moderate and gentle making a profitable secretion without gripes or pains but for the most part with these more or less which by continuance and shaving the guts so thin at last do come to the quick and cause excoriations and this difference ariseth from the nature and quality of the humors or stimulating cause which sometimes is so extreme sharp introducing a Dysentery or bloody Flux These Fluxes sometimes produce good effects when the peccant matter of any disease or an exuberant humor is timely and moderately discharged and sent off but otherwise not and therefore saith Hippoc. In turbationibus alvi vomitibus sponte contingentibus siquidem qualia purgari oportet purgentur confert leniter serunt sin minùs vice versâ In respect of place or parts mandant from whence these Fluxes take their rise and the terminus à quo they proceed sometimes from morbific matter congregated and concentred issuing from the whole body and of this take the example of Hippoc. giving a Prognostic in this case 7. Aphor. 29. Si Leucophlegmatiâ detento fortis Diarrhoea supervenerit malum solvit Which is to be understood in the beginning of the disease strength firm and the Viscera sound else it is commonly mortal But sometimes also these Diarrhoea's do emerge from particular parts as the Ventricle Brain Spleen Liver Mesentery c. and therefore in the Cure of these Fluxes regard must be had to the part principally affected from whence as the original and fountain these Diarrhoea's do assurge And therefore examination is to be made by the Diagnostic signs of every principal part discovering thereby which performs their offices in integrity and which of them decline their functions and are depraved as being the Authors of this disturbance The third sort of Flux is a Dysentery or bloody Flux which is a dolorous and frequent excretion of blood from an Exulceration of the Guts There are several voidings of blood by stool that are to be distinguished and know from Dysenteries Galen mentions four others add two more The first is a profusion of blood arising from plenitude or fulness of good blood Nature over-burdened dischargeth her self this way by the Guts The second is an evacuation of crude and watry blood not having its full tincture The third is of a feculent and foul blood The fourth of an acrid and salt blood The fifth is of a tabefied blood in acute diseases The sixth which is Galens fourth is a Dysentery distinguished from the rest by Ulceration and great pain To examine this division in the several parts thereof and to set forth what truth and errour it contains therein is not our business at this time I shall only discourse upon the last viz. a Dysentery being painful and grievous to bear which kind of bloody Flux ariseth from and is accompanied with an Exulceration and commonly is the consequent of long or severe Diarrhoea's for those Fluxes not being checkt do sometimes make their transition and terminate in Dysenteries This word Dysentery taking its name from the part affected imports only a difficulty of the Intestines but may as properly be used for other diseases and pains there but Authors having fixed it to bloody Fluxes from Exulceration its general signification is restrained and custom amongst Physicians hath fastned it here as the character of this disease only The parts affected are the Guts either the small or the great and sometimes both but pains of the small are more grievous than those of the great the small Guts being of more exquisite sense The external and procatarctic causes that predispose and introduce a dysenterical disposition or promote and set forwards an inclination already begun are First the constitution of the Air. Secondly a bad Diet conspiring therewith or some unwonted kind of Meats or Drinks and therefore it is that many people upon the change of Climate and a new sort of Food do fall into bloody Fluxes hence it is also that these Fluxes are sometimes epidemical and malignant infesting many together in a City or Country as of late years in London and some other parts of England this disease was raging These epidemical Dysenteries arise sometimes to to the height of pestiléntial and are very contagious that it is not safe to converse with or be near the diseased but especially such as attend upon the sick are in most danger from the Excrements that send forth a pernicious and infectious vapor For the time of the year Autumn is most ready and does more frequently produce these Fluxes partly from the change of the season and partly from the effects of Summer fruits to which many are intemperately given the consequents whereof are commonly Diarrhoea's and Dysenteries Now the reason why these Fluxes do break out more frequently at this time of the year is because the external ambient Air and cool blasts condensing and incrassating the Juyces of the body as also occluding and shutting up the Pores denying and hindring the former Transpiration which in the Summer and hot weather did spend and evaporate that way much superfluous matter which vents being stopt humors accumulate ferment and grow turgid and forceth a discharge inwards by the Guts And not only this change of Air from hot to cold or Summer fruits are procuring causes but also some astral and inimical influences drawn in with our breath may deprave and alter the Crasis of the blood and nervous juyce as to effect this disease and make it popular in like manner as other Epidemical diseases are sometimes procured Also some sorts of Meats in quantity or quality offending and disagreeing and for want of good digestion may corruption and dispose to these Fluxes To these we may add as procurers some ill prepared Medicines and medicinal Drugs not well corrected that have and will produce a Dysentery But concerning the proximate cause and manner of generation of this disease we must farther declare And whereas before we mentioned several sorts of bloody excretions or fluxes not dolorous nor depending upon or conjoyned with exulceration of the Intestines and therefore not denominated nor to be understood as Dysenteries in the strict and present sense therefore I must wave the mentioning of their causes and only give an account of Dysenteries in the usual acceptation of the word In the forming or generating of this Dysentery you must understand that sometimes the Vlceration is planted first and hath the priority and a Flux of blood follows as the consequent but sometimes the voiding of blood precedes and an Vlcer or Vlcers is procured thereby as the effect and this consideration is not of small moment in the designment and intentions of curing for both the former and the latter happen in several persons Sometimes Vlceration is made by sharp corrosive humors as in Diarrhoea's which ulcerate the guts first then a Dysentery of blood follows Or Sometimes from an Inflammation of the Intestines or other Tumor coming to suppuration which breaks and makes a
