part affected is debilitated and overcome by this depraved malign matter that it cannot exercise its transmutative and digestive power nor will this cancerous matter obey Discussives by reason of the viscidity and grossness thereof wherefore Hippocrates gave sentence That such are not cured but by section or ustion and yet this is not to be done except the Cancer be small and in such a part as will admit of amputation If Cancers external are thus difficult to be managed although they appear to the eye and are subject to manual operation and tractation the internal must be greater and more hazardous where they cannot be applied unto after this manner with convenient Topical Medicines therefore prevention in time is mainly to be endeavoured when a Tumor is generated lest it change into this dangerous condition for I find by the design of Practisers in the Remedies appointed that palliation is sought for the Cure not hoped for The grand intention to be prosecuted for Cure is to change the condition of the blood which does feed and supply this Cancer so that the antecedent cause being taken away the continent will then more likely abate and until that be done this cannot be expected The means indicated for Cure of these cancerous Tumors are branched into three parts Dieatetic Pharmaceutic and Chirurgical but I shall not enlarge upon the Indications for Cure for that these cases are so nice and difficult as not to be handled with generals but from a collation of all the circumstances attending the Patient which varies every particular case And so I pass from Tumors to remark their usual commutation and transition into Vlcers the next considerable in order to be treated of Ulcers internal THE Latine word Vlcus is derived of 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 signifying a disjunction of parts or solution of continuity but to distinguish this from other solutions of continuity an Ulcer does yield a Sanies or purulent matter so that a Wound coming to digestion and affording pus may then be called an Vlcer and any part that is gauled raw and tender the covering Membrane being fretted and eaten away by some sharp humor or other cause it stiled Excoriation only until it produce corrupt matter and then it is properly called an Vlcer thus internal parts are sometimes excoriated raw and painful but cicatrized or skinned again before it arrive to the degree of an Vlcer And thus it is most frequently in the urinary ductures or passages and sometimes in the Guts but such Excoriations are not to be slighted or neglected lest they beget Vlceration as sometimes it falls out so By external or outward Vlcers which are manifest to the eye you may conceive of internal Vlcers for they arise from the same causes and have the same accidents but I shall not inlarge upon all the accidental differences that attend upon and distinguish external Ulcers as not so pertinent and necessary to our subject in hand The essential and most considerable difference of Vlcers does arise from their causes and from the part affected which bears the great sway in curing and from whence the chief indications are taken for although in external Vlcers other accidental differences may be observed and noted yet in internal Vlcers such differences cannot be regarded as being obscured or hid so that whether they be broad or narrow deep or shallow fistulous or otherwise is hot positively to be said and if it were known institution or method of Cure could not be so varied as external are capable of by reason these are subject to manual tractation The continent causes of Vlers are such matter as emane and flow from thence and that is of three sorts Ichor Pus and Sordes The first is an ichorous or sanious matter being thin indigested and watry or diluted bloody The second is a Pus or purulent matter of a betted consistence and concocted thicker The third is a sordid foul matter more thick and glutinous The ichorous thin matter usually issues in the beginning of Vlcers and denotes indigestion and also at any time afterwards does declare the same that the Vlcer is not in a good healing condition The Pus or purulent matter signifies the Vlcer to be in a better state of healing and if it be white and sweet these are good signs The sordid gross matter does intimate a preternatural heat of the parts strongly exsiccating but not healing for as much as this matter is foul and stinking Vlcers for their manner of generation and rise may be caused these four ways by Erosion by Frication Apostemation and Contagion 1. By Erosion Ulcers are begotten in any part of the body when a sharp corrosive humor does excoriate and eat into the substance of any part and being thus injured is thereby perverted in its office and self-preservation converting that nutritious Succus which comes for its supply into an ulcerous degenerate matter no way useful but to be excreted and voided And thus a Phthisis an Vlcer of the Lungs is sometimes generated from a sharp Serum invading that tender part and thus a Dysentery is sometimes begotten being an ulceration of the Guts from sharp excoriating humors and thus an ulceration in the Meatus Penis is bred from a sharp