Adenochoiradelogia, or, An anatomick-chirurgical treatise of glandules & strumaes or, Kings-evil-swellings : together with the royal gift of healing, or cure thereof by contact or imposition of hands, performed for above 640 years by our Kings of England continued with their admirable effects, and miraculous events, and concluded with many wonderful examples of cures by their sacred touch / all which are succinctly described by John Browne.

CHAP. VIII. Of the Tongue, and its Tonsils.

THe Tongue in Latine called a Lingua à Lingendo, being the Instrument both of Speech and Taste, and the help of sending down both meat and drink into the Stomach, is placed in the mouth under the Pa∣late; and this in its upper part hath in it somewhat of a glandulous flesh lodged under its Cutis; inwards and downwards it's seen perfectly muscu∣lous, and does every way shew the use of its muscles.* 1.1 Arantius is one who will have this to be a glandu∣lous part, and if we may credit him, he doth assign its composition to be framed out of three various sub∣stances; for immediately under its membrane, there's somewhat of a pulpy substance about its root espe∣cially, the other substance of the

Tongue is framed of most thin and implext fibres, amongst which is planted fat, peculiarly proper for keeping them moist, and making them more fit for use, and this may be one great cause why he was so rea∣dy to give it the name of a glan∣dule, and this his assertion he is rea∣dy to confirm with these three argu∣ments: As the Tongue hath in its substance all kind of fibres, and these so intertext, that they cannot be di∣vided one from another, as may in other muscles. Secondly, There's no ligamental fibres planted in the Tongue for its strength; as is in other muscles. And his Third is, No muscle tasteth, but the pulp of the Tongue is the instrument of Taste, as Piccolom; and therefore Arantius affirms that the Tongue is no muscle, but a glandule.* 1.2 But we on the con∣trary shall find that the Tongue's fleshy part is musculous, when as in all the differences of animal motion, to the most subtile vowels, syllables, and pronouncing of Letters; all which do most suddenly express the conceptions of the mind, never tired in their motion, being either contract∣ed,

dilated, doubled, or laterally mo∣ved, according to the minds pleasure performing all its actions; and with∣out this were a muscle, and had o∣thers joined in consent therewith, these laudable motions were not thus to be performed by it. But our dis∣course at present not being concern'd with muscles, I shall shew Dr. Whar∣ton's Answers to Arantius,* 1.3 where he first convinces, That the fibres of the Tongue do evince it to be muscu∣lous; and that its substance, for the most part thereof is musculous, which appears from its various motions which it performs, and the variety of its fibres so diversely intertext, do only suffice for the diversity of its motions. Secondly, it's no ways necessary that every Muscle must needs have a Tendon, but that which hath a fleshy beginning may have the like end. Thirdly, That Nerves do pass through its whole substance, and this is perceived in a Hemeplegia, in which is seen very oft one part may be sound, and the other perplexed with a Palsey. And then lastly, the musculous part of the Tongue doth not taste, but the membrane which

does cover its glandulous pulp, espe∣cially near its root; and thus by the intervention of this membrane it takes notice of all sapours. Thus much of Dr. Wharton.

* 1.4The Larynx is formed of diverse parts that it may freely enjoy its office modulation of the voice, and this requiring a continual stream of moi∣sture to afford it common liquoring,* 1.5 it hath several glandules placed as Sponges for its collective uses, a∣mongst which are two very large ones, conspicuous at the uppermost seat of the Larynx, or rather at the root of the Tongue, one on either side; and these by the Greeks are called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. lodging in the narrow passages of the Fauces. By the Barbarians they are commonly called Amygdalae, yet no ways carrying in them the likeness or figure of an Almond; in Latin they are called Tonsillae, and at this day do bear the English name of Tonsils amongst us: They are covered with the same coat as is the mouth, and are indued with small Veins and Arte∣ries, arising from the Carotid Arte∣ries and Jugular veins; and, as Whar∣ton

