affected.
Quinsy involves the surrounding structures of the throat, and usually
results in abscess. The disease is said to be frequently hereditary,
and often occurs in those subject to rheumatism and gout. It is seen
more often in spring and autumn and in those living an out-of-door
existence, and having once had quinsy the victim is liable to frequent
recurrences of the disease. Quinsy is characterized by much greater
pain in the throat and in swallowing than is the case in tonsilitis,
and the temperature is often higher--sometimes 104 deg. to 105 deg. F. When
the throat is inspected, one or both tonsils are seen to be enlarged
and crowded into its cavity from the swelling of the neighboring
parts. The tonsils may almost block the entrance to the throat. The
voice is thick and indistinct, the glands in the side of the neck
become swollen, and the neck is sore and stiff in consequence, while
the mouth can be only partially opened on account of pain. For the
same reason the patient can swallow neither solid nor liquid food, and
sits bent forward, with saliva running out of the mouth. The secretion
of saliva is increased, but is not swallowed on account of the pain
produced by the act. Sleep is also impossible, and altogether a more
piteous spectacle of pain and distress is rarely seen. Having reached
this stage the inflammation usually goes on to abscess (formation
behind or above or below the tonsil), and, after five to ten days from
the beginning of the attack, the pus finds its way to the surface of
the tonsil, and breaks into the mouth to the inexpressible relief of
the patient. This event is followed by quick subsidence of the
symptoms. Quinsy is rarely a dangerous disease, yet, occasionally, it
leads to so much obstruction in the throat that death from suffocation
ensues unless a surgeon opens the throat and inserts a tube.
Occasionally the pus from the ruptured abscess enters the larynx and
causes suffocation.

Quinsy differs from tonsilitis in the following respects: the swelling
affects the immediate surrounding area of the throat; there are no
white spots to be seen on the tonsil unless the trouble begins as an
ordinary tonsilitis; there is great pain on swallowing, and finally
abscess near the tonsil in most cases.

=Treatment.=--A thorough painting of the tonsils at the onset of a
threatened attack of quinsy with the silver-nitrate solution, as
recommended under tonsilitis, may cut short the disorder. A s