as they are found out by the force of Indication are the very indicated Actions so that the Scopes invented by the Indication and the Indicated Actions do really signifie the same things We say really becaus the Scopes even when found out differ in reason from them as they are Scopes seing that besides the Indicated Actions they seem to note together an intention of prosecuting the same Actions as the Scopes not yet found out do intimate an intention of enquiring into them Thus much of Indicates or things Indicated Thirdly The action of an Indicant is Objective and Indicant as an Object besides it self doth in som sort insinuate another thing to the understanding Perhaps som may wonder how an Object can represent any other thing besides it self We answer Such is the Nature of relatives that as such they cannot be conceived without an implication of their correlatives For one relative in his proper consideration doth at least obliquely involve the consideration of another and by that means it easily ushereth the understanding to the knowledg of the other Som may reply If the force of the Indication be built upon the meer relation of the Indicant to the Indicatum How coms it to pass that the use therof is restrained solely to the Art of Medicine To this we answer We deny not but this instrument may be extended to other Arts and Sciences as we have before insinuated For in moral Philosophy it is lawful to say that Vertu doth Indicate the protection of her self and Vice the suppression of it self But neither doth this kind of relation consist only between the States of things and the Actions therunto belonging but also between the terms meerly speculative as twice two are four a man is not a horse But here we consider the Indication and the efficacy of the Indicant only in order to the Method of Physick so as it wil not be here needful to extend the use of this instrument further neither indeed did Galen because it would contribute little to the scope therof Yet we affirm that every relation is not a sufficient basis of an Indication but it must be such as hath either an evident conformity and agreement between the Indicant and Indicatum wherby they may be fitly marshalled into a proposition of undoubted truth or a disparity and repugnance of them among themselvs that so they may aptly be divided from one another that is they may be disposed into a negative proposition equally certain Now because the propositions elected by this indication are certain and evident not needing any higher proof from thence it is manifest that every understanding that is Master of it self not clouded with a vail of prejudice nor wittingly ensnared with sceptical Sophisms and fallacies must necessarily pay an assent unto them so soon as he understandeth the terms Moreover the Scepticks themselvs though in their disputations they wil lie in wait to traverse any verity how manifest soever it be and busy themselvs to equal the most certain principles with things extreamly doubtful yet in performing the necessaries of life seing that they relieve hunger by food hoard up mony avoyd stripes and do these and the like things constantly and without any distemper of mind they plainly discover that they are led by som bad disposition of mind or governed by a desire of glory or tickled w th a hope of victory in the contention rather that they doubt really of the truth of such Propositions In the interim it must be observed that the very Indication is fallible and deceitful where the absolute nature of the Indicant or the Indicatum hath not been exactly understood before For in this art of Indications we do not presuppose only that a Physitian should always have learned before and duly known what al those things are which we cal according to Nature as also in what the Essence of a Diseas and all the parts therof consist and to have an exact knowledg of all the causes of an Affect Yea it is necessary that he understand all Medical actions and upon occasion be able to render a ready account what alteration is what heating what cooling c. what evacuation purgation and the section of a vein c. what conservation and the like For the Indication doth not make manifest the absolute nature either of the Indicant or the Indicatum but presupposing this as already known it representeth only a mutual relation namly either a strict connexion and conformity which they retain among themselvs or a disparity and opposition wherby they may be formed into an undoubted proposition but the certainty of the indicated proposition cannot exceed the certainty of the knowledg of the Indicant Therfore if at any time we scruple the certain knowledg of the Nature of the Indicant it is not safe to trust to the Indication alone til it shal better be confirmed by som other Reason or experience But this doubting must not be imputed to the Nature of the Indication but to the ignorance of the Indicant Moreover it must be considered that the relation of the Indicant in the Method of practice doth demonstrate besides the evidence somwhat of duty in respect of the Indicated action and that the propositions formed from the Indication do either explicitly or at least implicitly insinuate that duty As in this Proposition a Diseas doth Indicate the ablation of it self the ablation is decreed and resolved upon as a requisit action on the part of the Indicant that is a Diseas as if one should say a Diseas requireth or importuneth the removal of it self Yet this duty of the action is more frequently and indeed much more elegantly expressed by the Participle in dus as a Diseas is to be taken away which Proposition in the fulness of its signification hath a manifest coincidence with the former There remaineth stil an objection to be answered concerning the action of the Indicant and this it is If the Indication be the very action of the Indicant how can it be called an operation of the understanding For all writers refer the Indication to som generation of the understanding We answer The Indication is indeed an action of the Indicant but yet an objective action and that it is united to the intellective faculty and abideth in it as in its subject Moreover that the understanding a power both actuated and as it were informed by its subject Wherfore although the action of Indication be objectively attributed to the Indicant yet subjectively it is ascribed to the Soul and especially to the intellective part therof which is as it were the act and form of it And from hence it wil be most easy to reconcile Galen with himself who somtimes defineth Indication to be an Emphasis somtimes a Catalepsis Fourthly It must be examined whether that distinction of an Indicated action into an action helpful and hurtful may tend For som may urge that Galen doth perpetually
parts to whom the Natural Vital and Animal Faculty is communicated For although these Faculties as to the first act may be said to depend upon the Soul which relation hath indeed no relation to the Medicinal art yet in respect of the second act they are necessarily rooted in some material Constitution of the parts to which they belong For whereas some say that the Vital Faculty is derived from the Heart and the Animal from the Brain unto the other parts that must not so be understood as if the Faculties themselves in a wandring manner were transient from part to part for the passing of an accident from subject to subject cannot be conceived by any understanding but that the Vital Faculty is derived with and in the vital Spirit from the Heart unto the parts or at least is excited by some motion of the Heart and Arteries in the parts themselves and in like manner the Animal Faculty doth descend in and with the Animal Spirit by the Nerves or is produced in the parts by some motion of the Nerves in the Brain Which way soever it comes to passe we must needs confesse that some alteration is imprinted in the part it self receiving it either from the said Spirits or from their motions Which alteration as it is here granted to be the root of the Faculty either Vital or Animal in the respective parts so is it a moveable Constitution because it can be variously changed remitted and intended without the dissolution of the whole and it is the Constitution wherein either Health or Sicknesse may consist seeing that whensoever alteration is deficient unto the parts wherein it ought to be or any other wayes administred then is requisite the action will thereupon be unavoidably depraved but if it be rightly performed then sound and perfect health is said to be present from the part of that Constitution Considering therefore that there are two kind of Alterations besides the natural and inherent Constitution one from the influx of the Heart another from the influx of the Brain in most parts and seeing the said alterations as they themselves are more perfect or more imperfect do render the Faculties in the respective parts at least as to the second act more perfect or imperfect and that the actions are thereupon depraved or sound it is necessary that this threefold Constitution reside in most of the parts and that the said kind of alterations be medical constitutions whereon Health and Sicknesse may be grounded That this Division or Distinction is not frivolous or altogether unprofitable appeareth from hence because the practical Physitians in their Methods do rightly admonish that in obscure