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214 ANATOMY. ;

pharyngeal muscles arise from closely-related portions of the palate,
and diverge as they descend to their insertions, causes the tonsillar space
to be narrow at the top and wider at the bottom ; and the further fact
that the gland is about of eipial width and thickness causes it to be
compressed above, while below it is comparatively free from pressure.
The tonsils are about three-fourths of an inch long, half an inch
wide, and about the same in thickness, their extremities being rounded.
They vary considerably in size in different individuals, the two often
being dissimilar in the same person. They are comjjosed of masses of
connective-tissue fibres and diffused adenoid tissue embracing lymph-
follicles. On their free or proximal surface they are pitted with from
twelve to twenty indentations or f)ldings, in such a way that they pro-'
duce small recesses or crypts situated within the substance of the gland.
These give the free surface of the gland a perforated appearance. The
crypts are lined by a continuation of the stratified epithelium covering
the mucous membrane of the mouth. The lymph-follicles above
referred to are arranged around the walls of the crypts, and outside
of the follicles are a number of small mucus-secreting glands. The
secretion from these mucous glands is thick and grayish in appearance
it is discharged into the crypts. The retention of this fluid causes the
breath to become fetid. Sometimes this secretion becomes inspissated,
and is discharged in the shape of small balls of yellowish-gray matter
having a very offensive odor. The retention of this matter may cause
the tonsils to become highly infiamed.
AVhen the tonsils are in normal condition, lymph-corpuscles migrate
from the body of the gland, through the mucous membrane on its free
surface, and enter the muco-salivarv fluid of the mouth. These corpus-
cles, when detected in the saliva, are called In- some writers mucous or
salivary corpuscles. These corpuscles absorb water, become splierical
in form, and finally disintegrate.
The InfratonxiUar or Pharymjeal Tonnih are situated below the ton-
sils proper, in the upper part of the pharynx. As the raucous mem-
brane in parts of this region is covered by ciliated columnar ejjithelium,
it follows that some of the crypts of these glands are lined Avith the
same structure.
Arfrries.—The tonsils are extremely vascular bodies, being supplied
with blood through tlie medium of the tonsillar and palatine branches
of the facial artery, the descending palatine branch of the internal max-
illary, and the ascending ])hnryngeal. From these arteries a fine ]>lexus
of capillaries is fi)rmed. These ca]Mllaries are distributed to the differ-
ent tissues within the gland. The extreme vascularity of the gland
causes its excision in wliolc or in part to be followed by considerable
hemorrhage. Although tlie internal carotid artery passes to the outside
of the superior constrictor'of the pharynx, and is usually about three-
fourths of an inch back of the gland, it has been cut in performing
tonsillotomy, with verv serious results. In operations upon the gland
the sursjeon should direct liis knife awav from the arterv.