TON 



TON 



po'lifiied, nearly entire. [Stalks crowded, fingle-flowered. 

 Branches rough." — Native of Madagafcar, as the uncouth 

 name, \vhich ought to have been changed, imphes. The 

 Iratjcbes are faid to be oppofite, leprous, but not downy 

 nor hairy. -Leaves an inch and half long, or fomewhat 

 more, j-ather coriaceous, fometimes flightly toothed towards 

 the end. Flower-Jlalh very numerous, from each axillary 

 tubercle. F/oivers drooping, fmooth. Petals linear. 



7. T. mult'rflrira. Many-flowered Tonfclla. Vahl. n. 6. 

 (Hippocratea multiQpra ; Lamarck Illuftr. v. i. loi. H. 

 obovata ; Richard Aft. Soc. Hift. Nat. Paris, v. i. 106.) 

 — " Leaves obovate, entire, polifhed. Stalks crowded, 

 each bearing two or three flowers." — Fo.und by Richard 

 in Cayenne. Branches oppofite, fmooth. Leaves three or 

 four inches long, fometimes' oblong-ovate, very fmooth, 

 deilitute of veins. Floiuir-Jlalhs numerous, fcarcely half 

 an inch long, each divided into two or three fimple 

 partial ftalks, about the fame length, vvith minute hraHeas 

 at the bafe of each. Petals oblong, fmooth. The friiil of 

 thefe tliree laft plants has not been examined, but Vahl 

 was induced, as in the fimilar cafe of our fourth fpecies, 

 to remove them hither, on account of their very -clafe 

 affinity to T. africana. 



The author juft mentioned confiders this genus as very 

 nearly related to the Linnsan Salacia, fee that article. 

 This opinion is extremely probable, ;md if it be correft, the 

 name of TonJeUa mud give place to Salacia. In the habit of 

 the plants we find no grounds for any difliinftion. 



TONSET, in Geography, a town of Norway, in the pro- 

 vince of Aggerhuus ; 145 miles N. of Chriiliania. 



IXDNSILS, in Anatomy, the glandular bodies, alfo called 

 from their fize and fhape amygdala, placed at the paflage from 

 the mouth to the pharynx. See Deglutition. 



Tonsils, Difeafes. and Extirpation of. The tonfils are 

 exceedingl-y liable to inflame ; and fometimes the fwelUng 

 thus produced is fo great as to obftruft deglutition and ref- 

 piration in a very dangerous degree. Prompt fuccour is 

 now mofl; urgently required ; and relief may commonly be 

 obtained by fcarifying the enlarged tonfils, and promoting 

 the bleeding with warm gargles. 



This operation may be done with an ordinary lancet, or 

 with a broad one contained in a fheath, and conftrufted fo 

 that its point can only be pufli^d out to a certain diftanee. 

 Pharyngotomus is the name ufually given to this inftrument. 

 Abfcefles in the tonfils are alfo to be opened, when the 

 fwelling caufes ferious inconvenience. 



When fcarifications cannot be made, the beft means are 

 venefcftion, applying leeches to the throat, exhibiting mer- 

 curial medicines, inhaling the iteam of hot water, and ufing 

 proper gargles. 



Abfcefles of the tonfils have been obferved of confiderable 

 extent, not burfting in the mouth, as is ufual, but in the 

 Euftachian tube, or even the meatus auditorius externus, 

 attCJided with caries of the maftoid procefs, deafnefs, and 

 fiflulas. Such cafes are frequently incurable. 



The tonfils fometimes become enlarged, without being in- 

 flamed. This fwelling is improperly termed fcirrhous. The 

 glands are only fwollen and of moderate firranefs. A portion 

 of a tonfil, thus enlarged, may be cut off, without the leali: 

 danger of tire refl; aflfuraing a malignant nature. This pre- 

 ternatural fwelling of the tonfils is mottly owing to repeated 

 inflammations. Sometimes there is no palpable caufe. 

 The malady is conllantly free from pain. . When the tiunc- 

 faftion is confiderable, it obftrufts the- fpeech, deglutition, 

 and refpiration. 



