As this frequent affection is divided into several species, each of which requires a particular treatment, it will be necessary to state the symptoms, by which they may be distinguished from each other.
The first is the common sore-throat, where the glands, or tonsils, situated at the posterior part of the mouth, appear swollen, red, and painful; the deglutition and respiration are difficult; it occurs in the spring and autumn, when the air is moist, and chiefly attacks the middle-aged, and those of plethoric habits. The event is generally favourable, either by resolution, or suppuration.
The second is an inflammation of the throat, at the posterior part of which a redness, though no swelling, is discernible ; the pain is more violent than in the former deglutition more difficult ; respira-tion is, however, easier, but accompanied with cough and hoarseness. It likewise terminates in a few days, and in general, without danger.
The third, or malignant sore-throat, affects the tonsils and throat with swelling, redness, and mucous crusts of a whitish or ash-colour, which cover the ulcers : it is attended with a putrid lever, the greater or less violence of which determines the degree of" apprehension for the life of the patient. -This malady originates in a contagion of the air, similar to the small-pox, and other epidemic diseases.
The fourth is an inflammation of the windpipe, when the breathing is difficult; the inspirations are loud ; the voice is hoarse with a cough, but scarcely any visible swelling in the throat; deglutition easy ; and the fever is extremely violent. This disorder frequently attacks children, from the time of weaning till the twelfth year of their age, with this peculiar circumstance, that the inside of the windpipe is lined with a substance, which is apt to obstruct the passage of the air, and thus often proves fatal by sudden suffocation, unless timely relief be procured. — See Croup.—A favourable issue, however, may be expected, if an expectoration of a yellow matter streaked with blood, or even a swelling on the side of the neck appear; which last symptom indicates, that the disease will terminate externally.
The two first species require a cooling diet, and diluent drink; such as barley-water with currant-jelly, linseed-tea with honey, etc. A large blister applied to the chest,. or between the. shoulders; and gargles of sage-tea, honey and vinegar, aided by bathing the feet in warm water, will generally be sufficient to procure. .relief. But, if the swelling continue to increase, leeches should be applied to the outside of the neck ; and recourse must be had to other means, in order to promote a suppuration : this may be effected by fumigating the throat through a funnel placed over a vessel of hot-water, into which should be thrown some camphor reduced to a coarse powder. After After the disease is removed, care should be taken to avoid a re-lapse, by keeping the neck warm ; though too anxious measures, and cravats too heating, would doubtless lead to the opposite extreme.
The cure of the ulcerated sore-throat, depending chiefly on the nature of the fever with which it is attended, requires the aid of a professional man : we shall, therefore, here only point out the regimen to be observed during its course. The diet ought to consist of sago, tapioca, panada with a proper quantity of wine, ripe sub-acid fruit, such as prunes, currants, raspberry-jelly, etc. Negus, perry, cyder, etc. may be allowed for drink; but the. patient should always previously use the gargle above directed. His posture in bed ought to be such, that the discharge from the mouth may be facilitated, and the greatest attention must be paid to clean linen and pure air.
In the fourth species of quinsy, blood-letting is the principal remedy; hence, from three to six leeches should be immediately applied to each side of the neck, and a blister to the front ; at the same time administering a brisk emetic, to dislodge the membrane which is forming; and by the removal of which, the inflammation often speedily disappears.—In this complaint, the patient should be suffered to sleep as little as possible ; for no circumstance has a stronger teudeucy tendency to aggravate the disease. At all events, medical advice ought not to be neglected.