its approach. There is fever, quick,
full pulse, and dryness of the skin; the tongue is furred, and the
breath offensive. The tonsils are intensely red, swollen, and painful,
the pain often extending to the ear. Sometimes but one tonsil is
affected, though generally both are involved. In severe cases the
patient cannot lie down, in consequence of the difficulty of breathing.

TREATMENT. In the early stage of the disease, the spirit vapor-bath is
invaluable. The sweating which it produces should be kept up by the use
of the Compound Extract of Smart-weed in some diaphoretic infusion. Hot
wet-packs to the throat, covered with dry cloths, are useful. The
inhalation of the hot vapor of water or vinegar, or peppermint and
water, is beneficial. A carthartic should be given at night. When the
disease does not show a disposition to yield to this treatment, the
services of a physician should be obtained. When pus, or "matter," is
formed in the tonsil, which may be known by the increased swelling and
the appearance of a yellowish spot, the services of a physician will be
required to lance it.

ENLARGED TONSILS.

[Illustration: Fig. 147.
_A A._--Enlarged Tonsils. B.--Elongated
Uvula.]

Chronic enlargement of the tonsils, as shown in Fig. 147, _A A_, is an
exceedingly common affection. It is most common to those of a scrofulous
habit. It rarely makes its appearance after the thirtieth year, unless
it has existed in earlier life, and has been imperfectly cured. Both
tonsils are generally, though unequally enlarged. A person affected with
this disease is extremely liable to sore throat, and contracts it on the
slightest exposure; the contraction of a cold, suppression of
perspiration, or derangement of the digestive apparatus being sufficient
to provoke inflammation.

CAUSES. Repeated attacks of quinsy, scarlet fever, diphtheria, or
scrofula, and general impairment of the system, predispose the
individual to this disease.

SYMPTOMS. The voice is often husky, nasal or guttural, and disagreeable.
When the patient sleeps, a low moaning is heard, accompanied with
snoring and stentorian breathing, and the head is thrown back so as to
bring the mouth on a line with the windpipe, and thus facilitate the
ingress of air into the lungs. When the affection becomes serious, it
interferes with breathing and swallowing. The chest is liable to become
flattened in front and arched behind, in consequence of the difficulty
of respiration,