Diseases the Faculties must be accurately observed when their actions are seen to be depraved which diligence may serve as it were for a Manuduction to guide us to the Origine of the affect now if it be a consideration of so just importance to note the interupted Faculties in Diseases certainly it will be an exercise of no lesse moment to take cognizance of the Constitutions themselves upon which those Faculties have an immediate and strict dependance Now least any man should conceive that there is almost a coincidence between this third Division and the second he may observe if he will diligently weigh the matter That every member of this division doth in some manner include al the members of the next precedent namely that the natural Constitution doth comprehend primarily indeed the similar Constitution but that secondarily and in order to the whole creature it containeth in a sort the conformation and continuity in like manner that the Vital and Animal Constitution do in their way so clearly participate of all the Members of the said Division that to offer proofs of it were an unnecessary undertaking Only we desire the Reader to take notice which also we even now intimated That the natural Constitution primarily and principally hath respect unto the temperament the common qualities the plenty of the Spirits and the peculiar disposition of them which by some are refered to the form and the whole substance but that it hath respect unto the manner of the Organe and the continuity as it were secondarily and in order to the whole creature and that it can scarce be otherwise hurt or vitiated by them Yet we must not deny but that the natural Constitution is sometimes vitiated as it is meerly Organical for thus it falleth out in the obstructions of the natural passages as for example when a stone is impacted or grown to hardnesse in the passage of the Meter or the yard and in the like cases but this happeneth unto it especially in as much as the passage is ordained for the use and conservation of the whole but for the most part the Organical vices in the natural Constitution are of lesse note and consideration then the similar These things may suffice to be spoken in a general way of this triple Constitution We will now in particular speak a few things of them in few words The Natural Constitution which is proper unto and inherent in every part may be known by this discription That it is the manner of the natural Being setled in the parts competible to them in as much as they are aptly constituted by their temperament and common quallities by their sufficient portion and convenient disposition of ingenerated Spirits and by their just conformation and continuity to a perfect performance of natural actions together with the concurrence of the Vital and perhaps the Animal influx Therefore when there is in any part a just temperament convenient common qualities an exquisite proportion and harmonious disposition of inherent Spirits Finally when there is a laudable conformation and unity and yet notwithstanding all this the natural action is depraved we may well conclude that it is not vitiated by the natural Constitution but by reason of the concurrent cause namely the vital or natural influx or of both together for the natural actions in creatures in regard of the union and wedlock of life are exalted to a more eminent condition then otherwis they would attain unto by the natural Constitution alone And from hence it comes to passe That although the natural Constitution in slain Creatures remaineth after death undepraved for a while yet the attractive and retentive Faculty the concoction of the aliment and the expulsion of the exctement do altogether cease And in Diseases also many times the natural Constitution is at first untoucht yet the natural action is vitiated meerly by the defect of the due concurrence of the vital influx after the same manner somttimes the natural and vital Constitution being sound and healthful yet some natural action is depraved by reason of the defect of some animal influx and concurence but this for the most part happeneth only in the Nervous Fibrous and Membranous parts especially where they make a hollownesse but seldom or not at all in the substance of the parts As in the
Palsy the excrements are many times unduly retained by reason only of the astonishment and insensiblnesse of the guts the other constitutions being sound Therefore in these cases when some natural action is hurt we must not presently conclude that the natural Constitution is first vitiated but we must with dilligence enquire out that Constitution which is first vitiated for that is to be looked upon as the root and first essence of the evil in like manner if some vital action be depraved we must not presently infer that the vital Constitution is primarily vitiated because sometimes the first Origin is more rightly deduced from the natural or perhaps the animal Constitution as for example Through the intensivenesse of cold a finger is mortified by inflamation in this case it is true that the influx of the vital bloud is plainly intercepted yet the beginning of that interception must be sought out in the natural Constitution of that very part so benumned So also in a Convulsion the circulation of the bloud is perhaps something disturbed and interupted but the first depravation must be ascribed to the animal not to the vital Constitution On the contrary in a Feaver the Head is invaded but the source of the evil will peradventure be found out in the vital Constitution so perhaps the Flesh is wasted and al the natural Spirits are decayed yet the root of the evil wil be found out in the vital not in the natural Constitution So that any Constitution of the three before named may be in several Diseases sometimes the first sometimes the second and sometimes the third cause of vitiated actions Not only many other parts of the body yea simply al the sensible which exhibit not an influx neither are subservient as delatory parts do naturally admit this threefold Constitution but besides also even the Heart it self and all the arteries and the Brain and al the nerves so that the Brain excepting the fault in its natural Constitution may be cherished and helped by the vital Spirit which is transmitted thorow the veins and the arteries being wel affected or vitiated and hurt if that be ill affected And after the same manner also may the Heart by the animal Spirit which hath an influx thorow the recurent nerve of the sixth pair the arteries also by the animal influx thorow the nerves by a way perhaps not yet found out And Finally The Nerves also by the vital Spirit deduced thorow the Arteries CHAP. IV. That the Essence of this Disease consists not in the Animal or Vital but in the Natural Constitution not as Organical but as Similar Three Limitations are Propounded THese things being Presupposed We shal proceed to enquir in what Constitution of the parts the first Root or Essence of this affect is lodged Be the first Conclusion therefore this The First Root of this Affect is not in the Animal Constitution or in that which dependeth upon the Influx of the Brain into the parts Indeed we confesse that al the nerves which without the Skul proceed from the spinal marrow are found to be loose and weak in this affect yet this doth not here seem to arise from a defect of the influx of the Brain which we thus prove First the loosnesse and weaknesse of the nerves which cometh primarily from the Brain is almost alwayes consociated with somnolency and drowsinesse but this Symptom happeneth but rarely and by accident only in this affect Secondly As we remember we never knew the Palsy or the Apoplexy to supervene or follow upon this Disease but it ought necessarily so to do and that very often at least in the confirmation of the Disease if this loosnesse and weakness of the nerves should take beginning from a defect of the influx of the Brain Thirdly We have observed the Brain to be sufficiently firm and inculpable in many dissected after death Fourthly For the most part those that are afflicted with this evil are ingenious in respect of their age which doth evidently attest the vigour and vivacity of the Brain The Second Conclusion The first root of this affect is not in the Vital Constitution or in that which dependeth upon the Influx of the Heart into the parts An unequal distribution of bloud indeed almost if not altogether perpetual may be observed in this affect neverthelesse the chief reason of this inequality must be ascribed not to the inequasity of the influx of the Heart or Arteries but to the unequal reception and unaptnesse in the parts themselves to receive it for the Heart and the Arteries do for their part indiscriminately or equally distribute the bloud with the Spirits every way into the parts But if it so fal out that an Artery of some part be interupted in his function by reason of the benumnednesse and stupefaction of that part or the parts adjacent there is a necessity that the bloud must be minutely transmitted thither and so unequally in respect of the other parts which expeditely and aptly receave the bloud Therefore in this case this inequality of distribution doth properly and primarily depend upon a preexistent fault without the artery pertaining to the natural Constitution of the parts Object But some may Object Although perhaps the aforesaid