A systeme of anatomy, treating of the body of man, beasts, birds, fish, insects, and plants illustrated with many schemes, consisting of variety of elegant figures, drawn from the life, and engraven in seventy four folio copper-plates. And after every part of man's body hath been anatomically described, its diseases, cases, and cures are concisely exhibited. The first volume containing the parts of the lowest apartiments of the body of man and other animals, etc. / by Samuel Collins ...

CHAP. XVI. The Pathologie of the Gulet.

THe Gulet is discomposed by variety of Diseases, where the power of Swallowing suffereth a total loss, or at least a Diminution of its Operation, proceeding from a disaffection of the Brain, spoiling or weakning the tone of its Fibrils, or from some Tumour in the Gulet, or from vari∣ous Swellings of the adjacent parts, compressing the passage of it; or from a strange degeneracy of the substance of the Gulet, rendring it unca∣pable to Contract it self; or from some External Error, as being stopped by some Extraneous Matter: And last of all, the action of the Gulet is de∣praved by unnatural Motions, and Convulsions.

The Operation of the Gulet is very much discomposed, * 1.1 or wholly taken away by reason of a disaffected Brain, causing a Resolution, or weakning of the tone of the Muscles, belonging to the Gulet, for want of Animal Liquor and Spirits, when the origen of the Nerves is obstructed in the Cor∣tex of the Brain, caused by the grossness of the Nervous Liquor; or when the Nervous Fibrils are more or less straightned by the Swellings of the Membranes, or Ambient parts of the Brain compressing its Fibrils: Where∣upon the Current of the Animal Liqour and Spirits is wholly intercepted, or checked in its Motion, * 1.2 into the Extreamities of the Nervous Fibrils, so that it cannot be transmitted at all, or only in a small quantity into the Par Vagum, implanted into the Muscles of the Gulet, whence its Nervous and Ten∣dinous Fibrils are despoiled of, or lessened in their Motion, and thereupon not able at all, or not vigorously to Contract themselves to lessen the Cavity of the Gulet, and thereby to protrude the Aliment into the Cavity of the Stomach, whence ensueth an Abolition, or lessening the faculty of Deglutition.

The lost power of Deglutition, * 1.3 may also proceed from a straightness of the Nervous Fibrils, in their progress through the Processes of the Brain, made by stuffing its Ventricles with a gross clammy Matter, squeesing the Interstices of the neighbouring Filaments so close together, that they are not receptive of Animal Liquor, whence its course is impeded into the Par Vagum, and its Branches terminating into it, whereupon the Nervous Li∣quor is rendred destitute of its Motion, and the Swallowing Faculty, seated in the Gulet, is taken away.

A Countryman, having often Debauched himself to Intemperance with strong Liquor, was surprized with a sudden loss of Swallowing, which he survived but a small time; and then his Head being opened, the Ventricles were found full of a gross Viscid Matter, compressing the Nervous Compage of the Brain.

In order to the Cure of Sleepy Disaffections of the Brain (producing Diseases in the Gulet) proceeding from gross Humours, * 1.4 obstructing the Fi∣bres of the Brain, Purging Medicines may be advised, mixed with Lime Flowers, Lilly of the Valley, Paeony, and other Cephalicks, which may be given also in Decoctions without Purgatives, mixed with Cephalick Wa∣ters of Langius, Compound Paeony, Compound Lavender, sweetned with Syrups of Cephalick Flowers, and with Simple Waters of Paeony, Lavender,

Betony, Black Cherrys; and to every Dose of these Vehicles, may be added twelve drops or more of Spirit of Harts Horn, or Salt Ammoniack, succina∣ted in Spirit of Castor, &c. Clysters are also very proper in these Distem∣pers, made of a common Decoction, to which may be added, Leaves of Rue, Mel Anthosatum, the Lenitive Electuary, or any other proper Purgative Ele∣ctuaries: And last of all, when Universals have been Administred, Fumes of Amber, and Sternutatories, Blistering Plaisters may be advised, * 1.5 which are very proper in all Cephalick Distempers, disordering first the Brain it self, Per Idiopathiam, and afterward the Gulet, and other parts, Per Sym∣pathiam.

Another cause of the Abolition, or Diminution of Swallowing, * 1.6 may pro∣ceed from an Inflammation, or any Tumour, shutting up, or lessening the Cavity of the Gulet, by bringing its sides more or less close, whereby the passage of the Meat and Drink is hindred in its motion toward the Sto∣mach.

Another cause of ill Swallowing, may arise from a lump of Flesh, grow∣ing in the Fauces, and stopping up the entrance of the Gulet: Of which an Instance may be given in a Young Man, which had a large fleshy sub∣stance filling the hinder part of the Mouth, so that the beginning of the Gulet was so closed up, that it was not capable to give admission to Meat and Drink.

