Whitethroat

“ A contraction or relaxation of the throat-muscles and of the vocal chords generally was not infrequently noticed. The tendency to swallow is spoken of. The throat is felt often to be "concave" when certain bad feelings are sufficiently pronounced. A contraction in the mucous membrane, with teeth on edge, such as one would experience in eating something sour, is frequent. A twitching of the ears, squinting of the eyebrows, and a "heavy feeling" through the neck and chest occur often, or again a pressing hard of the tongue against the roof of the mouth. ”

“ Those who were Seized with it, first complained of a Pain in the Throat, with a Stiffness of the Neck, an Uneasiness upon Motion, and a Difficulty in Swallowing their usual Nourishment. On Inspection, the Uvula, the Tonsils, Pharynx, and the whole Fauces, appeared of a remarkably florid red Colour, like that attending an Erysipelas: This Colour was not uniformly intense, but Some Parts Seemed to be of a deeper Dye than others. The Parts above-mention'd were swell'd more or less, tho' seldom so much as to affect Respiration, as in a common Angina; but the Sick could not Swallow without Pain. ”

“ Symptoms.—The throat is dry and feels stiff. There may be tenderness at the angle of the jaw and outside of the neck. Pains some to swallow. In a day or two there is a mucous secretion, making the patient inclined to clear the throat by hawking or coughing. The throat looks red and in the early stage this is more noticeable on the anterior pillars of the fauces, the soft palate and uvula. On the back wall you see bright red spots, the inflamed lymph follicles. It usually gets well in two to seven days. It may become chronic after repeated acute attacks. ”

“ Soreness of the throat is present in some, but not in all of these examples of dysphagia, being most marked in the inflammatory condition of pharyngitis, tonsillitis, scarlet fever, and diphtheria. Ulceration of the throat should always be carefully looked for, and if present investigated to ascertain whether it is simple, diphtheritic, or syphilitic. We must be careful not to mistake a mere local accumulation of mucus, or aphthous vesicle, or the curd-like formation of thrush or muguet, either for ulceration or pseudo-membranous deposit. ”

“ The throat is a double highway, as it were, through which the air we breathe traverses the larynx on its way to the lungs, and through which the food we swallow reaches the œsophagus on its passage to the stomach. It is, therefore, a very important region of the body, being concerned in the great acts of respiration and digestion.
The throat is enclosed and protected by various muscles and bony structures, along which run the great blood-vessels that supply the head, and the great nerve trunks that pass from the brain to the parts below. ”

“ All the muscles of the neck had a livid colour, such as we sometimes observe, after death, in persons who have died of the sore throat. The muscles employed in deglutition [329] and speech were suffused with blood. The epiglottis was inflamed, and the glottis so thickened and contracted, as barely to admit a probe of the common size. The trachea below it was likewise inflamed and thickened, and contained a quantity of mucus in it, such as we observe, now and then, after death from cynanche trachealis. The œsophagus exhibited no marks of disease ”

“ The patient may feel rather ill.
Or the disease may be like a very severe sore throat, with small or large gray or white patches. Not only the tonsils but also the uvula, the small rounded end of the palate which hangs down between the tonsils, may have on it white or gray patches. (If there is a membrane on the uvula, the disease is almost certainly diphtheria.) With such a throat the person feels very sick. Not only does the throat hurt, but there are usually aches in the back of the neck and in the muscles generally. The glands in the neck may be quite large and feel painful when touched. ”

“ There is little chance of immediate union taking place; and the wound not being approximated when recent and bleeding, does not diminish the chance, but on the contrary augments it. Adhesion is prevented by the insinuation of air and mucus betwixt the edges, by frequent motion of the edges on each other, by the slightest change in the position of the head, either rotatory or nodding, by the action of the muscles of the os hyoides, and by attempting to swallow food or saliva. Every circumstance is opposed to complete approximation and immediate union of transverse wounds of the throat. ”

“ Mouth breathing is the cause of many ills. As a result of this, the mucous membrane of the tongue, &c., becomes dry, micro-organisms multiply and the mouth becomes foul. Also from disease of the nose, the upper jaw, palate and teeth do not make proper progress in development. There is overgrowth of tonsils, and adenoids, with resulting deafness, and the child’s mental development suffers. An ordinary “sore throat” usually signifies acute catarrh of the fauces, and is of purely organismal origin, “catching cold” being only a secondary and minor cause. ”

“ The white-throat is an excitable little bird, rapid in all its movements; and though it will apparently allow a person to come near, it incessantly flits on, gets to the other side of the hedge, warbles its quaint little song, flies to a short distance, sings again, and so on, for a long time, returning in the same way. It erects the feathers of its head when excited, and swells its throat so much when singing, that the feathers stand out like a ruff, whence it has obtained the name of Muffety, or Charlie-mufty, in Scotland. ”

“ The prevalence of throat troubles is so marked in America, and by no means least so in this city, that if one hundred individuals, collected at random, had their throats examined, it is probable that four out of every five would be found to have these delicate organs more or less affected. Whatever cause may be assigned by the medical expert in each particular case, the importance of a thorough mastery of the art of correct « 172 » breathing can hardly be insisted upon too strongly. ”

“ Croup exceeds by contracting the trachea enough to impede the passing of air to the lungs; diphtheria has more swelling of the tonsils, throat and glands of the neck, but all depend upon the same blood and nerve supply, or a general law of blood beginning with arteries to and from veins, lymphatics, glands and ducts to supply and take away all fluids that are of no farther use to the vital and material support. As all authors have agreed that the brain furnishes the propelling forces to the nerves, it would be proper to inquire how the brain is nourished. ”

