Author: Dr Ranjeet Singh
Tonsil is derived from the “tonsilla” means almond shaped. It is refers to the inflammation of the pharyngeal tonsils. In tonsillitis, tonsils are enlarged, red and often coated with substance that is yellow, grey or white. Tonsillitis usually occurs as a part of pharyngitis and begins with sore throat and painful swallowing. It is also known as acute sore throat. Chronic tonsillitis is a term applied to cases in which there is enlargement of the tonsils accompanied by repeated attacks of infection.
Functions of tonsils?
The tonsils are two small lymphoid organs that lie one on each side of the throat. They can be seen just behind the back of tongue between two folds of membrane running up to soft palate. Normally, they are about the size of a Lima Bean but they can become very much larger if severely infected. They are valuable organs of selective elimination and perform at two fold function. Firstly, they protect the throat against disease germs. Secondly, they serve as barometers for indicating infection elsewhere in the body, when they become sore and swollen.
Aetiology of tonsillitis
Acute tonsillitis often effects school-going children, but also affects adults. It is rare in infants and in persons who are above 50 years of age.
Hemolytic streptococcus is the most commonly infecting organism. Other causes of infection may be staphylococci, pneumococci or haemophilus influenzae. These bacteria primarily in infect the tonsil or may be secondary to a viral infection.
Acute tonsillitis can be classified as:
Acute catarrhal or superficial tonsillitis
Here tonsil substance is a part of generalized pharyngitis and is mostly seen in viral infections.
Acute follicular tonsillitis
Infection spreads into the crypts which become filled with purulent material, presenting at the opening of cryptss as yellowish spots.
Acute parenchymatous tonsillitis
Here tonsil substance is affected. Tonsil is uniformly enlarged and red.
Acute membranous tonsillitis
It is a stage ahead of acute follicular tonsillitis when exudation from the crypts coalesces to form a membrane on the surface of tonsil.
What are the Signs and Symptoms of tonsillitis?
The main symptoms of tonsillitis are sore throat , fever, headache, pain in various parts of the body, difficulty in swallowing and general weakness. Fever may vary from 38 to 40 degree Celsius and may be associated with chills and rigors. Sometimes, a child presents with an unexplained fever and it is only on examination that an acute tonsillitis is discovered.
The tonsils are seen to be inflamed and red when the mouth is opened wide. In many cases spots of pus exude from them. Externally, the tonsillar lymph glands which lie just behind the angle of the jaw are tender and enlarged. In severe cases there maybe pain in the ear. Pain in the ear is either referred pain from the tonsil or the result of acute otitis media which may occur as a complication.
What are the possible complications of tonsillitis?
- Chronic tonsillitis with recurrent acute attacks. This is due to incomplete resolution of acute infection. Chronic infection may persist in lymphoid follicles of the tonsil in the form of microabscesses.
- Peritonsillar abscess
- Cervical abscess due to suppuration of jugulodigastric lymph nodes.
- Acute otitis media recurrent attacks of acute otitis media may coincide with recurrent tonsillitis.
- Rheumatic fever often seen in association with tonsillitis due to group A-beta hemolytic streptococci.
Management of tonsillitis
- Patient patient is put to bed and encouraged to take plenty of fluids.
- Take decoction of Kachanaar (leaves and bark), Hastisundi (Heliotropium Indicum) ( leaves and flowers) and Guggulu.
- Use poultice made of leaves of Shigru (Horse radish tree) over tonsils externally.
- The throat may be gargled several times daily with neat lemon juice. Gargles made from the fenugreek seeds is very effective. In severe cases, to make such a gargle, 2 tablespoonful of fenugreek seeds should be allowed to simmer for half an hour in a litre of water and then set aside to cool. The entire quantity should be used as a soothing gargle in a day with beneficial results.
Some classical Ayurvedic formulations can be used to cure acute tonsillitis e.g. Mrityunjana Rasa, Tribhuvan kirti rasa, Lakshmi Vilas rasa, Sudarshna powder.
Surgery for the removal of the tonsils is necessary only in very rare cases, when tonsils are seriously diseased, rugged and contain hopelessly incurable pus pockets.