Effect of Homoeopathic remedy Baryta Carb on throat associated disorder

Dr Puneet Kumar Misra

Abstract
The throat disorder is the most common disorder in the all age group and many person having the repeated tendency of it. The clinical appearance of this disorder is varying pattern due to its association with nose and ear   i.e. coryza, malaise,   nasal discharge and obstruction, sneezing and cough, hoarse or lost voice ,ear pain .  In few patient  throat discomfort are mild  while in the few case it is moderate to marked and   produce some common chronic disorder i.e. pharyngitis and Tonsillitis . When focus on the of baryta carb holistic  clinical description  we found that this medicine having the good effect on the improvement and remove  of all disorder related to the throat with or without association of  ear and nose with above mentioned clinical condition .

Key words – Nasal Discharge ,Sneezing ,Cough ,Tonsillitis ,Pharyngitis.

Introduction
Sore throat– It is one of the commonest of all symptoms. Viral pharyngitis is the most common cause. Tonsillar inflammation is also common. Acute follicular tonsillitis begins with local redness, developing into a punctate or confluent yellow exudate on the tonsils, often due to group A Streptococcus infection. In glandular fever (Epstein-Barr virus infection), the tonsils are covered with a white membrane with palatal petechiae. A grey membrane is the classic feature of the now-rare infection with Corynebacterium diphtheriae. A throat swab for culture and sensitivity is a useful test. Find out the frequency and severity of attacks of tonsillitis, as estimated by the amount of time lost from school or work, and any antibiotic treatment; such considerations help to decide whether tonsillectomy is merited. Generally in children, at least four attacks a year for 2 years is the minimum indication for tonsillectomy. An abscess adjacent to the tonsil (quinsy) is very painful, causing dysphagia and trismus (spasm in the lower jaw). Surgical drainage is usually required. Squamous cell carcinoma of the tonsil is also often painful. It presents as an exophytic mass or ulcer. In the early stages, diagnosis is difficult. Ulceration in the oropharynx also occurs in glandular fever, rubella and streptococcal tonsillitis. 1

Upper respiratory tract infections (URTIs), such as coryza (the common cold), acute pharyngitis and acute tracheobronchitis, are the most common of all communicable diseases and represent the most frequent cause of short-term absenteeism from work and school. The vast majority are caused by viruses  and, in adults, are usually short-lived and rarely serious. Acute coryza is the most common URTI and is usually the result of rhinovirus infection. In addition to general malaise, acute coryza typically causes nasal discharge, sneezing and cough. Involvement of the pharynx results in a sore throat, and that of the larynx a hoarse or lost voice. If complicated by a tracheitis or bronchitis, chest tightness and wheeze typical of asthma occur. Specific investigation is rarely warranted and treatment with simple analgesics, antipyretics and decongestants is all that is required. Symptoms usually resolve quickly, but if repeated URTIs ‘go to the chest’, a more formal diagnosis of asthma ought to be considered. A variety of viruses causing URTI may also trigger exacerbations of asthma or COPD and aggravate other lung diseases. 2

CLINICAL MANIFESTATIONS The signs and symptoms of nonspecific URI are similar to those of other URIs but lack a pronounced localization to one particular anatomic location, such as the sinuses, pharynx, or lower airway. Nonspecific URI commonly presents as an acute, mild, and self limited catarrhal syndrome with a median duration of ~1 week (range, 2–10 days). Signs and symptoms are diverse and frequently variable across patients, even when caused by the same virus. The principal signs and symptoms of nonspecific URI include rhinorrhea (with or without purulence), nasal congestion, cough, and sore throat. Other manifestations, such as fever, malaise, sneezing, lymphadenopathy, and hoarseness, are more variable, with fever more common among infants and young children. This varying presentation may reflect differences in host response as well as in infecting organisms; myalgias and fatigue, for example, sometimes are seen with influenza and parainfluenza infections, whereas conjunctivitis may suggest infection with adenovirus or enterovirus. Cough secondary to upper respiratory inflammation after such an illness frequently lasts 2–3 weeks and can be misinterpreted as an indication of a process that necessitates antibiotic therapy. Findings on physical examination are frequently nonspecific and unimpressive. Between 0.5 and 2% of colds are complicated by secondary bacterial infections (e.g., rhinosinusitis, otitis media, and pneumonia), particularly in higher-risk populations such as infants, elderly persons, and chronically ill or immunosuppressed individuals. Secondary bacterial infections usually are associated with a prolonged course of illness, increased severity of illness, and localization of signs and symptoms, often as a rebound after initial clinical improvement (the “double-dip” sign). Purulent secretions from the nares or throat often are misinterpreted as an indication of bacterial sinusitis or pharyngitis. These secretions, however, can be seen in nonspecific URI and, in the absence of other clinical features, are poor predictors of bacterial infection.3