their inconvenient and disturbing objects as the Philosopher says Excellens sensibile laedit sen sum as the light of the Sun or flame is troublesom to the Eyes and great noise as of a Bell or Gun if near especially sudden and unexpected does offend the Ears and a strong or stinking scent is offensive to the Nose and an ungrateful taste as too salt too sowre or bitter is unpleasant to the Palate but pain affects the sense of feeling Parts therefore that are capable of pain are endowed with the sense of feeling and those parts are membranous that is they are invested with or lined with some Membrane by which the sense of feeling is communicated and hence the Bones are capable of pain by the Periosteum that Membrane which covers them And this sense as it is more general extending through all parts and more useful than the rest of the senses so the disturbance arising thence is more insufferable and grievous to be endured and better it is to want any other sense than this yea all for where feeling is departed the life is ceased in that part This sense therefore being supreme the defections and disturbances thereof must be of greater importance and concernment than the rest The other Senses are confined to and exercise their functions in one Organ or part of the Body the Eye the Ear c. but feeling is not restrained to so narrow a compass but is seated in all parts of the Body even in the Organs of those other senses The great Prerogative of this sense above the rest having no limits but reaching through the whole Body and exercising its power among the other senses and an inseparable consort with the life were worth inquiring into the reasons thereof if time would give leave for that diversion What pain is scarce any one but can tell and some by woful Experience whereby they will consent with the definition thereof dolor est tristis sensatio in tactu pain is a trouble arising in the sense of feeling but that which is so plainly felt is not very easie to be understood from whence it does arise The Causes of pain are as various as the Objects of the sense of Feeling for whatever objects assault that sense violently or extremely as too hot cold hard sharp heavy c. are offensive to the Organ of Feeling and do raise pain Concerning the approximate cause of Pain there are several opinions I wave the more extravagant and improbable and shall recite those in which the most Philosophers and eminent Physicians do consent and pitch upon as most agreeable to reason One Party asserts That a sudden and violent mutation of the active qualities or the tactil qualities suddenly and violently acting upon the sense of feeling are the approximate cause of pain The other Party determines That solutio continui a solution or disjunction of continuity is the immediate cause of all pain The third Opinion joyns these two together and will have pain to arise from them both according to the definition of Plato Est itaque dolor tristis in sensu tactûs affectio à membri intemperie continuitatis divortio subitò facta And Hippoc. before him taught the same doctrine Quae naturam inquit mutant ac corrumpunt dolores excitant To which Galen does subscribe Now to comment a little upon these different Judgments I cannot but observe and do owne that there is something of probability and reason in these several sentiments but not a full satisfaction to the matter queried nor the whole truth rightly stated and for this reason I am the more nice and strict in this inquiry because from hence the nature of Anodynes or asswagers of pain are discovered and this is the ground-work upon which they are formed and rightly adapted I allow that unity is the perfection of Bodies and is necessary to perfect sanity disjunction or separation dissolves the harmony and leads or is the progress to destruction for whatever tends to disjoyn or make a separation of parts does threaten to ruine the whole And true it is that the active qualities or tactil objects do cause pain as they do make their impulsions violently upon the Organ of Feeling which when they do it moderately placidly and amicably they cause pleasure or no pain But whether the impetuous and vehement acts of those Agents raising pain do always cause a solution of continuity approximately and immediately is much to be doubted I yield that the vehemency of these tactil objects may procure a solution of continuity sometimes as we see from pain that Imposthumes Vlcers Gangrenes and Mortifications do follow but these are not inseparable and necessary consequents for they happen but sometimes pain may continue for a time cease again and no breach of continuity remain a◠an effect thereof To which our Adversaries have this evasion by way of Reply That pain is caused à continui solutione non à soluta unitate which as I conceive the meaning is as much as to say solution of continuity in fieri is sufficient though it be not in facto esse But to pass over this Sophistry as not worth the expence of time to lay it open and if we make appear that the whole matter or controversie is bottomed upon this error mistaking the cause for the effect and the effect for the cause Cujus contrarium then the pleadings of our Antagonists will be put to silence as absurd the doctrine laid aside and practice grounded upon better principles They affirm solution of continuity to be the approximate cause of pain the contrary whereof we will set forth and prove that pain is the cause of solution of continuity And here we must first distinguish between violent external Agents as sword staff bullet fire c. causing wounds contusions fractures combustions c. and internal causes gradually arising in the Body as products of a degenerate state In the first cases solution of continuity causeth pain as when the wound is given pain follows as an effect so likewise upon a sudden fracture or rupture in the latter pain precedes as the approximate cause solution of continuity comes after as the product or consequent For example some indigested or degenerate matter lodgeth or fixeth in this or that part of the Body Nature not able to subdue or transmit it away this like a thorn irritates and provokes the vital principle to a disquietness and disturbance which is pain this pain draws a confluence of humors to the part grieved and increaseth the first offending matter causing Inflammation and Tumors this apostemates and then breaks forth into an Vlcer Observe the Series first here is peccant matter as the occasional cause raising pain this pain attracts humors from other parts which being transplanted out of their proper place they degenerate corrupt and then produce an Imposthume and Vlcer Thus you see pain goes before solution of continuity follows after and therefore it is plain as in
errour and folly of the rest for by insisting so much upon this heat the supposed obstacle of Cure or the thing to be cured the opportunity perhaps may be lost but the Patient certainly injured by the vain use of Medicines levelled at this mark Few diseases there are amongst the Chronic or slow of motion but some febrile or preternatural heat more than the ordinary and natural temper does attend them especially at such times if the disease have any manifest intentions of degrees or Paroxysms of pain and scarce any among the acute or swift but a brisk and high Feaver does always accompany for in all cases where pain is continuing especially if severe a Feaver is adjoyned and they become fratres in malo or rather a branch from that stock and the order of causation runs thus First there is the morbific cause planted in this or that part or transient which is either some degenerate or peccant humor there infesting or corruptive seminary the fundamental matter of Pains Tumors c. or some extraordinary production as stones worms c. These preternatural causes do seldom lye dormant but raise pain by obstruction by oppression or compression by convulsion distention corrosion putrefaction c. The parts being thus affected and grieved the vital principle residing as governor there is hereby excited and irritated to remove expel and cast off the offending cause this strugling and irritation of the life is the very pain and anguish that is felt in the part for the Organ is not capable of pain of it self but the life inhabiting and inabling the part to perform vital offices that does dolere and aestuare Now a Feaver which is pain diffused ariseth from particular pains thus As the members or parts of the body being many do consent with one another some more