Mumps usually begins with a feeling of stiffness about the joint of the jaws, which is followed by pain, heat and swelling beneath the ear, but with little or no redness of the skin. The swelling rapidly extends in all directions, sometimes considerably down the neck.

The skin is somewhat tense, but the tumour is not very hard or elastic. When the swelling is at its height, there is often great difficulty in opening the mouth, and sometimes swallowing is painful; though the latter symptom is occasionally quite wanting. There is generally more or less fever, but seldom sufficient to confine the patient. Sometimes, however, it is very high, with a furred or dry tongue, loss of appetite, heat of skin, and even some delirium. The inflammation usually reaches its height in two days, continues about the same for two days longer, and then gradually subsides; disappearing altogether in about a week. The gland very seldom suppurates, (gathers and breaks.) When it does occur the suppuration is usually superficial. Sometimes only the gland on one side of the throat is affected, but more generally both, either at the same time, or one after the other. Not unfrequently-generally from careless exposure to cold-the inflammation of the glands suddenly subsides, and the testicle of the male or the breast of the female, becomes painful and swollen. Generally the new inflammation subsides in three or four days, without showing any inclination to suppurate. The chief danger in mumps is the risk of the shifting of the inflammation from the glands to the brain; this happens occasionally, and sometimes ends in death. In some rare instances, after the inflammation has left the glands of the neck, alarming constitutional disturbance with prostration sets in, which generally subsides when the inflammation is established in its new locality. Contagion is supposed to be a frequent cause of mumps. Like most contagious disorders, it seldom attacks the same individual more than once. Sometimes, however, it does so; many escape it altogether.

Treatment

Avoid exposure to cold. Keep the throat and neck well covered and warm with a piece of warm flannel, which should be worn constantly. The patient should keep in-doors, particularly if the weather is cool. A dose or two of some cathartic; salts and senna, cathartic No. 3, or senna tea; may be taken once a day. The diet should consist of oatmeal gruel, bread puddings, rice puddings, sago, mush, or arrow-root, with a little chicken broth. Should the inflammation shift from the neck to the breast or the testicle, the latter should be bathed frequently with hot water, and at the same time a warm poultice of linseed meal or bread should be applied to the throat, and changed as often as it gets cool. Should there be much fever, the patient may take small doses of antimonial wine and sweet spirits of nitre three or four times a day; for a patient fifteen years old, twenty drops of antimonial wine and twenty drops of sweet spirits of nitre, in a little gruel, for a dose. Or she may take the febrifuge mixture, No. 9.