ACUTE PHARYNGITIS

AETIOLOGY Acute pharyngitis is very common and occurs due to varied aetiological factors like viral, bacterial, fungal or others . Viral causes are more common. Acute streptococcal pharyngitis (due to Group A beta-haemolytic streptococci) has received more importance because of its aetiology in rheumatic fever and poststreptococcal glomerulonephritis.4

CLINICAL FEATURES Pharyngitis may occur in different grades of severity. Milder infections present with discomfort in the throat, some malaise and low-grade fever. Pharynx in these cases is congested but there is no lymphadenopathy. Moderate and severe infections present with pain in throat, dysphagia, headache, malaise and high fever. Pharynx in these cases shows erythema, exudate and enlargement of tonsils and lymphoid follicles on the posterior pharyngeal wall. Very severe cases show oedema of soft palate and uvula with enlargement of cervical nodes. It is not possible, on clinical examination, to differentiate viral from bacterial infections but, viral infections are generally mild and are accompanied by rhinorrhoea and hoarseness while the bacterial ones are severe. Gonococcal pharyngitis is mild and may even be asymptomatic.4

DIAGNOSIS Culture of throat swab is helpful in the diagnosis of bacterial pharyngitis. It can detect 90% of Group A streptococci. Diphtheria is cultured on special media. Swab from a suspected case of gonococcal pharyngitis should be cultured immediately without delay. Failure to get any bacterial growth suggests a viral aetiology.4

TREATMENT  General measures. Bed rest, plenty of fluids, warm saline gargles or pharyngeal irrigations and analgesics form the mainstay of treatment. 4

CHRONIC PHARYNGITIS
It is a chronic inflammatory condition of the pharynx. Pathologically, it is characterized by hypertrophy of mucosa, seromucinous glands, subepithelial lymphoid follicles and even the muscular coat of the pharynx. Chronic pharyngitis is of two types:

1. Chronic catarrhal pharyngitis. 2. Chronic hypertrophic (granular) pharyngitis.

AETIOLOGY A large number of factors are responsible:

1. Persistent infection in the neighbourhood. In chronic rhinitis and sinusitis, purulent discharge constantly trickles down the pharynx and provides a constant source of infection. This causes hypertrophy of the lateral pharyngeal bands. Similarly, chronic tonsillitis and dental sepsis are also responsible for chronic pharyngitis and recurrent sore throats.
2. Mouth breathing. Breathing through the mouth exposes the pharynx to air which has not been filtered, humidified and adjusted to body temperature thus making it more susceptible to infections. Mouth breathing is due to: (a) Obstruction in the nose, e.g. nasal polypi, allergic or vasomotor rhinitis, turbinal hypertrophy, deviated septum or tumours. (b) Obstruction in the nasopharynx, e.g. adenoids and tumours. (c) Protruding teeth which prevent apposition of lips. (d) Habitual, without any organic cause.
3. Chronic irritants. Excessive smoking, chewing of tobacco and pan, heavy drinking or highly spiced food can all lead to chronic pharyngitis.
4. Environmental pollution. Smoky or dusty environment or irritant industrial fumes may also be responsible for chronic pharyngitis.
5. Faulty voice production. Less often realized but an important cause of chronic pharyngitis is the faulty voice production. Excessive use of voice or faulty voice production seen in certain professionals or in “pharyngeal neurosis” where person resorts to constant throat clearing, hawking or snorting, and that may cause chronic pharyngitis, especially of hypertrophic variety. 4

SYMPTOMS Severity of symptoms in chronic pharyngitis varies from person to person.

