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July 7, 1917


Author Affiliations

New Orleans Fellow of the American College of Surgeons

JAMA. 1917;LXIX(1):38-39. doi:10.1001/jama.1917.25910280001013b

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Some textbooks in describing injection of the tonsils for local anesthesia show six or seven points at which we are told to inject. Others use a curved needle and inject just under the mucous membrane. Both of these methods cause an edema of the tissue, causing so much distortion that often it is hard to find the tonsil, and after operation there is bound to be more or less reaction from the introduction of so much fluid into the tissues. Again, our anesthesia is often poor and unsatisfactory.

The middle and posterior palatine nerves (branches of Meckel's ganglion) join with the tonsillar branches of the glossopharyngeal nerve to form a plexus around the tonsils (circulus tonsillaris).

With the exception of the mesial free surface, the tonsil is surrounded by a distinct fibrous capsule, and external to this capsule is found the pharyngeal aponeurosis, which is rather loosely associated with the

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