TONSILLAR AFFECTIONS 



1747 



TONSILLAR AFFECTIONS. 



Every type of tonsillitis met with in temperate climates is observed 

 also in the tropics, although there is no doubt that tonsillar andjthroat 

 affections are less frequent in warm climates than in cold. Diph- 

 theria is on the whole less frequent than in temperate zones, \hut a 

 fairly large number of cases occur in every tropical country. We 

 have seen a number of cases of follicular tonsillitis and other strepto- 

 coccal affections; quinsy or tonsillar abscess is not rare, and cases 

 of Vincent's angina occur, due to Vincent's Bacillus fusiformis in 

 association very often with 



spirochaetes. We do not r ' ' "" — 



propose giving a description [ , 

 of Vincent's angina, which 

 may be found in any text- 

 book on general medicine, 

 but we would call attention 

 to the possibility of mis- 

 taking it for a syphilitic 

 condition. Certain authori- 

 ties state that Wassermann 

 reaction is positive in Vin- 

 cent's angina, but in our 

 experience this is not so, 

 and we can confirm the 

 researches of Taylor and 

 others, according to which 

 Wassermann reaction is 

 negative in Vincent's angina, 

 except, of course, when it 

 develops in a syphilitic 

 person. Cases of tonsillitis 

 possibly due to amoebae and 

 flagellates have also been 

 recorded. We propose say- Fig. 743.— Tonsillar Affection caused 

 ing a few words on certain by Hemispora rugosa Castellani. 

 affections of the tonsils to 



which little attention has so far been paid — viz., mycotic infections. 



Tonsillar nocardiomycosis and lesions of the tonsils due to 

 Nocardia bovis and other species of the genus Nocardia and 

 Cohnistreptothrix have been placed on record, but we desire to call 

 attention to the comparative frequency of a granular Nocardiasis 

 of the crypts which may lead to the formation of tonsillar calcuh. 

 The affection, which is not new, but is little known, runs a chronic 

 course and is not painful. The patient often does not come to 

 consult the doctor because of sore throat, but because of the un- 

 pleasant odour of the breath. On examination the teeth and gums 

 may be quite healthy, but on examining the throat small whitish- 



