about the joynts The cause of the gout Solution of Unity in the Gout from whence it happeneth Now this solution proceedeth not as Capivaccius wil have it only from a Compression of the sensible parts about the joynt caused by a preternatural repletion of the Ligaments with a Humor flowing thereto For why the Ligaments are most solid and most thick in so much that in the first place they themselves cannot admit of the Humors and the pain is oftentimes in the highest degree when there is scarcely any swelling appearing and indeed far greater then that it should possibly be caused by compression only This pain is therefore rather caused by the distention and twinging or pricking in the sensible and tender parts about the Joynt But now what the Cause of this distention Pulling and Pricking is cannot easily be explained by reason of the difference in Opinions among Physitians touching the same For some there are that teach us how that the Gout is generated only from a distemper others from a Winde a third sort only from a Humor and some of these will have this Humor to be flegm others Choler others Flegm with Choler others assert it to be Flegm mingled with blood others Crude and Watery blood others say that it is a whey and others there are that admit of all these Humors And indeed some affirm that this Humor floweth down from the Head others again from the internal parts others from the external parts between the Skul and the Skin some again wil have it to flow forth of the Veins and others by both these waies touching which we intend to discourse more at large below in the seventh Question But in brief The neerest causes of the gout that we may here in a word state the Controversie the immediate and neerest Cause of the Gout is a Humor partly distending the parts of a quick sense about the joynt and partly pricking and lancing them to wiâ— the serous or wheyish Humor and yet such as is not waterish but Salt and sharp and as the Chymists call it Tartarous bred in the sanguification in the Liver and in the Spleen and by Nature thrust forth by the Veins and Arteries into the parts about the joynt And indeed this Humor is altogether of a peculiar Nature and much different from these other Humors that breed an inflammation in other parts and it hath its original from the same kind of Aliment that Plants draw from the Earth For in all sorts of Earth there is somthing that is saltish and partaking of a Mineral Nature Which whether we call it the Salt of the Earth or else Tartar with the common sort of Chymists it matters not with me so that we agree in the thing it self And yet notwithstanding it seems not al one to me Whether the Salt of the Earth and Cartar differ whether we call it the Salt of the Earth or else Tartar For Salt is indeed a simple Body of its own kind but Tartar as it is in truth taken here generally in this place by the Chymists is a compound of Salt and Earth yea and of Sulphur likewise From whence also it is that there are constituted Differences of such like Earths and so there ariseth a diversity of the Humor breeding the Gout in divers Bodies and places And from either the abundance or scarcity of this Salt and the mixture of it with other Juyces there arise various differences of Earths so that some of them are dirty others muddy a third sort Clayish a fourth sandy and Crumbling a fifth Limye and in some Earths there is an abundance of that we call Marle in others Chalk and in others there is somthing else that aboundeth and in some Earths in the which likewise Bread Corn grows very plentifully there is so great a store of this Salt that even out of them there may be destilled a certain spirit that dissolveth Metals That Salt or Tartar is attracted from Plants together with their Aliment out of the Earth and hence it is derived into men unto whom those Plants serve for Meat and Drink and unless it be severed and separated in a Convenient manner it is at length mingled together with the blood and being altogether unfit for the nourishing of the Body it is in the end driven down and thrust into the joynts for those Causes that we shal anon declare unto you And this Salt Humor that causeth the Gout oftentimes cometh very neer unto the Nature of spirits as the Chymists call them such as are those of Wine and other Vegetables endued with a volatile Salt as also of Salt Vitriol Nitre and Aqua Fortis which although that they are thin Subtile and Resemble the Nature of Water yet notwithstanding they contain in them a most sharp and biting Salt And this Salt is contained as well in the Arteries as in the Veins from whence likewise it is that being most subtile it exciteth very extream intollerable and most acute pains For it is not requisite that those Humors should alwaies hurt the Body in a thick and gross manner but oftentimes they are made spiritual as we shal afterwards also in the Causes shew you touching Wine And many things there are that teach us the truth of this First of all the very vehemency and fiercenss of the pain it self which cannot possibly proceed from a Flegmatick or watry Humor or else from Blood distending the parts but from a very sharp Humor being oftentimes indeed but little in its quantity and bulk but yet in power very great and most efficacious And moreover it appeareth from this that at length there are generated in the Joynts certain hard knobs and knots out of which there is taken and goeth forth a matter like unto Lime such as also some certain Wines before they be wrackt and taken off their Lees do yield forth which happeneth not at all in other Tumors which are rather turned into Pus then any such matter as this and therefore it sufficiently sheweth that the Gout hath some other peculiar cause that the rest of the Tumors or swellings have not And Thirdly the Causes do argue and prove the same since that there is nothing that maketh more for the generation of the Gout then Wine which most of all aboundeth with such a Salt and Tartar as we mentioned before there being no plant as we shall also further shew you below that doth more attract that that is Salt Clayie and Limye in the Earth then the Vine it self although indeed other Plants likewise as Wheat and Barley do draw unto them the very same matter as the Vine doth but in nothing neer so great an abundance Yea and this matter is somtimes likewise contemed in the Water and from hence it is that now and then such as are Abstemious or that otherwise by reason of their poverty they drink no Wine but Water are yet troubled with the Gout and in some places we find that
even Beer is exceeding hurtful unto those that are subject unto the Gout whether this happen by Reason of the Corn there growing of which they make their Beer or from the Water they use for the same purpose And from hence it cometh to pass that the Gout in very many places is a Disease almost Epidemical And in those very places where the Gout is in a manner Epidemical as it is in many places of Moravia the inhabitants there besides the Gout are troubâ—ed likewise with the Stone Colick and that which ariseth from thence the Palâ—â— and contraction of the Members and likewise the Falling-sickness which affects all or most of them proceed not from the Watery Humor but also from that which is sharp and Salt And last of all even this teacheth us that this Humor is serous or wheyish that the Gout can by no means be drawn to a suppuration For the blood is easily turned into Pus and so are likewise the other Humors but as for the serous and Salt Humors this is the Nature of them that if they be altogether thin they are then wholly resolved or if they have any thing that is Tartarous and thick mingled with them they are then converted into hard knots and smal Stones that are brittle and crumbling This matter in regard that it cometh neerer unto the Nature of Minerals then of vegetables it cannot therefore by any means afford a good and fit Aliment unto the Body and so it ought either immediatly in the First or else in the Second Concoction to be expâ—lled which when it happeneth the Gout is not then generated And from hence it is that many Wine-bibbers and Gluttons are free from the Gout which therefore happeneth because that they have those their Bowels that are destined for Concoction very strong and vigorous so that they do exactly separate all whatsoever is Excrementitious in those Meats and Drinks that they take in and evacuate them by convenient waies But if this matter be not forthwith evacuated but be reteined stil in the Body it is then thrust forward hither and thither in the Body until it be at the length driven unto the Joynts And therefore without cause or ground it is as anon in the 5. Whether Choller Flegm or â—eleacholy c. be the cause of the gout Question we shall more at large shew you that by some Choler Flegm Melancholly and Blood are here accused For possibly it may be that in one Body this Humor may abound and in another that Humor may be in great abundance and may together flow unto the pained Joynt yet nevertheless that wheyish Humor which Nature desireth to expel forth and therefore thrusts it forward unto the Joynâ—s is the first Cause of the motion and then afterwards the pain likewise stirs up and causeth other humors to flow unto the place affected and therefore if the Body be Plethorical the blood but if Cacochymical then other Humors also are moved unto the place affected Mean while those very Humors are not the prime cause of the Gout and if they had been altogether without that salt and serous Humor it had never flown unto the joynts since that there are many that are Plethorick and Cacochymick who yet notwithstanding are not troubled with the Gout And therefore what Mercatus writeth is a truth to wit that although juyces or Humors may much abound in the Body and become very vitious they do not for this presently degenerate into the Articular affects and produce the Gout but that Humor which ought to produce the Gout as we have already said is serous Salt Sharp and Tartarous and hath a peculiar tendency unto the joynts And now What required unto every fluxion whereas unto every fluxion there is required the matter flowing the Term from which and the place whitherto it tendeth and the way by which and that we have now already spoken unto the matter the cause of the Gout it remaineth that we proceed to speak of the Term from whence or the place in which the matter is generated the way by which it floweth and the term unto which it tendeth or the part receiving And that we may first of all Treat of the part receiving that so we may afterwards Joyntly explain the Causes both internal and external in the first place the parts recipient are here the Joynts and those of the Feet especially from which the Gout Podagra hath its original as weaker then al the rest of the parts in regard that they are endued with a weaker heat consisting as they do of bones ligaments The part receiving the fluxion in the gout Cartilages Tendons Nerves and Membrans and are further distant from the Fountain of heat and are likewise greatly exposed unto the injuries of External Causes and are also much weakned by labor and frequent exercises and hereupon are rendered most apt and ready to receive the Humors that flow thereunto The weakness of the joynts how is concureth unto the Gout And yet notwithstanding the alone imbecillity of the joynts is not sufficient for the generating of the Gout but there is likewise altogether necessary the fluxion it self For as Galen hath it in his Sixth B. of the preservation of Health Chap. 13. they who Collect and Treasure up nothing within them that is superfluous in them these weak and infirm parts remain stil in safety Of which this is one most evident Argument that some have for many Months together been very weak and infirm in divers parts of their Body without any such pain as the Gout bringeth along with it whereas if weakness alone would cause it the infirm part should perpetually be troubled there being no Cessation at all of the Cause of its weakness and infirmity And now therefore because that it is not perpetually afflicted the Cause of its imbecillity being still continued we may conclude as a thing most manifest that there is something else intervening which is the Cause of the breeding of this affect and this most certainly is nothing else but that that is redundant either in quality or quantity And yet notwithstanding that the imbecillity of the parts is the necessary cause of the generating of the Gout as the most of the ablest Physitians do assert and determine is denied by Carolus Piso in his B. touching Diseases from the affluence of the serous Humor Consil â— of the Gout whilest he writeth that Physitians oftentimes trouble themselves to no purpose when they admonish us that there is a very special regard to be had unto the weakness of the recipient parts seeing that the Joynts do more easily and readily of their own accord receive and admit the hot Wheyish Humor then the rest of the Members this doth not saith he proceed from their imbecillity or from any distemper that is loosness or rarity but from the very Conformation it self and this not placed in the Cavity but rather in the Conjunction with the
of the heat the salt and Tartarous humor is then more heaped up and then after this the older they grow the more they are afflicted with it by reason of the weakness of the native heat and the imbecillity of the expulsive faculty For Men for the most part live not so temperatly as Women sustain greater Labors are more addicted to Venery and hurt thereby But Women on the contrary are more temperate and besides they have likewise their monthly Evacuations by and with which Nature is wont to thrust forth together with them all the vitious humors and so to expel them out of all parts of the Body Whereupon likewise it is that Hippocrates in the sixth of his Apborism Aphoris 29. writeth that Women are not troubled wâ—th the Gout until after their Courses fail and leave them But the truth is that it is not alwaies â—o that either Women or Men that are above or under the aforesand age aâ—e wholly â—ree them this Malady and albeit that Hippocrates in the 6. sect of his Aphorism Aphorisin 30. writeth that yong Men before the use of Women are not at all troubled with the 〈◊〉 and that it is a thing very rarely seen that Youths are herewith affected yet 〈…〉 its sometimes found so to be and that even these are troubled with it as we may likewate see many that are above fifty yeers old taken oftentimes with the Gout And I my self 〈◊〉 late saw a Learned Man that in the sixty second year of his age was 〈…〉 fits of the Gout Neither also are Eunuches although that Hippocrates in the Sixth Sect. of his Aphorism Aph. 28. doth except them alwaies wholly free from this Malady as we shal anon shew you further in the Nanth Question Chap. 3. Signs Diagnostick THe very Malady doth sufficiently appear of it self The Diagnostick signs of the gout and the sick persons complain of a pain about the Joynts in their Feet Hands Knees and other parts unto which there is afterward added a swelling a redness and for the most part a Feaver And indeed when the Gout begins first of all to invade a person it likely taketh him first in the great Toe of his Foot and that most commonly the left And so in all the other joynts the pain most of all consisteth and staieth in the place affected without spreading any further But in the Sciatica this pain is not felt only in the Joynt by the which the Head of the Thigh is inserted into the Hip but it is from hence by the Nerves and Membranes carried unto the very Buttocks by the way where the Nerves spring from the Loyns and the great bone by the Latin Physitians called the Os Sacrum or holy Bone and from thence the pain is also extended unto the Calf of the Leg and unto the Foot according to the guidance and conduct of the Nerve And in other Joynts also as lying outwardly there is wont manifestly to appear a swelling and redness and a great heat to be perceived but now in the Sciatick painful affect these things do not so plainly appear in regard the place affected lieth very deep and because that therein that place the top of the Skin hath not many Veins dispersed here and there in it In a word in the Gout that which most especially troubleth the sick person is the pain he feeleth and an impotency in his motion and upon this there follow watchings and restlesness a dejection of the Bodies strength and other Symptoms all which Lucian in his Tragopâ—dagra hath very elegantly described But now in reckoning up the signs by which the differences of the Causes and the different Humors may be discerned The signs of the Causes the most of Physitians are very long and prolix and they take much pains in reckoning up the signs of the Gout from the blood Choler Flegm and Black Choler or Melancholy But since that as we told you before those Humors cannot properly be said to excite the Gout but only that they are either stird up and down by that Humor that is the Cause of the Gout or that being attracted by the pain of the part affected they flow together thereunto We shall therefore in this regard here spare our selves the Labor further to treat of them But yet Nevertheless if for the better ordering of the Cure the knowledg of the affluent Humor seem to be altogether necessary and requisite it appeareth from the general discourse of an inflammation in which we have declared what a pure Phlegmone is and what signs it hath as also the signs of Oedematodes of Erisypelatodes and also of Schirrbodes what signs these have and indeed from the signs of the Humor predominant in the Body which we have elswhere explained and likewise from the qualities of the swelling and by the observing of those things that benefit or hurt the sick person it may easily be known what humor it is that floweth together with it And yet notwithstanding it is here acknowledged by the more learned and able Physitians even those who have asserted that the Gout proceedeth from divers humors that there is little heed to be given or regard to be had unto those signs that are taken from the Color heat or the like Accidents since that very many things occur which may be the Cause as of the Colour so likewise of the heat and coldness of the Member contrary unto the Nature of the peccant Matter For the humor as Guainerius saith that is the true and proper cause of the Gout abiding in the bottom of the Member doth not for the most part change the superficies of the said Member and so then the Color of the Member cannot afford us any sign or token at all but it may possibly so happen that a Humor abounding in the Body may by pain be stirred up and darwn unto the place affected and there it may cause a swelling and yet nevertheless it may not be the Cause of the Gout Chap. 4. Prognosticks I. THe Gout for the most part is a disease not Mortal Prognoslicks of the gout For albeit that the strength may be much impayred by pains and for want of rest insomuch that the sick persons may at length be forced to take their Beds yet this is not done but in a long time And we see that such as are troubled with the Gout do oftentimes live long and attain unto old age to wit for this Cause that Nature by certain intervals thrusteth forth unto the Joynts those vitious Humors from which other more dangerous Diseases might have been generated and so by this means freeth the principal parts from vitious Humors II. If yet notwithstanding there happen any dangerous inflammations or pernitious Feavers or that Nature fayl and lie under the burthen so that it can no longer expel the vitious Humors the Patients life may then be much endangered And if any such dangerous Symptom be Joyned together with the vehement pain of
and variety of opinions as we have somtimes already told you hath not been the least but indeed the greatest cause why so few of those troubled with the Gout have hitherto been cured thereof each Physitian here setting himself to oppose that as an enemy which he hath often to himself fancied so to be and in the mean time altogether negreeting that which is indeed the true enemy Why s◠few have 〈◊〉 Cured of the Gout And this evidently appeare 〈◊〉 the Consilia or advisings of Phyfitians one with the other which have likewise been in the behalf of persons of the greatest worth and quality in the must of which opinions being asked and resolves sent from one to the other the whole result of the business for the most part came to this that the Cure was chiefly to be directed to the head as the commanding Member and unto the Joynts as the recipient Member And so the authority of Fernelius alone a Physitian otherwise of great learning and experience hath drawn very many into the same error with him and kept them from searching after the truth and hath likewise caused that many sick of this grief have taken such Physick and several sorts of Medicaments that were very unfit and altogether improper for them We therefore leaving unto every man his Judgment and Opinion insisting upon those Fundamentals which we have above propounded will here briefly declare our Opinion as touching the way and Method of Curing the Disease we are now treating of Now the Cure so called in general consisteth in two things The Cure of the gout the former whereof is that the present Paroxysm whether Pain Swelling Impediment of the motion and all other things that are wont to be troublesom unto such as are afflicted with the Gout be taken away And the other is that a course be taken to prevent the return of the Paroxysm being once removed And in the first place indeed for the manner of Curing the Gout that is present there are three things especially which in the Paroxysm the Patient desireth a speedy removal of viz. the Pain Swelling and the Impediment of his motion And now seeing that all these three have their original from a preternatural Humor fallen into the joynt the total removing of the Paroxysm confisteth in this that the influx of the Humor be withstood and that the Humor already fallen in be taken away For that Humor being removed there followeth both a cessation of the Pain and a vanishing of the swelling and the motion of the part again returneth But yet nevertheless in regard that the pain doth oftentimes so extreamly excruciate and Torture the sick Person that he cannot well beat it until the Humor the Cause thereof be taken away the pain is therefore somtimes first of all to be moderated yea even before the Cause be wholly removed And so then the whole Cure of the Gout afflicting the sick Person consisteth in the taking away of the Cause and the mitigation of the pain As for the first of these seeing that the flux taketh its beginning from the motion and boyling as it were of the blood and Humors in the Veins that motion and boyling of the Humors is first of all to be stopt and the Humors that with violence rush unto the part affected are not only to be turned another way but they are also to be wholly evacuated and emptied forth out of the Body for unless this be done the pain wil be but the more exasperated And afterwards the humor that hath flown in is to be discussed and scattered And because that pain is the thing that chiefly grieveth the sick Person this is somtimes also to be mitigated even before the Cause be taken away And therefore if any Cause either external to wit the distemper of the Ambient Air or the thickness of the body shal have given the occasion it is forthwith to be removed yea and also to be corrected after a quite contrary manner Venesection And secondly Venesection If Blood abound in the Body which may be also so moved by the violent motion of the humor that it may as it were boyl and by the pain be attracted unto the part affected and so concur as a Joynt Cause of the Gout and may possibly likewise augment the Malady and that moreover a Feaver be threatned as neer at hand or else if it shal accompany it then in this case if the Patients strength wil bear it Blood-letting is to be instituted that so the afflux unto the part affected may be diminished and that that somenteth addeth sewel unto the approaching Feaver may be withdrawn and yet notwithstanding so that there be not too great a quantity of the Blood evacuated But if there shal be no danger at al threatned by the abounding of the Blood or that also a flegmatick humor aboundeth Venesection is in this case rather hurtful than any waies usesul and profitable in regard that then by the evacuation of the Blood the Spirits may be dissipated and the Native heat wasted whereupon the heat in the part affected may be so weakned that it may not be able to overcome the humors in the part affected and so easily to scatter them and hence it is that the Patients are longer ere they can recover their strength and health yea and somtimes also there are by this means hard knobs and knots generated in the Joynts And if all or most part of the Joynts be affected then the basilique Vein either in the right or left Arm is to be opened But if one only Joynt be affected then the opposite Vein is to be opened As for example if the Joynts in the right Arm be affected the Vein in the left Arm is to be opened and so on the contrary If the right Foot be troubled with this grief then the Vein of the right Arm is to be opened if the left Foot then the Vein in the Arm is to be opened on the same side For this is more commodious than to open the Vein in the Foot of the opposite side for by that former Venesection the fluent humors are drawn back whereas by this latter they are only derived unto some other part And the like is to be done if the pain be in the Hip. Venesection in the Arm in the Sciatica pain being premised for derivation a Vein may afterwards very fitly be opened in the Ham or neer unto the interior Anckle or also the exterior in the Vein there appearing which by reason of the great benefit it bringeth unto the sick Person if it be then and that in due time opened they cal the Ischiadick or Seratick Vein which and that very often alone cureth this Affect But yet for the most part it is opened in the pained Thigh although that Platerus writeth that upon the opening of a Vein also in the sound and unpained Thigh very great benefit hath followed thereupon and that all the pain
hath thereby been suddenly and unexpectedly taken away But in regard of the urgency of the Malady and that the Flux cometh very speedily therfore even forthwith if there be occasion Venesection is to be instituted and as much of the Blood as is needful if the strength of the Patient wil bear it to be taken forth at once opening of the Vein But if the Patients strength wil not bear nor allow of a more large evacuation of the Blood all at once then at several times and by intervals so much of the Blood is to be drawn forth as may answer unto the Bodies fulness thereof Cupping-glasses and Leeches Instead of this Venefection Cupping-glasses may also be applied which are wont to be affixed in the very first beginning of the Pains unto the sound opposite part with Scarification And so likewise Leeches applied in the accustomed places for the Hemorrhoids bring some kind of benefit unto the sick Person by their drawing forth the Blood Purgation These Revulsions by the Evacuation of the Blood being thus made Purgation purging is then next of all to be appointed unto the Patient touching which although there be some that think otherwise as we shal afterwards further shew you in the 11. Question yet for the most part it is very fitly and successfully administred But it is instantly to be ordained even in the very beginning of the pains or if occasion be when they are suspected as nigh at hand before such time as by the said pains as also by restlessness and want of sleep or by the augmentation of the Feaver the strength be too much impaired neither need we here to expect any Concoction or use any preparation before which most of the Physitians of former Agee were wont to do who first of all made use of Lenitives and then Secondly Preparatives or Digestives as they calthem for some certain daies and Lastly of Purgers that draw the humors from the Joynts For even then when the humors have already before been in their motion and are become thin and that Nature her self endeavoreth the separation of them as burthensome to her from the good Blood and that there is cause to fear left that as we said before ere ever any such things as these can be done and finished the humors may rush unto the Joynts and that by pain and want of rest the strength be too much dejected and that a Feaver following thereupon forbid a Purgation even then the Purgation is forthwith to be instituted And the exhibition of one only Purge doth for the most part less hurt and offend the stomack than those so often repeated digestive Potions which resolve and weaken the Stomack so that the Crudities being afterwards augmented there is caused a greater afflux of humors unto the Joynts Altering Medicaments Yet nevertheless Alterers if the humors be over-hot and sharp they may be attempered by Broths altered by Cichory Endive Sowthistle Purslane Sorrel and Medicaments made out of these neither are we to omit the administring of the Conserve of Roses with the species Diatrion santalon it being of singular use in the altering of the humors As Take Conserve of Roses three ounces Spec. Diatrion sant one dram Red Coral one scruple and with the Syrup of Pomegranates make an Electuary Or Take Margarites prepared one dram Red Coral prepared and all the Sanders of each one dram and half Red Roses one dram the Bone taken out of the Staggs heart one Scruple and make a Pouder Or else with Sugar dissolved in Rose Water make little Roâ—â—s But now as touching Purgation we are to advise you in these two things especially First that a fit time be made choyce of as we gave notice before and that the Purgation be not too long deferred For if dready the whol humor be flown in unto the Joynts it is easily called back And thereâ—â—â—s that the humor which is now ready to flow into the Joynts may be turned 〈◊〉 the â—elly and by it be evacuated presently in the very beginning of the Paroxysm 〈…〉 also so soon â—s ever we do but suspect it to be nigh at hand the Purgation is to be ocdaineâ— and adâ—â—isired for by this means the humor that is now flowing and that which was after tossâ—â— iâ— evacuated by convenient places and hindred that it rush not to the part affected and the encrease of the pain and swelling is hereby prevented and so that which hath already flown in unto the part affected is easily dissolved And experience it self testifieth that this kind of Cure hath profited very many And so Petrus Bayrus writeth of himself that he himvelf being by tour men carried to the Close Stool after that he had four times eased his Belly having before taken his own Caryocostin Electuary he was freed from all his pains and that he could then go without help from any other And then Secondly It is to be considered by what Medicaments the Purgation is to be inftituted and begun Some think that we ought to abftain from the stronger sort of Medicaments and to make use only of those that are more mild and gentle or of the stronger in the smallest quantity because that a strong purge may draw store of humors from the more ignoble and external parts unto the more noble and so it may somtimes happen that some of these sick Persons may by a vehement and strong Purge fall into burning Feavers as also Feavers Malignant and Mortal Which as we willingly grant and think that the humors that were hoâ— before are not by vehement Purgers to be more inflamed and that the motion of Nature is not altogether to be disturbed so also on the other hand we conceive that great care ought to be taken that the humors be not only stirred and moved up and down in the Veins and not wholly drawn forth and sufficiently evacuated Which when it happeneth they afterwards rush with a greater violence unto the part affected as unto the which they are withal attracted by the pain And therefore in the beginning of the Paroxysm or when it is nigh at hand we ought to make choyce of Medicaments that are somwhat stronger than ordinary and yet notwithstanding such as do no way offend the Stomack For as we said before if we make use of those that are too gentle and weak in their operation the humors are then only moved up and down in the Body and nothing worth speaking of is evacuated whereupon there is afterward a greater Conflux unto the part affected But now that during the purgation there may be no Conflux unto the part affected and that the Humor being moved by the Purgation may not rush unto the part affected this we ought carefully to prevent and it is done by placing the part affected in a higher place in the Bed until the Purgation shall be fully 〈◊〉 or which is the more sure and certain way by imposing a defensive Medicament after the administring of
