The workes of that famous chirurgion Ambrose Parey translated out of Latine and compared with the French. by Th: Johnson

CHAP. VIII. Of the Angina, or Squinzy.

THe Squinancy, or Squinzy, is a swelling of the jawes, which hinders the entring of the ambient aire into the weazon, and the vapours and spirit * 1.1 from passage forth, and the meate also from being swallowed. There are three differences thereof. The first torments the patient with great paine, no swelling being outwardly apparent, by reason the morbificke humor lyes * 1.2 hid behinde the almonds or Glandules at the Vertebrae of the necke, so that it cannot be perceived, unlesse you hold downe the tongue with a spatula or the Speculum oris, for so you may see the rednesse and tumor there lying hid. The patient can∣not * 1.3 draw his breath, nor swallow downe meate, nor drinke; his tongue, (likes Gray-hounds after a course,) hangs out of his mouth, and he holds his mouth open that so hee may the more easily draw his breath; to conclude, his voyce is as it were drownd in his jawes and nose; he cannot lye upon his backe, but lying is forced to fit, so to breathe more freely: and because the passage is stopt, the drinke flyes out at his nose; the eyes are fiery and swollen, and standing out of their orbe. Those which are thus affected are often suddainely suffocated, a foame rising about their mouthes.

The second difference is said to be that, in which the tumor appeares inwardly, * 1.4 but litle or scarse any thing at all outwardly, the tongue, Glandules, and jawes ap∣pearing some what swollen.

The third being least dangerous of them all, causes a great swelling outwardly, but * 1.5 litle inwardly.

The Causes are either internall, or externall. The externall are a stroake, splin∣ter * 1.6 or the like things sticking in the Throat, or the excesse of extreme cold, or heat. The internall causes are a more plentifull defluxion of the humors either from the whole body or the braine, which participate of the nature either of blood, choler or flegme, but seldome of Melancholy. The signes by which the kinde and commixture may be knowne, have beene declared in the generall treatise of tumors. The Squincy is more dangerous, by how much the humor is lesse appa∣rent within and without. That is lesse dangerous which shewes it selfe outwardly, because such an one shuts not up the wayes of the meate, nor breath. Some dye of a Squincy in twelue houres others in two, foure or seven daies. Those (saith Hippocrates) * 1.7 which scape the Squincy, the disease passes to the lungs, and they dye within seven

dayes; but if they scape these dayes, they are suppurated; but also often times this kind of disease is terminated by disappearing, that is, by an obscure reflux of the humor into some noble part, as into the Lungs (whence the Empyema proceeds) and into other principall parts, whose violating brings inevitable death; sometimes by resolution, otherwise by suppuration.

The way of Resolution is the more to be desired; it happens when the matter is small, and that subtle, especially if the Physition shall draw blood by opening a veine, and the patient use fitting Gargarismes. A Criticall Squincy divers times proves deadly by reason of the great falling downe of the humor upon the throtle, by which the passage of the breath is sodainely shut up. Brothes must be used made with Capons, and Veale, seasoned with Lettuce, Purslaine, Sorrell, and the cold seeds.

If the Patient shall be some what weake, let him have potched Egges, and Barly * 1.8 Creames, the Barly being first boiled with Raisons in water and Sugar, and other meates of this kinde. Let him be forbidden wine, in stead where of he may use Hydro∣melita, and Hydrosachara (that is, drinkes made of water and Hony, or water and Sugar) as also the Syrupes of dryed Roses, of Violets, Sorrell and Limons, and others of this kinde. Let him avoide too much sleepe. But in the meane time the Phy∣sition must be carefull of all, because this disease is of their kinde, which brooke no delayes. Wherefore let the Basilica be presently opened, on that side the tumor is * 1.9 the greater; then within a short time after the same day, for evacuation of the con∣junct matter, let the veine under the tongue be opened; let cupping-Glasses be ap∣plyed, sometimes with scarification, sometimes without, to the necke and shoulders, and let frictions and painefull Ligatures be used to the extreme parts. But let the humor impact in the part be drawne away by glisters and sharpe suppositories. Whilest the matter is in defluxion, let the mouth without delay be washed with a∣stringent gargarismes to hinder the defluxion of the humor, least by its suddaine falling downe it kill the Patient, as it often happens, all the Physitions care and dili∣gence * 1.10 not withstanding. Therefore let the mouth be frequently washed with Oxy∣crate, or such a gargarisme: ℞ Pomorum silvest. nu. iiij. sumach, Rosar. rub. an. m. ss. berber. ʒij. let them be all boyled with sufficient quantity of water to the consump∣tion of the halfe, adding thereunto of the wine of soure Pomegranats ℥iiij. of dia∣moron ℥ij, let it be a litle more boyled and make a gargle according to arte. And there may be other Gargarismes made of the waters of Plantaine, Night-shade, Verjuice, Iulep of Roses and the like. But if the matter of the defluxion shall be Phlegmaticke, Alume, Pomgranate pill, Cypresse nuts, and a litle Vinegar may be safely added. But on the contrary, repercussives must not be outwardly applyed, but rather Lenitives, where by the externall parts may be relaxed and rarified, and so the way be open either for the diffusing or resolving the portion of the humor. You shall know the humor to begin to be resolved, if the Feaver leave the patient, if he swallow, speake and breathe more freely, if he sleepe quietly, and the paine begin to be much aswaged. Therefore then natures endeavor must be helped by apply∣ing resolving medicines, or else by using suppuratives inwardly and outwardly, if the matter seeme to turne into Pus. Therefore let gargarismes be made of the roots * 1.11 of March-Mallowes, Figgs, Iujubes, damaske Prunes, Dates, perfectly boyled in water. The like benefit may be had by Gargarismes of Cowes milke with Sugar, by oyle of sweete Almonds, or Violets warme, for such things helpe forward sup∣puration and aswage paine; let suppurating cataplasmes be applyed outwardly to the necke and throate, and the parts be wrapped with wooll moistened with oyle of Lillyes. When the Physition shall perceive that the humor is perfectly turned into pus, let the patients mouth be opened with the Speculum oris, and the abscesse opened with a crooked and long incision knife; then let the mouth be now and then washed with clensing gargles; as ℞. Aquae hordej lib. ss. mellis ros. & syr. rosar. sic. an ℥j. fiag gar∣garisma. * 1.12 Also the use of aenomel, that is wine, and Hony will be fit for this purpose. The ulcer being clensed by these means, let it be cicatrized with a litle roch-Alume added to the former gargarismes.

[illustration]

The Figure of an incision knife opened out of the hafte, which serves for a sheath thereto.

Notes

• * 1.1

  What it is.
• * 1.2

  The differen∣ces. The first kind.
• * 1.3

  The Sym∣ptomes.
• * 1.4

  The second kinde.
• * 1.5

  The third.
• * 1.6

  The Causes:
• * 1.7

  Hip. sect. 3. prog. z. Aphor. ••0. sect. 5.
• * 1.8

  Dict.
• * 1.9

  Cure.
• * 1.10

  Repelling Gargarismes.
• * 1.11

  Ripening Gargarismes.
• * 1.12

  Detergent Gargarisma.