do not wholly cohere nor participate of a common life So it extends not to the hairs nails fat and marrow of the bones which though they wholly cohere yet they are not sharers in life neither are they truly nourished but onely increased by neighbouring position so those things which are preternaturally adnate to the body as gravel hard skin and warts which though they have a total adhesion to the body yet enjoy no life So neither are carnous excretions Parts though they cohere to the whole and communicate in life because they are not appointed to any action or use You will object that Galen and Aristotle often honoured the hairs nails fat and marrow with the compellation of Parts I answer That in their time this term Part was taken in a great latitude as it signified any thing concurrent to the constitution of the Body but with us the acceptation is strict as being taken for parts onely animate and subject to Diseases Yet the hairs and nails cause sturdy doubts which many Neotericks add to the number of living parts of which dispute see Tardine in his most elegant Treatise of the Hairs CHAP. II. Of the differences of the Parts and first of the Similar Parts All Parts are divided into Similar and Dissimilar The Similar Parts are they which are divided into Parts of the same nature and not differing in species THE Matter of the Parts lends occasion of this division for some Parts being made of the same and every where alike matter are called Similar but if the matter be diverse they fall under the notion of Dissimilar But we say they have a like matter because at the first glance they represent themselves so to the sense such is the substance of the nerves whose parts appear to sense wholly similar but yet a curious Scrutinist will discover some dissimilar parts in them for their interiour substance is soft and marrowy but the internal hard and membranous But this difference is not of such validity nor so manifest but that the nerves may find place in the catalogue of Similar parts Avicen defines a Similar part thus whose parts retain the same name and definition with the whole So every part of the bone is bone and every part of the nerve nerve But you must alwayes apprehend this discourse to signifie the matter of the Parts not their figure or use for in relation to these every particle of them retains not the definition of the whole for example a nerve is defined a similary part white arising from the brain or the spinalis medulla prepared for the communication of motion and sense to the whole body which definition is not agreeable to every particle of it These Similar parts are two Spermatick and Carnous The spermatick are produced by the incrassation of seed in the first fashioning of our bodies The principles of our generation are two viz. the seed and menstruous blood which are the platform of all the parts of our bodies for seed is the Author of those first rafters viz. bones ligaments tendons membranes and such like The Carnous owe their composition to blood The carnous parts are easily distinguished from the spermatick because they are red but these white and most commonly solid and hard but blood being hot and moist therefore the carnous parts have also acquired a temper hot and moist Yet it is not so with the spermatick parts which though seed be hot and moist are yet cold and dry because the calidity of the seed depends upon its spirits which convert not into the substance of the part but have the title only of efficients in generation but the moisture of the seed is wasted that the parts generated out of it may become dry and hard whence heat subsisting upon moisture is diminished proportionally to the diminution of moisture The flesh of the similary parts is threefold of the muscles of the bowels and flesh properly so called But the quantity of the musculous flesh is greatest for almost the whole bulk of the body is composed of muscles and their substance is commonly and simply termed flesh but the substance of the bowels also is called flesh and the greater part of them is composed of blood alone yet to the constitution of some there goes a permixtion of seed with blood such is the substance of the ventricle intestines the wombe and such like For the due execution of the actions of the similar parts there is but one condition necessary viz. their just temper The similar parts as similar and as distinguished from the organical exercise onely one action viz. Nutrition for which cause they attract retain and assimilate to themselves their proper and convenient aliment which cannot be effected but by their temper for according to the various temper of any part the aliment must be various and diversly changed whence a similar action is defined whose original being only from the temper of the part it is perfected by the same and is wholly and perfectly exercised by every punctilio of the part CHAP. III. Of the Dissimilar and Organical parts The Dissimilar parts are those which are divided into parts unlike in nature and differing in species SO the Heart Liver Reins and other parts are termed Dissimilar as being composed of many similar parts viz. membranes veins arteries nerves and a parenchyma So the hand and arm is pieced up of bones nerves musculous flesh skin and the rest Every Dissimilar part is Organicall but every Organicall part is not Dissimilar Many confound the Organical with the Dissimilar so that they suppose it to imply all one if we divide the parts into similar and organical as into similar and dissimilar But in this they erre because many similar parts are also organical for the bones veins and arteries are similar parts yet being variously formed and exercising organical actions they are usually called organical and so in relation to their matter they are similar but in respect of their form and figure organical But an Organical part is that which by the vertue of its owne conformation acts determinately The similar parts simply and strictly considered as being conflated of one matter and busie in one action viz. Nutrition may stand in direct opposition to the organical hence it is common to divide all the actions of our body into similar and organical and though as before is noted there be but one onely similar action yet the organical run almost to infinity as they are various and particularly want an organ variously conformable this signifies a necessity of constituting many instrumental parts Hence is that large catalogue of the parts contrived with such rare artifice that causeth us to stand amazed in admiration of the juncture of our own bodies To cause the action of the organical parts there are four things necessary conformation magnitude number and conjunction Conformation imports three things figure passage and cavity asperity and laevity It is impossible that an organical part should
Second Book of MEDICINAL INSTITUTIONS CONTAINING PATHOLOGY Introductions to Pathology In Pathology is considered Mans body deviating from Nature and faln into a state of Disease NATURE is twofold according to the Philosophers universal and particular The laws of universal nature require generation corruption and various alteration to be strictly observed in bodies which are therefore obedient to the dictates of this universal nature but particular nature viz. humane hath enacted laws proper to the constitution of her own Republick differing from the laws of universal nature which if they be cancelled a man is then thought to decline from nature viz. particular nature So a certain harmony of first qualities constitute Mans body together with a due conformation and adunation of the parts in which when there happens any distraction a body becomes preternatural as shall be at large expounded in the following Treatise Observe that some in the front of whom marches Fernelius distinguish things preternatural from those which are contrary to nature so that that is preternatural which though it be illegal in its aberration from the rule of nature yet it offers no violence to it as pimples to the face and the colour contracted from the heat of the Sun But that is contrary to nature which violently opposeth it and manifestly mutilates its actions But these two are commonly confounded by Physicians and used for one and the same The state of mans body is threefold healthy unhealthy and neutral The Philosophers disavow this division and affirm that there intercedes no medium between disease and health But the Physicians term that unhealthy or morbous state when some actions of the body are manifestly out of tune healthy when they persist in a symmetry but neutral when they are neither manifestly vitiated nor altogether whole such a disposition is evidently apparent in those which are in a tendency to or in a recovery from a Disease for it was necessary to induce these three constitutions into the Art of Medicine for two causes chiefly The first is drawn from Medical operations and the manner of dyet to be instituted to every one for cure is necessary for the sick conservation for the healthy but to bodies neuters if they incline to disease preservation to the recovery from a disease refection or restauration The second cause is taken from the decretory dayes which are not to be computed from the beginning of every weakning of health but from that time in which the sick person hath suffered manifest and notable impediments in his actions so that he is necessitated to rest which could not be so distinguished unless a neutrality of state were distinguished from insalubrity Yet the difference between Philosophers and Physicians is not so wide that it abhors reconciliation which may be made if we say That the Philosophers Discourse of Disease and Health in a wider sense as also Galen sometimes takes them so that in this latitude they comprehend the state of neutrality The Physicians close nearer and use them more strictly as the use of Art requireth For the more copious explication of these three states I referre you to Galen in his Ars Parva We must now by course treat of the state of insalubrity by which means are three considerations 1 Disease 2 The Cause of the Disease 3 The Symptomes All that Treatise discourseth of that disposition of the body which is termed Disease For that we may attain a perfect knowledge of it the first proposition must be of its nature then we must make a search into all its differences next the causes which produce those Diseases are to be enquired into and lastly the effects produced by them will require our contemplation for the effects of Diseases the Physicians call Symptomes By this means all Pathology is commonly divided into three Sections in the first of which the nature of the Disease and its differences in the second the causes of Diseases in the third the symptomes of Diseases are by explication made obvious But because the consideration of the Crisis is not any where so appositely placed as in Pathology being defined by a mutation made in the Disease therefore we have resolved to adde to our Pathology a fourth Section comprehending the whole doctrine of the Crisis and Critical dayes and this we will advance to the second place So that the first shall handle the nature and differences of a Disease the second the changes contingent in Diseases of which the chief is the Crisis the third the causes of Diseases and the fourth the symptomes The first Section of PATHOLOGY Of the nature and differences of a Disease The First CHAPTER Of the nature of a Disease A Disease is a disposition of a body preternatural primarily and by it self injuring the actions GALEN in his first Book of the Method of Healing and in his Book of the Differences of Diseases in a well-contrived and clear method hath omitted nothing discoverable in the nature of a Disease whom in this place we propose for our pattern First then we deliberate of action it self which if it be hurt in mans body we say it is sick but if whole and unhurt we say it is in health I call that action hurt which manifestly and sensibly appeareth such for small harms and imperceptible by the sense are excluded from this place Moreover action being a motion and having no permanent essence onely so long in being as it is doing and performing therefore it implies a necessity of a constant and permanent cause But this cause is a corporeal instrument which exerciseth the action as the Eye seeth the Stomach concocteth But because one and the same instrument doth not alwayes exercise in the same manner its operations but sometimes unhurt and according to nature sometimes hurt and beside nature it will necessarily follow that the constitution and disposition thereof is various Hence if it be disposed according to nature the body will also be naturally disposed and exercise actions conformable to nature If therefore the body be in health when being naturally disposed it produceth perfect actions it will be diseased when it being disposed beside nature it exerts actions imperfect and so this detriment of actions will depend upon this preternatural disposition This definition therefore perfectly opens the intricacie of a Disease and is compleat bearing in his bulk a genus a subject a cause and an effect the genus is the disposition which being not circumscribed by the limits of any difference is predicated not onely of a Disease cause of Disease and symptomes thereof but of health also the subject is mans body the cause effecting the Disease is the discomposure of the symmetry of the parts or an excess overflowing the proper and natural constitution which by that terme Preternatural is demonstrated Lastly the immediate effect of a Disease is an ingredient also of the definition which is the detriment of actions which perpetually attending the Disease and being obvious to our senses
likeness of children to their parents chap. 6. p. 65 The second Book of Medicinal Institutions Containing Pathology Introduction to Pathology The first Section of Pathology Of the nature and differences of diseases OF the nature of a disease chap. 1. p. 69 Of the kindes and differences of diseases chap. 2. p. 72 Of the species of a similar disease chap. 3. p. 73 Of the species of an organical disease chap. 4. p. 77 Of the difference of the common disease or solution of the continuum ch 5. p. 80 Of the accidental differences of diseases chap. 6. p. 81 The second Section of Pathology Of the changes of diseases and chiefly of Crisis OF the changes contingent in diseases chap. 1. p. 85 Of the nature of a Crisis chap. 2. p. 86 Of the differences of Crisis chap. 3. p. 87 Of the signes of Crisis chap. 4. p. 91 Of the Critical dayes chap. 5. p. 92 Of the causes of Crisis and Critical dayes chap. 6. p. 99 The third Section of Pathology Of the causes of diseases OF the nature of the morbifick cause chap. 1. p. 102 Of the differences of causes chap. 2. p. 102 Of the causes of similar diseases chap. 3. p. 104 Of the causes of organical diseases chap. 4. p. 106 Of the causes of common diseases chap. 5. p. 106 Of the causes of the accidental differences of diseases chap. 6. p. 108 The fourth Section of Pathology Of the nature differences and causes of Symptomes OF the nature of Symptomes chap. 1. p. 109 Of the difference of Symptomes chap. 2. p. 109 Of the differences of action hurt chap. 3. p. 110 Of the difference of excrement chap. 4. p. 112 Of the difference of changed quality chap. 5. p. 112 Of the causes of Symptomes in the genus chap. 6. p. 113 Of the causes of injured actions chap. 7. p. 113 Of the causes of Symptomes which are in excrements chap. 8. p. 114 Of the causes of changed qualities chap. 9. p. 115 The third Book of Medicinal Institutions containing the Semeiotical part The Preface The first Section Of Signes in their Genus OF the nature and definition of a signe chap. 1. p. 116 Of the differences of signes chap. 2. p. 117 Of the general originals of signes chap. 3. p. 118 The second Section of the Semeiotical part Of the diagnostick signes OF the signes of bilious humor predominant in the whole body ch 1. p. 119 Of the signes of pituitous humor predominant in the body chap. 2. p. 121 Of the signes of bloud predominant in the body chap. 3. p. 122 Of the signes of melancholy predominant in the body chap. 4. p. 124 Of the signes of the affected part chap. 5. p. 126 Of the signes of a part primarily diseased