of the Ancients in regard that there is here no worm that lieâ—h underneath The Westphalianâ— for the Cure hereof use as a peculiar Remedy Earth-worms of which see Wierus in the place alleadged But we shall add no more touching this affect in regard that it doth not properly apperrain unto Arthritis of which we are now treating And yet by the way I think it not fit to pass over in silence what I find mentioned in the Hâ—stories of those that were troubled with the Arthritis which Forestus bringeth in his 29. B. a nd so likewise in his 14. Observation where we find mention made of one Hugo Cornelius twenty eight years of Age who over wearied and tired out in the imployments of his Husbandry and very sleepy as he was laid himself down upon the Ground and there he slept for some certain hours at length awaking in his left hand about the wrist he felt an intollerable pain which at length seized his whole Arm insomuch that he was not able to move his Hand or so much as to stir his singers which were now grown stiff as it were and soon after he was troubled with the same pain about the Foot unto which was added likewise a very strong and violent Feaver Of all which not withstanding by purging and altering Medicaments and by the administring of Topicks he was cured in seven daies times or less Where he likewise maketh mention of another who very drunk as he was lying all night in his Garden upon the cold ground when he awoke was immediatly taken with a violent feaver and most intollerable pains of which in a very short time he died But as it seems to me those affects were not properly Arthritick but rather acute feavers contracted from Vapours exhaling out of the Earth which they both of them received by sleeping thereon in which feavers Nature thrust forth part of the vitious Humor unto the extream parts of the Body and so from this Humor there were not only pains excited in the Joynts but also in the whole Arm the Membranes of the Muscles being there affected and so great was the pravity of this Humor that it likewise snatcht away one of these two by a sudden Death Seeing therefore that neither a naked and bare distemper Whether a Humor and what kind of humor it is and whether al the four Humors may be the cause of Atthritis neither yet a windiness alone can be the cause of Arthritis most Physitians indeed therefore agree in this that it is some Humor that causeth the Arthritis but what kind of Humor this is herein they greatly differ Some of them think that all the four Humors to wit Blood Choler Flegm and Melancholly may be the cause of Arthritis and this they endeavour to make good more especially from hence that in Arthritis there appear many different colors of the swellings divers kinds of pains and various accidents the term of the declination not one and the same and a much different way and Method to be observed in the Cure according to the variety of the Causes To wit that I may use the very words of Petrus Salius Diversus in his sreatise of the Parts affected Chap. 16. in some the Colour is much inclining to be red in others yellow and in a third sort white The swelling is now and then of a considerable bigness and somtimes again it scarcely appeareth And as for the pain it is somtimes indeed very troublesom but yet not so but that it may well be born but then at other times according to the Humor the cause thereof it is most sharp and intollerable And then again this pain is somtimes soon gone and vanished but that continueth a long while But oftentimes also divers evil Symptoms do follow as an extraordinary great heat and burning in the place affected But somtimes again either there is present no heat at all or on the contrary there is a coldness that greatly troubleth the party some of these persons being offended by the Air when it is over hot and others by an Air too cool The way and course of Curing is somtimes also very varâ—ous because in some of these such Medicaments as heat are found to be most beneficial and in others those benesit most that cool the pains in those being the more enraged by things that are cold but in these they are heighthened by such things as are hot And then again some of these pains are appeased by the Evacuation of the Blood some by the purging forth of Flegm a third sort from the emptying forth of the Choler and the last kind of them by the Evacuation of Melancholly are very much mitigated and allaied All which seemeth to denote thus much unto us that the cause of the Arthritis is somtimes hot and now and then cold and somtimes the matter thereof very various and different But these Reasons do not sufficiently prove that which they ought For although that according to the various treasuring up of Humors divers kinds of Humors may flow unto the part affected yet these are not the prime and principal cause of the Arthritis but together with the Serum or Whey they are foreibly carryed unto the part affeâ—â—ed or else they are drawn thither by the pain And that that Humor which breedeth the swelling is not the principal Cause of Arthritis appeareth even from hence that in the beginning before the part swelleth the pain is most intense and violent but as the part by degrees swelleth up so the pain more and more remitteth Neither indeed is this opinion agreeable to the truth For many there are who although they be troubled with a Plethory and Cacochymy yet notwithstanding they are not at all taken and seized upon by the Arthritis Whether the bâ—ood may cause 〈…〉 〈◊〉 And in special as for what concerneth the Blood it doth not at any time any manner of way generate the Arthritis by its abundance For the blood is the Treasury of Nature and therefore although it doth abound yet nevertheless Nature doth not easily and upon all occasions expel it unto any part whatsoever but more especially those parts that are void of blood such as they are that are affeâ—â—ed in the Arthritis And then again if the blood should also happen to be driven forth thither seeing that it is milde and harmless it could not possibly stir up soâ—great and vehement pains which yet are alwaies present even in the beginning of the Arthritis before such time as the part begin to swel and grow red And iâ— the Arthritis were from the blood why should not the Tumor then be suppurated since that there is no Humor so easily brought to a suppuration and converted into Pus as is the Blood And as for Melancholly the Case is likewise very plain Whether Melancholly may be the cause of Aâ—thriâ—is and there are but few that will have this Humor to be the cause of
another change for now there were very few puâ—â—les seen and almost no pains or much gentler but many gumoleties and which seenâ—ed wonderful in al the shedding of the haire made men almost ridiculous some appearing without beard some without hair on their eyebrowes others with bald pates from which change Fracastorius had good hopes and did think that the old age of this disease was now entring and that ere long it would come to pass that it could not propigate it self by contagion because the matter grew dayly â—â—icker in which both fewer and weaker seminaries are produced but his hope did much deceive him and this disease last even in these times nay as some think 't is welâ—nigh worse than it was of old CHAP. III. Of the Nature of the Veneral Disease SInce then so great a Hodge-podge of diseases and Symptoms appear in this affect we must diligently enquire what the nature of it is of which divers Authors have their divers opinions and as Epiphanius Ferdinandus writes of this business in Hist Med. Hist 17. the Authors which have writ of this Disease although they amount to the number of eighty and perhaps more are al almost differing concerning the Essâ—â—ce of this Disease and every one defines it at his own pleasure for whenas this Disease was unknown to the Ancients nor described by them nor they had not The Veneral diseas is from an occult quality as is usually wont to be the opinions of the Ancients to insist upon every Modern using his own liberty hath proposed his own Opinion Truly I think this is not doubted that 't is a Contagious Malignant and Venenate Affect neither doth it seem to want any great pains to prove it for it appears sufficiently by this that in so smal a quantity of matter by which this Disease is contracted by contagion there is so great force and power of action as no first quality or the temperament made up of the first qualities can have and the variety of Diseases and Symptomes in this evill is so great that it cannot be reduced to any manifest cause therefore as in pestilent constitutions such as that Aâ—tick one was in Thucidides and that which Hippocrates hath described 3. Epid. there was so great a multitude of evils that they were forced to fly to occult qualities and a venenate cause so also there being so great a filth of diseases and symptomes in the Venerous Disease that the original of them all cannot be refer'd to any manifest quality here also we fly to a malignant and occult quality But although these things be thus yet Authors differ stil of this What it is whether that malignity consist only in the cause or whether there be also some malignant Disease present Capivaccius de Morb. Gal. Cap 1. thinks this affect not to be the Disease but the cause while he defines the Veneral Disease Capivaccius opinion that it is an excrement wholly preternatural abâ—e to hurt man many waies produced out of humane substance by its like Thus also Hercules Saxonia de lue Vener Cap. 1. writes Hercules Saxony that the Veneral Disease is the Cause not the Disease nor the Symptome therefore because it can exist our of mans body in Linnen or other such kind of vertues besides in the sweat Seed and Blood being seperated from the body but within mans Body it infects and possâ—sses also those parts which are not living and are not subject to Diseases viz the humors and spirits Aurelius Minadous de virulentia Vener holds that 't is neither the disease Aurelius Minadous nor the cause nor the symptom nor the disease for this cause cap. 17. because 't is neither a distemper nor evil Composition nor a solution of unity but he denies it to be the cause of the Disease Cap. 9 since that is properly the preternatural the cause between which and the Action there fals a medium viz. the disease whenas the disease is that which doth next of al hur the Action but the cause doth hurt it by intervention of the Disease but between the Veneral virulency and the action hurt he thinks there fals no medium but that of it self by its own strength doth promarily and immediately vitiate and hurt the operations but that the Veneral virulency doth of it self and primarily hurt the operations he thinks this is confest amâ—ngst Physitians and therefore deems it to be presupposed and unless this virulency did of it self and primarily hurt the operations so many Physiâ—ans would no have labored in searching out its nature He proves it is no Symptome Cap 18. beâ—â—â—e it is no action hurt nor quality changed nor excrement altered That it is no action hurt he proves by this because the veneral vituleâ—cy it selâ—â—is that which hurts the actions neither is it any quâ—lity changed because the qualities changed to follow the actions hurt and besides so many diseases are seen in this virulency which are not Symptomes But Aurelius Minadous himself when he had rejected aâ—â—ne opinions definitioâ—s of others at length he fiâ—s himself to make a perâ—ect definition and to explain the nature of this evil But first of al Chap. 16 he preâ—uppores this as the ground of his opinion viz that the French Disease ought not to be defined by a quality but rather by the name of a body for this reason because it passeth from one body to another which is the propriety of bodies not of qualities and because it toucheth other bodies for none but bodies can touch and be coughâ— again as Lucretius hath it Again if it were a quality it were either maniâ—est or occuâ—â— no manifest one as he proves rightly by many Arguments but that it is no occult quality he brings no special Argument but repeats the general one because 't is moved from place to place and toucheth other bodies This presupposed afterwards Chap. 30. he affirmes the Veneral virulency to be somwhat corporeal internal and truly a spirit or a vapor for this reason because 't is carried commuicated and participated in a very short space of time Yet he holds it to be such a vapor which is endewed with an occult quality and veâ—â—ue from its whol substance or the whol mode of its nature by reason of which quality it cannot only infect any humors of the body but also al parts of the body and corrupâ— them turn them to its own likeness but that this evil consists in a spiritual substance he further proves because some are infected not only by the act of Venery but also by a Kiss or the use of garments next of al because some have felt no other hurt from this evil than only the falling of their hair because the â—oots of the hairs were gnawed off by the acrid vapors Thirdly because some only by vehement exercise have discussed this virulency Yet he denies that vapor or spirit to be properly an excrement Chap. 20. whenas that is properly
do effect a Rose as fear frights anger and the bubo is extended towards the Thighs as it were by a red line and a little after the Erysipelas breaking forth it vanisheth but if the Bubo be Veneral 't is not extended according to the longitude of the Thigh but rather obliquely and imitates the situation of the spermatick Vessels For in unwholsome Copulation the seminal vessels are easily first of al infected which whenas they have their Original from the Vena Cava not far from the Liver it self that virulency is easily communicated to the Liver which being affected drives it back again by the same waies from it self from whence are caused both the Buboes and the running of the Reins And thus these two Diseases are for the most part complicated and being Joyned are a sure sign of the veneral Disease and one failing the other is of force but if this evil be contracted without whorish Copulation and if by kissing there are Ulcers raised about the mouth if by giving suck to an infected infant there are inflamations about the breasts pustles and clefts if from Garments and common lying together there are pustles every where raised in the Skin But if the evil do now increase The signs of this disease increasing and grow more grievous and the virulency it self be already communicated to the Liver and thence the nutrition in the whol body be depraved diseases and symptomes of al kinds such as were reckoned up before cap. 2. in the history of this disease do arise which indeed though singly by themselves they afford not a proper and inseparable signe of this disease yet if they be taken together and their peculiar condition be diligently considered they may clearly enough detect this evil For there is scarce another disease in which there is a concourse of al these nay there are many of them so proper to the Veneral disease that they are found in no other disease after that manner How the buboes which are seen in the beginning and sometimes in the increase of this disease may be distinguisht from other buboes was said even now theveneral pustles are some of them crusty others without a crust the crusty are chiefly the signs of this disease and sometimes they are eminent that in the head and forehead they resemble the horns of a Ram under which somtimes is contained matter Somtimes none and they appeare in the face head beard whol body but especially about the privities and hips And Fallopius writes that these kinds of Veneral tumors may be distinguished from those which are not Veneral after this manner That the Veneral if they be rubbed and the skin taken off three daies after they appear unchanged but benign pustles if they be rubbed are increased by the attraction of blood and that good and alimentary So the the tumors which are commonly called Gummesities it they be joined with a swelling or do firmly adhere to the parts void of flesh and the bones especially if they be in the head forehead in the fore part of the Leggs area most certain signe of the Veneral disease for the Veneral matter hath an eating virulency even in a crâ—â—s humor and joined with paine the like of which is nor in other tumots which do proceed from a thick matter But though 〈◊〉 do happen also in many other diseases yet if they rise chiesly in the yard and especially on the forâ—â—kin and about the â—ut and towards the end of the yard or also in the mâ—â—th 〈…〉 palate the 〈◊〉 or jawes and those to putrid and stinking and there was no inflamation of those parts precedent nor signs of the scurvy they are also signs of the Fâ—ench Disease also the falling of the hair causeth no light evidence of the disease for if after childhood no other disease foregoing which is wont to be accompanied with the shedding of the hair the hairs of the head and especially of the beard and eye-brows fal off and also there appear ulcerous pustles or a filthy Scab this is altogether a sure signe of the French Disease In like manner Chapps and clefts in the Palms of the hands and soles of the â—eeâ— if no other cause preceded are an undoubted sign of this evil so also those bunches somtimes low and broad somtimes somwhat long and those excrescencies which they cal ficus condy lomata and crusts if they appeare in the privy parts or about the Arse-hole do sutely enough discover this disease pains of the head although they happen in many other diseases yet if their bunchings out and gummoâ—â—â—es in the skin if there was a Gonorrhea and it be stopped if a bubo and it be vanishâ— those also are sure signs enough of this disease paines also in other parts may likewise discover this disease for if the paine be not in the very joints ouâ— in that part which is in the middle of the bones and neer to the Joints as upon the skin or upon the shoulder bone which is between the head and the joint of the elbow and they be most cruel and sharp and are exasperated towards the evening and night they are also sure signes of this disease There is familiar also with this disease such a distillation by which there is emptied by the mouth and note much flegm and watrish matter by which the parts through which they pass are exulcerated but in the first place the sure signe of this disease is that French Gonorrhea of which was spoken before Last of al this also is a sure signe of this disease if the aforementioned diseases and symptomes be not taken away or made more gentle by medicines that do work by manifest qualities applyed according to art but rather do grow worse but are mitigated by those proper and specifick remedies Last of al if this evil be inveterate diseases and symptomes of al kinds may happen callous fistulous and cancerous ulcers knobs in divers parts of the body Signs of an inveterate Pox. rottenness of the bones in the Leggs Armes especially in the Skul the bone of the Palate and Nose a Hectick Feaver Consumption Pthisick evil habit of the body Falling-sickness falling of their teeth Deafness Blindness Vidus Viduus lib. 2. de curat membrat cap. 18. reports that he saw at Barciconia a Spannish Souldier who by the French Pox suffered a rottenness of Skul and afterwards fel into an epilepsy that filth distilling from his rotten skul and pricking the membranes of his brain from which notwithstanding he was freed by cauterizing his Skul with a hot Iron and Forestus lib. 7. Observat 9. in schol relates of one infected with the French Pox though he seemed to be wel cured yet was afflicted with a long and continual paine of his head which could be cured by no remedies til at last his Skul being opened there was found under it upon the dura mater somwhat black like a wevil which worme when it was taken away that
seat of the Joynts stick fast in these more streight and narrow places where all the parts that end there are joyned together and infolded the one within the other whereas elswhere they might more freely be moved up and down and have room enough to disperse themselves hither and thither And indeed the truth is that now and then that Humor is also diffused into other parts and there is a certain Nameless Author who in the eighth Section of his B. of the Gout added unto the writings of the principal Physitians telleth us that these kind of fluxions do not only infest the Hands Feet and all the joynts but that it likewise maketh an impression upon the very Head upon the very Liver yea and somtimes upon the very Heart it self And Hieronymus Capivaccius also in his Consil collected from Scholtzius Consil 226. maketh mention of the Gout pain in the side by reason of which the sick person was constrained to lie upon his Back neither was he able to move his sides And a person of Honor once told me as I remember that a certain man afflicted with the Gout felt likewise very fore and grievous pains in his very Yard and it was related unto me by an Honorable Lady that a Kinswoman of hers being troubled with the Gout a certain Marl for so she called it and indeed not unfitly brake forth also in her Fore-Head so that it might have been even swept off like sand and grains of Salt But the truth is the Cause breeding the Gout if it be in great abundance it may likewise be diffused into other parts besides the joynts but yet notwithstanding it doth not breed the Gout any where else but in the joynts But now it may here in this place and that not without good cause be demanded how it comes to pass that those persons that are afflicted with the Gout do yet so seldom suffer any Convulsion but only a pain whenas yet the Nervous parts are here affected Why those who are troubled with the Gout do seldom suffer any convulsion The opinion of Erastus and indeed so twinged and pulled by the sharp Humor that there may seem to be great cause for the exciting of a Convulsion Thomas Erastus in his 4. Disputat against Paracelsus thinks this to be the Cause that the Humor that is poured forth about the Nerves is waterish and Flegmatick and therefore doth more loosen then extend them and if this be not the Cause he confesseth ingeniously that he is altogether ignorant of it and knoweth not what it is But yet we do not acknowledg this for the only true Cause neither is it indeed a truth that the Humor exciting the Gout is simply waterish and Flegmatick that rather looseneth then extendeth the parts as we shall hereafter prove and as it appeareth even by the pain it self which is most sharp and intollerable And therefore I conceive the cause hereof to be in the place affected to wit that not the very Nerves themselves as they are inserted into the parts destined unto motion v.z. The Muscles that serve thereunto are affected but rather the Membranes and the Membranous Ligaments which parts are not ordained for motion neither serve they thereunto and therefore although they suffer most grievous pains yet nevertheless they excite no Convulsive motion unless haply the Brain be drawn into consent like as we may plainly see the truth of this in the pains of the Teeth the Eyes the Pleura Membrane the Colon Intestine and the like pains in all which it is not the Nerves appointed for motion but rather the Membranes that are affected without any kind of Convulsion And the very same happeneth in the Gout in which the membranous parts that are about the Joynts and knit together the extremities of the Joynts are either distended or twinged and pulled by the Humors flowing thereunto There are some indeed who assert that the very Cavity or hollow space that is between the extremities of the Bones do receive the Humors that flow thereunto and that this space is the true subject of the Cause breeding the Gout But this is false as anon we shall shew you in the Third Question The Proxime or next Cause of the Gout pain as in other parts likewise is the solution of Continuity which is produced by the afflux of the sharp Humors into the Membranous parts about the Joynts either by distending them or else by their acrimony at once both pricking and pulling them Now those things that accompany this pain are First an impotency and weakness of the motion Symptoms of the gout and by the motion of the joynt the pain is irritated and augmented And then also a swelling and this for the most part with a redness and heat followeth upon it and is discerned more especially in the extream joynts and yet nevertheless there appeareth now and then only a moist and waterish swelling without any redness at al. In the Hip and Shoulder blade being fleshy places there scarcely appeareth any swelling at all externally but the Humor that hath flown thereunto lieth hid and covered by the flesh And there is also a Feaver a continued one that almost alwaies with a pain invadeth in the Arthritis or Gout in general and oftentimes also in the Gout of the Feet and Knees and the sick person is first of all taken with an extream Chilness and then presently a heat followeth upon it and this is the Cause that the sick persons are so vexed and troubled with thirst and that the pulse is changed and that the Urines become very red which oftentimes at the first beginning are waterish But now what kinde of Feaver this is that accompanieth the Gout in this many Authors differ as below in the fourth Question we shall shew you And somtimes there are likewise other Symptoms that follow upon the said pain and among the rest watchings restlessness and a Spasm If the Gout continue long and often afflict the sick party then at the length there are generated in the joynts hard knots and knobs from the more thick part of the serous or wheyish Humor that even of its own accord tendeth to a Coagulation or Clotting together and if the Skin be opened out there runneth a matter somtimes fluid and white and somtimes like unto Playster or white Lime and somtimes the matter is hard like unto gravelly stones that may be crumbled This Malady is likewise known to disperse it self among the common People the Cause being Generated from the general and common fault and vice either of the Air or of the ordinary diet in many places But now whether it may at any time happen by Reason of any defect of that kind of fruit we call Mulberries we shall further discuss this point anon in the fift Question Chap. 2. Of the Causes of the Gout THe Proxime or nighest Cause of this pain in the Gout is the Solution of Unity in the Membranous parts
