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

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

Viral or bacterial infections and immunologic factors lead to

tonsillitis and its complications

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

TonsillitisClinical 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

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Conventional Treatmentof 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

Selection of homoeopathic remedy corresponding to the totality

Acute totality to be tackled first ( in case of acute affection)

Anti miasmatic treatment, once the acute state has subsided to prevent recurrence and chronicityStep 1

Step 3

Step 2

Step 4

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

• 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 PHOSPefficacious remedy in enlarged adenoids. It corresponds to the scrofulous dyscrasia,which permits adenoid

growths or tonsillar enlargement

1

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

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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