2. Tonsillitis
Definition
Tonsillitis refers to inflammation of the pharyngeal tonsils. The
inflammation may involve other areas of the back of the throat, including
the adenoids and the lingual tonsils
Tonsils are the first line of defense of the immune system against bacteria
and viruses that may enter the mouth
3. Causative factors
Viral or bacterial infections and immunologic factors lead to
tonsillitis and its complications
Viruses commonly known to cause Tonsillitis are:
Adenoviruses
Influenza virus
Epstein-Barr virus
Parainfluenza viruses
Enteroviruses
Herpes simplex virus
Streptococcus species are common bacterial cause of Tonsillitis
Tonsillitis caused by bacteria streptococcus species typically occurs in children
aged 5 to 15 years, while viral tonsillitis is more common in younger children
4. Clinical Presentation
Acute
Tonsillitis
Chronic
Tonsillitis
Peritonsillar
abscess
(Quinsy)
Recurrent
Tonsillitis
Symptoms usually resolve in three to four days, but may last up to two weeks despite
therapy. Fever, sore throat, foul breath, dysphagia (difficulty swallowing),
odynophagia (painful swallowing), tender cervical lymph nodes. Airway obstruction
due to swollen tonsils may cause mouth breathing, snoring, nocturnal breathing
pauses, or sleep apnoea. Lethargy ,malaise. Hoarseness or loss of voice, headache,
loss of appetite, ear pain. In young children signs of tonsillitis may include drooling
due to difficult or painful swallowing, refusal to eat & irritability
This diagnosis is made when
an individual has multiple
episodes of acute tonsillitis
in a year
Individuals often
have chronic
sore throat,
halitosis,
tonsillitis, and
persistently
tender cervical
nodes
Severe throat pain, fever,
drooling, foul breath,
trismus and muffled ,hot
potato voice
5. Tonsillitis
Clinical Signs
Source: http://www.hcs.calpoly.edu
Tonsils visibly red and swollen
Patches of white discharge on infected
tonsils
Fever and enlarged inflamed tonsils covered
by pus.
Tender cervical lymph nodes and neck
stiffness .
Unilateral bulging above and to the side of
one of the tonsils when peritonsillar abscess
exists. A stiff jaw, difficulty opening the
mouth, and pain referred to the ear may be
present in varying severity
6. Adenoids
The nasopharyngeal tonsil when hypertrophied in response to viral, bacterial
or allergic stimuli, so as to produce symptoms is called Adenoids
This leads to symptoms of nasal obstruction such as:
mouth breathing
noisy breathing
nasal tone of voice
persistent nasal discharge
deafness due to obstruction if Eustachian tubes
Typical facial appearance called “Adenoid Facies” with elongation of the face and an
open-mouthed slack- jaw, prominent eyes
Inflammation of Adenoids may cause persistent nasal discharge, post nasal
drip, cough or otitis media
9. Conventional Treatment
of Tonsillitis and Adenoids
Medication:
Adeno-Tonsillitis resulting from a streptococcal infection is usually treated
with an antibiotic
Unfortunately, there is currently no medication for the viruses that cause
tonsillitis
Surgical removal of Tonsils & Adenoids:
In general, a patient may be a candidate for tonsillectomy if he or she meets one of
the following criteria:
Seven or more episodes of tonsillitis in one year
Five or more episodes of tonsillitis each year over a period of two years
Three or more episodes of tonsillitis a year for a period of three years
Tonsillitis that recurs despite treatment with antibiotics
Airway or swallowing obstruction due to swollen tonsils
10. Drawbacks of conventional treatment
Surgery is often advised arbitrarily even to patients not meeting the criteria
Surgery can never be without its accompanying risks, morbidity and complications
Post operative hemorrhage
Infection
Ear Pain
Poor oral intake of fluids
Lower immunity hence overall increase in susceptibility to infections
Iatrogenic complications
Removing tonsils may reduce the risk of throat infections, it won't necessarily
prevent them completely .
Surgery is an expensive option
12. Hahneman’s classification of diseases
Tonsillitis and Adenoiditis may be categorized as a Local Diseases due to an internal cause
Local Diseases of Internal Cause
Internal cause : Altered immune status
Exciting cause: Exposure to pathogen
13. Approach to management of Tonsillitis
Ascertaining
complete picture of
disease by proper
case taking
Step 2
Selection of
homoeopathic
remedy
corresponding to
the totality
Step 3
Acute totality to be
tackled first ( in
case of acute
affection)
Step 4
Anti miasmatic
treatment, once the
acute state has
subsided to prevent
recurrence and
Step 1 chronicity
14. Homoeopathic therapeutics for Tonsillitis
Remedy Indications
AGRAPHIS NUTANS
• Enlarged tonsils
• Throat and ear troubles
• Adenoids
BARYTA CARB
• Chronic tendency of having swollen tonsils which tends to suppurate from every cold
• Pain worse from empty swallowing, solid food, on thinking of ailments; can only swallow liquids
• Scrofulous children who are backward mentally and physically
BELLADONNA
1
• Acute tonsillitis with a sudden and violent onset
• Ailments from exposure to dry cold wind
• Tonsils look bright red; throbbing pain with sensation of heat ; paroxysm of pain appear and disappear
suddenly
• Patient is restless, sensitive and nervous
• Tonsils red, worse on right side. Throat feels constricted; difficult deglutition, worse liquids
CALC CARB
• Swelling of tonsils and sub-maxillary glands
• Usually indicated in chronic tonsillitis for children who take cold easily
• Fat, fair child with large head having profuse sweat and distended abdomen
• They are slow, sluggish and shy, get tired easily
CALCAREA PHOSP
efficacious remedy in enlarged adenoids. It corresponds to the scrofulous dyscrasia,which permits adenoid
growths or tonsillar enlargement
15. Homoeopathic therapeutics for Tonsillitis
Remedy Indications
CALCAREA SULPHURICA
• Good for torpid glandular swellings with tendency to suppuration
• Pus in tonsils which is thick, yellow and bloody. It differs from Hepar sulph. in sensitiveness to air: Hepar
cannot bear the slightest exposure, Calc-s. is better in open air, better walking in it, desire for it
• Both are worse from change of weather but Calc-s. does not have the excessive sensitiveness to touch as
found in Hepar. Useful in 30C and 200C
CARBOLICUM ACIDUM
• Burning in mouth to stomach. Fauces red and covered with exudation.