1. Discomfort or pain in the throat. This is especially noticed in the mornings.
2. Foreign body sensation in throat. Patient has a constant desire to swallow or clear his throat to get rid of this “foreign body.”
3. Tiredness of voice. Patient cannot speak for long and has to make undue effort to speak as throat starts aching. The voice may also lose its quality and may even crack.
4. Cough. Throat is irritable and there is tendency to cough. Mere opening of the mouth may induce retching or gagging. 4

SIGNS 1. Chronic catarrhal pharyngitis. In this, there is a congestion of posterior pharyngeal wall with engorgement of vessels; faucial pillars may be thickened. There is increased mucus secretion which may cover pharyngeal mucosa.

2. Chronic hypertrophic (granular) pharyngitis

(a) Pharyngeal wall appears thick and oedematous with congested mucosa and dilated vessels.

(b) Posterior pharyngeal wall may be studded with reddish nodules (hence the term granular pharyngitis). These nodules are due to hypertrophy of subepithelial lymphoid follicles normally seen in pharynx .

(c) Lateral pharyngeal bands become hypertrophied.

(d) Uvula may be elongated and appear oedematous. 4

TREATMENT

1. In every case of chronic pharyngitis, aetiological factor should be sought and eradicated.
2. Voice rest and speech therapy is essential for those with faulty voice production. Hawking, clearing the throat frequently or any other such habit should be stopped.
3. Warm saline gargles, especially in the morning, are soothing and relieve discomfort. 4

ACUTE TONSILLITIS
Primarily, the tonsil consists of (i) surface epithelium which is continuous with the oropharyngeal lining, (ii) crypts which are tube-like invaginations from the surface epithelium and (iii) the lymphoid tissue. Acute infections of tonsil may involve these components and are thus classified as:

1. Acute catarrhal or superficial tonsillitis. Here tonsillitis is a part of generalized pharyngitis and is mostly seen in viral infections.
2. Acute follicular tonsillitis. Infection spreads into the crypts which become filled with purulent material, presenting at the openings of crypts as yellowish spots.
3. Acute parenchymatous tonsillitis. Here tonsil substance is affected. Tonsil is uniformly enlarged and red.
4. 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. 4

AETIOLOGY Acute tonsillitis often affects school-going children, but also affects adults. It is rare in infants and in persons who are above 50 years of age. Haemolytic streptococcus is the most commonly infecting organism. Other causes of infection may be staphylococci, pneumococci or H. influenzae. These bacteria may primarily infect the tonsil or may be secondary to a viral infection. 4

SYMPTOMS The symptoms vary with severity of infection. The predominant symptoms are:

1. Sore throat.
2. Difficulty in swallowing. The child may refuse to eat anything due to local pain.
3. Fever. It may vary from 38 to 40°C 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.
4. Earache. It is either referred pain from the tonsil or the result of acute otitis media which may occur as a complication.
5. Constitutional symptoms. They are usually more marked than seen in simple pharyngitis and may include headache, general body aches, malaise and constipation. There may be abdominal pain due to mesenteric lymphadenitis simulating a clinical picture of acute appendicitis. 4

SIGNS

1. Often the breath is foetid and tongue is coasted.
2. There is hyperaemia of pillars, soft palate and uvula.
3. Tonsils are red and swollen with yellowish spots of purulent material presenting at the opening of crypts (acute follicular tonsillitis) or there may be a whitish membrane on the medial surface of tonsil which can be easily wiped away with a swab . The tonsils may be enlarged and congested so much so that they almost meet in the midline along with some oedema of the uvula and soft palate (acute parenchymatous tonsillitis).
4. The jugulodigastric lymph nodes are enlarged and tender. 4

TREATMENT 1. Patient is put to bed and encouraged to take plenty of fluids. 2. Analgesics  are given according to the age of the patient to relieve local pain and bring down the fever. 3. Antimicrobial therapy. Most of the infections are due to Streptococcus and penicillin is the drug of choice.  Antibiotics should be continued for 7–10 days. 4