hence appeareth that the Gout is not generated by the collection of humors that is not done but by degrees now a little and then a little And therefore the most learned Solenander writeth truly in his fourth Sect. Consil 24 The humor saith he which is by little and little collected by the vice and fault of the particle of Nourishing if at any time it could excite pain and hinder the Motion The long continuance of the Gout from whence it is yet notwithstanding there was never yet any Physitian that ever told us that it could excite the Disease we call the Gout But this notwithstanding in the mean time I deny not that in those who are scarcely ever wel in their Feet or other Joynts the imbecillity and weakness of the Joynts may possibly conduce very much unto the long lasting and continuation of the Malady For the part that is infirm and weak doth not rightly assimilate the Aliment unto it self but collecteth the excrements and thereupon it likewise the more easily receiveth the humors flowing unto it and the more difficultly scattereth them when they are gotten together Felix Platerus indeed maketh mention of a certain peculiar kind of Gout Peculiar kinds of the Gout such almost as we shal likewise make mention of a little below in the Sixth Question out of Erastus which is excited not by the matter that floweth from elsewhere but from the excrement that is heaped up together from the Blood about the Region of the Joynts the place affected being extreamly weakned from the many fluxions and there heaping together new excrements and causing a pain that is not very grievous or intollerable which produceth a moist and watry kind of swelling rather than any other and he asserts it for a most certain truth that those who are thus affected are very seldom or never free from the Gout and somtimes by reason of the affluence of the humor and somtimes again by the congestion and heâ—â—ing of it up from the one or the other of these Causes they alwaies carry about with them certain signs and tokens of the same and are continually suffering somthing or other by reason of it But the truth is this is no peculiar kind of the Gout and if so be that it differ from the Gout which we have described it is not then the Gout but rather a moist and watry swelling in the Feet And hence it is that Platerus himself confesseth that it very seldom or never first beginneth of it self but that it is wont to follow some other that was caused from affluxion To wit by pain and the long continued and frequent afflux of the humors the Joynts are so weakned that they cannot rightly concoct the Aliment that floweth unto them much less assimilate the same unto themselves and hence it is that there are many Excrements collected and these being heaped up do excite that moist and watry swelling without any grievous pain which swelling notwithstanding if the pain proper unto the Gout be not present with it is not properly the Gout But if the true Arthritis or Gout be joyned together with it the debilitated part cannot then without much difficulty and long time discuss and scatter the humor that hath flown unto it and hereupon it hapenneth that before one humor be dispersed which as Hippocrates writeth is seldom or never before the fortieth day another humor floweth unto it and so the sick Person may seem continually as it were to be afflicted with the Gout or likewise if the Afflux be but by short intervals he is in very deed perpetually troubled therewith But now From whence the Afflux proceedeth in what manner and from whence this afflux proceedeth here likewise Authors seem to differ much among themselves But if waving and laying aside Authority we heedfully attend and observe the thing it self and those things that are done about the sick person we shal easily perceive that this Afflux is by the Veins and Arteries For in such as are troubled with the Gout upon the very first approach of the Paroxysm the Vessels that tend unto the Hands and the Feet and are inserted into the extream Joynts are wont manifestly to swel And then again this Disease doth suddenly invade and the afflux is wont to be very sudden which cannot happen but only by the Veins and Arteries And moreover How and from whence the Afflux is in the Gout it easily passeth out of one place into another especially if cooling and repelling Medicaments be applied unto the part affected and that pain that but even now afflicted the Foot this Foot is no sooner freed therefrom but it presently beginneth to afflict the other Foot or the hand Or if Nature lie under the burden and be not able to expel those vitious Humors these sticking fast about the Bowels and especially about the Heart there are then excited streightnings of the Heart and faintings with swounding fits as I have oftentimes observed which cease not until that the vitious Humor be again driven out into another Joynt which motion of the humor cannot be but by the common Vessels And furthermore Feavers as wel continual as intermitting are somtimes terminated into the Gout which could not be unless the matter were in the Veins And lastly a Feaver is wont to happen and a change in the Pulse which sheweth that the Humor is contained in the Veins and Arteries And therefore seeing that this Humor the cause of the Gout is contained within the Veins and Arteries and out of them poured forth into the Joynts Where the Humor the cause of the gout is generated without doubt it must of necessity be generated in some Concoction of the Blood and indeed such a Concoction as out of which the Veins and Arteries receive that Humor which they contain and this we determine to be in the Liver and Spleen the Sanguification being there hurt in its own manner But now the Causes by reason of which this humor is generated are two For what causes it is generated The former whereof is somthing amiss in the Liver and Spleen and more especially the excessive heat and driness of those parts and then the other cause thereof this being indeed the chief and principal is such a kind of Aliment from Meats and Drink as maketh a continual supply of such a like Tartarous matter As for the first of these The Stomach may indeed likewise confer somwhat hereunto if in it the Chyle be not rightly elaborated and if that after this Concoction the Tartarous feces or dregs be not most of them instantly separated and hence it is also that al Physitians warn us in the preventing of the Gout to have a special regard unto the first Concoction and yet notwithstanding that hurt Concoction of the stomach doth not most immediately conduce unto the generating of the Gout but that there is a necessity that the Concoction in the Liver and Spleen should likewise
very Paroxysm it self touching this Hippocrates writeth in his sixth Sect. and 49. Aphoris They that are troubled saith he with the Disease of the Gout these may in fourty daies be cured of their fits by removing the inflammation provided that as Galen adds in his Comment The Physitian fail nothing in the Cure and that the Patients be obedient unto his prescriptions For seeing that the Humors in the Gout are dispersed by the Ligaments Membrans and Nerves and that these parts are more thick and more cold then the fleshy parts it is therefore no wonder at all that there is a longer time for the discussion of the Humor required in these parts then in the fleshy parts But yet this Aphorism is here only to be understood of the last and very utmost term seeing that experience testifieth that many have been Cured of the Gout within fewer then fourty daies For in some the fits of the Gout are more moderate and shorter and so may be made to cease in a shorter time but in others they are more sharp and of longer continuance and therefore require the longer time And some there are that refer the cause unto the Humors and those tel us for a truth that the Gout which proceedeth from Choler is shorter but that which is from Flegm of longer continuance But be it so indeed that somtimes the Blood somtimes Flegm and somtimes Choler may together and at once flow unto one and the same part yet nevertheless that very Salt Humor which is the next and most immediate cause of the Gout is somtimes thinner so that it may be the sooner and more easily discussed and somtimes it is more thick Unto which we may in the Second place add the strength or weakness of the part affected For the stronger the part is the more easily doth it discuss the Humor that hath flown unto it but the weaker it is the more slow it is in dissipating the said Humor and from hence it happeneth that those which first begin to be troubled with fits of the Gout have these fits shorter and in such as have been longer troubled with this Disease the Paroxysms are of so much the longer continuance unless they have the greater care of themselves For the ofther any member is afflicted with the Gout the weaker stil it groweth And Thirdly the lick persons themselves also do not observe one and the same course of Diet whereupon it is that such of them as observe an accurate and exact kind of Diet these are more easily freed and some of them do by the Errors of their Diet much prolong unto themselves their Paroxysms and give the Cause of a new fluxion XIV The more and the more frequent the Symptoms are that follow upon the Gout the harder is the Disease to be cured For somtimes by Reason of the most sharp and vebement pain the sick persons do unseasonably desire repelling and stupefying Medicaments which drive back the Humor that was flowing unto the Joynts unto the more noble parts and from hence it happeneth that the sick persons fall into the affects of the Heart by Reason of its being streightned into Faintings and Swounding sits or other mischievous Diseases yea and they may be cast into great peril of their lives and then the only hope they have of escape lieth in this to wit that the aforesaid Humors if it possibly may be be again driven back unto the joynts XV. Now there are four manner of waies to dissolve and cure the Gout Four ways of dissolving the Gout For first of all and more frequently the matter is resolved and indeed all of it so that there are not left so much as any footsteps thereof remayning or as for the most part nothing but the very signs and footsteps of it are left behind And Secondly but this is more rare the matter is changed into a substance very like unto Pus For a true and genuine Pus it is not but a certain Sanies or thin Ichorous Excrement sweateth back and Eateth its way through both the Flesh and the Skin But now why the Gout cometh so seldom unto a suppuration Why the Gout is so rarely suppurated is well worthy our consideration and enquity Some are of this Opinion that it is therefore because that the joynts are removed from the Fountain of heat and have not in them so much heat as is requisite for a suppuration But that this is not the true cause appeareth by this that sometimes there ariseth an inflammation in the ends of the Fingers which yet nevertheless cometh unto a suppuration And therefore a more true cause seemeth to be this to wit the Nature of this very Humor it self as being Salt and wheyish which is not to be changed into Pus but it is either inwardly dissipated or if any of it be left remaining it groweth and hardneth into knots and knobs The Third way and manner is when by Reason of the weakness of the place the matter sticking over long in the part affected is at length turned into a knot or knob And of such a Gout as this it is that Galen writeth in his 10. B. of the Composit of Medicam according to the place and 2. Chast after that the Calli are once produced saith he there is no further hope or expectation that the Joynt should ever exactly return unto its pristine Constitution And of this the Poet Tollere Nodosam nescit c. That Physick worketh rare effects ther 's none can doubt And yet it knows not how to Cure the knotty Gout The Fourth manner is when the Humor is transferred and carried unto some other place and as it somtimes happeneth unto the more noble Members to wit the Lungs the Heart the Brain and this of all other the changes is the worst and by reason whereof the sick persons die unless the matter be drawn back again unto the joynts and somtimes the Humor is translated unto the more Ignoble parts as the varices according to what we said before in the 11. Prognost and somtimes it is evacuated quite out of the Body and as Rhases tels us it is oftentimes carried unto the Intestines and there it exciteth a flux of the Belly and excoriateth the said Intestines and this flux continueth somtimes all the life after and the strength by degrees and by little and little failing by reason of Feavers and pains the sick persons after long wasting and consuming by Marasms at length they die Chap. 5. The Indications and Cure SInce that the perfect Cure of preternatural affects doth chiefly consist in the taking away of the Causes The indicationâ— Cure of the Gout and that the Authors as we told you before differ among themselves as touching the Causes of the Gout it is therefore no wonder that there is to great a discord among them about the Cure some propounding one way and some another for the Curing of this Disease Which difference
which there had been boyled the Root of the greater Dock which having drunk up when he could not be cured by any other remedies of the Physitians he made a great deal of white Water his Urine being like Milk and so was freed from all his pains Or Take Sarsaparilla one ounce Sassafras Wood half an ounce the Root of the Clove Tree one ounce Citrine Saunders two drams Infuse all in three pints of Water for twenty four hours and afterward boyl the same and give of this Decoction one draught in the morning either alone or else with Harts horn Topicks The Body being thus in a due manner evacuated Topicks and the Antecedent cause that would have augmented the Disease being once taken away we then come to the very moderating of the pain and the taking away of the Conteining Cause of the pain and swelling and so unto the Topicks But if Topicks shall presently be administred before those Universal and General Remedies shall have been first made use of the Patient shall receive from thence far more hurt then benefit For either the matter which Nature endeavoureth to thrust forth to the Joynts is driven back unto the more inward parts from whence very grievous Symptoms are excited or else it is impacted into the Joynts and so the pain is exasperated or else the part is effeminated and made weak and loosened and so the flux is increased Which being not commonly taken notice of and Topicks being oftentimes most unseasonably and without any caution at al administred the sick persons do for the most part receive more hurt then good from them and from hence it was that the common and received opinion had its first original to wit that the best course is to administer nothing at al unto the pained Joynts And the truth is that it is fir becter to apply nothing call but to commit the whole business to Nature then to make use of such Medicaments as are altogether unfit and improper Now the Topicks that are applied they respect either the pain only or else withall the Cause of the pain to wit the Humor that now and formerly hath flown in exciting both a pain and a swelling Mitigaters of Pain The Pain in this Disease for the most part is a most grievous Symptom Mitigaters of Pain and which is most troublesom to the sick parties and which they most of all Curse and Bann as Lucian hath it in the beginning almost of his Tragopodagra and therefore also it is that they most of all desire the removal thereof And indeed it is altogether necessary that the Physitian should have regard thereunto because that if it be too great it causeth a restlessness dejecteth the strength and by attracting the Humors it augmenteth the Malady and so deservedly draweth our care unto it for its removal as Gaien in the 12. of his Method C. 1. and thereupon it sheweth and pointeth us unto the asswaging thereof by Anodynes Now Anodynes or Mitigaters of pain have likewise this Good and benefit going along with them to wit that by loosning the parts they make that the Humor that before flowed only unto the interiour parts about the Joynts comes now also to flow and be diffused unto the Ambient and fleshy parts And hence it is that the pains in the Gout before the swelling of the part are most Vehement and Intollerable and that so soon as the part affected beings to swel they are much Mitigated But now these Anodynes of what kind they are we have told you elswhere in our Institutions to wit such as mollifie and loosen the part affected and yet do not discuss the very Cause it self And here they may be provided of Goats Milk newly drawn out of their Dugs as also white bread and Milk together with the Yelks of Eggs and a little Saffron as likewise of the Leaves of Marsh-Mallows Mallows Colewort or Cabbage laid upon the place affected as hot as the Patient can wel endure them as also of Mallow Seeds Seeds of Marsh-Mallows Quinces Fleabane and especially the Mucillages of them Cassia newly drawn out of the Pipe with the Decoction or Water of Nightshade which as Avicen tels us is the best Remedy that can be unto which if there flow any hot Humors thereunto we may add some of the Oyl of Roses or Rose water but if the flowing Humors be cold then we are to add thereto the Oyl of Camomil and instead of Cassa out of the Pipe we may likewise make use of the Rob of the Elder Tree of white bread and Wine and indeed if the Humor be more hot red Wane but if cold or betwixt both then white Wine with the pouder of Camomile flowers and Oyl of Roses of Cheese new made of sheeps Milk and imposed upon the pained part and often changed of fresh-made Ox or Cow dung in the first beginning of the Spring as also the Water that is distilled out of it Amost useful Remedy also is the Mucillage of Fleabane Seed extracted with the Water of Roses or Night shade unto which somtimes a little Vinegar may be added and this Medicament is by Serapton and others very much commended In the very first beginning of the Disease Solenander taketh the thick stalks of Hendock and sils them with Salt and then stoppeth them with Clay or Paste and puts them in a moist place that the Salt may dissolve which liquor he keeps in a glass and with Clothes applieth it unto the pained part And he oftentimes also made use of this Cataplasm Take Mallows the whole Herb Root and all cut it into very smal pieces and boyl it in equal parts of Wine and Vinegar in a new Earthen Vessel until a third part be wasted away and then mingle therewith the thicker Bran of Rye as much as will suffice for the making of a Cataplasm and apply this hot unto the grieved part Forrestus relateth that he knew one that added hereunto a little Barly flower and that of the Water Lentile boyled in Milk with Camomile flowers and so reducing them into the form of a Cataplasm he put them upon the part affected with miraculous success as one could judg no other of it And here also very useful is the Yelk of an Egg reduced into the form of a Liniment with the Oyl of Violets and so is also the Water of the Sperm or seed of Frogs which perhaps have in them some kind of Narcotick quality Adrianus Spigelius writes that among the Moravians there is in use a very notable Remedy and noble experiment for the speedy cuting of the Gout-pains to wit the Water of Meadow Sweet distilled with its Roots and Flowers and this water is likewise in frequent use among the Silefians And it is also very convenient to foment the part affected with the Decoction of Parietary or Pellitory of the Wall And very many there be likewise that make use of Oyls and Fat 's But here we are to give you
Oxycrate then add the Yelks of two Eggs Saffron one scruple and mingle them Or Take Mucillage of the Seed of Fleabane extracted with Rose Water two ounces Mucillage of Marsh Mallow Seeds one ounce Barly Meal as much as will suffice the yelk of one Egge and so make a Cataplasm Or Take The water of the Sperm of Frogs four ounces Water of Nightshade of the flowers of Elder and of Plantane of each two ounces Camphire half a scruple and mingle them well together If you think fit the Mucillage of the Seed of Fleabane and of Quinces of each one ounce may be added Or Take Juyce of Henbane Sengreen Lettice of each two ounces Barly Meal one ounce the Yelk of one Egg and Oyl of Roses two ounces Mingle them well together Or Take Red Roses â—ne handful the Meal of Fenugreek Seed Beans and Barly of each one ounce Red Sanders one dram and half Camomile flowers one pugil when they are boyled and throughly bruised you are to add the Yelks of two Eggs Vinegar four ounces Oyl of Roses as much as will suffice and make a Cataplasm Or. Take Water of Night-shade of Plantane of the Sperm of Frogs of each two ounces Oyl of Roses and Camomile of each one ounce Cows Milk three ounces the Meal of Beans Marsh-Mallows and Barly of each one ounce or as much as will suffice Saffron one scruple the yelks of two Eggs Smallage two scruples Make a Cataplasm Some there are that steep Harts-born burnt and prepared in the Water of Mulleyn flowers or else they boyl it in the same Water and in the streyning they wet and soak Linen Clothes and these they lay upon the part that is pained Or Take Mulleyn new and fresh gathered six pound Wine one Quart Let them be Macerated for three whole daies and then afterwards let them be destilled Or Take The Flowers of Mulleyn and fill a Glass bâ—ttle ful of them and then stopping the month thereof very close set it in the Sun for so they dissolve as it were into a liquor wherein you are to wet a Linen Cloath and lay it upon the part affected for the asswaging of the pain If you judget sitter to make use of Oyls Then Take Frogs five of them in Number Earth-worms washed in Wine three ounces boyl them in the Oyl of Roses and strain them Discussing Medicaments But now when the force and violence of the fluxion is once past and gone Discussives and the part become swoln then those things are withall to be mingled which do cal forth the Humor and gently discuss the same and so take away some part of the Cause But now here Physitiaus are wont for the most part of them to be very long and Tedious in reckoning up and distinguishing the several Medicaments which of them are fit and proper in a hot Cause and which of them when the Cause is cold yea and which of them are most convenient for all kind of Humors But although we deny not but that we are in some kind of manner to have respect unto the Condition of the Humor that floweth in unto the Joynts yet nevertheless our chief and main Care ought to be that the ferous and sharp wheyish Humor which is the nighest and most principal Cause of the pain may be called forth of the more deep and close parts in the Joynts unto the external parts and that they be insensibly discussed and yet that this may the more conveniently be so done we may likewise as we said but now have some regard unto those Humors that the aforesaid serous and sharp Humor forcibly draweth along with it and which by Reason of the pain are together attracted to the part that is pained and which are very commonly taken for the highest and most immediate Cause of the Gout Yea and moreover that very serous Humor it self the prime and principal Cause of this Evil is in some more and in others less hot And therefore if the flowing Humor be more hot then the discussing Medicaments ought to be so ordered that they may indeed gently disperse the Humor but yet so that they give no occasion at all for any new afflux And such a like hot Humor inregard that it is withall moveable and thin is easily discussed neither needeth it any stronger Medicaments But if the Humor be less hot or somwhat cold then we may very safely administer Medicaments that are more hot Neither will there be any Cause to fear that then a new flux may easily be excited and therefore for the dispersing of such a like Humor there are necessarily required such Medicaments as are more hot then ordinary But now with what Medicaments that wheyish and as it is so called by the Chymists Tartarous Humore is to be drawn forth and discussed we are here and that for very good Reason diligently to make inquiry For we have elswhere told you viz. in our Tract of Chymic Confil. Diss Chap. 15. that the Medicaments ought in their own kind to be like unto the Cause For there is not any thing that suffereth from every thing neither is there any thing that may be united unto every thing Gum Arabick and Tragacanth and the Gum of Cherry Trees are dissolved by Water because of the neer alliance and agreement in their Natures but but so is not Sulphur and other things of a Sulphurous Nature and those things that are Oyly Sulphur is dissolved by Oyl but not by Aqua Fortis although the said Water is able to dissolve silver and other Metals The hands when they are all foul with Pitch or Turpentine are not to be made clean with Water but with Oyl or some thing else that is fat In burnings we use not to administer cold Water but Linseed Oyl Vernish and the like that may draw forth that fire and burning are to be applied And so in the Erysipelas or other wise called Rosa we ought not to impose those things that are fat and Oyly but ley tempered with Oyl and Sope that is dissolved in Elder Water and the Like which do not at al shut the pores but yet nevertheless they draw forth and discuss that subtile and hot Humor And the very same is the case in the Gout and since that it hath its Original not from a Watery Humor neither yet also from that which is Oyly or Sulphurous as the Chymists speak but from a Humor that is sharp and Salt for the drawing forth and dissipating of this Humor those things that contain in them a volatile and flitting Salt are rather to be administred then those things that are fat and Oyly And experience hath already taught many that the Gout pains are increased by such things as are fat And hence it is that the Chymists do so much commend and not without cause Salt Armoniack oftentimes sublimated dissolved in Wine or some other convenient liquor and so imposed upon the pained part Others commend the Salt of Urine
then indeed the grief and trouble being derived unto the very bladder produceth a difficulty of making Water and then most especially it is that the whole Leg from the Hips even unto the very Heel suffereth Pain Fernelius in his Sixth B. of the Diseas of the parts and the Symptoms Chap. 18. saith that the Ischias or Sciatick pain being absolutely the most vehement of all the rest hath not its seat in that Joynt by which the head of the Thigh is inserted and fastened into the Hip but deeper at the utmost of the Buttocks by which the Nerves that proceed from the Loyns and the great bone called Os Sacrum or the holy bone are carried into the Thighs the great and terrible pain is not in the Hip alone but it is likewise extended into the Thigh and into the Calve of the Leg and unto the extream part of the Foot to wit whithersoever that branch that is derived from the Hip affected reacheth and extendeth it self But some other as Platerus attribute the Sciatick pain unto the Joynt with the Thigh But here we are to understand that about the Hip as also now and then in the shoulder there happeneth somtimes a pain which is indeed very often most vehement and yet nevertheless it is not properly a pain of the Joynts in regard that it is not in any Joynt because it seizeth upon the Membrane of the Muscles neither again doth it consist alwaies in one and the same place but for the most part descendeth downward unto the inferior parts And such almost is that Ischiadick pain that Aetius hath described out of Archigenes And I grant that this pain hath its original from the Serous and sharp Humor that floweth from the Head under the Skin and sticking about some Membrane or some Nerve but now that this pain is not properly the Gout appeareth from hence First because it consisteth not alwaies about the Joynts but also in the middle spaces within the Joynts And so I have here Cured a person of honor that suffered such a pain in the very Muscles themselves that are between the Knees and the Hip. And the like pains often happen in the Breast and there excite a certain bastard Pleurisie And then Secondly because that they very rarely return by intervals and constantly at some certain times but often after they have afflicted a man once or twice they return no more afterwards all the whole life long Thirdly because those that suffer these pains are not afflicted with the Gout in any other parts which happeneth in the true Gout and that is properly so called For those that are long troubled with the Gout are very seldom afflicted with the Gout in the Feet alone but they afterwards suffer pains likewise in their Hands and their other Joynts And Lastly likewise the true Gout for the most part if not alwaies hath a Tumor or swelling Joyned with it but now these pains have no such swelling Joyned with them not only when they are in a deep place but also when they are in a place that is not deep as it often happeneth in the shoulder and this cometh to pass for this Cause to wit that the Humor floweth not out of those Veins by which that part is nourished as in the true Gout But we intend not here to treat of that pain but only of that which is properly the Arthritick or Gout pain But now that Ischiadick or Sciatick pain hath this proper unto it that it is diffused more abroad then in the other Joynts and oftentimes unto the places that lie next and this happeneth first of all because that the Hip bone is large from whence it is that we distinguish it by three names and when it is knit unto the sides of the Or Sacrum we then cal it the Ileum bone when unto the hollow part of the said bone we then call it Ischium and when it is Joyned with the forepart we then call it Os Pâ—bis or the share bone And then Secondly because that the Nerves that come from the Loyns and the Os Sacrum to that Articulation are distributed into divers parts and therefore the pain of the Hip doth somtimes diffuse it self into all places and reacheth even unto the Nerves that are derived from the Hip. But now this Malady is very difficult to be cured by Reason of the deepness and largness of the place and the abundance of the matter which the wide Place receiveth They who being infested by a long continued pain of their Hips have the Hip-bone fallen out of its place and again returning into its place these have a filthiness and nastiness following thereupon in the fixth Section and 59. Aphorism For if by the Humor flowing in the Ligaments be relaxed the Hip falleth out of its place and the Humor that is gotten into its Cavity is made dul and thick yea and oftentimes it groweth there into a stony hardness whereupon because the Veins and Arteries are moved out of their proper places and are pressed down together thence it is that an Atrophy followeth in the Legs And if this Ischiadick pain invade any one in the time of youth it threateneth the shortning of the life because that by pain and hunger the sick person wasteth and withereth away and from hence likewise the Ischiadick Consumption hath taken its Name As concerning the â—ure for Revuision the Basilick Vein in the same side is most fitly opened but the Ischiadick if it be for derivation And indeed if the pain extend it self more externally that Vein that is in the outward Ankle or the Saphena which is at the inward Ankle if the pain tend more inwardly And Hippocrates likewise 6. Epid. Sect. 5. Text 21. writeth that when there are Kedmaâ—a present by which Galen and others understand the fluxions into the Hip then the Veâ—ns behind the Ears are to be scarifyed But yet these think not that this precept of Hippocrates is true or that it ought to be followed But yet nevertheless Sceggbâ—us defendeth Hippocrates and thinks that he did upon very good ground propound that which without doubt he had observed by experience For seeing that the Cause of the evil destilleth into the Hip by the hole of the Nook or Fernelius his way for the taking away the very Fountain and source of the Malady he rightly determineth that the Remedy must be administred about the Ears But if all this should be granted yet nevertheless those Redmata are not the Ischiadick pains properly so called which belong unto the Gout but those of which we made mention before The stronger kind of Purgations have here their place and here the Caryocostine Electuary is of singular use as also the Arthritick Pills Pill Faetidae and the Pills of Hermodactyls Crato indeed in his 247. Consil writeth that the Ischiadick or Sciatick pains will not admit of nor bear purges in regard that the Humors have seated themselves more in those places but this is to
