Causes: traumatic; thermic; gaseous; medicinal; chemical;
physiological irritants; in solipeds, cattle, swine, dogs; debility;
exposure; cold baths; youth; age. Microbes in solipeds, cattle, dogs,
birds; facultative microbes. Symptoms: constitutional; difficult
swallowing; nasal rejection of water; pharyngeal swelling and
tenderness; extended head carried stiffly; cough loose; salivation; in
cattle, grinding of teeth; in dogs, rubbing of chops; buccal heat and
redness; often fœtor. Course. Duration. Diagnosis from parotitis, from
abscess of guttural pouch, from pharyngeal tuberculosis, from
actinomycosis, from adenitis and phlegmonous pharyngitis, from
specific fevers affecting the pharynx. Lesions: redness and swelling
of mucosa, epithelial degeneration, elevations, erosions, and ulcers;
lesions of tubercle, glanders, rabies, anthrax, actinomycosis, etc.
Prevention. Treatment: soothing; dietetic; laxative; expectorant;
eliminating; locally antiseptic astringents in solid, liquid, or
vapor; embrocations and blisters; tonics.
_Causes._ As in stomatitis the starting point of pharyngitis is usually
in a local injury or a systemic condition which lowers the vitality of
the pharyngeal mucous membrane. It may come in all animals from the hot
air of burning buildings, from acrid gases inhaled, food, drink or
medicines given at too high a temperature, from caustic alkalies, acids
or salts, from physiological irritants like croton, euphorbium,
cantharides, from barley and other spikes entangled in the follicles,
from drinking freely of iced water. In _solipedes_ there are the
injuries caused by giving boluses on pointed sticks, and the wounds
caused by tooth files in careless hands, and by coarse fibrous fodder,
which has been swallowed without due mastication. In _cattle_ injury
comes from foreign bodies impacted, from the rough use of probang, rope
or whip and even of the hands in relieving choking. _Swine_ have the
part scratched and injured by rough or pointed objects which they bolt
carelessly with the food. _Dogs_ and especially puppies are often hurt
by solid and irritant bodies that they play with, and swallow
accidentally or wantonly. They also suffer at times from the pressure of
a tight or badly adjusted collar.
The system is debilitated and rendered more susceptible by chills
consequent on exposure to cold blasts, or draughts, or rain or snow,
when heated and exhausted, by cold damp beds, by pre-existing disease,
by underfeeding and by overwork. In the larger animals this may come
from the excessive ingestion of iced water, while in dogs the plunging
in rivers, ponds or lakes may chill.
The weakness of _early age_ and _old age_ have a perceptible
predisposing influence especially in solipeds and carnivora.
Finally as in other catarrhal inflammations the local action of disease
germs on the mucous membrane must ever be borne in mind. These may be
the germs of specific diseases localized in the pharynx;—in =Solipeds=
the streptococcus of strangles, the bacillus of glanders, the
diplococcus (streptococcus) of contagious pneumonia, the germ of
influenza, and actinomyces;—in =Cattle= the bacillus tuberculosis, the
bacillus of anthrax, actinomyces, the germs of aphthous fever and of
pseudomembranous angina; in _dogs_ canine madness and distemper;—in
birds the bacillus of pseudomembranous pharyngitis.
In addition to such specific germs the micrococci, streptococci and
bacilli which are normally present and harmless in the mouth and
pharynx, enter, colonize and irritate the debilitated tissues in case of
trauma, inflammation or constitutional disorder and serve to perpetuate
and aggravate the affection.
_Symptoms._ Acute pharyngitis is manifested by impaired or lost
appetite, dullness, weakness, by difficulty in deglutition, by the
rejection through the nose of water or other liquids swallowed, by
swelling over the parotid and above the larynx, and by a disposition to
keep the head extended on the neck and the nose raised and protruded.
Fever is more or less marked according to the severity of the attack the
temperature being raised in mild cases to 100°, and, in the more
violent, to 104° or 106°. The pulse and breathing may be excited,
amounting sometimes to dyspnœa, the throat is tender to the touch and
its manipulation rouses a cough, the nasal mucosa is congested and the
buccal membrane, and especially along the margin of the tongue may be
red and angry. Salivation is shown more or less, in _solipeds_ the
saliva accumulating especially during mastication in froth and bubbles
at the commissures of the mouth, while in _ruminants_ the grinding of
the teeth or frequent movement of the jaws in the absence of food or
actual mastication leads to a free escape of the filmy liquid at the
same points. _Dogs_ will rub the jaws with the foot as if to remove some
irritating object from the mouth. In the last named animals the swelling
of the tonsils, fauces and pharyngeal mucous membrane, may be seen
marked by patches and spots of varying redness and swelling, covered
with glairy or opaque mucopurulent secretions, or particles of food, or
even showing erosions.
The cough of pharyngitis is painful, paroxysmal, and softer and more
gurgling (even in the early stages) than that of laryngitis or
bronchitis. It is roused by handling the throat, by swallowing, by a
draught of cold air or by passing out of doors, in _dogs_ by opening the
mouth, and in _cattle_ by pulling on the tongue which causes pain and
resistance. The cough is followed by the rejection, mainly through the
nose in _solipeds_, but also through the mouth in other animals, of a
glairy mucus or an opaque mucopurulent discharge often mixed with and
discolored by the elements of food or in bad cases by blood.