Difcutient and aftringent applications here 'prove inef- 

 feftual. The tumour admits of being removed ; but it is 



unneceflary and improper to take away the -whole tonfil, as 

 a dangerous and even fatal haemorrhage might be the confe- 

 quence. Only fo much of the fwelhng ftiould be removed, 

 as is fufficient to afford relief. The remaining portion in 

 general heals, without the leafl: difficulty : a clear proof 

 that the difeafe is not of a malignant nor cancerous nature. 



The extirpation of a part of a tonfil, thus difeafed, has 

 been accompliflied with caufl;ic6,.the aftual cautery, the liga- 

 ture, and cutting inftruments. The firfl: of thefe plans was 

 fuccefsfully praftifed by Wifeman ; but is now quite 

 abandoned. The fecond is alfo relinquiflied, as no modern 

 furgeons employ it, except nowand then, with a view of 

 deftroying fungous excrefcences, W'hich, in a few inftanceSf 

 originate after a part of the tumour has been removed by 

 fome other operation. 



A variety of inftruments has been devifed for putting a 

 hgature round difeafed tonfils. 



There are very good furgeons, who {lill prefer tying difeafed 

 tonfils to cutting them away, and the mode to be adopted 

 diff"ers according as the fwelling has a narrow or broad bafe. 

 The ligature ought to be made of filver wire, or catgut. 

 When the tumour has a narrow neck, the ligature is to be 

 doubled, and introduced through the nofl;ril, fo that the 

 noofe may be feen in the throat. With the aid of a pair of 

 forceps, the noofe may then be eafily placed round the neck 

 of the tumour. The ends of the ligature are then to be 

 brought through a double cannula, and the latter inftru- 

 ment introduced as far as the tonfil. The ligature on each 

 fide is then to be drawn tightly, and fattened round rings at 

 the end of the cannula. The inftrument may next be 

 twifted, till a due degree of conftriftiori is produced. 



Default employed an inftrument, called a ferre-nceud, for 

 putting the noofe of the ligature over a difeafed tonfil, and 

 producing the neceflary degree of conftriftion. The ferre- 

 nceud was nothing more than a little ring, mounted on a 

 longitudinal, narrow piece of fteel, about five inches long, 

 the other end of which was grooved, or rather forked. 

 The difeafed tonfil was firft taken hold of with a double 

 hook. With the ring, the noofe was condufted along the 

 hook, and put over the tonfil ; the ligature was then drawn 

 out, while the ring prefled the noofe downward and back- 

 ward. Thus the due confl/riftion was made, and it was 

 next maintained by twifting the ends of theligature round 

 the forked extremity of the inftrument, on the outfide of the 

 mouth. Default par Bichat, tom. ii. p. 233. 



Wiien the difeafe had a broad bafe, and was of a conical 

 fliapc, fo that the hgature was apt to flip off', Chefelden has 

 recommended the ufe of an inftrument like a crooked 

 needle, fet in a handle, with an eye near the point, threaded 

 with a ligature, which is to be thruft through the bottom of 

 the gland, and laid hold of with a hook. The needle is then 

 to be withdrawn. The double ligature is next to be 

 brought forwards, and one part tied above, the other below 

 the tumo.ur. The hgatures are now to be cut off near the 

 knots. 



We have already obferved, that the removal of the whole 

 enlarged tonfil is unneceffai'y, and therefore injudicious. 

 We may now notice, that a portion of the tumour may be cut 

 away, without any juft ground for fearing a dangerous 

 bleeding. The apphcation of a hgature occafionally pro- 

 duces a molt perilous fwelling of the difeafed tonfil, at- 

 tended with fuch hazard of fuffocation, as to compel the 

 furgeon to cut and remove it. Bertrandi, and many other 

 eminent furgeons, have been in the habit of cutting away 

 enlarged tonfils, without ever meeting with an inftance of 

 danger from the fubfequent bleeding. 



Default fometimes employed a flat fheath, made of filver, 



and 



