Tonsure

“ This sympathy between the stomach and the skin of the face is apparent in the eruption of the small-pox; since, where the disease is in considerable quantity, the eruption on the face first succeeds the sickness of the stomach. In the natural disease the stomach seems to be frequently primarily affected, either alone or along with the tonsils, as the matter seems to be only diffused in the air, and by being mixed with the saliva, or mucus of the tonsils, to be swallowed into the stomach. ”

“ But there's no such movement; the dire thorax-torture is kept up.
Manure-desiccation sets up irritation and then inflammation will follow,
Your tonsils get red, you've a pain in your head, and you find it a labour to swallow.
And as to your nose!—well, I do not suppose for that organ reformers feel pity,
Or I really can't think every species of stink would find such ready home in the City.
There's nothing more foul than your grim Asphalte-ghoul, —save that dread Tophet Valley of Bunyan's!—
And then manhole whiffs! Or nose-torturing sniffs from the shops that sell "Sausage-and-onions"!! ”

“ In some cases, notwithstanding the fever is high, the pulse frequent, and the [Pg 36] throat sore, there may be no external redness, but the mouth and tongue will have a scarlet hue, indicating the existence of disease more dangerous than when it appears externally. In the malignant form, the same symptoms are present, the patient suffers more pain in the head; the back and throat, root of the tongue, tonsils and soft palate become ulcerated, turn black, and sometimes gangrenous, proving fatal in a few days, or slough out in large portions, the ulcers destroying the parts extensively. ”

“ The Tonsils are frequently the seat of inflammation, and acute tonsillitis or quinsy is one of the most common forms of sore throat. This affection is usually induced by cold, but it would appear to arise under other conditions also, such as digestive disturbances, &c. It is said to be more common in persons of rheumatic constitution, and one attack predisposes to others. The symptoms come on somewhat suddenly .and sharply, with chill followed by fever, the temperature frequently attaining a high point of elevation. Pain is experienced in the act of swallowing from the outset. ”

“ Indeed, if both tonsils are acutely inflamed it may be impossible to swallow even fluid and the breathing may be seriously embarrassed. The temperature may be raised several degrees. There is pain about the ear and about the jaw, and there is a swelling of the glands in the neck. The breath is offensive and the tongue is thickly coated. ”

“ Inflammation of the surface of the tonsils. As the tonsils and parts in their vicinity are covered with a membrane, which, though exposed to currents of air, is nevertheless constantly kept moist by mucus and saliva, and is liable to diseases of its surface like other mucous membranes, as well as to suppuration of the internal substance of the gland; the inflammation of its surface is succeeded by small elevated pustules with matter in them, which soon disappears, and the parts either readily heal, or ulcers covered with sloughs are left on the surface. ”

“ Symptoms.—The mouth-breathing is more noticeable during sleep; snoring is common, and the breathing is of a snorting character with prolonged pauses. Children suffering from enlarged tonsils and adenoids are often backward in their studies, look dull, stupid, and even idiotic, and are often cross and sullen; the mouth remains open, and the lower lip is rolled down and prominent; the nose has a pinched aspect, and the roof of the mouth is high. ”

“ Membrane is seen in the throat. It may cover the tonsils and spread over the entire throat cavity, or it may extend up into the nose and over the roof of the mouth. All the parts are much swollen and breathing is interfered with, sometimes seriously. If the attack is very severe there is an active absorption of poison going on from the throat which soon renders the little patient intensely sick. There is marked weakness and prostration, the circulation becomes poor, the pulse rapid and the child falls into a stupor. ”

“ For inflammation of the mouth a similar combination is used as a mouth wash, in the throat as a gargle, and in the nose as a wash and sometimes as an ointment or spray, the ointment possessing the advantage of protecting the delicate nasal mucous membrane from irritation by stopping the entrance of irritant dust into the nasal cavities. In the stomach we aid the vomiting by which microbes or the products of decomposition of food are usually eliminated by giving to the patient repeated draughts of hot water so as to wash the stomach clean. ”

“ Adenoids and enlarged tonsils are abnormal growths of lymphatic tissue in the nose and throat that make breathing difficult and inefficient, and that become breeding places for germs. The infection that they harbor leads frequently to colds, earache, deafness, tonsillitis, diphtheria, measles, scarlet fever. They obstruct the breathing and reduce the supply of oxygen, spoil the shape of the face, reduce the ability to think, and by their discomfort produce irritability and nervousness. They greatly interfere with the vitality. ”

“ The act of swallowing becomes increasingly difficult, and fluids are apt to regurgitate through the nose. Pain is felt along the Eustachian tube towards the ear, and there are tenderness and swelling in the neck about the angle of the jaw on the affected side. The voice acquires a peculiar and very characteristic snuffling tone, and there may be some embarrassment to the breathing. In a few days the inflamed tonsil shows signs of suppurating, and an abscess is seen to be bulging forward into the mouth. ”

“ To get a correct idea of the throat we should look into the wide-open mouth of some friend. Depressing the tongue we can readily see the back wall of the pharynx, which is common to the two main avenues leading to the lungs and the stomach. Above, we notice the air passages, which lead to the posterior cavities of the nose. We have already described the hard palate, the soft palate, the uvula, and the tonsils (Fig. 46) . ”

“ The tonsils may almost block the entrance to the throat. The voice is thick and indistinct, the glands in the side of the neck become swollen, and the neck is sore and stiff in consequence, while the mouth can be only partially opened on account of pain. For the same reason the patient can swallow neither solid nor liquid food, and sits bent forward, with saliva running out of the mouth. ”

“ There is always a fever at the beginning, but the child never seems sick enough to go to bed. If the throat is examined it will be found to be red and slightly inflamed, there may be spots on the tonsils, or there may be a gray film over them. There is no discharge from the nose and the child does not complain of an excess of mucus from the throat. ”