eroding Gonorrhaea and an Ulcer in the neck of the Bladder may be planted there by a sharp gauling Urine 2. By Frication or attrition as when any hard bony or stony substance does fret raze and excoriate a part and thus a stone begets an Vlcer in the Kidneys or Bladder and sometimes in other parts of the body 3. By Apostemation as when any Apostem breaketh and dischargeth its matter an Vlcer is left behind though the Apostem be gone and thus are Vlcers generated sometimes in the Ear from a preceding Apostem in the aspera Arteria after an Angina or Squinance in the Breast after a Pleurisie in the Lungs from a Tumor suppurated there also in the Liver Spleen Womb or other parts apostemated 4. By Contagion or infection and thus women whole Privities are infected do communicate this virulency or venom and seize the Genitals of their Partner from whence venereal Vlcers do arise and thus men whole Seed is tainted do infect sound women and cause virulent Vlcers in their Privities which malignity not being well managed and mastered by skill and efficacious Medicines it spreads breaks forth and begets Vlcers in many other parts of the body as at large I have set forth in another Tract entituled The Mystery of the Venereal Lues Internal Vlcers though they disappear yet are known to be by these signs First Pain which is more or less according to the nature and sensibility of the part Secondly From preceding causes as Inflammation or Tumor preceding whose Symptoms being allayed and ceased yet pain remains Thirdly and manifestly From excretion of ulcerous matter where there is any ducture or outlet for discharge by the Intestines by the Privities the Nose Ears or Mouth but where there
the foundation or first cause of complaint be removed else you begin at the wrong end for in vain it is to endeavor amendment in the part consenting until the other be in its rectitude sublatâ causâ tollitur effectus For example if the Head complain from the Stomach let the Cure be designed upon the Stomach and that being performed the work is done Thus you see plainly that the Cure of Head-pains by consent is as various and different as the parts of the Body are different in organization situation and office whereby they become liable and are seized with various diseases requiring a different manner or methods of curing which are to be treated of in their proper places Touching the Cure of Head-pains that are the products or consequents of essential or idiopathical Diseases seated in the Head the removing or taking away those pains depends upon the Cure of those Diseases whereof they are the effects and concomitants and do require their due and regular course of means suitable to the nature of the disease but in cases of extremity and for mitigation of pain and the inconveniencies arising thence as long watching or want of rest and prostration of strength there are such good Remedies as Anodynes prudently to be used for allay and giving ease or respite until the causes can be eradicated and a perfect Cure wrought Pains in the Thorax or Breast AMongst the several divisions of mans Body into parts we may observe three insignal Cavities each containing principal Members of the Body the first and supreme is the Head and all contained therein the middle cavity is the Breast which contains the Lungs and Heart the lower region called the Abdomen or Belly comprehends the Stomach Liver Spleen Guts Kidneys c. And having taken cognizance of those pains incident to the Head we now come to remark what pains happen to the containing and contained parts of the Breast Hence we may note that these pains from their situation and place may be distinguished into external and internal External pains we may call such as are outward amongst the musculous and fleshy parts as the Paps Dugs and intercostal Muscles Internal pains are such as seize the Heart Lungs Mediastinum c. parts contained The Breast is circumscribed thus the upper part is from the two Canal-bones called Claviculae about the bottom of the Neck the lower part is bounded by the Diaphragma or Midriff spread just above the Stomach and Liver from side to side the fore-part is the Sternon or Breast-bone seated in the middle which joins and fastens the Ribs on the back-part is the Vertebrae or Spine consisting of many bones knit together where also the Ribs have their articulation the sides are compassed with Ribs swelling outwards and they reach from the Spine to the Sternon And this is the extent or limits of the Breast Pain may fall into the Paps or Dugs of both Sexes but most commonly it happens so to women except from external causes blows or falls and thus it is upon a sixfold account First Because those parts are more capacious and swelling outwards in Women which being glandulous spongy soft and porous are thereby apt to imbibe or receive any vagrant humor coming to this part Secondly More liable to the impressions of cold from its tender soft nature and being by them more frequently exposed to the air which may occasion and lay a foundation for pain and other Symptoms to follow Thirdly In Women these parts being furnished with more Vessels of use for lactation or suckling are