Chapter 6 - Diseases of the Nose and Throat
Nasal Catarrh
Pharyngitis
Laryngitis
Acute Laryngitis
Chronic Laryngitis
Laryngitis Sicca
Symptomatic Laryngitis
Tuberculosis of the Larynx
Hare Lip
Elongation of the Uvula
Tonsilitis
Chronic Inflammation of the Tonsils
A Cold. Influenza
La Grippe
Acute Inflammation of the Epiglottis
Mumps
Adenoids and Enlarged Tonsils

6.11 Tonsilitis

Acute Inflammation of the Tonsils. Tonsillitis.

THE tonsils are chiefly a collection or mass of small mucous follicles or glands. They secrete a portion of the fluid which keeps the throat moist.
There is a class of persons who suffer about every winter, sometimes oftener, with an attack of acute inflammation of these glands, which causes great suffering for several days. The trouble usually is ushered in by high fever, backache, headache and often by chills; the temperature often reaches to 103' and 104' F.; swallowing is difficult on account of the swollen glands, while pain in the ear is not infrequent. The tonsils are at first swollen, reddened and inflamed; later a whitish patch of secretion forms on the surface of the gland and is distinguished from that of diphtheria by being whiter and less tenacious; if removed, the underlying surface does not bleed as in the case of diphtheria. It is, however, very difficult, at times, to distinguish between the two diseases at first.
Another form of Tonsillitis occurs without patches, and is in reality an inflammation of the substance of the gland itself. This variety, often called Quinsy, goes on developing into an abscess, the anterior pillar of the fauces becomes intensely red, swollen and shiny.

Treatment. For the more common variety some antipyretic to reduce the fever and allay the intense aching of the head and bones is properly indicated. For this purpose 10 grains of Pbenacetine (for an adult), repeated every two to four hours according to the effect produced, is quite efficacious. Ammonol in same dose may also be used. Some simple astringent and soothing gargle will next be found to render signal relief. Tannin, 30 gr., strong Carbolic Acid (95 c/,), 30 drops, Glycerin, 1 oz., and peppermint water, 3 oz., is an admirable gargle for the average case: this should be used hourly.
Equal parts of Glycerin, Alcohol and Water makes a very soothing gargle, while equal parts of Peroxide of Hydrogen and Water is preferred by many. The diet should be limited in amount and consist only of liquids.
Tincture of aconite in I or 2 drop doses together with half teaspoonful of sweet spirits of nitre repeated every hour will help to allay the fever and congestion of the throat, and goes far to prevent pus formation which is usually spoken of as Quinsy sore throat. This abscess, if formed, may be evacuated by the physician, who alone should attempt it, as the region is a dangerous one, being close to the carotid artery and jugular vein, which would cause instant death if cut.
It has been found that Tonsillitis is apt to be recurrent and that he who has suffered once is very prone to have one or more attacks annually thereafter. This class requires constitutional treatment in the intervals as outlined below.
These inflammations are likewise found to be an expression oftentimes of rheumatism, and need corresponding treatment. But the only cure is to be found by cutting off the tonsils, after the inflammation has subsided. This will put an end to the attacks at once.
Tonsils which are subject to these periodical attacks of acute inflammation %re always more difficult than others to operate upon, as they are almost invariably bound down very tight to the throat, and cannot be raised up for convenient excision.

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