being
on the patient's right, depresses the tongue and insinuates the
curette provided with the hooks behind the soft palate, carrying it to
the roof of the naso-pharynx between the growth and the posterior free
edge of the nasal septum. Firm pressure is then made against the vault
of the naso-pharynx, and the curette is carried backwards and
downwards in the mesial plane and withdrawn with the main mass of the
adenoids caught in the hooks. The unguarded curette is then introduced
and several strokes are made with it, the instrument being carried on
either side of the mesial plane. With Hartmann's lateral ring knife
the posterior naso-pharyngeal wall and fossae of Rosenmueller are
curetted. The curette should not be used on the lateral pharyngeal
wall in case the Eustachian orifices and cushions are damaged.
Bleeding soon ceases when the head is again elevated, and the patient
should be at once laid well over upon his side so that the blood may
escape from the mouth.

No local after-treatment is required, and spraying or syringing may
prove harmful. The patient should remain in the house for five or six
days. If nasal obstruction has been the outstanding symptom,
respiratory exercises through the nose should be carried out for some
considerable time; on the other hand, if Eustachian obstruction and
deafness have been the main features of the case, a course of Politzer
inflation should be conducted after the wound has healed.

#Tumours of the Naso-Pharynx.#--Tumours are occasionally met
with growing from the muco-periosteum of the basi-sphenoid
and basi-occipital, and projecting from the vault of the
naso-pharynx--_naso-pharyngeal tumour_ or retro-pharyngeal polypus.
This usually occurs between the ages of fifteen and twenty, and while
it may originally be a fibroma, it tends to assume the characters of a
fibro-sarcoma and to exhibit malignant tendencies. At first the tumour
is firm, rounded, and of slow growth, but later it becomes softer,
more vascular, and grows more rapidly, spreading forwards towards the
nasal cavity and downwards towards the pharynx.

_Clinical Features._--In its growth the tumour blocks the nostrils,
and so interferes with nasal respiration and causes the patient to
snore loudly, especially during sleep. It may also bulge the soft
palate towards the mouth and interfere with deglutition. In some cases
the face becomes flattened and expanded and the eyes are pushed
outwards, giving rise to the