It is more proper then first to anoint the neck over with liquid cerate[(9)]: next to apply ox-bladders or bottles filled with hot oil, or a hot cataplasm made of meal, or pepper bruised with a fig. But it is most suitable to foment with moist salt; the manner of doing which I have already shewn. When any of these has been done, it is fit to bring the patient to the fire, or if it be the summer-time to the sun; and to rub his neck, and shoulders, and spine with old oil, which is fittest for that purpose; if that cannot be had, with Syrian[(10)]; if that cannot be got neither, with the oldest fat.
As friction is serviceable to all the vertebræ, so it is particularly to those of the neck. Wherefore day and night, but at proper intervals, this remedy must be used. When it is intermitted, some heating malagma must be applied. And cold is of all things to be avoided. And upon that account there ought to be a constant fire in the chamber, where the patient is nursed, and especially in the morning before day-light, when the cold is most intense. Neither will it be improper to keep the head close clipped, and to moisten it with hot ointment of iris, or the cyprine, and to keep it covered with a cap; sometimes to dip the whole body in warm oil, or in a warm decoction of fenugreek, with the addition of a third part of oil. A clyster also often relaxes the superior parts.
But if notwithstanding the pain has grown more severe, cucurbitals are to be applied to the neck, and an incision made in the skin. Eschars are to be made either by irons, or mustard. When the pain has abated, and the neck has begun to move, we may know, that the disease yields to the remedies. But all food that requires chewing must be long avoided. Gruels must be used, also sorbile eggs, or broth made of chickens, or some other tender flesh. If this has succeeded, and the neck shall appear to be entirely well, we must begin with pulse or intrita well moistened. But the patient may sooner venture to chew bread than taste wine; for the use of this is very dangerous, and therefore to be deferred for a longer time.
CHAP. IV. OF THE DISEASES IN THE FAUCES, AND THEIR CURE.
As the former kind of distemper afflicts the whole neck, so there is another common one equally dangerous and acute, the seat of which is in the fauces. Our authors call it angina: amongst the Greeks the name varies according to the species. For sometimes there appears neither any redness nor tumour; but the body is dry, the breath is fetched with difficulty, the limbs are relaxed. This they call [ CK ]synanche[(11)]. Sometimes the tongue and fauces are red and swelled, the voice is stopped, the eyes are turned, the face is pale, and there is a hiccough. That is called quasi synanche[ CL ]. These symptoms are common to both: the patient is not able to swallow either food or drink; his breathing is obstructed. It is more slight, when there is only a swelling and redness, and the rest of the symptoms do not follow. That they call parasynanche[ CM ].
Whatever species it be, if the patient’s strength will allow, blood must be let, although there is not a plethora; the next thing is to give a clyster. A cucurbital also is properly applied below the chin, and about the fauces, in order to evacuate the suffocating matter. Then there is a necessity for moist fomentations. For dry ones cut the breath. Therefore it is fit to apply sponges, which are better dipped now and then in warm oil, than in warm water. And it is of great efficacy in this case too, to put on salt in warm bags. Then it is convenient to make a decoction of hyssop, or cat mint, or thyme, or wormwood, or even bran, or dry figs, in hydromel, and use it as a gargarism; after that to touch the palate either with ox-gall, or the medicine, which is composed of mulberries. Fine flour of pepper is also proper to sprinkle upon it.
If from these things there is little benefit, the last remedy is to make pretty deep incisions under the jaws above the neck, and in the palate about the uvula, or to open the veins, that lie under the tongue, that the distemper may be discharged through these wounds. If this method don’t relieve the patient, we may be assured, that the distemper has got the better of him. But if the disorder is mitigated by them, and his throat is capable of admitting meat and drink, health will be easily recovered again. And sometimes nature assists too, if the disorder passes from a more contracted place to a larger. For this reason, when a redness and swelling begins in the præcordia, it is a sign that the malady has begun to leave the throat.
Whatever has relieved it, he must begin with a moist diet, and especially hydromel; then take soft food, and not acrid, till the fauces return to their former soundness. It is a vulgar opinion, that if a person eats a young swallow, he will be in no danger of an angina for the whole year: and that if it be preserved in salt, to burn it, and powder the coal of it, and give it to drink in hydromel, does service in this distemper. And as this is confidently reported by men of good credit among the common people, and the practice can be attended with no danger, although I have not read of it in medical treatises, yet I thought fit to give it a place in this work.
Of a difficulty of breathing.
There is also a disorder about the fauces, which amongst the Greeks has different names, according to its different degrees. The whole consists in a difficulty of breathing: but while it is moderate, and does not wholly suffocate, it is called dyspnœa[ CN ]; when it is more severe, that the patient cannot breath without a noise, and quick fetches, asthma[ CO ]; when the difficulty is so great, that respiration cannot be performed, unless the neck be kept erect, orthopnœa[ CP ]. The first of these may be of long continuance without endangering life: the two following are commonly acute. These symptoms are common to them all, that by the straitness of the passage, through which the breath comes, a wheezing is occasioned; there is a pain in the breast and præcordia, sometimes also in the shoulders, and that goes and comes; besides these there is a slight cough.