Tonsillar disease in children / by James Carmichael.

Date:
[1884]
Catalogue details

Licence: Public Domain Mark

Credit: Tonsillar disease in children / by James Carmichael. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    frequently, I believe, in scarlatina. Diphtheria is no doubt frequently' met with in this disease at the commencement, or it may come on at a later period, being thus grafted, as it were, upon an ordinary catarrhal condition of the throat. The ulcerous and parasitic forms of sore throat are commonly met with in connexion with similar affections of the mouth in children, and do not demand special note. An important point in connexion with these catarrhal inflamma- tions of the throat, and one which is peculiar both to them and diphtheritic affections, is infectiousness. It is a matter of common experience that, under certain conditions at all events, ordinary catarrhal sore throat is infectious. In a family you seldom have one case without others. So much so, that we con- stantly hear it said that the sore throat has gone through the house. It seems probable that catarrhal diseases generally are more or less infectious. Conjunctival catarrh and bronchial catarrh are not unfrequently- so. Some years ago, when a number of tourists visited the island of St Kilda, one of the party, in writing an account of the excursion, mentioned an interesting fact confirmatory of the infectiousness of ordinary catarrh. He stated, that the islanders were always afraid lest any of the visitors who came ashore were affected with cold, because it not unfrequently happened that the disease spread through the island. In the light of recent pathology, we find a possible explanation of the infectious- ness of diseased conditions of mucous membranes, especially of the mouth and fauces. We know, that in children at all events, the buccal mucous surface forms a suitable nidus for various kinds of vegetable micro-organisms, the Saccharomyccs albicans (Keess) or thrush fungus flourishes readily in the mouth, and so, in diseased conditions of the mucous surface generally, we may find micrococci and other vegetable forms. These, no doubt, in some way or other, may act as bearers of infection, taking root on any mucous surface, which forms a suitable nidus for their growth. An interesting point, and one well deserving of future investigation in regard to the simpler inflammatory affections of the tonsils, is to what extent these glands may form a nidus or a point of entrance for pathogenous micro-organisms into the lymphatic system. The ques- tion, for instance, whether the bacillus tuberculosis in this way gains entrance into the lymph spaces, with which these glands abound, is worthy of attention. The extreme liability of children to tuber- cular infection is well known, and in them it is often difficult to determine the starting-point of the disease. The clinical fact, that diseased conditions of the buccal mucous membrane, whetlier catarrhal or otherwise, are usually infectious, is, I think, sufficiently proved. Symptomatic or secondary forms of sore throat are met with in the eruptive fevers, more particularly scarlatina and measles. The scarlatinal form of tonsillitis is one of the most interesting