thereby more liable and obnoxious to disorder Fourthly From the communication and intercourse between this part and the Womb whose diseases and distempers may affect the other by consent Fifthly From the attraction of suckling ill humors may be drawn and gathered there which otherwise would not resort to that part Sixthly Pain seizeth this part in Women from the various conditions of their milk Now the variations of milk causing this effect arise upon a double account redundance or plenitude and Cacochymy or alienation Sometimes by plenitude for milk abounding and distending the Vessels causeth pain and trouble in the part Sometimes by alienation of milk from its natural good condition to a degenerate state and this proceedeth from a cachectic or vicious habit of body for as the blood is good or bad so likewise the milk which is sanguis dealbatus blood changed white by another digestion This milky substance being balsamic dulcid and pure in its integrity yet is very subject to alterations and change from distempers and various dispositions of the Body as sometimes from thence being not so sweet but saltish bitter acrid and punging sometimes curdling and coagulating thereby not flowing freely in the Vessels but causing obstructions in those small ductures hence arise pains inflammations hardness tumors c. if not prevented by a due course with good means And such inconveniencies as these are frequent to Women after the birth of children when milk flows plentifully into those parts and this many times or for the most part does proceed from the imprudent custom of managing Women in child-bed especially some Nurses who would be thought more careful kind and diligent to their Mistresses do feed them too plentifully giving them Caudle at every 〈◊〉 or after every short sleep night and day telling them they are empty and must fill up again and make up their loss which after this manner being done too hastily and the body changing from a large evacuation to a sudden â—epletion the Stomach thereby fails and is clogâ—â—… the blood ferments into disorder causing â—â—…e and dangerous Feavers of which the milk â—â—…ticipates and thereby degenerates endangerâ—â—g both the Mother and the infant But indeed by experience I have found and reason urgeth the same that nothing is more safe than a spare diet which preserves the Stomach quick and sharp and keeps the whole body in a moderate temper and a regular condition not occasioning such overflowings of milk or otherwise flouding and this I have cautioned and made some Nurses sensible of who by observance thereof afterwards found their offices more successful and have given me thanks for my advice as being the safest and best way to discharge the trust and care reposed in them In the next place we are to take notice of pains that are seated in the musculous parts namely the intercostal Muscles in number 44 so called from Costae the Ribs which these Musc les do cover and also are inserted filling up the spaces between each Rib. In these parts pains sometimes do fix and settle and are most perceived upon drawing in of the breath when the Muscles are upon extension and swelling outward These pains are called by some Bastard Pleurisies though improperly and by mistake for pains of the Pleura are different Sometimes these pains are not of continuance as to time nor constant as to place but move here and there and these are
pressure here raiseth a fainting pain the Cartilage yielding and giving way to any force But sometimes a pain is planted here not always by any external manifest cause but from internal and preternatural state of the parts and this pain is rarely taken notice of by Physicians and mentioned but by a few practical Authors Now to examine into the cause of pain you must know that this Cartilage is flexible and yielding in its natural condition being of a middle nature between a Bone and a Ligament and therefore may be curvated and bent inward upon a threefold account By Laxation Exsiccation and external depression 1. By Laxation as when too much moisture resides here mollifying and loosning the part from any small occasion the Cartilage may be inflexed and turned inward changing its due position and rectitude and from the like cause Ligaments are sometimes relaxed which renders Junctures ready and apt for dislocation and disjuncture and upon this score the Vertebrae of the Spine have been displaced also the Hip and Ancles 2. By Exsiccation this Cartilage may be distorted and wrested from its posture as sometimes that which was straight green and pliable by drying and shrinking becomes crooked bent and drawn aside So this Cartilage that was a Grisle tender and pliable sometimes becomes dry hard and bony and fixed upon distortion or writhing as not returning to its rectitude or straightness and distance from the subjacent parts over which and for whose guard it is placed 3. By external Depression as from a blow or fall any thing too much or too long pressing upon that part may pervert and alter the situation and due posture and those whose business or imploy keeps them bending or pressing forward too much and constant renders them liable to this inconvenience