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Homoeopathic Management of 
Adeno-Tonsillitis 
Clinical Tips
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
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
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
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
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
Adenoids 
Source: www.arthursclipart.com/medical
Investigations 
 Throat swab and culture for streptococci 
 •X-ray Nasopharynx is helpful in 
determining the size and shape of the 
adenoids 
 •Blood tests CBC for diagnosing infections 
such as mononucleosis 
 Sleep study, or polysomnogram for 
evaluating sleep disturbance or apnoea due 
to enlarged tonsils or adenoids 
Image © OpenI is the service of the National Library of Medicine
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
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
Homoeopathic Perspective 
Hahneman’s classification of diseases
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
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
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
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
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
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
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
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

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Clinical tips for the management of adeno tonsillitis

  • 1. Homoeopathic Management of Adeno-Tonsillitis Clinical Tips
  • 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
  • 8. Investigations  Throat swab and culture for streptococci  •X-ray Nasopharynx is helpful in determining the size and shape of the adenoids  •Blood tests CBC for diagnosing infections such as mononucleosis  Sleep study, or polysomnogram for evaluating sleep disturbance or apnoea due to enlarged tonsils or adenoids Image © OpenI is the service of the National Library of Medicine
  • 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
  • 11. Homoeopathic Perspective Hahneman’s classification of diseases
  • 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