Advice to the people in general, with regard to their health

by S. A. D. Tissot

§ 105. The most usual kind of this Disease is that which affects only the Tonsils (the Almonds) and the Palate; or rather its Process, commonly called the Palate. It generally first invades one of the Tonsils, which becomes enlarged, red and painful, and does not allow the afflicted to swallow, but with great Pain. Sometimes the Disorder is confined to one Side; but most commonly it is extended to the Uvula, (the Palate) from whence it is extended to the other Tonsil. If it be of a mild kind, the Tonsil first affected is generally better, when the second is attacked. Whenever they are both affected at once, the Pain and the Anguish of the Patient are very considerable; he cannot swallow, but with great Difficulty and Complaint; and the Torment of this is so vehement, that I have seen Women affected with Convulsions, as often as they endeavoured to swallow their Spittle, or any other Liquid. They continue, even for several Hours sometimes, unable to take any thing whatever; all the upper inward Part of the Mouth, the Bottom of the Palate, and the descending Part of the Tongue become lightly red, or inflamed.

A considerable Proportion of Persons under this Disease swallow Liquids more difficultly than Solids; by Reason that Liquids require a greater Action of some Part of the Muscles, in order to their being properly directed into their Conduit or Chanel. The Deglutition (the Swallowing) of the Spittle is attended with still more Uneasiness than that of other Liquids, because it is a little more thick and viscid, and flows down with less Ease. This Difficulty of swallowing, joined to the Quantity thence accumulated, produces that almost continual hawking up, which oppresses some Patients so much the more, as the Inside of their Cheeks, their whole Tongue, and their Lips are often galled, and even flead as it were. This also prevents their Sleeping, which however seems no considerable Evil; Sleep being sometimes but of little Service in Diseases attended with a Fever; and I have often seen those, who thought their Throats almost entirely well in the Evening, and yet found them very bad after some Hours Sleep.

The Fever, in this Species of the Disease, is sometimes, very high; and the Shivering often endures for many Hours. It is succeeded by considerable Heat, and a violent Head-ach, which yet is sometimes attended with a Drowsiness. The Fever is commonly pretty high in the Evening, though sometimes but inconsiderable, and by the Morning perhaps there is none at all.

A light Invasion of this Disease of the Throat often precedes the Shivering; though most commonly it does not become manifest 'till after it, and at the same Time when the Heat comes on.

The Neck is sometimes a little inflated, or puffed up; and many of the Sick complain of a pretty smart Pain in the Ear of that Side, which is most affected. I have but very seldom observed that they had it in both.

§ 106. The Inflammation either disappears by Degrees, or an Abscess is formed in the Part which was chiefly affected. It has never happened, at least within my Knowledge, that this Sort of the Disease, prudently treated, has ever terminated either in a Mortification, or a Scirrhus: but I have been a Witness to either of these supervening, when Sweating was extorted in the Beginning of it, by hot Medicines.

It is also very rare to meet with those highly dangerous Translations of this Disease upon the Lungs, such as are described in that Species of it from [§ 103], [104]. It is true indeed it does not occur more frequently, even in that Species, whenever the Disease is thrown out upon the more external Parts.

§ 107. The Treatment of the Quinsey, as well as of all other inflammatory Diseases, is the same with that of an Inflammation of the Breast.

The Sick is immediately to be put upon a Regimen; and in that Sort described [§ 103], Bleeding must be repeated four or five Times within a few Hours; and sometimes there is a Necessity to recur still oftner to it. When it assaults the Patient in the most vehement Degree, all Medicines, all Means, are very generally ineffectual; they should be tried however. We should give as much as can be taken of the Drinks [Nº. 2] and [4]. But as the Quantity they are able to swallow is often very inconsiderable; the Glyster [Nº. 5] should be repeated every three Hours; and their Legs should be put into a Bath of warm Water, thrice a Day.

§ 108. Cupping Glasses, with Scarification, applied about the Neck, after bleeding twice or thrice, have often been experienced to be highly useful. In the most desperate Cases, when the Neck is excessively swelled, one or two deep Incisions made with a Razor, on this external Tumour, have sometimes saved a Patient's Life.