MEDICINE. 
5. C. maligna, malignant sore throat, chiefly 
symptomatic of scarlet and other fevers of 
a putrid tendency. 3. C. trachealis, croup ; 
a disease most commonly ofinfancy. 4. C. 
pharyngea, a mere variety of C. tonsillaris, 
by its being extended to the pharynx. 
6. C. parotidsea, mumps ; generally a slight 
inflammatory affection, and lasting only a 
few days, of the parotid and maxillary 
glands ; tliough sometimes succeeded in 
men by symptomatic intumescence of the 
testes, and in women induration of the mam- 
mae, usually, however, yielding to repellent 
applications and gentle aperients. If the 
head be affected by stupor, or delirium, 
from a similar sympathy, it should be bathed 
with warm water, and a few ounces of 
blood, according to the strength of the pa- 
tient, should be taken from the arm. 
Generally speaking, indeed, the common 
means employed in the removal of other 
local inflammations, with the use of acid 
gargles, is the plan to be adopted in Cy- 
nanche; yet the two following species re- 
quire to be noticed separately. 
C. trachealis. This disease very rarely at- 
tacks infants until after they have been 
weaned ; it generally commences with a 
sensation of uneasiness, or somewhat of an 
obtuse pain about the upper part of the 
trachea, which is increased on pressure, or 
a sense of constriction is perceived in the 
neighbourhood of the larynx; upon in- 
specting the fauces, little or no tumour is 
generally observed, sometimes, however, 
there is some trifling degree of redness ; a 
hoarseness and particular ringing, shrill 
sound of the voice accompanies both speak- 
ing and coughing; the noise appears to pro- 
ceed as from a brazen tube, and has been, 
not inaptly compared to the crowing of a 
cock; there is dyspnoea, attended with a 
wheezing sound, in the act of inspiration; 
the cough which attends the disease is 
commonly dry and slrort ; if any thing be ex- 
pectorated, it is pntriform, and mixed with 
small portions of a whitish membrane, simi- 
lar to what is found in the trachea upon 
dissection, which is, by that illustrious ana- 
tomist and physician, I)r. Baillie, supposed it 
to be formed by some peculiar action of the 
blood vessels of the i;;mer surface of the la- 
rynx and the trachea, which is superadded 
to inflammation ; the face is somewhat livid, 
or is flu.shed. With these symptoms there 
is some degree of frequency and hardness 
qf the pulse, great thirst, restlessness, and 
an unpleasant sense of heat ; the deglutition 
is but little or not at all affected; the urine, 
at the commencement of the disease, is ge- 
nerally high coloured ; sometimes, however, 
it is limpid ; but in the advanced stage it is 
turbid : there is seldom any delirium ; some- 
times, however, the patient seems stupid, 
and mutters to himself, and often in the 
perfect use of his senses he is seized with 
great difficulty of breathing, and a sense of 
strangling about the fauces, and is suddenly 
carried off. This disease chiefly appears in 
the winter and spring ; it generally attacks 
the most robust and ruddy children, and 
frequently comes on with the ordinary 
symptoms of catarrh. The remote causes 
are cold, combined with a moist state of the 
atmosphere ; infancy ; exposure to air pas- 
sing over large bodies of water, and many 
of the causes producing the Phlegmasiae, 
and the other species of Cynanche. It 
is said to be most frequently met with 
in marshy situations, and near the coast. 
The proximate cause appears to consist 
in an inflammation of the inner coat of 
the trachea and the larynx, together with 
an altered and peculiM action in the blood 
vessels of the parts ; and the adventitious 
membrane is the consequence. 
Treatment. We must attempt the cure of 
this disease by the remedies which are re- 
commended for the removal of inflamma- 
tion ; blood-letting, both general and topi- 
cal, must be immediately had recourse to, 
and it must be repeated according to the 
strength of the patient, violence of the 
symptoms, state of the pulse, and the ef- 
fects produced from it : repeated emetics 
should be administered, and mild cathartics 
orlaxative clysters should be at the same time 
employed ; blisters should be applied to the 
external fauces, or stimulating liniments, as 
the liniment of ammonia with oil of amber 
and tincture of cantharides should be made 
use of; the warm bath should be ordered, 
and the vapour of warm water, with or with- 
out a portion of vinegar, should be frequent- 
ly received into the fauces ; in every stage 
of the disease the antiphologistic regimen is 
peculiarly necessary, and the patient should 
lie with his head raised high in bed ; small 
repeated doses of calomel have been ad- 
ministered with the best effects, at the 
commencement and throughout the whole 
course of the disease, as two or three grains 
two or three times in the course of the 
day. This disease sometimes attacks adults; 
in which case the most powerful remedies 
against inflammation, together with the 
employment of emetics, must be immedi- 
ately had recourse to, and persevered in 