or by consent chap. 6. p. 129 Of the signes of the species of a disease chap. 7. p. 131 Of the signes of a great and a small disease chap. 8. p. 133 Of the signes of a great and malignant disease chap. 9. p. 134 Of the signes of an acute and chronical disease chap. 10. p. 136 Of the signes of morbifick causes and first of the signes of preternatural choler chap. 11. p. 138 Of the signes of preternatural flegme chap. 12. p. 139 Of the signes of serum abounding chap. 13. p. 139 Of the signes of flatulency chap. 14. p. 141 Of the signes of the times of diseases chap. 15. p. 141 The third Section Of the Semeiotical part of the Prognostical signes OF the signes discovering when a disease shall be long or short chap. 1. p. 142 Of the signes of a disease tending to health or death chap. 2. p. 147 Of the manner how a disease will end whether by Crisis or a leasurable dissolution chap. 3. p. 207 Of the time when the disease will end wherein the day and hour of the Crisis is foretold chap. 4. p. 208 Of the place where the Crisis shall appear and first of the signes of the approching Crisis by vomit chap. 5. p. 209 Of the signes of the Crisis by looseness chap. 6. p. 209 Of the signes of an approching Crisis by sweat chap. 7. p. 210 Of the signes of future Crisis by urine chap. 8. p. 212 Of the signes of future Crisis by bleeding chap. 9. p. 212 Of the signes of future Crisis by the monthes and hemorrhoids chap. 10. p. 214 Of the signes of an ulcer chap. 11. p. 214 Of the signes of those things which will happen to one already sick or falling into a disease and first of the signes of approching madness chap. 12. p. 215 Of the signes of approching convulsions chap. 13. p. 217 Of the signes of a future relapse chap. 14. p. 218 The fourth Book of Physical institutions Of the conservation of health The Proem OF meat drink or of the matter of our nourishment chap. 1. p. 220 Of the substance of aliments chap. 2. p. 221 Of the quality of aliments chap. 3. p. 222 Of the quality of meats chap. 4. p. 225 Of the order of aliments chap. 5. p. 226 Of the time and hour of eating chap. 6. p. 228 Of the preparation of the nourishment chap. 7. p. 232. Of custome and delight in the use of meats chap. 8. p. 233 Of meat convenient for every age chap. 9. p. 234 Of diet convenient for every season of the year chap. 10. p. 236 Of Bread chap. 11. p. 257 Of Barly Rice Oats Beans Pease Vetches and Lentiles chap. 12. p. 259 Of pot-herbs most in use and their faculties chap. 13. p. 261 Of roots fit to eat chap. 14. p. 263 Of fruits fit to eat chap. 15. p. 264 Of animals fit for nourishment and first of flesh in general chap. 16. p. 278 Of the flesh of fourfooted beasts chap. 17. p. 279 Of the entrails and extreme parts of beasts chap. 18. p. 280 Of the nourishment contained in the parts of fourfooted beasts chap. 19. p. 281 Of nourishment from birds chap. 20. p. 283 Of fish chap. 21. p. 285 Of sauces chap. 22. p. 285 Of honey chap. 23. p. 287 Of drink and matter fit for drink chap. 24. p. 288 Of the air chap. 25. p. 295 Of the season of the year chap. 26. p. 297 Of motion and rest chap. 27. 299 Of sleep and watchings chap. 28. p. 300 Of Excretions and Retentions chap. 29. p. 302 Of the passions of the mind chap. 30. p. 303 The fifth Book of Physicall institutions containing the cure of diseases The Preface The first part of the cure of diseases Of the general method of curing The Proem The first Section Of the method of curing and the indications WHat is the method of curing what curation is and what are the conditions of it chap. 1. p. 307 Of Indications and their differences chap. 9. p. 308 Of the things that indicate chap. 3. p. 310 Of coindicaments contraindicaments and correpugnants chap. 4. p. 311 Of the things indicated chap. 5. p. 313 Of the first and most general principle of curation chap. 6. p.
that is juyce which is absolutely necessary that the aliments being prepared by that first coction may passe freely thorough those narrow veines which usualy conduct them to the Liver and also those smal veines which are dispersed thorough the substance of the Liver But when the Liver hath discharged its duty in sanguifying there is not further necessity for so much moisture therefore nature segregates the greater part of it which it hath designed to be attracted by the Reins and from thence is excluded to the bladder where it is called Urine but before while it confines it self to the veines it is called Serum Part of which remaining still in the veines is confused with the masse of blood to be the vehicle of the humors which being made more thin and fluid may have an easier accesse to every particle of our body but when this portion of Serum hath performed its office part of it retires to the Reins and accompanies the other Urine part inclines to the bulk of the body and is purged by sweat The office of it is to be a conduct to the alible humors for their easier transmigration thorough the body It is called to this duty as long as it is lodged in the veins but when it hath broke up house there it is useless in the body as choler and melancholy The differences of it are four viz. sanguinious bilious pituitous and melancholick Every humor hath its Serum properly and peculiarly appertaining to it and assimilated to its proper nature and temper so the Serum of the blood is held to be hot moist and somewhat red the Serum of choler hot dry and somewhat yellow the Serum of flegme cold moist and somewhat white and the Serum of melancholy cold dry and of colour dark CHAP. XI Of Excrementitious Flegme Excrementitious flegme is an excrement of the third concoction Cold and Moist of colour white as to the taste insipid or something sweat generated in divers parts but principally in the brain PArts of a cold and moist temper derive their nutrition from pituitous blood from whence proceed many excrements caused either by the coldness of the part it self unapt to concoct perfectly or by the humor it self which being the more crude part of the blood is of a difficult concoction and a great part of it converts into excrements Which is very evident in the brain for that copiously gathers excrementitious flegme which is purged out of the mouth and nose But the brain collects not this flegme solely by the concoction of its proper aliment but by reason of its advanced situation which is the cause that many vapors from the ventricle Liver and other bowels make upward to the head and by the frigidity of the brain are condensed into a waterish matter which is the original of this flegme Hence by reason of the copiousness of flegme congregated in the brain these two wayes Hippocrates and other Physicians have termed the braine The Metropolis of Flegme and Author of all defluxions It is differenced by the taste and consistency of it In relation to the tast it is four-fold Insipid Sweet Acide and salt Insipid proceedes from moderate cold which causeth no tast This is the most natural being an excretion in well disposed bodies conveyed away by the spittle The Sweet is produced from the insipid by a smal alteration of heat When the insipid is concocted by a moderate heat it is sweetned for sweetness is the produce of heat but yet hence we must not inferre that sweet flegme is hot because indeed an intense sweetness signifies heat but not a sleight and moderate one so fruit and milk of a cold temper yet are much sweeter then any flegme The Acide is caused by intense cold inducing Acidity When the smal heat of the flegme is extinguished or dissipated the necessary consequence is acidity no otherwise then as the juyces of many fruites meanly hot being infrigidated become easily acide which fares not so with hotter which do usually retain their soundnesse longer as appears by wine Salt Flegme is produced either by putrefaction or the permixtion of salt serous moisture As Galen in Book 2. of the diff feb cap. 5. It becomes salt by putrefaction because when putrefaction makes a separation between the siccity and humidity and that siccity being parched by a putredinous heat falleth again into conjunction with the humid substance it causeth a salt taste But it proceeds from the permixtion of salt serous humidity which being too much brin'd by intense heat is mingled with the sweet flegme but the serous humidity becomes salt when the action of heat upon it produceth scorched vapours which by permistion with it cause saltnesse Observe that these two species of flegme viz. the acide and salt are preternatural but the sweet and insipid natural As to its consistency it is also four-fold Thin Thick Vitreous and Gypseous The Thin is of a watery consistency very fluid and easily diffusing it self into divers parts Such is that which distilles from the brain thorough the nose and flowes thorough the mouth and is effused also in many parts thorough the middle intervals of the muscles Thick is when this thin hath acquired incrassation and clamminesse by heat The heat by resolution incrassates the thinner parts whence this flegme being gluish is properly called Snot Vitreous flegme is still thick but transparent as liquefied glasse or the white of a raw Egge It is a sturdy doubt and resolved to my knowledg by no Auther why vitreous flegme and that which is termed crasse are for the most part equally crasse yet one is very transparent and diaphanous the other very obscure This in my opinion proceeds from the diversity of the efficient cause which of crasse flegme is heat but of the vitreous cold In the crasse the heat resolves the thinner more airy and waterish parts which cause perspicuity hence it is clouded with opacity but in the vitreous being incrassated by cold not by heat while it is so condensed nothing is resolved but the diaphanous parts remain from whence it seems transparent as is manifest in ice But it will be objected That flegme cannot acquire such a degree of cold in our body that by the force of it it may be condensed and incrassated all our body being actually hot therefore whatsoever is cold is necessarily heated by the part in which it is contained To this I Answer That that flegme to which the vitreous owes its production is exceedingly crude and out-vying the strength of nature therefore it is banish'd her dominious as contumacions and insuperable and remised to its proper nature viz. coldness communicated to it by water and invincible by the weak heat of the parts in which it is contained as the intestines which are the head quarters of this vitreous flegme and doth not seldome torture them with most painfull fits of the Collick for by its glewy nature adhering to the intestiness by its cold it bites
substance To the fifth I Answer That the concurrence of three things cause cogitation Faculty Instrument and Object all which being supplyed the mind operates indefatigably for not only waking but often also sleeping we exercise our cogitations because we use the object of the internal senses but both failing cogitation ceaseth as also in default of the Instrument viz. Animal spirit which is tyred with many operations whence the careful ingeniety of nature hath provided sleep for living creatures by the benefit of which as it were by a truce the Animal actions keep high Holy-day and the spirits are refreshed CHAP. III. Of Innate Heat Innate Heat is the primigenious moisture diffused thorough all the parts of the body and every where replete with implanted spirit and native Heat HEat is a concrete term which signifies not only an accident but the subject to which it inheres There are therefore three things concurring to the constitution of innate heat viz. primigenious moisture implanted spirit and native heat in the spirit is constant heat but this implanted spirit is alwayes in conjunction with this primigenious moisture and confused with it and from them so united results the innate heat The true understanding therefore of these three will cause an easy knowledg of the nature of innate heat and the implanted spirit was at large explained before the primigenious moisture and native heat only rest for explication Primigenious moisture is a humid fat and oily substance diffused thorough all the body by preying on which as its proper food the native heat is preserved Aristotle defines life to be the dwelling of native heat in certain moisture that therefore this heat the Author and preserver of life may long continue in the parts it wants certain fuel no lesse than our fire to keep it from extinction But moisture being two-fold in our body one waterish the other fat and aiery this vivifying heat cannot be fuelled by the waterish but by the fat and aiery moisture as a lampe or candle lighted is not inflamed by waterish but oily and pinguedinous liquor or some such like substance so Trees and other Plants which abound in this fat substance are of long continuance and excellent fuel when they are burned But on the other side green wood in which waterish humidity is as copious or wood of too much growth in which this fat humidity is exsiccated make no good fire But when we discourse of oily and fat substance we understand not that fat or grease which most commonly in women or idlers is collected about the skin and membranes but hardly comes nigh the substance of the bones nerves and bowels for those are not the subjects of vital heat but are rather by their over-growth an impediment to actions But this native and genital humidity according to its copiousness is more useful and commodious to the exercise of all functions and the prolongation of life It derives its original from the first principles of our generation viz. from the seed and maternal blood The first upstart of our generation is abundantly furnished with this radical moisture hence it is that when this is substantialized into the parts of our body the whole masse in the preface of life is very well stock'd with this moisture which afterward by the continual action of the native heat is by degrees as our Age posts away wasted and dryed till it arrives to the last stage of exsiccation whose consequence is the extremity of Age and natural death But the fat and oleous moisture of Aliments is the cause of preservation While this moisture continually suffers under the insulting activity of heat it would quickly fall into a consumption unlesse the losse were recompenced by the accesse of new aliment At the charge of this reparation are fit aliments prepared by divers coctions in which we find two-fold moisture one fat and aiery near related to the nature of the primigenious moisture and makes up the losse of it the other waterish keeping in repair the common humidity of the parts which breaks the force of heat lest it should consume this fat and aiery moisture as appears in Sugar Honey or Oyle when they are boiling that the water mixt with them encounters the forces of the external fire and is vanquished when they remain in their integrity or with smal diminution And though the loss caused by heat is continually repaired by new aliment yet that which is acquired in the place of what is lost is much worse and more impure and deficient both in quantity and quality otherwise it were possible for life to be stretch'd to infinity but this primigenious moisture by degrees decaying and it being impossible to equalize this diminution with any aliment it inferres an absolute necessity of death Native heat is a quality proper and familiar to all living creatures by the help of which they live and act It is in our bodies twofold one the consequent of the first mixtion of the body and parts which after the destruction of the creature removes not as long as mixtion keeps its dwelling which is made out of the foure Elements guarded with the retinue of their qualities the other proper onely to living creatures termed Vivifical because by it as long as it is our guest we obtain the advantage of nutrition growth conservation and life whence Aristotle defines Life as is before mentioned the conservation of this heat in certain moisture It is derived from the first principles as is the primigenious moisture The first principles of generation seed especially is well fraught with many spirits and much heat hence this heat in our first conception exactly commensurates all the parts and as long as it sojourns with us afterward increaseth and preserveth them Conservation proceeds from the primigenious moisture by the ambiency of air and influence of heat The primigenious moisture is the subject of native heat and its ordinary fare which it continually devours for its own safety as a Lamp alwayes needs Oyl for its conservation and Fire the continual addition of Fuel of which as plenty causeth the inflammation to rise higher and withdrawing it a diminution so native heat is increased or diminished according to the proportion of the primigenious moisture But as is before alledged this moisture never increasing but wasting from the very Prologue of our life it happens that the heat also is perpetually diminished to the Epilogue of our life And as our Fires lack not fuel alone for their preservation but also the kind embraces of Air by which they may be refreshed to refocillation for being confined to a narrow circumscription though they have sufficient fuel yet they are suffocated which is evident in Medical Cupping-glasses So our native heat wants the ambient air for commodious eventilation But this air by the benefit of the Lungs is conducted to the Heart which is the principal furnace of heat but to other parts by insensible transpiration by the defect of which the