The Gulet is subject also to a lessened, or abolished Deglutition, * 1.7 by rea∣son of the Palate, Tonsils, and other parts adjacent to the entrance of the Oesaphagus, are more or less swelled by a quantity of Blood, Pituitous, or Salival Liquor, transmitted into the Interstices of the Vessels; whereupon the neighbouring parts of the Gulet, growing very much distended beyond the bounds prescribed by Nature, do more or less obstruct the Mouth of it, and either lessen or take away Deglutition. * 1.8

Sometimes Swallowing may be disaffected by some hard Body, a Bone, or the like, transmitted into the passage of the Gulet, in which it sticketh, causing a great Torture, and difficulty of Deglutition; which offereth a great Violence to the Gulet, and by great Pain, and sometimes Laceration of the Capillary Arteries, the Blood is Extravasated in the substance of Oeso∣phagus; whence sometimes followeth first an Inflammation, then a Gan∣graen, and last of all, a Mortification of the Gulet.

Fabritius Hildanus, among his Observations, giveth an Instance of this Case: Juveni (ait ille) cum inter caenandum ossiculum in Gula remansisset, & tota nocte, ut illud rejicere possit, occupatus fuisset, sequenti die Circa vespe∣ram ad me venit, Cathaeterem incurvatum clementer in Oesophagum immisi, & ea qua potui diligentia exploravi quo in loco infixum posset esse ossiculum, sed nihil praeter naturale invenire potui, praeter augustiam quandam Oesophagi, ere∣gione laryngis, & ea quidem in parte, ubi de dolore, non tamen pungitivo, sed obtuso conquerebatur. Cum itaque Curationem instituere vellem, Barbitonso∣rem accedit, qui per aliquot vices, instrumentis in guttur immissis, malum adeo exacerbavit, ut aucto dolore, tandem nihil amplius deglutire possit, quare iterum Octavo Die in consilium vocor, tum collum undique durum, tensum, supra mo∣dumque ad ipsum pectus Tumefactum inveni, dolor erat maximus, respiratio difficilis, Pulsus celer & debilis, neque guttulam jusculi deglutire potuit; quare ipsum in periculo esse astantibus significavi: Interim tamen ut dolor, reliquaque Symptomata mitigarentur, omnes Nervos intendi, collum & pectus Oleo Lilio∣rum & Amigdalarum dulcium inunxi: Cataplasma & sacculos Emollientes & Ano∣dynos applicui: Decoctum etiam è radicibus, & foliis Altheae, Malvae, Florum Cha∣maemeli,

Liliorum, & Meliloti cum pauco Melle è Cocleare lambendum dedi: sed omnia frustra, sequenti enim die placide obiit.

Post obitum Inciso collo Cesophagum cum vicinis partibus, sed eo praesertim loco, ubi ossiculum infixum fuerat, plane sphacelatum, cum maximo faetore inve∣nimus; ossiculum vero nusquam, immo nec in ipso Ventriculo; pulmones ob prae∣cedentem Inflammationem lividi erant, & Ventriculus plane vacuus; ossiculum vero illud prima nocte, & antequam ad me veniret, in maximis istis conatibus, quos immisso digito in Gulam sibi excitaverat, per superiora, rejectum, aut ad Ventriculum, & Intestina delapsum fuisse.

Deglutition is sometimes violated, when a straightness of the passage re∣lating to the Gulet, proceedeth inwardly from some fleshy substance grow∣ing in the inside of the Oesophagus, thereby lessening its Cavity, so that it cannot give a reception to the Aliment.

Other times Swallowing is prejudiced more or less, * 1.9 when the Gulet is straightned by a Tumour of the neighbouring parts; as in the Inflammation of the Muscles of the Larynx and Neck, which by the Compression of the Gulet, doth lessen its Cavity.

A Gentlewoman of Quality, endued with a Fat Plethorick Body, caused by often indulging her self in the foul feed of gross Flesh, Cabbage, Colly-flowers, and the like; whereupon she fell of a sudden into a violent Sqi∣nancy, flowing from a large quantity of Extravasated Blood, lodged in the Muscles relating to the head of the Wind-pipe, which being highly Tume∣fied, made a Compression upon the top of the Gulet, and gave a stop to the reception of Meat and Drink into the Oesophagus: so that the ••ips be∣ing shut after the taking of Liquid Aliment, it recoiled when it arrived the Pharynx, through the passage of the Mouth into the Nostrils: Whereupon she took her ultimate Vale of her Friends, and recommended her Spirit by a holy Resignation, into the Hands of her Gracious Redeemer. This Dis∣ease of the Gulet, being a consequent of the Inflammation of the Muscles of the Larynx, is Cured by Blood-letting, and other proper Medicines, which I will mention hereafter, in the Cure of a Squinancy, when I do Treat of the Diseases of the Aspera Arteria.

Another cause productive of an abolished or lessened Swallowing, * 1.10 may arise (which is very rare) from the unnatural substance of the Gulet, high∣ly indurated by Concreted, Earthy, and Saline Particles, turning the Mem∣branous and Fleshy substance of the Oesophagus, into a Cartilaginous nature, which being hard and stiff, cannot be Contracted in order to protrude the Aliment into the Stomach.