and twinge them And thirdly although the pain be more excited while the joynt is moved yet this happeneth not therefore because that the humor is contained in the very joynt for as we told you but even now this is void of sense but because the Membranous parts about the joynt being before preternaturally distended by the humor are now more stretched forth Neither lastly doth that prove that the humor doth first of al fal forth into the space of the joynt because that the pain when the Disease first seizeth the party is perceived to lie deep before the external parts swel up which when it happeneth the pain is mitigated It is true indeed that these things do often so come to pass and that in the beginning there is very little or no swelling appearing and that yet in the mean time the pain rageth in the top of the part affected and there becometh most grievous which is afterwards asswaged when the external parts swel up But this doth not therefore happen because that the humor falleth into the very Cavity of the Joynt and from hence maketh it self a way unto the exterual parts the extream parts of the Bones being as we said before altogether destitute of sense but it happeneâ—h from hence that the whol vitions humor doth first of all by the extremities of the Vessels flow unto the Nervous and Membranous parts about the Joynts and greatly afflict them but afterwards when part of the humor is likewise distributed into the fleshy parts the pain becometh more mild and moderate when the humor is distributed into many places it doth then act less powerfully and those parts are made more loose and so are distended with less pain than otherwise like as we see the very same to be in the pain of the Teeth which at first is very great and intollerable when all the humor floweth into the Teeth and these Nerves inserted into them but afterwards when part of this humor is distributed into the Jaw lying neer as likewise the Gums then the pain is mitigated But yet in the mean time as we said before we deny not this that at length also even some of the matter may possibly sweat through into the very Cavity of the Joynt if the afflux continue long Neither do the two last Aphorisms of Hippocrates make at all against our Opinion where in the sixth Section he thus writeth Those saith he that have been long conflicting with the pain of the Hips if in these the top of the Thigh fall out of the Hip-Bone and then return and fall in again these have in that place a Mucous and snotty flegm collected And again they that by being vexed with a long continued Sciatica pain have the top of their Thigh fallen out of the Hip in these the Thigh wasteth away and unless they be burnt they halt and become lame For that Joynt doth not therefore fall forth because that the Bone is thrust out of its place by the humor fallen into the Cavity but as Galen in his Comm. upon the Aphorisms teacheth us because the bonds of the Articulation being soaked and moistened by the flegmatick humor are thereby rendred more loose But now what those parts are about the Joynt that receive and entertain the humor that floweth unto them neither do they al fully agree in their Opinions as touching this Capivaccius and some others with him determine that this afflux is made only unto the Ligaments and that in the Arthritis the Ligaments are filled ful but not so the Nerves and Tendons since that if these parts were filled there would then be Convulsions for these parts come to be affected only by the consent of the Ligaments whiles that they are pressed together by these Ligaments being filled with the humor But the Ligaments are so hard and solid that it is not credible that these especially should receive the humor flowing unto them and be replenished thereby And the pain is not therefore excited because that only the Nervous and Membranous parts are pressed together by the Ligaments preternaturally filled with the humor For if this were the Cause the pain could not possibly be so fierce and bitter but because that a sharp and gnawing humor doth prick and twinge the tender and sensible parts For as in other parts the Membranous Periostia and Nerves are the subject of the paâ—â— so likewise in the Arthritis they contain the nighest and most immediate Cause of the said pain But now that there is no Convulsion excited we have already shewn you the reason thereof above to wit because that the parts that are by Nature assigned for motion are not affected but such only as are appointed for sense as the Membranes or the Nerves likewise themselves such of them as are not destined unto motion according to the Membranes Quest 4. What kind of Feaver that is that accompanieth the Arrhritis THere are indeed very many that assert this Feaver to be only symptomatical But since symptomatical Feavers are those properly which follow the Inflammations of other parts and more especially the Bowels to wit when that heat that is in the affected Member or likewise even the putrid and sooty vapors are communicated to the heart and kindle up the heat in it and so the fewel of the Feaver is in another affected part it easily from hence appeareth that the Feaver which is joyned with the Arthritis is not Symptomaticall but primary For in the Feaver that accompanieth the Arthritis the Fewel of the Feaver is not in the part affected that is to say the part that laboreth under the Arthritis but it is in the great Vessels Yea and the Feaver either it precedeth the Arthritis or else it invadeth together with the invasion of the Arthritis and doth not in any wise follow the same And therefore this Feaver is deservedly referred unto those continued primary Feavers which now adaies we cal accompanying Feavers to wit those that are not solitary but such as have some other Disease joyned with them and that depending upon the very same cause with it to wit when by the motion of some humor which Nature endeavoreth to thrust forth unto some outward part or into the habit of the Body a Feaver is kindled or at least the matter that is moved unto any part becometh withall so putrid that it may cause and kindle a Feaver And as it is in the Erysipelas Pleuresie smal Pocks and Meâ—seâ—â— and the like Diseases so this cometh likewise to pass in the Arhtritis which so his like Feayer is wont oftentimes to precede and to invade the Party a day before or aâ— the seast most bertainly invadeth together with it although it be oftentimes very smal and therefore it is not so much as taken notice of by many sick Persons and especially such as altogether head and mind nothing but their pain But now this Feaver is continual which yet nevertheless remitetth somwhat in the morning but
about the evening returneth again in its ful heighth and this happeneth from the return of the Blood unto the inward parts this being either voluntary or else such as is caused by the coldness of the ambient Air very familiar unto all continual Feavers But the very Feaver it self according to the nature of the humor which together with the humor that is the nighest cause of Arthritis is somtimes excited is wont to be augmented day after day Now that humor which kindleth the Feaver is not contained in the Veins alone but somtimes also in the Arteries and then the signs of puâ—ridness are not so evident and apparent in the Urines yea in the beginning the Urines are oftentimes very thin and like unto cleer Water wanting a setling which kind of Urines are likewise very familiar in other Diseases that proceed from the motion of the serous or wheyish Blood Quest 5. Whether the failing of Mulberries may produce ihe Gout or whether the Fruits of the Mulberry Tree may Cure the Gout THe Occasion of this Question was at first given by Athenaeus who in the second B. of his Dipnosophist thus writeth Pithernus as saith Hegesander hath left it behind him for our information that in his Age the Mulberry Trees did not bear any fruit for twenty yeers together and that then the Gout as a common and Epidemical Disease raged so fiercely among the People that it seized upon not only Men but even Children Virgins Eunuchs and Women and not only so but this Disease became so vehemently outragious among the smaller Cattle that it swept away two parts of all their Sheep Whereupon some thought that this happened by reason of the defect of the Mulberries for those twenty whole yeers and they attributed unto the Mulberry Fruit a Power and virtue of curing and driving away the Gout And true indeed it is that Mulberties do loosen the Belly and that they afford much benefit unto a hot and boyling Stomack but that they should have in them any power or peculiar virtue to cure People of their Gout this neither Reason not Experience can perswade us to Neither can this be proved from hence that when Mulberries were wanting for twenty yeers the Gout greatly raged among the common People For it is more probable that by reason of some extraordinary notable faultiness in the Air which so continued for twenty yeers together that it every yeer hurt the Mulberry Trees vitious humors fit to generate the Gout were heaped up Which may appear even from this that not only Men and Women but even the Sheep also which yet never eat of the Mulberry Fruit were not free from this Disease Quest 6. What the Cause of Arthritis is VVE have told you indeed that the nighest and most immediate Cause of Arthritis is the solution of continuity in those parts that are about the Joynts proceeding from a humor that hath flown into them whiles it either distendeth those parts or else pricketh and launceth them or else doth both these And yet notwithstanding as touching this thing the Physitians do not a little differ among themselves and as for the nighest cause exciting the Arthritis some of them determine one thing and some another Which disagreement among Physitians I conceive hath not been the least Cause why the Arthritis hath oftentimes been so unhappily and unsuccessfully cured For when the Cause of a Disease is not sufficiently agreed upon it is not possible that the Cure should ever be rightly performed And first of all Whether a bare distemper may be the Cause of Arhritis there are some likewise that do indeed reckon up a naked and bare distemper among the Causes of Arthritis and this is also asserted by Costaeus in his third Book upon Avicen Fen. 22. tractate 2. Chap. 5. for this reason because that somtimes there is a pain felt without any swelling at all which is wont to be joyned unto a distemper with matter But a bare distemper let it be even what it wil is not the nighest cause of this Affect seeing that the distemper that somtimes exciteth so long a continuing pain cannot possibly subsist alone neither can it likewise be the cause of so great and grievous a pain And moreover the very humor it self oftentimes manifest enough doth sufficiently shew that besides the distemper there is likew I se present an afflux of the humors And although in the beginning there is oftentimes no swelling at al that appeareth outwardly yet neither doth this sufficiently evince that there is therefore no humor within Like as in the Pleurifie the Toothach and the many other pains of other parts the humor lying hid within discovereth it self by pain alone but by no swelling at all Moreover purging and sweating Medicaments are of singular use in the curing and prevention of this Disease which yet are no waies necessary in a pure distemper And although that Paraeus relateth a History of his own Disease by which he would prove that a naked and bare distemper may produce the Arthritis yet this story of his doth not sufficiently prove that there was no afflux at al of the humors present since that the qualities of the external Air may excite an afflux of the humors Petrus Salius Diversus indeed in his Tract of the affect of the parts maketh mention of an Ischias or Arthritis from driness the cause whereof was neither known to Galen nor yet unto any of those that came after him but Hippocrates only knew it as appeareth in his B. of the internal Affections But as he writeth we are not by driness to understand any dry distemper of the parts constituting the joynt it self to wit of the bones ligaments and tendons but a wasting and consumption of its glutinous humidity by which it is naturally nourished and whereby the joynt it self is oyled as it were and made the more fit for motion For if upon any occasion whatsoever it so happen that this humidity be wholly dried up then the motion of the joynt is hindered and a difficulty of the motion and withal a pain succeedeth And he tels us that this Affect if it be in the joynt of the Hip it is then by Hippocrates called the Ischiadick or Sciatick pain but that he himself had likewise taken notice that it might be bred in any other joynt whatsoever But Galen was not ignorant of this Affect only he denieth it to be the true Arthritis and he tels us that it was only a certain kind of Impediment in the motion whilst that in the third Section and 16. Aphorism he thus expressly writeth If immoderate drinesses consume the humidity of the joynts it then indeed causeth a certain difficult motion by reason of the driness and perhaps likewise now and then a pain But that this passion which they cal Arthritis is in no wise caused unless any one be disposed to cal al the pains whatsoever of the joynts by the name of Arthritis
Ebullition of Synovia and a salt Spirit according to the Chymists be Cause of Arthritis And lastly that we may likewise a little consult the Chymists we do indeed very much expect and hope for some light to be given us by them for the cleering up of the point now in controversie But we shal hardly get any the least light or satisfaction from Paracelsus and his followers who for the most part even obscure the plainest truth For Paracelsus as he is wont speaketh very variously touching the thing in question For in his Tract touching the Podagra Gout pag. 540. he there saith that the Gout is a disease the seat whereof is Synovia which when it is exalted the Gout is then excited And that the disease is a Mineral liquor or a sowr juyce such as are Allum Vitriol Vinegar Barberries Acacia and the like for seeing that these Salts are contrary and opposite unto the Synovia if they be generated in any man and mingled together with the Synovia they then cause the Synovia to boyl over and then he afterwards tels us strange and wonderful things touching the influence of Heaven which here I scarcely think worth the relating as Irkewise those things which he hath in his 2. B. of the Gout In his Paramirum he referreth this Disease to Mercury precipitate But in his B. of Tartarous Diseases Chap. 19. he referreth it unto Tartar Petrus Severinus in his Idea Medica cap. 12. teacheth us that the excited Roots of these Podagrick Affects if they have their seat in the blood they boyl up with hear and send spiritual and vaporous Tinctures unto the Domestick places and that the Matrixes of the Roots having there gotten fruit do by a dolorous calamity of the Symptoms absolve the revolutions of the Predestinations But the truth is the differences of the pain that I may in plain and easieterms shew you what he by an affected pomp of words obscureth do all of them proceed from a diversity of the Salts of which some are more and some less sharp and biting but that these spiritual and vaporous Tinctures are received by their Matrixes that is those parts that are obnoxious unto the drawings out of the Podagrick fruits when they are resolved and they have in the general an affinity with them and therefore readily admit of and give entertainment to the guest coming unto it to wit the joynts or the Synovia of the Hands and Feet But here they do by their words obscure a thing that is in it self most plain and they likewise mingle falsities with truths For as for what they bring touching the Ebullition of the Synovia and the fervent boyling heat thereof this Synovia of Paracelsus is a meer fiction and invention of his own touching which we have already spoken in our Tract de Consens dis Chymicor cap. 15. But as for what they speak of the salt Spirits this if it be rightly explained and wel understood is very agreeable unto the truth as we shal shew you by and by And so likewise we may wel enough bear with them in this that they endeavor to explain the differences of the pains in Arthritick persons from the differences of the Salts that appear in Vegetables and Minerals in regard that our own ablest Phyfitians and among the rest that most experienced Felix Platerus are al of Opinion that the humor which is the cause of Arthritis is not simply a Water but endued with a quality of a different Nature and mingled together with the Ichores and Excrements of the Humors by which it is rendered more vehement And so we likewise judg this more fit to be rejected in them which yet Severinus delivereth unto us in words too obscure to wit that the other excrementitious humors are moved unto other parts and that the humor which is the cause of Arthritis hath in it a peculiar tendency unto the joynts as we also shewed you above The Authors Opinion touching the cause of Arthritis And therefore that we may at length conclude this controversie it appeareth from what hath been hitherto said that neither simply the blood nor flegm nor melancholly nor yet a Water is the neerest and immediate cause of the Arthritis But when I have wel weighed al those things that befal Arthritick persons and which cannot possibly be derived from the Humors as is manifest by what hath been hitherto said I cannot otherwise determine than that a salt sharp subtile humor and such as for the most part resembleth the nature of the salt spirits is the nighest cause of Arthritis And now let who wil cal it Choler or Flegm mingled with Choler or Salt or Tartar or what he please he may do it for me so that the thing be but rightly explained I for my part shal make use of the word Serum or Whey Salt and Tartar that so I may likewise by a proper and peculiar word explain a thing that differeth from Choler and the ordinary and common Flegm But now that the Serum or Whey is not only a watery humor even the Ancients have acknowledged and Galen in the sixth of his Epidem Comment 3. text 33. writeth that the serous or wheyish blood is by Hippocrates and Plato called not only a Water and a waterish humidity void of biting but biting likewise and corroding to wit which resembleth the nature of the Sallow or Willow spirits and therefore it is that it pricketh and biteth those parts that are so sensible and quick of feeling and in these it exciteth most acute and intollerable pains There is to wit in the Earth out of which Plants grow whereby both Man and bruit Creatures are nourished somthing that is salt which answereth unto Minerals and it may not unfitly be called the salt of the Earth which yet notwithstanding is scarcely to be found pure and alone but it is mingled together with other bodies from whence divers kinds of Earths have their Original and thereupon according to the great variety of Soyls it is very various and different as Muddy Clayie c. and then at the length in Plants and Animals it is called Tartar and so it cometh to be tranfused into men But this albeit that in Plants and Men it become in the many various Concoctions very subtile and volatile if it be not such before as very manifestly also it appeareth from the Salt of Urine and that at length it is mingled even with the blood it self yet nevertheless in regard that from the very first original of it it is altogether unfit for the nourishing of the body and is as Hippocrates speaketh wholly unserviceable thereunto at the length unless it be forthwith even in the first Concoction expelled forth by the belly or afterwards evacuated forth by sweats and Urines it is treasured up and being burdensom to Nature it is thrust forth unto the Joynts as having a certain kind of neer allyance with such like matter where by its acrimony
it exciteth most vehement and grievous pains Neither let any be hereat moved and wonder that we say that this matter is one while spiritual and somtimes also Tartarous and so very fit likewise for the generating of those hard knots which they cal Tophi For that I may speak with the Chymists spinits may proceed from bodies and again bodies may be from spirits This matter in its original and while it was in the Earth was a body and somwhat as it were Earthy and Mineral like but it cometh afterwards to be attenuated in the various Concections both in Plants and Men and so it is made as it were spiritual which hath been acknowledged by many of Galens followers and among the rest by Cardanus who upon the 47. and 49. Aphorisms of the sixth Section writeth that the Matter to wit the cause of Arthritis is as it were a spirit And Lucian in his Tragopodagra calleth it a violent and injurious spirit And yet afterwards this thin humor or spirit when it hath once gotten a fit place to wit the bones and the places about the joynts it again betaketh it self into the body and is there coagulated like as it is a thing generally wel known unto the Chymists and other salt spirits may again be coagulated and return into bodies And yet nevertheless if any one shal assert that there is likewise a volatile Salt in the very Earth it self which the Plants draw unto themselves this doth no way thwart or oppose this Opinion of ours but the whol result of the business and Controversie in hand cometh al unto one and the same conclusion Quest 7. Where the Humor the cause of Arthritis is generated and by what waies it floweth into the Joynts IN what place the Humor that is the cause of the Arthritis is bred and by what waies and passages it floweth into the joynts in this Physitians do greatly differ among themselves which disagreement of theirs hath much hindered the Cure and made it far more difficult than otherwise it would have been and therefore not without cause is it that Fernelius in his sixth B. of the Diseases of the parts and the Symptoms Chap. 18. writeth that from the very ignorance of this thing the pain of the joynts hath hitherto been held and left for incurable and called the shame and disgrace of the Physitians We have briefly above given you our Opinion as touching this thing in Controversie But because there are many and those some of them of the more able and learned Physitians that are of another Judgment and differ from me in their Opinion as in this darkness of Mans mind it is generally wont to be even in the greatest and most serious Controversies I shal not think it time mis-spent nor my pains il bestowed in laying before you with what brevity I can their several Opinions and in the recital of them I shal weigh them accordingly And first I shal indeed begin with Fernelius who asserteth that they are much mistaken who think that the Humor the cause of Arthritis doth break forth of the more secret and inmost parts of the body into the Joynts For how saith he is it possible that any pure and sincere humor can from the bowels and the most inward seats be carried through the Veins or that that humor which was so lately mingled with the blood should now without any mixture thereof by the Orifices of the veins fall pure into the blood or if there should also together with the humor flow forth any of the blood which being collected and gotten together in the Joynts doth it not excite a Phlegmone And why likewise doth not the crude humor which is carried into the Joynts by any other passages than by the Veins cause the Arthritis For in the Cacheâ—ie the crude humors that from the bowels fall down into the feet and cause them to swell do not yet excite the Gout in them But even Fernelius himself taketh it for granted and plainly asserteth that the Head is the Fountain and Original of this Malady from whence saith he a flegmatick humor and this very thin floweth forth into the Joynts And this humor as he tels us is not indeed gathered together in the Brain as whose excrements are either purged forth by the Nostrils or else by the Palate fall down upon the great rough Artery and the Lungs or else into the Stomack and the more inward seats but it is saith he collected in the external parts of the Head and such as are placed without the Skul and by the top and superficies of the body run along downward under the Skin For seeing that there are many Veins running forth thither that are derived from the external Jugular Veins he conceiveth that they may there lay up their thin and serous excrements and that in regard the Skin of the Head is thick and impenetrable so that the humors cannot easily expire and breath through the same that therefore in progress of time they are there stored up and from thence by the superficies and outside of the body fall down into the joynts There are very many other Physitians that follow this Opinion of Fernelius of the which some of them wil have the humor the Cause of Arthritis to be collected in the Head alone betwixt the Skul and the Skin of the Head and they tel us that is the one only place from whence the matter floweth down unto the Joynts but there are others of them who although they likewise add other waies yet notwithstanding they do withall joyn this way of Fernelius and there are very few or none of them who do not believe but that this matter doth withall flow down likewise from this place of the Head But in very truth what Fernelius complaineth of touching the other Opinion that by reason of it it so came to pass that the Arthritis was almost lest as a desperate and incurable Disease and was termed the Opprobium or disgrace of Physitians I conceive without disparagement unto any mans Judgment that it may more truly be affirmed of this his own Opinion and I am of Opinion that that Physitian who seeketh for the Spring and Fountain of this Malady in the Head only neglecting in the mean time the true Fountain and sourse thereof is scarcely ever likely to cure the Arthritis For albeit it be indeed true that certain various flitting and wandring pains may be here and there excited by the serous humor falling down from the extenal part of the Head under the Skin by the outside and supersicies of the Body yet notwithstanding the Arthritis is never from hence generated neither is that matter wont to subsist about the Joynts but for the most part about the membranes of the Joynts But now the generating of the humor that is the Cause of the Arthritis is very different and of a far other nature For this is generated in the sanguification by reason of the Errors
in Dâ—et and the weakness of the Bowels and somtimes likewise it is supplyed from the suppression of the Courses in Women and the sudden stoppage of the Hâ—morthâ—ids 〈◊〉 both Sexes and then it is heaped up in the Veins and Arteries whereupon also so â—oon as ever iâ— beginneth to be moved and to become as it were boyling hot there is almost alwaies a Feaveâ— joyned with the Arthritis yea and somtimes the Feavers are terâ—â—areâ— in the said Arthritis and hence it likewise cometh to pass that in the Arthritis the Urâ—â—giveth 〈…〉 and manifest signs and Tokens of the humor that is peâ—â—an in the Veins And hence it is 〈◊〉 Galen himself rencheâ—h us in the third Section Apâ—â—â—nm 20. that in little â—â—ellings and pains of the Joyâ—â— the deepâ—â— parts of the Body are throughâ—â— purged the â—â—tious humors being thrust from the more principâ—â— parts unto the ouâ—side and supersicies oâ— the Body Neither can there any thing else be proved by firm and soâ—ud Reaâ—onâ— Al which being truâ— as is alleadged and the care standing thus and it being most undeâ—â—able that the Humor the cause of the Arthritis is contained in the Veins and Arteries there can no reason be rendered or any necessity either in Nature or else in the Disease why these Humors ought necessarily first of al to asceâ—â— up 〈◊〉 the Head before they be carried into the Feet in regard more especially â—â—at there is an open and strait way by which themay be moved through the Veins and Aâ—â—eries and 〈◊〉 carried into the Joynts And that the matter the cause of Arthritis is carryed unto the Joynts through the Vessels and not without them appeareth also even from hence that the Veins in those joynts that are like to be invaded by the Arthâ—â—â—â— swel up and grow big when it first beginneth and in that the Humor exciting the Arthritis if Repelling Medicaments be unseasonably applied runneth back again into the Veins and Arteries and is either transmitted unto the Noble parts and there exciteth Acute Feavers anxieties of heart and other dangerous and deadly Symptoms or else it is suddenly conveyed into another joynt whereupon the pain which but ere while infested the Foot instantly if Repellers be unadvisedly administred thrusteth it self forth and appeareth in the hand which could not be done were it not that the Humor were moved through the Vessels For it is not at all possible that the Humor which but just now was in one of the Toes should under the Skin be so suddenly carried up into the hand And if the Humor should in some space of time mount up thither under the Skin yet it must of necessity cause pain in all those parts through which it passeth as we may often take notice in those pains that arise from the Serous Wheyish Humor descending without the Skul that the pain is first of all in the Head and then afterward it is excited in the Neck and then in the shoulder blades and the back and that at the length both the Humor and the pain descend even unto the Thighs which doth not at all happen in the Arthritis And moreover it oftentimes cometh to pass that a man by wrath or 〈…〉 cast into the Arthritis which happeneth most certainly from the 〈…〉 suddenly moved in the Veins and Arteries but if the head should 〈◊〉 these Humors sensibly and by degrees heaped up in its own Skin this could 〈…〉 happen And again if the fountain and original of this Malady were under the 〈…〉 Head why is not then the Cure chiefly directed to that seat and why 〈…〉 â—â—sicatories Cauteries and issues applied unto the Neck seeing that 〈…〉 a fitter place then this to be found whereby the matter gathered 〈…〉 the Skul and the Skin of the Head may be evacuated And furthermore 〈…〉 the Original of the Humor were alwaies in the external part of the Head then of necessity there would be present likewise some signs thereof heaped up there and descending which yet in the most are not at al taken notice of their Heads being altogether safe and sound when yet their Joynts are invaded by the Arthritis 〈…〉 indeed among other the signs of the Humor heaped up reckoneth the â—â—avinâ—ss of the Head for one as also overmuch desire of sleep an external pain or the Head and which is stiâ—d up only by the touching thereof especially if the hair be kembed back but never so little an Oedematous waterish swelling like unto soft wax lying under the Skin more especially in the hinder part of the Head but he reckoneth up for signs of the Humor flowing downward a pain running up and down from the Neck or by the shoulders into the Arm and Hands or else turnd down by little and little along the back into the Hips Knees and feet there arising somtimes some kind of sense and seeling of Cold. But indeed it cannot at all be denied that these signs are present when there is a Serous and Wheyâ—â—h Humor heaped up together in the Head and falling down by the external parts of the Body but they very seldom appear in the Arthritis it being most manifest by experience that such as are troubled with the Arthritis are yet for the most part very wel in their Heads Neither do such as are taken with the Arthritis alwaies perceive that deflux of Humors from the Head and the pain proceeding therefrom as but even now we told you And grant indeed that it be so that in the beginning of the Arthritis the head may likewise in some where it is but weak be offended and that there may be a kind of heaviness and pain perceived therein Yet nevertheless neither doth this sufficiently prove that the Humor the cause of the Arthritis is generated in the head in regard that the very same often happeneth in Feavers although the cause of the Feaver be not generated in the Head but the head is then offended by its consent with other parts For when the Humors boyl with heat in the Arteries and Veins and that they begin to be moved they partly rove and run up and down by their own impeâ—uous motion this being proper unto them when they abound and swel up and partly they are by Nature thrust forth hither and thither and then they more especially siez upon the weak parts until at the length they seat and fix themselves in one certain place And therefore it is not at all to be wondered at that in such persons as have weak Heads and heads that are otherwise very subject to excite defluxions in the first invasion of the Arthritis some of the Humors now about to ruâ—h forth unto the Joynts should be poured out by the Capillary Veins under the Skin in the head and there excite pain and other Symptoms Which yet notwithstanding doth nothing at all patronize this Opinion of Fernelius since that even those very Humors are not bred and collected under the Skin of
