THROAT, AFFECTIONS OF THE. Common inflammatory sore throat has been already described in the article Quustsv; and other important throat diseases, aphthae or thrush, and diptheria, have also been discussed in special articles. The malignant sore throat •of the older nosologists is now recognized as a modification of scarlatina. Another important variety of sore throat occurs as one of the forms of syphilis. Bronchocele or goitre, which, to a certain degree, is an affection of the throat, is specially described under the latter name.
The disease popularly known as clergyman's sore throat, or dysphonia clericorum, and 'hich is recognized in medicine under the name of follicular inflammation of the pharynx, first shows itself by huskiness of the voice, with more or less coughing, hawk ing, and expectorating, from an uneasy sensation in the throat; there is, moreover, a constant inclination to Swallow. On examining the back of the throat, its mucous membrane is seen covered with granulation, caused by an accumulation of secretion in the follicles, which sometimes burst and discharge their contents, which are of an elastic consistent nature. This discharge is occasionally followed by ulceration. The disease commonly arises from too prolonged or powerful excercise of the voice by persons in whom the mucous membrane of the throat is in a relaxed condition. Perfect rest from pub lic speaking, preaching, acting, etc., is of more importance than anything else in the way of treatment, and a residence during the winter and spring in a mild and equable climate is expedient. Torquay, Ventnor, Nice, Mentone, Algiers, and Egypt, afford a choice of suitable residences. Tonics, such as iron, quinia, and strychnia (in small doses not of a grain, three times a day), should be tried; but the local application of a strong solution of nitrate of silver (from 20 to 80 grains in one ounce of distilled water), applied by a probang to the affected mucous membrane, is usually of far more service than internal remedies. The best work on this subject is that of
Dr. Horace Green, an American physician.
Passing over several throat affections of minor importance, we proceed to the consid eration of wounds in the throat. These wounds are comparatively seldom the result of accident; they are more often made with a murderous intent, and most frequently they are made with the view of committing suicide.
The first duty of the surgeon, in treating a case of cut throat, is to arrest the flow of blood. Ligatures should be applied to the wounded arteries, and steady pressure with the finger (beneath which a small pad of lint is placed) to the wounded veins, such as the external jugular. If the internal jugular is wounded, fatal hemorrhage will very rapidly ensue, unless the wound is immediately plugged with small pieces of sponge, or pressure with the finger is maintained as long as necessary. With a knowledge of these means of checking hemorrhage by pressure, an intelligent non-professional person may be the means of saving life. When the bleeding has completely ceased, but not till then, means may be taken for bringing together the edges of the wound. In most cases, sutures, or even adhesive plaster, are inexpedient and even dangerous, and it is best to keep the parts in simple apposition. "The patient," says Mr. Gray, "should be placed in bed in a moderately warm room, the shoulders well raised by pillows, and and the head bent forward and retained in that position by a bandage, and the wound should be covered with a strip of wet lint or linen."