. A manual of diseases of the nose and throat. HYPERTROPHIC TONSILLITIS. 325 cedure for reducing these slight hypertrophies, ob-literating the lacunae, and thereby preventing theformation of secretion and tendency to acute ton-sillitis. A tonsil having been cocainized with a 10per cent, solution of cocaine, the electrode is heatedto a red heat and pushed into the tonsillar sub-stance one-half or two-thirds the depth of the bent Fig. 85. Galvano-cautery electrode. portion of the electrode. Four or five such insertionsare to be made in each tonsil at one sitting. Whenhealing has taken place, usu
. A manual of diseases of the nose and throat. HYPERTROPHIC TONSILLITIS. 325 cedure for reducing these slight hypertrophies, ob-literating the lacunae, and thereby preventing theformation of secretion and tendency to acute ton-sillitis. A tonsil having been cocainized with a 10per cent, solution of cocaine, the electrode is heatedto a red heat and pushed into the tonsillar sub-stance one-half or two-thirds the depth of the bent Fig. 85. Galvano-cautery electrode. portion of the electrode. Four or five such insertionsare to be made in each tonsil at one sitting. Whenhealing has taken place, usually in about eight or tendays a second application should be similarly made. Fig. 86. ? . Douglas tonsil knife. This may have to be repeated as many as half a dozenor more times before all of the hypertrophied tonsil isremoved. In place of the galvano-cautery knife being employedin this class of cases, the Douglas tonsil knife (Fig. 86)may be introduced deeply into each lacuna and then 326 DISEASES OF OROPHARYNX, TONSILS, withdrawn, cutting up or down so as to enlarge greatlythe outlet of the lacunae and thus favor drainage andthe escape of the hitherto pent-up and decomposingsecretions. When it is desired to remove small portions of tonsiltissue that cannot be includedin a tonsillotome the Myles an-gular punch-forceps will befound very efficient. They areshown in Fig. 87, full size,right and left. If 1 drop ofa 1 to 1000 solution of adre-nalin is added to 10 minims ofa one-fourth of 1 per cent, solu-tion of cocaine and a few dropsof this mixture injected into thetonsil with a hypodermic syringeit will be found to make the operation nearly painlessand bloodless. When properly performed the most satisfactorymethod of removing diseased tonsils is that of enuclea-tion or tonsillectomy. For adults, cocaine anaesthesia,produced by injecting a 1 per cent, solution into thepillars and substance of the organ, greatly diminishingthe pain, suffices, but for children
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