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The mucous membrane and tissues of the nose have an abundance of vitality, like most hard workers, and usually react, overwhelm, and destroy the invading germs, and recover from the attack; but the useless and half-dead tissue of the pharyngeal tonsil has much less power of recuperation, and it smoulders and inflames, though ultimately, perhaps, it may swing round to recovery.
But the resources for mischief of this pharyngeal "Old Man of the Sea" are not even yet exhausted. Next comes a very curious and unexpected one. We have all heard much of "the struggle for existence" among plants and animals, and have had painful demonstrations of its reality in our own personal experience. But we hardly suspected that it was going on in our own interior.
In a case studied by Fevrier the exploration of a lateral pharyngeal fistula produced by the introduction of the sound violent reflex phenomena, such as pallor of the face and irregular, violent beating of the heart. The rarest of the lateral class is the preauricular fissure, which has been observed by Fevrier, Le Dentu, Marchand, Peyrot, and Routier.
Dufosse, who has especially attended to this subject, says that the sounds are voluntarily produced in several ways by different fishes: by the friction of the pharyngeal bones by the vibration of certain muscles attached to the swim bladder, which serves as a resounding board and by the vibration of the intrinsic muscles of the swim bladder.
#Clinical Features.# In pharyngeal diphtheria, on the first or second day of the disease, redness and swelling of the mucous membrane of the pharynx, tonsils, and palate are well marked, and small, circular greenish or grey patches of false membrane, composed of necrosed epithelium, fibrin, leucocytes, and red blood corpuscles, begin to appear.
The epiglottis during the production of the highest notes rises upward and backward against the posterior pharyngeal wall in such a way as almost entirely to separate the pharyngeal cavities, at the same time that it gives an unusual conformation to those resonant chambers." Complete absence of the eyes is a very rare anomaly.
But of greatest interest is her remarkable control over the muscles which regulate the division and modification of the resonant cavities, the laryngeal, pharyngeal, oral, and nasal, and upon this depends the quality of her voice. The uvula is bifurcated, and the two divisions sometimes act independently.
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