The Eugenic Marriage, Volume IV | Page 7

from cold, when the child has a cold in the head and a running nose, or when its stomach is out of order. Any condition in which the child should be carefully watched and tended to, rather than allowed further liberties, or risks, conduces to sore throat of some kind.
Some children have the disease a number of times; they seem to be predisposed toward a sore throat. These are children who have large tonsils or who are rheumatic. The tonsils should be removed in the one case, and the tendency to rheumatism should be the main treatment in the other case.
These children should be encouraged to cleanse the throat and nose morning and night with a warm salt solution (half a teaspoonful of ordinary table salt to three-quarters of a cup of warm water). This will help greatly to prevent these chronic sore throats.
Symptoms of Tonsilitis.--The disease begins suddenly. The child may have a chill or be seized with sudden vomiting or diarrhea. A very young infant may have a convulsion. The usual way is for the child to develop a fever quickly, to complain of being sick and tired. Muscular pains all over the body and a severe headache are constant symptoms. The fever is usually high from the beginning. The child will tell you its throat is sore, but there is as a rule very little pain in the throat. The little spots or patches can be seen on one or both tonsils. The general symptoms are more pronounced than the local throat symptoms. The amount of physical depression that is caused by a tonsilitis is out of all proportion to the seriousness of the disease.
Tonsilitis lasts three days usually. The throat symptoms may take a day or two longer to clear up, and the patients feel more or less weak for some time after all the symptoms have disappeared.
Tonsilitis is medically regarded as one of the mild diseases of childhood. It is, however, of very great importance because of its likeness to diphtheria, and inasmuch as a positive diagnosis must be promptly made, in the interest of the patient, it is given close attention and treated with considerable respect by the medical profession. The chief differences between the two diseases are as follows:
Tonsilitis begins abruptly with pronounced prostration and a high fever the first day. The patient feels distinctly sick all over. The second day the patient feels somewhat better, the fever is lower and the prostration and pain are not so marked. The third day he feels better still, and but for a little weakness would feel well. Diphtheria begins slowly and insidiously, with very little prostration and a very low fever the first day. The patient scarcely feels sick. The second day more prostration is present, the fever climbs upward a little more, and the patient begins to feel sick. On the third day the prostration is much more profound, the fever is higher, and all the evidences of a serious sickness are present. Two very different pictures: The one begins bad and ends easy, the other begins easy and may end bad.
The important fact, however, so far as the similarity of the two diseases is concerned, is, that we must make the diagnosis positive on the first or second day, because if we are dealing with a case of diphtheria we must give antitoxin at once. This is essential, because the efficacy of antitoxin is greatest when given early in the disease. By "early" we mean the first or second day of the disease. When antitoxin is given late (the third or fourth day of the disease) it is much less efficacious and must be given in relatively larger doses. The need, therefore, of a quick, positive diagnosis is a real one.
Another important element involved in a speedy diagnosis is, that we must not take any chances of infecting other children. So important are these conditions that it is the proper treatment to give antitoxin at once in every case of tonsilitis that in the slightest way resembles diphtheria. An examination of the throat contents,--a culture of which is taken during the first visit of the physician,--will, of course, reveal the true condition and dictate the future use of the antitoxin. Antitoxin is absolutely harmless when given to a patient who has no diphtheria. Every case of tonsilitis should be quarantined when there are other children in the house.
The local condition of the throat helps in the diagnosis: In tonsilitis (as the name implies) the disease is limited to the tonsils and on the tonsils (one or both) do we find the spots or patches. In diphtheria, on the other hand, the membrane is not limited to the tonsils, but may cover every part of the throat and extend into the nose and mouth.