shaking and trembling or at least with an ordinary and slight kind of Chilness and Cold. For this quaking and cold is no sign at al of the humor descending from the head under the skin but rather of the humors being poured forth out of the Veins like as we see the very same to happen in feavers and the Erysipelas Others also there are as Bustachius Rudius who think indeed that this matter floweth down from the head but then that it doth flow unto the Joynts not only without the Skul between the Skin and the pericranium by the spaces that are under the Skin but that it descendeth within the Scul also by the extream superficies of the spinal Marrow others there are also that tell us how that it floweth down through the very middle of the substance of the spinal Marrow But if it were thus as they say there should rather a Palsy or Convulsion be from thence excited and in the middle space by the which the humors should flow the Nerves should likewise be affected Others there are who Joyn both these Opinions together and these tel us that the Humor doth partly flow from the head and partly are conveyed through the Veins and this is indeed the most common Opinion which therefore Platerus is very large in the explaining thereof who teacheth us that the Humors exciting the Arthritick pains may fal down either within or without the Veins Within the Veins indeed when the bloody humor causeth the hot Arthritis as some cal it having the Feaver Synochus Joyned with it For as by a subtile and thin blood poured forth into the superficies of the Skin Erysipelas's that are accompanyed with the Feaver Synochus or a continual Feaver are excited so likewise while it is poured forth into the seats of the Joynts the pain of the Joynts which the same feaver likewise doth accompany is bred so that indeed whosoever they be that are Obnoxious unto both these Diseases when they are siezed upon by the Gout they may then comfort themselves with an Opinion and conceit that it is no more then an Erysipelas All which things are indeed most true and certain And yet notwithstanding he determineth likewise that the Serous or wheyish Excrementitious humors being heaped up together may excite the Arthritis and that their Original is from the head and that the Source and Spring of defluxions hath there its existence and that from it they flow down into the parts lying beneath but that they are there somtimes heaped up together in its interior seat betwixt the Skul the crude and impure Blood affording matter unto it For then that part of it that is altogether unuseful for Nutrition and Excrementitious is by some and some heaped up in the brain which when afterwards it falleth down it then breedeth the pains aforesaid which are accompanyed with a heaviness of the head and somtimes with a great pain therein and other accidents the sure signs and tokens of the matter there heaped up together And he tels us that the Excrementitious blood is caused by the vice and errour either of the first or the second or even of the third Concoction that is made in the brain by reason to wit of some distemper or weakness therein And withal he telleth us that al this filth and excrementitious Humors that are heaped up in the head do either by Reason of their too great abundance when they are stirred to and fro flow downwards or else they are pressed forth and poured all abroad by the external cold and the moystness of the Air or else that they are stirred up by the heat of the Sun or some Bath the Pores and passages being opened and the expulsive faculty provoked And yet he determineth likewise that the very same serous and excrementitious humor may likewise be stored up without the Skul betwixt it and the Skin and that it may from thence flow down into the inferior parts But he teacheth us that the waies and passages by which this defluxion is from the Head are very various As for the humor collected within the Skul in the Basis of the Brain consisting of three Cavities ending in the very bottom of the Skul he tels us that it is somtimes strained through by the hole of the Bone they call Cribrosum bearing some kind of resemblance with a Sieve and distilleth out of the Nostrils and that it then exciteth that distillation we cal Coryza or the Pose and that somtimes likewise it is carried into the middle Cavity which is full of holes and looketh toward the Palate and that then it is either blown forth by the Nostrils or brought forth of the Jaws and spit out by screaming and retching or that descending into the seat of the Eyes it exstilleth forth by tears and that sometimes it followeth the conveyance of the Nerves in the midst of this seat of which some of them pass through by these holes and that somtimes it being carried into the hinder Cavity of the Skul which is lower and wider it descendeth through the great hole in the hinder part of the Head of the Spinal Marrow into some place of the habit of the Body and that it stoppeth either in the fleshy parts any where or about the Region of the Joynts and there causeth the aforesaid pains of defluxions or of the Joynts But as for the humor collected without the Skull and flowing downward under the Skin as it insinuateth it self either into the Joynts or the fleshy seats he endeavoreth to produce divers kinds thereof all which he explaineth at large But in very truth as we willingly admit of those things that he produceth touching the motion of the humors without the Veins in which he agreeth with Eustachius Rudius so we cannot be induced to believe that the Arthritis is generated from thence For first of all the matter that is generated in the Brain and exciteth the Coryza or abundance of spittle and is cast forth by the Nosethrils and the Jaws it is of a far different nature from that which breedeth the Arthritis and it could not possibly otherwise be but that if a matter so sharp and fiery as it were should be generated in the Brain it must needs produce most grievous symptoms And moreover whether this humor descend according to the passage of the Nerves or according to the conveyance of the Spinal Marrow it could not be but that it should first of all in its passage cause either a Convulsion or a Palsey or some kind of pain before ever it could come unto the extream part of the Feet and Toes and should there excite pain whereas notwithstanding on the contrary we oftentimes see and especially in the beginning of this Disease that there is suddenly a pain excited in the Feet no pain at all or symptoms elsewhere appearing And furthermore I likewise willingly indeed grant that from the matter heaped up under the Skin of the Head the pains of Defluxions
an excrement which redounds from nourishment which is cast off from another although he grants there that is commonly called an excrement whatsoever is superfluous in the body whether it be a spirit or humor or some other solid body whether it be usual or unusual whether according to nature or preternatural furthermore he holds this vapor to be wandring thin and viscid Chap. 21. and to be raised from a spirituous humorous solid substance but he proves Chap. 22. by many Arguments that this vapor is contrary and preternatural by its whole substance of which we shal speak hereafter and at last Chap. 27. he desines the Veneral vitulency that it is a vapor by its whol substance inimicous to the natural faculty working by degrees And that he might unfold his mind more clearly and not leave the Reader doubtful to what kind of things preternatural this vitulency ought to be referred when as he had said before that it was neither the Disease nor the cause nor the Symptome yet it primarily hurt the actions at length Chap. 28. he holds that 't is an externall error and he endeavors to prove it by this Sylogisme whatsoever doth primarily hurt the operation and is not of the constitution of the body is an external error but the Veneral virulency doth primarily hurt the operation and is not of the constitution of the body therefore 't is an external error Some that they may briefly quit themselves and hold with al men say that this disease is a heap of al evils Diseases and symptomes That we may clear our selves out of this difficult controversy The Veneral disease depends on an occult quality first of al 't is already proved and shal be proved more at large hereafter that they are in the right who do here admit of an occult quality and a power depending on the whole substance as they commonly speak neither can they hold any other waies Since 't is without doubt that 't is a contagious and malignant disease while it is such Iâ— performes two things to wit it alters the body by which it is received and changeth it to its owne similitude and indeed it alters it not by the first qualities as shal be said by and by since it is not expeld by the first qualities neither is that change alwaies with putrefaction whenas putrefaction is not induced but by a long time but this change is made in a moment as it were neither is it an adustion as John Baptista Montanus and some others do h old whenas there is not alwaies a hot dry distemper present neither is it cured by cooling and moistening things and oftentimes there is a fordid putrefaction in which there is no exustion But whereas they hold this malignity is only in that matter seated without the living parts 'T is a disease and that there is no such disease present in this they erre very much Indeed we willingly grant that that contagious inquination sent forth from the body infected with the veneral disease may adhere to the garments neither do we deny this that the humors in our body may be tainted with the same yet in the interim it doth scarce follow that the living parts remain free and found for as in a purrid feaver though the humors and spirits do first grow not by the feaverish heat yet afterwards the living parts are seized on by the same distemper so though the humors in the Veneral disease are first infected by that occult malignity yet there is no cause why the same fault may not be communicated to the living parts But though some do acknowledg that this cause cannot be idle Not hot and dry yet whenas they know nothing beyond the manifest and first qualities they endeavour to reduce also the effects of the veneral virulency to manifest causes John Baptista Montanus as was said even now thinks the essence of this evil consists in a hot and dry distemper but the cure tels otherwise whenas 't is cured by hot and dry Medicines as by the Decoction of Guajacum and the like besides because there is a great putrefaction in the Humors which doth not proceed from a hot and dry distemper Nicolaus Massa de Morb. Galli Cap. 5. Not cold and dry saith it is a coldness of the Liver declining to a little driness with an occult quality but as concerning the occult quality he writes truly but that it is no cold distemper the effect doth teach us as the Ulcers rottenness of the bones and the like and what other distemper soever they alleage Yet they produce nothing agreeable to the Diseases and Symptomes which appear in this Disease nor to the Cure Therefore when as the action of the veneral virulency can be referred to no manifest quality We may wel say that by that is induced an occult quality But occult For first of al every efficient cause is said to be a cause from the nature of its efficiency and therefore this malignant quality doth not only alter and change the humors but also the living parts into its likeness again though the morbifick cause be taken away and this disease seem now to be overcome yet unless that malignant disposition be destroyed the man recovers not his perfect health For it hath been observed that the Veneral Disease hath somtimes grown fresh after thirty years past which doubtless happened not because the Vitious Humors lay so long hid in the body for these would have sooner discovered themselves by their signs but because that malignant disposition imprest on the body was actually there which afterwards by degrees produced vitious humors and corrupted and so broke forth into act and Trincavellius Lib. 11. de curand rat particul affect cap. 11. reports that a certain Woman brought forth a Child sick of the French Disease and every whereful of crusty Ulcers whenas she her self never had any sign of that Disease contracted but was alwaies wholly wel and on the contrary it may happen that one may have a French Ulcer which yet when that Malignity is distroyed is no longer rightly said to be Gallical but is cured by vulgar Medicines as other Ulcers Al which being thus we conceive the the Veneral Disease doth not only exist in the Humors but also in the living parts and that it doth consist not only in the change of the first qualities but also there is an occult malignant quality imprinted on the parts and therefore the veneral Disease is to be referred to diseases and those of occult qualities Which are called by Fernelius diseases of the whol substance but not on every part rightly explained as we have said before the which if Capivaccius and Saxonia had known the one would not have defined this evil by the excrement nor the other by the cause An examination of Aurelius Minadous opinion if the same also had been known to Aurelius Minadous he would not have endeavoured to maintain that this
evil was no Disease but an external error For whereas he endeavors to prove that the veneral Disease is not a Disease of the similar parts because it is not a distemper nor an evil composition nor a solution of unity in this proof he labors to no purpose for al this we willingly grant but this he ought to prove that there is no other kind of Disease in the similar parts besides the distemper of the first qualities but that there are such diseases which Fernelius calls of the whol substance we more rightly of occult qualities is sufficiently proved above part 1. and this very Disease as all other venenate Diseases do shew that it can be referred to no other kind than to malignant qualities this follows from Minadous his own supposition and confession which he hath Cap. 20. where he writes that the Veneral virulency hath power not only to infect al Humors but al parts of the body and to corrupt and convert them to its own similitude The same Minadous if he had known these Diseases had not taken so much pains to what kind of preternatural things the veneral virulency ought to be referred For first of al there was no need of excluding from the number of causes those vitious Humors which are found in the bodies sick of the veneral Disease and have power to alter and change the Humors themselves and parts of the body For whereas he saith that is properly the cause between which and the action hurt the disease doth interceed that is true of the next cause but the antecedent causes also may do hurt as they have the Nature of a vitious object and external Error and in this very Disease whiles the virulent Humors do imprint a malignant quality on he parts between them and the action hurt that Malignant disposition and occult quality doth intercede Therefore whereas he thinks that Humor or venenate vapour in the veneral disease doth imediately hurt the action 't is false unless that humor have the nature of an external error For al hurt actions in the Veneral disease do happen whiles between them and the humor or malignant vapor a midling diseafe doth intercede to wit that of occult qualities But whereas he denies the Veneral virulency to be a quality The Veneral disease is not a Body and holds it to be a body first of al he confounds the cause and the disease next of al he doth not distinguish between the quality and its subject For whiles we say the Veneral evil we understand either the disease it self or its cause if the disease that is a quality as al diseases are to wit a preternatural disposition of the parts and indeed an occult and malignant quality but if the veneral evil be taken for the cause either which without being communicated doth induce this disease or which is in the body which raiseth divers diseases and symptomes and can infect others we grant that cause may be called a body But we must take notice that those humors or vapors are not said to be causes as they are bodies but as they have an occult and malignant quality which Minadous himself cannot deny while Cap. 20. he writes That that vapor or spirit which he cals the veneral virulency is endewed with an occult quality and vertue depending on its whole substance by which it is able not only to infect any humors of the body but al its parts and to corrupt and convert them to its own similitude For what similitude is that I pray to which the Veneral virulency converts not only the humors but also the parts of the body unless it be that occult quality with which that vapor is endewed Whereas last of al Cap. 38. he refers the Veneral virulency to external error because it primarily hurts the operation and is not of the constitution of the body But before denied it to be either the disease or cause of the disease or symptome in vain doth he multiply things preternatural for there are not more preternatural things than the disease cause and symptome and the Veneral virulency as he describes it doth wholy belong to the causes two manner of waies for either it induceth the like disposition into the parts of the body or it raiseth other diseases while it eats and exulcerates the parts But whenas he saith the Veneral disease taken for the cause Whether it be a Vapor or a spirit is a vapor or a spirit that is rightly to be understood for indeed it can no way be denied that it is a humor also whenas in copulation 't is rubbed against the body and sticks in the cloaths yet such is its nature as 't is also of other contagious humors that though it be resolved into vapors and the least bodies yet every one of them contains its whole essence and hath power to affect others and this thing may be declared by musk castor and the like For those things though they be bodies and humorous too yet are such that though they be resolved into the least bodies nevertheless they retain their ful strength After the same manner it is in the Veneral disease and other contagious diseases in which though the malignant and contagious humor he resolved into the least bodies yet every one of them obtaines the same essence and vertue and power to infect others But whereas he thinks that humor and vapor is not to be called the cause but an external error in that also he is mistaken for an external error belongs unto the causes from whence the Symptomes arising from an external error are called the symptomes of the cause where this also is to be observed that Physitians do not vouchsafe the name of the cause to the next cause only but also to the antecedent which do not yet effect the disease therefore there is bad nourishment by reason of vitious humors although they have not yet imprinted a distemper and vitious disposition on the parts but whereas he denies the Veneral virulency considered as a vapor to be the cause because it hurts the actions not by the mediation of a disease but next of al and imediately he presupposeth that which is not yet granted and so begs the question for this spirit or vapor hurts the very constitution of the similar part and imprinteth on it a malignant quality the which he himself cannot deny whiles Cap. 23. he holds that by this disease of venery many actions are hurt but not al in al people but the hurt of the natural faculty is common to al and that there is none that is possest with this disease who is not troubled with some fault in his natural actions and hence proceeds al that filth of excrements and the gummosities arising from thence tumors pustles pains running of the reins ulcers rottenness and such like evils and that the Veneral virulency hath a peculiar enmity and discord with the natural faculty and is inimicous to it by its
hurt of the Liver In the interim he cannot deny this that this evil doth most properly and chiefly appear when the Liver is affected when as the operations of the Liver are necessary to the whol body The same Author Cap. 4. endeavors to prove that the Liver is not the subject of the Veneral disease whenas the face saith he is the index and truest glass of the internal affects of the body yet especially the affects of the Liver doe appear in it therefore if the Liver were perpetually affected in the Veneral disease also the color of the face should alwaies appeare vitious the which we have found false by experience for we have seen both men and women infected with this disease who notwithstanding have had a fresh color in their face and the evil hath been in their privities again he thinks that by carnal copulation the privites may first of al be affected and from thence the evil may creep through the veins and by the spirits to the other parts of the body and as one part is more apt and disposed than another to receive the infection so somtimes this somtimes that is infected but not alwaies the Liver That we may cleare our selves of this controversy first of al we must enquire from the actions hurt what part is affected The Authors opinion and what faculty is opprest but though divers actions hurt that part in the veneral disease yet al of them cannot bring us to the knowledg of the first and proper subject It happens indeed somtimes that there are pains felt in the head about the muscles and bones but that is not alwaies Somtimes also the hurt happens in the external and internal sence but this also is seldom somtimes putrid vapors are inflamed and hence a Feaver is raised which somecal a French Feaver but this also happens seldom In like manner 't is in other diseases and fymptomes One action is hurt which is common to al that are sick of the veneral disease viz. nutrition is corrupted hence we see that in those who are possest with this disease the color of their body is changed and sulled and sometimes turns black somtimes of a lead color somtimes livid There arise every where in their body divers kinds of swellings and bunchings out also ulcers the bones rotten the hairs fal off al which proceed from corrupt nutrition From which we conclude that the veneral disease is primarily an enemy to the natural faculty The Veneral disease is an enemy to the natural faculty but 't is no wonder that this poyson is only an enemy to the natural faculty whenas there are other poysons which are inimicous to other faculties thus the poyson of the pestilence and many others are enemies to the heart cantharides to the bladder mad nightshade and opium to the animal faculty Whence that we may briefly conclude the business this evil indeed may be contracted by one member yet if it be spread into more from that one that comes to pass because the Liver is infected yet because this poyson hath principally an enmity with the natural faculty and the fountaine of that or chiefe seat is the Liver that also is primarily infected with this virulency and through that the rest of the parts contract this evil Therefore whereas Minadous objecteth the color of the face is sometimes fresh therefore the evil is not yet communicated to the Liver but stil sticks in the privities which were first of al infected and the force of this virulence is sometimes greater sometimes less from whence also 't is sometimes sooner sometimes later communicated to the Liver Besides this evil consists not in the first qualities but in occult whence 't is no wonder that that malignity may consist in the blood which to the appearance is good but al those things wil be yet made clearer by the discovery of the causes Chap. IV. Of the Causes BUt concerning the causes of this disease two things are to be explained the first is how at this day the Veneral disease is contracted the other is The Veneral disease is contracted only by contagion what was its original when it first appeared At this day indeed I think this evil is no otherwise contracted than by contagion and that 't is manifest that every Veneral pox is not contagious Hercules Saxonia lib. de lue Vener cap. 3. Holds that every Veneral pox is not contagious and that which is old and confirmed is for the most part less contagious than that which is new and of a middle age Whether it be alwaies contagious and that which discovers it self by knobs is not contagious and he endeavors to prove it first of al by reason because the contagion is placed in a hot and movable excrement but when nothing breaths forth from the part affected which can be communicated to another the disease then is not contagious and therefore because in the knobs there is no such excrement contained or if it be contained it is not carried to the genitals therefore that disease shal not be contagious next of al by experience for he writes that a certain noble man of Padua who had used Guajacum almost twenty times and was thrice anointed with quicksilver yet could never be cured and though he lay with Virgins yet he never infected them and out of Antonius Musa he relates of one who had a wife possest with the Veneral disease about her breast yet he never contracted the disease But here we cannot assent to Saxiona but we hold that every Veneral disease is in its manner contagious but whereas he objects against us experience it doth not follow that if one sick of the Veneral disease doth not actually infect another that the disease it self is not contagious for that an effect may follow there is necessary both an agent and a disposition required in the patient Hence we see that many do converse with those sick of the Plague and are not infected yet we must not conclude from thence that that Plague was not contagious Gabriel Fallopius de morb Galli Cap. 22. makes mention of twelve Schollars that had to do with one whore yet of al them three only were infected And Saxonia himself affords an answer to this argument while he writes That this disease is not contagious if nothing breath forth from the part affected which may be communicated to another the which may happen in the knobs and callosities or if any thing do breath forth and be not received by another Therefore though one have an ulcer in his head or a knob in his thigh but the Genital parts be sound 't is not necessary he infect her he lyes with But whereas he teacheth that the inveterate Veneral disease is less contagious than the new or middle aged it may in its manner be granted and from that very thing we may collect that the Veneral disease is not only the cause but also the disease For
when as this disease is communicated by the cause or contagion it may come to pass that the cause may be for the most part taken away which doubtless happned in him who so often used the decoction of Guajacum and was thrice anointed and such men indeed if the disease be stil upon them but the corrupt humors being for the most part emptied by sweaters 〈…〉 they are not so conragious as those who were lately infected with this out of whom those malignant humors have not yet been emptied Therefore we conclude though for certaine reasons those who are sick of this disease do not alwaies infect others yet at this day there is no man taken with this evil but who hath been infected by contagion from another and so this evil at this day is propagated only by contagion But how The first original of the veneral Difease and from what causes this Disease was raised when it first appeared in Europe Authors are diverse in their opinions and whenas they themselves who lived about the rife of this disease could not agree in this business by much less shal we which are now removed above an age from that time be able to reconcile them therefore we shal only reckon up their opinions The most learned Leonicenus and Fracastorius Whether it were first of al an epidemical disease and certain others were of this opinion That this disease at us first rise was epidemical and proceeded from a common cause when at its first beginning boyes men old folks Girles women were infected and as Hieron Fracastrius writes de morb Gallic cap. 7. Though the greatest part of mankind hath contracted this disease by contagion it hath been observed that a number of others infected by themselves without any contagion have suffred this disease Besides Fracastorius thinks it impossible that in so smal a time contagion which of it self is slow nor is not easily received could spread it self over so many lands being first brought by one fleet of the Spaniards when it is plain that either at the same time or very neere it was seen in Spain and France in Italy and Germany and almost al Scythia which if it be so there is no reason why we should not grant this disease to have been first of al epidemical yet this makes me doubtful because that no German Physitian nor of the neighboring places hath taken notice that this disease was knowen in Germany about that time In which it appeared in Italy when notwithstanding they have most diligently described the English sweating disease the disease in Hungary and the like diseases newly sprung up But what was the cause of that epidemious disease if it were such a one those Authers themselves do differ in opinion indeed they agree in this That it had its original from the fault of the ayre but whence the ayre contracted that fault therein they differ Some were of opinion That this disease had its original from the great inundation of Ether and other Rivers which hapned in the time of Adrian the sixt Pope of Rome for the Summer following they think by that corruption and filth left by the waters the ayre was infected with putrefaction and thence this disease did proceed But truly this evil cannot be imputed to that inundation of waters since that happned chiefly at Rome but this disease first appeared at Naples besides those inundations of waters are wont rather to cause pestilent diseases and there has often happned such inundations before yet such a disease was never caul'd by them before Others do more probably if this disease were at first epidemious refer the cause to the Stars And Fracastorius writes concerning this business lib. 2. de morb contag cap. 12. That it ought not to seem wonderful that new and unusual diseases do appeare at certain times and he proves it by examples and histories of divers diseases and to pass by others in the memory of our Grandfather that malignant Feaver raged which is commonly known by the name of the English sweat the like of which we have not read in any History before wherefore he thinks it is not strange if also the French disease not known before through many ages in our Orb did now first of al break forth And there wil come saith he other new and unusual sicknesses when time shal bring them as there was the thing out amongst the Ancients which afterwards was seen no more This same disease wil dye and be extinguisht and by and by again wil be renewed and seen again by our Nephews even as in former Ages it is to be beleeved it was seen by our Aucesttors for which there are no smal signs yet evident A certain Barber a friend of mine had a book of certain experiments very ancient amongst which was written one amongst the rest whose title was For the thick scabb which happens with the paines of the joints he therefore when the disease was very fresh at first remembring this medicine asked counsel of some Physitians whether he might use that medicine in that new contagion which he thought was signified by that thick scabb but the Physitians viewing the medicine sharply forbad him because it consisted of quicksilver and sulphur Happy man if he had not consulted with those physitians being like to be very rich with an incredible gaine but he obeyed them nor durst not make tryal of his medicine which at last he did try and finding it to be excellent good he was very sorry that he had used it too late the profit being now carried away by others Thus far Fracastorius But he refers the cause of this disease newly sprung up to the conjunction of Saturne Mars and Jupiter which hapned at that time Others hold that in the yeare 1483. In the Ides of October at two of the clock after noon That there was a conjunction made of Mars Jupiter the Sun and Mercury in Lihra in the right house which is the house of Sickness and that Jupiter was burnt and furthermore the same yeare on the Calends of November in the same house and signe there was a conjunction made of Mars and Venus also of Jupiter and Venus Others as Nicolaus Massa de morb Galic cap. 6. refer that disease to the conjunction of Saturn Mars and Venus which happened in Scorpio about the rise of this disease But as it is not impossible for certain configurations of the Stars to induce certain diseases so no man is able easily to render the specifick cause of this disease if it were epidemious Truly al the effects of the Stars are good and benigne and nothing evil in it self doth proceed from them yet by accident it may come to pass whiles they alter the ayre the bodies of men after this or that manner that they may produce evil diseases whenas in their way they are Authors of the generation and corruption of natural things but that they could produce this disease in specie I