A Gentlewoman of Vertue and Honour, had her Deglutition first lessened, and afterward wholly taken away, as not able to receive any suste∣nance through the Gulet, into the Stomach, whereupon she grew more and more Languid, and at last Expired: And afterward, upon opening the Neck by Dissection, the Musculus Oesophagaeus encircling the Membranous parts of the Gulet, was found Cartilaginous, which took away the use of the Fibres, by wholly disabling them to Contract, for the transmission of Ali∣ment into the Ventricle.

A difficulty or loss of Swallowing, * 1.11 may also be derived from the Swelling or Induration of the Membranous parts of the Wind-pipe, confining on the Gulet, whereby its Cavity is lessened, or wholly closed up; and the Aspera Arteria being rendred hard, is not capable to give way to the Aliment en∣larging the Gulet, and compressing the Aspera Arteria in its passage through

it; whereupon it cannot be conveyed through the entry of the Oesophagus, into the Chamber of the Stomach.

The third kind of ill Swallowing, is its depraved action, * 1.12 accompanied with Irregular and Convulsive Motions, flowing from the unkindly contra∣ctions of the Carnous Fibres, relating to the Oesophagaean Muscle; which I have lately seen in a worthy Gentlewoman, Wife to an Officer of the Navy who was highly afflicted with unnatural motion of the Gulet, in the act of Swallowing, produced (as I humbly conceive) by Acid and Saline Particles, disaffecting the Tendinous and Carnous Fibres of the Muscles (encircling the inward parts of the Oesophagus) which were hur∣ried with violent Agitations, when they were Contracted in reference to Deglutition.

A depraved action of Swallowing, * 1.13 may be derived not only from Con∣vulsive Motions, which are tremulous agitations of the Carnous and Nervous Fibres of the Muscles of the Gulet; but also from Convulsions, in which the Musculi Cephalopharingaei, Sphenopharingaei, Stylopharingaei, are rendred unnatu∣rally tense and rigid in disorderly Postures; so that they cannot accomplish their due Operations in regular Contractions, for opening the entrance of the Gulet, to give admission to the Aliment, and afterward the Musculus Oesophagaeus being Convulsed, is not capable to Contract and lessen the Ca∣vity of the Gulet, upon the reception of the Aliment into it, and thereby to protrude the Meat and Drink into the Stomach.

An Instance may be given in the Daughter of a worthy Merchant of London, who was highly afflicted with Hysterick Fits (as they are common∣ly called) producing an Universal Convulsion of the Muscles, relating to the Gulet and whole Body, named by the Greeks, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, in which the whole Body is rendred so stiff, so that it cannot be bent backward, forward, or sideways: In which unnatural posture, the said Gentlewoman remained Eleven Hours in Twelve, and was not able to Swallow but one Hour in a Day; whereupon I ordered an Hysterick Plaister to be applied to her Na∣vil, and opening Hysterick, and Cephalick Potions and Pills, both Purging and Alterative, to evacuate the gross offensive Humours, and to sweeten the Blood, and to rectifie the Nervous Liquor: And above all, I often ad∣vised Bleeding (which was most significant in reference to the Cure) where∣in some of the depraved Blood being let out, and the rest Depurated, and the weakned Nerves Corroborated by proper Medicines; the Convulsions ceased, and the Patient, through the Almighty Physicians Goodness, was perfectly restored to her former Health.

Notes

• * 1.1

  Deglutition is wholly lost by the defects of Nervous Li∣quor, or by its grossness.
• * 1.2

  The course of the Animal is intercepted by Tumours of ambient parts compres∣sing the origen of the Fibres of the Brain.
• * 1.3

  The Animal Liquor stop∣ped in the processes of the Brain.
• * 1.4

  Purging and Cephalick Potions are very proper in sleepy Dis∣eases of the Brain.
• * 1.5

  Blistering Plai∣sters are useful in these Dis∣eases.
• * 1.6

  Lost or dimi∣nished Swal∣lowing, may be derived from an In∣flammation, or any Tumour compressing the Bore of the Gulet.
• * 1.7

  Lost or lessen∣ed Deglutiti∣on may also proceed from the swelling of the Palate, Tonsils, and parts adjacent to the en∣trance of the Gulet.
• * 1.8

  Swallowing may be disaf∣fected by some hard Body fal∣ling into the Cavity of the Gulet.
• * 1.9

  Deglutition is much disor∣dered by an Inflammation of neighbou∣ring parts.
• * 1.10

  Lessened or or abolished Deglutition may proceed from a Carti∣laginous Gu∣let.
• * 1.11

  Lost or lessen∣ed D••glutiti∣on may be de∣rived from the swelling of the Wind-pipe.
• * 1.12

  Depraved Do∣glutitio•• is accomparied with Convul∣sive motions.
• * 1.13

  Depraved De∣glutition may proceed from the Muscles of the Gulet ren∣dre convulsed.