Pathological Hypertrophy of the Lymphatic Ring of Waldeyer and its Influence upon Physical and Psychical Development

Abstract

Adenoids and hypertrophy of the tonsils occur in all kinds of people and give rise to numerous symptoms. The first group of these comprise oral breathing and its injurious consequences, nasal breathing being hampered. Since the adenoids mostly close only the upper part of the choanae, it is possible for the air to circulate through the small opening which remains frée on the inferior part. But if there is an accumulation of mucus, or if the inflamed adenoid tissues are swollen, the obstruction may temporarily become complete. The disturbances in expiration usually begin earlier, since the adenoids are pressed into the opening of the choanae by the circulating air and set up a valvelike obstruction. The patients breath through the mouth, and when they lie horizontally the tongue slips back, so that even oral breathing is obstructed under such circumstances. The disturbances are even more serious if the tonsils are enlarged, and besides this, sometimes hypertrophy of the tonsilla lingualis increases the difficulties of breathing too. In such cases the patients often suddenly wake up, and their sléep is very much disturbed (pavor nocturnus). Children do not féel refreshed after sléep; they are out of humour and tired when they wake. They snore in their sléep, which is produced by the vibrations of the frée margin of the velum, of the radix linguae, and of the epiglottis. Occasionally they are seized by asthma-like attacks; it is a matter of experience that adenotomy puts an end to asthmatic, heavy breathing. Sometimes the spasmus laryngis of children is the consequence of adenoids too, and it is caused by the saliva getting into the larynx.