immediately and peculiarly than with the rest by vessels of communication partnership in office or vicinity yet the life being one entity or common being extended and expanded throughout the whole fabrick of the body cannot suffer here or there but the whole is injured disturbed and drawn into consent more or less manifestly or secretly and the Spirits upon great occasisions are raised up in commotion throughout the body as instruments to vindicate the publick from an enemy invading And farther take notice that particular pains beget the general a Feaver greater or less sooner or flower upon a double account 1. From the Nature and Quality of the Part in formation and office 2. From the greatness or inconsider ableness fierceness or mildness of the morbific cause For example Sickness which is pain at the Heart or Stomach raiseth a Feaver great and soon and this by reason of the excellency and necessity of their offices whereby the whole body consents forthwith that what afflicts these is a general complaint more immediately but other parts in a lower station subservient and ministerial whose function being not so general but of particular and private use do not communicate their diseases so soon nor the whole body so highly resenting their ill affects because the publick can spare their offices and be without their exquisite or compleat assistance for a time without great complaint or manifest want Secondly the cause or morbific matted being greater or less in any part does thereby affect more or less sooner or later and therefore sand or small gravel in the Kidneys do not afflict the part nor raise so great a disturbance in the body as a stone there that obstructs the ducture and stops the current of the Urine and is much more difficult to be removed And sickness or pain at the Stomach by little over-drinking of good liquor Wine or Beer c. is not so lasting nor molesting nor preading in the effects over the whole body â—s a surfeit of meat fruit or an over-charge of bad liquors these shall produce not only sickness or pain in the stomach but sickness or a hot pain in the whole body which is called a Feaver and this sickness may be dangerous as sometimes it proves mortal Pain is fixed in one part but the Feaver is universal spread throughout the body for from this pain of a particular part the whole life estuates is incensed and disquieted as if a cord be tyed or fastned at both ends of great length and strait strike it hard in one place and it jarrs the whole length but at the place struck the vibration is greater and more manifest So where the disease is seated the pain is more apparent and that part most sensible where the wound is given where the oppression lyes where the obstruction is where the humor is corroding putrifying c. there pain is eminenter limited or bounded and to be pointed at particularly here and not there eminently but from hence ariseth the Feaver which is pain diffused in a remiss degree and seemingly of another nature or quality a different thing supposed by some therefore denominated a Feaver This Feaver although it be a pain yet it is not so felt by the Patient nor so understood by others because of the greater particular pain that drowned it and because of its expansion and latitude all parts bearing their proportion and share so that where a Feaver stands alone without a particular pain in this or that part yet the Feaver the general pain is not so manifest to the sense of the Patient because every part hath its portion and therefore is not so discernable and uneasie for a Feaver is pain expatiated through the body and you are not so sensible of it as when pain is contracted into a narrow compass the rest being free and at ease That all Feavers are pains greater or less examine but the definitions of Febris and that of Dolor Feaver and pain you will be fully informed how they agree a Feaver being comprised under pain as a Species of that Genus being a hot pain or the pain of heat Dolor est tristis sensatio in tactu Gal. Febris est calor contra naturam in corde accensus ex eo in totum corpus diffusus which is Hippocratic and Galenic Doctrine Now where there is heat higher or exceeding that which is natural it must affect the sense of feeling and cause pain and although I do not like the definition of Febris yet it will serve my turn here being right in the opinion of those Galenists with whom I now contend From hence we must understand and be untaught again that Dolor and Febris do differ as genus and species a Feaver being contained under and is one sort of pain viz. a hot scorching pain and sometimes a Feaver is a cold pain as the rigor of intermitting Feavers called Agues do testifie And since that all Feavers we pains little or great we shall not need to institute a Method of Cure different upon the notion of a Feaver but only having respect unto the cause that raiseth this feaverish or hot pain and therefore
to discharge and abate blood by the Nose by the Haemorrhoids or Menstrual purgations sometimes by plentiful feeding and too much ease so that evacuation and transpiration is not proportionable in abatement and to balance the imported food Conjunct causes are such as more immediately and nearly concur or conspire actually in forming of these pleuritic pains and they are either acidity or viscidity within the Vessels of the Pleura or a violent fluxion from the larger Vessels too great for the capacity and reception of these exiguous canals 2. Acidity or an acrid serosity does sometimes fabricate and finish this disease by punging and lancinating the Pleura for omne acidum extra stomachum corpori est hostile says Helmont thereby irritating and exciting the vital spirit to estuate and be incensed and from this focus a febrile heat is kindled and communicated to the whole Body and that oftentimes and for the most part it is a sharp serous humor predominant in the blood which caused this disturbance in the Pleura is confirmed by the manner of solution or termination of the disease which most frequently is by a sudorific evacuation or insensible transpiration and therefore Hippoc. in his Predictions says Sudores urinas in Pleuritide probè fieri bonum esse salutare Friendly Sweats and effusion of Urine presageth a good event 2. Viscidity or grumosity of the blood does sometimes cause pleuritic pains for by obstructing those small ductures of the Pleura and stopping the Circulation a Tumor thereby is raised within this double Membrane for the Veins Arteries and Nerves lye between these two Coats of the Pleura And that the blood is thus apt to be stagnant especially in the smaller Vessels by coagulation grossness or congelation is confirmed by Phlebotomy for being let out of the body it is sometimes found destitute of its Serum or Latex that keeps it fluxile thin and transient and also is manifest so to be when it is in the Vessels as in Gangrenes where the blood is fixed and the part almost mortified and when Pleurisies do happen upon this cause of concretion they commonly tend to suppuration as not capable of being discussed or put into motion for a discharge of the part Now the Blood becomes thus incrassated gross and viscous from every cause that does too much exhaust and expend the serosity thereof as too great transpiration or sweating or immoderate making of urine and sometimes from a malignant or a venemous Miasm that curdles or congelates the blood 3. Fluxion or ebullient and preternatural Fermentation causeth pleuritic pains and thus it happens when a Pleurisie is the consequent or appendent to a Feaver preceding for sometimes a Pleurisie does precede and is the cause of a Feaver as when the dart is felt to strike the Pleura before any febrile distemper