The store-house of physical practice being a general treatise of the causes and signs of all diseases afflicting human bodies : together with the shortest, plainest and safest way of curing them, by method, medicine and diet : to which is added, for the benefit of young practicers, several choice forms of medicines used by the London physicians / by John Pechey ...

Of Diseases of the TONGUE.

CHAP. XLIII. Of an Inflammation of the Tongue, and other Tumours of it.

AS all parts of the Body, especially such as are fleshy, are wont to be inflamed, so also is the Tongue some∣times, by reason of Blood flowing into it; and as it is Pure, Cholerick, Flegmatick or Melancholly, it occasions either a Flegmon, or an Erysipelas, an Oedema, or a Scirrhus, and sometimes it ends in Suppuration; whereof Forestus mentions an Observation, of a Brewer who had a great Inflammation of the Tongue, which Suppurated.

But most commonly the Swelling of the Tongue is soft and loose, and purely Oedematous, of which Galen pro∣poses an Example, of a Man whose Tongue was so tumi∣fied, that it could not be contained in his Mouth.

And sometimes also the Tongue grows excessively big, when there is no Oedema, no Scirrhus, nor any other kind of Tumour, and without any kind of Pain, and is only an increase proceeding from too great Nourishment of the part.

The Diagnostick of these Tumours is not difficult, for they may be seen; but the differences of them may be so distinguish'd, if there be an Inflammation, Pain and Heat, and Redness attend it, and the Face is also affected there∣with; but if the Swelling proceed from Flegm, the Tongue is white, and much Flegm flows out, which tasts sweet and insipid: But if it be only an increase of the Tongue, there are no signs of other Tumours or ill Humours.

As to the Prognostick; Tumours of the Tongue, for the most part, do not endanger Life, unless they grow so

great, that Suffocation should be feared from thence, or take their rise from some Malignant Humour, which may generate a Cancer, which is known by Hardness, pricking Pain, and a livid Colour.

The Cure of an Inflammation of the Tongue, must be begun with such things as cause a Revulsion, and with repelling Medicines: And then first a loosening Glister must be injected, and a large quantity of Blood must be taken away; presently after Cupping-glasses with Scarri∣fication must be applied to the Shoulders; afterwards cooling and repelling Gargarisms must be used. Galen commends the Juice of Lettice wherewith the Tongue must be washed; or a Gargarism may be prepared, of a Decoction of Plantane, Nightshade, of Syrup of dried Roses.

After Bleeding Purging may be prescribed, with a Me∣dicine made of Cholagogs and Flegmagogs.

The Fluxion being stopt by Evacuation, Revulsion and Derivation, the Derivation of the Humour stuft into the Tongue must be endeavoured; to which end the Veins under the Tongue must be opened: But if it cannot be done, by reason of the bigness of the Tongue, a Cup∣ping-glass, with Scarification, must be applied under the Chin.

If the Tumour tends to Suppuration, it must be pro∣moted by applying a Fig cut in the middle, which must be frequently changed, or by a Gargarism made of a De∣coction of Barly, Mallows, Violets, Figs, Raisins of the Sun, of the Seeds of Quinces and Fenugreek, adding to them Syrup of Violets and of Jujubs.

Suppuration being made, if the Abscess does not break of it self, let it be opened with a Knife, and the Ulcer must be presently cleansed with a Decoction of Barly, Agrimony and Plantane, with Honey of Roses.

But a soft and loose Tumour arising from Flegm, is cured first by Revulsion made by Bleeding, if the Sick abound with Blood; afterwards some strong Purge must be given, as is the Pill Coch minor: But if the Sick can∣not take Pills, a strong Purging Potion must be used.

After these Evacuations, cooling and repelling Medi∣cines must be applied at the beginning: The Tongue may be washed with the Juices of Lemons, Pomegranates, Sorrel, of Plantane, or with Simple Oxymel, to which

may be added in the increase of the Disease, a little Ginger, Sal Gemma, or Sal Armoniack. Zacutus Lusi∣tanus in a very dangerous case, when Suffocation was feared, by reason of the bigness of the Tongue, applied four Leeches to it, and soon after a great quantity of Blood was evacuated, and the Tongue asswaged. The same Zacutus Scarrified the Tongue deep in a Boy of Ten Years of Age, when the Tongue was soft, and by that means a great quantity of Salt-water flowed out, and the Patient was presently cured.

Lastly, When the Tongue is much increased, Claudinus proposes the Cutting off the Superfluous Flesh, necessary Preparations being first used.

CHAP. XLIV. Of the Ranula under the Tongue.