heat is immediately suffocated as appears in Suspension But this native heat being weak in most parts of our body and so easily obnoxious to extinction Nature hath so provided that by the continual influence of heat it may be nourished and sustained Hence Physicians divide Heat into two parts viz. implanted and adventitious The adventitious flows in from the two fountains of heat viz. the Heart and Liver in company of the spirits and blood A COROLLARY LEarned Fernelius was so transported in admiration of the noble effects of this native heat that he was of opinion that it was to be struck out of the number of Elementary qualities as being of a higher extract and wholly divine and heavenly which lest he should seem an indeliberate babler he endevours to evince by the following reasons First All action depends upon a predominant quality but there are in Nature examples of many Plants as Poppy Hemlock Mandrakes and of Animals as the Salamander which is thought to be cold in the fourth degree yet they live and heat is the cause of life it is therefore necessary to constitute another heat differing from the Elementary which in them is very weak by the help of which they live and exercise their actions Secondly If Elementary heat caused life Brimstone Arsenick and such like things which are intensely hot would chiefly live but they live not because they are destitute of this celestial and vivifying heat so cadaverous reliques retain Elementary heat yet live not Thirdly If our heat were Elementary it would admit of no contrary Elementary heat as that of a Feaver which most of all dissolves it Fourthly Fernelius grounds this assertion upon the authority of Aristotle Book 2. of the Gener. of Anim. Chap. 3. where he affirms That native heat is not of an igneous but some more divine nature correspondent in proportion to the Element of the Stars But though this opinion is grounded upon the invention of a most ingenious and excellent Artist we cannot betray our reason to it by a quiet assent for the species of the qualities of our bodies are not without the command of necessity to be multiplyed our judgement therefore is that native heat is wholly of an Elementary nature as we shall prove by the following arguments First Celestial bodies have not the first qualities for then they would be corruptible for all corruption depends upon the qualities so the Philosophers prove the Heavens incorruptible because they have no qualities So they argue the Sun to have no heat in it but to produce it in these inferiour bodies energetically and virtually viz. by motion light and influence Secondly If native heat were celestial it would abhor a contrary according to the sense of Fernelius himself But Elementary cold hath a contrary for the extremity of cold sometimes causeth death by the extinction of native heat therefore it is not celestial Thirdly If it were celestial it would want no fuel to prey on and if it wanted it could not be proportioned to it in our body for Celestial cannot be nourished by Elementary To this is opposed That this heat though it be celestial is by a familiarity with elementary heats changed as it were into elementary or at least models it self into an elementary fashion which seems not satisfactory because celestials receive the impress of no passion from elementaries it is not possible their nature should be so inverted as to savour of the conditions of things elementary Fourthly Native heat derives its original from seed and seed from blood and spirits which are also the production of blood but the blood is elementary therefore by consequence native heat The Arguments of Fernelius though they represent some truth yet may be easily thus resolved by us To the first I answer That heat in a living body is twofold one as the body is mixt the other as it is living as mixt it hath the foure first qualities tempered and so only potential heat mixt bodies inanimate affecting not the touch with heat as living it hath actual heat by the help of which it exercises the functions of life and this heat though it be no ingredient of mixtion and though its operations are performed in a different manner from the operations of mixt heat yet it is not distinguished from it specifically but onely numerically as if Pepper be heated in the fire that acquired actual heat differs from the heat produced by mixtion yet both are elementary To the second I reply That Brimstone Arsenick and such like live not through the defect of a soul which is the true and principal Author of life whereof heat is but onely the instrument but the instrumental cause acts nothing of it self but at the command of the principal though that heat proceeding from mixtion as before is said concurs not to the operations of life but onely the living heat of which they are destitute So dead carcasses have neither soul nor that actual heat so bodies just expired retain that heat for some time yet live not wanting a soul So seed is largely fraught with that native heat though it live not through defect of a soul though our learned Neoterikes judge it to be animate which discourse shall be referred to its proper place To the third I answer That feaverish heat is contrary to the native as it is more intense for an intense degree of the same quality in comparison with a more remiss is accounted contrary because it effects its destruction by raising it to intensity Besides feaverish heat is contrary to native by reason of the passive quality attending it for feaverish heat is dry native moist Lastly we shall thus disoblige our selves from the duty we owe to Aristotle's authority that he referred to the effects not the nature of native heat But the effects of this heat are almost divine the honour of which is rather to be conferred upon the soul and its faculties though the heat of our fire being temper'd according to Art produceth admirable effects in Chymistry And so even in our Culinary fire as in Aegypt according to the report of Scaliger Eggs are wont to be excluded in some Furnaces so artificially built that the heat of the fire may be in them so temperate that it may be fit to effect generation The fifth Section of Physiology Of the Parts CHAP. I. Of the Nature of the Parts A Part is a body cohering to the whole Mass and participating of life and fit for its functions and offices THIS definition of a Part being the most ingenious invention of Fernelius was afterwards ratified by the consent of most learned men For he considers a Part as it is related to Medicine viz. as it is capable of health or disease and in his opinion all those deserve not the name of Parts which though they concur to constitute the body yet they cannot sympathize in a Disease Therefore the Humors and Spirits have no share in this definition because they
duly perform its action unless it first rightly conform and especially acquire a proper figure so for instance the head ought to be round the arm long and so forth Besides the parts for the discharge of their offices must have certain passages and cavities so the veins and arteries have their passages the ventricle useth the passage of the Esophagus but the cavity is all that space which contains the aliment Thirdly some parts for their more convenient operation ought to be smooth as the aspera arteria whose interior superficies is smooth and polite for the sweeter modulation of the voyce for it is not termed rough as being unequal and rugged according to the usual acception of that term but being made up of an unequal viz. cartilaginous and membranous substance But it is requisite some parts should be rough and rugged as the interior superficies of the ventricle that it may the better contain the aliment A certain and determinate magnitude also is proportioned to every member requisite to the exercise of its action So the Liver is bigger than the Heart the Brain than the Eye and so forth But one part of the same kind are sufficient for the exercise of certain actions for others many So for speech the tongue onely is requisite but to hold any thing many fingers are necessary Conjunction signifies two things viz. site and connexion So the liver is situated on the right hypocondrium but the milt in the left the intestines in the middle of the abdomen the wombe between the bladder and the intestinum rectum so the bones effect motion by their mutual connexion in the joynts on the contrary the lips and the eye-lids for the performance of their offices ought not to have any connexion but are open and separate But the organical parts are two the principal and the ignoble The principal are they which are without exception necessary for the conservation of the individual and are liberal in the distribution of faculty and spirit to the whole body And these are three the brain the heart and the liver There are in our bodies three faculties as we shall afterwards instance the animal vital and natural every of these keeps a peculiar court in peculiar members in which it is more glorious and majestical and from which in fellowship with the spirits which are also generated in it it flows into the whole body hence these parts are nobilitated with the title of Principal This is the ancient and customary tenent of School-Physicians which we propose for the sake of young Practitioners from which opinion in the Physical Schools it was a sin to dissent though it be inconsistent with the assertions of the Peripateticks who obtrude that the Soul with the train of all its faculties resides wholly in the whole and wholly in every part therefore there needs no influence of faculties they dwelling in every part and operating every where if they want not convenient instruments which caused Aristotle to say If the eye were placed in the foot the foot would see The ignoble are they which send forth no faculties nor spirits or which are the servants and vassals of the principall So the organs of the senses are framed for the sake of the brain onely so the lungs midriffe and arteries are designed to the temper and purgation of the heart so the ventricle intestines milt reins both bladders are made for the use of the liver To be short all the parts of the whole body are ignoble excepting the three principal parts mentioned Yet Galen in his Ars parva reckons the testicles among the principal parts because they are necessary for the conservation of the species We must therefore distinguish that in respect of the species they are principal parts not in relation to the individuum A COROLLARY THat which should here be discoursed of the substance temper figure situation action and use of every part is so accurately and perspicuously handled by the learned Laurentius in his Anatomical History that repetition will be superfluous Therefore thus much shall suffice to be spoken of the Parts The sixth Section of Physiology Of the Faculties and Functions The First CHAPTER Of the Nature of Faculties and Functions The Faculties and Functions depending upon the Soul as their first cause it will not be amiss to explain what the Soul is The Soul therefore is the substantial form of a living body by which we enjoy life sense nutrition understanding and local motion ARistotle defines it the perfection or act of an organical body potentially living which definition lies invelop'd in obscure terms and is a point of nice speculation We therefore suppose this our definition to be more clear and more convenient for our conduct in the course of Physick for man being constituted of matter and form as all other natural bodies and all his parts being the matter it is consequent that the soul should be the form For all actions having a dependency upon the form and the soul being the cause and principle of all the actions of a living body we must necessarily acknowledg that the soul is the form Hence in the absence of the soul action ceaseth By this means we arrive at the knowledg of her by her actions onely because immaterial substances are understood only by their effects But these various actions are exercised by the soul through the help of divers vertues and proprieties which are the immediate retainers to its Essence and immediately depend upon it and these proprieties are termed faculties of which we institute our following discourse A Faculty is a proper and inseparable accident of the soul which is instrumental to it in the execution of certain Functions in the body The faculties are accidents referred to the second species of quality Their subject is the soul in which they inhere not as common but as proper and inseparable accidents hence Fernelius weakly asserts them separable from the soul which he endeavours to verify by an instance of the auctive faculty which he affirms to be abolished when the vigor of Age declines Yet this faculty is not abolished but only lies idle for want of Instruments for the whole Aliment is wasted in nutrition because the body being well grown requires more nutriment and innate heat being debilitated cannot operate accretion of which nature also is unmindful while it hath filled the body to its due proportion yet this faculty is not extinct as neither the procreating faculty in a Child though it is quiet without wantonizing till Youth when it finds the seed elaborated to maturity fit for the exercise of its functions A Function is an Active motion or the effect of a Faculty in any part of the body As the faculties wait immediately upon the form or the soul so the functions upon the faculties as effects depend upon their causes But in this lies the distinction between the actions and faculties that they are appropriated to the soul the functions to
