Adenoids.—Overgrowth of the same tissue as that which forms the tonsils may occur in other parts of the throat, for the tissue—lym phoid, lymphatic, or adenoid tissue—exists in and beneath the mucous membrane all along the alimentary tract, and overgrowth may occur anywhere, forming tiny little masses projecting from the mucous surface, or masses of consider able size. Such little overgrowths may often be seen ou the back wall of the pharynx, form ing irregularities on what ought to be its smooth surface. Such masses also occur in the pharynx above the level of the mouth about the level of the line from b in Fig. 101 (p. 195). If they occur to any size in this situation they will block the posterior opening of the nostril and render it impossible to breathe through the nose. A small growth will easily do this in children. Growths in this position are called post-nasal adenoids. The child cannot breathe through the nose and consequently keeps the mouth always open, and snores badly in sleep. Au unintelligent dull expression of face usually accompanies the condition, and in many cases the general health is affected. The growths should be removed by operation.
Obstruction of the Gullet (Stricture of CEeophugue), altogether preventing, or render ing very difficult, the passage of food and drink to the stomach, may be due to actual constric tion of the tube, to spasm, or to some foreign body blocking the way. The former is a con dition that arises from inflammation, such as would very readily be produced by the attempt to swallow some corrosive poison, like oil of vitriol, &c. The inflammation causes.thicken ing of the walls of the tube and consequent narrowing of the passage. The chief sign is difficulty in swallowing — dysphagia. Such stricture can sometimes be overcome by the repeated passing into the gullet of tubes for the purpose of stretching it, larger and larger tubes being used as the passage gets wider. The process of widening requires to be con tinued for many months.
Obstruction by spasm occurs with hysterical women. That the obstruction is not due to organic disease is evident from the fact that the difficulty of swallowing is only temporary.
It must be treated as hysteria, to which refer.
Obstruction from a foreign body is not un common. All sorts of substances, that persons have been holding in the mouth, have been known to slip down into the gullet and block the way. False teeth have been known to do it. Consequently, every wearer of false teeth, that are not tightly fastened, should remove them before going to bed, as this accident has often happened during sleep. Practically a large mass of something that one may have been eating, or that may have accidentally slipped into the gullet without proper prepara tion, may act the part of an obstructing foreign body--a piece of an apple, for example. If the substance is actually in the gullet, and not simply in the pharynx at the entrance to the windpipe, immediate danger is not great. A sense of choking is, however, felt. Breathing may be quite unaffected, though fits of a suffo cative cough may be produced. Spasm of the top of the windpipe, due to the irritation of the foreign body, may arise and threaten to suffocate. The body itself, if allowed to remain too long, may produce inflammation, ulceration, &c. A surgeon will decide whether an attempt is to be made to get the foreign body up or to push it down. If it is some soft substance which may become acted upon in the stomach and broken down, the tube of a stomach-pump, gently passed down to the place where the body is fixed, may succeed in pushing it onwards into the stomach. A mass of meat frequently "sticks in the throat,' in the pharynx, where it can readily be removed by anyone who knows how. Let the person's head be supported by the left arm, let his mouth be opened by the handle of a spoon, or piece of wood, and then insert two fingers of the right hand into the mouth, pushing well to the side against the cheek. In this way the fingers will get well into the back of the throat, and one may be able to sweep out or hook up the obstructing mass. (Refer to (COKING, under Acciozwrs AND EMERGENCIES.)