“ If colds are neglected and allowed to run on, the inflammation spreads through the nose back into the upper part of the throat, or pharynx. Here it attacks a spongy group of glands, like a third tonsil, which swells up until it almost blocks up the nose and makes you breathe {257}through your mouth. These swollen glands are called adenoids, and cause not only mouth-breathing, but deafness, loss of appetite, indigestion, headache, and a stupid, tired condition ”

“ Chronic enlargement of the tonsils, as shown in Fig. 147, A A, is an exceedingly common affection. It is most common to those of a scrofulous habit. It rarely makes its appearance after the thirtieth year, unless it has existed in earlier life, and has been imperfectly cured. Both tonsils are generally, though unequally enlarged. A person affected with this disease is extremely liable to sore throat, and contracts it on the slightest exposure; the contraction of a cold, suppression of perspiration, or derangement of the digestive apparatus being sufficient to provoke inflammation. ”

“ With many there is no trouble, but there are also quite a number of patients whose throats are so irritable from disease as to prevent the introduction of the laryngoscope. In other cases the patient's tongue has an almost irresistible tendency to keep rising up toward the roof of the mouth and thus obstruct the view. Enlargement of the tonsils according to the degree of their enlargement makes an examination either very difficult, or else, if so much enlarged that they meet and almost close up the throat, makes it impossible until the enlargement has been reduced. ”

“ Infected tonsils are looked after, not simply because they bring about sore throat now and then, but even more because of the poison which they are likely to send through the body. It is probably not too much to say that the practice of dentistry has been revolutionized since the significance of pus pockets has been discovered. ”

“ When this goes on for some time the nose and throat should be examined by a physician for adenoids, or growths of soft masses of tissue which fill up the nose cavity, thus causing a shortage of the air supply for the body. Many a child, backward at school, thin and irritable, has been changed to a healthy, normal, bright scholar by the removal of adenoids. Sometimes the tonsils at the back of the mouth cavity may become enlarged, thus shutting off the air supply and causing the same trouble as we see in a case of adenoids. ”

“ Chronic enlargement of the tonsils predisposes to tonsillitis and to all the infective and contagious throat diseases. In addition, the breath is apt to be fetid, and swallowing the mucus, germs, and toxins has a deleterious effect on the stomach and general health. ”

“ The glands at the angle of the jaws may be enlarged. In older children the tonsils are enlarged and the crypts plugged with a creamy deposit. The surface is covered with a deposit and the pillars of the fauces, uvula and pharynx may all be inflamed. The tongue is coated, the breath is bad, the urine high colored, swallowing is painful; the pain frequently runs to the ear and the voice sounds nasal, as if one had mush in his mouth when talking. In severe cases the symptoms all increase, and the parts become very much swollen. ”

“ Frequent gargling of the throat and mouth, with a solution of lactic acid, strong enough to taste sour, will help to keep the parts clean, and correct the foul breath. If there is great prostration, with the nasal passage affected, or hoarseness and difficult breathing, a physician should be called at once. ”

“ Ulcers of the throat occur, of a very alarming kind, quickly destroying the parts attacked, spreading chiefly towards the posterior part of the fauces, rapidly extending to the pharynx and to the nostrils, and in some instances also involving the larynx. The pendulous velum of the palate and the tonsils are often wholly destroyed, the bones of the nose, more especially the turbinated, are deprived of their coverings, and exfoliate, the osseous and cartilaginous portions of the septum are discharged, and the nose becomes sunk, or is supported merely by the columna. ”

“ It is well known that tonsillitis is much more frequently produced by exposure to a draught which strikes the back or side of the head than by a current of air meeting one full in the face, or even by long-continued exposure to a storm in the open air. ”

“ A recent examination made by the New York Board of Health of 150 school children, all in some way abnormal, showed that 137 had either adenoids or enlarged tonsils. Example after example could be given of school boys and girls whose mental and moral development has been markedly retarded because of mouth breathing. One need only look at a child or adult who constantly keeps his or her mouth open to be impressed by the listless, vacant, inert appearance of the face thus disfigured. ”

“ The consensus of advanced scientific opinion is now to the effect that the activity of the tonsils as possible accessories of disease has been vastly exaggerated, that like the thousand and one successive misleading theories which in turn, from time to time, have seized upon the imagination and obsessed the minds of the medical fraternity for brief and passing periods, this pernicious craze too, has about run its course. ”

“ This can be counted on, however, only in cases where the tonsils are not of extreme size, and have not undergone frequent attacks of inflammation. Whenever the hearing is habitually dull, and the voice always thick, when cough is frequent, the nostrils narrow, the chest pigeon-breasted, and the child feeble and ill-thriven, removal of the tonsils is absolutely necessary. In cases where the question is doubtful, its decision must turn on whether the tonsils have often been inflamed. So long as their surface is smooth, and their substance soft and elastic, delay is permissible. ”

“ The growths are apt to keep up a constant catarrh near the orifice of the ventilating tubes which pass from the throat to the ear, and so render the child dull of hearing or even deaf. They also give rise to asthma, and like enlarged tonsils—with which they are often associated— they impart to the child a vacant, stupid expression, and hinder his physical and intellectual development. ”

“ In the throat, there is soreness with pain just back of the isthmus of the fauces, a feeling of excoriation and soreness extending deep down in the pharynx. The uvula is elongated, the tonsils are swollen and red, there is a sensation of rawness in the throat strikingly reminding us of Phytolacca. Externally, there is scarlet redness of the neck below the mastoid process, throbbing of the carotids, the neck feels tired, the head heavy and the parotid glands are swollen and painful. It is unnecessary to name the remedy having similar symptoms. ”