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Related post: lial cells, the crypts, except under extraordi-
nary circumstances, such as poor drainage Zantac 25 Mg or
virulent strain, are able to handle the germs.
The Peyer's patches of the lower ileum are
for Zantac 30 Mg the same immunizing purpose against the
bacteria of the bowel. The function of the
appendix is not unlikely the same as the tonsil,
for it is filled with lymphoid tissue and
atrophies in early adult life. Zantac Price
The pathological findings in this paper are
based on the macroscopical and microscopical
study of 108 cases, 213 tonsils, operated by
Drs. Wright & Bowen and the late Dr. R. L.
Edwards from October, 191 1, to November,,
19 13. In three cases only single tonsils were
studied. All of these cases except ten were
done under ether anesthesia Zantac 150 Tablets with no fatalities,
and only one case of secondary hemorrhage
which was never alarming. The operation per-
formed was a complete tonsillectomy by instru-
mental dissection and snare method, the capsule
SOUTHE}RN MEDICAL JOURNAL
being removed in all except fourteen. The Zantac 15 Mg ton-
sils were in one piece in nearly every case and
the capsule was found in place in 199. Very
careful examination was made for muscle at-
tachment to the capsule, which was found
present in 53 cases. Microscopically it was
found present in nearly every case to a greater
or less degree, but in no case in sufficient
amount to seriously impair the function of the
oropharynx.
The patients were from two to thirty-five
years of age, excepting one patient, age Zantac Cost 54—
43 males and 65 females. Of these Generic Zantac tonsils, 144
were classified as large and 69 small ; 25 were
submerged, 74 partially so and 114 free; 144
had deep crypts, and 17 were so distorted Zantac 150 Mg Tablets as
to appear grossly not to have any crypts. This
point was not searched for in the early series.
Twenty-five were seen to contain concretions
on section. No effort Zantac 75 Tablets being made to express
the concretions, there were fewer found than
might have been present. Microscopically,
concretions were seen in 154, abscesses in 30;
connective tissue increased in 164 to a more
or less extent — some almost entirely sclerosed.
One hundred Price Of Zantac and eighteen showed fibrin; es-
pecially How Much Does Zantac Cost was this true where connective tissue What Are Zantac Tablets For
was on the increase. In twenty-eight there
were foreign inclusions — the most of these
consisted of solid hyaline desquamated
epithelial plugs. These may be accounted for
by islands of epithelium being cut off in an
arm of a crypt by previous inflammatory pro-
cess and thereafter Zantac 150mg Tablets the epithelium being re-
tained. Three contained islands of cartilage.
One hundred and ninety-eight showed evi-
dence of chronic inflammation. Pericryptal
inflammation in 165. Cost Of Zantac This was usually "found
at the bottom of the crypts, which contained
concretions, and consisted of round cell in-
filtration of the surrounding epithelial layers
and lymphoid tissue. The epithelium in many
cases had been ulcerated or lost, and in thirty
tonsils actual abscesses had formed. These
concretions consisted of decomposed food,
desquamated epithelium and leucocytes.
The germinal centers were large or normal
in 134, small in 38 and not found in 19. Ten
tonsils were tubercular and in one case the Zantac 20 Mg
disease was bilateral. Only one case had no
cervical glandular . enlargement ; the other
eight cases had cervical glands from size of
almond to walnut. Unless several sections of
suspected tonsil are studied, the tubercular
lesion is apt to escape detection. From one to
six areas of these tonsils were examined be- Zantac 50 Mg
fore the involvement was discovered. Many
of these cases had typical tubercular lesions
extending down to the capsule and only a part
of the respective tonsil involved, hence a ton-
sillotomy would not be sufficient to remove
the disease. These patients have all been very
carefully examined for pulmonary involve-
ment, but no appreciable change found, and
their subsequent history has sustained the
above negative findings.
It is surprising to see the following state-
ment made by E. S. Judd, in his paper report-
ing operative treatment of 649 cases of tuber-
culous cervical adenitis : "We are seldom able
to demonstrate positively the exact avenue of
the infection. Occasionally we may find the
bacilli in a decayed tooth, tonsil, or lupus
area, but more often the point of invasion
cannot be found. It. has been shown,
experimentally, that cultures of tubercle bacilli
swabbed over the surface Zantac Effervescent Tablets of the tonsil may
leave no trace of their passing through that
organ, but will invade the glands draining the
tonsil. In our cases we were seldom able to
trace Zantac Tablets 150mg back to the source of entrance. Zantac Tablets Exami-
nation of several hundred tonsils showed tu-
bercles in much less than one per cent. In
1,000 cases 2.3 jier cent had positive tul>ercu-
lous lesions."
A further study and report will be made
on the tonsil as Zantac 150 Price the avenue of infection in
tuberculous cervical adenitis.
I wish to thank Dr. H. J. Haves for his
great assistance and good work in the prep-
aration of material for this paper.
CONCLUSIONS.
I. All tonsils that are hypertrophied after
fourteenth year are pathological and should be
BIGGS and NORRIS: ENUCLEATION OP THE EYEBALL
removed, especially if patient is subject to re-
current attacks of tonsillitis.
2. Tuberculosis was present in 5 per cent of
tonsils removed in this series.
3. Tuberculous cervical adenitis of same
side was present in every case of tuberculosis
of tonsil of this series of ten cases, excepting
one.
4. Tonsillectomy should be done as a pre-
liminary operation to excision of tuberculous
cervical glands.

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