and therefore Students and Clerks that write much pressing upon this part are injured thereby and find it upon age though youth bears it off for a time Now since this Cartilage is thus exposed to depression and bending inward and thereby the tender parts subjacent to be pressed upon and molested the cause of pain and manner how is made evident and which most commonly is felt after eating and upon a full stomach when the parts are dilated and swelling up to this Cartilage And farther as all parts of the Body in several persons do vary and differ much in figure position magnitude and distance so thereby some are more liable and apt for this pain than others although subject to the same external procuring or internal antecedent causes And so I dismiss this particular pain and pressure and must take cognizance briefly of that which is more general upon the whole Breast The Thorax or Breast suffers by compression or constriction whereby a general obtuse pain of angustness is perceived and that chiefly upon inspiration and drawing in of the breath and why now more than at another time is because the inspired air fills and distends the Breast which makes opposition to or resists the compressing causes Now the cause of angustness or coarctation is from the Genus nervosum that gives motion to the Muscles and other parts of the Breast which Nerves sometimes are impedited and contracted that their functions are not freely executed and therefore to this Symptom of compression is commonly adjoyned shortness or difficulty of breathing upon the same score and sometimes spasms or convulsive motions And this complaint of straitness or contraction of the Breast does frequently happen to scorbutic persons whose nervous juyce being degenerate and tainted their Organ or Vessels perform not their office duly as they ought in giving the full motion and extension or every part for this nervous liquor being fed and supplied from the mass of blood which is scorbutic feculent and depauperated in spirit that also which is extracted thence must be answerable and of a degenerate nature so then this nervous juyce which should be vegete noble and spirituous for putting the motive faculties into action with vigor and briskness is become dispirited flat and depraved and the Organs acted thereby move heavily and irregularly so that upon inspiration or filling the Breast with Air the parts do not readily give way by expansion to let in hence the Patient feels himself girt or strait-laced It remains now in the last place that we finish this second division in examining and searching into the nature and causes of those pains that more peculiarly and eminently afflict the Heart The Heart being a noble or the noblest and principal part is as the Sun of the Microcosm whose irradiating lustre and beams of vital heat enlivens and refresheth all the regions and parts thereof the Eclipses storms and clouds then that happen as the consequents of its distempers and sufferings must needs be eminent and remarkable This supreme Organ that bears the government of vitality is so generally concerned in all diseases and discomposures of the Body that few there are but the Heart is made sensible thereby and gives notice thereof by variation of the Pulse as a sigrial from thence And not only distempers of the Body or the defect and decay of some particular member or faculty does affect the Heart but also the disorders and passions of the Mind have influence thereon that from thence the Heart akes beats or suffers pain and restless disturbance hence it is that grief anger fear desire c. Changeth the regular motion of the Heart and the Pulse alters as a token and manifest character of its sufferings Now the Heart is made thus sensible of the Bodies infirmities and preternatural mutations from the vital government that is planted here having commerce and communication with every member from the circulating afflux and reflux of the crimson vital stream continually transmitted through this Organ which thereby is affected well or ill as the blood is better or worse in the current and quality thereof And the Heart is also affected from the mind for as much as the Soul exerciseth her power more eminently here and if a particular part may bee assigned this may be said to be the seat or Throne of Regality The Heart being of a solid fibrous flesh the pain thereof is obtuse not so accurately perceptible so acute and sharp as those of the nervous parts notwithstanding the effects and consequents thereof are impressed upon the whole Body and each member is impaired in its vivacity and vigor and although this Heart pain by the nature and substance of the Organ is not so great commonly and perceptible as that of some other parts yet when this pain does arise to some degree a Syncope seizeth the Patient a deprivation or cessation of life for a time that what it wants as to sense is doubled in the consequents as threatning and endangering the life so that extremity of pain is not perceived here because sense decays as the cause of pain increaseth The Heart is molested and suffers pain these several ways by extension
