I'm loving the news this week. Just like they said but a few months ago about ear infections, the NHS declares today "No more antibiotics or lozenges for throat infections!... If you've got a tonsillitis, like 80% of cases we see, it's probably viral" they say. "Just take paracetamol or ibuprofen instead." Oh, Ok then. Every heard of quinsy?
For those not acquainted with this fruity ancient medical term, 'quinsy' refers to the kind of bacterial tonsillitis that is so bad it was like the C word back in the day. No one dared mention it. It's so gruesome that your tonsils keep swelling until they're French kissing and you're in danger of choking or sepsis, or both. I've seen it first hand. Please ref Patient A below. (Nervous readers please now look away).
It's not pretty, and it's pretty dangerous. Life threatening in fact, if you leave it for 10 days or so. You laugh, who would leave a sore throat that bad for 10 days before seeking medical help?
Well I'm guessing you might, if you'd been told by the NHS that your sore throat is 'probably' viral and that viruses take 7-10 days to to say hello, make you miserable and then wave goodbye again. The few hypochondriacs amongst us won't be able to sit it out, but us Brits are mostly a stoic lot and do what we're told, and if Nursie NHS has told us to stop making such a fuss about our silly sore throat, then we'll put up and shut up until, well, it's potentially a very serious to do indeed.
The point I am making is that not all sore throats are born equal and isn't it a doctor's job to let us know the difference? I cannot work out whether the latest NHS directive is to reduce the amount of visits to the GP or just the amount of antibiotics prescribed needlessly. It might be about both, but either way, A&E quinsy admissions might just be about to go through the roof.
This grave concern aside, would you like to know what happened to Patient A above and her kissing tonsils with fabulously coated tongue? She came to see me last year after her local doctor had advised a good gargle with salt water, and yes, some paracetamol (a GP obviously ahead of the times).
By day five her fever of 102F was rising and her voice was so husky and faint that I thought she must have been moonlighting from her bus conductor day job as some late night jazz club crooner. She perhaps should have gone back to her doctor but her lack of telephone voice, the dizzying sweats, and a large waiting list for appointments meant she was too weak to try. A friend recommended her to try the homeopath round the corner. You might suggest that was irresponsible but it was either me or the four hour triage wait at A & E and this lady was a working single mum.
It wasn't an easy case, that much I can tell you. I ran through all the usual remedies for uber bad tonsillitis - Lycopodium, Merc Viv, Lac-c, Silica, Belladonna, all the while with the threat of a sepsis timebomb ticking in my head.
And then I turned to a lovely little old out of print book called 'The Patient Not the Cure' by a hospital ward doctor turned homeopath called Dr Margery Blackie who worked for years at our beloved and now seriously endangered NHS London Homeopathic Hospital and who was employed by our current queen HRH Elizabeth as the first homeopath to the Royal family from 1968 onwards. That and 'Magic of the Minimum Dose' which recounts the many cured cases of another doctor turned homeopath Dr Dorothy Shepherd during her years tending the slums of London in the 1940s, guided me in nicely to a remedy called Merc-i-f (Mercurius Iodatus Flavus).
A couple of doses of Merc-i-f later and Patient A was fever free and more importantly her tonsils had split up and were definitely no longer on kissing terms. A good night's sleep, another dose of the Mercury compound and she was eating well and even singing in the bath. She went back to work 24 hours later.
I expect I'll be seeing quite a few more Patient A's in the coming months. Bring it on.