SECT. II.
Of Diseases of the Neck
The diseases in that part, are indeed very numerous; but as they have so strict a connexion amongst themselves, the classes may be considered but very few; of which some have been already taken notice of.
Of the malignant Sore Throat.
Every body who is liable to catch cold, is frequently apt to have a hoarseness and consequently in some degree, more or less, a sore throat. If a fever attends it, methods should be used accordingly, as is mentioned under the head of colds: with respect to the throat, use the gargle, No. [XVIII]. pretty frequently, and the disorder will soon go off again.
But when an ulcerated sore throat is attended with a malignant fever and inflammation, it is called a quincey; this case is alarming, and requires very careful treatment; for first we must observe, that the larynx is of a very complicate and curious structure; and secondly, it is composed of various, and delicate materials; namely, cartilages, membranes, muscles, and glands.
The glands are very numerous in the various parts of the composition, whence the inflammation becomes not only painful, but is apt to swell up and obstruct respiration; wherefore an inflammation in such parts becomes highly dangerous to the life of the patient.
When the patient perceives a burning pain in the throat, and the parts all round swell up, respiration becoming difficult, add to this a hoarseness, great difficulty in swallowing, there is no time to lose, for immediate assistance is wanting.
Bleeding is indispensably necessary, particularly if the inflammation is sudden; warm foot-bathing also is highly requisite; to remove the humours downwards; a gargle should also immediately be applied like the foregoing No. [XVIII]. with the addition of a little camphor spirits. Externally apply the poultice, No. [II]. and give the following draught.
No. XXXIV
Take fever powder (L), one scruple; calomel (N), two grains; liquid laudanum (T), twelve drops; water two spoonfuls; mix it into a draught.
This may be given every six hours, for two days successively; and this generally will break the disorder. The patient should be made to drink as freely as he possibly can; and perspiration should ever be promoted. A blister as the case requires, may also be used with much advantage. If the body is bound, clysters may tend to incline the humours to be drawn down from the part.
No. XXXV
Take Glauber’s salts (19), one ounce and a half; honey (E), one spoonful; hot water, a pint and a half.
Sometimes the inflammation is so very great, as to choak up both the passage of respiration, as well as that of deglutition; so that the poor afflicted patient can neither breathe, nor swallow; and is not only liable to be suffocated, but even starved to death, besides the danger from the malignant inflammation.
In this exigency, have recourse to the following simple but excellent remedy.
No. XXXVI
Take a pipkin, or a tin sauce-pan, with a quart of water, a pint of vinegar, and two spoonfuls of honey; then take a funnel that will pretty well cover the vessel; then take a piece of iron, or some old nails, or a little stone, or what you have handy; heat it red hot, and put it into the pipkin, and put on the funnel so that steam may ascend through it. Over this let the patient hold his mouth, so that he breathes nothing but the steam; and to secure it the better, put something over his head, that he may reap the more the benefit of it. When the steam ceases, heat it again as before. Instead of heating it with the iron, it may be shifted with boiling, but the former is generally more handy.
In the mean time, if the patient should by the inflammation, be deprived of all nutriment, recourse must be had to nourishing clysters: milk in this respect is the best; but in want of that, fowl broth may be used; and if that is wanting, take water gruel. Milk however is superior to all: I shall give a receipt of each kind.
No. XXXVII
Take milk and water, of each a pint; cinamon (16), one drachm; boil them and strain the liquor; then dissolve one ounce and an half of good loaf sugar; add six drops, of the essential oil of peppermint (U), upon a little lump of sugar.
No. XXXVIII
Take half a fowl, bruise the bones, and cut the flesh small; this boil in three pints of fresh water, with about one drachm of cinamon; strain it clear, and add as before, an ounce of sugar, with a few drops of the oil of peppermint.—A tea cupful of good white wine may be added, if the patient is very weak, and not feverish.
No. XXXIX
Take oatmeal, two spoonfuls; malt, one spoonful; cinamon, two drachmes. Boil it in two quarts of water for some time, till when it is strained, it becomes one quart; put to it fine sugar, six ounces; a few drops of essential oil of peppermint, and a tea cupful of good wine.
These clysters are perfectly safe, and very nourishing. Some have added salt to the animal broth, perhaps through a notion to make it the more palatable, and so of course more nourishing; but probably they forget that the part they are now about to feed, differs widely from the depraved taste of the palate.
Salt is stimulating; besides, it indurates the aliment, that it never yields so much nourishment, because it always opposes assimulation; and it is universally known, that salt victuals is by far, less nourishing than fresh.
The quincey is sometimes so desperate, as to strangle the afflicted patient, particularly if assistance is given too late; in so much that bronchotomy, or opening the wind-pipe, has been the last resource in this deplorable dilemma. I have mentioned this operation, in the third lecture, and have only to observe, that in this case little hope is left after that operation, on account of the great inflammation of the parts; though we have instances of its success. If however the method which I have here laid down, together with strict observance of managing fevers is duly observed, there can scarce be a failure of success; for if I may be allowed to judge from my own experience and success, it is merely neglect, in the first setting out of these diseases, that for the most part, renders them so very desperate and mortal.