saith, although in sound Bodies they are less protuberant, yet in a morbid body, where these are much inflamed or tumefied, they do carry a good resemblance of an Almond; and hence it is presumed they had this name given them. They are loose and spongy in their nature, and are of a similar friable substance, much resembling Honey and Oyl con∣creted together by cold, save only they are more firmly adherent as it were by a membranous connexion; soft to touch, but being boyled, hard: for upon their boyling, they do lose their porosity, and so become indurate: they have various Ductus's,* 1.6 and these proper to themselves; they have one Sinus, both large and oval, on either side opened into the mouth, whose skirt doth obtain two large ones, and much lesser cavities; in the same manner are also many protuberancies, like little Papillae or Teats, disperst through the glan∣dulous root of the Tongue, eve∣ry of which have their proper perfo∣rations allowed them; and out of these various Foramina is a Mucus sent forth, disposed thus by the root

of the Tongue, where these glan∣dules are most thick (the mouth be∣ing opened) doth send the same by their common cavities into the Throat; and this cavity in an Oxe will admit the entrance of a little finger into it. Fallopius hath ob∣served, that sometimes the open∣ing of this great Sinus doth in some measure represent a small Ulcer, and is oft times treated and taken by the inexpert Chyrurgion as the same; this oft-times hapning in the mouth by a plenty of Tumours falling into this glandule, and so causing it to give its thus patent appearance, as shall be made good by some Obser∣vations thereof at the end of this Chapter:* 1.7 Under these Tonsils are planted two others, next to the low∣er Region of the Larynx, one on either side; at the sides of some of the first Annulars, or Rings of the Windpipe, these because they are guifted with many small Veins and Arteries, do carry a more bloody and solid substance in them than other glandules, and do resist the Knife in dissection more than others. There's much controversie about the uses of

these glandules,* 1.8 some supposing they are framed for moystning the La∣rynx outwardly with a viscous and pinguid humidity, and so making the Cartelages more apt for motion; but because there is not much need of them for this use, I do suppose they may more properly give assistance to the Salival vessels; others, with Rio∣lan do affirm, that they are framed for collecting the humidities which are sent thither from the Brain; and with him do allow that these were here planted for preventing the fall of the same upon the Lungs; and that this may appear somewhat probable, he enlarges upon the blowing of the Nostrils, and in sucking in of the Palate, by which we find a kind of mucous slimy matter or spittle co∣ming thence, which must necessarily proceed from the Brain; so also he supposeth that that which enters the Tonsils, may also distil and fall from thence, for in such creatures who do want these glandules, as Peacocks and the like, who also want Teeth, nor do not chew their humi∣dities, in such it doth immediately fall into the cavity of the mouth, not

into the Thorax. Again, if the ex∣crements of the Brain must first ne∣cessarily fall into the mouth before they enter the Lungs, and then into them likewise; these Tonsils will make nothing for their sufflamination.* 1.9 A second use which some do attri∣bute to these glandules is, that they do convert the humidities sent to them from the Brain into spittle: Against which assertion we offer this objection,* 1.10 The humour which is thus sent into the mouth by the glandules is not spit∣tle, but rather some mucous and pi∣tuitous matter, not much unlike that which is dispatcht by the Nostrils, and what difference this carries from spittle, every man may easily judge: but of this more fully, and more pro∣perly when we come to the Salival glandules of Steno and Wharton. A third use given to these, is to keep the Tongue moist, and all its circum∣jacent parts; this use may be allow∣ed them, the humour coming from them naturally being mucilaginous, and therefore most proper for keep∣ing the parts most lubricous; and moreover, the small Lymphatick ves∣sels or Salival vessels, as also the small

cavites of the membrane of the mouth may very well allow the same, especi∣ally when the Mouth and Tongue are moved, the which every one may ex∣perience in himself when he pleaseth. And hence when the nutriments are chewed in the mouth, partly spon∣taneously, partly by the masticated nu∣triment, this liquor thus exprest out of the glandules doth much more plen∣tifully flow into the mouth, both for the framing a better mixture, use∣ful for the fermentative preparation of nutriment, as also for a more rea∣dy and more easie deglutition of the same: In rest therefore when the Mouth is not moved, and when the effusion of this liquor doth also cease, as is generally seen in those which are asleep, the Mouth and Fauces do soon become dry, being robb'd and de∣prived of this liquor, especially if they do sleep with an open mouth. A fourth use is, That they do help Tasting, the Which cannot be done without moysture; of which Opini∣on our worthy Wharton is, who al∣lows these the primary Organ thereof, the moister parts most relating to spitting; both which do much con∣tribute