appears sometimes a Pleurisie does supervene and follow a Feaver as an effect from that general ebullition the hot spumous blood rushing into the Pleura Having established these causes in their due Series presenting them in the method and order of their causation and action we shall not trouble our selves with Choler Flegm and Melancholy the supposed materials of every disease nor shall I controvert the insufficiency of that doctrine here For Indications of Cure prompting what is to be done which way and with what they are various as the case presents 1. Plethory indicates Phlebotomy and requires a depletion or abatement of the redundance of blood that there may be room for the peccant matter to retire and for a revulsion and derivation thereof as also to avert the current and flux tending towards the pained part 2. Purgation by sedate and amicable Cathartics if you can procure such else by Clysters the best substitutes in that defect is necessary to absterse and cleanse the whole Body thereby subducting fuel from the fire and for rendring the Patient not so liable to effervescency and turgid estuation and for a retraction from the part affected 3. Topical Discussives are available and contribute to the remove of the morbific cause both as defensatives giving robor to the grieved part for resistance of the humors flowing in and also for a transmission and discharge of the conjunct matter residing 4. Diaphoretics to rarifie dissipate and set open the Pores for a free transpiration and exsudation are not only safe but exceeding necessary thereby to avert the antecedent cause resorting to the pained place and to disperse and scatter the morbific conjunct cause from the part affected if possible to prevent suppuration which is very dangerous and commonly mortal 5. Anacathartics or proper and truly expectorating Medicines are auxiliary and profitable in promoting expectoration by digesting the peccant matter and rendring it more apt and easie to be brought up and of these some are attenuating others incrassating to be used pro re nata suitable to the offending cause which if it yields soon and freely and Nature throws it up by cough and spitting it portends good promising shortness of the disease and a prosperous event which Hippoc. 1. Aphor. 12. confirms 6. Anodynes elected by a discerning Judgment and cautiously used may be of good advantage in some cases and at some times else may prove very pernicious Having dispatched these pleuritic pains we are next to take notice what other pains are incident to the Thorax or Breast And here we find pain to arise from Inflammations of the Lungs of the Mediastinum and of the Diaphragma whereof an account will be given in their proper places hereafter when we treat of Inflammations But the Lungs do suffer pain also from other causes as from Tumors not inflamed sometimes from adhesion or sticking of the Lungs to the sides of the Breast sometimes from stones and worms that have bred there observed and found upon Dissections and sometimes by Erosions and Vlcers of which in their due place following Back-pains of the Thorax are either upon the Spine between the shoulders or upon the Scapulae the shoulder blades And these pains do arise from some impressions of cold lately taken or from defluxion of a serous humor from the Head or sometimes from a maligne Miasm Venereal or Scorbutic that infests those parts Pain sometimes is seated at the bottom of the Sternum between the short Ribs under the Cartilage mucronata vulgarly called the Pit of the Stomach but improperly This Cartilage hangs down being as it were a defensative to the subjacent parts namely the Stomach and Liver yet is flexible to give way to the extensions of the stomach without compression This place is very tender at all times insomuch that a blow here is ready to make a strong man faint the part being thus sensible pain therefore here must be very troublesom Now this place is of acute sense or feeling in regard the upper Orifice of the Stomach being very nervous and almost subjacent to this Cartilage and the Heart adjacent hence it is that a blow or
pressure here raiseth a fainting pain the Cartilage yielding and giving way to any force But sometimes a pain is planted here not always by any external manifest cause but from internal and preternatural state of the parts and this pain is rarely taken notice of by Physicians and mentioned but by a few practical Authors Now to examine into the cause of pain you must know that this Cartilage is flexible and yielding in its natural condition being of a middle nature between a Bone and a Ligament and therefore may be curvated and bent inward upon a threefold account By Laxation Exsiccation and external depression 1. By Laxation as when too much moisture resides here mollifying and loosning the part from any small occasion the Cartilage may be inflexed and turned inward changing its due position and rectitude and from the like cause Ligaments are sometimes relaxed which renders Junctures ready and apt for dislocation and disjuncture and upon this score the Vertebrae of the Spine have been displaced also the Hip and Ancles 2. By Exsiccation this Cartilage may be distorted and wrested from its posture as sometimes that which was straight green and pliable by drying and shrinking becomes crooked bent and drawn aside So this Cartilage that was a Grisle tender and pliable sometimes becomes dry hard and bony and fixed upon distortion or writhing as not returning to its rectitude or straightness and distance from the subjacent parts over which and for whose guard it is placed 3. By external Depression as from a blow or fall any thing too much or too long pressing upon that part may pervert and alter the situation and due posture and those whose business or imploy keeps them bending or pressing forward too much and constant renders them liable to this inconvenience and therefore Students and Clerks that write much pressing upon this part are injured thereby and find it upon age though youth bears it off for a time Now since this Cartilage is thus exposed to depression and bending inward and thereby the tender parts subjacent to be pressed upon and molested the cause of pain and manner how is made evident and which most commonly is felt after eating and upon a full stomach when the parts are dilated and swelling up to this Cartilage And farther as all parts of the Body in several persons do vary and differ much in figure position magnitude and distance so thereby some are more liable and apt for this pain than others although subject to the same external procuring or internal antecedent causes And so I dismiss this particular pain and pressure and must take cognizance briefly of that which is more general upon the whole Breast The Thorax or Breast suffers by compression or constriction whereby a general obtuse pain of angustness is perceived and that chiefly upon inspiration and drawing in of the breath and why now more than at another time is because the inspired air fills and distends the Breast which makes opposition to or resists the compressing causes Now the cause of angustness or coarctation is from the Genus nervosum that gives motion to the Muscles and other parts of the Breast which Nerves sometimes are impedited and contracted that their functions are not freely executed and therefore to this Symptom of compression is commonly adjoyned shortness or difficulty of breathing upon the same score and sometimes spasms or convulsive motions And this complaint of straitness or contraction of the Breast does frequently happen to scorbutic persons whose nervous juyce being degenerate and tainted their Organ or Vessels perform not their office duly as they ought in