THough in the foregoing Chapter we treated of the Tumours of the Tongue, yet one remains, which we thought best to treat of in a Chapter by it self, because it is of a different Nature from the others, and requires a different way of Cure.

A Ranula is a Tumour under the Tongue, in that part wherein it is joyned to its bridle; and so great is this Tumour most commonly, that it rises higher than the lower Teeth; a cleft is in the middle of it, whereby it is divided into right and left, and by this means it re∣sembles the hinder part of a Frog, from whence it takes its name: It is of the Nature of a Meliceris, and the Matter which flows from it is like Honey, and contained in a Bag, and in this Bag a Stone is sometimes found.

It is most commonly without danger, but it is dan∣gerous when it looks black and brown, and is hard, for then it is of a Cancerous Nature, and ought not to be medled with.

As to the Cure of this Disease, First the antecedent Cause must be taken away; and if it be Inveterate, then you must use Cauteries and Sudorifick Decoctions,

Afterwards you must endeavour to dissolve it by Topical Remedies.

Take of Pomegranate-peel, of dried Hyssop, and of common Salt, each two drams; make a Powder to be held under the Tongue, and to be repeated often.

Forestus says, That a Girl of Twelve Years of Age was cured by this Remedy within two days: But in grown People it is best to use Sal Armoniack, which dissolves and penetrates more powerfully.

But if the Tumour cannot be cured by Medicines that discuss, it must be opened, which most commonly must be done; for it is seldom dissolved; but a large Apertio•• must be made, that all the Matter may come out toge∣ther; afterwards the Ulcer must be washed, first with gentle things, as with a Decoction of Mallows, after∣wards with cleansing things, as with Whitewine▪ mixed with Honey of Roses: Lastly, With Oxymel: When the Ulcer appears clear, and free from the Bag, it must be cicatrized, by washing the Mouth often with Allum dis∣solved in Claret.

If the Ulcer be Inveterate, and cannot be cured by the foresaid Remedies, touch it twice a day with the Oyl of Sulphur, tempered with Rose-water, viz. Mix one drop of the Oyl with five or six drops of the Water; for so the Intemperies will be corrected, and the part dried; which may be also strengthned by washing the Mouth often with a Dissolution of Allum in Claret: But if it will not be cured by these means, the actual Cautery must be used. You may see the manner of using of it in Paraeus, Book VII. Chap. 5.

CHAP. XLV. Of Tasting diminished, abolished or depraved.

TAsting, as the other Senses, and all the Actions of the Body, is injured three ways, it is diminished, abolished and depraved. It is diminished when it scarce perceives Tasts that are not strong, and but little such as are. It is abolished when it cannot taste any thing. And lastly, It is depraved, when it supposes the Object tasts differently from what it really does.

The Causes of Diminution, and Abolition of Tasting are the same, they only differ in degree; for if they are small, they only diminish the Taste; if they are great they abolish it.

The Causes are either a Defect of the Animal Spirits in the part, or an Intemperies of the Nerve, that comes from the third Pair to the Tongue, or the Tongue it self is some way preternaturally indisposed.

The Spirits are in fault, either by reason of the Paucity of them, as in People that are Dying; or upon account of Obstructions of the Nerves of the third Pair through which they are conveyed; or by reason of a Tumour in that part of the Brain from whence the Nerves rise.

The Tongue is either covered with a moist and Fleg∣matick Humour, or it is affected with Tumours, Pustles or Ulcers; and by these its proper Action, or the Sense of Tasting, may be either diminished or abolished.

The Taste is depraved when the Tongue is affected with some vitious Humour, as in Feavers, when it is in∣fected with Choler, all things seem bitter; and when it is infected with Salt Flegm, or a Melancholly Humour, all things taste Acid or Salt; for the External Objects coming upon the Tongue move the vitious Juice of it; and so all things that are tasted seem of the same Taste with the Humour in the Tongue: But sometimes the Tongue perceives the Taste of the Juices contained in it, although no External Object come near it. This is daily seen in Feavers, when the Tongue is infected with Choler,

for if it be very bitter, there is continually a bitter Taste in the Mouth.

The Diversity of the foresaid Causes may be known by the Variety of the Tasts, and by the Disposition of the Tongue; A sweet Tast, and a Redness of the Tongue signifies Blood, bitter Taste and a Yellow Colour signifies Choler; whiteness with Sweetness Flegm; a brown Colour and Sharpness Melancholly; an abominable Taste shows ill Humours contained in the Stomach: Pustles, Tumours, and Ulcers may be easily seen. But lastly, if there be no Alteration seen in the Tongue, and yet the tast is either diminished or abolished, we must suppose that the Cause lies hid in the Brain or Nerves.

