SORK THROAT. 51 



to that seen in the roof of a Gothic church, where the groinings from the windows 

 on cither side meet in a central boss or pendant. The central boss is the uvula, the 

 windows are the tonsils, and the groinings are the pillars of the fauces uniting to 

 form the lower edge of the soft palate. The normal colour of these parts is a pink, 

 like that seen in the lips. In a really bad case of sore throat the amount of swelling 

 of the parts may be enormous. The tonsils may be as big as Tangerine oranges, the 

 soft palate swollen and thickened, and the uvula enlarged to the size of the little finger, 

 and dropsical. The colour of the parts is either livid or bright scarlet, and the 

 amount of tenacious secretion may be considerable. In cases of extreme swelling of 

 the throat, swallowing is impossible, or is a matter of great pain and difficulty, and 

 occasionally the respiration is very seriously interfered with. This condition of throat 

 is most commonly seen in ordinary quinsy, but it occurs also in scarlet fever and 

 some other forms of blood poisoning. A patient in this condition can never be con- 

 sidered as free from danger, and skilled and constant assistance should be at hand. 

 The best treatment is, in the first place, to clear out the bowels by a brisk purgative 

 (two or three grains of calomel, followed in four hours by a " black draught"), to 

 allow the patient to inhale the steam of boiling water almost constantly, and to 

 apply hot poultices and fomentations to the outside of the neck, which must be 

 changed at frequent intervals. Nourishing soups and hot milk must be given, and the 

 patient should remain in bed. Some practitioners order small doses of aconite (a 

 drop of the tincture every hour), but the present writer cannot say that he has ever 

 seen any reason to suspect that any benefit has resulted from the practice, although 

 he has made use of it very many times. If an abscess form in the tonsils, it is 

 better to allow it to burst spontaneously than to cut into it. There are exceptions 

 to this rule, however, which the practitioner in. attendance would recognise. The 

 sore throat of scarlet fever cannot be accurately recognised, but its sudden occurrence 

 and bright scarlet appearance are the facts which generally arouse suspicion. The 

 appearance of the scarlet fever rash soon decides the question. 



Diphtheria is known by the growth of a false membrane, closely resembling a 

 piece of wet wash-leather, which begins at one point and spreads, usually equally in. 

 all directions. It is important not to mistake the natural secretion of the tonsils 

 for the diphtheritic membrane. The tonsillar secretion appeal's on the tonsil itself, 

 and is usually scattered over its surface in a series of points. 



The facts which show a sore throat to be serious, if not dangerous, are (1) great 

 swelling of the throat itself, with obstruction to swallowing and breathing ; (2) a 

 scarlet appearance of the throat ; (3) the growth of false membrane ; and (4) grave 

 constitutional symptoms : great weakness and prostration ; a weak, feeble, and quick 

 pulse ; headache, shivering, and any undue elevation of temperature, or the appear- 

 ance of any of the fever-rashes. Any of these symptoms would tend to show that the 

 sore throat has passed the bounds of the trifling ailment which we include under that 

 name. Enlargement of the glands of the neck is an indication of severity. If the 

 breath be horribly offensive, or the patient expectorate blood or matter, this would show 

 that the discharges are becoming decomposed. For the description of the various forms 

 of sore throat, we must refer the reader to the articles on diphtheria, scarlet fever, 

 and enlargement of tonsils, measles, &c. Sore throat is one of those diseases which is 



