Throat, AFFECTIONS OF THE. The term throat is applied somewhat loosely to the back of the mouth and front of the neck; its diseases may therefore be taken to include those of the Larynx (q.v.) and upper part of the trachea, of the upper part of the œsophagus, and of the thyroid gland (see GOITRE). Sore throat, however, as commonly used, refers to inflamed and painful conditions of the tonsils and neighbouring parts (see under PALATE), which are numerous. One of the most important (Quinsy, q.v.) has already been discussed; and those attending diphtheria, measles, scarlet fever, syphilis, and other infectious and contagious diseases are sufficiently referred to under their several headings. Sore throat may also be a result of the gonty or rheumatic diathesis, or of the action of certain drugs (especially belladonna and iodide of potassium). See also THRUSH, MUMPS, &c. A few other conditions remain to be considered here.
The disease popularly known as Clergyman's Sore Throat first shows itself by huskiness of the voice, with more or less coughing, hacking, and expectorating, from an uneasy sensation in the throat; there is, moreover, a constant inclination to swallow. On examining the back of the throat, its mucous membrane is seen covered with elevations, caused by an accumulation of secretion in the follicles, which sometimes burst and discharge their contents, which are of an elastic consistent nature. This discharge is occasionally followed by ulceration. The disease commonly arises from too prolonged or powerful exercise of the voice by persons in whom the mucous membrane of the throat is in a relaxed condition. Perfect rest from public speaking, preaching, acting, &c. is of more importance than anything else in the way of treatment, and a residence during the winter and spring in a mild and equable climate is expedient. Tonics, such as iron, quinia, and strychnia, should be tried, but local applications are usually of far more service than internal remedies. The most important of these are strong caustics, carefully applied by the surgeon to the affected spots: solid nitrate of silver, 'London paste' (equal parts of caustic soda and unslaked lime), and the galvano-cautery are among the means chiefly employed.
Simple or catarrhal sore throat is usually a slight affection, most common in young persons, and often resulting from cold. The throat is reddened, but little swollen. A day or two in the house is usually sufficient to effect its disappearance; the sucking of astringent lozenges (e.g. tannin or red gum) or chlorate of potash pellets is also useful. In its chronic form (relaxed sore throat) it is more troublesome, but will generally yield to continued use of astringent lozenges, or the application, twice a day with a brush, of glycerine of tannic acid, or solution of perchloride of iron (one drachm to the ounce of water), if attention be at the same time paid to the general health.
Ulcerated sore throat is generally the result of unhealthy conditions acting on persons in a weakly state. It is particularly common in nurses and students occupied in hospital work, and is generally speedily recovered from when the patient is placed in healthy surroundings and put upon tonic treatment. The white spots seen on the tonsils in follicular tonsillitis, a more common and slighter affection, are often mistaken for ulcers, but they really consist of excessive and thickened secretion from the recesses of the tonsil.
Cutting the throat is comparatively seldom the result of accident; it is more often due to a murderous attack, and most frequently to an attempt at suicide. The first duty of the surgeon in treating a case of cut throat is to arrest the flow of blood. Ligatures should be applied to wounded arteries, and steady pressure with the finger (beneath which a small pad of lint is placed) to wounded veins, such as the external jugular. If the internal jugular is wounded, fatal hemorrhage will very rapidly ensue, unless the wound is immediately plugged with small pieces of sponge, or pressure with the finger is maintained as long as necessary. With a knowledge of these means of checking hemorrhage by pressure, an intelligent non-professional person may be the means of saving life. When the bleeding has completely ceased, but not till then, means may be taken for bringing together the edges of the wound. When the air-passages are wounded there is great risk of the occurrence of bronchitis or pneumonia, and the patient must be kept in a warm room, and care taken to prevent either food or discharges from the wound from passing down the windpipe. See Sir M. Mackenzie's Diseases of Throat and Nose.