Acute tonsillitis is an acute infectious and often a contagious disease
characterized pathologically by inflammation of the tonsils. Some
authors differentiate between follicular tonsillitis in which the
crypts or lacunæ are involved, and parenchymatous tonsillitis in which
the parenchyma is involved.
=Etiology.=—The predisposing and exciting causes are the same as in
other acute infections of the upper air passages except that there is
usually a chronic tonsillitis as a result of some previous attack.
=Symptoms and Diagnosis.=—The symptoms also are similar to other acute
infections of the nasopharyngeal tract, with sore throat, variable
temperature, headache, etc. By direct examination of the pharynx, the
protruding masses with white or yellow patches are readily seen.
=Treatment.=—Infection, drainage and elimination are three words
inseparable in the therapeutics. The local treatment (I doubt if many
will agree) in either acute or chronic tonsillitis is essentially the
same—radical aspiration drainage. In all cases, except young children
who will not permit it, I place a vacuum cup directly over the tonsil
and apply as much vacuum as can be obtained. This treatment will, when
properly done, empty the crypts of all pus. This accomplished, each
crypt is probed with a cotton applicator dipped into phenol-glycerine.
Cervical and upper thoracic treatment and deep relaxation of the
sub-tonsil tissues to increase the normal blood supply and to decrease
congestion by drainage elimination are essential. The lower thoracic
and lumbar should receive due attention for the purpose of increasing
general elimination. The diet and other treatment are no different from
that in other infectious fevers.
Peritonsillar Abscess
(Quinsy Sore Throat.)
Peritonsillar abscess results from the collection of pyogenic bacteria
and pus formation between the tonsil and the pillars of the fauces. It
is perhaps a result of the closing of an infected crypt causing deep
penetration of the pus.
=Diagnosis.=—The symptoms are those of acute tonsillitis but usually
more marked and with one tonsil decidedly more protruding than the
other. In some cases the location of the abscess can be seen and it is
comparatively easy to open with a knife or probe, but in many cases the
abscess is so situated that it cannot be located except by exploratory
probing.
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