inequality hath no dependance upon the Heart yet it may so happen that a weak Pulse may suffice to distribute the bloud thorow the lesser Circulations in the inner parts which nevertheless may not be altogether so sufficient to undergo that duty thorow the greater Circulations in the outward parts which are more remote from the Heart the fountain of bloud Answ We Answer That this Objection was formerly of so great importance with one of us that he supposed such an inequality of the vital influx did belong to the prime Essence of this Disease and did therefore endeavour to deduce the reason of the first Symptoms from it But after second thoughts the matter being more neerly and deeply examined he was of Opinion That this inequality of the vital influx had no relation to the primary but to the secondary Essence of the Disease But we return to the solution of the Argument And First we grant indeed that in this affect there is an unequal distribution of the bloud and that in the internal parts and in the head it is more liberal in the external more sparing Secondly we grant that the Circulation of the bloud may be kept in the inward parts even although no Pulse apear in the outward parts but this happeneth only in a vehement either weaknesse or oppression of the vital Spirits as in a swouning and a strong hysterical paroxism or fit of the Mother in which affect some that have been accounted for dead have been seen to revive again Thirdly we grant that a more liberal Circulation of the bloud may be in the internal then the external parts yea and in some one external part more then in another as it happeneth in the inflamation of some external member
which are inferred by bad and invalid consequence First Therefore we grant that the mas of blood is viciated in this affect and that from thence is conveied a continual â—â—â—â—editatiâ—◠〈◊〉 the disease We grant also for the present that the Liver is the Officin of sanguification but we deny that every viciosity of the blood doth depend upon the viciated sanguification constitution of the Liver For first the blood may be corrupted by unwholsom aliment the Liver in the mean time remaining sound in like manner if the first concoction in the ventricle by any cause whatsoever be rendred imperfect yet it cannot be fully corrected by the second concoction in the Liver be that bowel never so sound Besides although the generation of vicious blood should be solely ascribed to the Liver yet the other parts should necessarily concur to the conservation of that which is generated as the Kidneyes the Spleen the Pancreas the Womb c. yea and it seemeth undeniable that all the parts which the blood washeth in his circulation do variously alter it whilst according to the capacity of the subject they imprint their qualities in it for they are natural agents and act by necessity and continually without any suspention of their actions or intervenient pauses unless they be estrained by some predominant power therfore if these be il affected they give a greater or a less tincture of pollution to the blood which passes through them as may be seen in a contagion gotten by an external contact communicated to the inward parts Moreover sometimes a great pollution from the other diseased parts is insinuated into the blood the liver in the interim being safe as hath been sometimes observed in opened bodies that have perished by a Dropsie in whom the Liver was found to be sufficiently sound and whol Moreover We grant that the faults of the Blood do frequently derive their beginning from the depravedness of their sanguifical constitution of the Liver and that that depraved constitution is an affect of the Liver But we deny this to be the same Disease whereof we now treat because it differs from it in the whol Species For that same depraved constitution of the Liver is alike common to men of full age to Boys and Children but this disease is solely apropriated to boys and infants Again We grant that a vicious constitution of the Liver may by generating a corrupt blood be a common cause and foment the augmentation of this affect but we deny that to be the disease it self whereof we now speak or any part of the first essence thereof For it is one thing to produce a common cause of a disease and another thing to be of the first essence of a disease We deny also that to be the continent cause of this disease or to be a sufficient cause of it self alone or to be alwaies a cause For the vicious constitution of the Liver of what kind soever you will suppose it doth not produce this affect in those that are come to ripenes of yeers nor perhaps always in yong boys and this our answer in general to the argument we proceed now in a like method to the confirmation of it First Therefore we grant that this affect doth often follow other diseases be they either acute or chronical but not so much because they had hurt the sanguiffical constitution of the Liver as because they had left the outward parts cold and benummed the ingrafted Spirits exhausted Although we may easily admit the viciated liver to be able to foment the evil by reason of the depraved sanguification Secondly We grant that this affect doth not only depend upon outward causes but also upon inward namely the faults of the blood it self but that all these faults have their beginning from the Liver that we flatly deny for the Reasons before alleadged Thirdly We grant that the mole or substance of the Liver is augmented in this affect but we deny that to be the first essence of the Disease for the reasons above rehearsed where we reject the organical vices from the primary essence of this evil Yet we admit this and the like diseases in a secondary essence of this affect as we shal see hereafter Fourthly We grant that internal Medicines can both alter and purify the blood but in the present Affect they conduce to the cure in this regard principally because they facilitate the distribution of the blood to the outward members attenuating the thicker and cutting the viscous parts thereof and because they also do impregnate the blood with a copious and benign Spirit whereupon it happens that the implanted Spirits of the parts before languishing are cherished augmented and excited In the mean time we acknowledge that general benefit which accrew to the whole body by the purging of the blood by siedge vomit urine or any other ways of evacuation Only this is it which we affirm that the more specifical part of the cure is wrought by way of alteration with the medicines aforesaid as we have intimated already Fifthly and lastly We grant that the opening the veins in the ears doth somewhat attenuate the blood and conduce to the renovation of it as also to the distribution of it to the external parts and the withdrawing of it from the internal parts oppressed with too much plenty and in that respect very much to advance the cure yet we deny that it can from thence be rightly inferred that the first Essence of the disease is radicated in the Liver And thus we suppose we have satisfied the reasons brought for the confirmation of this opinion We wil now produce some arguments that seem to perswade the contrary The first is this The first Essence of a disease doth Specificate the Disease But the vitiated sanguifical constitution however it be conceived doth not specificate this Disease For seing that this Disease doth appertain to infants only and children it behoveth them who adhere to the contrary opinion to design some certain way of the depraved sanguifical Constitution of the Liver which may be proper to the tender age alone but no depravation of the sanguifical Constitution of the Liver can be imagined which is not also common to those of ripe years If therefore the first Essence of this Disease should consist in that this Disease would at least sometimes be observed in those of ripe years which notwithstanding hath never been hitherto observed Secondly The subject of the first essence of a Disease is so long affected with that Essence as the Diseas continueth For neither can the Diseas Exist without its Essence neither can that Essence wander from one part to another If therefore the Liver be the subject of the first Essence of this Diseas then should it be affected thorowout the whole progress of the Diseas which nevertheless doth not seem credible seeing that the Livers of those who have died of this Diseas and have been dissected have excepting the augmented bulk thereof