constriction obstruction inflammation or intemperate heat Imposthumation by erosion by exotic generation 1. The Heart is pained by extension from a sudden ebullition and turgid fermentation of the blood raised by passion or otherwise whereby the Vessels are suddenly forced upon distension to receive and transmit the inundation and swelling current of the blood and from hence pain and trouble ariseth at the Heart 2. By constriction the Heart is pained and that from external and internal cause externally from the Pericardium compressing whereby the Heart is denied the full liberty of its Diastole or expansion and this may arise upon a double account either from the Pericardium being too replete and full or too much exhausted and empty You must understand therefore that this Pericardium or Capsula cordis is a Membrane designed by Nature to involve and inclose the Heart for its defence as also being a moist Bath to irrigate and keep it souple containing a Serum or water and this Membrane should extend and be enlarged according to the motions of the Heart being greater or less now when this water does abound filling the cavity of this inclosure the Heart thereby is prohibited its full expansion and è contrà when this water is too much wasted and dryed up the Pericardium cleaves to the Heart and impedes its pulsific motion thus either plenitude or vacuity begets anxiety and trouble at the Heart Internal cause of constriction is when the Heart it self is seized with a Tabes or vehement exsiccation and the fibres so contracted that it hath no capacity or less for dilatation and permission of the transient blood 3. Obstruction causeth pain and trouble at Heart when the free current of the blood is impeded from within due Vessels and this is procured sometimes from a perturbation of the movent spirits and sometimes from an indisposition of the impulsed blood First from a sudden and violent recurrence of Spirits from other parts and tumultuous confluence at the Heart whereby the circulation is checkt and the blood stopt in the Ventricles causing a suffocation for a time and this happens upon vehement passions and consternations of the mind Secondly From an inhability and incapacity of the blood being gross concreted or grumous that it hardly or with difficulty passeth through this Organ causing thereby an obtuse pain oppression or heaviness at the region of the Heart and sometimes a Lipothymy or Syncope fainting or swooning 4. By Inflammation or intemperate heat the Heart is pained as in most Feavers where intensness of heat is accompanied and this heat continuing does exsiccate and contract the heart and brings a Tabes or Consumption upon the whole Body 5. By Imposthumation the Heart is pained sometimes as also by other Tumors there bred Which by dissection hath appeared after death 6. By Erosion or Vlceration sometimes the Heart is pained and suffers by continual palpitation 7. By exotic Generations and strange productions the Heart sometimes is pained as when worms stones or bony substance is bred in the Parenchyma of ' the Heart which hath been found there upon dissection after death and to these diseases and such as most of the forementioned the Symptom of Palpitation does necessarily belong shewing the continual molestation and trouble the Heart lyes under who endeavors to acquit and extricate it self by laborious lofty and strong pulsations Pains in the Abdomen or lower Region of the Body NOW we have done with those pains incident to the middle Cavity namely the Thorax or Breast I come in the next place and by the order proposed to the lower Region called the Abdomen or Belly containing the Stomach Liver Spleen Kidneys c. And here first as the principal member we shall inquire into pains belonging to the Stomach or Ventricle being the great Office and Laboratory to prepare Aliment to supply and maintain the whole Body therefore if this part be pained and out of order all the rest must needs fare the worse for it every part having a concern from hence Pains of the Stomach are various both in respect of their causes and also from the different parts of the Ventricle where they do infest and those are three the upper Orifice called Os Ventriculi the lower Orifice called Pylorus and the whole cavity of the Stomach The upper Orifice or mouth of the Stomach is subject to great pain as being very tender and sensible in regard it is very nervous and this pain is the more eminent and remarkable for that commonly two principal parts are hereby affected and drawn into consent the Brain and the Heart the former by the Nerves of the sixth conjugation derived from the Brain whose ramifications are wreathing or twining about this Orifice and therefore from hence Head-aches Vertigoes and Epilepsies do often arise The Heart also is affected both in respect of vicinity as near adjoyning to this Orifice and also for that the same pair of Nerves doth serve both the Heart and Stomach whereby of necessity there must be a communication of pain and therefore it is that this pain in extremity causeth Fainting and Swooning and hence it is that this pain by a peculiar distinguishing title is called Cardialgia and also for that the ancient Greeks called the mouth of