Abstract
In the palatine tonsils with focal infection (26 cases of articular rheumatism, 16 cases of nephritis, 8 cases of febricula) were observed remarkable pathohistological changes as follows. The forms and ramifications of the tonsillar crypts were exceedingly complicated. The epithelial layers were incrassated or papillary, while others were thin, partly broken or forming ulcers. In some locations they were reticulated owing to the infiltration of many round cells. Iii the tonsillar crypts many desquamated horny epithelial cells and their detritus accumulated, and lymphocytes and neutrophil leukocytes often mixed, forming plugs. Complicated ramifications and windings of the tonsillar crypts interrupted the discharge of the plugs. There were many cystic dilations or cysts were formed in the peripheral parts. Besides these actinomycotic granulas and colonies of bacteria were also found in large quantities, and crypts were also found which showed signs of acute or subacute inflammation. Cyst formation was discovered at high percentage as one of the pathological changes caused by inflammation. In the lymphatic tissue were also observed granuloma with giant cells and scars caused by the destruction of the cysts. In the areas besides the crypts, remarkable mesenchymal reaction was observed. Trabeculae and capsules were incrassated and scarred, new blood vessels had grown, there was remarkable growth of the connective tissue of the tunica externa of the blood vessels, the parenchyma of the tonsil was atrophic. Most of the secondary nodules of the lymphatic tissue were in the active or reactive stage, but some were of the disturbance type. Various changes were observed in the blood vascular system. The changes were mostly incrassation and hyaline degeneration of tunica interna, hyperplasia of tunica externa, fibrinoid swelling of the connective tissue of the arterioles, remarkable infiltration of the plasma cells and lymphocytes around the venules. In a few cases analogous changes to Aschoff's