way from whence we have a little erred seing that the vitiated Tone may hurt as we have said the internal actions it doth not properly belong to that kind of Symptom which is wont to be called by the name of a changed quality Thirdly we say That this vitiated Tone seing it is neither a Morbifical caus nor a Symptom and yet is somthing preternatural must needs be the Diseas it self Moreover the same is clearly proved by the very definition of a Diseas For this vitiated Tone is a preternatural Constitution primarily or immediatly hurting the internal action therfore it is a Diseas For to what the definition is competible to that also the thing defined is competible That it is a preternatural Constitution is manifest by this because it is inherent in the solid parts of the body that it likewise depraveth the Internal actions is manifest from hence because an extream laxity lubricity and flaccidity of the parts being granted presently the agility is weakned no other cause approaching and a certain sluggishness deadeth the irritation of the vital Spirits In agility the matter is plain seing that firm and stretched bodies other things being answerable are more active and so on the contrary that the same thing also happeneth in the dulness of the irritation shal be shewed in its place for the present we labor to prove no other thing then that the vitiated Tone in this affect is a Diseas We say fourthly That this vitiated Tone in this Diseas is not any simple affect having an existence apart by it self but that it is so conjoyned and compounded in those same parts with the primary Essence that the whole Essence of the Diseas wherof we dispute may be said to consist of many Diseases united together in themselvs indeed simple if they be considered asunder and therfore that the vitiated Tone is only a part of the whol Diseas And this needeth no other proof then because the first Essence proposed above and the said vitiated Tone are both found in those same parts For that is properly called a compound Diseas which is produced by many simple Diseases conjoyned in the same Part. Fifthly We affirm that the vitiated Tone is not only a part of the whole Essence but such a part as hath some dependance upon the primary Essence and therfore that it is a secondary part of the Essence Before we proceed to the proof of this Proposition two grants or concessions are to be premised We grant first That the said Tone may be even immediatly vitiated in other causes perhaps and likewise by other causes although that happen not in this present Diseas For the inherent Tone of the Parts may be primarily loosned in the Animal Constitution and that suddenly as may be observed in the dead Palsy For the natural tensity and not the Animal only of the Paralytical member is loosned and indeed suddenly without any conspicuous intervention of any part of the aforesaid primary Essence After the same manner in a Lipothymy or defection of the mind loosness and languishing suddenly attatcheth al the parts Now we cannot in either of these two causes refer the cause of the loosness to the cold and moist distemper of the natural Constitution seeing that cannot be so suddenly and so sensibly changed Which let them consider that we may give warning of it by the way who wil have these common qualities to be always second and dependent upon the first alone yea on the other side let them in that cause observe how a cold and moist distemper doth afterwards by degree follow that loosness suddenly introduced Again as for the flaccidity of the parts that may be immediatly produced by large evacuations as a flux of the belly sweatings and the like immoderate vents the temperament being not yet considerably changed although we deny not but this may easily and doth usually follow Moreover an internal lubricity may be manifestly separated from coldness though very difficultly from moisture Secondly We grant that in the present Diseas the vitiated Tone doth not in any manner depend upon the first admitted Essence nor that in every respect is subordinate unto it For first the qualities of the Tone here vitiated do also ow somwhat to common causes namely to themselves and also to those that are common to the first granted Essence For extream moistening things by one and the same operation are apt to produce both too much moisture and also loosness In like manner from violent evacuations a want of Spirits and withal a witheredness doth arise Also from things too too slippery either outwardly administred or inwardly tataken or both an internal lubricity is augmented together with a moist distemper For there is so great a connexion of the whole Essence hitherto propounded with the common causes that there is scarce any thing which doth augment the first essence of the Diseas but at the same time more or less it hath an influence upon the vitiated Tone These things bring granted We say notwithstanding that in the present affect there is a very great dependance of the vitiated Tone upon the first Essence of this Diseas for which respect alone we have here referred the vitiated Tone to the secondary Essence If any list to contend That the said Tone in another respect may relate more clearly to the Secondary Essence because he may imagine that the primary Essence of every Diseas is necessarily similary and perpetually grounded upon the first qualities alone or because he may conceive that the qualities wherein the Tone consisteth are perpetually secondary and that they follow the first only as the shadow doth the Sun that man may take notice that we purposely decline such questions least we should straggle into an unwarrantable digression It remaineth therefore only that we prove the Dependance of the vitiated Tone upon the first Essence of this Diseas to be very great and that we shal do by parts We wil begin at the laxity We grant indeed that a laxity may be somtimes suddenly produced and in that cause a moyst distemper may often follow upon it Namely when the laxity primarily dependeth upon the fault either of the Animal or Vital Constitution but in this Diseas seing that neither the Animal nor the Vital Constitution are primarily affected there is a necessity that it must flow from other causes Moreover such is the condition of laxity and tensity that they are obnoxious to sudden alterations For the strings of a Lute may almost in a moment be stretched and loosned again the same thing likewise from some causes befalleth the Fibers of the Parts But in this affect the laxity stealeth on by degrees and slowly therfore necessary it is that it must begin be ruled and moderated by some caus leisurely and slowly augmented Although therfore we granted even now that the laxity doth own somwhat to the common causes of the Diseas yet the augmentation therof is chiefly restrained and moderated by
either an unfruitful deed or such as is propense to this Diseas somtimes those parts are infested with a virulent vicious or waterish Gonorrhea and they excern a Seed not sufficiently elaborated the same must be said of the white and red Fluxes of Women Again some things outwardly applied to those parts have reference hither as Ointments of Hemlock and other Narcotical things especially if they be often anointed with them in like manner Oyntments that are incorporated with white or red Lead Chalk of Lead Litharge Sugar of Saturn and the like dayly and for a long time adhibited to those parts For such as these blunt the activity of the inherent Spirits in those Parts and introduce a certain dulness in them which being communicated to the Seed prepared in them disposeth the progeny to this affect At length we have finished our intended enumeration if not of all yet at least of all the most principal causes which happen before Conception about the Generation of the prolificative Seed and have any concurrence to produce this Diseas or to dispose to the production therof Now follow the faults and errors of the Mother in the time she beareth the Embryon in her Womb which also must be reputed among the causes of this Diseas before the Birth First There hapneth a cold and moist distemper of the Womb it self which as were we silent is easily manifest to every one may most readily be communicated to the Embryon by the perpetual contact of the Womb. In the Second place All those things offer themselves which suppeditate to the Embryon crude and impure Juyces converted by excrementions and corrupt humors instead of laudable aliment Hitherto principally belongeth the unwholsom and preposterous diet of Women with Child especially inclining to moisture coldness and the heaping together of crudities The same things also happen by the imperfection and defect of the first or second Concoction especially when they are not excerned by vomit or some other evacuation of the Crudities from thence proceeding but are at length transmitted with the Mothers Blood for the aliment of the Embryon Besides if a moist and cold Diseas as a cold and moist distemper with the matter an ill digestion a Cachexia or Dropsy c. do invade a woman with Child after Conception it may thereupon easily happen that the impure aliment also which nourisheth and cherisheth the Seeds of this Diseas be dispensed to the Embryon In the third place are to be reckoned al those things that defraud the Embryon of du aliment as any excessive evacuation especially a lashing flux of Blood in any part also a rash opening of a Vein or Phlebotomy that exceeds in quantity The suckling of another child may also divert the afflux of sufficient aliment from the Womb towards the Breasts Hitherto likewise belongeth inordinate fasting or any indigestion in the Mother any inappetency after meat or defect of concoction Moreover an acute Feaver hapning to a woman with Child besides other inconveniences may also defraud the Child of du aliment so also an Hectick Feaver All these things do not only infer to the Embryon a dejection of Vital Spirits and a defective nourishment but also they cause a want of natural Spirits For the Naturall Spirits are wasted and dissipated without due nourishment and are also destitute and disappointed of necessary reparation Seing therfore that a part of the Essence of this Diseas consisteth in the defect of Natural Spirits som disposition to this affect must need be bequeathed to