Diagnosis.—An ordinary pharyngitis can usually be readily recognised. The chief difficulty is to exclude diseases of which pharyngitis is a promi nent symptom, especially scarlatina and measles.
In scarlatina, the pharynx usually presents a peculiar appearance. The redness is of a very bright colour, and is diffused over the whole of the fauces. Often it is punctiform on the soft palate, or, even if the redness here is uniform, the punctate appearance can be detected at the edges of the redness. Moreover, in scarlatina, the feeling of soreness begins quite suddenly, as a rule, and the attack is accompanied by vomiting and a very rapid pulse. In twenty-four hours the characteristic eruption is to be dis covered.
If the signs of catarrh are general, and the sore throat is accompanied by slight ophthalmia and running from the nose, measles may be suspected. Indeed, the invasion of the eruptive fever is accompanied by symptoms which cannot be distinguished from those of an ordinary catarrh. If, on the third day, the fever is as high, or higher, than on the first, the continu ance of the pyrexia tells in favour of the exanthem ; but no positive opin ion should be hazarded until after the fourth day, when, if the case be one of measles, the characteristic rash may be expected to appear.
Treatment.—It is not often that medical advice is sought in a case of ordinary catarrh, the derangement being one which is considered espe cially suitable, for domestic medication. If, however,, the fever is high, the. medical practitioner may be called in. A feverish child should be con fined to his bed. He should take a grain of calomel, followed by a saline aperient, and his diet should consist of milk, broth, and dry toast. A cold. compress, or a layer of cotton wool, may be applied to the throat. If the case be seen early, it is useful to prescribe the hypophosphite of lime, which has a really remarkable influence in cutting short an ordinary catarrh.
For a child five years of age, three grains of the salt may be given with five. drops of spirits of chloroform and ten of tincture of cardamoms, in teaspoonfuls of water. three times a day. A mild catarrh is often arrested at once by this means, and even in severe cases the course of the derangement is sensibly shortened by the remedy. The pyrexia usually subsides quickly after the action of the aperient. If it persist, a drop or two of tincture of aconite may be given in a teaspoonful of water every two or three hours.
If the throat remain relaxed after the subsidence of the pyrexia, a mild astringent gargle, if the child can use it, or a rhatany or tannin lozenge sucked two or three times a day, will produce a bracing effect. In cases where there remains a great sensitiveness to chills, the susceptibility may be considerably diminished by the daily use of a cold douche, administered in the manner elsewhere recommended (see page 17).
Severe scalds of the throat usually occur in the younger children. If the pain be severe, it may be allayed to some extent by sucking ice, or by administering, occasionally, a teaspoonful of crushed ice on which a little sugar has been sprinkled. Small closes of opium are often necessary ; and this remedy applied locally, as by spraying the throat with glycerine and water, made anodyne with a few drops of laudanum, is very beneficial. If the child cannot swallow, he may be fed through a stomach-tube passed through the nose, as directed in a previous chapter (see page 15). Rectal alimentation is very unsatisfactory in young subjects.
If laryngitis occur, it must be treated as described elsewhere (see page 410).