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Miss Pearl S., set. 17, Springfield, Ohio, was referred to me by Dr. Langdon, March 3,1892, The vault of the pharynx was covered with adenoid tissue, rough and lobular, which extended from the region of Luschka's tonsil back and down aver the posterior pharyngeal wall to a point on a level with the upper surface of the epiglottis. This tissue was apparently about half an inch thick in the center above, and gradually grew thinner as it extended downward and toward either side.
On pressing down the tongue a reddish glandular tumor was disclosed, which, on further examination proved to be attached to the epiglottis. The tumor was about the size af a large English walnut, the surface being divided at irregular intervals by deep seams and covered by small granulations, giving it somewhat the appearance of a large lobular strawberry. It was attached to the free border of the