A CLINICAL STUDY OF THE SKULL. 



33 



chamber when there is a history of adenoid disease at the pharyn- 

 geal vault. (See p. 27.) 



Fig. 7. The posterula of a North American Indian (Upsarooka, No. 



1228), showing large foramina for the transmission of veins. (See also 

 Fig. 4.) 



1. Lateral superior foramen. 



2. Vaginal process. 



3. Lateral inferior foramen. 



4. Palatal bone. 



5. Vomer. 



In a well-defined group of cases characterized by excess of tena- 

 cious mucus in the pharynx, a disposition to vascular obstruction in 

 the nasal chambers, a sensation of weariness, if not of pain, in the 

 sides of the neck (which is especially liable to ensue upon a moderate 

 use of the voice, as in reading aloud and in singing), it is found that 

 the roof of the pharynx is occupied by small growths which do 

 not appear to differ, either in locality or consistency, from the 

 adenoid growths found in the same locality in young persons. I 

 have seen many instances in which the symptoms narrated had 

 existed for many years entirely disappear twenty-four hours after 

 the pharyngeal vault had been rasped by the finger nail, the vege- 

 tations removed, and the surface subsequently entirely restored by 

 the removal, with the forceps, of bits of remaining tissue. It is 

 reasonable to suppose that the increase of nasal congestion in such 

 cases is dependent upon unusual freedom of communication which 

 3 T 



