INFLAMMATIONS. 35 



painful and difficult deglutition ; with a pain sometimes shoot- 

 ing into the ear ; with a troublesome clamminess of the mouth 

 and throat ; with a frequent but difficult excretion of mucus ; 

 and the whole is accompanied with a pyrexia. 



CCCIII. This species of quinsy is never contagious. It ter- 

 minates frequently by resolution, sometimes by suppuration, but 

 hardly ever by gangrene ; although, in this disease, some sloughy 

 spots, commonly supposed to be forerunners of gangrene, some- 

 times appear upon the fauces. 



CCCIV. This disease is commonly occasioned by cold exter- 

 nally applied, particularly about the neck. It affects especially 

 the young and sanguine, and a disposition to it is often acquired 

 by habit ; so that, from every considerable application of cold 

 to any part of the body, this disease is readily induced. It oc- 

 curs especially in spring and autumn, when vicissitudes of heat 

 and cold often take place. The inflammation and tumour are 

 commonly at first most considerable in one tonsil ; and after- 

 wards, abating in that, increase in the other. 



" The Cynanche tonsillaris affects especially red-haired peo- 

 ple. I have known people who gradually, as they advanced in 

 life, became less subject to this affection ; so that from never 

 missing it once a-year, they would not have it for several years. 

 When once the vessels have been distended by an afflux of 

 blood, they are more readily affected afterwards : this is the 

 reason of a disposition for the disease being acquired by habit. 11 



CCCV. In the cure of this inflammation, some bleeding may 

 be proper, but large bleedings will seldom be necessary. The 

 opening of the ranular veins seems to be an insignificant reme- 

 dy, and leeches set upon the external fauces are of more effi- 

 cacy. 



" This inflammation seldom requires general bleeding, as 

 most of the other internal inflammations do. The only urgent 

 symptom is a considerable swelling, threatening suffocation. It 

 has rarely occurred to me of a dangerous nature, but it may be 

 in some cases considerable, especially where both tonsils are 

 much swelled at once, which is not common. In that case res-' 

 piration is difficult, but generally there is passage enough to 

 prevent danger. Practical writers, as Dr. Sydenham, have 

 however observed that the disease became suddenly suffocating. 



c 2 