towards the extraction of the tincture of meats, as also towards a plentiful mastication; and so may more properly be allowed to be fra∣med for the purpose of Tasting or Gust's sake. For dry things, with∣out having some tincture in them, are altogether unuseful as to taste; when therefore the mucilaginous hu∣mour is less fit for the extraction of Tincture, and also less proper in ma∣stication for mixing with the meats, how far this may make towards tast∣ing, any one may judge; but how far it may conduce towards a gust, when it is as its proper Organ, is al∣ready described by him. The true uses hereof, allowed by Wharton, are these five,* 1.11 which I shall only name: As First, he declares these glandules the primary Organ of Taste; where he also writes, That in all parts of the Mouth in which Taste is perceived, this glan∣dule by its intervening membrane doth act the same; Nature never interpo∣sing between the gift which is to feel, and the Organ it self which feels it; when as therefore the part is seen every way exercised in Taste, this approaches near the gustile object,

and this is necessary that it should be the instrument of Taste, and if it be the instrument, it doth thence con∣vince its gift, which is by him called the first use thereof. The Second use allows them as an excretory In∣strument, its office being to separate some mucous and pituitous matter, falling from the lower part of the Brain, by the nerves especially; those of the third pair distilling and flowing thence, partly from the san∣guinary mass effused by the Arteries, and so refunded into the Fauces and Mouth, as is already described by him; but this is readily refuted by Diemerbroeck, when he writes, That whereas Wharton doth say that these glandules (without all reason) are endued with a notable sense, and that they are the true and primary Organs of Taste, and supposeth that the pituitous matter flowing from the Brain to them by the Nerves, (as if thick and viscid matter could pass through these minute and visible pores of the nerves so plentifully) is a thing which requires not great dif∣ficulty to refute, he allowing them to be a great productive towards this

faculty of Tasting. A Third use of these glandules he allows is, to moysten the Fauces, Larynx and Tongue, for their better and more easie respiration, that the voice hereby may be more sound, and that deglutition may thereby also with more ease be performed. His fourth is, That in plentiful Catarrhs of the Brain, the Nostrils at this time being obstructed, part of the matter being imbibed into their spongy substance, may hence be dispatcht and discharg∣ed by the mouth. And his last is, That by its fermentative faculty, the liquor which thence comes into the Mouth, and so entring the Stomach, doth therein promote digestion; by whose acidity also it doth contract the same, the which doth chiefly tend towards the promoting a fer∣mentation, and is the chief cause thereof.

* 1.12Langius Epistol. 7. Tom. 2. tells us there of a Noble man, who being af∣flicted with a continual Cough, ari∣sing by a Stone concreted in his Ton∣sils; Physicians using all drying Re∣medies, in hope of stopping his Rheum, which they suspected was

the occasion of his Cough; by the use of which the Muscles of his La∣rynx were much tumefied; by Lan∣gius his advice, Emollients and sup∣purating Medicines being prescribed, the Tumour began to grow soft; and a strong Cough arising hence by this distillation, did herein frame a kind of Lime-stone, much like to the Chalk-stone or Tophies which are usually seen in the Joints of those which are troubled with the Gout, arising chiefly from glassy flegm.

Joannes Jessenius also writes of one,* 1.13 who having a Tumour in his Ton∣sils, so as that he could scarce breath, or swallow any nutriment, who ha∣ving made use of many drying Gar∣garisms made of Red Roses, Balau∣stians, with Roch Allome, and the like; and not well mundefying the whole, by which the thinner part was dried up, whilst the more Terrene part thereof was left remaining be∣hind (the which do frequently hap∣pen in Aedematous Tumours) this grew into a Chalky and Stony sub∣stance, the which advancing in hard∣ness, and encreasing in bulk, the Muscles of the Larynx being here∣with

extended, his breathing grew more difficult, and a distillation thence arising, by his strong coughe¦ing, the patient forc't out the Ston- which was lodged therein, and his Spirits very speedily recruited, and he himself suddenly restored to his former health.

