On the Causes and Symptoms of Acute Diseases (1.8)

THE solid body suspended from the roof of the mouth between the two tonsils is called columella and gurgulio. Uva is the name of the affection. The columella (uvula) is of a nervous nature, but humid, for it is situated in a humid region. Wherefore this body, the columella, suffers from various affections, for it becomes thickened from inflammation, being elongated and of equal thickness from the base to the extremity, and is attended with redness. Columna is the appellation of this affection. If it be rounded towards the extremity alone, and with its enlargement become livid and darkish, the name of the affection is Uva; for it altogether resembles a grape in figure, colour, and size. A third affection is that of the membranes when they have the appearance of broad sails, or the wings of bats, on this side and on that. This is called Lorum, for the lengthened folds of the membranes resemble thongs. But if the columella terminates in a slender and elongated membrane, having at its extremity a resemblance to the butt-end of a spear, it gets the name of

Fimbria. This affection arises spontaneously from a defluxion, like the others, but also from an oblique incision when the surgeon leaves the membrane at one side.[*] But if the organ (uvula) become bifid with two membranes hanging on this side and on that, it has no distinct appellation, but it is an easy matter for any one who sees it to recognise the nature of the disease.

A sense of suffocation accompanies all these affections, and they can by no means swallow with freedom. There is cough in all the varieties, but especially in those named lorum and fimbria. For a titillation of the trachea is produced by the membrane, and in some cases it secretly instils some liquid into the windpipe, whence they cough. But in uva and columella there is still more dyspnœa and very difficult deglutition; for, in these cases, the fluid is squeezed up to the nostrils, from sympathy of the tonsils. The columella is common in old persons, the uva in the young and in adults; for they abound in blood, and are of a more inflammatory nature. The affections of the membranes are common in puberty and infancy. It is safe to apply the knife in all these varieties; but in the uva, while still red, hemorrhage, pains, and increase of inflammation supervene.