vomiting of which one or two have been seen living without a Skul Of which by and by shal be said more in the Diagnostick and Prognostick signs CHAP. VI. Of the Diagnostick Signs BUt though out of those things which have been spoken before of the History of this Disease the Diagnostick signs of this Disease might easily be fetcht yet in this place the same are to be propounded in specy But first of al we must remember this those signe as Galen teacheth 1. Aphor. 17. and else where which ought certainly to denote a Disease which are commonly called Pathognomonical ought to be not only proper but inseparable so that where they are there is the Disease and they being taken away the Disease is removed But though as in many other diseases The diagnostick signs of the cause so in the Veneral there is not one sign by which the Disease may be known yet a concourse of signs may do the same Yet what that concourse is in the Veneral Disease is not easie to define whenas in this Disease there is a great Accumulation of Symptoms and Diseases and therefore this Disease hath affinity with other Diseases Which thing doth cause as was said before that many when they saw almost the same concourse of signs in that Epidemious disease which Hippocrates propounds the 3. Epid. they thought the Veneral Disease was described there and others referred it to the Elephantiasis but the reason why it is hard to define the concourse of signs in this Disease is this because the Liver and nutritive faculty of the whol body is chiefly hurt For when the heart or brain is hurt their hurt actions do easily appear being such as are simple and restrained to few parts But when as the Lives affords nourishment for the whol body from thence if nourishment be huâ—◠〈…〉 â—â—ppen â—â—vers Diseases and Symptomes for though the nutriment of the whol body be one that is blood yet almost an innumerable variety presents it self in every part according to the variety of the parts which are nourisht whenas 't is necessary that every part do peculiarly assimilate its nourishment yet if we consider the precedent causes those things which are present and what things are helpful what hurtful or the Remedies neither can this Disease he undiscovered As concerning the causes first of al if the parents be or have been sick of this disease and some signs in the infant present themselves which argue the Veneral disease there is scarce any reason to doubt of the Disease In like manner 't is if an infanchave sucked a nurse sick of this disease But if any one born of sound Patents and nourisht by the milk of a sound Nurse yet have diseases and some Symptoms which give suspition of this Disease we must diligently enquire whether he hath had to do with infected persons which if he confess the case is plain and there need no further doubt of the species of the Disease but if as it often fals out one to preserve his Honor and reputation deny that he hath acted any such thing then we must enquire into the condition and course of the life past of the husband or wife if the party be married For from these things somtimes we have no slight conjectures of the infection But if there be no ground for such a conjecture we must further enquire whether he hath slept in the same bed with one infected with that Disease or hath used his garments But if out of al these there can be had no firme conjecture of this Disease the present state of the patient is diligently to be considered which indeed is one in the beginning of the Disease another in the increase and another when 't is inveterate whence also the signs of thâ—s Diseaâ—e beginning encreasing inveterate are wont commonly to be delivered And truely to know this Disease when 't is Inveterate is not very difficult as shal be said by and by but whiles it yet lies and is in the first blade then to know it is not so easie For as plants and trees when they are at ful growth are known by the vulgar but to know them at their first appearance is the part only of an artist and good herbarist So also this Disease when it discovers it self by diverse Diseases and Symptomes 't is known even by the vulgar but when it lirks in obscurity 't is not discovered but by experienced Physitians Yet there are some signs which may discover this Disease The signs of the veneral disease in its beginning even at the first beginning the first is that they who are taken with this Disease do presently without the appearance of any signs of a Feaver imminent perceive a kind of weariness and heaviness in their whol body and somtimes a drowsiness after sleep There is a vehement and wandering pain which is felt somtimes in the Head somtimes in the Muscles somtimes about the joynts and this pain is more troublesome towards night than at other times of the day The fresh color of the Face is changed strangely and some write that there is a Livid circle appears under their Eyes such as we usually see in Women that have their Courses there is added to these a sadness fear and those that before were merry and jesting become sad and pensive without any cause All which signs are of greater force if the signs of the Veneral Disease did go before and vanish without any convenient and sufficient means And truely if this evil be contracted by Copulation and hath not yet plainly possest the Liver but sticks yet in the Privities then chiefly this Veneral Disease at its beginning discovers it self by the running of the Reins Ulcers in the Privities and buboes for when that Malignant vapor is first of al communicated to the Testicles and genital vessels the seed is corrupted and the generation of seed is depraved in the genital vessels whence instead of good seed there is generated a stinking and corrupt Humor which doth irritate Nature to expulsion From whence also the Gonorrhaea although improperly so called is easily distinguished from that running of the Reins which is not French because this gallical is joyned with a great heat and pain somtimes also with an Inflamation of the Testicles and Vessels resembling a varix the matter which is cast forth is far different from seed viz. yellow green Acrid corroding the glans neither doth it yeild to those Remedies with which a true Gonorrhaea is cured Next of all there appeare pustles in the Privities about the bigness of a grain of Millet and somtimes they compass the whol Ring which when they are broken there remain white Ulcers which in process of the Disease grow deep and callous of divers colors and with pain joyned with them Thirdly also Buboes show forth themselves in this Disease for though somtimes the Buboes do precede an Erysipelas or a Rose yet then there went before those causes which
pain ceased nor returned no more And Johannes Schenckius ex D. Georg Garneci observat relates of one sick of the French Pox that was il cured who was taken with a great inflamation in his palate in the five-like bone in his uvula and al the neighbouring parts which presently turned to a Gangrene and that to a cancer that every day he voided somwhat of those corrupt and putrefied parts and the uvula and next parts being first of al cast forth at last he spit through his mouth his very brain with a most noysome stink And Felix Platerus lib. 1. observat makes mention of an Abbot who by the French Pox was made blind deaf and dumb who could no otherwise understand and perceive the meaning of others but if they with their finger or a peice of wood drew letters expressing some sentence upon his bare arme from al which singly perceived he made a word and from many words a sentence God the just Judg doth somtimes punish wandring lust with so grievous and horrid a punishment As concerning the differences of this virulency Signs of the differences although its formal essence be unknown yet there is a certain difference According to its manner of acting and its vehemency which is known from its effects for somtimes more somtimes fewer somtimes the contagion and active power is great sometimes less and Eustachius Rudius reports de morb occult lib. 5. cap. 10. that he knew some whores infected with so powerful a French Poyson that al who had to do with them were not only presently infected with the same evil but were wholly possest with most grievous symptomes which could not be removed nor mitigated by any remedies or art nay some of them not long after died But we know the vehemency of this evil if as was said even now some be presently infected if the pain be most cruel if the erosion pierce to the bones if many putrid and stinking excrements proceed every where from the body For by how much the evils are the more and more grievous by so much the power of this virulency is the greater CHAP. VII Of Prognosticks BUt that we may know what hopes there is concerning the event of this disease we must enquire whether the disease is like to be short or long whether easy or hard to be cured and at last what end it shal have But first of al concerning this disease Whether this disease shal cease 't is wont to be questioned amongst some Physitians in general whether it shal once have an end Fracastorius indeed did hope for it as was said before and thought that even in his time this disease grew aged and that a little while after it would wholly die chiefly for this reason because he thought it was epidemious and took its original from the Starrs which impressions of heaven do not last alwaies but in process of time are changed and because he saw this disease did grow more mild For as Jul. Palmarius writes of this subject lib. 1. de lue Vener Cap. 5. it was reported that this disease at its first rise was so filthy that that which reigns now is scarce thought to be of the same kind for there were innumerable ulcers rough and standing out in the figure and bulk of an acorn a filthy humor flowing from them and such a stink exhaling that his nose that it reached was beleeved presently to be infected The colour of the pustles was between black and green as much tormenting the sick with the sight of them as with their pain Therefore al people did shun the sight of them and so abstain from touching them as in no disease besides But Fracastorius his hopes deceived him for as yet we do not see this disease grow old much less cease and though the filthiness of the ulcers and pustles be more tolerable yet in pains and torments it is grown more cruel as the same Palmarius writes It is more likely that as long as those copulations and conversings wiâ—h infected people and wandering lusts shal indure so long also this disease wil last and be propagated by contagion For such is the nature of this poyson that it doth not suddenly kil a man in the interim those who are sick of that disease are infect ous those waies of which we spake before Whenas therefore there are every where many who are poluted with that disease and others converse with them there is yet no hopes that this disease should cease are long whenas the effect doth not cease unless the cause be taken away Neither is that reason firm enough which some who are of a contrary opinion do alledg for they say whenas this disease is a contagion preternatural and violent it must necessarily have an end whenas those things which are preternatural and violent have not perpetual causes and therefore must needs cease to be but the answer is easie nothing indeed that is preternatural and violent is of it self perpetual yet if the cause be perpetual that also may be perpetual Therefore though as the plague is sometimes extinguished so this disease also might be if the same diligence were used which is in preventing and curing the plague as was said before yet because there are alwaies men who are sick of this disease and can infect others and others do not abstain from their society even this disease shal continue so long as that contagion shal last And therefore Eustachius Rudius rightly of this subject Lib. 5. de Morb. occult Cap. 11. writes if there were one prince of the whol world or one conspiracy of many of them against this disease by the help of physitians this disease might be wholly rooted out viz. if they who are sick of this disease were al committed to physitians to be cured in the interim were removed from the society of other men and the same were done with the infected with this disease as is wont to be with those infected with the plague or leprosie there were hopes this disease might be extirpated for this cause too because the Veneral disease is not contagious at a distance as the plague is but for the most part is communicated by copulation somtimes by kissing and garments But here is no diligence used and as the same Rudius saith Theeves robbers and murderers and other wicked persons are sharply punished but publique whores ful of this disease and who daily destroy more than a thousand men polute whol Families and Cities are cherisht smoothed up with slateries and kept gallantly But leaving these let us see what may be foretold of every particular diseased patient 1. Prognosticks The Veneral disease for the most part of it self is a disease of long continuance for this reason Because the liver principally and the nutritive faculty is infected in it But Galen teaches rightly 5. de lo. affect Cap. 2. That of diseases of the heart al people die most speedily of affects of
the Liver especially For whenas that is the Forge of Humors which are carried through the whol body and they are purged by the benefit of sweat and freed from al defilements also the Liver polluted may be this way cleansed and though Nature somtimes do empty the virulent humors by some other part as by stool or by Urine and then her endeavor is not to be hindered but to be helped forward yet he holds that without sweating the whol body cannot be freed from that Disease and he thinks that sweat only can empty from al places both internal and external quickly safely and pleasantly But neither of these opinions doth fully reach the Truth The decision and both delivers an imperfect Cure For whenas the Curative indication so called in general is twofold the one preservative which is taken from the cause the other in specy called Curative which is taken from the Disease they who think this disease may be cured without sweat because it consists in a certain hidden and Malignant quality think right concerning the curative indication whenas that malignant quality cannot be taken away by sweating or other Evacuations but by proper Alexipharmaca yet they neglect the preservative indication and the cause for whenas it is certain that in the Veneral disease there is not only a vitious disposition and Malignant in the parts especially the Liver but that al the Humors of the Body are corrupted there is required then an Evacuation of them which is most commodiously done by sweating as Minadous rightly proves For though somthing be discussed insensibly yet that insensible Evacuation is not sufficient and 't is too slow But Aurelius Minadous thinks wel concerning the taking away of the Cause and the Evacuation of vitious Humors which is most rightly done by sweating but he neglects the disease it self or that Malignant quality imprinted nor only on the Humors but also on the Living parts from which it appears which is diligently to be taken notice of that the dispute of occult diseases is not amongst those which Galen calls Logical but does conceive the very essence of these diseases and that the ignorance of the occult diseases doth not only breed Errors in theory but also in pactice Therefore though we do grant that the Evacuation of Humors is wel ordered by sweating yet Alexipharmaca are necessary also against that malignant disposition in the parts especially in the Liver and Fernelius whom Palmarius follows or this very cause do add peculiar Alexipharmaca as shal be said that that Malignant disposition may be pulled up by the Routs For though al the vicious Humors be emptied and al other diseases and Symptomes do cease after their emptying yet unless that Malignant disposition be taken out of the parts the evil grows fresh again and oftentimes a long while after And this I think is the cause that not only the decoction of Pockwood Sarsaparilla and the like is given in the morning to provoke sweat but also without sweating is taken as common drink for the very same proper Medicines which do destroy the occult cause and malignity in the humors and do empty the vitious humors by sweat are able also to Eradicate the disposition imprinted in the parts Last of al this must not be past over that the indications proposed before are not necessary to be observed in every French disease but only in that which hath almost invaded the whol body and especially hath possessed the Liver But if the evil be new there is no need either to let blood or to give purges whenas the fault is not yet communicated to the humors but it is enough to wipe off or cal forth the contagion received which also is sufficient in the scab newly contracted by contagion where yet we must observe whether those pustles and French rottenness as they cal it do immediately proceed from contagion and whorish copulation for then external medicines do suffice or whether they do arise from the Liver now affected for then there is need of evacuations and alexipharmaca Chap. X. Of the Cure And first of bleeding FIrst of al therefore as concerning indication preservative or the removing of the causes and bleeding at the beginning truly the cause of this disease properly and next of al is not taken away by letting of blood yet if blood do abound in the body and that especially be too hot the proper remedies of this disease which are hot and dry cannot be safely administred unless the abounding blood be first diminished And truly if the virulent matter have no peculiar motion to any part the basilick veine may first of al be opened but if the matter have motion to some particular part as to the groin and nature thrust forth a bubo bleeding is warily to be used for if the bubo tend to suppuration we must not let blood and especially in the Arme lest nature be troubled in her expulsion and the matter be recalled to the inward parts And it hath been observed that many from the bubo opened and the matter a long while emptied by it have become perfectly found on the contrary from unseasonable bleeding the evil hath been prolonged therefore in bleeding we must attend the motion of nature and when the tumor doth not afford hopes of suppuration a veine must be opened in the lower parts for so the the matter is retracted towards the lower parts and by reason of the efflux of hot blood 't is afterwards more easily suppurated After the same manner a veine is to be opened in the yard if there be rottenness in the privities or a running of the Reines and wholly if the parts below the Liver be affected but if the matter rush to the head and there cause most vehement pains filthy ulcers falling of the haire the cephalick veine in the Arme is most commonly opened The other precepts which are propounded in general concerning the right administration in bleeding are here also to be observed which whenas they are not proper to this affect we shal no further propose them here If the strength wil not beare bleeding instead thereof the hemorhoidal veines of the Arse may be opened or Cupping-glasses be applied in convenient places Chap. XI Of the preparation and purging of vitious humors NExt of al if the body be cacochymical Preparation and purging of humors the vitious humors must be emptied and prepared with convenient medicaments whenas in an impure body alexipharmacal meanes and proper remedies of this disease do profit little nay they may bring hurt and though that disease be overcome may tender the body obnoxious to other diseases For vitious humors collected about the bowels cannot al be discussed and dissipated by sweat but the thinner part being discussed the thicker is left and grows dry and is fastened in the bowels and oftentimes contracting an acrimony doth weaken the substance of the vessels from whence that disease grows somtimes more stubborn to cure
teacheth that this Medicine doth exulcerate and cause heat and inflamation on the other side it causeth numness Palsies and other cold affects and that it proceeds from the inequality of its temperament and because 't is an imperfect mixt body and if it be prepared by calcination that the cold substance doth fly away and that which is left is fire But these authors erre very much The authors opinion indeed it cannot be denied that there are many Medicines which have Heterogeneous parts by vertue of which they produce divers effects which parts also may be separated by the help of art But that Quick-silver hath such parts is fals neither was there yet ever found any Chymist who could show the diverse parts in it and separate them by art for the whol is Homogeneous if there be any thing so in Nature and either it al flies away or al remaines and what way soever it is prepared Quicksilver is Homogeneous at last it al revives wholly Homogeneous and whatsoever Chymist can show any Heterogeneous parts in Quick-silver as in Rhubatb shal be in my esteem a great Apollo Neither is precipitate of another Nature then that which is crude neither doth Quick-silver loose any thing by its preparation and that prepared does differ from the crude only in external form which is caured by the admistion of other things which somtimes are Salt parts as happens in Mercury Sublimate and Precipitate somtimes only watry as when Mercury is reduced into water by a retort without the admistion of any other thing as the same Vnzerits teacheth Lib. 2. de Anatom Mercu. cap. 2. n. 4. for this water is nothing else but the Quick-silver resolved into the smallest bodies or Atomes by the strength of the fire and mixt with watry Vapors or the moist Air. Yet in that there appeare no effects of cold but rather of heat and that very water as other mercurial waters wil dissolve gold in like manner Saxonia is mistaken for Quick-filver is no imperfect mixt body but a body that hath the most perfect mistion and cannot be destroied by any art of the Chymists but every where retaines its form neither whiles it is calcined or rather exposed to the sire for Quick-silver cannot properly be said to be Calcmed do the cold parts fly away and the fiery stay behind but if those parts which are raised up be received they are of the same Nature with those that remaine as is wel known to the Chymist Therefore whenas this Reconcilation is of no force Quick silver is hot let us see who is in the righter whether those who hold Quick-silver to be hot or those that say 't is cold But I think that they are altogether of the righter judgment who think it to be hot for that appears by its great penetrating and corroding vertue so that it penetrates and Eats into Mettals and the flesh nay the very bones are corroded by Mercury precipitate and sublituate And Libavius writes in tract de igne natu cap. 30 that he knew by the relation of a most learned Physitian that a certain Chyrurgion dying by the too frequent use of Mercurial Medicines had his bones plainly britle or frangible But whenas they object first of al The answer of the reasons against it that whiles 't is quick and whol it doth not corrode the cause of that is because it cannot infinuate it self into the body and worke upon it whenas al its parts are most closely knit together nor cannot be mixed with other bodies but the Medicines prepared out of it as Mercury sublimate Precipitate Oyl of Mereury and it there be any more of this kind have a great power to burn and corrode not only by the reason of Salts commixt which is very little but because 't is resolved into the smalest bodies and being mixt with the Salts it can adhere to the body and by the benefit of things admixt most intimately insinuate it self into it Secondly whereas Quick-silver appears cold to the touch that is common to it with steel Brass Lead Wine things of their own Nature hot which by accident feel to be cold Thirdly whereas some also from the effects would collect quick-silver to be cold in that they are very much deceived and they attribute those effects to cold which have their dependance elswhere Truly they that drink the waters infected with quick-silver on the Alps are sick of divers fluxes and are taken with a bronchocele Goldsmiths and others who often deal with quick-silver are seldom healthful and long lived but are obnoxious to numnesses tremblings palsies convulsions lethargies suffocating catarths and appoplexies Thus Fernelius relates of a certain Goldsmith that imprudently admitting the vapour of quick-silver only presently became stupid drowzy and wholly speechless Ferdinandus Ponrertus relates that the same happend to another lib. 1. de vene cap. 3. And Forestus lib. 8. obser 5. writes That a certain yong man learning the Smiths art upon the atching of a Cup with quick-silver had all the hair of his head fell off and that his face became extraordinary pale and all his body tremulous and many others have observed the same And Jacobus Oethoeus in his observat reports That a certain yong Noble man troubled with Crab-lice in his Privities used Mercurial Oyntment to drive them away upon which his Yard grew cold and sluggish and unfit for Venery But here is a fallacy of the cause for quick-silver doth not do these things by cooling but because it hath a peculiar and occult quality that is an enemy to the Nerves and Brain as appears in many other stupifying poysons Fourthly That which is Objected is easily Answered to wit That the damage brought upon mans body by quick silver is cured by the use of hot things as Sage Hyssope Origanum Clary Rue Castor and the like For those Medicaments are not therefore applied to the preternatural affects caused by quick-silver only because they are hot but because they are friends to the Brain and Nerves and furthermore as they themselves grant by a specifick property are enemies to the Mercurial virulency and that such things are not therefore applied because they are hot but because by a peculiar vertue they are friends to the Nerves it appears by this because other hot things as Ginger Pepper and the like which have no specifick property freindly to the Nerves do not perform the same But concerning the Occult Vertue and Propriety of Quick-silver we chiefly meet with two doubts First of all Whether it be poysonous next of all Whether it be rightly applied for the Cure of the Venereal Disease Concerning the former Question Whether Quick-silver be Poysonous Whether quick-filver be Poysonous we have already treated before in tractat de Chym. Aristot consens dissens cap. 19. where we speak of Mercury and we said there That Matthias Vnzerus de anatem spagyr Mercu. did endeavour to prove at large That Mercury is not