* 1.14Forestus lib. 14. de Aegritud. Lingu. Obs. 26. hath this History of a Wo∣man about 23 years of age, who for a long time having much pain about her Mouth, near her Chin and low∣er Mandible, under her Tongue, in the Musculous parts thereof, and about the root of the same; Peter Frederick, the Chyrurgion, who vi∣sited this patient daily for some time, and perceiving a hardness still con∣tinuing, did hope that he might bring the same to suppuration, the which he endeavoured by a cut Fig, apply∣ing it to the place; the tumour be∣yond expectation growing more soft by the use hereof, at length did break, whence issued a little Stone, somewhat hard, and forc't it self thence without any incision, the big∣ness of a Hasel-nut; this being gone, all pain suddenly ceased, no suppu∣ration,

or Sanies or matter followed it; and that which herein was wor∣thy of Observation was, That the lips of the wound healed up without any help of Medicine. Soon after which, he writes he saw just such another coming out from these parts, somewhat larger than the former. And

Diemerbroeck tells us a History of a Woman of Breukelens,* 1.15 who in the year 1659. in the month of April, upon eating of Damask Pruines, which had been boyl'd, and upon her over-ready swallowing one of them, the Stone thereof past into the mouth of the great Sinus of this glandule, whence the glandule imme∣diately tumefied, in that measure that it shut up both the passages of her eating and drinking. So that in four days after the sick Woman could neither eat nor drink, he being sent for to consult her distemper, her Tongue being kept down, her glan∣dule was seen very much tumefied in- the right side, but little inflamed, and this apertion already discoursed of, more than ordinarily opening, not seeing the Pruine-stone; she af∣ter

taking the Decoction of Barly, with Syrup of Marsh-mallows mixt together, he ordered her to suck it into her Mouth, and putting his Thumb to the outside of the tume∣fied part of the glandule, and strong∣ly compressing the same, commands the Woman with her utmost strength to swallow down the same which she had put into her Mouth; the first liquor, upon her thus endeavouring, threw it self forth by her Nostrils; but upon the second tryal, when his Thumb had made a considerable compression outwards, and keeping the Tongue down and inwards, this stone flew out of the glandule into her Mouth, presently after which she swallowed both meat and drink very well, as she formerly did. And the same Woman, he also writes, in the year 1664. had the like mischance happened to her again upon eating of stewed Pruines, in the month of May, whose glandule catcht into it another Pruine-stone in like manner as the former, which was cured the second time, but with more trouble. Another like case happened in the year 1661. in the month of December,

upon a certain Citizen,* 1.16 who upon eating of Cheese, and having a piece of hard crusty Cheese fallen into this cavity, hindring his whole swallow∣ing; this Cure did not succeed, he tells us, with the same ease as the for∣mer, but took many days tryal be∣fore this Cure could be effected.

Notes

• * 1.1

  Arantius will have the Tongue a glandule, although improper∣ly.
• * 1.2

  The Tongue proved to be a mus∣cle.
• * 1.3

  Wharton's Answer to Arantius.
• * 1.4

  Of the Larynx.
• * 1.5

  Several glandules given to it.

  Two very large ones at the root of the Tongue.
• * 1.6

  They have various Ductus.
• * 1.7

  Two more under these, next to the lower part of the La∣rynx.
• * 1.8

  A Contro∣versie a∣bout their uses.
• * 1.9

  Four uses allowed by Whar∣ton.
• * 1.10

  What the humour is which is sent into the mouth by them.
• * 1.11

  Five uses allowed by Whar∣ton.
• * 1.12

  History 1.
• * 1.13

  History 2.
• * 1.14

  History 3.
• * 1.15

  History 4.
• * 1.16

  History 5.