• Uvula whitened and shrivelled. Putrid discharge. Almost impossible to swallow. When given in 30C potency
repeatedly works like a homoeopathic antibiotic
CISTUS CANADENSIS
• In scrofulous or arthritic individuals who have enlarged adenoids. There is extreme sensitiveness to cold air,
this is characteristic.
• Sensation of heat and dryness in the throat throat feel cold. Uvula and tonsils swollen. A small, dry spot in
throat; must sip water frequently.
• Hawking of mucus. Swelling and suppuration of glands of throat. Head drawn to one side by swellings in
neck. Sore throat from inhaling the least cold air. Heat and itching in throat.
EUCALYPTUS Q • Enlarged ulcerated tonsils and inflamed throat
FERRUM PHOS
• Tonsils red and swollen
• Ulcerated sore throat
• Eustachian tubes inflamed
2
16. Homoeopathic therapeutics for Tonsillitis
Remedy Indications
GUAIACUM Q
• Rheumatism and tonsillitis
• Acute tonsillitis
• Stitches towards ear
HEPAR SULPH
• Throat extremely sensitive to cold air and to touch.
• Quinsy with impending suppuration
• Sensation of a splinter, fish bone or plug in throat > from warmth Sensation of a plug in the throat.
• Chronic hypertrophy of tonsils
HYDRASTIS • Enlarged adenoids, yellow mucus and general lymphoid hypertrophy
KALI MURIATICUM
• Follicular tonsillitis
• Greyish patches or spots in the throat and tonsils
LACHESIS
• Tonsillitis of left side or first left, then right
• Pain < after sleep, from least pressure and from hot drinks
• Empty swallowing more painful than solids
LYCOPODIUM
• Tonsillitis begins on right side and spreads to the left
• Pain < from cold food , 4-8 pm, > from warm things
3
17. Homoeopathic therapeutics for Tonsillitis
Remedy Indications
MERC. SOL
• Used in advanced state when there is suppuration
• Sensitive to both hot and cold
• Tongue- flabby with imprint of teeth
• Profuse salivation and profuse offensive perspiration Constant desire to swallow
• Putrid sore throat < Right side
• Stitches into ear on swallowing
MERCURIUS IODATUS
RUBER
• Left sided sided tonsillitis with other symptoms similar to Merc. Sol
MERCURIUS IODATUS
FLAVUS
• Right sided tonsillitis with other symptoms similar to Merc. Sol
PSORINUM
• Useful in chronic tonsillitis
• Extremely chilly patient; ailments from every draught of cold air > from warm clothing
• Profuse offensive saliva - carrion like odour
STAPHISAGRIA • Stitches flying to the ear on swallowing, especially left
TARENTULA CUBENSIS
• Adapted to the most severe types of inflammation of tonsils. Pain, early and persistent prostration. Malignant
suppuration with burning,
• Stinging pains and intermittent septic chills. Also useful in peritonsillar abscess
TUBERCULINUM • may be used as an intercurrent remedy to correct the underlying constitutional dyscrasia
4
18. General Measures
Gargle with warm water (one cup) to which 1 teaspoon of salt has
been added - repeat this twice in a day or more frequently if required.
Take ginger juice mixed with honey.
Gargling with warm water mixed with salt and turmeric powder may
be effective
Drinking plenty of warm fluids, ginger tea etc may be comforting
A humidifier should be used in the room as dry air can further irritate
a sore throat
Avoid spicy foods, smoking, acidic drinks
Suck on throat lozenges as they soothe the throat.
Make a drink by mixing honey and lemon juice in warm water - sip it
often to soothe the throat and reduce mucus production.
Rest and sleep
Adequate fluids must be taken to keep the throat moist and prevent
dehydration.
Irritants from cigarette smoke and cleaning products that can irritate
the throat hence avoid them
19. Contributors: Compiled & Edited by:
Dr Jithesh T.K, C.M.O
Dr Pradip Kumar Roy, S.M.O
Dr Anjali Miglani, S.M.O
Dr. Nirmal Yadav Pangtey, M.O
Dr Paramjeet Kaur, CMO
Dr Shruti Naskar, MO
Dr Deepti Chawla
C.M.O, Dte. of AYUSH
