These symptoms often assume a more alarming character, or are complicated by others; in fact, the condition very rarely stops at pharyngitis, but is usually accompanied by inflammation of the larynx, of the soft palate, and of the naso-pharynx. The whole throat is then inflamed; the nose and sometimes the eyes discharge, and there is difficulty in swallowing, interference with respiration or noisy respiration, and intense fever.
Diagnosis. The diagnosis presents no difficulty, the symptoms mentioned being easy to identify, whether the condition be simply inflammation of the pharynx or be of a more extensive character. Nevertheless, cases occur where the symptoms are alarming, but in which one might hesitate between the diagnosis of ordinary acute sore throat and the sore throat which ushers in gangrenous coryza. A definite expression of opinion must then be deferred to a later date; for one cannot be absolutely certain whether or not the other signs of gangrenous coryza will appear.
When there is only difficulty in swallowing one might à priori suspect traumatic injury of the mucous membrane, with or without the presence of a foreign body. It is also necessary to bear in mind the possibility of difficulty in swallowing being occasioned by reflex irritation without local lesions, originating in enlargement of the retro-pharyngeal lymphatic glands as a consequence of tuberculosis or other disease.
The prognosis is favourable; even without treatment acute pharyngitis usually tends to recovery in eight to twelve days, and rarely becomes complicated. Nevertheless, some reserve ought to be exhibited in cases of pharyngitis due to the action of rough forage, the removal of the cause being here indispensable to any improvement. Similarly in cases of pharyngitis due to foreign bodies having penetrated the mucous membrane, which are chiefly characterised by inability to swallow, the disease may continue for a very much longer time than above indicated, unless the foreign body is discovered and removed. Inflammation is limited to a zone surrounding the point of implantation. It extends more deeply with movements of the foreign body, and may end in the formation of an abscess. Of this variety is Hopsomer’s remarkable case, in which a darning-needle finally obtained exit through the submaxillary space, in which it had caused the formation of an abscess.
Treatment. The treatment is the same whether we are dealing with a simple acute pharyngitis or with a more widely distributed inflammation. It consists in smartly stimulating the region of the throat with mustard, cantharides oil, or ointment, or with an ointment containing 2 per cent. of tartar emetic and of bichromate of potash, and then covering the parts with a flannel hood. This mode of treatment seems preferable to that recommended by German authors—viz., the application of cold compresses to the throat, the administration of cold gargles, etc. Moderate bleeding, to the extent of two or three quarts, has the great advantage, as in all similar cases, of lowering the temperature.
This treatment may, if necessary, be completed by the internal administration of 3 to 5 drams of Kerme’s mineral (oxysulphuret of antimony) in electuary, according to the animal’s size. Medicated inhalations diminish local irritation, render swelling less painful, and facilitate the separation of false membranes and the discharge of adherent mucous secretions.
The ordinary food should be replaced by cooked roots, lukewarm drinks and gruels, all rough fodder being prohibited.
If difficulty in swallowing alone continues, the operator should examine the mucous membrane of the pharyngeal cavity with the hand, in order to discover and remove any foreign body which may have become implanted there.
PSEUDO-MEMBRANOUS PHARYNGITIS IN CATTLE.
In addition to the above acute forms of pharyngitis, a pseudo-membranous, croupal, or pseudo-diphtheritic pharyngitis has been described in the ox. It is due to polymicrobic infection, and is characterised by the formation of false membranes on the pharyngeal mucous membrane. The condition seems to be a pharyngitis of exceptional intensity, varying markedly from the classic type and being most nearly related to severe sore throat, laryngitis, gangrenous coryza, etc.