Phlegm

“ All diseases are said to be derived from phlegm or bile. This seems very unlike the etiology of diseases, as laid down in the true Hippocratic treatises. Pleurisy is to be treated by purgatives and soothing applications, but without any mention of bleeding. The termination of the disease in empyema is described. The symptoms of pneumonia are also given in brief but striking terms. The sputa, at first, are said to consist of phlegm, and are thick and pure, but on the sixth and seventh day they become somewhat bilious and sublivid. This disease is also said to terminate in empyema. ”

“ They are Blood, Choler, Phlegm, and Melancholy, every one whereof produceth its particular Tumour: Thus the Blood produces the Phlegmon, Choler the Erysipelas, Phlegm the Oedema, and Melancholy the Scirrhus. The Mixture of these is in like manner the Cause of the Erysipelatous Phlegmon, the Oedomatous Phlegmon or Phlegmonous Erysipelas, and the Phlegmonous Oedema, according to the quality of the Humours which are predominant, from whence the several Tumours take their Names. ”

“ Yet again they vex the minor vessels of the ear with superfluity of phlegm; or with the same phlegm they infect the vessels of the lung, so that he coughs and can scarce breathe; and the phlegm may pass thence into the vessels of the heart and give him pain there, or the pain may pass into the side, exciting pleurisy; under such circumstances also, the moon being in defect, the man may lapse into the falling sickness.’106
Sometimes Hildegard’s anatomical ideas can be paralleled among her contemporaries. ”

“ For when a defluxion of cold phlegm takes place on the lungs and heart, the blood is chilled, and the veins, being violently chilled, palpitate in the lungs and heart, and the heart palpitates, so that from this necessity asthma and orthopnoea supervene. For it does not receive the spirits as much breath as he needs until the defluxion of phlegm be mastered, and being heated is distributed to the veins, then it ceases from its palpitation and difficulty of breathing, and this takes place as soon as it obtains an abundant supply ”

“ REMEDIES. What are the Remedies proper for a Phlegmon?
They are of two sorts, viz. General and Particular; the former having regard to the antecedent cause, and the other to the conjunct. The Phlegmon is cur'd in its antecedent Cause, by Phlebotomy or letting Blood, by good Diet, and sometimes by Purgations, by which means the Plethory, Heat, and Alteration of the Blood is diminished; But Fomentations, Cataplasms and Plaisters facilitate the Cure in the conjunct cause, either by dissolving the Tumour, or bringing it to Suppuration. ”

“ Soot, though dry in appearance, contains nevertheless much humidity, as appears from this analysis; seeing there comes over at first a considerable quantity of phlegm, that doth not seem to be impregnated with any principle, except perhaps an extremely subtile, saline, and oily matter, that communicates to it a disagreeable smell, from which it cannot by any means be entirely freed. ”

“ The vitreous phlegm being the coldest of all, if it accumulate in the body, and remain free from putrefaction, it occasions the rigor without heat, which is not attended with fever. In those fevers which are kindled by the humours, it is putrefaction for the most part which kindles febrile heat. If it become putrid, and that through its whole substance, which is rarely the case, owing to its great coldness, it occasions quotidian fever. ”

“ If it be jumping like a frog, or similar to the flight of a crow or a sparrow, it indicates the predominance of bile. When it strikes the finger slowly and resembles the strutting of a peacock, it shows that the phlegm is in excess. ”

“ Pituita or phlegm is a cold and moist humour, begotten of the colder parts of the chylus (or white juice coming out of the meat digested in the stomach) in the liver. His office is to nourish and moisten the members of the body,” &c. “Choler is hot and dry, begotten of the hotter parts of the chylus, and gathered to the gall. It helps the natural heat and senses. ”

“ For fat Women, and those who are troubled with impurities of the Matrix, from a superfluous phlegmatic humour, it is very profitable; for by the benefit of it, every redundancy and incommodity of Phlegm is purified, consumed, and dried up, so that the seed may more easily rest in the Womb, and fertility be greatly promoted. ”