the stomach 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 As for the causes of this Cardialgia or stomach-pain sometimes they are sharp acrid and hot biting humors fluctuating and rising up to the Orifice of the stomach where they cause an eroding or gnawing pain and sometimes a scalding or heat there and this vulgarly is called the Heart burning Sometimes flatulency and wind causeth this pain by way of distension and a swelling fulness and the Orifice is constringed and shut up so as denying vent in this case the Patient labours and strains to belch but cannot unlock or loosen the Orifice of the stomach but so soon as the Orifice does slacken and give way the wind breaks forth and ease followeth Sometimes Worms do cause this pain having gotten up to the mouth of the Ventricle where they gnaw and bite Sometimes churlish and deleterious or ill prepared Physick or discordant food having such properties as may irritate and provoke this tender part or food received in too great a quantity above what the stomach is able to master and digest then it riseth up to the mouth of the stomach causing oppression and pain there until it be discharged upwards or downwards by the strength of Nature or the assistance of Art Besides this Cardialgia there is also another sort of pain that afflicts the mouth of the stomach and that is Singultus a Hicket or Hickop and although the whole Ventricle be molested therewith yet the chief pain or trouble is at the Orifice or mouth of the stomach This Hickop is a convulsive motion of the stomach thereby causing pain The general causes assigned by Hippocrates are two repletion and inanition under repletion is comprehended whatever humor or vapor is in the
moderate and gentle making a profitable secretion without gripes or pains but for the most part with these more or less which by continuance and shaving the guts so thin at last do come to the quick and cause excoriations and this difference ariseth from the nature and quality of the humors or stimulating cause which sometimes is so extreme sharp introducing a Dysentery or bloody Flux These Fluxes sometimes produce good effects when the peccant matter of any disease or an exuberant humor is timely and moderately discharged and sent off but otherwise not and therefore saith Hippoc. In turbationibus alvi vomitibus sponte contingentibus siquidem qualia purgari oportet purgentur confert leniter serunt sin minùs vice versâ In respect of place or parts mandant from whence these Fluxes take their rise and the terminus à quo they proceed sometimes from morbific matter congregated and concentred issuing from the whole body and of this take the example of Hippoc. giving a Prognostic in this case 7. Aphor. 29. Si Leucophlegmatiâ detento fortis Diarrhoea supervenerit malum solvit Which is to be understood in the beginning of the disease strength firm and the Viscera sound else it is commonly mortal But sometimes also these Diarrhoea's do emerge from particular parts as the Ventricle Brain Spleen Liver Mesentery c. and therefore in the Cure of these Fluxes regard must be had to the part principally affected from whence as the original and fountain these Diarrhoea's do assurge And therefore examination is to be made by the Diagnostic signs of every principal part discovering thereby which performs their offices in integrity and which of them decline their functions and are depraved as being the Authors of this disturbance The third sort of Flux is a Dysentery or bloody Flux which is a dolorous and frequent excretion of blood from an Exulceration of the Guts There are several voidings of blood by stool that are to be distinguished and know from Dysenteries Galen mentions four others add two more The first is a profusion of blood arising from plenitude or fulness of good blood Nature over-burdened dischargeth her self this way by the Guts The second is an evacuation of crude and watry blood not having its full tincture The third is of a feculent and foul blood The fourth of an acrid and salt blood The fifth is of a tabefied blood in acute diseases The sixth which is Galens fourth is a Dysentery distinguished from the rest by Ulceration and great pain To examine this division in the several parts thereof and to set forth what truth and errour it contains therein is not our business at this time I shall only discourse upon the last viz. a Dysentery being painful and grievous to bear which kind of bloody Flux ariseth from and is accompanied with an Exulceration and commonly is the consequent of long or severe Diarrhoea's for those Fluxes not being checkt do sometimes make their transition and terminate in Dysenteries This word Dysentery taking its name from the part affected imports only a difficulty of the Intestines but may as properly be used for other diseases and pains there but Authors having fixed it to bloody Fluxes from Exulceration its general signification is restrained and custom amongst Physicians hath fastned it here as the character of this disease only The parts affected are the Guts either the small or the great and sometimes both but pains of the small are more grievous than those of the great the small Guts being