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THE BOSTON MEDICAL AND SURGICAL JOURNAL SOCIETY, INC.

1915

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text-books of anatomy, most of it seems to be based on the original work of Sappey, which was done on children many years ago, and that of Poirier, Cuneo, Delamere and Most. It is stated in many monographs on the subject that the tonsils drain into the superficial and deep lymphatics, but I am unable to find any valid, anatomical statement for their drainage into the superficial lymphatics. The superficial lymphatics drain the areas of the anterior part of the mouth and tongue, and then pass into the deeper chain, while all that is posterior, including the entire pharynx, the post-nares, the upper pharynx, the tonsils and the base of the tongue, drain into the deep lymphatics of the jugular chain, of which there are two or three sets.

Briefly, this anatomy is as follows:-There are two principal retropharyngeal glands, one on each side of the median raphe, at the junction of the posterior and lateral surfaces of the pharynx, corresponding to the situation of the arch of the soft palate, with sometimes three or more additional lymph nodes on one side or the other. These glands correspond to the general situation of retropharyngeal abscesses, these being invariably found on one or the other side of the median line. They receive the lymph coming from the mucous membrane of the nasal fossae, and adjacent cavities, and drain into the upper glands of the internal jugular chain, passing behind the vessels and the nerves. general lymphatic drainage of the pharynx ends either in the retropharyngeal glands or the internal jugular chain. The glands of this chain also receive the lymph from the internal group of the sternomastoid glands. The lymphatics from the tonsil appear to drain into the posterior lymph glands of the tongue, thence into two lateral trunks, thence passing down the lateral wall of the pharynx terminating in large glands of

The

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