TONSILLITIS, acute inflammation of the tonsils (see LYMPHATIC SYSTEM) due to their invasion by infective micro organisms. Sometimes an attack follows on exposure to sewer gas, and it is common in house surgeons, nurses and others who have to spend most of their time in a hospital.
Tonsillitis is frequently associated with acute rheumatism (q.v.) and it is thought that the tonsils are often the portal where by the streptococci causing rheumatism gain access to the body. A similar view obtains with regard to the sore throat in scarlet fever. Acute tonsillitis may run on to the formation of abscess (quinsy). Tonsillitis may begin with a feeling of chilliness or an attack of shivering. Then come on swelling in the throat, pain, tenderness and difficulty in swallowing, pain about the ear and jaw, and swelling of the glands in the neck. The temperature is raised, breath offensive and the tongue thickly coated. There may be yellow spots of inspissated mucus in the tonsillar crypts but these differ from the "false membrane" of diphtheria in that they can be easily brushed off by a swab, though often a true diagnosis can only be made bacteriologically. The most trust
worthy drugs are salicylic acid, iron and quinine. If abscess threatens, a slender-bladed knife should be thrust from before backward deeply into the swollen mass. And if, as most likely happens, matter then escapes, the patient's distress speedily ends.
Chronic tonsillitis is often associated with adenoids (q.v.) in children. It leads to enlargement of the tonsils which may meet across the middle line of the throat. The lymphoid tissue of which the tonsil is composed is one of the body's lines of defence against invasion by infective micro-organisms, but these enlarged tonsils are abnormal in structure and not only fail as defensive mechanisms but also interfere seriously with the general health. Often, therefore, it becomes necessary to remove them surgically. Formerly the projecting mass was simply cut off but now the general procedure is enucleation of the entire tonsil.