the off-spring from the causes aforesaid 4ly lastly excessive sleepines of women with child slothfulness eas any vehement labor and exercise after Conception do also contribute their share For although violent motions and actions of any kind are forbidden to women in such causes yet moderate labors watchings and exercises which offer no violence to the womb or provoke to abortiveness do not only conduce to the health of the Mother but in som degree they drive away that dulness from the Embryon and augment the heat vigor and activity of it And thus we put an end to the first Chapter of the causes of this Diseas before the Birth Those which happen after the birth shall be the subject of our next examination CHAP. XVI The Causes of this Diseas incident to Children after their birth WE have noted in the precedent Chapter that Infants from their first Origin are seldom afflicted with this Diseas but by reason of the Causes there rehearsed that they are frequently affected with a natural disposedness and propension to the same We shal now prosecute those causes which are apt to actuate that Natural disposition after the birth or newly and fully to produce this Diseas For it must be known that the same causes which may actuat that predisposedness to this Diseas may produce this Diseas a new if they be sufficiently intensive in their degree And therfore we confess that those children which are prone to this Diseas from their Nativity are easily affected but that other which are free from al Natural corruption fall not into the same but upon more potent causes and yet those causes are the same for their kind and differ only in the degree We therfore thought it needless to speak of these things distinctly and apart it may suffice that we have spoken of them indescriminately and together At the very entrance a Question there is which importunes a Resolution namely Whether Contagion may be numbred among the causes of this Diseas and therfore whether this Diseas in a proper and right understanding be a contagious Diseas indeed he that considereth this Diseas unknown to the Ancients how it first invaded the Western Parts of England and in few years hath been since dispersed all England over will at the first thought easily judg it to be contagious and to have been spread so far and wide by the infection of it But the matter will seem to be otherwise to him that will consider it more intentively For although this Diseas may in some manner endeavor to imprint an affection like unto it self in other Bodies yet it scarce advanceth so far that it can totally produce a Diseas of the same kind For perhaps it may in one some slight inclination in another Body yea somtimes perhaps it may accelerate or hasten the invasion of an affect in a Body highly predisposed unto it yet it cannot therfore deserve the Name of a Diseas properly contagious For all Diseases conspire to change and assimilate those Bodies which are neerest to themselves yet that is not sufficient to denominate Diseases contagious For to constitute a contagious Diseas properly so called it is further required that out of it self it propagate a certain Seminal fermentation of it self which secretly insinuating it self into other Bodies may by degrees introduce into those Bodies a Diseas of the same Species But this Diseas containeth no such fermentation in its essence neither is it secretly propagated
affirm that one Indicatum only can be insinuated from one Indicant and that in his Method Med. he doth affirm That they vainly attempt the Method of cure who are ignorant that one thing is Indicated from one Indicant and that all who have written of this matter do seem to attest the same thing We answer That Galen must be understood of the three distinct kinds of Indicants which must by no means be confounded nor their Indicates that is the things indicated by them For that which a Diseas doth properly Indicate must not be attributed to the causes or the Spirits In like manner that which the causes Indicate must not be applyed to the Spirits or the Diseas it self Finally that which the Spirits Indicate must neither be ascribed to the Diseas nor the causes For in this respect one Indicate answereth to one Indicant and he that observes not this must unavoydably confound all things and in the employments of art makes an unsuccesful use of this instrument according to the judgment of Galen But it must be considered that in each of these kinds the Indicatum may be divided into two parts one wherof is an advantageous action and to be prosecuted the other is noxious and to be avoyded yet each of them belongeth to one and the same kind amongst the aforesaid three and is as it were a middle part of the whole Indicate For the Spirits direct to an election of such things as may cherish and protect them and to an avoidance of such things as may in a further degree empair them and both these actions concur to advance and ascertain the compleat and final conservation of them In like manner both in cure and restauration and also in caution and prevention there is found an action as well to be embraced as abandoned yet whether of them exceedeth the bounds of its kind so that no confusion can from thence be feared For whilst we cure we make choice of those things that wil demolish the Diseas and we deliver the application of such things as wil augment it In like manner when we preserve we take away the causes and withal we shun the use of thos things that may conspire either the continuation or future breeding of them And for this Reason in the definition which we have presented above of an Indication we distinguished the action indicated into that which ought to be prosecuted and that which ought to be waved which very thing also we were about to do in the enumeration of the particular Indications to this Diseas It is now time for us to proceed to the second enquiry propounded at the beginning namely Unto which operation of the Intellective faculty the Indication belongeth We say first That the Indication doth in som sort include the simple apprehension of each term both of the Indicant and the Indicate For he can never understand a Proposition who is ignorant of the Terms therof Yet this knowledg is only preparatory and presupposed in the art of Indications as we have already noted We affirm secondly That composition and division is an explicit operation of the Intellective faculty in the perception of an Indication For the Indicant by force of his relation doth represent the Indicate to be aptly continued together into a relative proposition Now that a Proposition thus constituted may in its own nature be so manifest and evident that no man can reasonably doubt of the truth therof or need any cleerer proof is expresly taught by Galen 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and again in another place 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Here som calumniate Galen as if he had devised an art separated from all experience and quarrelling with Reason but because Galen intended nothing else than that Propositions framed by Indication are of self credit and need not any comprobation from Reason or Experience thes Criticks may perceiv their own rashness and retract the scandal Senertus indeed objecteth that the Indication cannot belong to the second operation of the mind because the Indicate is neither affirmed nor denied of the Indicant But that learned man was herein mistaken For although peradventure that the Indicate be neither affirmed nor denied of the Indicant directly and by the bare Verb Substantive or Copulative est Yet indirectly and obliquely it is manifestly predicated of the same and after the same manner as it useth to be in relative Propositions As for example A sound State is the Indicant of its own conservation a sickly condition is the Indicant of som remedy c. And if any man wil express the Indicate with his relation to the Indicant by the participle in dus than the Predication will be direct As a sound State is to be preserved a diseased State is to be cured a Diseas must be removed c. If the Learned Senertus can deny these to be Propositions he may with the like facility deny that an Indication belongeth to this Operation of the Understanding but if he must needs confess that there is no room left for the denial of this Now we have said that the Indication doth belong to the second Operation of the Mind becaus the Understanding in reference to the order of time doth withal comprehend the mutual relation between the Indicant and the Indicate and thereupon frameth a Proposition which formation and contexture of the Proposition is the very Indication and explicitly a second Operation of the Understanding Now that the Understanding doth together at one time comprehend the Indicant and the Indicate in the Indication is elegantly expressed by Galen in a decompounded word which he useth in the definition therof 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 also in another definition 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 We say Thirdly That Indication may likewise implicitly be referred to the third operation of the Understanding Becaus in the order of Nature the Understanding seemeth first to perceive the evident relation of the Indicant to the Indicate before it can conclude of the certainty of the Proposition from thence resulting Although in the order of time the Mind as hath been said comprehendeth them together neither is it necessary to form an explicit Syllogism for the truth is The Understanding can comprehend those things together at one time which by the Institution of Nature are termed Successive as the Sun and Light Fire and Heat c. But in regard that this simultaneous comprehension of an Indication doth include a certain dependance of the knowledg of the Indicate from the perceived relation of the Indicant it supposeth also that the said relation is sooner perceived at least in the order of Nature and that the Indicate is later understood and by an implicit bringing in for a kind of transition in respect of the order of Nature doth seem to be here implied from the relation of the Indicant as the Medius terminus to the Proposition constituted of the Indicant and the Indicate as to the conclusion and this
