Common sore throat is so well known that there is no use in wasting space in describing the symptoms; as on looking into the mouth and throat they are plainly seen: a red, inflamed surface, and usually great swelling of the tonsils; frequently so great that the patient has great difficulty in swallowing. In severe cases, when the inflammation is intense, and involves the root of the tongue, the patient is sometimes unable to open his mouth sufficiently to allow the throat to be seen; and the inflamed parts can only be examined by means of the finger, and occasionally the power of separating the jaws is so limited that even the finger cannot be passed between the teeth.

In ordinary cases, however severe the disease may be, there is scarcely any difficulty of breathing; but the throat is so blocked up that the speech is altered, becoming thick, guttural, and inarticulate. When the swelling of the tonsils is very great, the breathing does sometimes become impeded; and it is almost alone in such cases that the disease is at all alarming.

Quinsy is usually accompanied by considerable fever, severe headache, and a quick pulse.

Under proper treatment, the complaint will generally subside after a few days, but when neglected at the commencement, or where the inflammatory symptoms run high, the tonsils are very apt to gather and break, discharging a quantity of matter of a nauseous taste, and very unpleasant smell. As soon as the abscess bursts the pain ceases, and the patient is able to swallow, and usually soon recovers his usual health.

When the mucous secretion increases in quantity, and becomes thinner, while the difficulty of swallowing diminishes, and the fever lessens, we may hope for recovery without an abscess; when, on the contrary, the inflammation is severe, the tonsils much swelled, so much so as to obstruct the breathing, when a throbbing pain is felt, shooting to the ear; when the patient can scarcely open his mouth, or move his tongue, or turn his head; when there is more than usual outward swelling, and when the symptoms increase or even do not diminish in five or six days, we may expect a termination in suppuration. Shiverings frequently announce this result.

Some individuals appear to have, by nature, a strong predisposition to the disease; and in them its attacks are more or less periodical; returning at particular seasons, and commonly during changeable weather in spring and autumn. This predisposition sometimes runs in families. The liability to the disease is also very much increased by repetitions of its attacks.

The usual, indeed almost the only cause, is exposure to cold. Occasionally it prevails as an epidemic, but is not contagious.

Treatment

If taken at-the very commencement, as. soon as there is a slight feeling of pain and uneasiness in the throat, the disease may be sometimes quickly checked, by putting the feet and legs in hot water, then wrapping them up warm and sitting by the fire, and constantly allowing little lumps of ice to melt on the back of the tongue and trickle down the throat; and by continuing this for some hours, the inflammation may be subdued before it has made much progress. When the tonsils have commenced to swell, a couple of leeches applied to each side of the throat, beneath the angle of the jaw, will frequently reduce the inflammation; the patient should take a brisk purgative of Epsom Salts, or a Seidlitz Powder; after that has operated, let him put his feet and legs in hot water, wrapping them up warmly afterwards, and carefully avoiding getting fresh cold. He may apply a warm poultice to the throat after the leeches, or tie a piece of flannel round it.

The following mixture may be taken:

Carbonate of Potash..............................3 Drams.

Citric Acid...........................................2 Drams.

Sweet Spirit of Nitre.............................6 Drams.

Compound Tincture of Cardamoms...........Half an Ounce.

A tablespoonful to be taken every three or tour hours.

The throat may be gargled occasionally with a gargle made of

Nitre.........................................Half an Ounce.

Infusion of Roses or Mint Tea.........One Pint.

Or if he can get them the patient may suck occasionally a Nitre Lozenge.

The diet must bo of a soft and cooling nature; Oatmeal Gruel, Corn Starch, Sago, Rice, etc.

When it is certain that the inflamed tonsil will gather and break, it may be assisted by holding warm water in the mouth, or by inhaling steam from hot water.

In very rare cases, where the tonsils ulcerated, the patient has lost his life either by suffocating through the matter blocking up the windpipe or the bronchial tubes, or through the bursting of a blood-vessel.

Repeated attacks of Quinsy will sometimes produce a chronic enlargement of the Tonsils: while they are in this state the surface is generally irregular and notched, something like that of a walnut shell, and a white or yellow secretion is often seen lying in the hollows, which might be mistaken for ulceration. While in this state they are easily re-excited into a low state of inflammation. This chronic enlargement is sometimes productive of great inconvenience, and even sometimes of danger. There is trouble in swallowing; confused and inarticulate speech; frequently partial deafness; more or less impediment to breathing; and even sometimes danger of suffocation.

These may be reduced by the frequent application of Tannic Acid, or Iodine Liniment, or by touching them occasionally with caustic; or they may be removed by amputation; either by passing a ligature round them, or by cutting them off with scissors, or with an instrument invented for that express purpose.