COMPLICATIONS 1. 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. 2. Peritonsillar abscess. 3. Parapharyngeal abscess. 4. Cervical abscess due to suppuration of jugulodigastric lymph nodes. 5. Acute otitis media. Recurrent attacks of acute otitis media may coincide with recurrent tonsillitis. 6. Rheumatic fever. Often seen in association with tonsillitis due to Group A beta-haemolytic Streptococci. 7. Acute glomerulonephritis. Rare these days. 8. Subacute bacterial endocarditis. Acute tonsillitis in a patient with valvular heart disease may be complicated by endocarditis. It is usually due to Streptococcus viridans infection. 4

CHRONIC TONSILLITIS

AETIOLOGY

1. It may be a complication of acute tonsillitis. Pathologically, micro abscesses walled off by fibrous tissue have been seen in the lymphoid follicles of the tonsils.
2. Subclinical infections of tonsils without an acute attack.
3. Mostly affects children and young adults. Rarely occurs after 50 years.
4. Chronic infection in sinuses or teeth may be a predisposing factor.

TYPES 1. Chronic follicular tonsillitis. Here tonsillar crypts are full of infected cheesy material which shows on the surface as yellowish spots.

2. Chronic parenchymatous tonsillitis. There is hyperplasia of lymphoid tissue. Tonsils are very much enlarged and may interfere with speech, deglutition and respiration . Attacks of sleep apnoea may occur. Long-standing cases develop features of cor pulmonale.
3. Chronic fibroid tonsillitis. Tonsils are small but infected, with history of repeated sore throats.

CLINICAL FEATURES 1. Recurrent attacks of sore throat or acute tonsillitis. 2. Chronic irritation in throat with cough. 3. Bad taste in mouth and foul breath (halitosis) due to pus in crypts. 4. Thick speech, difficulty in swallowing and choking spells at night (when tonsils are large and obstructive). EXAMINATION 1. Tonsils may show varying degree of enlargement. Sometimes they meet in the midline (chronic parenchymatous type). 2. There may be yellowish beads of pus on the medial surface of tonsil (chronic follicular type). 3. Tonsils are small but pressure on the anterior pillar expresses frank pus or cheesy material (chronic fibroid type). 4. Flushing of anterior pillars compared to the rest of the pharyngeal mucosa is an important sign of chronic tonsillar infection. 5. Enlargement of jugulodigastric lymph nodes is a reliable sign of chronic tonsillitis. During acute attacks, the nodes enlarge further and become tender.

TREATMENT

1. Conservative treatment consists of attention to general health, diet, treatment of coexistent infection of teeth, nose and sinuses. 2. Tonsillectomy is indicated when tonsils interfere with speech, deglutition and respiration or cause recurrent attacks .

COMPLICATIONS

1. Peritonsillar abscess. 2. Parapharyngeal abscess. 3. Intratonsillar abscess. 4. Tonsilloliths. 5. Tonsillar cyst. 6. Focus of infection in rheumatic fever, acute glomerulonephritis, eye and skin disorders. 4

Tonsilloliths (calculus of the tonsil). It is seen in chronic tonsillitis when its crypt is blocked with retention of debris. Inorganic salts of calcium and magnesium are then deposited leading to formation of a stone. It may gradually enlarge and then ulcerate through the tonsil. Tonsilloliths are seen more often in adults and give rise to local discomfort or foreign body sensation. They are easily diagnosed by palpation or gritty feeling on probing. Treatment is simple removal of the stone or tonsillectomy, if that be indicated for associated sepsis or for the deeply set stone which cannot be removed. Intratonsillar abscess. It is accumulation of pus within the substance of tonsil. It usually follows blocking of the crypt opening in acute follicular tonsillitis. There is marked local pain and dysphagia. Tonsil appears swollen and red. Treatment is administration of antibiotics and drainage of the abscess if required; later tonsillectomy should be performed. Tonsillar cyst. It is due to blockage of a tonsillar crypt and appears as a yellowish swelling over the tonsil. Very often it is symptomless. It can be easily drained 4.

