Where the Disease is mild, the Symptoms favourable, the Sloughs superficial, or scarce perceptible, it may be sufficient to order a Gargle of Sage-Tea with a few Rose-Leaves added in the Infusion; three or four Spoonfuls of Vinegar may be mixed with half a Pint of the Tea, and as much Honey put to it, as will leave it agreeably acid.
But where the Symptoms are urgent, the Tendency, to Putrefaction great, the Sloughs large and thick, and the Breath offensive, Recourse must be had to more efficacious Remedies: A Composition like the following, varied only as the Patient's Age and the Circumstances of the Disease required, has in general been attended with very good Effects. The Proportion here given may be used for Adults, and the more active Parts lessen'd for younger Subjects.
℞ Decoct. Pectoral. ℥ xij. cui inter coquendum add. Rad. Contrayerv. contus. ℥ ss. Liquori colato admisce Acet. Vin. Alb. ℥ ij. Tinct. Myr. ℥ i. Mel. opt. ʒ vi. f. Gargarisma.
As the Parts about the Gullet are frequently so much affected, as to render it painful or impracticable for the Sick themselves to make use of the Gargle so freely as they ought, it is commonly order'd, that a few Spoonfuls of this Liquor, made somewhat warm, should be very often injected into the Fauces with a small Syringe; and especially before the Patient swallows any thing, in order to wash off as much as possible the putrid Sordes adhering to the Ulcers, and prevent it from passing into the Stomach and Bowels. In young Subjects this Method is the more necessary, as they don't always know how to manage a Gargle to any Purpose, did the Soreness of the Parts permit them to do it.
If the Sloughs are large, and cast off slowly, they may be touched with Mel Ægyptiacum, by means of an armed Probe; or it the Condition of the Fauces is such, that this cannot conveniently be done, a Spoonful of the following Mixture may be injected, and retain'd in the Throat, as long as the Patient can endure it; the Parts may then be washed two or three times with the Gargle alone.
℞ Gargarism. præscript. ℥ ij. Mel Ægypt. ʒ j. m.
By the constant and regular Use of these Applications, if the Patient is kept warm, and the Method of treating him in other Respects is observed, agreeable to what has been mention'd above, it seldom happens but that the febrile Symptoms disappear, the Sloughs come off, and the Ulcers are disposed to heal in a few Days; unless it be where Mismanagement at first, Malignity of the Infection, or an unfavourable Constitution, have one or all contributed to increase the Disease, and to render its Consequences more lasting and mischievous.
What Effects improper Treatment produces in this Case has already been observed. With regard to the Matter of Contagion, or Nature of that Cause which so suddenly brings on such a Train of Symptoms as hath been described, little can be said with any Degree of Certainty: Thus much, however, seems to be true in Fact, that in some Cases the Disease appears to be of so mild a Nature, and so benign, as to require but little Assistance from Art: Persons even recover from it under the Disadvantages of unskilful and injurious Management; whilst in others, the Progress of the Symptoms is so rapid, and the Tendency to Corruption so strong, that nothing seems able to oppose it. Just as it happens in the Small-Pox; the benign and distinct sort bears ill Treatment without Injury; in the malignant flux Kind, the utmost Art and Experience are too often insufficient to conduct the Distemper to a happy Issue. Whether this Diversity in the Sore Throat we are speaking of, is owing to a Difference of Constitutions, or of Seasons, to the different Quality or Quantity of the Contagion, or the Manner of receiving it; or whether there are in Reality distinct Species of it; may perhaps hereafter be more certainly determined.
With respect to Constitution, it may be further observed, that in soft, lax, leucophlegmatic Habits, and languid inactive Dispositions, every thing else being equal, the Disease seems to proceed more slowly, to go off more irregularly, and to leave behind it more lasting Effects. In some Persons of the Temperament described, tho' the Fever has grown less, and all the Symptoms abated in four or five Days, yet the Sloughs in the Throat have continued almost a Week longer; whilst in the opposite Constitution, tho' the Disease has been much more acute, yet the Symptoms have no sooner abated, than the Sloughs have cast off, and the Ulcers healed of their own Accord.
A copious Hæmorrhage from the Nose, Mouth, or Ears, the last especially, coming on after the Disease has continued three or four Days, or longer, is a dangerous Phænomenon: For at this time of the Distemper, it most probably proceeds from the Branch of an Artery destroy'd by the Mortification, and laid open by the Separation of the Slough. If the Vessel is therefore large, the Bleeding may prove fatal to the Patient in a very short time; or if he escapes for the present, the Loss of a considerable Quantity of Blood at this time of the Disease, will occasion various ill Consequences.