Angina Simplex.

Synonyms.—Sore Throat; Acute Pharyngitis.

Definition.—An acute inflammation of the mucous membrane of the pharynx, and sometimes of the entire pharyngeal structure.

Etiology.—While the exciting cause is most frequently sudden atmospheric changes inducing colds, it may follow certain infectious fevers, notably scarlet fever and la grippe. Not infrequently there seems to be a rheumatic or gouty taint, which renders the patient very susceptible. It occasionally appears in epidemic form, when it is undoubtedly due to infection. Acrid secretions from nasal catarrh may prove sufficient in some cases to give rise to pharyngitis.

Symptoms.—The symptoms of sore throat are characteristic, the patient complaining of pain and fullness in the throat, especially when swallowing. The surfaces are dry and swollen, and the patient swallows frequently to give relief. On inspection, we see a vivid redness of the mucous surfaces, and where the submucous tissues are involved, the throat presents a dusky hue. The inflammation, quite often, invades the posterior pillars of the fauces, the tonsils, and, sometimes, even the larynx.

The patient hawks or coughs frequently to relieve the sense of constriction in the early stage, and to remove the secretion, which constantly bathes the surfaces, in the latter stages. The lymph glands are swollen, and frequently the neck becomes quite stiff. With the ushering in of the disease, there may be chilly sensations, followed by slight fever, dry skin, constipation, and general arrest of the secretions. If the larynx be involved, there may be a sense of constriction of the throat, hoarse voice, and frequent cough.

Diagnosis.—Inspection reveals the character of the disease, and it can scarcely be mistaken for any other trouble.

Prognosis.—The disease readily yields to specific treatment, though in delicate children it is apt to leave the throat susceptible to a repetition on slight exposure.

Treatment.—Aconite has a special affinity for lesions of the throat, and we find it one of our best agents, and useful in nearly every case. To this may be added phytolacca, where there is swelling of the lymphatics; belladonna, where there is a vivid redness; guaiac, where the tonsil is involved. If the tissues are dusky, baptisia will answer a better purpose.

Where there is sepsis and the tissues livid, echinacea will give better results. If the tongue is coated with a yellowish moist coating, and there is offensive breath, potassium chlorate and hydrastis are the remedies, while sodium sulphite replaces these agents when the tongue is broad and heavily coated with a dirty, moist, pasty coating. When the tissues are dark red, and the tongue is red and dry, muriate tincture of iron is a specific.

Where the larynx is involved and the voice is hoarse, drop-doses of stillingia liniment internally, and applied over the larynx, will give prompt relief, or hamamelis and collinsonia are good remedies for laryngeal complications.

The local treatment will vary in different conditions. If the inflammation is active, wring a small towel out of cold water, and apply snugly around the throat, being careful to have a dry binder over this. As a gargle I know nothing superior to potassium chlorate and hydrastis; use every one or two hours. If the deeper tissues are involved and the throat presents a relaxed appearance, gargle with hamamelis or perchlorid of iron. Of the latter use one dram to glycerin and water of each two ounces. Where the patient can not gargle, potassium chlorate may be triturated with gum arabic and sugar, and about as much as will lie upon a dime placed upon the tongue and slowly allowed to dissolve, repeating every two or three hours.

Upon recovery, the patient should be directed to flush the throat and chest every morning with cold water, to be followed by brisk rubbing till the parts are thoroughly dry. If this be persisted in for several months, the patient outgrows the susceptible condition.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.