Phlegmonous Pharyngitis. 55 



classes of domestic animals. As a specific infectious disease it 

 has its type in strangles (infectious adenitis), also in cattle in 

 the complicated infection of purulent tubercle, but apart from 

 such it is often the result of the penetration of the pus microbes 

 from a catarrhal pharynx into the lymph plexuses and lymph 

 glands. Traumatism may play an important part in causation as 

 when vegetable barbs, awus, chaiT or seeds, or .strong hairs or 

 bri.stles enter the open mouths of the mucous follicles, or the 

 tonsillar cavities. Similarly trouble may arise from scratches by 

 tough, fibrous fodder, from pricks by pointed or cutting instru- 

 ments, b}' fractures of the hvoid, or by bruises by probangs, or 

 tooth rasps. An overgrowth of the last molar, and a resulting 

 wound and ulcer of the soft palate, and the presence of local de- 

 posits like those of glanders and actinomycosis, are other oc- 

 casions of the entrance of the pus organisms. It will be recog- 

 nized that this affection is not neces.sarily due to a difference in 

 the infecting organism, but rather of the tissue involved, the 

 microbes gaining the submucous tissues and expending their 

 violence on these instead of confining their ravages to the surface 

 layers of the mucosa. For this reason the deeper or phlegmonous 

 affection may supervene on a catarrhal inflammation which may 

 have already persi.sted for several days. 



Symptoms. Beside the general phenomena of catarrhal pha- 

 ryngitis, this form of the malady is characterized by a greater 

 swelling and tenderness of the throat, extending from ear to ear, 

 and from the trachea forward in the intermaxillary space ; b}' 

 nodular and painful swellings of the pharyngeal lymph glands, 

 by the greater difficulty of deglutition, the muscular tissue being 

 involved ; by wheezing breathing amounting at times to violent 

 roaring and threatened asphyxia. Perspiration on the throat, 

 the ear, the side of the head or neck, of the fore arm, or of the 

 dor.sal region is not uncommon, and has been attributed to the 

 compression of the vagus, or of the superior cervical ganglion of 

 the sympathetic by the swelling. Fever usually runs 

 higher than in simple catarrhal pharyngitis, which may be partly 

 accounted for by the implication of the deeper and important 

 structures but also in no small degree by the entrance into the 

 circulation of the ptomaines and toxins, which in the catarrhal 

 affection escape largely from the inflamed surface. 



