PART 23
Ulceration of the throat with fever, is a serious affection, and if
any other of the symptoms formerly described as being bad, be present,
the physician ought to announce that his patient is in danger. Those
quinsies are most dangerous, and most quickly prove fatal, which make
no appearance in the fauces, nor in the neck, but occasion very great
pain and difficulty of breathing; these induce suffocation on the
first day, or on the second, the third, or the fourth. Such as, in
like manner, are attended with pain, are swelled up, and have redness
(erythema) in the throat, are indeed very fatal, but more protracted
than
[p. 57] the former, provided the redness be great. Those cases in which
both the throat and the neck are red, are more protracted, and certain
persons recover from them, especially if the neck and breast be affected
with erythema, and the erysipelas be not determined inwardly. If neither
the erysipelas disappear on the critical day, nor any abscess form
outwardly, nor any pus be spit up, and if the patient fancy himself
well, and be free from pain, death, or a relapse of the erythema is
to be apprehended. It is much less hazardous when the swelling and
redness are determined outwardly; but if determined to the lungs,
they superinduce delirium, and frequently some of these cases terminate
in empyema. It is very dangerous to cut off or scarify enlarged uvulae
while they and red and large, for inflammations and hemorrhages supervene;
but one should try to reduce such swellings by some other means at
this season. When the whole of it is converted into an abscess, which
is called Uva, or when the extremity of the variety called Columella
is larger and round, but the upper part thinner, at this time it will
be safe to operate. But it will be better to open the bowels gently
before proceeding to the operation, if time will permit, and the patient
be not in danger of being suffocated.