be burnt or whether it be reduced to water or what other external forme soever it puts on it retaines its whole essence and with a litle labour may be reduced to its ancient forme Besides Rudius renders no reason why Mercury out wardly anoynted on the body is rather moved to the head then to the stomach and carries the humors thither with it for whereas he thinks that it is resolved into vapour and carried up into the head t is fals whenas it may be collected whol both in the mouth and in other parts 'T is more agreeable therefore to trueth Quicksilver an Enemy to the nerves that quicksilver is offensive to the nerves and brain as the tremblings which it causeth do sufficiently de monstrate and therefore that it creepes up by the nerves to the brain and carries the vitious humors thither with it which together with the vitious humors whenas nature and the expulsive faculty of the brain doth expel and cast down to the jawes hence follows salivation and quicksilver whether outwardly applied or inwardly taken stil creeps up to the head and causeth much spitting But there are divers wayes of using Quick-silver to raise a flux The wayes of ussng quick silver to wit either 't is outwardly applied to the body by unguents plaisters epithems and lavatories so called by a girdle by bracelets and Rings by suffumigations or t is taken inwardly by al which ways not withstanding there is nothing else done but that the Quick-silver may be reduced into the smallest parts that it may the eafier penetrate into the body yet what way soever t is broke into peices it keeps its nature and the least parts are easily again united to one another and returne to their ancient corpulency that it hath bin observed that sometimes a great quantity of it hath bin collected in the veins and cavities of the bones Yet the most common way of applying Quick-silver is by unction How the unction with quick-silver is to be ordered but that unction may be performed rightly sometimes are to be observed before unction some in the anoynting and some after unction before unction the body if need require must be emptied either with purging medicines or bleeding for if very many vitious humors abound in the body t is to be feared that by the use of these unctions they rush together in a heap to the jawes and suffocate the patient or being rapt up to the brain do cause an apoplexy or palsie and therefore first of al part of them ought to be emptyed Also if their be plenty of blood least the patient may suffer an inflamation of his jawes or a feaver t is good to take away a little blood Falopius also that part of the matter may be consumed the bowels strengthened and not be offended by the Quicksilver gives the decoction of Guajacum eight or ten dayes before unction As concerning the unction it self the basis of these unguents is Quick-silver which must be chosen pure or vivified by cinnabar and it must be mixed with hogs-grease hens-fat butter oyl turpentine that it appeare no longer quick to the sight which is commonly called mortifiying of it How Quick silver is to be prepared Some also ad to six ounces of Quicksilver four ounces of red sugar Some do mix divers other things to correct the malice of Quick-silver and indeed this or that according to the different constitution of the disease which notwithstanding profit little For those oyly and unctuous things or other things do stick on the skin and superficies of the body and cannot follow the Quicksilver into the innermost parts of the body nor correct its malignity But those things which are necessarily mixed are mixt to that end that the quicksilver may be reduced into the smallest bodies and â—o may the easier insinuate it self into the body Some also in the composition of this unguent think we ought to have respect to divers things and therefore Hercules Saxonia if there be hard knobs ads those things which do mollifie as the sat and grease of geese ducks the Marrow of oxe bones butter oyle of sweet almons if there be ulcers he bids us ad drying pouders Franckincense Myrrh alâ—e Litharge white lead which if they be il conditioned he ads Cincabar precipitated Besides he commands us to mix medicines which strengthen the parts more over 〈◊〉 bids us ad those things which do respect the principal parts and those that are most hurt and therefore if the joynts be affected he bids us ad ground pine if the liver hepatick means if the stomach things stomachical But besides the rest he doth aprove of oyle of Guajacum added to the ointment al which as we do not wholy disallow of so they ought to be explained First of al if the unction be ordered cheifly for tumors or ulcers medicines may commodiously be mixed with it but if salivation and emptying by spittle be cheifly intended there is no need of that laborious composition Secondly Quick-silver it self if it be reduced into smallest parts doth easily penetrate neither hath it any need of helpers and there is nothing that can penetrate easier then that Thirdly I can scarce be perswaded that medicines outwardly anointed can penetrate to the stomach and liver and strengthen them this likes me best that he thinks oyl of Guajacum ought to be added to those unguents The Quantity of Quick-silver that is used The quantity is sometimes more sometimes less according to the vehemency of the disease and the patients strength Yet we must not exceed seven ounces which is sufficient for strong bodies in weak bodies 't is sufficient to use three foure or five ounces but every time use two or three ounces of the unguent or for every dose take two scruples in tender children for every place so much oyntment as is the bulk of a lentil is sufficient Such oyntments therefore may be made thus Take of mercury six ounces Formes of Meacurial Vnguents of hogs-grease without salt one pound Kil the Mercury with the grease and mix it exactly then ad of the marrow of an oxâ—leg half an ounce of Turpentine three ounces of the oyl of it one ounce of the oyl of Guajacum two ounces mix them Or Take of venice Turpintine one pound of Quick-silver seven ounces mix them diligently then ad of hogs-grease eight ounces oyl of sweet and bitter almonds of each two ounces pouder of cinamon two drams Musk six granes mix it and make an ointment Eustachius Rudius commends this form which he used with most happy success for many yeares at Utine in the great hospital of that City with so much safety that not one of them perisht which he had in cure Take ake of Quick-silver one ounce and half Fresh Sows grease three ounces pouder of mastick one ounce oyl of mastick one ounce and half Saffron half a dram two Sweet apples of a middle size First of al let the sows
ends of all the Vessels which Conformation to alter and change is not at all within our power And he hath there asserted that the Joynts for this Reason only admit of and drink in the hot Wheyish Humor because that in them are terminated the external branches of the internal Vessels To wit that the Ebullition or boyling out of this serous Humor doth first of all begin in the greater and the internal Vessels and that from hence it falleth forth into the lesser and at length into the extream branches which having no other place whither they they may pour back the Humor they have received in it is thereupon stopt and heaped up together in the joynts in which the external Vessels almost al of them are terminated All which although it may seem very agreeable unto the truth yet notwithstanding two things there are that must here be taken notice of The former is this that although it be true that those greater Trunks of the hollow Vein and the Arteries their branches being dispersed hither and thither are for the greatest part of them terminated in the joynts yet Nevertheless there are likewise many of those branches which here and there are Terminated in the Flesh and other parts and yet for all that they Transfuse not the matter of the Gout into those parts And moreover also the matter of the Gout is not alwaies poured forth even unto the extream Joynts but that it oftentimes also stops and staies in the mid-way in the Hip Knees and Elbows The other thing to be taken notice of is this that albeit that Conformation of the Vessels by reason of which they are terminated into the Joynts cannot be changed yet notwithstanding the Laxity and weakness of the parts into which they are ingrafted may in some measure be changed by those medicaments that cotroborate although it be the least part of the Cure as hath been said that is to be expected from these But besides the imbecillity of the Joynts Why the humor that is the cause of the gout is moved unto the Joynts rather than to the other parts there is yet something else that seemeth to me to be the Cause why this humor is moved unto the Joynts rather than to any other parts which conceit of mine I submit as a Paradox only and leave it unto the free judgment of the Judicious and Candid Reader and it is this It is most certain that the Blood in our Bodies is not altogether homogeneous but obtaineth divers parts and that divers parts of the Body are nourished by those different parts of the Blood as the Flesh by the more temperate the Bones by the thicker the Lungs by the more subtile and so likewise the rest of the parts attract unto themselves from the blood a fit and convenient Nutriment And this seemeth also to be proved by the stone called Osteocolla so called because that it hath in it a notable virtue of Conglutinating the broken Bones which being taken inwardly penetrateth into the Bones rather than into any other parts and causeth that the Calli are generated in a very short time yea in those that are yong it produceth an overgreat Callus as we may see in Guilhelm Fabricius his first Century Observat 90. 91. Neither are these things done in a sound Body only but even the vitious humors likewise have not an inclination al of them neither are they al driven unto any one part but some of them tend unto one part and others of them unto other parts and this we are taught as by other diseases so more especially by the Plica Polonica above mentioned And therefore seeing that Hercules Saxonia in his Book of the Plica Chap. 26. writeth nothing but the truth when he saith that the humor the Cause of the Plica hath a propriety not wel agreeing with the Joynts Ligaments Tendons Nerves and al the Membranes but a certain familiarity with the Hairs and the extream part of the skin I conceive that I may also as rightly Assert that the Humor the Cause of the Gout hath a certain kind of familiarity and natural alliance with the Bones but that it is an Enemy unto the Membranous parts if not in an occult manner yet certainly by its Acrimony and by its twinging and lancing faculty For very probable it is seeing that the Bones as also the Ligaments and tendons are nourished by a Blood that is more Earthy as having an alliance with the Tartarous humor that other Tartarous humors also as wel the thick as the subtile are thrust forth more unto the Joynts than unto any other parts and more especially unto the Joynts of extream parts since that Nature as much as possibly she can is wont to thrust forth the vitious humors from the principal places unto the most remore parts For although it be so somtimes that Nature doth not presently thrust forth into the extream Joynts of the Feet or the Hands the matter that is the Cause of the Gout but that it stops and staies in the mid'st of some Joynt yet notwithstanding afterwards when the pains begin Nature if she be yet any thing strong driveth back again into the greater Veins the Matter by the same waies by which it flowed in and from hence she thrusts it forward even unto the extream Joynts touching which as also whether there lie any thing hid in the very Bones themselves that may make for the exciting of the Arthritick Paroxysm we shal speak more hereafter in the eighth Question Secondly Whether the Gout be generated by a collection of the humors As touching these humors that are the Cause of the Gout where they are Generated and by what waies they pass into the Joynts the Opinions of Physitians are various and different of which we shal speak further in the seventh Question But now that I may in few words comprize the sum and substance of the thing in question seeing that al swellings and the preternatural Collection of humors in any part is done two waies to wit either by Congestion by which the humor is by little and little collected and heaped up in the part or else by Afflux we cannot conceive that the former of these waies hath any place in the Gout For if by Congestion and the alone weakness of the parts the humor should be collected in the Joynts then the pain and swelling could not be bred so suddenly so easily and so evidently and the infirm part should perpetually labor and suffer in regard that the Cause of this distemper and pain should never be absent from it But now since that Persons that have the Gout are not in a continual suffering condition but that some of them are free for six months together and that afterward the matter again floweth unto the Joynts and that indeed suddenly to wit when there is a vitious humor collected in the Body which urgeth and provoketh Nature unto the expulsion thereof it easily from
be hurt For if there be any thing amiss in these which cannot indeed very easily and determinately be demonstrated and made to appear it then cometh to pass that the unuseful parts salt and tartarous which are in the Chyle cannot be rightly separated but remain mingled with the blood and together with it are derived unto the Veins And by reason of this Vice and fault of these Bowels it happeneth that oftentimes from Meats and Drinks in themselves not very hurtful some persons are very easily offended and on the contrary others that have strong Bowels in whom the Concoction of the blood and the separation of the excrements is rightly performed although they usually feed upon meats apt to breed the Gout and fil themselves also with Wine and that likewise none of the wholsomest they are not yet for al this at al troubled with the Gout But what this distemper of the Liver and Spleen is What kind of distemper it is that maketh for the gout cannot so easily be explained and unfolded And yet nevertheless if any one shal determine it to be a hot and dry distemper I shal not at al gain-say him But in what manner this hot and dry distemper doth effect what hath been said this is not so clear Franciscus Vallesius tels us for a truth That by this distemper there is strongly pressed forth a water from the rest of the Juyces which is not probable unless it be fitly explained For this we willingly grant That if the Liver be more hot and dry than what naturally it should be instead then of a moderate Elixation or boyling there wil be a certain Assation or rosting and so the blood that is generated must needs be sharp Others affirm and indeed not unfitly that the Liver and Spleen when they are vehemently and intemperately hot attract the serous and salt Juyce in the Food which ought to have been separated and evacuated in the first Concoction and so it comes to be mingled together with the blood Yea and haply also in the distempered Liver it self and Spleen the Blood is not wel elaborated and somthing there is left remaining therein that ought by right to have been separated which being afterwards heaped up in the Veins is the cause of the Gout And I am of Opinion that the very same happeneth in the Liver and Spleen that happeneth in the Reins For many there are that eat Cheese and other meats that are very apt to breed â—he Stone and yet notwithstanding they do not generate the same whereas others on the contrary in whose Reins there is a sandy gravelly and stony constitution as Fernelius calleth it or a power in the Reins of breeding the stone these are easily offended by the meats aforesaid And I conceive that the case is the same in the Gout and that there is a certain vitious constitution in the Bowels of those that are troubled with the Gout and I am of Opinion that this vitious Constitution is the efficient cause of that Salt or Tartar by reason of which that Humor which is the cause of the Gout is produced which when it once cometh to abound it is then afterwards thrust forth unto the Joynts And this vitious constitution is communicated unto some from their Parents and by others it is contracted from the use of Meat and Drink of a like Nature and likewise from the Errors they commit in the whol course of their Dyet And moreover Although the faculty of the Bowels be wel constituted yet if the Meat and Drink abound with such a like Tartarous matter it cannot al of it be evacuated by Nature in regard that neither in the first Concoction nor yet in the second it cannot be separated as it ought to be but remains stil mingled with the Blood But yet in the mean time as much as may be it is altered by Nature and by her spiritualized also if I may so speak or as Mercatus speaketh it is attenuated poured abroad and changed into a thin spiritful and sharp humor which is afterwards by Nature thrust unto the Joynts For the Joynts as I said before are parts that are weak and extream bony and bloodless unto which Nature is wont to thrust not only the serous Humors but whatsoever likewise hath any alliance at al with the Humor that floweth But now the imbecility of the Joynts is either Native or acquired The weakness of the Joynts twofold It may then be said to be Native when either the Joynts themselves in their first structure are more loose softer and more apt to receive the Humors flowing unto them or else when they have either from the Parents or from the Grand Parents thus affected by a right of Inheritance as it were contracted this distemper and weakness But it may then be said to be acquired when the Joynts are weakned either by overmuch labor excess and injuries of the Air or other Causes altering the Joynts But now Why the Humor is moved to the joynts that the Humor which is heaped up in the Veins and about the Bowels should be moved unto the Joynts this cometh to pass Because that Nature being stirred up and forced by the abundance of vitious humors attempteth the expulsion of them And yet if any thing happen that may move the humors the Paroxysm is then more easily excited And this cometh to pass if any one be provoked to wrath or stricken with terror or any other vehement affect of the mind or if any shal be very hor and then suddenly cool again on one and the same day or else shal exercise himself immoderately or make use of the Bath unseasonably And this is likewise done by the retention of the usual and accustomed sweat or the excess in qualities of the Ambient Air and the change thereof and more especially that change that is made at certain times of the Yeer and it is manifest by Experience that about the beginning of the Spring and Autumn the Blood is moved and stirred up and down in the Body and if there be any thing faulty in it Nature is wont to expel it unto the more ignoble parts from whence arise scabbiness the Erysipelas Feavers Gouts and many other Diseases according to the various disposition of bodies From al which it is easie to find out the Antecedent The Antecedent causes Procatartick and altogether remote Causes as also the external and internal Causes which of what kind soever they be either they make for the generating of the matter and humor producing the Gout or else they weaken the joynts or else lastly they so cause it that the humors are moved and excited But since that these are various and that some of them do concur more waies for the generating of the Gout than others they may therefore be considered according to those things we cal Things not Natural And first of al Air. As for the Air We have already said that in the Spring
the purge upon the head of the part affected As for example if the pain be in the Hand the defensive is to be placed upon the Shoulder and this may be made and provided of the Flowers of Roser Pomâ—granate flowers Roots of Bistort Tormentill the greater Consound the Rinds of Pomegraâ—ateâ— â—ole-Armenick mingled with the white of an Egg and Rose water or Vinegar Aâ—dâ—ner this Cataplasm being dried and so made hard may not excite Pains and thereby further provoke the flux a little of the Countesses Vnguent or of the Oyl of 〈◊〉 Omphacine is to be added thereto Or else instead of the Cataplasm a swathe that is long enough may be wet in posset in which Oak-moss Red Roses or other Astringents even now mentioned have been boyled and drawn over the upper part as for instance in the Gout of the Feet upon the part above the Knees And those Defensives are to be continued so long as the Purgation lasteth yea for the whole day as we see occasion But now we cannot in general desine with what kind of Medicaments this purgation is to be performed in regard of the great variety there is in Bodies For although the Humor the nighest cause of the Gout be wheyish Salt and Tartarous yet nevertheless this very Humor is in divers Bodies constituted after a different manner and hurrieth along with it other Humors also that abound in the Body Yea and in one and the same Body the same Medicaments are not alwaies fit and proper because that the stare of the Body is not evermore one and the same And therefore the Physitian ought to be present with the Patient when he prescribeth such like Remedies Now for the Evacuating of Serous Humors and Cholerick Ichores such as these following ought to be provided viz. Syr. of Roses solutive de Spina Cervma commonly called the Domestick Syrup Manna Mechoacan Sene the Seeds of wild Saffron and the compounds from any of these as also Electuar Diacatholic Triphera Persica de Succo Rosarum And so likewise in the stronger kind of Medicaments those are of special use that are made of Hermodactiles and among them the Caryocostine Electuary of Bayrus of which we shal anon make surther mention when we come to speak of the Preservation from the Gout Or Take The Choycest Turbith and Hermodactiles of each three drams Diagridium one dram and half Ginger and Mastick of each a dram Sugar six drams make a Pouder hereof the Dose whereof is one dram or a dram and half with flesh broth Or Else let the Patient make use of the Pills of Rhases which as he writeth in his 9. B. to Mansor Chap. 90. will presently make and enable those that keep their Beds to Rise stir and walk up and down and they are in this manner to be Compounded Take Aloes one dram Scammeny half a half peny weight red Roses a double quantity to the former Hermodact half a dram Make pills thereof and give them all at once and yet not without regard unto the strength of the Patient But now although the serous or wheyish Humor be the nighest cause of the Gout yet notwithstanding because that this Humor doth also violently carry along with it other vitious Humors in the Body and especially when the pain cometh the Physitian therefore ought to be present with the Patient when he is to prescribe such various purging Medicaments for the present occasion of the sick Person Vomitories A Vomit is likewise very useful in such as are accustomed thereunto A Vomit and seeing that it may Evacuate the Humor by a shorter way there is no such cause to fear the rushing of the Humors unto the part affected And yet not withstanding we dare not here give such strong Vomitories that may evacuate the Humors out of the very Veins but it will be sufficient if such be administred that do evacuate the first waies and the parts neer unto the Stomach For if there be many vitious Humors residing about the Stomach Spleen and the hollow of the Liver and in the places neer thereunto it may very easily come to pass that these Humors being stird up and down throughout the whole Body they may both penetrate unto the Veins and rush unto the part affected And purges may be likewise appointed unto the sick person after his vomiting yea and if one purgation will not serve the turn it is again a Second time to be repeated Franciscus India in his 2 B. of the Gout and the Third Chapt. doth here wonderfully extol a Vomitory that he maketh of Butchers Broom a sufficient quantity of the pouder thereof given with the defilled Water of unripe Oranges a little warm which as he writeth can with special benefit unto the sick person Evacuate both the Choler and the Flegm not only upwards but downwards also Sudorificks or Sweaters The Body being sufficiently purged Sweaters we are to endeavour that sweat may be provolâ—ed either of its own accord or else by administring of Medicaments For as Crain writeth truly in his 24. Cons if the sweat be at all deteined within and hindered from coming forth especially if the Patient hath been accustomed thereunto it will not be long ere a fit of the Gout come yea and without all doubt the Paroxysm will be much augmented and provoked if in it the sweat be deteined and if the remainders of the wheyish Humor in the Veins be not discussed and Scattered and on the contrary the Paroxysm wil be the shorter if the Serum or Whey be by sweat dispersed But since that in the first invasion of the Gout there is as it were a certain kind of boyling of the Humors and that for the most part there is likewise present a Feaver Sweaters of what kind they must be in this regard hot sweaters such as are Treacle Mithridate and the like are here scarcely fit and convenient because that by them the Humors may be the more inflamed But yet Harts-born either crude or prepared without any burning may be very fitly exhibited either alone or with the Water of Carduus Benedictus And so likewise Diaphoretick Antimony is very useful But if the Constitution of the Body and the disposition of the Humors wil bear it the Decoction of Sassaphrass or Sarsaparilla or Chyna may be administred which yet nevertheless we ought to temper with Succory Endive Sowthitle and Dandelion or Lions Tooth But yet al those things that are useful in the Paroxysms for the discussing of the Humors either sensibly or insensibly they have not all of them their place here in the Cure And so likewise the Decoction of the greater Dock or Burr in regard that it cutteth discusseth moveth sweats and Urms is very useful and Forrestus relateth that Vastellius a Pensioner at Mechlin when he was forced to keep his Bed by reason of the pains of his Joynts insomuch that he was not able to move or stir any one Member he drank warm Beer in the
this Caution and good cause there is also for it that these Oyls and Fat 's are warily and carefully to be made use of For in regard that the Gout hath often some kind of alliance with the Erysipelas as to the cause thereof and that it is a thing generally wel known how that all fat things that stop up the pores in the Erysipelas do more hurt than benefit the very same seemeth likewise to be feared in the Gout lest that the Pores being stopt up by these fats the humor being detained within the pain may be augmented and this even very experience testifieth And it was related unto me by a certain honest Neighbor of mine that he himself in the asswaging of the Gout pains in his own Body found nothing to be better than Cheese of Sheeps Milk new and fresh made and laid on but often renewed For no sooner did the Cheese begin being made hot by the heat of the part to become fat and to drop forth butter as it were but as he said his pain was thereupon very much increased Take the Pith of wheaten Bread half a pound and boyl it in as much new Milk as wil serve to make a Cataplasm and then add of the mucilage of Marshmallow seeds two ounces the meal of Linseeds and Fenugreek of each two drams Powder of Camomil flowers and Melilote of each one ounce Saffron one dram Oyl of Roses and Camomil of each half an ounce and mingle them wel together Or Take Milk newly come from the Cow one ounce and half Crumbs of white Bread five drams Barly meal one ounce and half the common Hermodactyles six drams Saffron one dram Oyl of Camomile as much as wil suffice and make hereof a Cataplasm Or Take white Bread six ounces Milk as much as wil suffice and mingle them wel at the fire and then add the Yelks of two Eggs Electuary of Roses two ounces Saffron one scruple and mingle them Or Take the Meal of Barly of Beans of the bitter Vetch Orobus of each one ounce of Linseed six drams the Powder of Camomile flowers three drams of Melilote two drams of Saffron one scruple boyl them in a sufficient quantity of the Water of Camomile flowers then add the Yelks of two Eggs Oyl of Camomile and Roses of each one ounce and mingle them Or Take the soft Crumbs of Wheaten Bread one ounce Powder of the Mullein flowers two ounces boyl them in Milk and then add of the flower of Cassia one ounce and mingle them Or Take of Linseeds and Fenugreek seeds equal parts of each let the Mucilage be drawn out of them with Rose-water and then add the yelks of two Eggs and a little Vinegar and then sprinkle in Bean Meal and make a Cataplasm Or Take Meal of Barly of Linseed of Fenugreek of Beans Powder of Camomile flowers of each half an ounce Marsh-mallow Roots one ounce Oyl of Roses and Camomile of each one ounce and half Yelks of three Eggs the Rob of Wine one ounce mingle them and make a Cataplasm Or Take the flowers of Mulleyn as much as you think fit infuse them in a sufficient quantity of Red Wine for two months and then let them be distilled let the place be fomented with the distilled water and then after anoynted with the Oyl or Liquor of Mulleyn flowers that is in the Summer time collected by the Sun-beams in a Glass close stopped Or Take the yong and tender buds of the Hazel Tree press the Oyl out of them after the same manner as it is wont to be made of Linseed The Body of it that remaineth after the pressing forth of the Oyl let it be burnt and out of the Ashes let there be the Salt drawn forth with pure spring water and let this be mingled with the aforesaid Oyl The Oyl when it is mingled with the Salt let it be clarified by pouring and passing it through a Box of Wood as Painters are wont to clarifie the Oyl of Linseed for their own use and so it becomes a very excellent Medicament for the mitigating of pains But now these very Anodynes themselves may be somwhat varied according to the quality of the humor and in a humor that is more hot there may be added some certain things that are cooling as Roses and the Water that cometh from them Plantane Water and the like But in a cold Cause the Flowers of Camomile and Melilote Wormwood Linseed and Fenugreek may be added Narcoticks If Anodynes be not sufficient for the aforesaid purpose Narcoticks then Narcoticks are to be made use of which in regard that they bring a certain kind of numness upon the part they do not only forth with asswage the pain but they likewise by their heat which they obtain do also withal resolve the humors and so with benefit and safety and without any danger at al as it is thought they may be made use of as Platerus writeth in the 2. B. of his Practice and therfore he as likewise many others have done much commendeth the Leaves of Henbant and Mandâ—ake and Poppy if while they be new they be first bruised or boyled and so laid upon the part and their Oyls are also very useful and so is the Juyce also that is pressed forth of them and used for a fomentation as likewise the Root of Mandtake and Henbane seed applied together with other things in the form of a Cataplasm The new and fresh Leaves likewise of Tobacco bruised and laid upon the pained part do asswage the pain And the same Platerus as likewise other Authors have here recourse unto Opium also and they mingle it together with other Anodynes and unto two ounces of these they add a dram of Opium And he writeth also that if it be dissolved in the infusion of the Spirit of Wine alone or the infusion of Saffron four ounces of the yellowest of it and one scruple of Camphyre with a dram of Opium and the part where the pain is be wel washed or bathed with the said Liquor it is a most efficacious and soveraign Remedy And so likewise the Opiate Antidores as Treacle Mithridate Philonium may be added while they are new especially in case the quantity of the Opium may be augmented And yet notwithstanding we are not to continue long in the use of these Opiates in regard that they are enemies unto the native heat and Nerves And yet nevertheless the same Platerus tels us in the first B. of his Practice Chap. 5. of the burting of the Touch that he could never find that the Skin could be made stupid and sensless of pain by any external Narcotick applied thereunto albeit that so he might know somwhat of a certainty he had applied a Mass of Opium when he had first softened it unto the part pained with the Gout But the truth indeed is that Narcoticks when they are administred do very easily asswage the pain but then withal it being so that they hinder the motion