in its proper substance inclined to this crassity but by the permixtion of some other crass thing not separated through some defect in concoction which by the assistance of heat is wont to banish things heterogeneous The expulsive faculty is that by which the parts after concoction expel things of no use All that is attracted by the parts cannot be wholly consubstantiated with them but there alwayes remains something which estranges it self and will not accept of the benefit of concoction which therefore ought to be removed as strange and superfluous which for this reason is called Excrement This faculty then was requisite to turn out of dores this alien lest it should contrive any thing prejudicious to nature The official parts also drive out not the excrements onely but the useful substance being unable to naturalize all the aliment after they have for some time entertained it and pleasur'd themselves in it they thrust it away to other parts as a burdensome superfluity and useless mass And for this reason the very alimentary substance is called useful excrement in relation to the parts expelling it because whatever is expelled or cast out is in a common speech usually termed Excrement Private expulsion is caused by heat and siccity But official partly by those qualities partly by transverse fibres There is no cause of admiration in any one why attraction retention and expulsion being actions widely differing should be performed by the same qualities viz. calidity and siccity for this doth peculiarly evidence that we must needs acknowledge an higher cause of actions then the temper which is onely the instrument of the form So an Artist by one and the same instrument operates variously though it is undeniable that divers degrees of heat and dryness are requisite to divers actions which yet fall not under our knowledge But the transverse fibres are very commodious for official expulsion because especially by their contraction they crone up the part and compression is the cause of expulsion A COROLLARY Many hold the Number of faculties and functions attending on nutrition to be imperfect and deficient because Galen and other Authors enlarge this catalogue with many Additions but how many functions soever are found we must multiply the faculties which are their causes to equalize them in number First Therefore Galen serves up two courses of appetency in the ventricle not Animal only perceptible to the sense and named hunger but also natural by which through a natural appetite we desire convenient Aliment this appetite no part of the body wants Secondly Galen addes to the before rehearsed qualities the secretive and distributive for in the first of nat fac when he had informed us that the concoctive was in the veins and parts he further insists that a secretive faculty is necessary which might segregate things superfluous and useless from the useful and expel them And in the 5. of causes of symptomes he recites symptomes contingent by some error in secretion and distribution the Jaundies proceeding from a defect in secretion Atrophy from vitiated distribution Thirdly Apposition and assimilation differ from the rest before mentioned therefore their number must be multiplyed To the first I answer That appetency is not really distinct from attraction but the difference onely consists in the nicety of understanding for this vertue is implanted not to attract promiscuously but with choice viz. of that which bears a friendly compliance with the parts To the second I answer That distribution and secretion are not distinct but rather mixt faculties consequential to the operations of the other For the distribution of the Aliment thorough the whole body is effected by the other parts expelling it in which humors are copious and others attracting which want humor as Galen himself attests and so it depends partly from the faculty attractive partly from the expulsive So also secretion is usually caused when the retentive faculty of the parts keeps that which is of use and the expulsive expells that which is useless To the third I answer That apposition and assimilation proceed not from any peculiar faculty but only are various degrees of concoction so that through its mediums it is in progresse from the first motion of its alteration to the perfection of assimilation But the reason why Galen proposeth them all in proper and distinct terms is for the clearer understanding them not that they are really distinct from the other actions CHAP. IV. Of the Auctive faculty and of Accretion The Auctive faculty is that virtue of the soul by which the body upon conversion of aliment into its substance fils up its dimensions and to arrives a due proportion convenient for the exercise of actions Hence Auction or Accretion is an extension of the body into every dimension viz. long broad profound HEnce ariseth that distinction of Natural from Artificial Accretion for those things which are augmented or extended by Art lose so much of their longitude as they acquire in latitude and the contrary But true accretion is in this manner differenced from pinguefaction because pinguefaction extends not it self to all dimensions but most to profundity It is also distinguished from the Accretion of stones and metals which is by opposition not by an intrinsecal dilatation of the parts from aliment converted by nutrition for auction deviates not from nutrition but the parts receive augmentation from the same matter that they receive nutrition Yet though Accretion proceeds in the same course as Nutrition it is really distinct from it This auctive faculty is of such necessary alliance to the nutritive that without the assistance of it it cannot be compleat upon which ground many have been moved to assert them one and the same faculty therefore the auctive enjoyeth no singularity of action different from the nutritive but when so much is acquired by the prepared aliment as was carried away by quotidian effluxions then the body is said to be simply nourished but when the income is greater then it is augmented and increased But addition or diminution change not the species of the action therefore the auctive faculty differs not from the nutritive having one and the same object viz. nutriment But yet we may for certain conclude that these two faculties are set at a large distance for proof of which there are many arguments For first they agree not in their proposed end for the end of the nutritive is the restoring of the parts wasted but of the auctive an acquisition of due proportion Secondly they differ in form for the form of nutrition is the union of the aliment but of accretion a motion of extention Thirdly they are distinct in the manner of their mutation for in nutrition there happens no local mutation of the body but that which is augmented changeth place for it fills up more room Fourthly they are differenced in consideration of time for nutrition is at all times but accretion hath a determinate time of duration But that accretion
conservation of it will be the conservation of life hence this faculty is significantly termed Vital or the preservative of life And so life is an action depending upon this faculty as an effect upon its cause The Vital faculty is attended by two servants Pulse and Respiration It is ignorantly asserted by some that the Pulse is the chief of Vital actions and immediately to depend upon the Vital faculty for life as we before affirmed immediately depends upon that but the pulse is only a subservient action to it caused by a pulsifick faculty whose vertue is only to cause systole and diastole in the heart by which means it performs its duty to the Vital faculty Pulse is a function of the heart and Arteries composed of Systole and Diastole with some interposition of rest caused by the pulsifick faculty of the heart to further the generation of the Vital spirits and effect the distribution of them thorough the whole body The Pulse of the heart and Arteries is composed of three parts viz. diastole systole and the intercession of a pause By Diastole the heart and Arteries are impregnate When the heart dilates it selfe it attracts the Aire from the Lungs by the help of the Arteria Venosa and the blood from the Vena Cava that from the commistion of them in the left closet of the heart the spirits may be generated but the Arteries being strtech'd to a dilatation attract the spirits from the heart and are tumid with them as also the external Aire entertained by those orifices which are terminated in the skin and in this manner is transpiration caused which by this intromission of external aire fixes the internal heat to a due temperament and cherishes it for all heat is preserved by a moderate compliance of cold according to Hippocrates By Systole or contraction the heart by the assistance of the Arteria venosa purges out at the Lungs all the fuliginous excrements left in the generation of spirits For the Arteries by an insensible transpiration drive out the fuliginous vapors contained in them and send the spirits more copiously to the parts Lastly there mediate between the systole and diastole and intercessive quiet because a transition from one contrary to another cannot be effected but by a medium A doubt may be moved whether the spirit and blood contained in the heart moves upon its coarctation I Answer that there are two doores in the heart one in the right corner another in the left which are dilated when the heart is contracted and are so filled viz. the right with blood contained in the right cavity but the left with spirits contained in the left Three things are requisite to cause pulsation Faculty Instrument and Use The first necessary is a pulsifick faculty which is the primary and principal agent Secondly instruments disposed to pulsation viz. the Heart and Arteries moved by that faculty Thirdly use and necessity forcing the faculty to action viz. the generation of spirits and conservation of native heat Respiration is an action partly Animal partly Natural by which the Aire is ushered in thorough the mouth to the Lungs by the distention of the breast and by the contraction of the same the smoaky vapors are excluded for the conservation of Native heat and the generation of Vital spirit The parts of Respiration and of Pulsation are three Inspiration expiration and immediate quiet By inspiration the breast is dilated by the muscles destin'd to this office and in compliance with the dilatation of the breast the lungs are also dilated lest there should happen a vacuity in that cavity and the lungs are filled with air as bellowes the inspiration of which aire tempers the violent heat of the heart and thence the vital spirits are generated as is before urged But by expiration the breast and lungs are contracted which by their contraction turn out of doores the hot aire and fuliginous vapors issuing from the heart The concurrence of three things is necessary for expiration Faculty Instrument Use First Animal faculty concurs moving the muscles of the breast as also the natural implanted faculty causing motion in the lungs that they might be helpful to the heart Secondly There is a concurrence of instruments as all the parts designed for Respiration And Lastly use or necessity of Respiration for the ventilation of the heat in the heart A COROLLARY It is much disputed whether Respiration be purely Animal or mixt viz. partly Natural partly Animal Which being ingeniously disputed by Laurentius question 20. book the ninth I referre the Reader to him CHAP. VII Of the Animal faculty and function and first of the Principal faculties The Animal faculty is that vertue of the soul which moveth a man to the exercise of sense Auction and other principal functions of the mind The principal are three Imagination Ratiocination and Memory Imagination is that action of the Soul by which the species of every object offered to the external senses is made perceptible and distinctly discerned EVery sense enjoyeth its proper and peculiar object as shall after appear whose species it entertains in its proper organ without passing judgment of it for this is the prerogative of the Imagination only to which the spirits presents the species conveyed by the nerves from the brain to the instruments of the senses The brain therefore being the Court of the principal faculties while the objects of divers senses promiscuously resort to it they are first represented and distinguished in the imagination which the peculiar senses are not able to perform for instance the whiteness of milk is only represented to the sight but not the sweetness of it on the contrary the sweetness is represented to the taste not the whiteness But they are both together perceptible to imagination which rightly distinguisheth to what sense they be related Besides imagination apprehends not only things present as the senses but things absent also and represents them to the mind composing many things never existent yet in Analogy to those which are apparent to the senses The Philosophers divide those operations of the mind which we consenting to Galen include under the notion of imagination into two species viz. into the common sense and into fantasy or imagination commanding as it were the common sense to welcome only the species of present objects but the imagination to propose to it self things absent as if they were really present as also things not in being and impossibilities But seeing that they differ only in the method of their operation it is not necessary that they should depend upon faculties differing in species Ratiocination is that action of the soul by which a man discourses understands and reasons This is appropriate to man the others being enjoyed also by brutes But this receives the species of things from the imagination dividing and compounding them and unravelling their nature by the help of discourse distinguishing good from bad truth from falsity drawing out of them many things
occult from the senses yet all of them are understood by symptomes which are their effects and most of all by labefacted action which immediately and by it self depends upon disease and so essentially that if we assert action hurt we necessarily imply a disease on which it hath dependence But it may be objected That action is often hurt immediately by the very morbifick causes for aliment too copiously burdensome to the ventricle is hurtful to concoction without the interposing of a disease Therefore all action hurt depends noton a disease I answer That the coction of the ventricle is not therefore hurt because it cannot concoct a great plenty of aliment for it being requisite that there should be a certain proportion between the Agent and Patient for the right exercise of action if the Aliment be too copious or of quality troublesome the action of the ventricle is not hurt though it cannot master it as it is not troubled though it cannot concoct Iron This defect therefore depends on the disproportion of the object It is again thus objected Some symptomes may primarily and by themselves hurt action as the quality changed in the eye viz. the yellow colour of the cornea tunica of men troubled with the Jaundies caused by the effusion of yellow choler into it which immediately produceth sight for they can discern no colour but their own but no disease can be impeached of such treason against the eye Therefore that colour which is the symptome doth immediately injure action I Answer in the eye peculiarly a preternatural colour may be termed a disease for the eye in its natural constitution ought to be without any colour that it may be the fitter for the reception of the species of external objects pure and inconfused and their various colours for that colour of the eye may be referred to diseases in number because the number of qualities which ought naturally to be in the eye is increased The same may be held of an extraneous taste in the tongue and sound in the eare which are impediments to the due perception of taste and sound hence it appears that in these peculiar instruments of sense peculiarly constituted we may admit a peculiar kind of disease Here ariseth lastly cause of objection That in Sympathetick affects the actions of the parts are hurt without the violence of any disease for if a disease were in the sympathizing parts we should endeavour remedy for the which is not done neither when the action of the nerves is hurt by the obstruction of the brain can we impute a disease to the nerves but only to the brain I oppose to this That Therapeutick Physicians number not the sympathetical affects with the diseases because we apply no remedies to them but if we consider more seriously we shall find they may be referred to some genus of disease viz. the influence of animal spirits into the nerves is block'd up by the obstruction of the brain by the defect of which motion and sense decay but this defect may be reckoned among diseases in the number of deficients and so we may hold of many others CHAP. II. Of the Kinds and Differences of Diseases Hitherto of the Nature of disease it followes now that we discourse of the Differences thereof GAlen confounds the genus species and differences of diseases in 2. of his method and useth them for one and the same for he is not precise in their strict and logical consideration though either of them may be truely predicated in a diverse respect viz. in relation to the disease it self which is the principal genus they must be called species or differences in relation to the subordinate species into which they are subdivided they are honoured with the Title of genus But the differences of diseases are some essential some accidental The Essential are taken from the very essence of the disease and are otherwise called specifical because out of them the genus and species are constituted But