rather indeed confirms it For the unity of an Art consisteth in some community which may be attributed to all the parts therof and this union is to be esteemed so much the more firm as all the parts of art are reciprocally conjoyned among themselvs by more communities If therfore there are two general Actions and those common to all the parts of Medicine so much the more firmly will those parts conspire the advancement of the Art Wherfore he contradicts not Galen that affirms conservation also to be a general Action of all Medicine seing that the scope of Galen was only to shew the unity of the Medical art by the community of that general Action namely Correction now he might as easily have shewed it if the nature of the thing had required it by the community of Conservation For in the Hygienal part of the most noble circumstance is the Conservation of the whol concrete action and therupon the whol action is denominated from the more principal part and the Art it self an Art conservative Although otherwise as hath been said it also includes Correction But in the Prophylactical part the principal scope of the Medical Action is preservation namely the correction of the caus of the imminent Diseas yet this is so performed and by such means which the present spirits can allow but in no wise by such things as may destroy them And therfore also in the Prophylactical part regard is had to the Spirits and their conservation is Indicated Now after the same manner the whole concrete Action although as hath been said it also includeth Conservation is called Preservation and Precaution from the more Noble part Finally In the Therapeutical part although in like manner the whol concrete action be called Curation and the art it self a Curative Science from the principal part of the action yet to speak properly and truly all this action of cure may be divided into three abstracted parts and evidently distinct namly into the Cure of the cause the Cure of the Diseas and the conservation of the Spirits For the Vital or Conservative Indication doth evidently and by the unanimous grant of all Physitians belong also to this part of Medicine and must be consulted of in every curative action before it be undertaken From whence it is manifest that this part likewise of Medicine doth perpetutually conserve that is provide and foresee in every Cure least the Spirits should receive more detriment than profit from the prescribed remedies Al these things therfore being thorowly weighed we conclude That a general Indicate is a certain concrete thing and may be properly distinguished into two general abstracted actions which are exercised in every part of Medicine and that in the work of art they pertually make one compleat or complicated action Moreover The general Indicant namely the State of the Body as frail and in motion may be divided besides the parts or obstracted considerations already proposed into three kinds or rather three succeeding kinds equally and alike concrete namely into a sound state a diseased state and a neutrality These three Species are the subjects of the three kinds of Method to Practice namely the sound state of the Hygienal part the diseased state of the Therapeutical and the Neutral of the Prophylactical part These three states are also concrete Indicants and respectively Indicate what is particularly to be done or what the Physitians Duty is in all those Arts namely a sound state indicateth the conservation of health a diseased state the removal of some affect and the Neutral state that the caus of an imminent malady ought to be corrected least it break out into a Diseas Now these three Indicates are alike concrete and each of them as we have proved above abstractively includeth both Conservation and Correction Finally In a Diseased state the action of correcting is dissolved into two Species into the correction of Caus and the correction of the Diseas and so here may be discovered three kinds of abstracted actions For a diseased state brancheth it self into three Species evidently abstracted into the Essence of a Diseas the causes of a Diseas and the Spirits or those things which remain in this state according to Nature For those things which are preternatural and indicate correction in general are here separated as hath been said into two parts namely into the Essence of a Diseas and the Causes of a Diseas and therfore there are three parts of this state each of which do formally and distinctly Indicate Three kinds therfore that we may put an end to this matter of Indications are to be considered in this state namely from the Essence of the Diseas the Curative from the Causes the Preservative and from the Spirits the Vital or Conservative To the Causes we refer all impediments of cure as also vehement Symptoms and such as divert the Progress of the Cure to themselvs for in this respect they are invested with the Nature of Causes And thus much of Indications in general CHAP. XXV Indications Curative WE have already affirmed that these Indications are deduced from the Essence of the Diseas we shall therfore in this place slightly run over all the parts of the Essence of this Diseas that the Reader may perceive what every one insinuates to be done First Therfore the Essence of this Diseas partly consisteth in a cold and moist distemper this Diseas therfore in respect of this part of its Essence Indicateth not only that all those things are to be avoided which are in any wise endued with a faculty to cherish and augment that distemper but also that the aid of such things ought to be implored which may subdue the same namely hot and dry Secondly This Diseas partly also consisteth in the want of inherent Spirits therfore not only all those things are to be avoided which can any further scatter and consume the Spirits but such things must be elected which are vertuous to restore cherish and multiply them Strong discussing remedies are therfore in this case to be declined becaus withal they consume the Spirits in like manner such as are extreamly hot for they caus them to evaporate and vanish into air but much more such as have power to dissolve the parts as violent Catharticks But the best nourishment must be chosen and Medicines that are easy of Concoction as much as may be and amicable and benign to the Spirits Thirdly The Essence of this Diseas consisteth partly in a numbness or astonishment of the Spirits this numbness insinuates a prohibition and abstinence from all such things as vehemently make thick and fix the Spirits or any other waies stupifie them as narotical remidies and many Minerals which participate of the nature of Lead as Cerus Litharge Sinople or Vermilion and all such things as have power to excite the Spirits to expel their stupefaction and to render them active and agile are to be made choice of as exercises motions Frictions
evacuation hath gon before is first Indicated and indeed the viscous humors Indicate incident and the thick attenuant remedies Again when the Diseas is very Chronical and extended to many months yea perhaps to a year and upwards it is not to be supposed that the whol matter causing the Diseas can at once be prepared or evacuated wherfore in this rerespect it Indicateth that we insist upon things preparatory and evacuant by turns Besides we must know that Cholerick humors require one preparation and evacuation and Melancholy humors another flegm another and watry humors another And that the preparation and purgation is Indicated variously according to the diversity of the humors commixed with the Blood The humors that are impacted in certain parts of the Body do much more require preparation before they are evacuated according to that of Hippocrates When you would purg a Body you must first make it fluxible Neitherdoth a certain general purgation suffice to subdu thes humors but such a preparation is required that hath a peculiar reference to that part in which they are inherent and therfore the humors in the Liver require one kind of preparation those in the Lungs another c. Finally Seing that the propounded kinds of all humors after they are evacuated may grow and breed again they Indicate an avoyding of such things which may dispose the Body to an easy generation of such humors And thus much of Indications Preservative it remaineth now that we consider the Vital and Conservative CHAP. XXVII Indications Conservative or Vital THis Indication ariseth from those things which are according to Nature For Life in it self consisteth in these