giving the full motion and extension or every part for this nervous liquor being fed and supplied from the mass of blood which is scorbutic feculent and depauperated in spirit that also which is extracted thence must be answerable and of a degenerate nature so then this nervous juyce which should be vegete noble and spirituous for putting the motive faculties into action with vigor and briskness is become dispirited flat and depraved and the Organs acted thereby move heavily and irregularly so that upon inspiration or filling the Breast with Air the parts do not readily give way by expansion to let in hence the Patient feels himself girt or strait-laced It remains now in the last place that we finish this second division in examining and searching into the nature and causes of those pains that more peculiarly and eminently afflict the Heart The Heart being a noble or the noblest and principal part is as the Sun of the Microcosm whose irradiating lustre and beams of vital heat enlivens and refresheth all the regions and parts thereof the Eclipses storms and clouds then that happen as the consequents of its distempers and sufferings must needs be eminent and remarkable This supreme Organ that bears the government of vitality is so generally concerned in all diseases and discomposures of the Body that few there are but the Heart is made sensible thereby and gives notice thereof by variation of the Pulse as a sigrial from thence And not only distempers of the Body or the defect and decay of some particular member or faculty does affect the Heart but also the disorders and passions of the Mind have influence thereon that from thence the Heart akes beats or suffers pain and restless disturbance hence it is that grief anger fear desire c. Changeth the regular motion of the Heart and the Pulse alters as a token and manifest character of its sufferings Now the Heart is made thus sensible of the Bodies infirmities and preternatural mutations from the vital government that is planted here having commerce and communication with every member from the circulating afflux and reflux of the crimson vital stream continually transmitted through this Organ which thereby is affected well or ill as the blood is better or worse in the current and quality thereof And the Heart is also affected from the mind for as much as the Soul exerciseth her power more eminently here and if a particular part may bee assigned this may be said to be the seat or Throne of Regality The Heart being of a solid fibrous flesh the pain thereof is obtuse not so accurately perceptible so acute and sharp as those of the nervous parts notwithstanding the effects and consequents thereof are impressed upon the whole Body and each member is impaired in its vivacity and vigor and although this Heart pain by the nature and substance of the Organ is not so great commonly and perceptible as that of some other parts yet when this pain does arise to some degree a Syncope seizeth the Patient a deprivation or cessation of life for a time that what it wants as to sense is doubled in the consequents as threatning and endangering the life so that extremity of pain is not perceived here because sense decays as the cause of pain increaseth The Heart is molested and suffers pain these several ways by extension
constriction obstruction inflammation or intemperate heat Imposthumation by erosion by exotic generation 1. The Heart is pained by extension from a sudden ebullition and turgid fermentation of the blood raised by passion or otherwise whereby the Vessels are suddenly forced upon distension to receive and transmit the inundation and swelling current of the blood and from hence pain and trouble ariseth at the Heart 2. By constriction the Heart is pained and that from external and internal cause externally from the Pericardium compressing whereby the Heart is denied the full liberty of its Diastole or expansion and this may arise upon a double account either from the Pericardium being too replete and full or too much exhausted and empty You must understand therefore that this Pericardium or Capsula cordis is a Membrane designed by Nature to involve and inclose the Heart for its defence as also being a moist Bath to irrigate and keep it souple containing a Serum or water and this Membrane should extend and be enlarged according to the motions of the Heart being greater or less now when this water does abound filling the cavity of this inclosure the Heart thereby is prohibited its full expansion and è contrà when this water is too much wasted and dryed up the Pericardium cleaves to the Heart and impedes its pulsific motion thus either plenitude or vacuity begets anxiety and trouble at the Heart Internal cause of constriction is when the Heart it self is seized with a Tabes or vehement exsiccation and the fibres so contracted that it hath no capacity or less for dilatation and permission of the transient blood 3. Obstruction causeth pain and trouble at Heart when the free current of the blood is impeded from within due Vessels and this is procured sometimes from a perturbation of the movent spirits and sometimes from an indisposition of the impulsed blood First from a sudden and violent recurrence of Spirits from other parts and tumultuous confluence at the Heart whereby the circulation is checkt and the blood stopt in the Ventricles causing a suffocation for a time and this happens upon vehement passions and consternations of the mind Secondly From an inhability and incapacity of the blood being gross concreted or grumous that it hardly or with difficulty passeth through this Organ causing thereby an obtuse pain oppression or heaviness at the region of the Heart and sometimes a Lipothymy or Syncope fainting or swooning 4. By Inflammation or intemperate heat the Heart is pained as in most Feavers where intensness of heat is accompanied and this heat continuing does exsiccate and contract the heart and brings a Tabes or Consumption upon the whole Body 5. By Imposthumation the Heart is pained sometimes as also by other Tumors there bred Which by dissection hath appeared after death 6. By Erosion or Vlceration sometimes the Heart is pained and suffers by continual palpitation 7. By exotic Generations and strange productions the Heart sometimes is pained as when worms stones or bony substance is bred in the Parenchyma of ' the Heart which hath been found there upon dissection after death and to these diseases and such as most of the forementioned the Symptom of Palpitation does necessarily belong shewing the continual molestation and trouble the Heart lyes under who endeavors to acquit and extricate it self by laborious lofty and strong pulsations Pains in the Abdomen or lower Region of the Body NOW we have done with those pains incident to the middle Cavity namely the Thorax or Breast I come in the next place and by the order proposed to the lower Region called the Abdomen or Belly containing the Stomach Liver Spleen Kidneys c. And here first as the principal member we shall inquire into pains belonging to the Stomach or Ventricle being the great Office and Laboratory to prepare Aliment to supply and maintain the whole Body therefore if this part be pained and out of order all the rest must needs fare the worse for it every part having a concern from hence Pains of the Stomach are various both in respect of their causes and also from the different parts of the Ventricle where they do infest and those are three the upper Orifice called Os Ventriculi the lower Orifice called Pylorus and the whole cavity of the Stomach The upper Orifice or mouth of the Stomach is subject to great pain as being very tender and sensible in regard it is very nervous and this pain is