they are three viz. similar organical and common The whole essence of accidents depends upon subjects therefore their essential differences must be derived from the differences of their subjects but the subjects of diseases are the parts of our body which are properly called such viz. which cohere to the whole mass and partake of life in common for although by Hippocrates the parts be divided into the containing the contained and those that cause motion where by the containing he understands the living parts designed for the exercise of actions by the contained the humors by those causing motion the spirits there the name of part is tentered to the widest sense for nor humors nor spirits can be the subjects of diseases nor do they communicate of life but they are rather the causes of diseases when they are extravagant in quality or quantity Therefore seeing those living parts branch out into two differences viz. similar and organical diseases also shall be divided into similar and organical but because in both the forementioned parts there is required another common disposition besides their due temper and conformation that they may behave themselves according to the rule of nature viz. a natural continuity or union of these parts the corruption of which is the generation of another species of disease termed Common CHAP. III. Of the species of a similar disease Every similar disease is called Intemperancy THE similar Parts are composed of Elements onely and their actions are executed by the symmetry of the foure first qualities and the allaying them to a due fixation of temper For the similar Parts as similar are voyd of any action nutrition excepted by reason of which they retaine convenient aliment when it is attracted concoct it and thrust out superfluities all which are in them performed by the temper alone As long therefore as a due temper is preserved in the similar parts they regulate themselves according to nature But when they are intemperate they are in a morbous condition and so every disease affecting the similar parts will be intemperateness But intemperateness breaks out into other differences of which some are essential some accidental Again the Essential are some simple some compound the simple are foure 1 Hot 2 Cold 3 Moist 4 Dry. The Compound are the same in number 1 Hot and moist 2 Hot and dry 3 Cold and moist 4 Cold and dry These intemperatures are called morbous when they swell to such an excess that they do manifestly hurt the actions otherwise they confine themselves to the prescripts of health for instance though a man of a bilious temper be hotter and dryer than is convenient for the moderation of a fit temperament yet as long as in the exercise of his actions he is not irregular as to the prescript of his innate temperament he is not said intemperate to disease till transgressing the proper limitation of health he falls for example into a feaver or some other hot affect The accidental differences
ball of the eye and in the crooked veins as also in the anastomasis and diapedesis of the veins For an Anastomasis is caused when the orifices of the vessels are too much dilated but diapedesis when their tunicles are too much relaxed and rarefied that they easily yeeld to the effluxion of the humors To dilatation also is referred the excessive laxity of the ventricle so that it cannot conveniently embrace the Aliment which Fernelius unadvisedly placed with the diseases of the matter The diseases of magnitude are either in the Augmentation or diminution thereof Both are either in the whole body or in some part of it in the whole body magnitude is increased or diminished when the whole bulk is to extremity encreased or diminished Galen presents us with an example of encreased magnitude in the whole body of one Nicomachus Smyrnaeus who by reason of his excessive grosseness could not possibly move himself Diminished magnitude is apparent in atrophy and hectick Feaver in which the whole body pines away with leaness Magnitude is increased or diminished in some part when it exceeds or recedes from the dimensions allotted it by nature So a preternatural tumor in a part is magnitude increased so also the defect of a part in longitude latitude or profundity as of the Tongue Nose Finger the testicles or a notable smalness of some other part is diminished magnitude For the occasion of this smalness is either by generation for want of matter or after generation and that is again two-fold by defect of Aliment whence ariseth the atrophy and consumption of the part or the depriving the parts of their substance as when a part of the nose tongue or finger is cut off Diseases in number are either in excesse or in defect of Number A definite number of the similar parts is necessary to constitute the organical and in the greater and more composed the concurrence of a certain number of lesser organs and lesse composed is requisite But by their excess any way or defect they cause disease which is termed a disease of number increased or diminished Number exceeding is either of those which are regulated by nature or which are in the latitude of their genus preternatural They are said to be according to nature in respect of the substance from which they derive their original which substance is natural and they only erre in this that they conduce not to the exercising of the functions of the part but hinder them as a sixth finger an excrescence of flesh in an ulcer and the like But preternatural as to their whole genus are those which are composed of a substance wholly preternatural as maw-worms the stone c. which are referred to diseases in number as they are things of a preternatural superaddition vitiating the structure of the organ and by its presence hindering the functions thereof otherwise if they injure not the actions but produce obstruction or the like affection they are taken rather for the causes of disease as we have before observed Number deficient perpetually consists in natural things or in the parts of the body contracted either from the womb it self or after the desertion thereof Disease in deficient number contracted from the very birth is so called when for instance any one is born mutilated either in the Foot Hand Eye Testicle or any other part but after birth upon the amputation of some part as when the foot or arm infected with a gangren is chop'd off the testicles are fallen by a rupture a rotten tooth is pulled out and so of the rest Diseases in conjunction are two-fold in Situation and in Connexion Diseases in Situation are when the parts which ought to cohere fall off from their proper Station These diseases are obvious in a rupture when the intestines or the cause descends in the Scrotum so in the falling of the Anus or the womb and the like Diseases in Connexion are when the parts which should cohere stand at a distance or on the contrary those which should separate cohere Such affections appear in luxations when the connexion of the bones is perverted and in imperforate parts as also when the eye lids or the lips are united which should naturally be separated A COROLLARY Concerning Organical Diseases It is first objected That the number of organical diseases before a laid down is incompleat because their differences are not taken from all those things which are necessary for the performance of organical actions But besides those now mentioned there are many others concurring for the instrumentary parts want the influence of heat from the heart viz. blood and well affected spirits whereas when they are hurt or wanting all the actions of the body are out of tune as appears in a syncope trembling starkness c. From them therefore we may constitute another species of organical disease I answer in the proper constitution of every part the common instruments are to be distinguished which are necessary in all actions of the organick parts for they are not peculiarly considered in either but as vagrants and wanderers are excluded from the number of the parts of the living body or we may assert that the affections issuing from the vitiosity of them are not idiopathetick but ought only to be referred to the sympathy of the negative matter or faculty It is secondly objected That besides the aforesaid conditions ingredient to the constitution of organical parts there is a symmetry of them requisite for if the foot or the hand which ought to be conflated of bones nerves and ligaments are wholly offeous or camous the structure of them is bad though they are rightly framed as before is said I answer if an organical part which ought to be composed of many instruments be conflated but of one this is a disease in the deficient number nor need we make search after another diverse genus It is lastly objected That the actions of organical parts are offended by the qualities themselves as well first as second for example the harder or softer crasser or thinner parts are made more unfit for sense or motion as Galen is of opinion that the crassity of the brain is very noxious to sharpness of wit but the tenuity thereof very commodious so the laxity of the ventricle is inconvenient for concoction the cornea tunica of the eye being too rare or too thick hinders sight and so of the rest hence it appears that these qualities also ought to be added to the number of organical diseases I answer That diseases consequent upon the change of qualities cannot be attributed to the organical parts as organical but as they are compounded of the similar parts as their matter for a due symmetry of the similar parts must concur to the constitution of an instrumentary part and the temperament of the similars must be supposed to be as well in the first as in the second qualities therefore the disproportion of them must not be laid to the
neither retains its pure nature nor hath a sincere cause to which it may acknowledge its production A tertian feaver excited by sincere choler is called true and legitimate as also a quartan the effect of pure melancholy But those feavers are called bastard spurious and illegitimate when they have a confusion of other humors befides those now mentioned 3. In respect of the place or region in which diseases are generated some are called endemical some epidemical some sporadical Endemical diseases are those which are peculiar to some Region and are in it commonly powerful They are otherwise called vernacular and gentilitious because they are alwayes appendent to one Region by reason of the air aliments c. proper to that Countrey So the Inhabitants of the Alpes are troubled with a Bronchocele the Spaniards are perplexed with strumous swellings the Lusitanians pine away with tabifical consumptions and all these are judged Endemical diseases Epidemical diseases are those which in any Region rage among the popularity In this Endemical and Epidemical diseases are neerly related that they seise upon many and spend their fury upon the popularity But in this they differ that Endemical confine themselves alwayes to the same Countrey but Epidemical are indifferent and inclinable to forain invasions The reason of which is this because Endemical proceed from the peculiar disposition of the air water or dyet of the Countrey but Epidemical are caused by the air alone not infected by means of the place but rather by the malignant influences of superiour bodies The Sporadical are they which neither commonly range abroad nor particularize themselves to any Region They are also termed dispersed and are opposed to Endemical and Epidemical diseases because they are various and driven by contingences do sometimes light here sometimes there So in this or any other Region one is sick of a pleurisie another languishing by a continual or tertian feaver another troubled with a catarrhe nephretical pains gout dropsie or any disease of another nature according to the various nature and constitution of individuals Thus much of the nature and differences of diseases as well Essential as Accidental now it rests that we handle their Changes The second Section of PATHOLOGY Of the Changes of Diseases and chiefly of the Crises The First CHAPTER Of the Changes contingent in Diseases IN Diseases there are two mutations worth our notice either when they metamorphose into some other disease or when they are absolutely and simply dissolved without a transmigration into any other The change of one disease into another is frequently seen when the Apoplexy makes a transition into a Palsie a Tertian feaver into a Quartan a quartan the swelling of the liver or spleen and many other affections turn their stream and run into the channel of a Dropsie Diseases are absolutely and simply dissolved when without the intercession of any other disease they are determined either by health or death But their end in health or death is double To wit leisurely and by degrees or suddenly and unawares When a disease is slowly and by little and little ended in death it is called a Marasmus but when it is so ended in health it is called simply Solution by the Greeks termed Lysis When it is hastily and suddenly ended either by health or death it is called Crisis which is commonly opposed to Lysis or solution it being a frequent expression with Authors that all diseases are terminated by Crisis or Lysis CHAP. II. Of the nature of Crisis A Crisis is a sudden and unexpected change happening in a disease to health or to death HIppocrates and Galen use this term Crisis many wayes sometimes they intend by Crisis nothing else but a secretion of humors as Galen Comment on Aph. 13. Sect. 2. saith That a Crisis is caused by Nature separating the noxious humours from the good and preparing them for excretion But sometimes by Crisis they signifie excretion it self because the best Crisis is compleated by excretion So Hippocrates in his Book of Art terms the excretion of a corrupt bone a Crisis or lastly it is taken for a conflict which upon the imminency of a Crisis is usually waged between the disease and nature But the more frequent and usual acception of it is for judgement which construction hath been from Galen's age to this imbraced by many for Galen in his Comment on 1 Progn witnesseth that judication passed on diseases was derived from the Courts of Judicature and applyed to the Art of Medicine nor truly very improperly for though the things from whence these translations are taken be not altogether like yet the judgement passed in diseases hath some similitude with forensical judgement For in Courts of Judicature in capital causes there is the person that brings the action and the person guilty The person that brings the action maintains a conflict with the person guilty and constantly accuseth him produceth witnesses and menaceth death or punishment But if this accusation be falsly charged upon the person seemingly guilty he pleads boldly for himself and retorts the punishment on him that brings the action but if he cannot stand in contradictory opposition to the accusation he is forced to give up and yield All these things are transacted before a Judge who weighs them all and at last on a certain time gives judgement of the whole matter In the same manner in the Crisis the disease represents him that brings the action nature the person guilty the morbifick cause brings nature into the Court endevouring to overthrow it of this invasion the symptomes are witnesses which declare the whole progress of the contention But nature which is as it were in the capacity of a guilty person defends it self stoutly against its adversary disease whose resistance if she be well fortified she baffles and turns him off as an unjust Plaintiff and thrusts him out of Court but if she want good supports she must submit to the fury of her Antagonist All these things are points of accurate inspection to a Physician who after a serious pensitation of the strength of both parts gives sentence as a Judge and designes that day of judgement in which either the disease or nature shall be cast From hence it is evident that the comparison of a Crisis with Judicature is not wholly absurd and contemptible But to draw neerer to the very definition of a Crisis it being defined by mutation it is requisite to be known that in all motion according to the Philosophers there are many things considerable the point from which the point to which the medium through which motion is made motion the mover and the moveable All these things are perpetually found in a Crisis For the Mover is Nature it self performing coctions separating humors and at last expelling them on the Critical day The Moveable is the Morbifick cause and preternatural humors to which only a Crisis is incident The point from which a Crisis is derived is the augmentation