things namly in a triple Constitution of the Body the Natural Vital and Animal above rehearsed The Natural comprehendeth under it First The Temperament Secondly The Inherent Spirits with their plenty and vigor Thirdly The Tone of the Parts Fourthly The Structure of the Organs Fifthly The Continuity The Vital containeth First The Generation Secondly The Distribution of the Vital Spirits Thirdly Their participation with those parts unto which they are distributed namely from the union of them with the said parts and the communicated heat The Animal comprehendeth First The Generation Secondly The Distribution of the Animal Spirits Thirdly The due Stretching of the Parts depending upon the Influx of the Brain All these things because life consisteth in them are called Vital Indications But among Authors for the most part they are known by the common name of the Spirits but this name is somwhat to gross seing that in propriety of speech the Spirits are radicated in the said Constitutions and are faculties of them Yet we have no design to innovate the custom of speech provided that the things may be understood as it is These Indicants so long as they continue firm and sound they require only a general and ordinary conservation by the right use of the six non-Natural things but when they are all alike vitiated or obnoxious to imminent hurt they require not only a general conservation but such an one likewise as is mixt with cure and preservation Again Where some one Constitution or som one part therof is depraved more than the rest or subject to such depravation besides the general preservation it requireth in like manner an especial one to be associated to the peculiar Curation Lastly When a Constitution Subject to error or actually erroneous is fixed to som certain part it doth higher specify that conservation namly that respect may be also had of the part so labouring more than the rest But because som say That the Vital Indication is the only and that Conservation is the simple end and that they cannot be further subdivided because that all things which are according to Nature are comprehended in the word Spirits and that they Indicate one Action namly the preservation of themselvs We grant indeed that the Spirits if as we have already noted they be improperly taken for their causes namly the three Constitutions aforesaid may in one word comprehend al things which are according to Nature but then this word must be Generical and divisible into three species namly the three Constitutions as Spirits Natural Vital and Animal We grant also that the end or that the Indicated action is one namly Conservation but by the unity of the Genus not of the ultimate species For those very things which are according to Nature however they agree in the Genus yet in the species they may differ among themselvs and require a different conservation yea it is possible that thos things which conserv the Spirits on one part may impugn them on the other as for example Wine given may in one respect cherish and strengthen the Vital Spirits or rather the Vital Constitution but in the interim it may offend and debilitate the Animal Spirits or the Animal Constitution In like manner the Temperament requireth one preservation the Structure of the Organs another and the Continuity another Yea the very different Constitution of the parts Indicates a various conservation neither do we after one and the same manner or by the same actions provide for the special conservation of the Liver Lungs Brain c. Wherfore when som one Constitution is more infirm then another or when som one part is weaker than another it Indicates a proper conservation peculiar and special to it self and therfore both Conservation and Conservants may be divided into their Species For the Conservation the Conservants appropriated to the Animal constitution differ from those which are destinated to the Vital or Natural And from hence the three first kinds of Conservation are to be deducted namly the Conservation of the Animal the Vital and the Natural constitution In like manner the Conservation of the Liver is accomplished by the use of the Hepaticals and of the Lungs by Pectorals c. Yea all parts of an eminent diversity do subdivide the conservation into so many more species Thus much of the division of Conservation into its species Moreover The same Conservation seemeth to be further divisible unto its parts For this Conservation is somwhat complicated and doth not only relate to simples but in som sort to contraries to wit Indicates both Curative and Preservative and either permitteth or disalloweth those same things being estimated with the Spirits It seemeth therfore to be branched into three parts into an election of like matters into an election of contraries under a certain condition and into a prohibition of the same under a diverse condition The election of like things is the most appropriated Action to Conservation and seems withal to have reference to two kinds of things alike namely such as are easily assimilated and are properly nourishments and such which although they cannot be assimilated in respect of their substance yet they contain within the same qualities like unto the constitution of certain parts in respect wherof they are reputed amicable and familiar to Nature and
unaptly be referred Moreover the Spirits also although they prohibit all extream hot things yet they allow of these as mōderat and very congruous to Nature In like manner there is little or no particular repugnance between these causes and the Indicates albeit in respect of time and the order of administration som dissent may be observed as we shall see afterwards in due place Wherfore in what respect and how far these agree together whilst we intend a cure we do at once respect not only the Spirits but in som sort the causes by choosing such curative remedies or by mingling such ingredients with them which are able both to attenuate the thick matter to cut into the viscous to open the obstructed passages and the like In like manner whilst we are chiefly imployed either in preservation or in the rooting out of causes we make choice of such evacuants or els we compound them with such remedies as are also partly contrary to the Diseas And all these things we do to that purpose as that as hath been said we may be subservient to the most intentions we can Now having found out the actions simply requisit in the Species in the next place we shal enquire out their du circumstances 1. In regard that this is a great Diseas it requireth a great quantity of the Remedy in respect of it self For a Remedy unequal to the Diseas cannot extirpate it It is necessary therfore that the dose of the Medicine be equally to the magnitude of the Affect But in this Diseas the Spirits permit not so great a quantity of Remedies to be given at once Wherfore that quantity must be divided given by turns For this is a Chronical Diseas and of slow motion neither doth it necessarily require an hasty Cure and although the Spirits cannot wel endure either vehement Remedies or such as are given in a large dose yet they permit the use of Evacuant Medicins by an Epicrasis Wherfore by turns we must somtimes make use of Remedies Preparatory somtimes Evacuant somtimes Alterant and somtimes strengthing Secondly For so much as belongeth to the place of administration the general Rule is that the remedy ought to arive at the seat and penetrate to the very Cause of the Diseas If therfore it must have a passage into the Vessels it must be taken at the Mouth but if it will suffice to touch only the thick Guts it must be injected by the Fundament If the humors be naturally ready to move upwards expel them by vomit if downwards evacuat them by siege In like manner you must humor the inclination of Nature and root out the causes by spitting by Urin or by sweating Particular evacuations must be instituted in the very affected parts or in the parts adjacent For so the force of the Remedy doth the more surely make way to the seat of the Diseas and the morbifical Caus And for the same reason external and topical Medicines must be applied to the next convenient place Yet you must know that there is a certain Sympathy between som parts in which case the remedies ar frequently administred to the part wherwith that consent intercedeth and neither to the affected nor the adjacent part Thirdly The form of the Medicament doth partly depend upon the Rule last propounded For if the scope be to lenifie the Jaws or the Windpipe we chuse a licking or lapping form that by degrees the remedy may slide over the affected parts and stay the longer upon them In like manner if the Stomach be affected we often prescribe Pils Pouders or Electuaries that they may the longer abide in the Stomach To the Kidnies we rather design liquid things that they may the more easily be carried down to them with the wheyish part of the Blood The forms do also in som part depend upon the very nature of the Diseas as in burning Feavers liquid things are for the most part convenient dry things are scarce admitted on the other side in moist Diseases and when the Belly is oversoluble more solid forms are preferred Finally the forms of the Medicines do also partly depend upon the nature of the Ingredients So Cassia worketh most effectually in the form of a Bolus Hartshorn Coral and the like in the form of a Pouder