"Kirsty has a bizarre question - she has sneezed and a small white ball with a totally off-putting, disgusting scent has come out. This has happened to her three times in the last year. What is it?"

E2 already contains descriptions of many interesting 'cheeses' which are not really cheeses at all, such as head cheese, neck cheese, and corpse cheese. Here's another one to add to the list.

Tonsil cheese is formed in folds and wrinkles (known as 'crypts') of the tonsils. There is some debate about its actual makeup; it is most often claimed to be composed of a buildup of bacteria and cell debris. Other theories suggest that it is composed of trapped food that has rotted, that it is a buildup of solidified mucus, or that it is a ball of dried-out pus formed at the site of an infection.

Despite the disagreements regarding its exact composition, there is broad agreement on the following facts:

Tonsil cheese is usually white, though it can also have a yellowish, brownish, or even greenish tinge.

It most often appears in the mouth as a result of being coughed or hacked up. However, some people who regularly 'grow' tonsil cheese can become aware of its presence in the tonsils and can dislodge it. The literature describes many ways that experienced tonsil cheese growers have of achieving this, ranging from manually squeezing the sides of throat, to digging around in the tonsils with a straightened hairgrip.

Once dislodged, the lumps of cheese range in size from tiny to around half an inch in size, and usually take the shape of the crypts where they formed.

They smell absolutely foul. Descriptions of the odour include the distinctive stench of true halitosis (and in fact they are sometimes the cause of halitosis), and the reek of sulphur.

Tonsil cheese used to be known as exudate, although that term is now seldom used. If it is not dislodged it can eventually calcify, at which time it hardens and forms what are known as tonsilloliths. Once this occurs, surgical removal may be necessary. This is a fairly rare occurrence though, and tonsil cheese is not generally considered to be a condition which requires treatment, although in extreme cases (some people cough this stuff up every couple of days), the tonsils may be removed. It is also possible that frequent recurrence can be a symptom of a more serious condition.

I'll leave the final word on this to an actual sufferer of recurrent tonsil cheese; one who perhaps has a little too much spare time on their hands...

"I have also had this all of my life - those foul smelling white/yellow things with a tinge of green. (I happen to refer to them as 'sluff') Mine have ranged from a matchstick head size to a hazel nut without the shell (gross!). If left on a hard surface to dry it shrivels to a hard transparent yellow odour free mass. I once decided to monitor the amount I got by collecting it in a film canister with the intentions of taking it to the doctor - I never did, but the canister did get half full in about nine months."

Update July 27 2004: belgand says "the proper name is tonsillolithiasis"

Quotes are from http://www.abc.net.au/science/k2/stn/q&a/notes/020117-2.htm

One factoid about said nastiness which I find fascinating is that a much larger version is prized by people for its very odor. Sperm Whales produce an exudate known as ambergris which - although according its node is secreted in folds of the intestines, not the tonsils - is almost identical in appearance and odor. Except, of course, that version comes in sixty to two-hundred pound chunks.

Ambergris was prized in times past (and some places, in times present) as the primary source of scent for parfumerie, or the art, manufacture and dispensing of perfumes. Due to its rank strength, a single chunk of ambergris could provide esters for a huge quantity of perfumes.

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