these causes for that first the formal cause is nothing else but the proper essence of every thing but we have at large explained the nature and essence of diseases before Next there is no material cause in diseases for disease being an accident needs no matter out of which it should be produced but in which it should exsist which is nothing else but the subject thereof or the parts of our body As for the final cause though the lesion of actions may be termed as it were such yet this is by accident as it follows the generation of the disease but diseases by themselves and properly have no final cause as neither all those things which are constituted in a kind of imperfection therefore the efficient cause remains onely considerable in this discourse which is here taken by the Philosopher not only for that from which the effect is first produced but in a wider signification as appears by our description for all that which is in any manner conducible to the generation of the disease CHAP. II. Of the Differences of Causes The cause of a disease is either by it selfe or by accident The cause by it self is when by its own proper and implanted strength without the intervening help of any thing else it produceth a Disease But the cause by accident is when any thing else is summoned as auxiliary to the production of a morbous disposition SO cold water sprinkled upon our body by it self and naturally causeth a chilness but by accident upon the densation of the skin and contraction of the vapors within it heats So Scammony being an extreme hot Medicine by it self over-heats the bowels but by its powerful expurgation of choler and hot humors by accident it refrigerates and cures a feaver And there are causes of diseases some principal some helping some without which nothing could be The principal cause is that which either gave the first motion to the effect or is able alone to excite it The helping cause is that which produceth not the effect alone but is auxiliary to the principal The cause without which nothing could be is that which neither causeth the affection it self nor performs any thing else but without it nothing can be transacted The Gout is exemplary in all these three causes for the cold constitution of the air and the copiousness of excrementitious humors is the principal cause of a defluxion into the joynts the auxiliary cause is the tenuity of the humors but the cause without which nothing could be is the infirmity of the joynts and laxity of the passages There is also one cause of a disease remote the other nigh The remote is that between which and the disease others intercede The near cause is that to which the disease owes its immediate production The proposed differences of causes are of frequent use in the Art of Medicine but the succeeding are most frequent and of great validity in the explication of all diseases therefore in them we shall act the curious Scrutinists The causes of diseases are some external some internal The external causes are those which either outwardly applyed or differing from the constitution of our body usually cause diseases The term of external seems not very convenient because sleep waking and the passions of the mind are comprehended under it which yet seems to be contained among internal things yet because it hath found much acceptance with Physicians therefore we also reject it not averring those causes to be external because many of them are outwardly applyed as the air meat drink c. But the rest as sleep waking and the passions of the mind are so manifest that they are granted without any dispute for external positions Celsus therefore calleth them evident by a very apposite term Others call them procatarctick precedent and primitive because from them the first original of diseases flows But of them some are necessary some are unnecessary The necessary are those which do necessarily affect us and inevitably light upon us Yet though they necessarily affect us they do not necessarily introduce diseases but they are neutrals fluttering in an indifferency between health and disease for by the orderly use of them health is preserved but by the abuse and immoderateness of them it is destroyed But they are six 1 Air 2 Meat and drink 3 Motion and rest 4 Excretions and Retentions 5 Sleeping and Waking 6 The Passions of the mind They are vulgarly called the six not-natural things because by themselves they are neither agreeable to nor disconsonant from the nature of mans body but are made hurtful or useful according to the mode of well or bad using them They are peculiarly handled in that part of Medicine which treateth of Dyet therefore we omit the discourse of them The unnecessary are they which happen fortuitly and not concurring to the ordinary use of life All fortuite things are comprehended under these as the strokes of swords or stones the bitings of wilde beasts c. The internal causes are those which lurk within our body imperceptible to sense and discoverable only by an artificial conjecture So the humors spirits excrements flatulency vapors particles of the parts themselves and whatsoever is contained in them or agnate to them are circled into the nature of internal morbifick causes But they are either antecedent or concomitant The antecedent cause is that which is before the concomitant and moveth it and by the mediation of it effects a disease So in continuall feavers the antecedent cause is the matter fitted for putrefaction the concomitant which actually putrefies So in swellings caused by humors the flowing humor is accounted the antecedent cause the flux the concomitant The Concomitant cause is that which immediately and by it self produceth the disease Examples of this are after proposed in the explication of the antecedent But it is observable that external causes are sometimes concomitant as the sword which immediately makes the wound and therefore all the causes are not seldome divided into procatarctick antecedent and concomitant omitting the consideration of internal and external The concomitant cause is again simply concomitant or containing Simply concomitant is that which if it be the disease is but if it be taken away the disease remains So supposing the action wounding the wound is supposed but taking away the action that remains Continent cause is that which being supposed a disease is supposed and being taken away that follows So supposing the stone or some other matter causing obstruction we must suppose obstruction which if we take away obstruction removes also So taking away a sixth finger making an excess in number the error depending on that is taken away Hence it appears that all diseases have not a containing cause but some onely but all the rest have necessarily a concomitant cause CHAP. III. Of the Causes of Similar Diseases Thus far of the Causes of Diseases in their genus it followes that we handle them in their species
immediately on a disease The chief symptome is injured action immediately depending on a disease which is able to produce another in excretions and retentions and that to induce a change of qualities which yet depend upon the disease as their true cause some mediately some immediately as is before mentioned The symptomes may arrogate to themselves the honor of causes never of diseases So nutrition hurt is the cause of the consumption of the parts and leanness So excrements imprisoned in the body cause feavers obstructions humors and such like and so the symptomes become the causes of diseases but never presume to take the nature of a disease as being unable by themselves to injure the actions For though some diseases be called symptomatical because they are consequents of others as a feaver which follows a pleurisie or any other inflammation which is in it self a true disease yet in respect of the disease on which it depends it is called a symptome Yet certain it is that those diseases are improperly termed symptomes because they follow other diseases as symptomes but yet they are not the immoderate production of them but mediate by some true symptomes for as by humor or vapor which are the after-causes of diseases CHAP. II. Of the Differences of Symptomes There are three kinds of Symptomes action-hurt default in excrements and quality changed ACtion-hurt is the chief and principal symptome which immediately followes the disease and from which the rest are generated and depend Default in excretions follow the lesson of natural actions by which the aliments are ill affected corrupted or tainted with some evill quality or lastly are naturalized to a contrariety infestious to the body But by Excretions we here understand not onely true excrements but also all those which preternaturally issue out of the body as sand the excrements of the parts themselves c. But quality changed follows the before-mentioned symptomes and under it are contained all patible qualities perceptible by sense and inherent in the body it self or in any part thereof as colours smell taste and the like which in their proper place shall more at large be explained CHAP. III. Of the Differences of Action-hurt The differences of Action-hurt are taken either from the differences of laesions or from the divisions of the actions themselves The differences of laesions cause a triple difference of hurt-action 1 Action abolished 2 Dimished 3 Depraved 1 Action abolished is that which is impossible by any means to be restored AS sight in blindness and hearing in deafness are said to be be abolished because they cannot by any means be exercised Yet there is action called abolished as to the judgement of the sense as motion and sense in an apoplexy and in a suffocation of the wombe Action diminished is that which is infirm and scarce exercised and requires more time for perfection or never arrives to a just proportion thereof So the weak concoction of the ventricle or function of any other part imperfectly exercised is said to be diminished Depraved action is so called either when it is corrupted or not exercised as it ought to be Action is termed corrupt when it changes its object into another quality as when the ventricle changeth the aliment into nidorous juices as porraceous choler or matter wholly putrid It is not exercised as it ought to be in cold palpitation hiccough c. because in these affections the parts are unduely agitated or too violently provoked by a preternatural object From the differences of action Action hurt is threefold 1. Animal 2. Vital 3. Natural These branch out again into as many differences as in Physiology are proposed of animal vital and natural actions The animal actions are in Phisiology divided into Sensitive Motive and Principal The Sensitive actions are five Sight Hearing Tast Smel and Touch. All these as before is declared are subject to abolition deminution and depravation The Sight is abolished in blindness diminished in obtusion and dulness depraved in hallucination The Hearing is abolished in deafness diminished in slowness of hearing depraved in the tinckling of the ears and thus it is easie to conjecture of the symptomes of other Senses Motion is abolished in the palsy diminished in stupidity depraved in convulsions trembling cold c. So the principal actions ratiocination and memory are abolished in a carus and apoplexy diminished in fondness and lethargy depraved in phrensy and madness The Vital actions consist in the Pulses which also are frequently abolished diminished or depraved Lastly the natural actions concoction retention attraction and expulsion are accompanied with as many symptomes The Concoction of the ventricle is abolished in inconcoction diminished in slow concoction and depraved in bad concoction So we must judge of the other differences of actions all which suffer under as many differences of laesions of which many are not yet particularized by proper terms A COROLLARY Concerning the Differences of hurt Actions In the number of hurt actions is reckoned that which is termed a preternatural auction such as a canine appetency great thirst c. But it is dubious to what species it should be referred The vulgar answer is that it is contained under the notion of depraved action because it is amist and perversly exercised which is the condition of depraved action but it is objected that if this opinion hold that diminished action should also be placed under depraved since action increased and diminished stand in a direct contrariety and therefore ought to be placed under the same genus It is answered That in matter of diseases and symptomes it is not a Physicians business to consider the trifles of Logical contrarieties but only those diversities by which our bodies are preternaturally affected and so action increased standing in a wide distance from action diminished as well in respect of the cause as of the manner of operation when as we said it is amiste and perversly exercised it is in right reason contained under depraved action and distinguished in the whole genus from action diminished in a Medicinal consideration CHAP. IV. Of the Differences of Excrements Excrements may be peccant four wayes 1. In Substance 2. In Quantity 3. In Quality 4. In the manner of Excretion First they are peccant in Substance when they have a Substance quite different from that of vulgar Excrements AND they are said to be preternatural in the wide extension of their whole genus And they are twofold either wholly aliens or consisting of natural things The stone maw-worms c. are mere strangers to nature Excrements consist of natural things when the blood fat a part of the flesh or some such thing is driven out as an excrement which ought by all means to be retained Secondly Excrements are peccant in Quantity by reason of excesse or defect When either their effluxion is too copious as in a Diarrhaea Dysenteria Diabete plentifull sweat and profuse issuing of blood or when they are more sparingly than is convenient
