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Full text of "Diseases Of The Nose Throat And Ear"

CHAPTER 20
ACUTE INFLAMMATIONS OF THE PHARYNX

Acute pharyngitis is commonly met with, varying in severity from the
transient sore throat which is often the precursor of a virus infection of the
upper respiratory tract to a more severe septic pharyngitis.

SIMPLE PHARYNGITIS

This is the more frequent variety, occurring primarily during the winter
months and less often in autumn or spring. It precedes the common cold, and
may accompany influenza, measles, scarlet fever, typhoid fever or smallpox.
While all axe prone to this mild pharyngitis those with dental sepsis or nasal
obstruction are thought to be more susceptible.

SYMPTOMS. The sore throat which ushers in the coryza begins with a feeling
of chilliness, a slight pyrexia, headache, backache and joint pains. The throat
feels dry, raw, uncomfortable or painful especially on swallowing. There may
also be some hoarseness. These symptoms last for a day or two until the
coryza, influenza or infectious fever becomes apparent.

CLINICAL FEATURES. On examining the throat there is an obvious redness,
and sometimes swelling, of the mucosa of the soft palate, tonsils and posterior
pharyngeal wall. The uvula shares in this and occasionally there is some
haemorrhage into it. The cervical glands are palpable and tender. In children
the mouth should be examined for Koplik's spots in case the pharyngitis is the
precursor of measles.

TREATMENT. As a rule no treatment is required, but if advice is sought the
patient should remain indoors and take a hot bath and aspirin 0-3-0*6 g before
bed. There is no indication for prescribing antibiotics unless the pharyngitis
proceeds to one of the fevers. Hot astringent gargles, such as hydrogen
peroxide or ferric chloride, may be used three or four times daily. Lozenges,
such as domiphen bromide (Bradosol), dequalinium chloride (Dequadin) or
tyrothricin and benzocaine (Tyrozets), are often soothing if allowed to
dissolve slowly under the tongue.

SEPTIC PHARYNGITIS

This is a more serious condition and is caused by the pyogenic organisms,
haemolytic streptococcus, Staphylococcus aureus, pneumococcus and H.
influenzae. It is more severe in those with lowered resistance from overwork,
alcoholism, debilitating illnesses, etc.

SYMPTOMS. The onset is sudden and may be ushered in by a rigor. There is
severe pain in the throat so that swallowing, even of fluids, is difficult

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