4G8 AFFECTIONS OF THE PHARYNX 



catarrh of the pharynx and larynx, which is a very obstinate, although 

 not dangerous disease, has a very depressing effect on most patients. 



TREATMENT. When of moderate intensity, acute catarrhal angina 

 does not require any particular treatment. Often the patients do not 

 apply to a physician, but go to some old woman, who knows how to 

 raise the "fallen palate" by certain hairs at the top of the head. 

 These foolish ideas have a serious as well as a ridiculous side. The 

 apparent success of this and similar senseless procedures must teach 

 us to abstain from energetic treatment in affections where they have a 

 great reputation. This teaching is much opposed in the treatment of 

 catarrhal angina. We might say that more than half the physicians 

 superfluously give an emetic, partly with the idea that it will act as a 

 revulsive, partly to combat the gastric disorder, which is diagnosticated 

 from the symptoms of oral catarrh, on which the angina is thought to 

 depend. As the tongue is cleaner the day after the emetic, and the 

 angina has improved, as it would have done at any rate, the remedy 

 receives the credit of it. 



In catarrhal angina, the use of an emetic is only admissible under 

 certain circumstances, as when there are substances in the stomach 

 that have excited, or are keeping up, a gastric catarrh. In severe cases 

 it is well to let the patient apply moist compresses, well wrung out, 

 and carefully covered with a dry cloth, to the throat, every few minutes. 

 In persons who are afraid of the 'cold compresses, or where, for any 

 reason, we do not wish to use these, we may employ warm poultices. 

 At the same time, we may have the mouth frequently washed with 

 cold water, or with a solution of alum, sulphate of zinc, acetate of 

 lead, etc. Occasionally, by covering the inflamed spots with powdered 

 alum, or painting them with a solution of nitrate of silver, 3 j to f j, 

 we may abort the disease. 



Chronic catarrh of the fauces is best treated by the above-named 

 astringent mouth-washes, and particularly by painting the inflamed 

 spots with solution of nitrate of silver. 



Chronic pharyngeal catarrh must be very carefully and continu- 

 ously treated ; in many cases it defies medical skill. In the blennor- 

 rhoeal form even, which offers the best prognosis, treatment often fails, 

 because the patients cannot decide to give up the use of liquor, or to 

 smoke less. The best treatment in these cases is the local application 

 of solutions of nitrate of silver, alum, or tannin, and these seem to be 

 more efficacious when given in a nebulized form than when applied 

 with a brush. In the forms where there is little secretion, and par- 

 ticularly in the follicular and granular pharyngeal catarrh, it occasion- 

 ally appears as if the application of the above solutions caused a 

 '* toning up " of the affected mucous membrane, and an improvement 



