■260 HEALTH AND DISEASE 



ment extending from below the ear downwards towards the throat. The 

 swelling is hot and painful to the touch; at first hard and resisting, but, 

 should suppuration take place, a soft fluctuating point appears, denoting the 

 formation of abscess. In this condition the head is extended and the nose 

 poked out (fig. 93), there is some trouble in swallowing, and the breathing 

 becomes difficult, and is sometimes accompanied by a loud roaring sound. 

 Should the abscess point inwards instead of coming to the surface, it may be 

 expected to break into the throat. This will be made known by an escape 

 of white matter down the nostrils and a sudden subsidence of the more acute 

 symptoms. The difficulty in swallowing will now disappear almost at once, 

 and any abnormal sound that may have been emitted in breathing is no 



longer heard. The constitutional 

 disturbance which may have ex- 

 isted will now subside and the 

 general health become re-estab- 

 lished. In less severe attacks the 

 swelling of the gland is incon- 

 siderable, and there is no dis- 

 position to form matter. In 

 these cases the enlargement may 

 Fig. 93.-Parotitis altogether subside, or in part re- 



main permanent in the gland. 

 Treatment. — The object of treatment should be to subdue local 

 inflammation and cut short the disease, thus guarding against those 

 extreme structural changes involved in the formation of an abscess, as 

 well as that too common consequence — roaring. Hot poultices to the 

 throat should be promptly applied, and these may be continued without 

 intermission until the disease subsides. Where poulticing cannot be 

 thoroughly carried out, and frequent changes made, as sometimes occurs, 

 it is better to rely on counter-irritation. This may take the form of a mus- 

 tard poultice, or turpentine liniment, or a mild dressing of the oil of can- 

 tharides — one or the other — repeated thrice or oftener, as may be required. 

 Where swallowing is difficult and the formation of an abscess internally 

 is suspected, the ripening of the abscess will be hastened by repeated fumi- 

 gation of the throat with the vapour of hot water to which turpentine has 

 been added. This may be accomplished by means of a nose-bag containing 

 scalded bran, over which a little oil of turpentine has been sprinkled, or 

 the saw-dust of pine-wood will answer the purpose equally well. A small 

 quantity of belladonna electuary inserted into the mouth two or three 

 times a day will also assist in subduing local pain and add to the 

 comfort of the patient, 



