WOUNDS AND AFFECTIONS OF THE THROAT. 67 



speedy evacuation of the abscess, either by the abstraction of a 

 tooth, or by puncture. 



Ranula. — Is a sac formed beneath the tongue, by an expansion 

 of Wharton's duct, either from disease or obstruction. Inconve- 

 nience is felt in mastication, deglutition, and articulation. 



The treatment consists of dilatation of the duct, or making an 

 artificial opening. It is necessary to keep the orifice distended by a 

 tent or loop of wire, until the cyst contracts to its normal size ; 

 otherwise it will be refilled. 



WOUNDS AND AFFECTIONS OF THE THROAT. 



Tonsils. — Inflammation of the tonsil is characterized by the rapid 

 swelling of the part, great pain in deglutition, and fever. It is to be 

 treated by bleeding, leeches, purging, and gargles. An incision made 

 with a bistoury will unload the vessels, and give exit to any pus which 

 may have been formed. Chronic enlargement of the tonsil may 

 result from inflammation, especially in scrofulous persons ; degluti- 

 tion is impeded, the voice is rendered hoarse, respiration is noisy 

 and laborious, and there may be deafness, from the obstruction of 

 the Eustachian tube. 



The treatment should consist of the internal and external use of 

 iodine, astringent gargles, and the application of nitrate of silver. 

 If these means fail, it should be removed by the knife, or with an 

 instrument constructed for the purpose, such as Physick's or Fahne- 

 stock's. 



Elongated uvula may be removed simply by a forceps and 

 scissors. 



(Esojihagus. — The oesophagus may have a permanent or spas- 

 modic stricture. 



A spasmodic stricture comes on suddenly, generally at meals, 

 and is attended with pain, and a choking sensation. It depends on 

 a weakened or hysterical state of the system, or neuralgia. Tonics, 

 antispasmodics, and alteratives are the means of cure, with proper 

 attention to diet, and care to avoid swallowing food that is hot or 

 imperfectly masticated. 



Permanent stricture is a narrowing produced by inflammation 

 of the mucous and cellular coats, which forms a firm ring generally 

 opposite to the cricoid cartilage. It is most frequent in females, and 

 has these symptoms : difficulty of swallowing, which gradually in- 

 creases, and is never absent ; pain in the chest and neck. It is a 

 serious complaint, and may be followed by ulceration, salivation, 

 vomiting of purulent matter, and death, from starvation or irritation. 

 The treatment should consist of a mild course of mercury, com- 

 bined with some anodyne, a seton between the shoulders, and the 



