st variety; or the defect of
irritation, as in the second variety: all these kinds of erysipelas are
liable to return by periods in some people, who have passed the middle of
life, as at periods of a lunation, or two lunations, or at the equinoxes.
When these periods of erysipelas happen to women, they seem to supply the
place of the receding catamenia; when to men, I have sometimes believed
them to be associated with a torpor of the liver; as they generally occur
in those who have drank vinous spirit excessively, though not
approbriously; and that hence they supply the place of periodical piles, or
gout, or gutta rosea.

M. M. As the fever requires no management, the disease takes its progress
safely, like a moderate paroxysm of the gout; but in this case, as in some
of the former, the erysipelas does not appear to be a primary disease, and
should perhaps be removed to the Class of Association.

3. _Tonsillitis._ Inflammation of the tonsils. The uncouth term Cynanche
has been used for diseases so dissimilar, that I have divided them into
Tonsillitis and Parotitis; and hope to be excused for adding a Greek
termination to a Latin word, as one of those languages may justly be
considered as a dialect of the other. By tonsillitis the inflammation of
the tonsils is principally to be understood; but as all inflammations
generally spread further than the part first affected; so, when the summit
of the windpipe is also much inflamed, it may be termed tonsillitis
trachealis, or croup. See Class I. 1. 3. 4. and II. 1. 2. 4.; and when the
summit of the gullet is much inflamed along with the tonsil, it may be
called tonsillitis pharyngea, as described in Dr. Cullen's Nosologia, Genus
X. p. 92. The inflammation of the tonsils may be divided into three kinds,
which require different methods of cure.

_Tonsillitis interna._ Inflammation of the internal tonsil. When the
swelling is so considerable as to produce difficulty of breathing, the size
of the tonsil should be diminished by cutting it with a proper lancet,
which may either give exit to the matter it contains, or may make it less
by discharging a part of the blood. This kind of angina is frequently
attended with irritated fever besides the sensitive one, which accompanies
all inflammation, and sometimes requires venesection. An emetic should be
given early in the disease, as by its inducing the retrograde action of the
vessels about the fauces during the nausea it occasions, it