DISEASES OF LINGUAL TONSILS

1. Acute lingual tonsillitis. Acute infection of a lingual tonsil gives rise to unilateral dysphagia and feeling of lump in the throat. On examination with a laryngeal mirror, lingual tonsil may appear enlarged and congested, sometimes studded with follicles like the ones seen in acute follicular tonsillitis. Cervical lymph nodes may be enlarged. Treatment is by antibiotics.
2. Hypertrophy of lingual tonsils. Mostly, it is a compensatory hypertrophy of lymphoid tissue in response to repeated infections in tonsillectomized patients. The two tonsils are almost touching each other causing problems of deglutition, speech and respiration.   complaints are discomfort on swallowing, feeling of lump in the throat, dry cough and thick voice. Mirror examination of the base of tongue will show enlargement of lingual tonsils, sometimes associated with dilated veins over it. Treatment is conservative. Sometimes, diathermy coagulation or excision of lingual tonsils has to be done. These days they are excised by laser surgery.
3. Abscess of lingual tonsil. It is a rare condition but can follow acute lingual tonsillitis. Symptoms are severe unilateral dysphagia, pain in the tongue, excessive salivation and some degree of trismus. Protrusion of the tongue is painful. Jugulodigastric nodes will be enlarged and tender. It is a potentially dangerous condition as laryngeal oedema can easily follow. Diagnosis is made by mirror examination and palpation of the base of tongue. Treatment is by antibiotics, analgesics, proper hydration and incision and drainage of the abscess.4

Materia  Medica Chronicle

• # Persons subjects  to quinsy, take cold  easily,  or  with    every,  even  the   least,  cold   have  an   attack   of  tonsillitis,  prone to suppuration  [Hep. , Psor.  ]Inability  to swallow  anything  but  liquids  [Bap.  ,    ].  Haemorrhoids  protrude  every time he urinates [Mur. ac. ]. Chronic   cough  in psoric  children; enlarged tonsils or  elongated uvula; <.  after slight   cold   [Alum.  ]Swelling     and     indurations,     or  incipient   suppuration    of  glands,  especially  cervical  and inguinal.5

