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Dirt has been defined as "matter out of place," and the pharyngeal tonsil is an excellent illustration.
Sarcomas are devoid of lymphatics, and unless originating in lymphatic structures for example, in the tonsil they rarely infect the lymph glands. Minute portions of the tumour grow into the small veins, and, becoming detached, are transported by the blood-current to distant organs, where they are arrested in the capillaries and give rise to secondary growths.
But that only raises the further question, What is a tonsil? And to that no answer can be given but Echo's. They are one of the conundrums of physiology. All we know of them is that they are not true glands, as they have neither duct nor secretion, but masses of simple embryonic tissue called lymphoid, which has a habit of grouping itself about the openings of disused canals.
At the time I had a slight tonsillitis, and the doctor was careful to note that it was the right tonsil involved. He told me that if it had been the left one, the treatment would be entirely different. Up to this time I had, in my ignorance of the human frame, supposed that the two halves were the same in function and symmetrical in anatomy.
If now the throat is examined and examination of the throat should never be omitted in any case where there is the slightest difficulty of swallowing nothing may at first be seen but a very little swelling, and some redness of one or other tonsil.
The operator should be careful, however, only to excise those portions that are beyond the natural size, for if any of the natural substance of the gland is cut into, or if the incision is made beyond the projecting portion of the tonsil, there is grave danger of serious hemorrhage. After excision a mixture of water and vinegar should be kept in the mouth for some time.
It has also seemed in some cases that the only cause was excessive, hard physical labor, including excessive athletic work, and in other cases that prolonged anxiety and worry have been causes of cardiac degeneration and actual cardiac failure. Prolonged absorption of toxins from mouth and tonsil infections may be a not infrequent cause.
The lion's share of their influence upon the child's intelligence is brought about in a somewhat unexpected and even surprising manner, and that is by the effects of the growths upon his hearing. You will recall that this third tonsil was situated at the highest point in the roof of the pharynx, or back of the throat.
The dry, troublesome, tickling cough is generally due to a congestion of the blood vessels at the base of the tongue, in the lingual tonsil region, or possibly in the larynx. Later the passive congestion of the lungs may be sufficient to cause a bronchitis, with cough and expectoration. Sometimes, as indicative of primary cardiac distress, these patients have sharp pains through the heart.
On the other hand, malignant endocarditis may apparently develop de novo. Still, if the cause is carefully sought there will generally be found a source of infection, a septic process somewhere, possibly a gonorrhea, a septic tonsil or even a pyorrhea alveolaris. Septic uterine disturbances have long been known to be a source of this disease.
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