“ The onset is generally characterized by a rise of temperature from 100°F. to 104°F., chilliness, headache, and pain in the back and limbs. Albuminuria is common. The glands of the neck often become swollen. In mild attacks a slight sore throat is all that is complained of. In the majority of cases the disease attacks the throat and tonsils, and is characterized locally by the appearance of a membrane, which is usually gray or yellowish-white, elastic, and adheres tightly to the surface upon which it lies. ”

“ In speaking of these mechanical arrangements of dress I have as yet made no mention of the throat and the head as parts requiring to be clothed. In suggesting that girls should be clothed as fully as boys, I have incidentally conveyed that the chest of the girl should be covered, and I would add that in both sexes the throat should be covered also during the period extending from October to April. The throat is one of the most important parts to protect, and it is, as is well known, one of the most common parts of the body to become affected during cold weather. ”

“ In the absence of mucous patches and ulcers, the sore throat may be characterised by a bluish tinge of the inflamed mucous membrane and a thin film of shed epithelium on the surface. Sometimes there is an elongated sinuous film which has been likened to the track of a snail. In the _larynx_ the presence of congestion, oedema, and mucous patches may be the cause of persistent hoarseness. The _tongue_ often presents a combination of lesions, including ulcers, patches where the papillae are absent, fissures, and raised white papules resembling warts, especially towards the centre of the dorsum. ”

“ In the common sore Throat, a local Inflammation is the Disease: All the Symptoms are derived from this Source: An acute throbbing Pain, greatly increased upon swallowing even Liquids, is the principal Grievance. In the other, the whole Habit suffers, as if by a Stimulus of a peculiar Nature and although the Throat is always more or less affected, yet it is sometimes the least Part of the Patient's Complaint; and Instances have occurr'd to me of considerable Sloughs 42being formed, before any Soreness or Pain in the Fauces hath been mention'd. ”

“ Attacks of sore throat due to improper methods of breathing and of using the voice should be treated by judicious elocutionary exercises and a system of vocal gymnastics, under the direction of proper teachers.
Persons subject to throat disease should take special care to wear suitable underclothing, adapted to the changes of the seasons. Frequent baths are excellent tonics to the skin, and serve indirectly to protect one liable to throat ailments from changes in the weather. It is not prudent to muffle the neck in scarfs, furs, and wraps, unless perhaps during an unusual exposure to cold. ”

“ In the fever which has just been described there is always some degree of redness in the skin, and the throat is not without an uneasy sensation. Where it happens that the throat is full of little ulcers attended with considerable pain, there the disease, though the skin be ever so red, is not denominated from the colour, but from the soreness of the throat, and obtains the name of malignant sore-throat ”

“ He remarks, that swellings of the throat have always been common to the inhabitants of mountainous countries: and the old Roman authors say, ‘Who wonders at a swelled throat in the Alps?’ The people of Switzerland, Carinthia, Stiria, the Hartz forest, Transylvania, and the inhabitants of Cronstadt, he observes, are all subject to this disease. ”

“ The functions of the organs of nutrition are sometimes profoundly altered in the possessed, and these alterations are manifested by violent cramps, which show the extent to which the muscular system is affected. The hysterical lump in the throat is a frequent phenomenon in possession. A young girl in the Valley of Calepino had all her limbs twisted and contracted, and had in the œsophagus a sensation as if a ball was sometimes rising in her throat, and again falling to her stomach. ”

“ There are conditions in which we have an abnormal increase in the tissue elements but which strictly should not be defined as hypertrophies, such as new-growths, abnormal enlargements of bones and organs due to syphilis, tuberculosis, osteitis deformans, acromegaly, myxoedema, &c. The enormously long teeth sometimes found in rodents also are not due to hypertrophy, as they are normally endowed with rapid growth to compensate for the constant and rapid attrition which takes place from the opposed teeth. ”

“ Occasionally it would appear that the inflammation begins in the throat, and reaches the face through the nasal fossae. The redness gradually spreads over the whole surface of the face, and is accompanied with swelling, which in the lax tissues of the cheeks and eyelids is so great that the features soon become obliterated and the countenance wears a hideous expression. Advancing over the scalp, the disease may invade the neck and pass on to the trunk, but in general the inflammation remains confined to the face and head. ”

“ Toole, Sir Morell simply said in a very happy way, "I had great difficulty in examining him." Those who know the comedian will readily understand this.
"The great thing," prescribed Sir Morell, "is to try and harden the throat; do not wrap it up too much. Endeavour to make the neck as capable of exposure as the face. We do not cover up our faces, and they are practically the hardiest part of our bodies. Of course, when a person gets to a certain age it is too late for this. Keep the throat free from wrappings. The throat is the entrance to the lungs—a very vital part, narrow and tender. ”

“ A swelling under the throat, which, if lanced, emits a yellowish fluid; the hair stands on end or reversed; they become debilitated, and though the herbage is ever so luxuriant, refuse to fill themselves and become very thin; their eyes water, and at length, when their end is approaching, a continual rattling in the throat or chest may be heard a few paces off. Sometimes one out of the number recovers, but very rarely, and only when it has no work to perform after being bitten. Horses generally swell about the eyes, nostrils, and testacles, where, probably, the bites are most numerous ”

“ Meanwhile the throat becomes sore and swollen, ranging, according to the severity of the case, from a slight reddening and swelling to a furious ulcerative inflammation, with the formation of a thick membrane-like exudate, which sometimes is so severe as to raise a suspicion of possible diphtheria. The tongue becomes red and naked, with the papillæ showing light against a red ground, so as to give rise to what has been known as "the strawberry tongue." The temperature is usually high, and the little patient when he drowses off to sleep is quite apt to become more or less delirious. ”