ADENOIDS.
Authors: W. FREUDENTHAL
Journal: JAMA (1903)

About seventeen years ago, when I came to this coun¬ try, after having seen and operated on many cases of adenoids at Berlin and Freiburg, at one of the first meetings of the New York Academy of Medicine which I attended, a prominent colleague made the remark that while there might be found such things as adenoid vegetations among the children in Denmark or in Ger¬ many and Russia, the Anglo-Saxon race was free from that anomaly.In the years that have elapsed, I am confident that the gentleman has been convinced that they do exist in England as well as in the United States, and nowadays I have yet to see the practitioner who• has not encountered eases of so-called adenoids in his own practice.They have been, so to speak, part of my daily bread for more than eighteen years in clinics and private practice.Still, when your Chairman did me the honor of asking me to read a paper before this Section, I was somewhat embarrassed as to what to say to a body of experienced practitioners that would be new to them on this topic.The libraries abound in articles and pamphlets on adenoids, which for some time have been viewed, not as a curiosity, but as an every-day occur¬ rence.They have become so frequent in all parts of the globe that every practitioner must of necessity be familiar with them.Adenoids grow in a place which I long ago considered the most important of the whole breathing apparatus, viz., the retropharynx.We can and do examine easily all other parts of the upper respiratory tract, but the re¬ tropharynx, which is the locus minimoe resistentioe for many a disease, is too often overlooked.No wonder that adenoids, which have existed as long as civilization, were overlooked, and discovered only as late as 1868 by Wilhelm Meyer of Copenhagen.It is undoubtedly true, however, that Voltolini removed them already in 1865 with the galvano-cautery without recognizing their ' importance.Now, what are adenoids, or, as they are also called, adenoid vegetations, adenoid growths, pharyngeal tonsil, third tonsil or Luschka's1 tonsil ?We had known since the time of Morgagni that the parts in question belonged to the tonsillar tissue, but only through the works of Henle, Kòlliker and His have we acquired a thorough microscopic knowledge of these structures.It was my former teacher, Prof. Wilhelm His of Leipzig, who called it adenoid tissue, and since then the name ade noids has become so popular that we can no longer change it.Waldeyer showed that the adenoid tissue in the upper pharynx is only a part of a lymphatic pharyn¬ geal ring ("lymphatischer Rachenring"), which now goes under the name of Waldeyer's ring.Any part of this ring may undergo acute and chronic changes.Just as the faucial tonsil may become the seal of acute and chronic inflammation, the pharyngeal ton¬ sil may be similarly affected.ACUTE CATARRHAL INFLAMMATION OF THE PHARYN¬ GEAL TONSIL.This is called by the French adenoiditis, with which most likely the fièvre ganglionnaire is identical.It is not as infrequent as is ordinarily believed, for, accord¬ ing to my experience, it often occurs in young children.As an examination is difficult or often impossible the diagnosis is very seldom made.A digital exploration should be omitted, if possible, on account of the reac¬ tionary inflammation and pain following this procedure.