Il Cleveland Medical journal . normale. Gli alunni sono uguali e reattati alla luce, ma sono pigri per l'alloggio; sono centrici e regolari; nessuna ptosi o palesie oculari. La gola mostra un grosso tumore duro che riempie completamente la fossa tonsillar destra e che invola sulla theuvula. Esternamente si nota un rigonfiamento che si estende dal lobo dell'orecchio destro fino all'angolo della mandibola. Questo è liscio, rotondo, circa la taglia di un uovo piccolo; è leggermente mobile da un lato all'altro ma non verso l'alto e verso il basso. Le ghiandole sottomascellari deste sono ingrossate; post cervicalglands non palpabili; nessuna evidenza di acuto

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The Cleveland medical journal . normal. The pupils are equal and reactto light, but are sluggish to accommodation; they are centric and regular;no ptosis or ocular palsies. The throat shows a large hard tumor masscompletely filling the right tonsillar fossa and encroaching upon theuvula. Externally a swelling is noticed extending from the lobe of theright ear down to the angle of jaw. This is smooth, round, about thesize of a small egg; it is slightly movable from side to side but not upand down. The right submaxilary glands are enlarged; post cervicalglands not palpable; no evidences of acute inflammation. Heart, lungsand abdomen are negative. There is an old scar 1 cm in diameteron the prepuce. A clinical diagnosis of sarcoma of the tonsil was made.A specimen was removed from the tonsil for microscopic examination;this showed chronic inflammatory reaction but no evidence of tumor. Operation: March 18, 1913. Oblique incision in the right side ofthe neck. The sternomastoid was divided half way down to the clavicle;. Fig. 5. Case II. partial dissection of the glands from this point upward. A portionof the internal jugular was removed and the external carotid was ligated.Dissection carried up behind the angle of the jaw and the tumor removedin this way. There was considerable hemorrhage requiring many liga-tures. A portion of the vagus was resected; the hypoglossal was seenbut not injured; the facial artery was divided. Following the operationthere was considerable mucus in the throat, which patient had great diffi-culty in getting rid of; hoarseness was marked; the right pupil wascontracted and very irregular; irregular febrile reaction lasting two weeks 544 The Cleveland Medical Journal with indefinite signs of bronchopneumonia in the right lung. The patientwas discharged April 16, 1913, hoarseness and irregular, contracted pupilstill present. Pathological report: S. P. No. 9872. Unfortunately thetumor was preserved in 10 per cent formalin only. Specimenreceived in