in like manner bitter things such as beget a vomiting and stinking things are concealed in the form of Pills somtimes also they are guilded or els they are enwrapped in Wafers and exhibited in the form of a Bolus Now it must here be noted that for the most part the form of the Remedy is not so considerable as it gives place to the more easie and commodious administration in respect of the Admission or Reception of the Sick For many cannot swallow Pills others presently reject their Potions by vomit others are perhaps avers from other forms In this Affect in regard that all Children almost are loth to take Physick that form is to be preferred before the rest which shall be observed to be least distastful to them Fourthly As for the time of action you must so endeavor to sit your administrations that they may as little as possible be interupted with times of eating exercise or sleep for at this age the Spirits are scarce preserved sound and perfect without an interposition of those things by just internals Remedies evacuant opening attenuate and incident must be taken early in the morning upon an empty stomach and if they must be repeated the same day four of the Clock in the afternoon upon an empty stomach likewise is the most seasonable hour Strengthning and astringent Medicines and such as provoke sleep are to be taken rather in the evening than in the morning but perhaps som of these are most agreable after meals Medicines that are mingled with the nourishment ought to be gratful to the Palat lest they subvert the stomach and hinder concoction or caus a loathing of the meat or els empair the Spirits As for the order of proceeding there occur two general Rules The former is That that must first be don which being premised makes way for the following Remedies and therfore that ought first to be removed which hath the consideration of an impediment in respect of what must follow The later is That we must ever give our first help to the more urgent and weighty Indicant unless som impediment intervene If the Question therfore be Whether the Diseas or the Caus of the Diseas doth first require the help of Physick The answer wil be obvious according to the first Rule For the causes are reflected upon under the notion of an impediment in respect of the Cure of the Diseas for they cherish it and infringe the vertu of the Medicins Wherfore before that we are intent upon the vanquishing of the Diseas we premise all possible endeavors to root out the Caus or at least to lessen abate and retund it that it may oppose no considerable force to
retard the rooting out of the Diseas Yet in the interim whilst we are busie in the removal of the Causes the Essence of the Diseas must not be totally neglected as we have before admonished Yea when we have so subdued the Cause that it cannot for the present much interupt the Cure we may the Causes not being utterly over-come and cast out the more diligently and earnestly attempt the resisting of the affect yet with this condition That if the Causes revert and becom new impediments that then we are obliged presently to undertake the subduing and evacuation of them so that in this Chronical Affect somtimes the Causes somtimes the Diseas must be resisted by turns and the Spirits do better undergo this change of action than if we should continualy make our battery against the Causes till they were absolutely rooted out Moreover When the Causes of the Diseas in this Affect are unapt for motion by reason of their toughness grosness and perhaps setledness they must first be freed from this impediment and prepared before they are evacuated For according to the Rule of the great Dictator Quae movenda sunt fluida prius facere oportet In like manner that thickness toughness and setledness of matter if it be present indicate Remedies attenuant incident and opening But these things are not safly taken the impurities still flowing back into the first Passages for then perhaps they are carried along with the Medicines into the Veins and more defile the Blood or at least hinder the efficacy of the Remedies These therfore have the nature of an impediment and must be in the first place removed Lastly Universal Evacuants must be premised before Particular and Topical Remedies especially where it is not permitted at once to mind both intentions For the Universal Causes flowing in the Body are easily surrogated in the room of Particular Evacuations and renew the Afflux to the first affected part but the thinner part of Particular Causes and that which is most apt for motion is evacuated but the thicker perhaps is more impacted Wherfore Universal Causes yet flowing to and fro in the Body as considered are Impediments in respect of Particular Evacuation and by consequence must be first expelled The latter Rule was That we must releeve the more urgent and weighty Indicant first unless there be an interuption of som impediment That is termed an urgent Indicant which threatneth the most danger Now every such Indicant is supposed to induce great afflictions into the Body and not without manifest danger to wast the Spirits Therfore in this respect we must somtimes first help the Diseas the Caus being neglected Somtimes also we must neglect both the Diseas and the Causes and adress our endeavors to the pacification of the Symptoms as in a vehement Flux of the Belly long Watchings profuse and immoderat Sweating and the like But even in these cases we must have a prudent regard both to the Diseas and the Causes and when the urgent Symptom is corrected or the violence of the Diseas repressed then we must return to the regular Method of proceeding for this Rule belongs not to the ordinary and legitimate order of Cure but to the Method of Necessity Moreover to perfect the right administration of Indications there is required an exact and accurat knowledg of the Medical Matter whereof we shal discours in the subsequent Chapters CHAP. XXIX The Medical Matter answering to the Indications proposed and first the Chyrurgical THE Medical Matter must be found out by Experience and Analogismes or Arguments drawn by an answerable necessity from the Caus to the Effect although the truth is we conceive not any other Reasonings to be absolutly excluded It is vulgarly and not unaptly distributed into three kinds The Chirurgical the Pharmateutical and the Diatetical Of these in their order The Chirurgical commonly received and approved in this Affect and famous above the rest are chiefly two Scarification of the Ears and little Fountains or Issues But our enquiry as we shal see anon shal be extended to many more namly of Cuppin-Glasses Leeches Blisters Ligatures and Swathing-bands But the opening of a Vein the Spirits cannot brook as every one knows who but observes the frailty of the age the extenuation of the habit of the parts and the smalness of the Veins The Scarification of the Ears shal lead our discours The Empericks who undertake the cure of this Diseas make more of it than one would imagin For in their practice they celerate it with great vaporing and without it scarce hope for a happy cure But we although we disallow not this kind of remedy have seen many Children successfully recovered without the use therof And they themselves who attribute most unto it for the most part take away no considerable portion of Blood Yet some affirm that they have seen a large quantity of Blood drawn away with good event However it be it is credible that those Children do with most ease endure this remedy and obtain most profit by the use of it which are of a Sanguin complexion and wel habited and who are affected with an Alogotrophy rather than an Atrophy or a Consumption or any other remarkable extenuation of the parts Our Practitioners for most part repeat this operation two or three times in a week They seldom do it with an Instrument or sharp Pen-knife but most commonly with an ordinary blunt Knife taking no notice of the pain and crying of the Child Moreover For the most part they perform it in the hollow of the Ear but some extend it to the inward and outward circumference of the upper part of the Ear yea to the whol circumference No man hitherto as we know have attempted the Scarification of the hinder side of the Ear although indeed it is not easie to give a reason why it should conduce less being administred there than in the hollow part Yet it may be lawful for us to offer our conjectures why the hollow of the Ear should be chosen before the other parts for this operation which notwithstanding we will not confidently assert although we suppose we can at least probably assert it if that be true which the most diligent Chyrurgion Fubricius Hildanus hath written in his Observ 4. Centur. 1. de nervo quinti parts For this conjecture is grounded upon this Observation and if that be ruinous this perhaps must perish with it The Conjecture is this The distribution and use of the Nerve and of the fifth Pair before mentioned being supposed Scarification in the hollow of the Ear may very conveniently both free that Nerve from any kind of oppression and likewise shake off the numbness and give it vigor For the hollow of the Ear is the next place unto it which we can come at with an instrument Wherfore evacuation being here made may immediatly drive away the matter which commonly oppresseth the very beginning of that Nerve and withal causing pain and encreasing the