size inside their cyst-wall either in the cavities of the body or on its surface.
In their interior they contain well-fo•med fetal rudiments of brain, bone, and even of extremities (inclusio), which latter have at times shown spontaneous motions.