Quinsy (originally squinancy; Fr. esquinancie; from Gr. kynanchē), known also as Cynanche Tonsillaris and Tonsillitis, or as 'inflammatory sore throat,' is an inflammatory affection of the substance of the tonsils, attended when fully developed by suppuration (see PALATE). The inflammation is seldom limited to these glands, but extends to the uvula, the soft palate, and the pharynx. The disease usually manifests itself by difficulty in swallowing, and a sense of heat and discomfort in the throat, often amounting to considerable pain. On examination the throat at first exhibits unnatural redness, with enlargement of one or both tonsils. The uvula is enlarged and elongated, its end either dropping down into the pharynx, and, by exciting the sensation of a foreign body, giving rise to much irritation, or else adhering to one of the tonsils. The tongue is usually furred, and the pulse rapid, and there are the ordinary symptoms of that form of constitutional disturbance known as inflammatory fever. The inflammation terminates either in resolution (if the attack is not severe, and yields readily to treatment) or in suppuration, which may be detected by the occurrence of slight rigors, and by the increased softness of the enlarged tonsil. The matter which is discharged has sometimes a very fetid smell, and the fetor may be the first indication of the rupture. The pain almost entirely ceases with the discharge of matter, and recovery is then rapid. The disease usually runs a course of from three to seven days; but it may be prolonged if, as sometimes happens, the two sides are successively affected. It almost invariably terminates favourably. It is most common between the ages of fifteen and twenty-five. The ordinary exciting cause of this disease is exposure to cold, especially when the body is warm and perspiring; and certain persons (or even families) are so subject to it that slight exposure is almost sure to induce it.
The patient should remain in the house (or, in cold weather, even in bed), and should be kept on low, non-stimulating diet. According to Sir Morell Mackenzie, the best treatment at the commencement of the attack consists in the administration of guaiacum. He gives it in the form of lozenges, each containing three grains, and one to be sucked every two hours, and states that by this means the disease may generally be averted. Baking-soda (bicarbonate of soda) applied to the affected part on the tip of the forefinger every hour or half-hour often has the same effect. In more severe cases the patient may gargle frequently with hot water, or may inhale the vapour of boiling water, and apply hot poultices or fomentations to the side of the neck. Blistering and leeching will sometimes give relief, but if suppuration is once established they do harm rather than good. If the tonsils are very much enlarged they should be pricked with a lancet to let out the pus.