The faucial tonsil: its relation to focal infection with particular reference to cholecystitis

Abstract

PART I. I have attempted to collect some information regarding the anatomy, comparative anatomy and the much discussed problem of the physiology of the tonsils.(b) Fifty extirpated tonsils were examined microscopically and an attempt made to summarise the pathology of chronic tonsillitis to exulain how the tonsil may act as a focus of infection.(c) Bacteriology of the tonsils has been worked out. Notes are added regarding the classification of streptococci and the various test<semployed in the present investigation. Charts containing complete data of 110 tonsils examined are added. Technique employed for the examination of tonsils is also described in detail.(d) Experiments with animals are also given. The lesions produced are tabulated.PART II. I have described the new method of "Tonsil Puncture ". This part also contains the chart showing the bacteriology of tonsil- puncture as applied to 14 cases of cholecystitis.(b) Animal experiments with organisms obtained by tonsil puncture are also added to this part.PART III. "Tonsil injection with streptococci". Direct tonsil injection in two dogs was carried out in order to see whether repeated attacks of tonsillitis, caused by a strain of streptococcus obtained from the wall of the gall- bladder or the cystic lymph gland of a case of chronic cholecystitis, produces any disease of the gall -bladder in these animals.PART IV. A set of experiments on three series of animals (rabbits) were carried out where in addition to the organisms a second factor of "lowered resistance" was also introduced. Streptococci were obtained from various sources, e.g. from extirpated gall -bladder or cystic lymph gland, by tonsil puncture in a case of chronic cholecystitis, from an extirpated tonsil of a case where the patient had no abdominal disorder. The animals were opened up and their gall- bladder and lesser curviture of the stomach traumatised. The object of this series was to see:-(i) Whether lowering of resistance of a particular organ alone determines the localisation of any particular organisms.(ii) Whether any particular organisms show a greater tendency to localisation in one organ more than the other, the two organs being under similar conditions.PART V. Contains a short description of the lesions produced in the animals by streptococcal injection during the course of this work.(b) A general discussion and summary is added at the end.APPENDIX. The clinical histories, and other experimental details of all the cases studied are put in the appendix in order to avoid confusion.Some of the naked -eye specimens have been reproduced in water colours. All of them were drawn and painted by the author himself. Several photographs have been added to illustrate statements made in the text

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