• #Throat Submaxillary glands and tonsils swollen.TAKES COLD EASILY,  WITH  STITCHES AND SMARTING PAIN.QUINSY.SUPPURATING TONSILS  after EVERY COLD.  Tonsils inflamed, with swollen veins.Smarting  pain when swallowing; worse empty swallowing.Sensation  of a  plug  in pharynx.Can only swallow liquids.Spasm of  oesophagus  as  soon  as  food  enters oesophagus, causes  gagging  and  [Merc.  cor.; Graphit.]  Throat problem  from over use of  voice.   Stinging pain in tonsils, pharynx or larynx.6
• #Respiratory Dry, suffocative cough, especially in old people, full of  mucus  but  lacking  strength  to expectorate,  worse  every  change  of     [Senega.]   Larynx  feels as if  smoke  were  inhaled.  Chronic  aphonia.  Stitches in chest; worse  inspiration.   Lungs  feel full of smoke.6
• #Throat Sore throat, with swelling of the palate and of the    which  suppurate. Sensation, as if one had a plug in the  throat.  Suffocation and contraction in the throat. Shootings, and pain as  of  excoriation,  in  the throat, especially during  the  act  of  deglutition.  Spasm  of  oesophagus, can  only  swallow  liquids.  Sensation in oesophagus as if a morsel of food had lodged there.7
• #Respiratory Organs Catarrh, with cough, voice hollow and low, and  fluent    Suffocative  catarrh  and paralysis of the lungs in  old  people.  Sensation of smoke in the larynx. Spasmodic cough (like whooping- cough)  from roughness and tickling in the throat and pit of  the  stomach. Cough worse in the evening till midnight, after  getting  the feet cold, from exercise, when lying on the left side, in the  cold air, from thinking of it. Hoarseness and loss of voice, from  an  accumulation of viscid mucus in the throat and on the  chest,  with  dry  cough,  chiefly at night, in the evening,  or  in  the  morning.7
• #Throat In General Takes cold very easily, and has an inflammation of the throat  in  Dryness  and  severe  painful  sticking  and  pressure,  as  from  swelling,  in the back part of the left side of the throat,  only  when swallowing (after four days). After chilliness and heat, and bruised feeling in all the  limbs,  an  inflammation of the throat, with swelling of the  palate  and  tonsils, which suppurate, and on account of which he cannot  open  the  jaws, neither speak nor swallow, with dark brown  urine  and  loss of sleep (after eighteen days). Choking or constriction in the throat, with arrest of  breathing,  so  that he is obliged to open his clothes during  dinner  (after  twenty six days). Constriction in the throat, with sensation on swallowing as if a plug were in the region of the larynx; worse in the afternoon. Pressive pain in the throat when swallowing. Sticking in the throat (after fourteen days). Sticking pain in the throat on swallowing. Sticking  in the throat, worse when swallowing, with dryness,  in  the evening (after six days). Pain in the throat from taking cold; a sharp stitching pain  when  swallowing (seventh day). Smarting pain in the throat when swallowing, though most on empty  swallowing;  therewith the throat is painful externally  on  both  sides to the touch. Rawness  in  the  throat followed by severe  paroxysms  of  cough  (after one hour). Rawness  and  smarting in the throat after  a  night-sweat,  more  painful  on  empty swallowing than when  swallowing  (soft)  food  (after forty eight hours). The throat is scraped and raw, worse after swallowing (after  two  days). Feeling as if there were much mucus in the throat, and hence much  desire to drink in order to relieve the sensation. A  feeling  as though the throat were swollen internally  in  the  morning, when swallowing, with dryness of the tongue. Attacks  of choking in the throat after dinner, when sitting  and  writing  with  sensation  as if the thyroid  gland  were  pressed  inward,  which  thereby impedes respiration (after  twenty  eight  days). Tickling in the throat, which causes a constant hawking. Pharynx and Tonsils. When  sneezing a sensation in the pharynx as if a piece of  flesh  had become loosened in the upper part of the fauces, with burning  at that spot (after four days). A  feeling in the pharynx following previous scratching, as if  a  plug or a morsel had become lodged there. A  sensation  in  the pharynx as if a fine leaf  lay  before  the  posterior nares, in the morning after waking (second day). Swelling of the left tonsil. Swelling of the submaxillary gland (after thirty nine days).8
• #Respiratory Apparatus Stitches in the air-passages (second day). In the larynx  a feeling as if he inspired  only  smoke  (after  twenty-seven days). Hoarseness (after fourteen days). Hoarseness, or rather loss of voice (for several weeks). Cough after midnight. Suffocative cough. Cough excited by continued speaking (after thirty five days). Dry cough in the morning after rising, followed by a sensation as if a hard body were falling down in the chest (twentieth day). Dry short cough in the evening. Dry cough for three days, caused by a tickling in the bronchi and  in  the  precordial  region, which is  relieved  only  at  night,  sometimes also after dinner. Violent dry cough in the evening, followed by weakness  in  the  Cough with expectoration of mucus. Cough from an incessant irritation, with mucous expectoration. A loose cough, with salty, starch like expectoration, having lasted four weeks, disappears (curative action). Arrest of breathing, either in coughing or not (ninth day).8
• #Throat Scabs behind uvula and posterior nares. Sensation in  pharynx  as if a fine leaf  lay  before  posterior  nares; morning, after waking. Morning: viscid phlegm in fauces. Tonsillit is. Inflammation of cellular membranes of fauces and  tonsils,  with  fever; difficulty  swallowing and speaking. Quinsy.  Throat  is  pale  instead  of  having  bright  redness  of  Bell;  submaxillary  parotid  glands are swollen and tender;  breath  is  putrid; child scrofulous and dwarfish. Scarlatina. Diphtheritis. Stitches in right tonsil. Inflamed and enlarged tonsils.  Tonsils inflamed,  with smallpox or  scarlatina,  especially  if   and Bell. prove insufficient. Acute tonsillitis.  Suppurating tonsils. Sore  throat  and  swollen tonsils, with  ptyalism;  gave  speedy  relief when symptoms went from right to left. Angina tonsillaris. Swelling of parotids, tonsils and submaxillary glands, with  much  saliva. Disease in throat. Skin diseases. Liability to tonsillitis; after every slight cold, or  suppressed  foot sweat.  Disposition to acute tonsillitis, with suppuration.  Chronic angina, with great disposition to return. Chronic induration of tonsils; sensation as of a plug in  throat;  agg. after swallowing solids.  Tonsils tend to suppurate, especially right; palate swollen; dark  brown urine; sleeplessness.  Tonsils  both  hypertrophic  and indurated,  livid  and  full  of  varicose veins. Angina after taking cold, even phlegmonous. Worse when swallowing food or saliva. On swallowing, sensation as if food had to force itself  over  a  sore spot. Sensation in oesophagus as if a morsel of food had lodged there. Smarting  in throat when swallowing; agg. from empty  swallowing;  throat sore to touch.  Stinging when swallowing saliva and during empty deglutition. Pressing, stinging pain on swallowing; Skin disease. Attacks  of  choking  in throat after  dinner,  when  sitting  and  writing, with a sensation as if thyroid was pressed in;  impeding breathing. Unable  to swallow; liquids taken in mouth were  ejected  through  nostrils. Quinsy. Inability to swallow anything but liquids. Spasmodic stricture of oesophagus. Constant difficulty  in  swallowing; agg. after much  talking.  Tonsillitis. Oesophageal spasm, in old people; can only swallow liquids.9
• #Voice and Larynx, Trachea and Bronchia Feeling in larynx as if inspiring smoke or pitch. Hoarseness  and loss  of voice from tough mucus  in  larynx  and  Voice imperfect, aphonia; from tough mucus in fauces and larynx.  Old people. Voice husky, rough. Tonsillitis. Voice extinct. Hoarseness, with night coughs. Catarrh of trachea. Spasmodic cough (like whooping cough) from roughness and tickling in throat and pit of stomach.9

