Tonsils and adenoids provide a first defence against atmospheric pollution and infection entering the body through the mouth and nose. They also filter poisons in the bloodstream and those draining from the nose and sinuses. When they become swollen, inflamed and painful during an infection, they are responding to an increased demand for their cleansing work in an attempt to throw it off. The tonsils in so doing are fulfilling their protective role by inhibiting the spread of infection further into the body. For this reason the surgical removal of the tonsils should only be a last resort.

Tonsillitis can be both acute and chronic. Acute tonsillitis flares up in response to a viral or a bacterial infection, and tends to occur when there is low vital energy, excess toxins in the body and catarrhal congestion. It frequently heralds or accompanies a cold or flu virus, laryngitis or mumps. When bacterial, the onset is sudden with a severe sore throat and swollen neck glands, often with a fever, but with no or few other upper respiratory symptoms. The streptococcal bacterium involved can, in rare cases, affect the kidneys (causing nephritis) or the heart (in rheumatic fever). This means that the first signs of bacterial infections require prompt action.

Treatment of tonsillitis

At the first signs of infection, hot infusions can be given, and there are several different herbs that could be applicable:

• Antimicrobial herbs to support the work of the immune system: echinacea, garlic, self-heal {prunella vulgaris), wild indigo (Baptisia tinctoria), cat’s claw (Uncaria tormentosa), burdock, turmeric, golden seal (Hydrastis canadensis) and ginger.

• Depurative herbs to enhance the work of the lymphatic tissue in its cleansing work: cleavers (Galium aparine), self-heal, marigold and blue flag (Iris versicolor).

• Diaphoretic herbs to induce sweating and reduce fever if necessary: chamomile, catnip (Nepeta cataria), peppermint, elderflowers, limeflowers (Tilia europaea) and yarrow.

• Tannin rich herbs to astringe the mucosa and reduce accompanying catarrh and inflammation: agrimony (Agrimonia eupatoria), chamomile, elderflowers, ground ivy (Nepeta hederacea), plantain, thyme, marigold, blackberry (Rubus fructicosus) and raspberry (Rubus idaeus) leaves.

• Demulcent herbs to soothe and relieve painful tonsils: coltsfoot (Tussilago farfara), comfrey leaf (Symphytum off.), marshmallow (Althea off.), liquorice and mullein.

A useful recipe and one that I use frequently for children with tonsillitis, is equal parts of cleavers (Galium aparine), echinacea, ground ivy (Nepeta hederacea), plantain and thyme as an infusion with a teaspoon of thyme honey. Give one cupful 3-6 times daily.

Propolis is also an effective remedy (active against 46 strains of Streptococcus pyogenes) and can be combined with these herbs.

Local applications

Gargles or throat sprays can be made using pure lemon juice, herbal infusions or a teaspoon of tincture diluted in warm water of chamomile, turmeric, myrrh (Commiphora molmol), golden seal (Hydrastis canadensis), sage (Salvia off.) or thyme. These can be used every 2 hours if the throat is very painful; otherwise three times a day.

Inhalations using essential oils of chamomile, lemon, pine, eucalyptus, lavender or thyme can be helpful. The same oils can be used in vaporizers, diluted in sesame oil for massages or added to water for compresses applied to the throat and neck.

Dietary treatment

Follow treatment for fevers. Children should avoid dairy produce, sugar, grains and animal produce for a week and have plenty to drink. Hot lemon and honey, honey and cider vinegar, herbal teas, ginger juice or carrot and apple juice, elderberry juice, blackcurrant tea or juice (unsweetened) are all helpful during infection to enhance immunity, and to relieve the sore throat and catarrh. They can be continued for a few days after the acute symptoms are gone as they increase resistance to further infection.

Supplements of a teaspoon of cod liver oil daily, 100 mg natural vitamin C tablets every 2-3 hours and one or two garlic capsules every 2 hours can be given until the child is well again.

Ayurvedic approach

In Ayurveda tonsillitis is known as tundikeri and is said to be precipitated often by constipation.

• Hot fomentations applied to the area are recommended and the tonsil area kept warm.

• Decoction of Babula bark (Acacia arabica) with rock salt can be used as a gargle.

• Fenugreek (Trigonella foenum-graecum) leaves or seeds, and tamarind leaves (Tamarindus indica) can also be used for making gargles. Fenugreek contains soothing mucilage and essential oils with analgesic properties. Tamarind leaves also have a demulcent action and antimicrobial properties.

• Liquorice, Alpinia galanga (kulanjana), and calamus root powder combined together with honey to form a paste are used as a “lick” for children to soothe infection and inflammation.

Acacia catechu is given internally in pills (Khadiradi vati) to be sucked 2-3 a day.

• A handful of fresh rose petals boiled in a cupful of water, strained and sweetened with honey can be sipped warm as tea to relieve the pain.

Chronic tonsillitis

It is important to establish the background causes of chronic tonsillitis before embarking on treatment, so that these are properly addressed. Chronically inflamed or pus-filled tonsils may not be able to continue efficiently with their cleansing work and as a result a child can be run down and prone to other illnesses. It is possible that the tonsils are being overworked by toxins draining from elsewhere, such as chronic catarrh in the sinuses or ears, or by allergic response, possibly to milk produce. The child may be depleted from, for example, poor diet, digestive problems, sluggish bowels and pollution in the atmosphere, particularly passive smoking. Chronic tonsillitis can also be related to frequent use of antibiotics for treatment of acute bouts. There may also be emotional factors involved – the throat area is related to the voice and its use in the expression of emotions and communication. If there are unexpressed or suppressed emotions, such as anger, grief, unhappi-ness or frustration, these could cause problems involving the throat.

Treatment of chronic tonsillitis

• As in the treatment of acute tonsillitis, herbs for the immune system, such as neem, elderberry juice, turmeric, thyme, echinacea and garlic, can be combined with remedies to support the lymphatic system, such as cleavers (Galium aparine), red clover (Trifolium pratense) or marigold and herbs to astringe the mucous membranes such as raspberry leaves (Rubus idaeus), ground ivy (Nepeta hederacea), thyme, self-heal (Prunella vulgaris) or plantain.

• In addition, extra herbs, such as blue flag (Iris versicolor), burdock, celery seed (Apium graveolens), marigold, and nettles need to be used to help the body eliminate toxins.

• Gargles or throat sprays using sage (Salvia off.) and thyme can be used morning and night, myrrh (Commiphora molmol), propolis and turmeric are also suitable.

• Regular massages or compresses, applied to the throat area, can be given, using strong infusions of the herbs used for teas or from essential oils of rosewood or thyme in a base of sesame oil.

• The diet should be light and easy to digest with plenty of fresh fruit and vegetables, seeds and unrefined oils. Milk produce should be avoided altogether, preferably for a few months, as long as plenty of other calcium-containing foods are included in the diet. Sugar, refined carbohydrates and red meats should be kept to a minimum.

• Supplements of vitamin C, 500 mg daily, a teaspoon of cod liver oil, and garlic capsules, two twice daily, can be given until the problem is resolved.

• The child will need plenty of nurturing, rest and sleep, regular gentle exercise and fresh air.

• Grapefruit seed extract and probiotics are useful after antibiotics for acute bouts of tonsillitis.

In Ayurveda the herb of choice for chronic tonsillitis is agastya (Sebenia grandiflora) ½ tsp of the powdered lead / bark is used with honey twice daily over a period of 6 months.