of more exquisite sense The external and procatarctic causes that predispose and introduce a dysenterical disposition or promote and set forwards an inclination already begun are First the constitution of the Air. Secondly a bad Diet conspiring therewith or some unwonted kind of Meats or Drinks and therefore it is that many people upon the change of Climate and a new sort of Food do fall into bloody Fluxes hence it is also that these Fluxes are sometimes epidemical and malignant infesting many together in a City or Country as of late years in London and some other parts of England this disease was raging These epidemical Dysenteries arise sometimes to to the height of pestiléntial and are very contagious that it is not safe to converse with or be near the diseased but especially such as attend upon the sick are in most danger from the Excrements that send forth a pernicious and infectious vapor For the time of the year Autumn is most ready and does more frequently produce these Fluxes partly from the change of the season and partly from the effects of Summer fruits to which many are intemperately given the consequents whereof are commonly Diarrhoea's and Dysenteries Now the reason why these Fluxes do break out more frequently at this time of the year is because the external ambient Air and cool blasts condensing and incrassating the Juyces of the body as also occluding and shutting up the Pores denying and hindring the former Transpiration which in the Summer and hot weather did spend and evaporate that way much superfluous matter which vents being stopt humors accumulate ferment and grow turgid and forceth a discharge inwards by the Guts And not only this change of Air from hot to cold or Summer fruits are procuring causes but also some astral and inimical influences drawn in with our breath may deprave and alter the Crasis of the blood and nervous juyce as to effect this disease and make it popular in like manner as other Epidemical diseases are sometimes procured Also some sorts of Meats in quantity or quality offending and disagreeing and for want of good digestion may corruption and dispose to these Fluxes To these we may add as procurers some ill prepared Medicines and medicinal Drugs not well corrected that have and will produce a Dysentery But concerning the proximate cause and manner of generation of this disease we must farther declare And whereas before we mentioned several sorts of bloody excretions or fluxes not dolorous nor depending upon or conjoyned with exulceration of the Intestines and therefore not denominated nor to be understood as Dysenteries in the strict and present sense therefore I must wave the mentioning of their causes and only give an account of Dysenteries in the usual acceptation of the word In the forming or generating of this Dysentery you must understand that sometimes the Vlceration is planted first and hath the priority and a Flux of blood follows as the consequent but sometimes the voiding of blood precedes and an Vlcer or Vlcers is procured thereby as the effect and this consideration is not of small moment in the designment and intentions of curing for both the former and the latter happen in several persons Sometimes Vlceration is made by sharp corrosive humors as in Diarrhoea's which ulcerate the guts first then a Dysentery of blood follows Or Sometimes from an Inflammation of the Intestines or other Tumor coming to suppuration which breaks and makes a
pervious Caruncles or glandulous substances through which the Serum is strained and thus the water is transmitted by percolation The Vessels bringing into the Reins are the emulgent Arteries and these draw a Serum from the great Trunk of the Aorta Arteria and import it into the Kidneys the emulgent Veins from the Vena cava were thought by the Ancients to be for the same purpose but latter discoveries contradict it They also receive from the lacteal Veins the thinner and more watry part of the Chyle being an expedite and shorter way hence it is the Urine is pale or whitish when the Kidneys are not strong enough to give this milkie humor the urinary digestion or when drink is too plentifully poured in and forcing through before its due time therefore great Drinkers commonly piss a pale water There are also Nerves inserted into the Kidneys from a branch of the sixth pair which also serves the Ventricle hence it is that the Stomach is drawn into consent by loss of appetite nauseating and vomiting when the Kidneys are pained as in a fit of the Stone it is manifest By these Nerves the Kidneys do suffer not only a heaviness but sometimes very acute pains Vessels carrying the Vrine out of the Kidneys are the Vreters one belonging to each Kidney and they pass from hence down by the Loyns between the two Membranes of the Peritonaeum and are inserted into the Bladder to convey the Urine thither The length of these urinary ductures are about a span the cavity or hollow like a straw but capable of enlargement to the bigness of a finger as by a stone coming down though with extreme pain by reason they are membranous and nervous exquisitely sensible and therefore upon any obstruction are highly urged to expulsion