The Eugenic Marriage, Volume IV | Page 7

looks like curdled cream. This fluid sticks in the mouths of the
follicles forming spots. If enough of this fluid is coming out, these
spots join together forming patches, and the patches may join together
forming membrane. This is why it is sometimes so difficult to tell
whether the case is one of tonsilitis or diphtheria.
Conditions are favorable to the development of tonsilitis if the child is
not in good health when he happens to inhale the infection, when the
feet are wet or cold, or when the child is allowed out during inclement
weather and it becomes chilled or numbed 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