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OF the affections which form about the columella, some require to be treated by excision; but the surgical treatment of such cases does not come within the design of this work. Some are to be treated as acute affections; for some of them readily prove fatal by suffocation and dyspnœa. These are the diseases which we call uva and columella; for both are attended with inflammation and increase in thickness and length, so that the parts hang down, and come into the arteria aspera. The columna is of equal thickness from the base to the extremity in the palate: the uva is of unequal thickness; for its base at the palate is slender, whereas at its extremity it is rounded and thick, with redness and lividity, whence it gets the appellation of uva. These, then, must be speedily relieved; for the death from suffocation is very speedy.

If, then, the patients be young, we must open the vein at the elbow, and evacuate copiously by a larger incision than usual;

for such an abstraction frees one from suffocation, as it were, from strangulation. It is necessary, also, to inject with a mild clyster, but afterwards with an acrid one, again and again, until one has drawn from the parts above by revulsion; and let ligatures be applied to the extremities above the ankles and knees, and above the wrists and forearms to the arms. But if the suffocation be urgent, we must apply a cupping-instrument to the occiput and to the thorax, with some scarifications, and also do everything described by me under synanche; for the mode of death is the same in both. We must also use the same medicines to the mouth, both astringents and emollients, with fomentation of the external parts, cataplasms, and liniments to the mouth. For the forms named columella and uva, as an astringent medicine take the juice of pomegranate, acacia dissolved in honey or water, hypocistis, Samian, Lemnian, or Sinopic earth, and the inspissated juice of sour grapes. But if the diseased part be ulcerated, gum and starch moistened in the decoction of roses or of dates, and the juice of ptisan or of spelt (tragus). But in columella let there be more of the stronger medicines, from myrrh, costus,1 and cyperus;2 for the columella endures these acrid substances. But should the part suppurate, in certain cases even the bones of the palate have become diseased, and the patients have died, wasted by a protracted consumption. The remedies of these will be described elsewhere.

1 Auklandia Costus L. See Paulus Ægineta, t. iii. p.190.

2 Cyperus rotundus L. See Paulus Ægineta, t. iii. p. 204.

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