The Cure is various according to the Variety of the Causes, and therefore if the Disease be in the Brain or Nerves, such Medicines must be ordered as are used for the Cure of a Palsie: But when the Taste is depraved by vitious Humours, that Symptom most commonly proceeds from other Diseases, especially from Feavers, which being cur'd the Symptom ceases,

If the Taste be injured by Tumours, the Cure of it de∣pends on the Cure of them.

Lastly, If the Fault arise from Pustles or Ulcers of the Tongue, the Cure of those must be undertaken by bleed∣ing, and purging, and with the Application of cooling drying and astringent Topicks, in the Form of a Gar∣garism. But if the Ulcers are sordid, they must be clean∣sed with Honey of Roses, sharpned moderately with Oyl of Vitriol, or of Sulphur. But when you would dry more powerfully, the affected Part must be touched once and again with the Oyls unmixed. And so may be cured Aphthae and all Ulcers of the Mouth and Tongue presently.

CHAP. XLVI. Of a Palsie of the Tongue, and of the Motion of it Hurt.

THe chief Action of the Tongue is Speech, and that is abolished, diminished and depraved by various Causes, which have Reference to Simular, Organick, or common Diseases. As to Simular, a moist Intemperies joyned with Matter renders the Tongue too soft and loose, so that it cannot move readily; also too much Dryness hinders Speech, which happens in Feavers; but Organick Diseases are magnitude increased, as was said before of Tumours, which hinders the free Motion of the Tongue; the Figure of it faulty, as when the Tongue is naturally too short, or when the Top of it is cut off, or when the Bridle is too strait, and an Obstruction of the Nerves of the seventh Pair, which are brought to the Muscles that move the Tongue.

Lastly, Common Diseases are a Solution of the Con∣tinuum, and Wounds of the Part.

Too great a Moisture of the Tongue causes Stammer∣ing, and such so affected cannot pronounce the Letter R, and it is either native as in Children, who by reason of too great Moisture are troubled with it, and are freed from it in Progress of Time, whereby the Superfluous Moisture is consumed; But in some it remains all their Life long, and they always Stammer.

But in some Stammering is accedental, and comes from a Catarrh, and from a great Fluxion of a Flegmatick Humour falling upon the Jaws or Tongue, and is cured by Evacuation, Revulsion, and Derivation, and by strength∣ning and drying the Head.

The Cure of a Palsie of the Tongue, is performed by taking off the antecedent Cause, viz. The Humour abounding in the Brain, and by discussing the Conjunct Cause, viz. the Humour thrust into the Nerves moving the Tongue. And first, Purging must be ordered, and Bleeding must be used if Blood abound, and such a Quantity must be

taken away as is agreeable to the Age and Strength of the Patient; afterwards Cephalick things must be used, and if the Diseases be obstinate, a Sudorifick Diet-drink.

After universal Evacuations, Derivation of the Morbi∣fick Matter must be made by Cupping-glasses, and Blisters applied to the Neck, and by an Issue in the hinder part of the Head.

Avicen applies a Cupping-glass to the Chin, which is also approved of by late Authors. Bleeding under the Tongue is also used successfully after general Evacuations; and to discuss the Humour the following Gargarism is frequently used.

Take of the Roots of Florentine-orris half an ounce, of the Leaves of wild Marjoram, Sage, Staechas, Rosemary, each half an handful, of Cubebs three drams, of Li∣quorish, one ounce; boil them in equal Parts of Water, and Whitewine added towards the end; to one Pint strain it, and dissolve in it two ounces of Oxymel of Squils; mlke a Gargarism. But if it be not strong enough to do the business, two or three drams of the Roots of Pellitory of Spain, or the like quantity of Mustard-seed may be added to it. Castor also may be added if it be not too unpleasing.

The Juice of Sage is much commended the Tongue being rub'd with it, you may also add Mustard-seed to it. The following Pills may be also held frequently upon the Tongue.

Take of the Juice of Bettony, and Liquorish, each one dram and an half, of Castor, and Assa-faetida, each half a dram, of Nutmeg, and Spicknard, each one scruple, make them up into small Pills with Honey,

Fumes and Powders sprinkled into the Hair, and the like, must be used to strengthen the Brain, and to discuss the Relicts of the Flegmatick Humour.

And lastly, To hinder the Growth of new Matter, which the Intemperies of the Brain is wont to cause, after general and particular Evacuations things that strengthen the Head must be used.