Acute tonsillitis is a non-specific acute inflammation of the palatine tonsils, often accompanied by some degree of acute inflammation of the pharyngeal mucosa and pharyngeal lymphatic tissue. In Chinese medicine, it is called “milk moth”, “throat moth” or “lotus moth”. It often occurs in children and adolescents. Etiology: The main causative agents are Streptococcus hemolyticus B, Staphylococcus, and Diplococcus pneumoniae. Adenovirus can also cause this disease. Mixed bacterial and viral infections are also common. Bacteria may be invaded from outside or hidden in the tonsillar fossa. When the body’s resistance is suddenly lowered due to cold, humidity, overwork, weakness, excessive smoking and alcohol, and stimulation by harmful gases, the bacteria multiply and strengthen. Sometimes it is a precursor to acute infectious diseases, such as measles and scarlet fever. Acute tonsillitis is often a recurrent acute attack on the basis of chronic tonsils. Clinical manifestations: Although the clinical manifestations are divided into three types, such as catarrhal, cryptic and follicular tonsillitis, depending on their pathological changes, they can be divided into acute congestive tonsillitis and acute purulent tonsillitis for diagnosis and treatment purposes. (a) Systemic symptoms: rapid onset, chills, high fever, up to 39-40℃, especially in young children, convulsions, vomiting or lethargy, loss of appetite, constipation, and generalized soreness due to high fever. (2) Local symptoms: Sore throat is obvious, especially when swallowing, and it can be radiated to the ear if it is severe, and children often cry because they cannot swallow. If children’s breathing is affected by tonsillar hypertrophy, it may prevent them from sleeping, and they often wake up at night. (c) Examination: In acute cases, the cheeks are red, the mouth smells foul, the tongue is covered with thick moss, and the lymph nodes in the neck, especially those at the angle of the jaw, are often enlarged and painful to the touch. There is a marked increase in white blood cells. Different types of tonsillitis with different manifestations can be seen according to local examination. Acute congestive tonsillitis, also known as acute catarrhal tonsillitis, is characterized by congestion and swelling of the tonsils, with no purulent surface discharge. Acute purulent tonsillitis includes acute crypt tonsillitis and acute follicular tonsillitis, which manifests as obvious congestion of the tonsils and palatal arch and enlargement of the tonsils; the crypt type shows yellow-white pus spots at the mouth of the crypt, and sometimes the exudate can fuse into a membrane that does not extend beyond the tonsils and can be easily swabbed away without leaving a bleeding wound; the follicular type mainly manifests as congestion, swelling, and purulence of the lymphatic follicles of the tonsil parenchyma, and the tonsils Diagnosis and differential diagnosis: Acute tonsillitis generally has typical clinical manifestations, so it is not difficult to diagnose. Routine blood and urine tests, platelet count, pharyngeal swab smear and bacterial culture are important for differential diagnosis with other diseases. It should be distinguished from pharyngeal diphtheria, scarlet fever, epidemic hemorrhagic fever, ulcerative membrane pharyngitis, mononuclear leukocytosis, granulocytic leukodystrophy and lymphoid leukemia. Complications (a) Local complications: Inflammation may spread to the periphery and cause peri-tonsillar cellulitis, peri-tonsillar abscess, acute otitis media, acute cervical lymphadenitis and parapharyngeal abscess, etc. (b) Systemic complications: Most of them are thought to be caused by metaplasia, and can be complicated by rheumatic fever associated with Streptococcus haemolyticus infection, acute angioglobulomatous nephritis, myocarditis, arthritis, etc. Special attention should be paid to the sudden death of patients with myocarditis. Treatment: Take care of rest, drink more water, pass stools, eat liquid or soft food, relieve pain and reduce fever, take sulfonamide or antibiotics to control infection. Anyone with malignant cold, high fever, floating pulse and no sweating can use Gan and Orange soup (licorice, orris, Yinhua, Mab) or Ma Heng Shi Gan soup. For those with high fever, no vicious cold, dry mouth, dry tongue, and floating pulse, use Ganluo Drink (asparagus, maitong, raw earth, dendrobium, poria, Kaiqiao leaf, Yin Chen, licorice, Shu Di, heliotrope).