the more eminent and remarkable for that commonly two principal parts are hereby affected and drawn into consent the Brain and the Heart the former by the Nerves of the sixth conjugation derived from the Brain whose ramifications are wreathing or twining about this Orifice and therefore from hence Head-aches Vertigoes and Epilepsies do often arise The Heart also is affected both in respect of vicinity as near adjoyning to this Orifice and also for that the same pair of Nerves doth serve both the Heart and Stomach whereby of necessity there must be a communication of pain and therefore it is that this pain in extremity causeth Fainting and Swooning and hence it is that this pain by a peculiar distinguishing title is called Cardialgia and also for that the ancient Greeks called the mouth of the stomach 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 As for the causes of this Cardialgia or stomach-pain sometimes they are sharp acrid and hot biting humors fluctuating and rising up to the Orifice of the stomach where they cause an eroding or gnawing pain and sometimes a scalding or heat there and this vulgarly is called the Heart burning Sometimes flatulency and wind causeth this pain by way of distension and a swelling fulness and the Orifice is constringed and shut up so as denying vent in this case the Patient labours and strains to belch but cannot unlock or loosen the Orifice of the stomach but so soon as the Orifice does slacken and give way the wind breaks forth and ease followeth Sometimes Worms do cause this pain having gotten up to the mouth of the Ventricle where they gnaw and bite Sometimes churlish and deleterious or ill prepared Physick or discordant food having such properties as may irritate and provoke this tender part or food received in too great a quantity above what the stomach is able to master and digest then it riseth up to the mouth of the stomach causing oppression and pain there until it be discharged upwards or downwards by the strength of Nature or the assistance of Art Besides this Cardialgia there is also another sort of pain that afflicts the mouth of the stomach and that is Singultus a Hicket or Hickop and although the whole Ventricle be molested therewith yet the chief pain or trouble is at the Orifice or mouth of the stomach This Hickop is a convulsive motion of the stomach thereby causing pain The general causes assigned by Hippocrates are two repletion and inanition under repletion is comprehended whatever humor or vapor is in the
they are various and may be ranked under these Heads 1. Obstruction of the Meatus felleus 2. Wind and flatulent Vapors 3. Acrid punging and sharp Humors 4. Indurated Excrements 5. Stones generated in the Colon. 6. Worms 7. Compression 8. Inflammation 9. Venenous and malignant Matter 10. Apostems and other Tumors By the first it appears that Obstruction in the Guts which produceth Colic pains does sometimes arise from an antecedent obstruction in another part as when the Meatus cysticus the passage of the Gall into the jejunum is stopt it causeth also a stoppage in the Guts for the Gall being naturally discharged into the Guts does stimulate them to expulsion and moves the excrements downwards but for want of this exciting and provoking matter the Guts fill up are obstructed and distended thereby raising pain Wind and flatulency begets Colic-pains sometimes and these are not fixed but roving here and there and commonly attended with a rumbling and noise in the belly and this is an effect of crudities and weak digestion rising from a natural debility or occasioned by intemperance and a bad diet And this flatus is either in the cavity of the Colon involved in a viscous tough flegm inclosed as in a Bladder or sometimes shut up within the Tunicles of the Intestine where forcing its way out does cause great pain in the part Sharpness of an humor indigested or degenerate does sometimes cause Colic pains and this is either a mordant biting Choler or an acid serosity Driness and hardness of Excrements do cause Colic-pains sometimes for as much as they stop the passage and extend the Intestines denying vent to any sudden fermenting humor wind c. that should freely pase away This costiveness and constipation is acquired by ill diet in the use of hot dry astrictives by watching or sleeping too much immoderate Venus by heating the body and sweating much through exercise labour intemperate Air c. These are great dryers and take off the lubricity of the Guts that they perform not their office as they ought thus excrements not being transmitted and sent away duly they accumulate fill up distend and obstruct the Intestines and give great occasion to Colic-pains Stones sometimes are generated in the Colon and do cause Colic-pains also a clot of worms gathered and twisted together obstructing the Guts have raised Colic pains Compression and contraction by Inflammations and Tumors in the Guts or parts adjacent do sometimes cause Colic pains Also malignant and venenate matter hath procured the like as Paulus Aegineta relates of a pestilential Colic that arose in Italy and afflicted many of the Roman Provinces Fluxes of the Belly HAving spoken something concerning pains of the Guts Iliac and Colic attended with astriction of the Belly and costiveness I shall briefly set forth those pains that are accompanied with a Flux or loosness There are three sorts of Fluxes of the Belly distinguished by several names Lientery Diarrhoea and Dysentery The first is a Flux of indigested or semidigested food passing away before its due time from an imbecillity of the digestive faculty But this not being dolorous or painful we shall pass it by as not our subjevt in hand The Diarrhoea is a flux of humors depraved and injurious which stimulates Nature to expulsion and is for the most part painful and irksom to bear 1. This kind of Flux is various in the matter of 2. Different in the efficient cause as some are of opinion 3. Unlike in the manner and circumstances 4. Various in respest of place as issuing from several parts of the body Touching the diversity of matter in this flux physicians have distinguished it into phlegmatic choleric melancholic and serous or watry which distinction is not simply manifest but a complication and mixture of many sorts whereof one may abound and be predominant yet the denomination and character of the whole is hard to be given The variety of depraved matter that happens in mans body is not to be reduced to four Heads nor three times so many for this stimulating matter thus sent forth by a Flux is the manifold different material cause of hundreds of diseases which preternatural variation of humors or juyces are not to be comprised within so narrow a compass nor reducible to four Cardinal points for admit there were four natural constituent humors in mans body as common doctrine teacheth yet these in their sundry variations and complicate degenerations would be so variously changed as not to retain any relict or smack of their original descent that a denomination from thence if possible to be distinctly given would no way answer in the similitude or nature thereof and consequently of no use in practice In respect of the efficient cause Authors have distinguished these Fluxes into critical and symptomatical by critical they understand when Nature in due time and with good success throws off and expels any peccant matter and finds relief by it in any case A symptomatical Flux they mean when Nature irritated untimely or immoderately is not benefited thereby but rather injured and endangered The 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 of this is true and it often falls out thus but the distinction of critical and symptomatical