Note 36 — PART SECOND. OF PARTICULAR SURGICAL SUBJECTS. (continued 4)

[These abscesses are sometimes acute, the suppuration occurring as a consequence of active inflammation. They are seated in the submucous cellular substance, and often acquire a large size; at first there is merely soreness in the throat and pain in swallowing, but when matter begins to be poured out difficulty of breathing is superadded, from the pressure which it exerts upon the epiglottis and mouth of the larynx, and if it be not speedily evacuated the patient may die from suffocation. As soon as fluctuation is recognised, or even before, if there be much swelling and difficulty of respiration, relief should be afforded by a free incision, made with a sharp-pointed bistoury with the back towards the tongue, which is to be depressed with the forefinger of the left hand.—ED.]