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

by S. A. D. Tissot

§ 109. In that kind, and those Circumstances, of this Disease described [§ 105] we must have very frequent Recourse to Bleeding; and it should never be omitted, when the Pulse is very perceivably hard and full. It is of the utmost Consequence to do it instantaneously; since it is the only Means to prevent the Abscess, which forms very readily, if Bleeding has been neglected, only for a few Hours. Sometimes it is necessary to repeat it a second Time, but very rarely a third.

This Disease is frequently so gentle and mild, as to be cured without Bleeding, by the Means of much good Management. But as many as are not Masters of their own Time, nor in such an easy Situation, as to be properly attended, ought, without the least Hesitation, to be bled directly, which is sometimes sufficient to remove the Complaint; especially if, after Bleeding, the Patient drinks plentifully of the Ptisan [Nº. 2].

In this light Degree of the Disease, it may suffice to bathe the Legs, and to receive a Glyster, once a Day each; the first to be used in the Morning, and the last in the Evening. Besides the general Remedies against Inflammations, a few particular ones, calculated precisely for this Disease, may be applied in each kind or Degree of it. The best are, first the emollient Poultices, [Nº. 9], laid over the whole Neck. [²⁷] Some have highly extolled the Application of Swallows Nests in this Disease; and though I make no Objection to it, I think it certainly less efficacious than any of those which I direct.

2. Of the Gargarisms ([Nº. 19]) a great Variety may be prepared, of pretty much the same Properties, and of equal Efficacy. Those I direct here are what have succeeded best with me and they are very simple. [²⁸]

3. The Steam of hot Water, as directed [§ 55], should be repeated five or six Times a Day; a Poultice should be constantly kept on, and often renewed; and the Patient should often gargle.

There are some Persons, besides Children, who cannot gargle themselves: and in fact the Pain occasioned by it makes it the more difficult. In such a Case, instead of gargling, the same Gargarism ([Nº. 19]) may be injected with a small Syringe. The Injection reaches further than Gargling, and often causes the Patient to hawk up a considerable Quantity of glarey Matter (which has grown still thicker towards the Bottom of the Throat) to his sensible Relief. This Injection should be often repeated. The little hollowed Pipes of Elder Wood, which all the Children in the Country can make, may be conveniently employed for this Purpose. The Patient should breathe out, rather than inspire, during the Injection.

§ 110. Whenever the Disease terminates without Suppuration, the Fever, the Head-ach, the Heat in the Throat, and the Pain in swallowing, begin to abate from the fourth Day, some times from the third, often only from the fifth; and from such Period that Abatement increases at a great Rate; so that at the End of two, three, or four Days, on the sixth, seventh, or eighth, the Patient is entirely well. Some few however continue to feel a light Degree of Pain, and that only on one Side, four or five Days longer, but without a Fever, or any considerable Uneasiness.

§ 111. Sometimes the Fever and the other Symptoms abate, after the Bleeding and other Remedies; without any subsequent Amendment in the Throat, or any Signs of Suppuration. In such Cases we must chiefly persist in the Gargarisms and the Steams; and where an experienced and dexterous Surgeon can be procured, it were proper he should scarify the inflamed Tonsils. These discharge, in such Cases, a moderate Quantity of Blood; and this Evacuation relieves, very readily, as many as make use of it.

§ 112. If the Inflammation is no ways disposed to disperse, so that an Abscess is forming, which almost ever happens, if it has not been obviated at the Invasion of the Disease; then the Symptoms attending the Fever continue, though raging a little less after the fourth Day: the Throat continues red, but of a less florid and lively Redness: a Pain also continues, though less acute, accompanied sometimes with Pulsations, and at other Times intirely without any; of which it is proper to take Notice: the Pulse commonly grows a little softer; and on the fifth or sixth Day, and sometimes sooner, the Abscess is ready to break. This may be discovered by the Appearance of a small white and soft Tumour, when the Mouth is open, which commonly appears about the Centre or Middle of the Inflammation. It bursts of itself; or, should it not, it must be opened. This is effected by strongly securing a Lancet to one End of a small Stick or Handle, and enveloping, or wrapping up the whole Blade of it, except the Point and the Length of one fourth or a third of an Inch, in some Folds of soft Linnen; after which the Abscess is pierced with the Point of this Lancet. The Instant it is opened, the Mouth is filled with the Discharge of a Quantity of Pus, of the most intolerable Savour and Smell. The Patient should gargle himself after the Discharge of it with the detersive, or cleansing Gargarism [Nº. 19]. It is surprising sometimes to see the Quantity of Matter discharged from this Imposthumation. In general there is but one; though sometimes I have seen two of them.

§ 113. It happens, and not seldom, that the Matter is not collected exactly in the Place, where the Inflammation appeared, but in some less exposed and less visible Place: whence a Facility of swallowing is almost entirely restored; the Fever abates; the Patient sleeps; he imagines he is cured, and that no Inconvenience remains, but such as ordinarily occurs in the earliest Stage of Recovery. A Person who is neither a Physician, nor a Surgeon, may easily deceive himself, when in this State. But the following Signs may enable him to discover that there is an Abscess, viz. A certain Inquietude and general Uneasiness; a Pain throughout the Mouth; some Shiverings from Time to Time; frequently sharp, but short and transient, Heat: a Pulse moderately soft, but not in a natural State; a Sensation of Thickness and Heaviness in the Tongue; small white Eruptions on the Gums, on the Inside of the Cheek, on the Inside and Outside of the Lips, and a disagreeable Taste and Odour.