Avicenna calls the ranula an enlargement and induration of the sublingual gland. He approves of nearly the same treatment as our author. He recommends in particular burnt vitriol and hermodactylus with the white of an egg. Alsaharavius recommends, in the first place, applications containing nitre, sal ammoniac, and the like. If these do not succeed, caustics are to be applied, so as to occasion a blackening of the part. If this does not answer, an operation must be performed. Rhases makes mention of an application containing green copper, vitriol, &c.
For an account of the manner in which the veterinary surgeons treated ranula in cattle, see Columella (vi, 8), and Vegetius (Mulom. iii, 3.) They recommend the tumour to be opened and stimulants applied to it, such as garlic pounded with salt.
The disease which Hippocrates describes by the name of ὑπόγλωσσις appears to have been somewhat different from the one we have been treating of. The hypoglottis of Hippocrates was an inflammatory swelling of the tongue ending in abscess. When matter forms, he directs us to open the abscess. It is also described by Aretæus.
For inflammation of the tonsils and of the uvula. Since, as Galen remarks, the same treatment applies to inflammation of the tonsils and uvula, we shall treat of both together.
Aretæus has described inflammation of these parts with great accuracy and minuteness. He has also given a very circumstantial account of the ulcers which occur there. Some, he says, are common, mild, and not dangerous; others are uncommon, pestilential, and fatal. The latter are described as being covered with a livid or black crust. The ulcer, he says, is apt to spread to the tongue, or it passes down the trachea and proves fatal by occasioning suffocation. The disease, he says, is brought on by cold acrid substances, and sympathy with disease of the stomach or lungs. Children are most subject to it. It is endemial in Syria and Egypt. He gives a striking description of death occasioned by suffocation. With regard to the treatment, when the parts are inflamed, swelled, and threaten suffocation, he advises copious bleeding from the arm, acrid clysters, purgatives, ligatures to the extremities, astringent and emollient applications to the parts, cupping the hind-head or breast, and other such means. Respecting the pestilential ulcers, when attended with inflammation and sense of suffocation, he approves of clysters, venesection, gargles, fomentations, ligatures to the extremities, cupping, and so forth. When the disease is spreading, he directs us to burn the sore with powerful caustics, such as alum with honey, chalcitis and the like. Sometimes, as he remarks, the uvula and parts there are eaten down to the bone.
Galen gives a long and very interesting account of these complaints intermixed with curious extracts from Archigenes. The general treatment consists of venesection, acrid clysters, and purgatives. The local applications are mostly of an acrid and austere nature.
When the tonsils suppurate, Aëtius directs us to open the abscess. He gives an interesting description of pestilential ulcers, which, however, is not very different from that of Aretæus. He approves of bleeding at the arm, suppositories, clysters, ligatures to the extremities, and so forth. The subsequent Greek authors follow him and Galen in their descriptions.
Marcellus, the Empiric, recommends for swelled uvula various escharotic applications containing chalcitis, flos æris, alum, &c.
Celsus delivers a brief account of ulcers of the internal fauces. He speaks in rather equivocal terms of warm cataplasms, fomentations and fumigations; but is, upon the whole, inclined to permit the use of them if there be no danger of cold afterwards. He very properly forbids such things as will irritate the parts. He does not approve much of gargles of vinegar, although recommended by Archigenes, whom he calls, “multarum rerum auctor bonus.” He prefers emollient gargles at first, and afterwards repellent ones.
The Arabians treat inflammation of these parts like the Greeks. Avicenna follows closely our author’s plan of treatment. Mesue approves of bleeding, clysters, and so forth. Rhases mentions bleeding and gargles with vinegar, the water of roses, and other astringents. In inflammation of the uvula, Haly Abbas recommends general bleeding, gentle purgatives, and astringent gargles containing alum, pomegranate flowers, sal ammoniac, and the like; and when these do not succeed, he advises us to have recourse to the operation. (See [Book Sixth].) Alsaharavius recommends a plan of treatment perfectly similar, and, like Haly, directs us to have recourse to excision when other remedies fail. Alexander Aphrodisiensis says, however, that those who have had the uvula cut off die of consumption; and attempts to account for the operation having this effect. (Probl. ii, 3.)