“ It will, therefore, be manifest, that a remedy, which will remove the offending cause, should never be omitted.
Of the tough Phlegm, which usually precedes an attack of asthma.
Many individuals, especially those far advanced in life, are much subjected to a p. 6collection of tough phlegm, which adheres to the bronchial tube, or inner surface of the windpipe, in the morning, and renders their breathing most difficult and painful; occasioning hoarseness, and producing violent fits of coughing, until the matter is discharged. This affection is not, strictly speaking, a disease ”

“ It is much commended against the cough, to expectorate rough phlegm. It much eases pains in the head, and procures sleep; being put into the nostrils it procures sneezing, and thereby purges the head of phlegm. ”

“ If wind is predominant the bowels become costive ; when bile is in excess they become loose ; when phlegm predominates, the bowels remain in their normal condition. A proper equilibrium of the three alone keeps the body healthy. Sometimes defect in the humours is congenital. In that case bilious diathesis is considered better than windy, and phlegmatic better than either, though, on the whole, any disorder in the humoral functions is undesirable. The cardinal humours, VATA, PITTA and KAFA, are expressed in English by wind, bile, and phlegm respectively ”

“ General malaise, slight fever, and chilliness precede and usher in the disease. Locally, there appears at first a more or less circumscribed, circular redness, with swelling, tenderness, and pain. Soon a phlegmonous inflammation develops, the surface at times showing vesiculation, the lesion involving an area several inches in diameter and of considerable depth. The progress of the disease is not uniform. At the end of a week or two suppuration is fully established, the first signs of this process appearing about the hair-follicles. ”

“ A consumptive should not swallow his phlegm, as the disease may thus be conveyed to parts of the body not already infected. Kissing a consumptive person on the lips is attended with risk, and consumptive patients should not wear a heavy moustache or beard, as the phlegm drying on the hair is a source of danger. ”

“ In all these fevers the part inflamed is called a phlegmon, and by its violent actions excites so much pain, that is, so much of the sensorial power of sensation, as to produce more violent actions, and inflammation, throughout the whole system. Whence great heat from the excited capillaries of the skin, large and quick pulsations of the heart, full and hard arteries, with great universal secretions and absorptions. These perpetually continue, though with exacerbations and remissions; which seem to be governed by solar or lunar influence. ”

“ When the external skin is the seat of inflammation, and produces sensitive irritated fever, no collection of matter is formed, as when a phlegmon is situated in the cellular membrane beneath the skin; but the cuticle rises as beneath a blister-plaster, and becomes ruptured; and a yellow material oozes out, and becomes inspissated, and lies upon its surface; as is seen in this kind of erysipelas, and in the confluent small-pox; or if the new vessels are reabsorbed the cuticle peels off in scales. ”

“ Again, the substance which is formed by the liquefaction of new and tender flesh when air is present, if inflated and encased in liquid so as to form bubbles, which separately are invisible owing to their small size, but when collected are of a bulk which is visible, and have a white colour arising out of the generation of foam—all this decomposition of tender flesh when intermingled with air is termed by us white phlegm. ”

“ The cellular system not only receives the influence of other organs in its sympathies, but it exercises its own upon them. In phlegmon, which is the inflammatory state of this system, if the tumour is considerable, different alterations are oftentimes discoverable in the functions of the brain, the heart, the liver, the stomach, &c. Sympathetic vomiting, which is called an overflow of bile, delirium, &c. are phenomena that are seen with large phlegmonous swellings without belonging to the disease itself. ”

“ Now, the vessels are made straiter or closer several ways: sometimes by inflammation, schirrous, or other tumours; sometimes by compressions, scars, or by flesh and membranes that grow after a wound. The signs by which this is known are, the stoppage of the terms, not conceiving, and crudities abounding in the body, which are all shown by particular signs; for if there is a wound, or the secundine pulled out by force, phlegm comes from the wound; if stoppage of the terms be from an old obstruction by humours, it is hard to be cured ”

