Surgical therapeutics and operative technique . dealt with by tonsillotomy. When this operationhas failed to eradicate the deepest crypts of the gland, we have recourse togalvano-cautery; and, for extraction of any remaining calculi, to the bistouryand curette. Retro-Pha7yngeal Abscess. Retro-pharyngeal abscesses, acute or subacute, are often overlooked inchildren. They may be recognized by the presence at the back of the pharynxof a distinctly fluctuating and visible swelling. If rapid resolution is notobtained by administration of mycolysine, by the mouth and hypo-dermically, the pus must be
Surgical therapeutics and operative technique . dealt with by tonsillotomy. When this operationhas failed to eradicate the deepest crypts of the gland, we have recourse togalvano-cautery; and, for extraction of any remaining calculi, to the bistouryand curette. Retro-Pha7yngeal Abscess. Retro-pharyngeal abscesses, acute or subacute, are often overlooked inchildren. They may be recognized by the presence at the back of the pharynxof a distinctly fluctuating and visible swelling. If rapid resolution is notobtained by administration of mycolysine, by the mouth and hypo-dermically, the pus must be evacuated. Operation.—The ringed gag is used. The focus is recognized with thefinger, and incised with a straight bistoury rolled in a strip of paper. Theblade is guided along the left index-finger. Latero-Pharyngeal Abscess Hot or subacute latero-pharyngeal abscesses do not point in the cavity ofthe pharynx, but subcutaneously in the cervical region, in the vicinity ofthe angle of the jaw. In the buccal cavity we perceive the inflammatory. Fig. 234.—Incision of a Ketro-Pharyngeal Abscess. tumefaction on the same side, and behind the tonsil. Bimanual palpation,carried out while the jaws are separated by a gag, will reveal the extent ofthe purulent focus. The general treatment consists in administration ofmycolysine. If resolution does not supervene m some days, local operationmust be resorted to. Operation.—General anaesthesia. Lateral pharyngeal incision, throughthe point of fluctuation, by the procedure above described. When the OPERATIONS ON THE HEAD 125 collection is considerable, and points subcutaneously in the lateral cervicalregion, it should be incised in that position (see Surgery of the Neck). Hypertrophy of the Tonsils. Hypertrophy of the tonsils is a result either of repeated inflammations orof a general hypertrophy of the adenoid tissues of the pharynx in the are found in the crypts; sometimes tubercle bacilli. Simple Tonsillotomy—Ope
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