relating to the efficient cause and the reason thereof I do not assent to nor comply with since every Flux is symptomatical whether it produce good or evil for that which they call Critical and is seasonable and duly performed with good effects attending is but symptoma morbi the Symptom of some disease as well as the other so that the difference is in the nature of the disease afflicting the matter excreted or voided the fortitude of Nature the time where the way by which it ought or ought not to pass which does distinguish these Fluxes in their effects to be good or ill but shews no diversity in efficient causes which is one and the same for Nature is efficient whether irritated unseasonably and frustrated of her end or performing these endeavors in due time and to good purpose But although the efficient cause of Diarrhoea's be simple and single yet the occasional causes are many for these Fluxes are occasioned sometimes by change of air or place and variation of the seasons by some kind of meats or drinks taking cold or other casualties and accidents which puts Nature upon some disorderly fermentation and excretion and this commotion occasions and stirs up any morbific matter and noxious humors which before perhaps lay dormant and still now to grow turgid and active contributing to advance and promote the Flux begun but this managed by a discreet hand may not prove injurious but some advantage gained which if neglected and Nature not governed and guided in this prodigal expence much detriment may come thereby an exhaustion of nutritious Juyce with great debility and weakness As this Flux Diarrhoea is various in the matter discharged so likewise in the manner and circumstances as greater and more violent or
praep â„¥ ii vin alb lib. iv Diger sâ—…a in balneo Mariae per dies iv colat duleoret syr byzantin simp The aperitive Pills were these following R. Gum. ammonias acet scillit solut Ê’ ii myrrhae rub tart chalybeat anaÊ’ ss croci ℈ j. ol foenic. dulc chym gut viii succi cochlear q. s Fiat massa During which time from the beginning she was anointed with a Liniment all over her belly morning and evening The Liniment was this R. Ol. cappar unguent è succis aperit ana â„¥ j. Misce After this a Cataplasm was applied to the region of the Spleen every day for a week The Cataplasm was made thus R. Panis alb farin sem lini ana â„¥ iv farin hord â„¥ jss lactis vaccin lib. jss Coq ad exsiccationem adde mucilag rad althaeae foenugr ana â„¥ j. ol chamaem cappar ana â„¥ j. gum ammoniac acet scillit solut Ê’ iii. galban bdellii styracis liquid anaÊ’ ii crociÊ’ ss Misce f. Cataplasma After this the pain was gone and the Spleen began to be soft and yielding Then I appointed the former Apozem to be repeated which being taken the swelling of her belly was much gone down After this I caused a Fomentation to be applied morning and evening for some days and then ordered the Chalybeat Wine to be repeated The Fomentation was this R. Rad. bryon ireos nostr ana â„¥ iv rad cyclamin cucum agrest filicis mar ana â„¥ ii fol. lauri abrotan absinth menthae salviae hyssop ana M.ii. sem cymin foenugr ana â„¥ j. flor chamaemel melilot ana M.j. Coq in aq fabror lib. x. acet vin alb sub finem addit lib. ii ad tertiae partis consumpt pro Fotu After which one purging Potion was given and an Emplaster applied to the Spleen and then both the Spleen and Abdomen the whole belly as flat and soft as ever she was and perfectly cured and returned home All which was performed in the space of about seven weeks and two months after she conceived with child as I was informed by her relations and she stood firm in health long after Notwithstanding the success was very good and the Medicines well designed as such preparations will afford yet in the like cases I do not use the same now This in short and I could not rehearse the particulars so exactly being twenty years since but that I have the whole story with the several Medicines in writing now by me and this I have related to confirm what I asserted here before that a diseased Spleen may lay the foundation for and introduce a Dropsie and now I proceed on to set forth the causes of a pained Spleen which being rightly stated applications may more successfully be made in that complaint The most frequent and apparent Symptom that afflicts the Spleen is Pain and this doth arise and depend upon some of these several diseases Obstruction Tumor Inflammation Apostemation Compression Vlceration Obstruction in some of the Vessels of the Spleen is a frequent cause that produceth pain and this obstruction is procured from a feculency and grossness of blood which ariseth either from a natural debility of the Spleen not able to perform its office duly or occasioned by a melancholy disposition a studious sedentary inactive or a careful and afflicted life to which or singly an evil bad diet and irregular diaetetic customs may contribute or effect as more fully you may be informed in a late Tract of mine entituled The Preservation of Health and Prolongation of Life All which impedes the due fermentation and volatization of the blood in the Spleen from whence it becomes thick and foul and begets a stoppage or too slow a motion and fulness in those Vessels And whereas the office of the Spleen as before determined is to ferment anew spiritalize exalt and rarifie the thick indigested and melancholy blood sent thither for a farther elaboration and depuration it is most rational that this not being performed from some of the impediments aforesaid obstruction and stagnation there will be the consequent and the Patient from hence will feel a pain and heaviness about those parts But for a more promptness or aptness to these obstructions angustness and straitness of the Vessels so formed by Nature does render some persons more prone than others to obstruction and these splenetic pains And farther this obstruction does arise not always from the causes aforesaid but sometimes from a compression of other parts adjacent that may incommode and offend the Spleen or by contusion from a blow or fall or by an injurious dress and too strait lacing or girding as frequently amongst the female Sex These obstructions when continuing and contumacious are so aggravated and increased with additional influx that they form a Tumor this distension being perceptible by sight sometimes but always by seeling is to be adjudged and distinguished whether soft and flatuous or hard and scirrhous the former sooner yielding to means but the latter more difficult of cure Inflammation though rarely yet sometimes does affect the Spleen and this inflammation does arise from obstruction for the blood being stopt in its current and passage and upon some extraordinary causes being more hot and fiery does make a sudden ebullition and inflame causing great pain heat and extension and this pain is distinguished by pulsation and beating of the part having many Arteries This Inflammation not rightly applied unto by diligent and good means does make transition and passeth into Apostemation and sometimes terminates in a scirrhous Tumor but these two dangerous commutations are to be prevented with great care and industry therefore before the disease arrives to this height and when only pain or heaviness gives warning and tells you of a distempered Spleen it is then most seasonable and opportune to apply the means and then a little may prevent that which afterwards perhaps a great deal cannot cure And first the procuring causes if any there be apparent are to be avoided as a sedentary slothful life intemperance and gross feeding or unseasonable eating as late suppers immoderate study melancholy grief or care which introduce sometimes but always contribute to aggravate splenetic distempers and although a natural debility and infirm constitution of the Spleen may procure the effects aforesaid without other provocations yet most frequently they are so caused at least much heightned thereby and therefore for prevention as also for cure those injurious habits are to be abandoned and such a diaetetic course of life observed as may check this disposition of body as at large you may be directed in the fore-mentioned Book The preservation of Health and prolongation of Life c. For Pharmaceutic Remedies that are made publick I shall commend the aperitive Tincture of Mars Pil. Antihypochondriac Swelferi chalybeated Tartar Sal volatil Succini Spir. Veneris rightly prepared which prudently used pro re nata as the several cases require may prove advantageous Pains of the
