著者

立川 武

出版者

耳鼻

雑誌

耳鼻と臨床 (ISSN:04477227)

巻号頁・発行日

vol.6, no.1, pp.31-71, 1959

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The author perfomed provocative massage 120 times on each palatine tonsil in the cases of chronic tonsillitis and its consequent focal infection (nephritis, polyarthritis and slight fever). The following data proved that the process had much value for diagnosis and prognosis of the disease.<BR>1) Body temperature: Elevation of the body temperature as positive reaction to the massage was remarkable in the cases of slight fever of tonsillar origin, and was observed in 92% of the patients to whom tonsillectomy brought good effects.<BR>2) Erythrocyte sedimentation rate: In the cases of nephritis and polyarthritis of apparently tonsillar origin, the numbers of the patients whose erythrocyte sedimentation rates after an hour of the provocation increased, remained unchanged and decreased respectively were about the same.<BR>About 60% of the cases with good results after tonsillectomy, showed unexpected decrease in the rates of erythrocyte sedimentatiom, and, moreover, 60% of them showed increase in the rates after 6 to 24 hours of the provocation: diphasic variation. The cases with good results after the tonsillectomy among the cases of tonsillogenous slight fever, showed no definite difference between the rates before and after the provocation.<BR>3) The number of leukocytes: Increase in number of leukocytes after the provocation was found in 28% of the cases with chronic tonsillitis, 58% with suspected tonsillar focal infection, and 60% of those to which tonsillectomy was effective. Note that in the cases of foal infcction more than the half showed positive reaction.<BR>4) Serum protein: In 30% of the cases with chronic tonsillitis, and in 60 % of those with suspected tonsillar focal infection, there was high gammer-globulin value after the provoeation. The great majority of the cases with focal infection in which tonsillectomy proved effective showed even higher gammer-globulin value.<BR>5) Serum proein: The cases with increase more than 3 times of urine protein and erythrocyte in urine sediments were accompanied with elavation of body temperature (about 67% of the cases with changed urine findings), leukocytosis, and higher gammer-globulin value then before the maneuver. The cases with good results by tonsillectomy were frequently found in the cases which showed those changes in urine with additional diphasic erythrocyte sedimentation phenomenon.<BR>6) In the cases with positive reaction to the provocation, as the patho-histological changes of tonsillar parenchyma, abscess formation, cystic enlargement of the superior fossa tonsillaris and changes on the vascular wall and cavity were the frequent findings.<BR>7) The author noticed analogous changes to the above mantioned clinical results, experimentally massaging the aseptic abscess prepared in the abdomen of the rabbit after repeated instilment with hemolytic streptococci suspension and its filtrate into the abscess.