One may immediately be sure, when there is a large effusion of blood, that something is broken off from the bone. Therefore the scale, that has come off, must be sought for by a probe, and taken out with a vulsella. If it does not come away, the gum ought to be cut, till the scale loosened from the bone can be taken out. And if it be not entirely broken, but the external part of the jaw swells, so that the mouth cannot open, on the outside must be applied a warm cataplasm of meal and figs, till it bring on a suppuration there; then an incision must be made in the gum. A copious discharge of pus is also a sign of a fractured bone: so that even then it is proper to extract it. Sometimes too, when it is injured, there is a fissure, which ought to be scraped.
A rough tooth ought to be scraped, where it is black, and rubbed with the powder of rose leaves, with an addition of one-fourth part of galls, and another of myrrh; and pure wine must be held in the mouth frequently. And in this case the head must be covered, the patient must walk much, make use of friction to his head, and a diet not acrid.
But if either, from a blow, or some other misfortune, some of the teeth are loosened, they must be tied with gold to those that are firm; and restringents must be held in the mouth, such as wine, in which pomegranate bark has been boiled, or in which hot galls have been infused. And if one tooth should happen to grow in children, before the former has fallen out, that, which should have dropped, must be scraped round and pulled out; that which is growing in the place of the former, must be pushed into its proper place, with the finger, every day, till it come to its just size. Whenever a tooth is extracted, and its root has been left, that also must be immediately taken out by a forceps made for that purpose, which the Greeks call rizagra.
Of indurated tonsils.
Tonsils, that are indurated, after an inflammation, called antiades[ HI ] by the Greeks, when they are covered by a slight coat, should be disengaged all round by the finger, and pulled out. If they are not separated by this method, it is necessary to take hold of them with a small hook, and cut them out with a knife; then to wash the ulcer with vinegar, and rub the wound with a styptic medicine.
Of the uvula.
The uvula, if it is inflamed, and falls down, and is painful, and of a ruddy colour, cannot be cut without danger; for there is commonly a great effusion of blood: therefore it is better to make use of those remedies I have mentioned elsewhere. But if there be no inflammation, and nevertheless it is relaxed to a great length by a humour, and is small, sharp, and white, a portion of it ought to be cut off: and likewise, if the extremity of it be livid and thick, and the superior part small. There is no better method than to take hold of it with a vulsella (a kind of forceps), and under that, to cut off what we think fit: for there is no danger, that either too much or too little be cut off; as we have it in our power to leave no more below the vulsella, than appears to be useless, and to cut off so much as shall reduce the uvula to its natural magnitude. After the operation, the same applications are proper, which were prescribed above for the tonsils.
Of the tongue.
The tongue, in some people, is joined with the part below it from their birth; who are by that means deprived of speech. The end of their tongue must be taken hold of with a vulsella, and the membrane below it cut; great care being taken, that the contiguous veins be not wounded, and the patient hurt by an effusion of blood. The remaining part of the cure of the wound is already directed in the preceding cases. And most people speak, as soon as it is healed. But I have known an instance, where a person after the cutting of his tongue, though he could thrust it far enough beyond his teeth, did not attain the faculty of speaking. Thus it happens in the practice of physic, that what is always right to do, is not always attended with success.
An abscess under the tongue.