“ The flux is to the right rather than to the left because the veins there are more capacious and numerous than on the left side, for on the one side they spring from the liver, and on the other from the spleen. The defluxion and melting down take place most especially in the case of children in whom the head is heated either by the sun or by fire, or if the brain suddenly contract a rigor, and then the phlegm is excreted. ”

“ The Great Comfrey helps those that spit blood, or make a bloody urine. The root boiled in water or wine, and the decoction drank, helps all inward hurts, bruises, wounds, and ulcer of the lungs, and causes the phlegm that oppresses them to be easily spit forth: It helps the defluction of rheum from the head upon the lungs, the fluxes of blood or humours by the belly, women’s immoderate courses, as well the reds as the whites, and the running of the reins happening by what cause soever. ”

“ When a change is thereby effected, and no pus falls into the part, you may accomplish the cure by means of the plaster from chalcitis, or some of those plasters of a similar nature, which apply to defluxions; but clean wool soaked in austere wine is to be put externally to the medicine. In this manner you may cure phlegmons from defluxion. But such as are occasioned by any external cause will not be injured by moistening and heating applications, and if necessity require, you may scarify them with advantage. ”

“ When rigors are critical, we must not interfere with them, nor attempt to put an end to the struggle; and a chill succeeding to a sweat will readily pass away and give no trouble. But when the rigor and chills are protracted, and more particularly, if occasioned by a collection of cold phlegm, we are first to apply ligatures round the limbs in various ways, and then anoint them with the oil of chamomile, or of privet, or of iris ”

“ As this affection is frequent in the cutaneous, the serous, the mucous systems, &c. so this system, whose functions require but little insensible organic contractility, presents it rarely. Those who open many dead bodies know, that the texture of the heart is hardly ever found inflamed. Nothing is more common than phlegmasia of the external or serous membrane, and of the internal or mucous membrane of the stomach, the intestines, &c.; but nothing is more obscure and less frequently seen than that of their fleshy tunic. ”

“ Can you imagine that a man could stand calmly and hear himself charged with having a phlegmy cough? And before a lovely woman, too! Before a little marchioness, who—who—In a word, I could not stand it!"
"Really!"
"The military men, you see, are always sensitive. My seconds went, the day before yesterday, to try and obtain some explanation from those of the duke. I put the matter perfectly straight,—a duel or an ample apology."
"An ample apology for what?"
"For the phlegmy cough, pardieu!—the phlegmy cough that he fastened on me."
The notary shrugged his shoulders. ”

“ A. Phlegmon, as far as a layman can answer that question—means an inflammation of the tissues, and in the camp of Dachau phlegmons were very numerous because the people there were mostly sent to the hospital too late. Typical camp phlegmons, as far as I know, are caused by germs. Persons got phlegmons who suffered from lack of water.
Q. Witness, did you say that inmates were used for experiments in which they were injected with pus? ”

“ Cellulitis is excited by their presence, and the lymphatic glands become inflamed and enlarged. In pernicious forms they produce a sero-purulent oedema, which spreads rapidly with a wave-like progress after the manner of erysipelas; or in milder cases the progress of the disease-germs is arrested by the lymphatic glands or the resistance offered by the tissues themselves, and the ordinary circumscribed phlegmon is produced. ”

“ ABSCESS. A sequel of phlegmonous pharyngitis. Symptoms; masked by its depth; pharyngeal wheezing or roaring with little local swelling; difficult swallowing; resisting tissues tend to chronicity. Results; pharyngeal fistula, burrowing along œsophagus, rupture into chest or blood-vessels, lymphadenitis, compression of vagus, or jugulars, permanent infected cavity with small orifice. Diagnosis from pus in guttural pouches. Treatment; external opening; antisepsis. ”