A medical handbook : for the use of practitioners and students / by R.S. Aitchison.

Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: A medical handbook : for the use of practitioners and students / by R.S. Aitchison. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    ulceration ; or it may affect the connective tissue (peritonsillitis) or the deeper structures (interstitial tonsillitis)—the two latter forms commonly ending in suppuration. There is intense hypertemia of the tonsils, extending to the palate and uvula. The tonsils may be so swollen as almost to meet in the middle line. The secretion of mucus is increased, and it soon becomes muco-purulent. When pus forms, it tends to burrow down, and into the pillars of the iauces. The symptoms are at first those of an ordinary cold or chill, followed soon by heat, constriction at the throat, and pain on swallowing. The temperature rises to 102° or 103° F. The breath is foetid, and the tongue heavily coated. Pain shooting up to the ear is common, and it is often associated with noises in the ear and temporary deafness, due to the pressure upon the Eustachian tubes. The voice has a muffled tone, and the breathing is affected, especially if there should be much oedema of the surrounding parts. In inflammation of the deeper structures, the tonsillitis is usually unilateral, and the parts have a hard, brawny feel. Rigors indicate suppuration, and there is danger of the pus burrowing down beneath the aryteno-epiglottic folds, and the possibility of oedema glottidis supervening. Fluctuation may be made out with the finger. In severe tonsillitis, the glands of the neck enlarge and are very tender. The chronic form of tonsillitis is generally a manifestation of the strumous diathesis, and less frequently the result of acute attacks. Cold is generally the cause of acute tonsillitis. Chronic hypertrophy of the tonsils, with frequent subacute attacks of inflammation, is a very common condition met with in practice, and in early youth is generally associated with adenoid vegetations (post-nasal grovvths). Tonsillar affections are more common in youth. The duration of acute tonsillitis is about a week or ten days. Rapid recovery is the rule after free exit of the pus. . \Retro-pharyngeal abscess may be the result of mflammation ot the loose connective tissue, but more usually it is caused by disease of the cervical vertebra, or by suppuration of the deep lymphatic glands, extending to the pharynx. There is fever in the first case, and then a hard swelling may be made out, with pharyngeal obstruction. The latter symptom, with stiffness of the head, may tie the first symptom calling attention to the abscess, when it is secondary. There is danger to life if not evacuated.] In relation to the diagnosis of sore throats, generally, the scarla- tinal pharyngitis and syphilitic ulcerations have to be remembered. Simple sore throats are frequently accompanied by red rashes, especi- ally in children. Diphtheria requires to be noted, and the superficial form of tonsillitis with diphtheritic looking ulceration, requires to be carefully differentiated. The ulceration m the superficial tonsil- litis is more limited to the tonsils (see Diphtheria) Ordinarj- sore throats often accompany fevers, ahd inflammations of the air-pas.sages and lungs; but as the symptoms of the latter are sometimes latent, a sore throat and cough should always suggest an examination for them.