It sometimes happens, before the tumour breaks, that the swelling is so great, as entirely to prevent any thing from getting down into the stomach. In this case the patient must inevitably perish, unless he can be supported in some other way. This can only be done by nourishing clysters of broth, or gruel with milk, &c. Patients have often been supported by these for Several days, till the tumour has broke; and afterwards they have recovered.
Not only the swallowing, but the breathing, is often prevented by the tumour. In this case nothing can save the patient’s life, but opening the trachea or wind-pipe. As that has been often done with success, no person, in such desperate circumstances, ought to hesitate a moment about the operation; but as it can only be performed by a surgeon, it is not necessary here to give any directions about it.
When a difficulty of swallowing is not attended with an acute pain or inflammation, it is generally owing to an obstruction of the glands about the throat, and only requires that the part be kept warm, and the throat frequently gargled with something that may gently stimulate the glands, as a decoction of figs with vinegar and honey; to which may be added a little mustard, or a small quantity of spirits. But this gargle is never to be used where there are signs of an inflammation. This species of angina has various names among the common people, as the pap of the throat, the falling down of the almonds of the ears, &c. Accordingly, to remove it, they lift the patient up by the hair of the head, and thrust their fingers under his jaws, &c. all which practices are at best useless, and often hurtful.
Those who are subject to inflammations of the throat, in order to avoid that disease, ought to live temperate. Such as do not chuse to observe this rule, must have frequent recourse to purging and other evacuations, to discharge the superfluous humours. They ought likewise to beware of catching cold, and should abstain from aliment and medicines of an astringent or stimulating nature.
Violent exercise, by increasing the motion and force of the blood, is apt to occasion an inflammation of the throat, especially if cold liquor be drank immediately after it, or the body suffered suddenly to cool. Those who would avoid this disease ought therefore, after speaking aloud, singing, running, drinking warm liquor, or doing any thing that may strain the throat, or increase the circulation of the blood towards it, to take care to cool gradually, and to wrap some additional coverings about their necks.
I have often known persons who had been subject to sore throats, entirely freed from that complaint by only wearing a riband, or a bit of flannel, constantly about their necks, or by wearing thicker shoes, a flannel waistcoat, or the like. These may seem trifling, but they have great effect. There is danger indeed in leaving them off after persons have been accustomed to them; but surely the inconveniency of using such things for life, is not to be compared with the danger which may attend the neglect of them.
Sometimes, after an inflammation, the glands of the throat continue swelled, and become hard and callous. This complaint is not easily removed, and is often rendered dangerous by the too frequent application of strong stimulating and styptic medicines. The best method is to keep it warm, and to gargle it twice a-day with a decoction of figs sharpened a little with the elixir or spirit of vitriol.
OF THE MALIGNANT QUINSEY, OR PUTRID, ULCEROUS SORE THROAT.
This kind of quinsey is but little known in the northern parts of Britain, though, for some time past, it has been fatal in the more southern counties. Children are more liable to it than adults, females than males, and the delicate than those who are hardy and robust. It prevails chiefly in autumn, and is most frequent after a long course of damp or sultry weather.
CAUSES.——This is evidently a contagious distemper, and is generally communicated by infection. Whole families, and even entire villages, often receive the infection from one person. This ought to put people upon their guard against going near such patients as labour under the disorder; as by that means they endanger not only their own lives, but likewise those of their friends and connexions. Whatever tends to produce putrid or malignant fevers, may likewise occasion the putrid ulcerous sore throat, as unwholesome air, damaged provisions, neglect of cleanliness, &c.