especially by a solid sharp or rugged body as stone or gravel Hereby you may understand the office and use of these parts that is to drain the body from a superfluous saline and tartarous serosity and this ought daily and dully to be performed but this serosity is not all discharged this way by the Reins but some passeth off by insensible Transpiration and some by manifest Sweats but the greatest part by the Kidneys And from hence it appears that the Vrine is partly an excrement of the first digestion in respect of the aquosity drawn from the lacteal Juyce and partly of the second in respect of the Serum sanguinis exhausted from the blood by the emulgent Arteries And here you may observe that by a certain digestion or elaboration in the Kidneys these serosities are transmuted into Vrine and then carries an Odor or scent with it much different from what it was before and the like we may observe in other creatures that their urines have peculiar smells which argues a digestive transmutation But although Nature intends and endeavors this work constantly yet there are many casualties and impediments to disturb these parts and frustrate in some measure the designment of Nature the errors and failings herein we shall recite but those chiefly that are accompanied with or produce pain we shall discourse of with brevity The general and most frequent Symptoms that manifestly afflict or incommode the Reins are Pain and Weakness or Tenderness about those parts Diseases planted there from whence those pains or weakness do arise and depend are Intemperate Heat Imbecillity and a declining state Consumptive diminution and wasting Inflammations Scirrhous Tumors Angustness and Obstructions of the Cavities and Ductures Apertion of the Vessels Apostems Vlcers Some there are whose Pains are hot and molesting not by a natural constitution but acquired by time and evil customs or accidents happening to those parts and this begets a tenderness there and it is painful to lye on the Back The Vrine most frequently is hot or high-coloured sometimes sharp and then apt to make water often prone to Venery at least the constitution of those parts does dispose that way Causes introducing this distemper are too frequent use of Wine strong Drinks and hot Spices much Riding lying on the Back and soft Beds or too frequent Venery and for a correction of this distemper all these procurers and aggravators are sparingly to be used and some of them to be avoided and forborn But if this intemperate Heat depend upon any other disease seated there disturbing the office of the Kidneys and raising a preternatural heat then Remedies must be applied to that as the nature thereof does require which being removed this heat will allay and cease Imbecillity and weakness does sometimes affect the Reins and a decay in the performance of their office may be perceived and if this be not the consequent of some manifest disease debilitating and rendring them incapable then you must know that There is a natural Robor and fortitude implanted in every part by Nature whereby they execute their functions with integrity and constancy there is also an inequal distribution of this vigor and strength that some parts naturally are strong and durable in their stations others are not so firmly radicated in their principles but by time spontaneously fall off from their duties and decay much sooner than other parts of the body Hence it is that some though regularly living complain of this part others of that There are also occasions accidents and different manners of living which we call Diaetetic customs which as they are various do variously injure and decay this or that part of the body and cause it to decline sooner than the rest Imbecillity therefore of the Reins comes under some of these notions and hath its original from thence which when such a case present examination is to be made to which of these the case belongs and is to be ascribed Now that which I call Imbecillity or a decayed state is when the Reins do not make a due secretion or separation of the Serum from the blood and give it the urinary transmutation so that from hence the Vrine is but little and that not well digested the injurious consequents whereof are many for the blood remaining too much diluted and over-charged with the Serum or watry part which being distributed throughout the body and falling upon this or that part cause many Hydropic diseases and some of them mortal as examples hereof might be given The next considerable is Consumptive wasting diminution or lessening of the Kidneys not by ulceration but exsiccation proceeding from a hot and dry distemper of the Kidneys arriving to a colliquating Hectic or Tabes which by time begets a Consumption of the whole Body procured sometimes from a falacious temperament There is felt a heaviness and weakness about the Loins and the Kidneys do not perform their office aright Inflammation sometimes possesseth the Reins caused by pain of the stone gravel or otherwise by obstructions sometimes by a blow or fall also by an influx of blood or any foul corrupt matter transmuted thither and lodged there obstructing the passages and causing a suppression