§ 202. Parotitis, Angina parotidea.

Parotitis is generally preceded by a precursory stage; the patient feels languid, low-spirited, complains of pains in the limbs, sleeplessness, restlessness, loss of appetite, chills alternating with heat, drawing: in the cervical muscles, headache, coryza, etc. In a few days the parotid glands begin to swell, after which the submaxillary and sublingual glands become involved. If the lymphatic glands of the neck should become involved, the neck grows as large as the head, and becomes quite stiff. The affected parts are hard and painful, but the pain is, generally speaking, slight, tensive, itching, aching. The motion of the jaws, mastication and deglutition, are impeded. The fever generally abates when the parotis commences to swell.

The precursory symptoms vary in violence; the fever may be slight or violent, attended with delirium, convulsions, vomiting, etc.; it has distinct intermissions and exacerbations. The swelling generally appears on one side first, and then shifts to the other; it is not very tight, the skin over it is not very red; there is not much heat in the swelling; sometimes it is attended with pain about the neck and scapulae, or with pain in the ears. There are cases where the swelling disappears suddenly, and shifts to the testes, breasts, labia pudendi, ovaria, or to the meningeal membranes. Suppuration occurs very seldom, and then only when the inflammation had a phlegmonous character, or in parotitis typhosa or scarlatinosa. The termination in induration is likewise very rare. If the physician be called in time, and adopt proper measures, the disease generally ends favorably, except in very scrofulous subjects and in persons who have been frequently attacked with the disease.

§ 203. The disease appears both epidemically and endemically. Persons -of either sex are liable to it. particularly at the age of pubescence.

§ 204. The principal remedies are Rhus t. and Merc. sol. H. The latter may be used in any stage of the disease, even when suppuration has already set in. When the disease is characterized by erysipelatous redness and swelling, Bellad. should be given. When typhoid symptoms set in, Bellad. and Rhus. t. are indicated, (see § 75, etc.) Some physicians recommend Kali carb., when chilliness and heat alternate, the glands are highly inflamed, hard, painful to contact, and the hearing is diminished. If parotitis should set in, in conjunction with angina faucium, the remedies which have been indicated for the latter disease should be used. If lock-jaw should take place, Rhus. t., Hyoscyrnn., Bryon., and electricity will remove it, particularly when the closing of the jaws arises from the swelling or the. subsequent induration of the glands. Conium, Dalc, China, Bellad., Cocc, Ferr., Baryt. acet. or carb., Silicea, are likewise suitable for that condition.