(Quinsy Sore Throat.)
Peritonsillar abscess results from the collection of pyogenic bacteria
and pus formation between the tonsil and the pillars of the fauces. It
is perhaps a result of the closing of an infected crypt causing deep
penetration of the pus.
=Diagnosis.=—The symptoms are those of acute tonsillitis but usually
more marked and with one tonsil decidedly more protruding than the
other. In some cases the location of the abscess can be seen and it is
comparatively easy to open with a knife or probe, but in many cases the
abscess is so situated that it cannot be located except by exploratory
probing.
=Treatment.=—Drainage by direct incision of the abscess pocket is
indicated as early as a definite diagnosis can be made. There is no
definite technic to be followed except to observe certain general
principles. If the “pointing” of the abscess can be located, it is
comparatively easy to make a good, free, direct incision and accomplish
complete drainage. In many cases the only way to locate the pocket
is to employ a probe or small, long, scalpel and explore between the
pillar and tonsil until the pus pocket is found. As soon as this is
located the pus pours out around the probe and this gives the location.
Free drainage by means of a liberal incision should then be made.
Aspiration of the pus pocket and filling with phenol-glycerine is
effective after drainage has been obtained, but a liberal drainage must
be maintained.
The non-surgical treatment as described under acute tonsillitis is to
be applied here.