PHARYNGITIS, or sore throat, is common at all ages, and is a frequent com plaint in early life. The disorder may be met with as a simple catarrh of mucous membrane ; as an inflammation affecting especially the mucous follicles ; as an eruption of herpes in the pharynx, or as part of a severe constitutional disease. Four varieties will then be considered, viz., simple catarrhal pharyngitis ; follicular pharyngitis ; herpetic pharyngitis, and tu bercular pharyngitis.
of the pharynx, like catarrh attacking other parts of the body, is usually the consequence of a chill. Any cause which in clines the body to be affected by changes of temperature will help to induce the disorder. It is, therefore, common in scrofulous subjects, in children enfeebled by confinement to heated, ill-ventilated rooms, and in those resi dent in houses where the air is contaminated by an imperfect system of drainage. Direct irritants to the throat will also set up pharyngitis, which at once passes beyond the limits of an ordinary pharyngeal catarrh. The children of the poor are often brought to the hospital with severe scalds of the throat from attempting to drink boiling water out of the spout of a kettle. In the above cases the disorder is a primary lesion. It may, how ever, occur secondarily to some general disease. Thus, catarrh of the pharynx is an invariable consequence of measles and scarlatina. It is also common in typhoid fever, in rheumatism, and in erysipelas. In all cases, the derangement is •an acute process, although, if frequently repeated, it tends to set up a relaxed and congested state of mucous membrane.
Symptoms. —In mild cases, the first symptom is usually a sore feeling in the throat, which is increased by swallowing. On examination of the throat the back of the fauces, the soft palate, and the tonsils are noticed, to be red, and the latter may be slightly swollen. The tongue is furred, and the child is thirsty. In scrofulous subjects the temperature almost invaria bly rises, and there is a certain amount of pallor and languor. In the slighter forms little more is to be discovered. Alter a day or two the child begins to snuffle, and the throat affection disappears as a nasal catarrh be comes established.
In the severe variety the earlier symptoms are more pronounced. The child feels ill and looks tired. His face is pale, his eyelids are dark, he complains of weariness and aching in the limbs, and asks to go to bed. Often he sits over the fire and says he is cold. In a few hours soreness of the throat begins. The fauces are found to be red and the tonsils to be slightly swollen. Whitish pultaceous matter may be seen at the openings of the crypts of the tonsils, and sometimes at the back of the pharynx. In scrofulous subjects the temperature generally rises to or 105°, and in such children the glands of the neck, although little enlarged, are tender when the neck is pressed. The tongue is thickly furred, and in most cases the nasal passages and the gastric mucous membrane are also the seat of catarrh. Moreover, the eyes look red and watery, and the child avoids the light. In a day or two the catarrh often spreads to the Eustachian tubes, so that there is some deafness. The voice is nasal, and swallowing causes great pain, so that the child refuses all solid food. The bowels are usually confined ; but if there is any intestinal catarrh, the disorder may be accom panied by purging.
After twenty-four, or, at the latest, forty-eight hours, the fever consider ably diminishes, but the temperature may remain at 100° or 101° for a day or two longer. Usually, after the third or fourth day the symptoms begin to subside, and by the end of the week the child is convalescent. If the patient has suffered many times previously, the deafness may not subside with the other symptoms, but may persist for a week or so longer.
A. scald in the throat is accompanied by great nervous prostration. There is severe pain in swallowing, and consequently an almost entire ina bility to take food. The mucous membrane of the mouth, palate, and pharynx, looks whitish ; raw patches are seen, from which the mucous mem brane has been removed, and there is much swelling. Often the larynx is also injured, so that acute laryngitis is set up, and ceitema of the glottis may be induced.