Chronic Pharyngitis. 75 



present, and the tonsilar follicles are filled and distended with 

 tenacious mucous, a caseous granular debris, or even a cretaceous 

 material. In the vicinity of the tonsils, minute abscesses may 

 exist in or beneath the mucosa. 



Ulceration may be the result of tubercle, glanders, actinomy- 

 cosis, aspergillus, sarcoma, or some local infection, and attendant 

 symptoms of one or other of these diseases will guide the 

 diagnosis. Thus in tubercle there will be the implication of the 

 adjacent lymph glands and usually of distant ones ; in glanders 

 the deposits in the nose, submaxillary lymph glands and lungs 

 will enable one to diagnosticate ; in actinomycosis the hardness 

 of the neoplasm and the presence of the yellowish tufts which 

 present under the microscope the concentrically arranged club- 

 shaped elements, will show its nature; and in sarcoma or carcinoma 

 the structure of the new tissue will decide its character. The 

 pharyngeal muscles are the seat of granular or fatty degenera- 

 tion or of fibroid change. Friedenreich speaks of a fold from 

 the vault of the pharynx which had nearly closed the passage 

 and had killed the horse by inability to swallow. 



Treatment. Chronic pharyngitis is usually a very obstinate 

 affection and demands careful hygenic as well as medicinal treat- 

 ment. Hot, foul stables, unduly thick coats, unwholesome food, 

 irregular feeding, excessive meals at long intervals, overwork, 

 undue exposure to cold and wet, lack of sunshine or of grooming 

 are to be corrected. Next, the removal of mechanical irritants 

 such as pharyngeal bots, actinomycosis growths, etc. , will be in 

 order. Then the use of astringents and antiseptics internally 

 and of derivatives externally will be demanded. An occasional 

 embrocation of mustard, or the application of ammonia and oil, 

 will often serve a good purpose, and in obstinate cases the hot 

 iron in points will sometimes prove effective. 



Internally the inhalation of the fumes of tar, carbolic acid, 

 creolin, oil of turpentine, or of burning sulphur kept up con- 

 tinually or frequently repeated. Giving all drink in the form of 

 tar water will often have a good effect. Electuaries made with 

 boric acid, salicylate of soda, ammonium chloride or iodide, 

 borax, with honey, molasses, liquorice, Iceland moss, or gum 

 arabic will often prove beneficial. Agents that stimulate the mucosa 

 may follow, such as balsams of Peru or Tolu, copaiba, cubebs, 



