The seat of tracheal ulcers is usually the posterior wall and the lower portion, unless the upper portion is affected by extension from the larynx or by pressure from a tracheotomy-tube. They are found also in other portions, and sometimes are so numerous that they give to the membrane a sieve-like appearance. Occasionally they denude some of the tracheal rings. In shape they vary, being mostly irregularly circular or oval, and excavated or scooped out; in size they vary from that of a pin's head to that of a marble. In tuberculosis they are generally small and numerous, have a pale background, and are occasionally confluent, while in syphilis they are usually isolated and large, very destructive, and apt to cause contractions or other deformities by {139} partial or extensive cicatrization. Such contracting ray-like cicatrices have more than once produced fatal stenosis. The SYMPTOMS are frequently obscure, but local pain and irritation are usually, purulent or muco-purulent sputa are sometimes, present. The diagnosis is difficult unless tracheoscopic examination reveals the condition. Fig. 27 shows the tracheoscopical image, and Fig. 28 the post-mortem appearance, of a case of tuberculous tracheal ulceration on the upper portion of the front wall, while Figs. 29 and 30 show the image during life and the appearance after death of a case of syphilitic ulceration. In Fig. 30 the posterior wall is seen with the ulcers, and below them a star-shaped cicatrix. The PROGNOSIS generally depends upon the underlying disease, and is grave because the latter is. Perforation may take place, as well as cicatrization and hypertrophy, and either process may lead to a fatal issue. In a number of instances post-mortem examination has shown that tracheal ulceration may produce surprisingly great ravages before destroying life. TREATMENT, like the prognosis, depends somewhat upon the disease underlying the ulceration. Pain is relieved by anodyne, and cicatrization promoted by alterative inhalations, as of nebulized glycerated solutions of morphine, ethereal solution of iodoform, iodinic preparations, oil of solidago, citronella oil, etc. Catarrhal ulcers heal without special treatment with the subsidence of the catarrhal inflammation. In syphilitic ulceration, stenosis from cicatrization is to be dreaded, and specific constitutional treatment is the main reliance. The internal administration of cod-liver oil has been found of service in nearly all cases of tracheal ulceration, especially in phthisis, lupus, etc. Appropriate general treatment must be combined with the local. MORBID GROWTHS.