T 1 4 SURGICAL APPLIED ANA TOMY. [Chap. vm. 



for India ") quotes : " Natives of India are not in- 

 frequently brought to hospital dying of suffocation 

 and alarm, with a large cat-fish impacted in the 

 fauces." In one case (Indian Med. Gaz., 1878) the 

 fish had thought fit to take a firm hold of the uvula, 

 and declined to leave go until its head had been 

 pinched with forceps. 



The walls of the pharynx are in relation with the 

 base of the skull, and with the upper six cervical 

 vertebrae. The arch of the atlas is almost exactly on a 

 line with the hard palate. The axis is on a line with 

 the free edge of the upper teeth. The termination 

 of the pharynx corresponds to the sixth cervical 

 vertebra. The upper vertebrse can be examined, as 

 regards their anterior surface, from the mouth. When 

 the bones about the pharynx are diseased, the necrosed 

 parts may be discharged by that cavity. Thus por- 

 tions of the atlas and axis have been expelled by the 

 mouth, as have also been some fragments of compara- 

 tively large size thrown off by the occipital and 

 sphenoid bones. 



The mucous membrane of the pharynx is vascular, 

 and readily inflamed ; and such inflammations are 

 peculiarly dangerous, in that they may spread to the 

 lining membrane of the larynx. Much adenoid tissue 

 is distributed in the mucous membrane of the pharynx, 

 and it is this tissue that is the primary seat of inflam- 

 mation in scrofulous pharyngitis. The tissue imme- 

 diately outside the pharynx walls is lax, and favours the 

 spread of effusion. Thus, in acute inflammation of the 

 pharynx, the effusion has been found to extend along 

 the oesophagus, reaching the posterior mediastinum, 

 and advancing even to the diaphragm. In the lax 

 connective tissue between the pharynx and the spine 

 abscess is not infrequent, due, as a rule, to caries of 

 the vertebrse (post-pharyiigeal abscess). In this con- 

 nective tissue, and opposite the axis, is also found a 



