General inflammations of the throat, associated with redness, swelling, and excessive discharge of mucus, may have many different causes. Most common, of course, is exposure to cold, or an extension of inflammation from the tonsils, the adenoids, or the nose. Excessive use of tobacco, excessive exposure to dust, smoke, and irritating fumes, and sudden changes in temperature, excessive dryness and other atmospheric irritations may all cause irritation of the throat. People who are sensitive to certain food substances sometimes react with blisters on the tissue of the throat, which become secondarily infected and produce irritation and inflammation.
There may be severe pain associated with swelling and inflammation of the throat, including pain in the ears because of blocking of the tube which lead from the nose to the ears; there may also be a sense of fullness or obstruction, with much hawking and spitting.
The first thing to know about any inflammation of the throat is it cause. If the condition happens to be due to diphtheria, prompt action is necessary, including the giving of diphtheria antitoxin. If, however it is due to some other type of germ, other methods of treatment are employed. The pain of an inflamed throat is best relieved by use of an ice bag filled with cracked ice. Most doctors are now convinced that gargles seldom go deep enough in the throat in sufficient quantity or strength to permit them to have much effect in killing germs or in curing disease. To have a definite effect from any antiseptic in the throat, it is necessary to apply it directly to the infected or inflamed part. This is best done by spreading with a cotton swab or by using an atomizer properly. In order to get the antiseptic into the back of the throat it may be necessary to hold the tongue or to use a tongue depressor.
The primary purpose of a mouthwash or throat wash is to clean an soothe. A good cleansing mouthwash is merely salt solution, made by adding a fourth of a teaspoon of salt to a half glass of warm water. If there is much mucus, the addition of a quarter of a teaspoon of bicarbonate of soda or ordinary baking soda may be beneficial.
The infection of throat and tonsils often first manifests itself with chill, pain in the head and body, loss of appetite, and fever. The temperature may go up to 103F or 104F. The streptococci are usually the infecting agent, and, since they are practically always present in the nose and throat of people, the explanation seems to be that they grow and multiply every time the resistance is lowered. In epidemics, streptococci from infected food or milk or from the hands of food-handlers are spread about, and attack those who cannot resist. If children have repeated sore throats with infected tonsils, the tonsils may be removed during an intervening period when inflammation is absent.
The larynx, commonly called the voice box, consists of cartilage held together by muscles and ligaments so as to make a tubular structure holding the vocal cords. At its upper end is a structure called the epiglottis, which serves to keep food from going down the larynx and windpipe and causes it to pass instead from the pharynx into the esophagus and stomach.
The chief purpose of the larynx is to aid speech. However, it also is capable of helping with expectoration. When a moving column of air strikes the vocal bands, the column is set in vibration. Speech includes, however, not only the vibration of this column of air but the molding of the column with the help of the tongue, the teeth, the palate, and the lips. If any of these structures does not function properly, the voice can be greatly changed. The adult male possesses a deep voice because of the action of the long vocal cord during its relaxed state. A low-pitched voice is produced by a slow-moving cord, and a high-pitched voice is produced by a vocal cord that vibrates with an increased frequency.
The doctor looks at the larynx by means of several different techniques. For the usual examination he wears a head-mirror which casts light into the mouth. The person who is going to be examined puts out his tongue, which is held out with a piece of sterile gauze. While the tongue is held gently, the patient breathes through the mouth with short gasps of breath. Then the doctor puts a mirror, which has been slightly warmed to prevent condensation of air on its surface, into the back of the throat and requests the patient to ‘say “Ah.” This raises the palate, and the mirror may be passed a little farther into the throat. By regulating the angle of the mirror the doctor can see the vocal cords. As the patient makes various sounds, the doctor can determine whether or not the vocal cords vibrate properly. He can also see whether or not they have been modified by inflammation or swelling or growth of nodes. For some people who are sensitive the use of a local anesthetic may be necessary to permit passing the mirror into the back of the throat. Technique have also been developed which permit the doctor to look directly al the vocal cords, with instruments designed for the purpose.
Inflammation of the vocal cords may follow overuse of the voice, irritation by chemical substances, or infection. Men, who are more frequently subjected to exposure to irritant substances in their occupations and who indulge more than women in deleterious habits, suffer more from laryngitis than do women. Contributing causes to inflammation of the larynx include the swallowing of hot or spicy foods, the abuse of alcohol and tobacco and similar irritants. Occasionally the larynx becomes inflamed because there is an infection in the throat or the lungs. In fact, any condition that blocks breathing through the nose helps to cause laryngitis, because large amounts of air then pass directly to the larynx without having been modified, as is usual, in passing through the nasal tract.
In serious cases of laryngitis it is customary to go to bed and keep quiet. Nothing helps the vocal cords under such circumstances as much as continuous rest, speaking only in a whisper. The application of an ice bag or ice collar or moist compresses to the throat is soothing. A measure which comes down from ancient history is the inhaling of steam to which various aromatic oils can be added. Nowadays many special devices have been developed that use electrical heat in order to produce such steam for inhaling. These devices are usually much safer than the old-fashioned dish or kettle of hot water. Many instances have been known of severe burns from accidents with open kettles of exceedingly hot water used in this way. For serious laryngitis, particularly that complicated by inflammation or infection, the physician may prescribe many drugs that are helpful in securing rest and in soothing the area concerned.
The scientific name for the windpipe is the trachea. It is often involved in infections of the throat and the bronchial tubes. Any virus or germ that can produce inflammation of the respiratory tract can also cause the lining of the trachea to become infected. It is possible for the experts to see the lining of the trachea by the use of the bronchoscope.
When the lining of the trachea becomes inflamed the most typical symptom is the cough. These coughs are non-productive, hacking, and metallic. They tend to be worse after the person goes to bed and during
the night. An acute inflammation of the trachea is accompanied by rawness, tightness, and discomfort, sometimes even pain, in the lower part of the neck and behind the upper part of the breastbone, or sternum. As the inflammation goes on, there is mucus, and finally a good deal of sputum and mucus may be expectorated. If the infection is purulent, as with the staphylococcus or streptococcus, the material coughed up will be a mixture of mucus and pus.
These conditions can be helped by the usual treatment that is given to other inflammations of the respiratory tract. That means going to bed for a few days, applying warmth, and producing rest by the use of appropriate remedies which the doctor prescribes. Often inhalations of warm vapor treated with medicated oils help to bring relief.
In some instances the acute inflammation of the trachea becomes chronic. In such cases the cough is irritating and frequent. When these symptoms are present it becomes necessary for the doctor to make certain that the patient does not have tuberculosis or any other condition affecting the lungs. In such cases it is customary to prohibit smoking. The use of antiinfectious remedies such as the sulfonamides and penicillin are important, in eliminating infection.