 The study are focused on  the throat  disorder mainly occurred often or in recurrent manner    in the form of  coryza, nasal discharge and obstruction, sneezing and cough,  hoarse or lost voice ,ear pain , throat pain, malaise,    are other   and  Continues observation of drug action on more than four years  found on the  93 case (state pt J L N Homoeopathy medical college and hospital kanpur) details are given in table 01  .

 Table 01

TOTEL CASE

93

MALE

53

FEMALE

40

 Table 02

Age group distribution in Years
Up to 10	11-20	21-30	31-40	41-50	51 & above
28	12	13	13	11	16

 Discussion

1. The keys note prescribing of Baryta Carbonica is miss guide its clinical use and depth of its treatment. When approach its holistic sphere of action then we find its effect on the many common to till serious disorder of the respiratory as well as digestive and urogenital  system in the all age groups.
2. In throat disorder Baryta carb need the frequent use for some duration e. one or two time daily for minimum five to seven  day or more .
3. Commonly it is seen that 30c is effective in the child case and 200c in the adults, 8-10 drops in liquid forms or  6-8 pills of 40 no each dose .
4. If the body pain, malaise and fever are associated with throat disorder then association of Belladonna, Ferrum phos , Hepersul or Arnica  having major role for rapid recovery of the mention disorder
5. The action of baryta carbonicum  on throat start from onset of pain ,tingling , feel of dryness  till the fever with suppuration of tonsils along  with enlargement of  cervical lymph node and effectiveness of this remedy found   in all stage with   variation of duration .
6. Many time it proved effective in the abdomen pain of kids with enlarged mesenteric gland and in the old person in the prostate inflammation in the  1^st to 2^nd grade of enlargement , in the mentioned  cases the regular administration of remedy is needed up to three weeks or more as per response occurred.
7. The medicine shows its effect on the disorder nose and ear when its origin with association of throat  due to cold exposure  .
8. Most commonly its application starts from the onset of the winter season or when person expose in the chilling gadgets frequently in the summer season.
9. Use of Baryta car at the stage of thin discharge(early/viral  ) it prevent the stage of thick (secondary infection )discharge
10. This medicine use both type case i.e. acute and chronic . in the acute case it work as the preventive medicine for inhibition for secondary infection and in the chronic case it is work as curative  treatment for remove the infective agent .

Conclusion   –   Baryta carb is the well stabilised homoeopathy medicine for the treatment of tonsils disorder  in the acute as well chronic case  for the child stage as per recommendation of the different materia medica ,  during observation this is found that it is most effective in the throat disorder of  all age group with the change  of the environmental temperature or surrounding atmosphere temperature towards the cold , and it remove the all complain of the ear nose and face which associated with the throat disorder associated with cold .

Reference

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Dr Puneet Kumar Misra
Lecturer(Practice of Medicine) Govt L B S H M C  Prayagraj