CHAPTER VII. THE CURE OF QUINSEY.
THERE are two forms of quinsey. The one is attended with
heat, and great inflammation of the tonsils, and swelling outwardly;
moreover, the tongue, uvula, and all the parts there,
are raised up into a swelling. The other is a collapse of these
parts, and compression inwardly, with greater sense of suffocation,
so that the inflammation appears to be determined to the
heart. In it, then, particularly, we must make haste to apply
our remedies, for it quickly proves fatal.
If, then, it proceed from taking too much food and wine,
we must inject the bowels on the day of the attack, and that
with two clysters: the one a common clyster, so as to bring off
the feculent matters; and the other for the purpose of producing
revulsion of the humours from the tonsils and chest.
It will therefore be, but not undiluted . . . . . . . and the
decoctions of centaury and hyssop; for these medicines also
bring off phlegm. And if the patient has been on a restricted
diet, we open the vein at the elbow, and make a larger incision
than usual, that the blood may flow with impetuosity and in
large quantity; for such a flow is sufficient to mitigate the
heat most speedily, is able to relieve the strangulation, and
reduce all the bad symptoms. It is no bad practice, likewise,
to bring the patient almost to fainting, and yet not so as that
he should faint altogether, for some from the shock have died
of the fainting . . . . . . . . or binding them with ligatures
above the ankles and knees. It is a very good thing, likewise,
to apply ligatures to the forearms above the wrists, and
above the forearms to the arms. And if deglutition be easy, we
are to give elaterium with honeyed-water, and the whey of
milk, as much as will be sufficient to purge the patient. In
these cases, elaterium is preferable to all other cathartics; but
cneoros and mustard are also suitable, for both these purge the
bowels. If the inflammations do not yield to these means,
having bent the tongue back to the roof of the mouth, we
open the veins in it; and if the blood flow freely and copiously,
it proves more effectual than all other means. Liquid
applications to the inflamed parts, at first of an astringent
nature, so as to dispel the morbid matters: unwashed wool,
then, with hyssop, moistened in wine, and the ointment from
the unripe olive. But the cataplasms are similar to the liquid
applications,--dates
soaked in wine, and levigated with rose-leaves.
But in order that the cataplasm may be rendered glutinous
and soft, let flour or linseed, and honey and oil be added, to
produce the admixture of all the ingredients. But if it turn
to a suppuration, we are to use hot things, such as those used
in the other form of synanche. Let fenugreek be the powder,
and manna and resin the substances which are melted; and let
the hair of poley be sprinkled on it, and a hot fomentation
be made with sponges of the decoction of the fruit of the bay
and of hyssop. And the powdered dung of pigeons or of dogs,
sifted in a sieve, is most efficacious in producing suppuration,
when sprinkled on the cataplasm. As gargles, honeyed-water,
with the decoction of dried lentil, or of hyssop, or of
roses, or of dates, or of all together. We are also to smear the
whole mouth, as far as the internal fauces, either with Simples,
such as the juice of mulberries, or the water of pounded pomegranates,
or the decoction of dates; or with Compound preparations,
such as that from mulberries, or that from
besasa,
1 or
that from the juice of pomegranates, and that from swallows.
But if the ulcers proceed from eschars, these gargles, and
washes for the mouth, the decoction of hyssop in honeyed-water,
or of fat figs in water, and along with them starch dissolved
in honeyed-water, or the juice of ptisan, or of tragus
(
spelt?).
But in the species of synanche attended with collapse, we are
to make a general determination from within outwardly, of the
fluids, of the warmth, and of all the flesh, so that the whole may
swell out. Let the liquid applications then be of a hot nature,
with rue and dill, natron being sprinkled upon them; and along
with them the cataplasms formerly mentioned. It is a good thing
also to apply a cerate with natron and mustard for inducing heat;
for heat determined outwardly is the cure of such complaints; and
thus swelling takes place in the neck, and an external swelling
rescues from peripneumonia; but in cases of synanche, the evil
when inwardly is of a fatal nature. But those who, in order to
guard against suffocation in quinsey, make an incision in the
trachea for the breathing, do not appear to me to have proved
the practicability of the thing by actual experiment; for the
heat of the inflammation is increased by the wound, and thus
contributes to the suffocation and cough. And, moreover, if
by any means they should escape the danger, the lips of the
wound do not coalesce; for they are both cartilaginous, and
not of a nature to unite.
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