or not at all evacuated as in a constipation of the belly suppression of Urine c. Thirdly the Excrements are peccant in Quality either in the First Second or Third In the First when they are too Hot too Cold too Moist or too Dry. In the Second when they are thin or thick or soft viscid or spumous In the Third when they have a strange colour Smel or Tast Fourthly they are peccant in the manner of excretion when they are not expelled in due time or not thorough the usual parts or when they are too soon or too slowly evacuated CHAP. V. Of the Differences of changed Quality The Qualities of the body changed are first second or third BUT they that may deserve the name of symptomes must depend on some disease The first Qualities are heat cold moisture and dryness The second are Hardness Softness Gravity Levity Rarity Density Laevity Asperity and the rest The third are Colours Smels Tasts Sounds A COROLLARY Concerning the changed Qualities Among the changed qualities we place Heat Cold Moisture and Dryness which were before referred to the similar diseases which knits a knot difficult of resolution which we thus untye by averring that slight distempers which are only in a way to perfection and have no permanence in the part cannot be reckoned among diseases but are rather termed symptomes and changed qualities which by the vicinity or sympathy of some parts a morbous distemper being raised are generated and preserved Next asperity and laevity are here with the changed qualities which were referred to organical diseases To this it is answered that asperity and laevity if they be very remarkable so that they manifestly injure the actions of those parts wherein they reside are true diseases but if they be so slight that they are not at all troublesome to the actions and yet are produced from a preternatural cause as an humid or dry distemper it is a convincing evidence that they are true symptomes CHAP. VI. Of the Causes of Symptomes in the genus Eâ—â—â— Symptome depends upon some disease as its proper cause THIS is chiefly demonstrated in hurt-action which is the immediate effect of a disease as appears by its definition Besides it is undoubtedly true that the changed qualities do proceed from the first qualities which constitute the temperament which when it conforms to nature cannot produce qualities changed according to nature which it is evident do perpetually flow from the distemper Lastly seeing there happens no default in the excrements unless the concoctive expulsive or retentive faculties be vitiated it is very certain that this proceeds perpetually from some disease But the causes of symptomes in their species and the history of all diseases are exactly proposed in particular Pathology chap. 7. We will here illustrate onely by some examples for the better knowledge CHAP. VII Of the Causes of Injured actions The animal actions are usually hurt by various differences of distempers organical diseases and solutions of the continuum SO by the cold and moist distemper of the brain in excesse the animall actions are abolished as appears in folly and forgetfulness and by a more remiss distemper they are diminished as in fatuity and stupidity as also they are depraved by an hot distemper sometimes simple sometimes in conjunction with siccity as in a phrensie and madness Those actions are also sometimes offended by organical diseases as by obstructions and various tumors and by solutions of the continuum as by notable wounds in the head The vital actions consisting in the palsies are abolished depraved or diminished by an hot and cold distemper principally by obstruction and solution of the continuum according to the various intension or remission of causes So in feavers the pulse is depraved abolished in a syncope and diminished in a lipothymy The private natural actions are hurt only by similar diseases but the official by organical also The private natural actions related to nutrition viz. the attractive retentive and expulsive are perfected by the temper onely therefore distemper onely can hurt them but the official want the various conformation of those parts by which they are exercised they therefore are hurt by organical diseases also So the action of the ventricle liver or any other instrument is sometimes perverted by an Erysipelas a Phlegmon and other preternatural tumors and hence the concoction is depraved or diminished So also official attraction is hurt when by a carnous swelling or any other tumor arising in the throat the way is block'd up against food or else the attraction of it to the ventricle is very difficult Retention likewise is hindred by the same causes as also by the copiousness of flatulency And lastly expulsion is hindred by the narrowness and obstruction of the passages or also when it is too much provoked and accelerated by dilatation or vellication of the part CHAP. VIII Of the Causes of Symptomes which are in Excrements The errors in Excrements depend perpetually upon diseases but most usually by the mediation of the detriments of actions In this manner Too great a quantity of excrement depends either upon the weak retentive or expulsive faculty of the part by which excretion is made provoked by some vicious quality or exceeding quantity of humor SO a Diarrhaea is caused by sharp and bilious humors as also by the overflowing of some humor A vacuation also of the excrements too plentiful is caused by defect in the part containing by reason of which it is disabled to contain This happens when the orifices of the vessels are open or eroded by an internal or external cause or onely debilitated as appears in excretion of blood caused by the anastomosis diabrosis or diapeidisis of the veins The quantity of excrements is diminished either when they are sparingly generated or when the retentive faculty is too strong the expulsive too weak or when the passages are narrow and obstructed The excrements are sparingly generated either by paucity crassity or dryness of aliments or by contrary vacuations which do usually hinder the customary ones or by too much resolution of the whole body The reason of other causes is obvious CHAP. IX Of the Causes of changed quality The Symptomes which consist in the first qualities are caused by the distemper of neighbouring or sympathizing parts as is said But those which are related to the second qualities depend upon the various vitiosity of humors or distemper of the parts SO hardness is produced by dryness tension and congelation softness by humidity and so forth Lastly as to the third qualities these are the causes Colour is changed in the part either by distemper or by some humor lodged under its superficies So by a hot distemper the parts are red by a cold one pale so Choler diffused thorough the body causeth the yellow colour of men jaundised Vitiated smels arise from the putridity of the humors or of the parts Strange tasts by the excrements touching upon the tongue Preternatural sounds by
and cold as also by temperate injured by things cold and dry as vineger Effects Animal Actions Imagination Fear and sadness which without any manifest cause possesseth men very Melancholick But they who are Melancholick by a light adustion of the blood are cunning wary prudent constant and ingenious Atrabilary persons in whom melancholy is adust are haters and betrayers Melancholick persons are difficulty provoked to anger and difficultly appeased A difficult apprehension of things Memory Memory firm by reason of Siccity Watching Much watching troubled and interrupted sleep Dreams Dreams of black and horrid things of carcases sepulchres devils c. Sense A dulness of the senses an unconstant sad and horrid aspect Motion A slow heavy and composed motion Vital actions Pulse A slow and hard pulse Natural actions Hunger Insatiable voracity by reason of the acidity of melancholy which excites an appetency even when it is dejected Thirst Small thirst by reason of abundance of spittle and wheyish humor being plentiful in melancholick men Expulsion Acid belchings excited by crudities abounding in melancholick men Accretion Slow accretion and quick age Venery They are not easily excited to venery and by the use thereof are very much injured yet those Melancholicks are more forward to it which are very flatulent neither is venery so hurtful to them because they send not forth so much seed being by flatulency excited to coition Passions A frequent invasion of Melancholick diseases such as the Quartane swelling of the Milt and hardness the Leprosie loathsome scabs corrupt blood and the hemorrhoids c. Excrements Frequent vomiting of Melancholick humor By mouth Customary spitting and copious ejection of water whence Melancholicks are termed Spitters Belly The belly for the most part dry and constipated and blackish dejections Hemorrhoids Excretion of black blood through the hemorrhoids Bladder Urine thin and white sometimes thick and pale The habit of the body Skin first second third A skin to the touch cold dry hard and rough A dark leaden or blackish colour of the face Hairs Many hard rough thick black slow of growth and soon hoary hairs Vessels Narrow veins Flesh A slender and lean habit Thus much of the Signes of humors predominant in the whole body A COROLLARY By tracing in this method after the footsteps of these Signes we shall find out the temper of every part by applying them in the same manner to those parts and by contemplating chiefly their actions and excrements A Table of the Signes of the part affected The Signes of the part affected are taken either from The Essence which with Physicians is either The Temper which consists in qualities The first which are Calidity Frigidity Humidity Siccity The second which are Hardness Softness Magnitude Increased Diminished Situation Figure Causes External Internal Effects which are Actions Animal The principal Imagination Ratiocination Memory Less principal Sense Common to which refer Sleeping Watching Private Seeing Hearing Smelling Tassing Touching under which pain which is Purgitive Tensive Gravative Pulsative Motion The vital known by pulse Natural which are Nutrition whose servants are Attraction Retention Concoction Expulsion Generation Excrements in which is considered The substance which is either Of the essence of the part Naturally contained in the p. Preternaturally contained First Heat Cold Moisture Dryness Second Tenuity Crassity Viscidity Spumosity Third Colour Taste The Quantity Manner of Excretion Order Quality changed in Colour Taste Sound CHAP. V. Of the signs of the Affected part HAving duly enquired into the natural we come now to search out the preternatural disposition of the body First then we will make a diligent inspection for the better discovery of the signs of the part affected Next the species of the affection possessing that part and lastly the causes on which it depends The signs of the part affected may be derived from three heads the Essence the Causes and the Effects a Catalogue of which is proposed in the Table marked with the letter B. Therefore according to that Series the affected part is discovered by The essence First quality By the Temper of the part for if we perceive it hot moist or dry in excesse we shall judge it to be preternaturally affected Second By hardness and softness if for instance in Hypochondriacks we perceive hardness and retinency we shall judge the parts subjected the liver or milt to be obstructed or inflamed so too much softness in any part is a sign that the part is affected with some tumid distemper Magnitude increased A preternatural swelling whether external perceptible to the sight or internal sensible to the touch such as the tumors of the ventricle liver milt bladder c. Diminished A great consumption and atrophy of the parts Situation The situation of the part which in this case is very considerable for if we know by anatomical inspection what place is proper to every part in our body we shall easily conjecture by the humor distemper or some other sensible affection possessing that place that that part is diseased Figure The figure mutually distinguisheth the parts situated in the same place so a tumor in the right Hypochondrium shaped like the Moon shews that the bunchey part of the liver is affected but being of a long figure and more external it evidenceth to us that the straight muscles of the abdomen are affected External Causes External Causes also discover something for instance if any one hath taken Cantharides and conjecture that his bladder is affected because they have a peculiar vertue to alter the bladder if any one be affected after converse in the Sun we judge that his head akes because the sun doth usually affect that part rather than any of the rest if the affection be produced by the immoderate use of venery we say the spiritous substance and nervous parts are ill because venery is an enemy to these parts Internal causes We may number the affections themselves among external causes as where any one is troubled with a Tertian this speaks the liver affected a Quotidian the ventricle a Quartan the milt because these parts are the randezvouz of their causes Observe That when we in practise search for the part affected we must not trace it by its essence and causes but from its actions excrements and changed qualities the signes are first to be deduced and after from the essence and causes thereof The Effects Actions Animal The laesion of an action shews the part on which it depends to be affected for instance Principal Deliration watching abolition of sense and motion signifie the brain affected Sense private Laesion of a particular sense as of sight or hearing shews that the instrument thereof is affected Pain pungitive tensive A pungitive pain shews the membrane affected chiefly by sharp and eroding matter but a tensive pain is often caused in the membranes by flatulency and in the veins by over-repletion Gravative A gravative pain signifies the parenchyma of any of the bowels to be affected for all
those are together with the humors in them contained refrigerated it is not to be admired if they infrigidate the sweats conveyed through them though caused by very frequent humors imprisoned within Cold sweat then in acute feavers is a signe of death because it shewes that the native heat is too weake to lord it over these cold humors and must therefore submit to their pleasure But in more gentle feavers it signifies longitude because by reason of the exiguity thereof it doth not so enervate the strength as to lay it naked to the invasion of death yet plenty of cold humors cannot under a long space be concocted and subdued The second A very great extenuation of the whole body signifies a long disease If a person troubled with no inconsiderable seaver remaines in the same plight of body without extenuation this denotes a long disease Aph. 28. Sect. 2. For permanence and non-extenuation depends upon the density of the skin and crasseness of the humors and it therefore signifies a long disease The body very pale or of an orange colour denotes duration of a disease For this colour shewes a wide recess from natural state which cannot be retrograde but in a long time CHAP. II. Of the signes of a disease tending to health or death THat is called an healthy disease which endangers not the life but that a deadly one which threatens death to the sick party The prognostick signes of them are derived from three heads The Essence Causes and Effects according to the following table marked with the Letter L. L. The signes of an healthy and deadly disease are taken either from its Essence in respect of which it is either Similar Organical Common and these either Simple Complicate The Causes which are either Efficient or various humors Material or the subject Helpful or hurtful The effects which are either Actions Animal Principal Less principal which are either Sences Internal Sleep Watching Dreams External Seeing Hearing touching c Motion to which is referred A voluntary commotion of the members Lying down Trembling Convulsion Stiffness and shaking Sternutation Vital to which refer Respiration Pulse Natural to which belong Attraction to which Hunger Thirst Expulsion to which The Hicough Excrements ejected by The eyes Ears Nostrils Mouth Belly Bladder to which referurine Liquor Contents and in these Substance Quantity Quality Manner of excretion Sweats Abscesse and pimples Qualities First Calidity Frigidity Second Hardness Softness Third Colour Smell Taste Sound Proper accidents chiefly considered in The eyes Ears Nostrils Teeth Temples Lips Tongue Jawes Hypochondriums By observing the series of which Table the following Theorems will discover an healthy or deadly disease The Essence A day-expiring Feaver and all true intermitting Feavers are healthy and bring no danger The Solution of a strong Apoplexy is impossible of a slight one difficult Aph. 42. Sect. 2. That is called a strong Apoplexy which introduceth a total privation of sence and motion together with a great laesion of respiration But a slight one is that in which there is no such loss of sence and motion or so violent an injury of respiration In a strong one the brain is so oppressed that it cannot by any means free it self from it nor in a slight one neither without much struggling so that alwaies if a solution is made it degenerates into the Palsie by reason of the weakness of nature unable any longer to expel the morbifick matter Those who are taken with a Tetanus dy within four dayes but if they escape in them they recover A Tetanus according to Galen in his comm is a disease compounded of an emprosthotonus and an opisthotonus in which the body is so stiffe and unmoveable that the breast alone can hardly be moved It being therefore such a violent disease it kills a man in the first quaternion which if he escapes it is a signe that the fury of the disease is remitted otherwise it were intolerable Those who frequently and strongly swoune without the appearance of any manifest cause dye suddenly Aph. 41. Sect. 2. For this signifies a great infirmity or oppression of vital strength by which nature is soone overthrown Almost every dropsy is in its own nature deadly Because the temper of the liver being vehemently injured is irreparable All Feavers continual and burning as also the inflammations of internal parts as Phrensies