Lectures on the physical examination of the mouth and throat : with an appendix of cases / by G.V. Poore.

  • George Vivian Poore
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the physical examination of the mouth and throat : with an appendix of cases / by G.V. Poore. Source: Wellcome Collection.

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    On the subsidence of the inflammation the tonsils are often left enlarged, and in patients of a strumous habit this enlargement is very obstinate. It occasionally happens in strumous children that the tonsils undergo a slow progressive enlargement without any acute attack. The tonsils in these cases are large, pale, smooth, and hard-looking, and often meet in the middle line, while the rest of the pharyngeal mucous membrane remains healthy. The cause of the enlargement is either a general hypertrophy of the part, or is due to inflammatory products or occasionally to a larda- ceous change. The openings of the crypts on the surface of the tonsil may give the idea of ulceration. If the tonsils meet and rub against each other, a superficial erosion of the surface is not uncommon. These enlarged tonsils may inflame and swell up when the patient catches cold. There is a form of hypersemia and swelling of the pos- terior wall of the pharynx which must be mentioned. In this the vessels ramifying in the mucous membrane are distinctly enlarged, and the mucous follicles are swollen, giving a coarsely granular appearance. Hence the name of granular pharyngitis has been given to it. The mucous secretion of the part is increased, and strings of mucus may be generally seen adhering to the membrane. This form of pharyngeal disease is common among gourmands and steady drinkers. It seems, according to Riihle, to be very common in the Rhineland, and the cause of it is said to be found in the convivial nature of the inhabitants and the seductiveness of the famous wines, which leads to a large amount of drinking and singing in close, ill-ventilated taverns. Combined with a certain amount of laryngeal congestion, it constitutes one form of the so-called clergy- man's sore throat —a form of sore throat which demands a strict dietetic regimen for its relief. It is very common in gouty subjects. Pallor of the fauces and pharynx is present in anaemia and leucocytheemia. Occasionally the pallor of this part is out of proportion to that of the rest of the body. There may be extreme pallor combined with a great amount of chronic enlargement of the tonsils. Ulceration of the pharynx and fauces may take the form of aphthous ulcers, like those which occur on the tongue and mouth. The most common causes, however, of ulceration of this region is syphilis. Syphilis may attack the pharynx in its early or late stages, and the manifestations may be either secondary or tertiary.- The pharyngeal condition which
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