CHAP. IX Of Pain in the Jaws.
THe Kinds of pains in the Jaws or Throat, either in the uper Jaw, which is the receptacle into which the two Tonsils meet like an Isthmus, and in whose middle there is a Caruncle or lump of flesh called Gargareon root, or Palate: or those pains which are in the lower Jaw joyned to the Neck, whether in one place or more, or these pains which reach to the parts of the Mouth mentioned: are distinguished first as they move divers Senses, Somtimes there is a roughness only or trouble∣some imitation, somtimes a true pain, which is either stretching, or burning, or ulcerous.
Roughness of the Jaws is most hurt∣ful to the Voyce, * 1.1 and therefore decla∣red in Hoarsness.
Somtimes there is felt an Irritation with endeavor to Swallow or Vomit. And then either somthing itches in the Jaws, or the Gargareon or Uvula being grown longer and thicker hangs upon the Jaws, and if it stop them any way, it causeth difficulty of breathing and speech. the enlar∣ging of which is called Columella or 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 in Greek, or the falling of the Uvula.
A stretching pain in the inside of the Jaws, * 1.2 when a Cavity appears in the Neck by reason of the Verte∣bra or bone thrust out, hindereth Breathing of which we spake in the defect of breathing. This from the likeness of a Squinzy, we called The sixth kind of Squin∣zy, which is very seldom seen. There is often this stretching pain from a Desluxion (as we shal shew in the causes) without Burning or Inflammation, sometimes with straitness of Breathing: somtimes with hinderance of Swallowing and Voyce: sometimes with, somtimes without a swelling in the Jaws, or outwardly in the Neck. And this Disease is called A bastard Quinsie.
With the accidents whereof, the tonsils or Almonds somtimes swel in one or both sides round like a Ball, * 1.3 and appear open like a Spunge, This is called Paristhmia.
There is a Burning, Sharp, and Pricking pain, * 1.4 also in the Jaws in the Disease called A true Quinsie with difficulty of Breathing, which is small and often, and fetcht with sigh∣ing, sometimes that endangereth Suffocation, so that Breath cannot be fetcht but by holding the Neck upright, & men gape like tired or mad Dogs. This Disease is called Cinanch. In this swallowing is hindered, & Drink comes forth at the Nose, or it is swallowed with difficulty, & the endea∣vor increaseth pain. There is often a Fever joyned with it, and the accidents thereof, as Heat, Redness of Face. Thirst seen also by the Pulse and Urin. There is som∣times a manifest tumor, somtimes not, for which cause there are three sorts of Quinsies; for if there be no tu∣mor nor Inflammation within or without, it is the first time in which are the worst accidents: But if a tumor appears in the straitness of the Jaws, it is the second kind and hath great symptoms, but if there be an out∣ward tumor in the Neck, it is the third kind, and the symptoms are least.
There is a tumor with Redness and Heat in in the tonsils or Almonds, * 1.5 this is called An∣tiades. Somtimes this pain is in the roof, * 1.6 and is called Uva or Uvula when it swells or grows black with Inflammation. In these the accidents are mild, as in the gentler Quinsie, except that meet with it. If the Inflammations in these three places turn to Imposthumes, pain and other acci∣dents increase, and when it is broken they abate and an Ulcer followeth.
Somtimes there is an ulcerous pain in the Jaws, ei∣ther in the upper part of the throat, or in the Almonds or roof, with an Ulcer reaching to the Palate, and som∣times the roof is consumed wholly in part, or this pain is felt below, or deep, * 1.7 and follows the Quinsie mentioned, and matter is spet forth. Or if it come alone, the pain reacheth downwards to the stomach with great burning, especially when they swallow, which is hin∣dred: But when it is in the upper parts it hinders swal∣lowing, breathing, and voyce also.
The Cause of these Diseases, * 1.8 namely of Molestation with Irritation (we spake of roughness of the Jawes elsewhere) and of pains, with Distension, Inflammation and Ulcer, is either in hidden parts, as in the muscles of the Jaws and parts adjacent, or in the lower Glandules joyning to the rough Artery, or in the passages through the inside of the Neck, Oesaphagus or Gullet (for the Diseases of the rough Artery are described in defect of Breathing) Or is in manifest places of the Jaws, as in the tonsils roof or the tunicle by which it gets often to the Pa∣late. The cause of all these pains is either a Flux of Blood or excrements, or solution of continuity. Of solution of Continuity, we spake in Defect of Breath∣ing, how it comes from a Vertebra or Bone started in the Neck, which causeth sixth kind of Quinsie.
If Blood fall into the Muscles of the Jawes it causeth a true In∣flammation or Quinsie, * 1.9 which is gentler or worse, as the Flux is more inward or outward, for if it fall upon the inward Muscles of the Larynx, Jaws, and bone cal∣led Hyodes which serve for Breathing, Voyce, and swal∣lowing, because the pain is great, and as it were suffo∣cating, it causeth the first and worse sort of quinzy. But if it sal upon the outward muscles of the neck, it less hindereth those offices, and causeth a gentler quinzy, which manifesteth it selfe with an external tumor,