The _symptoms_ are at first those of phlegmonous pharyngitis, and, if the local swelling, induration and tenderness are less marked than in other cases, it is due to the location of the inflammatory lesion deeply between the pharynx and the atlas and occiput. Indeed the moderate aspect of the external swelling, conjoined with the noisy wheezing or violent roaring, may be taken as important diagnostic indications. The supra-pharyngeal region is so closely confined on its lateral aspects, by the union of the fascia of the sternomaxillaris and mastoido-humeral muscles, that the swelling is confined in the early stages just as the pus is later. As this resistant fascia prevents any relief by lateral expansion, the engorged tissues press downward on the softer and less resistant upper wall of the pharynx and seriously impair both respiration and deglutition. Similarly when pus has formed, these lateral fibrous barriers, reënforced by organized lymph, stand in the way of the advance of the pus toward the skin, and lead it to dissect its way downward toward the pharynx. Even here the thickening of the tissues by the organized products of the lymph will often interpose a serious bar, and the pus remains pent up indefinitely, a source of wheezing, roaring and impaired deglutition, and a constant threat of secondary abscess or septic infection. Even the dense fibroid tissues may soften and degenerate and the pus may make its way spontaneously to the pharynx, or less frequently through the skin of the parotid, or intermaxillary region, or into the œsophagus or larynx. A fistula of the pharynx opening externally and allowing the escape of alimentary matters has been often noticed. These are especially liable to follow puncture of the abscess. Among the less common sequelæ are fistula of the œsophagus; purulent pneumonia in connection with the purulent dissection of the œsophagean walls and rupture into the chest (Fichet, Schneider); ulceration of the blood vessels in the cow (Jonge); adenitis and lymphangitis of the neck, and the thoracic glands, followed by pericarditis and pleurisy (Cadeac); multiple embolic abscesses of internal organs (Dieckerhoff); compression and degeneration of the vagus nerve, with consequent respiratory and digestive troubles (Baudon); and compression and obstruction of the jugulars with passive congestion of the brain and vertigo. (Delamotte, Debrade). Even when the abscess opens into the pharynx the orifice is usually small, the pus escapes imperfectly, and food materials enter and the fistula may thus persist for a length of time. The same imperfect discharge is liable to take place with an external orifice and the pent up pus becomes inspissated, caseated and even calcified.