. Diseases of the nose and throat . id disease vary very much. In the former the sur-face of the adenoid enlargement presents a convoluted appearance, of(204) NASO-PIIABYNX. ADENOIDS. 205 strawberry-like contour, the nodules standing out over the whole sur-face, except when Luschkas sac is present; then the central portionwill exhibit a marked projection. In the latter the lymphatic cell-elements have given place, in some measure, to connective-tissue forma-tion, and a denser and smoother development occupies the position ofthe original adenoid structure. In the transition-period of life theto
. Diseases of the nose and throat . id disease vary very much. In the former the sur-face of the adenoid enlargement presents a convoluted appearance, of(204) NASO-PIIABYNX. ADENOIDS. 205 strawberry-like contour, the nodules standing out over the whole sur-face, except when Luschkas sac is present; then the central portionwill exhibit a marked projection. In the latter the lymphatic cell-elements have given place, in some measure, to connective-tissue forma-tion, and a denser and smoother development occupies the position ofthe original adenoid structure. In the transition-period of life thetonsillar hypertrophy will also indicate a blending of the two young children to the touch it is almost like the softness of cerebraltissue. Microscopically the surface is covered with columnar ciliated epi-thelium, but the cilia are frequently broken and bent and in some in-stances absent. Beneath this we have the myxomatous mucosa filledwith hTmph-corpuscles and the round lymph-follicles, separated from ■^mHIIIIfillUS^MW. Fig. 74.—Stalactite forms. (After Schadle. each other by interfollicular tracts (Fig. 75). It is essentially a lym-phoid structure, copiously supplied with blood-vessels, the whole beingarranged in the form of lobules (and secreting mucus or lymph fromthe crypts between the follicles). As the adenoid becomes old withincreasing years, the lymph-tissues become absorbed, often shrinkingaway by the fifteenth or the twentieth year. In other instances hyper-plasia takes the place of absorption, and fibrous connective tissue de-velops among the follicles and lobules of the adenoid. The general impression, founded on clinical experience, is thatthe fibrous, connective-tissue element varies in direct ratio with theage of the patient. McBride, in his recent work, takes issue with thisidea. Founding his opinion upon the examination of six hundredcases of adenoid disease, he says: That while in many cases there is 206 DISEASES OF THE PHAKYNX. a tendency to in
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