The present conviction that rheumatoid, cardiac and pyemic diseases emanate from foci of infection often situated in the tonsils, and the occurrence, which I have repeatedly noted, of nasal sinus suppuration, together with secondary infective tonsillitis, and again, with infective hyperplasia of the minor lymphoid groups, render important the evidence which serves to establish the microbic origin of the lymphoid enlargement, and tends to substantiate the sinus disease as the primary source of infection.
Though typical sinus suppuration makes itself obvious, the discharge need not amount to actual pus, the disease being prevalent in attenuated, yet virulent forms, which are readily overlooked.
The particular qualities noted as characterizing infective lymphoid hyperplasia are: a conspicuous enlargement of the smaller clusters and single follicles, an apparently diffused lymphoid infiltration of adjoining tissue, and a decided disposition, in consequence, to redevelopment after excision. In addition to these, recognition of its situation as being
CASSELBERRY WE. INFECTIVE LYMPHOID GROWTHS OF THE LARYNGOPHARYNX, SECONDARY TO SINUS SUPPURATION: A PREVIOUSLY UNDIFFERENTIATED TYPE OF LYMPHOID HYPERPLASIA. JAMA. 1915;LXIV(7):576–579. doi:10.1001/jama.1915.02570330024008
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