pervious Caruncles or glandulous substances through which the Serum is strained and thus the water is transmitted by percolation The Vessels bringing into the Reins are the emulgent Arteries and these draw a Serum from the great Trunk of the Aorta Arteria and import it into the Kidneys the emulgent Veins from the Vena cava were thought by the Ancients to be for the same purpose but latter discoveries contradict it They also receive from the lacteal Veins the thinner and more watry part of the Chyle being an expedite and shorter way hence it is the Urine is pale or whitish when the Kidneys are not strong enough to give this milkie humor the urinary digestion or when drink is too plentifully poured in and forcing through before its due time therefore great Drinkers commonly piss a pale water There are also Nerves inserted into the Kidneys from a branch of the sixth pair which also serves the Ventricle hence it is that the Stomach is drawn into consent by loss of appetite nauseating and vomiting when the Kidneys are pained as in a fit of the Stone it is manifest By these Nerves the Kidneys do suffer not only a heaviness but sometimes very acute pains Vessels carrying the Vrine out of the Kidneys are the Vreters one belonging to each Kidney and they pass from hence down by the Loyns between the two Membranes of the Peritonaeum and are inserted into the Bladder to convey the Urine thither The length of these urinary ductures are about a span the cavity or hollow like a straw but capable of enlargement to the bigness of a finger as by a stone coming down though with extreme pain by reason they are membranous and nervous exquisitely sensible and therefore upon any obstruction are highly urged to expulsion especially by a solid sharp or rugged body as stone or gravel Hereby you may understand the office and use of these parts that is to drain the body from a superfluous saline and tartarous serosity and this ought daily and dully to be performed but this serosity is not all discharged this way by the Reins but some passeth off by insensible Transpiration and some by manifest Sweats but the greatest part by the Kidneys And from hence it appears that the Vrine is partly an excrement of the first digestion in respect of the aquosity drawn from the lacteal Juyce and partly of the second in respect of the Serum sanguinis exhausted from the blood by the emulgent Arteries And here you may observe that by a certain digestion or elaboration in the Kidneys these serosities are transmuted into Vrine and then carries an Odor or scent with it much different from what it was before and the like we may observe in other creatures that their urines have peculiar smells which argues a digestive transmutation But although Nature intends and endeavors this work constantly yet there are many casualties and impediments to disturb these parts and frustrate in some measure the designment of Nature the errors and failings herein we shall recite but those chiefly that are accompanied with or produce pain we shall discourse of with brevity The general and most frequent Symptoms that manifestly afflict or incommode the Reins are Pain and Weakness or Tenderness about those parts Diseases planted there from whence those pains or weakness do arise and depend are Intemperate Heat Imbecillity and a declining state Consumptive diminution and wasting Inflammations Scirrhous Tumors Angustness and Obstructions of the Cavities and Ductures Apertion of the Vessels Apostems Vlcers Some there are whose Pains are hot and molesting not by a natural constitution but acquired by time and evil customs or accidents happening to those parts and this begets a tenderness there and it is painful to lye on the Back The Vrine most frequently is hot or high-coloured sometimes sharp and then apt to make water often prone to Venery at least the constitution of those parts does dispose that way Causes introducing this distemper are too frequent use of Wine strong Drinks and hot Spices much Riding lying on the Back and soft Beds or too frequent Venery and for a correction of this distemper all these procurers and aggravators are sparingly to be used and some of them to be avoided and forborn But if this intemperate Heat depend upon any other disease seated there disturbing the office of the Kidneys and raising a preternatural heat then Remedies must be applied to that as the nature thereof does require which being removed this heat will allay and cease Imbecillity and weakness does sometimes affect the Reins and a decay in the performance of their office may be perceived and if this be not the consequent of some manifest disease debilitating and rendring them incapable then you must know that There is a natural Robor and fortitude implanted in every part by Nature whereby they execute their functions with integrity and constancy there is also an inequal distribution of this vigor and strength that some parts naturally are strong and durable in their stations others are not so firmly radicated in their principles but by time spontaneously fall off from their duties and decay much sooner than other parts of the body Hence it is that some though regularly living complain of this part others of that There are also occasions accidents and different manners of living which we call Diaetetic customs which as they are various do variously injure and decay this or that part of the body and cause it to decline sooner than the rest Imbecillity therefore of the Reins comes under some of these notions and hath its original from thence which when such a case present examination is to be made to which of these the case belongs and is to be ascribed Now that which I call Imbecillity or a decayed state is when the Reins do not make a due secretion or separation of the Serum from the blood and give it the urinary transmutation so that from hence the Vrine is but little and that not well digested the injurious consequents whereof are many for the blood remaining too much diluted and over-charged with the Serum or watry part which being distributed throughout the body and falling upon this or that part cause many Hydropic diseases and some of them mortal as examples hereof might be given The next considerable is Consumptive wasting diminution or lessening of the Kidneys not by ulceration but exsiccation proceeding from a hot and dry distemper of the Kidneys arriving to a colliquating Hectic or Tabes which by time begets a Consumption of the whole Body procured sometimes from a falacious temperament There is felt a heaviness and weakness about the Loins and the Kidneys do not perform their office aright Inflammation sometimes possesseth the Reins caused by pain of the stone gravel or otherwise by obstructions sometimes by a blow or fall also by an influx of blood or any foul corrupt matter transmuted thither and lodged there obstructing the passages and causing a suppression