It is not, we have said, difficult to distinguish the inflammatory sore throat, when we reflect that it consists in a difficulty of swallowing, with fever, and a florid redness of the fauces. Scirrhi, spasms, tumours, and venereal swellings, can never be mistaken for this disease; for though there is often an attending redness, yet it is not of the florid kind, nor is inflammatory fever present. The inflammation sometimes affects the muscles of the larynx, and is in some cases dangerous; yet the easy access that may be obtained to the neighbourhood of the diseased parts, gives us a power of relieving quickly. The greatest danger arises from gangrene, and suffocation from the swelling of the parts, particularly the tonsils. In common sore throat, however, gangrene is a very unusual consequence; and we have more often seen an inflammatory cynanche arise from the active stimulants employed in the malignant species, than gangrene from the present disease. When the tonsils suppurate, the previous swelling often threatens suffocation; and it has been thought necessary to open a passage for the access of the air to the lungs through the rings of the trachea; see Bronchotomy. We have seen this more than once employed with success, but it has never appeared necessary in our practice. Active gargles to hasten the maturation, bathing the feet often in warm water, or inhaling warm vapours from the mouth of a funnel, sometimes with the addition of camphor, have generally ripened the abscess without danger. If the symptoms are more urgent, the swelled tonsil may be punctured with the point of a scalpel.

The treatment of inflammatory angina is not very difficult. When it is ascertained to be the true cy-nanche tonsillaris - and for the distinction of the greatest importance we must refer to a following article where we treat of the malignant kind - every part of the antiphlogistic regimen should be employed in all its rigour. Diluting liquors, abstinence from animal food, and even animal broths, and cooling purgatives, are highly proper. Gargles should be almost incessantly employed, and a great error prevails in using gargles occasionally only. Two or three times a day will indeed be sufficiently often; but they should never be employed for a less period than from an hour to an hour and a half. The syringe is chiefly useful in children, and in the malignant kind. Bleeding is seldom necessary, except when the swelling of the fauces is rapid and considerable, in healthy strong constitutions: it should then be actively employed, and not less than sixteen or eighteen ounces taken at once, and repeated after eight or ten hours. Such an emergency will, however, seldom occur: it has not at least occurred to us in a practice of above thirty years. Topical bleeding with leeches is sometimes employed, but seldom necessary; and this remedy is inconvenient, as it is difficult to stop the blood, when there is no bone against which a pressure can be made. As a purgative the salts perhaps with senna are preferable.

Vomiting early is often highly beneficial; and even in a more advanced state, if it can be practised without much pain, it is particularly advantageous, from the discharge it procures from the affected glands. We have heard of its being employed to burst an abscess formed on the tonsils; but it is, undoubtedly, at this period, precarious, if not highly dangerous.

Blistering is a remedy of peculiar importance. The plaster has been applied to the back or to the throat. Where the muscles of the trachea are greatly affected, the latter may be proper; and the former is, in no instance, improper The most useful application of blisters is, however, from behind the ear, extending under the lower jaw to the trachea. The ammonia, either in its mild or pure state, joined with oil, and mustard cataplasms have, at times, supplied the place of blisters; and, when the external fauces have been very sore, a common poultice is an useful application. We have not found the addition of camphor either to the liniments or poultices useful.

The kinds of gargle have occasioned some little discussion. In the early stages they have been emollient and discutient; in the latter astringent and antiseptic. A pint of barley water, with two drams of crude sal ammoniac, is a gargle of the former kind. We have not found a cold gargle of water with a portion of brandy recommended; and it has never before occurred to us, but we think it merits a trial. Acids have been reprobated in the early stages: but the disadvantages enumerated are those of the mineral acids. The acetous is, at any period, useful; and the sharper it can be borne, without pain, the more useful. This kind of gargle generally consists of an infusion of baum or sage, with a portion of honey, sharpened with vinegar to such a degree as the inflamed fauces can bear. The raspberry vinegar however, alone, swallowed slowly, is perhaps equally efficacious with any gargle; and, as it is pleasant, it will be more steadily pursued than a less agreeable medicine. In the same way, a small bit of crude sal ammoniac, or of salt prunella, held in the mouth till it gradually dissolves, has been highly useful. Figs, as they are supposed to have a peculiar efficacy in ripening abscesses, have been often used in decoctions employed for gargles. The addition of squills to the gargle, as recommended by Dr. Fordyce, is seldom of peculiar service.

The mineral acids and astringent gargles are scarcely in any instance required in inflammatory angina, though recommended in the more advanced stages. They are of great service in those inflammations which arise from relaxation; and when angina often recurs, the inflammation is of a less active kind. Decoctions of the oak bark with the vitriolic or muriatic acid, are more effectual than any form of the Peruvian bark. The myrrh we have never found necessary or useful.

Gangrene, we have said, scarcely ever follows inflammation of the throat; and scirrhi of the tonsils, though mentioned as a consequence, are certainly rare. The tonsils we have seen often scirrhous, but never cancerous; and they have remained in the scirrhous state through a long life.