The _course_ of the disease is comparatively rapid, and it usually ends
in recovery in seven to fifteen days, in cases that are not complicated
by dangerous local infections.
_Diagnosis_ is mainly based on the stiff carriage of the neck with the
nose elevated, the swelling and tenderness of the throat, manipulation
above the larynx rousing the cough, the soft or rattling nature of the
cough, the ejection of liquids and foods through the nose, the movements
of the jaws apart from mastication and the salivation. From _parotitis_
it is distinguished by the concentration of the swelling and tenderness
to the deepseated region above the larynx, by the abundance of the
discharge, by the ejection of liquids through the nose, and by the
readiness with which the cough is aroused. From _abscess of the guttural
pouch_ it is differentiated by the more continuous discharge from the
nose, rather than the intermittent one. From _tuberculous pharyngeal
glands_ by its acute nature, by the absence of the glandular swellings
in which the tuberculosis is concentrated, also by the absence of
tubercles in other parts of the body. From _actinomycosis_ by its more
rapid progress and by the absence of the hard indurated cutaneous or
subcutaneous swellings, and of the open sores with minute sulphur
colored granules that mark that affection. From _adenitis_ and
_phlegmonous pharyngitis_ it is distinguished by the absence of the
glandular swelling and dyspnœa which attend on that affection. From the
various fatal _febrile affections_, the germs of which may be localized
in the throat, it may be diagnosed by the absence of the more profound
constitutional disturbance, and of the more characteristic local
symptoms of these which are seldom altogether awanting, though often
greatly modified.
_Lesions._ Beside the thick covering of mucopurulent and alimentary
matters, the pharyngeal mucosa, when washed, shows redness, ramified or
reticulated, more or less swelling amounting at times to œdema, a soft
friable consistency, which like the œdema may in bad cases extend into
the submucous tissue, granular elevations, and raw abrasions caused by
the destruction and removal of the epithelium. In some instances the
ulcers may become quite extensive.
In the more specific inflammations (tubercle, glanders, rabies, aphthous
fever, contagious pneumonia, anthrax, actinomycosis), the lesions will
vary according to the specific nature of the disease.
_Prevention._ Avoid the various thermal, chemical, mechanical, and
unhygienic causes already referred to, and the exposure to such
infectious diseases as are liable to localize themselves in the throat.
_Treatment._ A piece of blanket or sheepskin placed round the throat
with the wool turned inward, a moderately warm stall with pure air, and
a diet composed of soft, warm or tepid mashes, (all hard or fibrous
food, oats, hay, etc. being withheld) are important conditions.
If costiveness exists a dose of Glauber salts for the larger animals,
and of jalap for the small, may be useful. Or pilocarpine or eserine may
be given hypodermically. Following this, mild saline diuretics will
serve at once to eliminate offensive products of the disease and lower
the general temperature.
The most important resorts however, are the local applications of dilute
acids, astringents and antiseptics to the pharyngeal mucosa, mouth and
nostrils. In severe cases benefit may be derived from inhalation of
water vapor, but this is rendered far more effective by the addition of
vinegar, carbolic acid, creolin, camphor, tar, or sulphurous acid. The
last may be obtained by the frequent burning of a carefully graduated
quantity of sulphur in the stall, the others by mixing them with hot
water, saturating cloths hung in the stall, or sprinkling them on sand
laid on the floor.
Chlorate of potash or borax may be dissolved in the drinking water, care
being taken not to exceed the physiological dose. Mercuric chloride
(1:2000) may be used to wash the lips and nostrils, but cannot be safely
injected into mouth or nose. Powdered alum or tannic acid may be used by
insufflation.
As a mouth wash and general medicament a saturated solution of chlorate
of potash in tincture of muriate of iron, diluted by adding thirty drops
to the ounce of water, may be given every hour or two. Or a solution of
chlorine water diluted so as to be non-irritating, may be substituted
with somewhat less effect. Even a weak solution of hydrochloric acid may
be employed.
Borax may be used in a solution of 2 per cent., or carbolic acid in one
of 1 per cent., or bisulphite of soda in the proportion of ½ oz. to the
pint, or salicylate of soda ½ oz. to the pint of water. The same agents
may be made into electuaries with honey or molasses and smeared every
hour or two on the tongue or cheek. In such cases the addition of
powdered liquorice, and, if the suffering is acute, of extract of
belladonna will serve an excellent purpose.
The danger of infection of the stomach and bowels may be met by
combining with the above or administering separately salol in doses of 2
to 3 drachms or naphthol in doses of 4 to 5 drachms to the larger
animals. For sheep or swine one-fourth of these doses may be given, and
for a shepherd’s dog one-sixteenth to a twentieth.
As alternate antiseptics may be named, boric acid, permanganate of
potash and salicylate of bismuth. These from their comparative absence
of taste are especially useful in carnivora.
Counter-irritants to the throat are useful. For the horse, sheep, dog
and cat, use equal parts of strong aqua ammonia and olive oil. For the
solipeds a cantharides blister. For cattle or swine equal parts of
strong aqua ammonia and oil of turpentine with a few drops of croton
oil, or grains of tartar emetic.
Finally during convalescence a course of iron and bitters may be useful,
especially in debilitated subjects.