Quinsies Pleurisies peripneumonies hepatitides and the like are naturally dangerow Yet they are not wholly mortal but according to the various condition of the sick person they end sometimes in health sometimes in death Nor can a Physician under pain of convincible ignorance give sentence of health or death on the beginnings of these affections but the critical dayes are to be expected which do commodiously discover unto us whether the disease incline to death or health Upon cessation of a Feaver into a dangerous disease without any evident cause death not health is to be expected Whatever Feavers not intermitting on the third day grow stronger are more dangerous But those which pause sometimes signifie no danger Aph. 43. Sect. 4. Continual Feavers either alwaies keep one station or are increased or diminished Those which are increased and exacerbated are worse then those which are not exacerbated because the evil in exacerbation is made much worse and more troublesome to the sick person But they are exacerbated either every day or every third day But those which are exacerbated every third day are more dangerous for that they are caused by bilious and so more hot juyces to which it is proper to be moved every third day Of this kind are burning Feavers and semitertians which are usually most dangerous But those Feavers which intermit are not dangerous because as Galen in his comm asserts they proceed not from any inflammation nor malignant putrefaction for neither of these acquiesceth without a Feaver Yet it is known by experience at least in these regions that intermitting tertians have been fraught with much malignity which in a third or fourth paroxysme did kill the sick parties We must say therefore that this opinion is of them which do most commonly but not perpetually happen or we may answer to the defensive argument of Hippocrates and Galen that these intermitting tertians have no perfect apyrexy and there alwaies lies hid some obscure sparkles of a Feaver raked up in the embers of intermission They who by an asthma or cough are distorted to gibbosity dye before their puberty Aph. 46. Sect. 6. For the heart and lungs being augmented by which they become disproportionable to their place this crookedness hindring the amplification of the breast it happens that the augmenting bowels cannot be long crouded up in too narrow a lodging so that sherly after gibbosity it introduceth death not that we may draw a consequence from this that the sick persons presently dye but that they fall far short of that diuturnity of life to which otherwise they might attain A Dropsie accompanying
rarifi'd the bloud increases the spirits revive and all things seem glad for the dissolution of Winters frost Neither is it absurd to say that many diseases are bred in Winter since the Spring naturally brings health not diseases and if it finde the body in good estate so preserves it But if there be an an abundance of humours collected in the Winter in the Spring they are melted and stirred and sometimes putrefie which causes various sorts of diseases And the Spring by accident not of its own proper nature is said to beget diseases You will object again that the Spring is hot and moist according to Hipp. but a hot and moist constitution is unwholesome and most liable to breed diseases that spring from putrefaction Therefore the Spring cannot be said to be most wholesome We answer that that is in the excesse of heat and 〈…〉 but where the heat exceeds the cold and the moisture exceeds the drinesse moderately that temper is most wholesome and most agreeing with humane nature which inclines to heat and moisture Besides life consists in hot and moist and must be preserved by things of that temper The summer is hot and dry it renders the body hot dry faint thirsty and weak it attenuates and burns the humours it increases choler which is the cause of the abundance of cholerick Feavers at that time Autumn is cold and dry fruitful of diseases because of the inequality of its tempers for in the morning 't is cold at noon very hot and lastly at evening 't is cold again The body is condensed at that time and the humours hindred from flowing being forc'd to the interiour parts by the coldnesse of the air whence arise many diseases very dangerous by reason of the black choler which abounds in the body in Autumn The Winter is cold and moist it strengthens the body and makes it more lively and full of natural heat and causes long sleeps through the tediousnesse of the nights it procreates flegm and makes the body liable to obstructions CHAP. XXVII Of motion and rest MOtion and exercise are a principal means for the preservation of health above all other things except temperance Here the common sentence of Hipp. may be fitly repeated l. 6. Epid. The way to preserve health is not to glut the stomack with meat and to be laborious in exercise Galen in many places chiefly commends exercise but in one place chiefly where he prefers it before temperance in diet in lib. de suc bon vit c. 2. Unlesse a man exercise sufficiently he cannot preserve himself from diseases by any temperance in diet unlesse he do recompense the want of exercise by requisite purgation or letting of bloud But if he use a through exercise though he sometimes exceed in diet yet he shall continue without diseases But Aristot Prob. 47. sect 1. questioning why it is good to diminish his diet and increase his labour Because saith he the superfluity of humours causeth diseases which shew themselves chiefly when either a man exceeds in diet or is wanting in exercise Motion and exercise excite the natural heat increase and stir up the spirits so that the body becomes more strong lesse liable to external injuries and fitter to undertake all actions Concoction is perfected better by the increase of heat and the stirring and exagitation of the spirits causeth a more plentifull transpiration the defect whereof is the cause of almost all diseases But there are many sorts of motion and exercise as walking running leaping riding gestation and infinite others of which some exercise the body more some lesse others the whole body others but some parts Galen commends the play with the little ball chiefly as that which exercises the whole body running and walking exercise the thighs particularly by handling arms and rowing the arms and superiour parts are exercised by singing hollowing and loud reading the voice and brest by riding the stomack The most used and most commodious kinde of exercise is moderate walking through green and pleasant places under a clear and serene skie But they that are soon weary of walking through infirmity or cannot walk free enough may more conveniently ride on horseback Moderate walking exercises almost the whole body causeth an appetite excites the natural heat strengthens the body and helps toward the evacuation of the excrements To make exercise profitable for the body two things are to be observed time and measure The fit time is before meat chiefly before dinner Exercise is more convenient before meat because the former meal being concocted the relicks of the excrements are evacuated by exercise and dissipated and so the body is the better disposed to concoct and receive new nourishment Whence Galen 1. de san tuen c. 2. bids him that hath not concocted rest altogether But exercise after dinner is worst of all for it carries the crude humours into the veins obstructs the liver oppresses the head and causes many diseases For this cause Scholars are often troubled with the Itch because they exercise after dinner which carries the meat out of the stomack before due concoction and fils it full of crude humours which vehement exercise carries to the skin where they turn to scabs The same happens to those that exercise when the body is in an ill temper and full of vicious humours which produces scabs and ulcers As teaches Hipp. 6. Epid. sect 5. If he labour unpurg'd scabs will break forth Exercise before dinner is better then before supper because in the morning the stomack is empty and the concoction better perfected by reason of the greater space of time between dinner and supper on the contrary the meat eaten at dinner is not so well digested Yet a gentle walking after meat is usefull as that which recals the heat and hastens not away the meat but causes it to descend to the bottom of the stomack where it is more quickly concocted and helps the distribution of the meat also when it is concocted The measure of exercise is appointed by Galen 2. de san tuen c. ult which may be referred to four heads 1. To continue exercise till the body swell 2. Till it appear fresh and lively 3. Till a wearinesse come upon it 4. Till a moderate sweat or hot vapour break forth any of which appearing then desist from exercise CHAP. XXVIII Of Sleep and Watchings SLeep is absolutely necessary for the preservation of health and if it be moderate it helps concoction refreshes and restores the strength lost in the time of watching moistens the inner parts of the body and is conducible to old men All the good which comes to men from sleep is to be ascribed to the retraction of the heat to the inner parts For the heat increased in the bowels generates copious spirits and restores them that were lost in the time of watching which helps the concoction in the liver and several other parts and forwards the expulsion of the excrements and because that
of intemperateness are taken from the cause or from the subject Though we have omitted the Treatise of the accidental differences of diseases till we put an end to this Section yet because they do properly belong to intemperateness alone therefore it will not be inconvenient to bring them upon this stage In respect of the cause one intemperateness is called Material the other Immaterial The Material intemperateness is that which comes in the company of an internal cause viz. Humor Vapor or Wind as it happens in humoural Feavers inflammations of the parts and infinite others and that Galen is termed intemperateness with the affluxion of humors but the immaterial which is also called a naked intemperateness is that which is produced by an exterior cause with the concurring help of the interior This is not so frequent as the other and very seldome happens yet it may be found in a Marasmus a great refrigeration of the parts being contracted in cold water or by a very cold Northwind or in the Head-Ach contracted by violent heat and the like In respect of the subject one intemperateness is in the Habit another in the Habitude Intemperateness which is in Habit or which hath contracted habit and is thereby confirmed is also called Hectick which doth so firmly inhere that it is indeleble it is also said to be wholly consummate of this kind are the Hectick Feaver and the leprosy but that which is in habitude or disposition is onely inchoate and still in its primordiums or at least part produced part unproduced and easily deleble as vulgar Feavers and other diseases without difficulty curable In respect also of the subject one intemperateness is Equal the other Unequal Equal intemperateness is that which is equally diffused into all the parts of our body so an hectick Feaver is an equal intemperateness because all the parts are over-heated in the same degree But Unequal intemperateness is that which is not equally distributed to the parts of our body so we call putrid Feavers unequal diseases because in them the solid parts are not plainly heated as the humors which heat hath wholly penetrated so the feavers termed Epiala and Lypiria are called unequal intemperatures because in the Epiala heat and cold are together felt all the body over but in the Lypiria the exteriors are stiffe with cold the interiors parched with heat A COROLLARY Concerning Similar Diseases It is in the front objected that there is no possibility of a simple intemperateness because it would be either joyned with the matter or stand apart from the matter it is not with the matter because such intemperateness depends upon some humor but every humor is doubly qualified but the immaterial proceeds from external causes and they are the elements every of which hath two qualities or mixt bodies which have also two qualities by the predominant element I answer That upon a due contemperation of qualities the excess must be in one onely when there are two causes internal and external joyned which agree in one quality are contrary in another as when a disease is generated from blood and choler the drynesse of the choler is tempered by the moistness of the blood and there is no excesse but both joyning the forces of their heat effect an hot intemperatenesse the same is plain in external causes for if the air be temperate to an hot and moist temper and the aliments be cold and moist the coldnesse of them with the heat of the other will cause contemperation but the moistness of both will produce a moist intemperatenesse It is again objected that there is no such thing as a hot and moist intemperatenesse because heat and moisture are the principles of our life and so they cannot be in conjunction diseased Again that heat must be very intense that it arrive to morbosity but intense heat doth powerfully prey upon moisture and soon summons in its mate siccity and so a hot and moist intemperatenesse cannot together subsist so we may say of cold intemperatenesse which generating great crudities brings humidity plentifully into the body hence it seems inconsistent with siccity To these I answer That heat and moisture are convenient for the principles of our life yet if they do so far transgresse that the humors shaking off their allegiance to nature and not admitting ventilation do necessarily putrifie which ushers in preternatural heat and that meeting with plenty of moisture causeth a hot and moist intemperatenesse Besides excesse of heat consumes indeed humidity but not so nimbly and therefore that space of time is sufficient for the generation of most violent diseases as appears in bloody feavers in which at the beginning there is plenty of moisture but upon their permanence they call in the auxiliaries of a dry intemperature In the same manner a cold and dry intemperatenesse spends time before the acquisition of a moist by crudities And though the effluxions of the excrements be copious yet the solid parts retain their dry intemperatenesse as is seen in old men The proposed differences of diseases and those alone Antiquity with a general consent imbraced which have also found entertainment with almost all Neotericks excepting Fernelius and some siders with him For Fernelius hath brought to light two new kinds of diseases one related to the matter the other to the form or the whole substance For saith he three things being considered in the similar parts matter form and temperament the natural constitution of them being health so the immoderatenesse of every of them will be disease And hence result three differences of diseases viz. intemperatures by the excesse of the first qualities the immoderatenesse of the matter is when a part becomes softer or harder looser or closer thinner or more crasse rarer or denser and the vitiating of the form is when either by manifest diseases as by putrefaction or by occult as poysonous contagious and pestilent the whole symmetry of the body is disturbed Fernelius in his 1. Book of his Pathology chap. 7. hath onely proposed this his opinion yet hath strengthened it by a long disputation in his 2. of the hidden causes of things chap. 9. which because it is famous being born up by the authority of so learned a man and hath wrack'd the wits of many we will therefore enter the lists in a short dispute with him The reasons then by Fernelius alleaged to confirm his opinion may be comprehended in the following discourse First Diseases usually possesse those by which the actions are performed But there are three things in a similar part which execute the actions thereof viz. matter forme and temperament therefore this will be the place of Disease Secondly The same is confirmed by the various detriment of actions in one and the same part for the ventricle as a similar part is often infirm by which the concoction is weakened but this infirmity is sometimes caused by immoderate refrigerations as by over much drinking of water eating of