that all the matter is discussed and wholly Rooted out unless haply that by an intemperance and irregularity in the life it collect a new fulness of matter For he determineth that the cause of the Arthritis is peculiar to wit the internal a fulness of the Vessels and more especially of the blood but the external is every occasion that bringeth labor and unwonted exercise to the â—oynts by the which they become hot loosened and dilated and the Humors poured all abroad waxing hot and stird up and down flow together in these â—oynts which the part weakned and made loose doth very casily draw unto it and receive it But as for the opinion of Franciscuâ— India the very truth is that the Word Gutta is a â—atine Word and not Barbarous but yet to use it for a flux on and Catarrh or for Arthritis is contrary to the use of the Latine Tongue and therefore he may very deservedly be accounted for no better then Barbarous that shall use this word for Arthritis or prefer it before the Word Arthritis And although that Galen in his sixth of the Apâ—oris and 28. Apho doth indeed affirm that almost all that are taken with the Arthritick affection that is to say the pain in the Joynts are such as have first of all been troubled with the Gout yet nevertheless this doth not prove that the Kame of Arthritis sitteth not unto every pain of the â—oynts for there are likewise Joynts in the Feet And as we told you above in the first Chapter this Name in general is somtimes taken in special for that Disease of the Joynts when all or most of the Joynts are affected which happeneth not unless a man be first taken with the Gout Podagra But more rightly Guainerius in his Tract of the Diseases of the Joynts Chap. 1. I saith he when I saw that the Arthetica for so all the Physi ians of that Age by Reason of their ignorance of the Greek Tongue called this Disease had its Name from a Limb or Joynt in which places the pains of the Joynts are wont to be was willing to call all such like paiâ—â—s whether with a swelling or without Artheticz like as also all that ever were before me have done But as for Cardanus and Mercatus I see no cause at all why they will not have the Gouts Podagra Chiragra Gonag a and the Sciatick pain and al other the pains of the Joynts to be comprehended under the Name Arthritis as a Species under its Genus or if the most or all of the Joynts be troubled with the like affect with that wherewith the Feet Hands Knees and Hip are wont to be grieved I know no reason saith he why it may not be called Arthritis But this in the mean while we deny not that every Disease of the Joynts or every swelling are not properly called Arthriâ—is and that it somtimes happeneth that other vitious Humors and not the blood as Mercatus will have it altogether of another kind from those that produce Arthritis properly so called may be heaped up in the Body and that they may somtimes with and somtimes without a feaver be driven unto the parts nigh unto the Joynts and may there excite and cause swellings and somtimes also pains which swellings notwithstanding are not properly the Arthritis seeing that as Merâ—atus himself hath determined they do not begin from pain and end in a swelling but on the contrary they begin with a swelling and then afterwards there cometh a pain How much less then are these swellings alone worthy of the Name of Arthritis and on the contrary this Name to be denied unto those pains of the Joynts of which we have hitherto been treating Especially since that those swellings do not return as the Gout doth by certain intervals but although they have once or so infested and disquieted any person yet they may afterwards never again return all the whole life long And therefore if Cardanus Me catus or any others will likewise have these swellings to be called Arthritis let them know that the Ancients were not wont to call all kind of Tumors or Swellings were the cause what â—t would they sprung from and all kind of pains I say they were not wont to cal all these by the Name of Arthritis And Hippocrates in the sixth Epidem Comment 4. Text 13. calleth those in Aenos that by exceilive eating of Puise had gotten a pain in their Knees not Arthritick but Gonalgick that is to say persons Diseased in their Knees and touching this we shall speak further in the Question text following Quest 2. Whether every pain about the Joynts deserve the name Arthritis THere are indeed some of this Opinion that every pain that happeneth about the Joynts is to be called Arthritis since that if there be any other such like pains they are no where expressed by any of the Physitians neither hath any of them written of any pain of the Joynts that is not Arthritick And although we may meet with some kind of seeming difference either according to the greatness or according to the duration of them a shorter or a longer time they conceive that this difference doth not at all vary the species or kind thereof But I think that Galen in the third Section Aphorism 15. and 16 writeth most truly that if the filthiness be so great that it may dry up and consume the moisture of the Joynts it may then indeed cause a difficulty of the motion by reason of the driness in the Joynts and that it may haply cause pain likewise yet nevertheless it never produceth that affection which is called Arthritis unless any one be minded to call all pains whatsoever of the Joynts by this name For Hippocrates himself for such as by the over-eating of the bitter Vetch Orobus and other Pulse had contracted these kind of pains he doth not call these Persons Arthritick but Gonalgick Persons And therefore although we scarcely find any Anthor handling all such pains as these in any one place yet nevertheless we find them created of and mention made of them here and there in several places of the same Author For it very frequently so happeneth that vitious humors heaped up in the Body may be by a Feaver or else also without a Feaver thrust forth into the Joynts and more especially the Knees and may there occasion pains which may oftentimes continue a long while and such no doubt were those mentioned by Hippocrates in the place afore alleadged which if not alwaies yet when the sick Person desireth to move his Feet they then excite Pain unto which notwithstanding to speak properly the name Arthritis properly so called doth not suit not agree So in such as have Dropsies and such as are Cachectick or of an ill constitution the â—evous humors falling down into the Feet may indeed excite there a swelling and those very humors likewise when the Feet are moved may breed
and cause much pain which yet cannot be said to be the Arthritick pain Neither doth the humor then flow into the part affected by and thorow the Veins but it by little little descendeth thereinto by the Pores in the Abdomen And if we exactly weigh the matter we shal find that such like humors as these do not seiz upon the very parts themselves that constitute and knit the Joynt together but that rather a humor from without is poured forth and floweth round about these parts and sticketh 〈◊〉 between the Skin and the parts constituting the Joynt And so in the lostening of the Joynes in Wounds and in Cotâ—usions the humors do oftentimes flow unto the Joynes and there cause a swelling and pain which yet is not worthy of the name Arthritis And so those that have their Joynâ—s much dryed and hardened as it is an the Scurvy and other Diseases these Persons cannot stretch forth nor move those Joynts without pain and yet they are not to be accounted Arthritick Persons neither do we call them so And therfore the Arthritis properly and in special so called is only that pain of the Joynts when the peculiar humor described above bred in the Bowels of the lower Belly and heaped up in the Veins and Arteries by them suddenly floweth into the Joynts and insinuateth it self more especially into the sensible and tender parts about the Joynts and there partly by twinging and partly by distending causeth pain Quest 3. In what place the humor that exciteth Arthritis consisteth MAny indeed there are of this Opinion that the humor the Cause of Arthritis doth consist especially in that Cavity or hollow space that is betwâ—xt the extremities or heads of the bones which by Articulation are joyned together and that the humors flowing together by the Veins do first of all flow unto those Cavities of the Joynts and that they then afterwards seiz upon all the parts lying round about the Bones and the Skin from whence it happeneth that the Bones sundering themselves and departing one from the other the Ligaments and Nerves and Tendons are all of them so extended that from thence there is excited a most vehement and wracking pain And for this their Opation they first of all alleadg that which Hippocrates writeth in Sect. 6. Aphorism 49. that the Arthritis is not ended before the fourtieth day and that the humors that have flown unto the part affected are not sooner discussed as being such as stick in a part destitute of heat whereas if they consisted in fleshy parts and such as have many Veins and Arteries they might easily be resolved And secondly they go about to prove it by this because that from the afflux of the humors into the Cavities of the Joynt the bones are made to divide themselves one from the other and so by distending the Tendons and Membranes they cause the pain Thirdly because that by the motion of the joynt the pain is encreased Fourthly because that a pain is first of al perceived in the bottom of the part affected before ever the external parts begin to swel but that after wards when the humors have gotten themselves a way unto the outward parts the external parts are then lifted up into a swelling But the contrary Opinion which determineth that the fluxion is first of al made into the very parts incumbent upon the joynt from whence they may haply somtimes but this is very rare sweat through into the Cavity or space of the joynt is altogether more agreeable unto the Truth and this we are taught first of al by the very breeding it self of the Arthritis For since that the afflux of the humor generating the Arthritis is by those Vesseis that carry along the Aliment unto the parts as we shal afterwards prove it is necessary that the vitious humor that insinuateth it self into the joynt should first of al flow into the parts lying upon the joynts and keeping them close together and that from hence if there be any great store thereof it may insinuate it self into the Cavity of the joynt Secondly the bones are so knit together by the strongest Ligaments that there is hardly any space at all left into which the matter may insinuate it self Thirdly The Ligaments are very thick and solid so that they wil not easily â—dmit of the humors flowing in unto them and much less wil they permit them first of al to flow into the very Cavity of the joynt Fourthly if the matter should flow into the very Cavity and the bones thereupon divide themselves the one from the other the Membranes would then be made longer which yet we see is never done Fiftly in the knotty Arthritis those hard knobs that are somtimes taken out of the joynts are not found in the space between the bones but about the Ligaments and the parts encompassing the joynt Sixtly if the humor should first of al flow into the very joynt it self and that it should from hence be communicated unto the external parts there would then be excited either no pain at al or such as would scarcely be perceived in regard that the heads of the bones in al that space in the which they are knit the one to the other are not covered with any Periostium but only with a Cartilage and there is no Membrane or Nerve at al in that place Seventhly the tumor or swelling that seizeth upon the external parts and from the juncture of the joynt is somtimes extended far abroad unto the parts lying neer unto it it sufficiently teacheth us that the humor the cause of the Arthritis is not contained in the very joynt it self but in the parts about the joynt And lastly if the humor should be contained in the very Cavity between the bones it could not be which yet we see that it often so cometh to pass that cooling and repelling Medicaments should forthwith drive back the humor from the place affected into the Vessels and from hence into other places And as for whatsoever they alleadg and bring for the contrary Opinion it may be easily answered For first of al That the humors in Arthritis are oftentimes long ere they can be discussed the cause is not that the humors are contained in the Cavity between the bones but because they stick in places void of blood and therefore having but little heat in them and the humor it self likewise is somwhat unfit to be perfectly discussed Neither yet nevertheless is this alwaies true for oftentimes also the matter is dispersed and scattered in a very short space of time to wit when there is not much thereof when it is thin when the Part is cherished with heat and the matter not thickned by unfit Topicks And moreover the pain is not therefore excited because the Joynts are stretched forth in length and made longer and so are separated one from the other but because that a sharp humor flowing into the Membranous parts doth distend
And moreover I speak it without detracting in the least from the worth of men so eminent be it so indeed that such a pain and impediment of the motion may proceed from driness yet I much doubt of this Whether or no this pain be caused only by the wasting of that humidity whereby the heads of the bones are as it were anointed and oyled For in the whol space in the which they are joyned together the bones are not covered with any Periostium and thereupon they are wholly void of sense and therefore in this place pain cannot be excited But it seemeth to be more agreeable to truth if there be any impediment of the motion or any pain excited in the joynts by reason of driness that this happeneth by reason of the over drying of the Tendons the extremities of the Muscles and Ligaments by means of which the Members are rendered unfit for motion and if it be so that they ought to be moved there is a necessity of their being violently extended and this violent stretching forth breedeth a pain Seeing therefore that a naked and bare distemper cannot cause the Arthritis Whether a windiness may cause the Arthritis it remaineth that we make enquiry from what matter it may be excited There are some indeed as Guainerius and Matthaeus that make mention of windiness and of the degrees the of But a windiness cannot possibly excite so great a pain and oftentimes also of long continuance in these parts unless by windiness any one be minded to understand the spirit touching which we shall speak more hereafter And although the pain be oftentimes movable and flitting from place to place yet this is not from any windiness but from the humor which is also most apt and fit for motion There are some likewise that unto Arthritis refer that Affect which by the Arabians is called Nakir Nakir what kind of Affect it is which Albucasis in his second B. and 93. Chap. thus describeth There is saith he in this Country of ours a certain sickness or Disease which they call Nakir and it is a pain that happeneth in some certain Members and afterwards is changed from one Member to another and of this disease I once saw such an Example as this that I shal now relate I was upon a time called unto a certain woman being sick and weak in a Village not far from me She uncovered her Arm where I beheld a smal Inflation in the Vein of the Arm and about an hour after I saw this Inflation to proceed forward with great speed like as a worm creepeth and ascending upwards unto the Shoulder much sooner than could possibly be imagined and it was moved upwards like as Quick-silver is moved when it runs from place to place The pain therefore departed out of the place where it was at first and fixeth it self in the Shoulder And afterwards as she her self told me it rowled up and down throughout the whole Body even as I my self might very easily discover it to be so I therefore greatly admired the swiftness of its motion from Member to Member for indeed I had never until now seen any such kind of Disease as I saw in this Woman Indeed I have seen many that have felt the pain changing and going from one member to another but not after this manner or with this celerity neither could I here conjecture any other cause then this to wit that the Woman was quite spent and dispirited by the heat of the Sun and her hard labor and pains-taking such as they are wont to undergo that live in villages her Body being very dry and her Veins uncovered And hereupon therefore that windiness appeareth to be changed even sensibly and of necessity it is that it cannot appear after this manner in such as live idle and delicate lives and in moist Bodies and where the Veins are kept covered And therefore whensoever thou attemptest the curing hereof and the Patient Feel that pain then if it be the same it appeareth to the Eyes as we said before Then hasten and bind both upon it and under it and cut upon it till the Windiness that is pent up and kept in hath a vent and passage made for it to go forth and Cauterize the place But if it be so that thou canst not see the place that is affected and the pain then Cure it with the excussion of the Body and some kind of Remedy that expelleth windinesses and extenuateth them And for this purpose very necessary and useful are the Foetid Pills the Pills de Sagapeno and the like Thus far Albucasâ—s But this Disease is not Arthritis For neither is it only about the Joynts but it ariseth from a Windiness or furious spirit poured forth out of the Vessels and running to and fro throughout all the external parts of the Body There are some who think that this motion of windinesses and spirits is made in the Veins themselves And true indeed it is that oftentimes in the Vessels and Bowels such like windinesses do run up and down with great violence and rushing like as Antonius Benivenius in his Tract of hidden Diseases and the Cure of the Causes Chap. 81. Relateth that Ludovicus Nicolinus was so affected with a winde rushing violently into his Bowels and Stomack that not only his Bowels and Breast but his shoulder-blades were likewise extended with an incredible pain and he was likewise forely troubled with a great and miserable streightness of breathing whereupon also he died the third day But in that History of Albucasis it is probable that the Flatulent and windy spirit that he speaketh of was poured forth of the Vessels into the very superficies and outside of the Body For seeing that the motion there spoken of was Joyned with a great pain that spirit could not be contained only in the Vessels as being such that are destitute and void of all sense And some there are who think and this rightly enough that this Affect if it be not one and the same yet that it is very neer of kin unto that described by Wierus in a peculiar Tract in a Book he wrote in the German Tongue touching unknown Diseases of which likewise Henricus a Bra wrote an Epistle to Petrus Forestus which Epistle is annexed unto the observations of Forestus in his twentyeth B. of Observations Those of our times do for the most part refer them to inchantment and they tel us I know not what of Elves and Fayries that as they conceive breed those pains when yet notwithstanding these and such like of flitting pains that run up and down in the Body may also have their Natural Causes and they may have their Original from a certain sharp Flatulency or a sharp whey bred out of a Humor almost Scorbutick and roving up and down the Body by the Membranous parts and Muscles And from hence it is also apparent that they cannot be fitly referred neither unto the Dracunculi
Arthritis for it being a very thick and dull Humor it cannot easily insinuate it self into those most streight and narrow passages But as for Choler there are some who upon very good ground will have the Arthritis to proceed from it also and not only from the flegm and this they endeavor to prove even by those very signs that appear in the Arthritis For the pain is for the most part extream sharp and violent and not unlike unto that pain that is pricking and shooting and the Diet that went before was dry and hot or at least very much tending thereunto the excercises also were over-violent and the habit of the Body thin and spare And the very truth is that this is not indeed to be denied that those things do somtimes befal the sick persons and that oftentimes also the pain is so sharp that it cannot possibly by any meanes be referred unto that Crude Humor Flegm but argueth rather a hot Humor But now a Question may be here made whether or no every preternatural hot Humor may be called Choler and we think that we may well deny this to be a truth and we determine with Carolus Piso that there may be a Serous or Wheyish Cacochymy although he doth not rightly explain it and that there may likewise be a Serous Humor that may be most hot and that under it there may also be comprehended those sharp Ichores of which we sind Hippocrates and Galen making mention and of which we shal have occasion to speak more anon or if you had rather speak as do the Chymists that Tartarous Salt or the spirits of Tartarous Salts Neither are all that are troubled with the Arthritis of a thin and lean or slender constitution of Body and a Cholerick Constitution and temperament Fernelius in his 6. B. of the Diseases of the parts and the Symptoms Chap. 19. Whether or no Flegm according to Fernelius may be the Cause rejecteth all the other Humors and he there determineth that not blood nor Choler nor Melancholly but only the cold pituitous or Flegmatick and Serous Humor may be the Cause of the Arthritis and that every Arthritis is cold and proceedeth from a cold Humor And in this indeed his Opinion is right and agreeable to the truth that of one Disease there is but one only cause but in this he is very much mistaken when he tels us that this Humor is cold since that almost all the Symptoms that befal Arthritick persons teach us the Contrary to wit that most acute and sharp pain burning heat sudden motion and the rest of them For although when this Humor first beginneth to be moved there may arise some kind of coldness by which the whole Body may be extreamly Chilled and made to shake yet notwithstanding this is no sure and certain sign of a cold matter since that even the hot Humors also when they are moved through those parts that have their fense and feeling may by little and little produce a coldness or chilness and horrour as it is also very manifestly to be seen in Cholerick Feavers And then Secondly he erreth likewise in this that he accounteth flegm and the Serous Humor for all one Humor as likewise in this that he will have the Serous Humor to be simply a cold Humor For albeit that in the Serous Humors there are many parts that are waterish yet there are also many parts therein that are sharp and Salt by which it differeth from simple and pure Water But Fernelius seemeth to have taken this his Opinion from Galen in his tenth Book of the Composit of Medicaments according to the place and 2 Chap. where he writeth that the Humor which exciteth the Arthritis is fomtimes indeed the blood but for the greatest part a Flegmatick Humor or mixt Humor partly Flegmatick and partly Cholerick or likewise of the blood mingled together with those aforesaid Or if any one would speak more exactly as concerning it he may say that it is not a flegmatick humor but that the Humor which most an end is called Crude and indigested and is for the most part predominant about the Joynts is now and then very thick and like unto the thicker sort of Pus but when it hath for a while continued in the joynts it is then rendered not only more thick but also viscid and clammy There are very many other Physitians that in this follow the Opinion of Galen and Fernelius and they account the Flegmatick Cold Crude and Serous Humor for one and the same and withal they teach us that it is the cause of Arthritis But in this they are al of them mistaken seeing that neither can so sharp a pain proceed from such a cold and crude humor and because that the Arthritis invadeth the sick person suddenly and then oftentimes lieth hid again for a while and is removed into another place for the doing of which the thick and dul flegmatick humor and that humor likewise that so neerly relembleth thick Pus is altogether unfit And moreover seeing that even in the very beginning when there is no swelling as yet appearing the pain is most vehement and exquisite this is sufficient to shew that it is caused by a humor both subtil and sharp and this also penetrating into the most streight and narrow passages and pricking the Membranes and that it proceedeth not from any thick and cold humor Neither do those Tophi that are generated in Arthrâ—â—ick persons sufficiently evince that Flegm is the cause of Arthritis because that those Tophi or hard knots before spoken of do rather proceed from a humor that is Tartarâ—â—s and neerly allied unto Earthy Minerals than from a crude and raw flegm Thomas Erastus indeed in his fourth Disputat against Paracelsus writeth that he never but once saw the Gout bred from a pure and meer flegm and this was in acertain noble person of Helmsâ—adt who was sick without any pain at al if he kept but his hands and feet quiet there was no redness to be seen but a white swelling loose enough although that his joynts were not without hard knots but had many of them and that for many yeers before he had not been able to stand upon his feet But that Affect at this time was not indeed the Gout truly and properly so called but only an Oedematous tumor with the which the feet by reason of a long and lasting afflux of the humors were much troubled But now that in the very beginning the blood with the flegm or rather indeed a serous humor flowed down into the Feet and corrupted them this is confessed even by Erastus himself Carolus Piso in his B. of Diseases from a Wheyish filthiness Whether or no the serous filth he the cause of Arthritis according to Piso in two of his Consilia touching Arthritis will have the serous and wheyish uncleanness to be the one only cause of Arthritis Which Opinion if it be
rightly explained is absolutely true and undeniable But in this he is deceived that he thinketh this Serum or Whey to be a pure Water since that we are taught far otherwise by the symptoms and those things that befal Arthritick persons But others there are and among the rest Mercurialis who both knowing and acknowleding that such vehement and grievous pains cannot possibly be excited from a flegmatick and crude humor in regard that it is certain that those most vehement and wracking pains are from a hot cause and that likewise the flegmatick and crude humor is altogether unfit for so quick and sudden a motion as we see to be in the Arthritis Whether flegm mingled with choler according to Mercurialis and that it cannot possibly infinuate it self into those Membranous parts they therefore take the latter of the two Opinions in the place alleadged out of Galen and determine that the Arthritis hath its original from Flegm mingled with Choler and that the Choler is mingled together with the thick and tough flegm being unto it as a Vehicle or Conduit-pipe for conveyance But yet neither doth this Opinion fatisfie us unless that mixture of Flegm and Choler be understood of the serous or wheyish humor For seeing that they themselves do acknowledg that so sierce and cruel a pain doth require a hot cause this cannot therefore be from Choler mingled with Flegm since that flegm doth dull and blunt the acrimony of Choler rather than increase it Ludovicus Mercatus whilest he acknowledgeth Whether crudity according to Mercatus may be the cause that the vitious humors although they abound in the Body do not presently generate Arthritis but even other Diseases therefore he betaketh himself unto a Crudity also and thereupon determineth that the vitious humors ought to be Crude and undigested before they can generate the Arthritis But then when he would again acknowledg that a Crudity is not simply enough and sufficient for the generating of Arthritis he feigneth and inventeth divers things as touching Crudity and determineth that that Crudity alone is fit for the generating of Arthritis which proceedeth from the rarity and thinness of the heat now whether or no he here â—peak properly I leave it unto any mans Judgment and that it is done three manner of wates First of all when the fatter part thereof is separated and drawn out from it Secondly by reason of its dissolution from an External heat Thirdly because that it hath naâ—glâ—â— with it somwhat that is unconcocted but hot And yet notwithstanding at the lenâ—â—â— he concludeth that this Crudity of the humors is not any ordinary kind of humor such as the rest are that procreate and beget Feavers Defluxions and many other Diseases but that it is a Crudity which obtaineth somthing that is peculiar and proper unto it by reason of which it more inclineth unto and sooner causeth this Affect than any other and this as he tels us is then done when the humors are made more thin by their being pouted all abroad and likewise by their mordacity and corroding quality by which they are easily separated from and rejected by all the other parts until they come to the Joynts In this indeed he rightly and most truly asserteth that that humor hath somwhat in it that is peculiar by which it generateth the Arthritis and no other Diseases But now if we well and exactly weigh and consider this Crudity or rather the Condition of the humor as he calleth it but yet every humor that is preternatural may not rightly be called Crude most certainly agreeth with the serous salt and tartarous humor before mentioned and described by us as such which is thin biting poured abroad or as the Chymists speak resolved by the tartarous salt So that Mercatus seemeth to have understood the thing wel enough but yet was not able wel to express himself in words as concerning it Whether a humor malignant and of an occult quality may be the cause according to Faraeus Ambrose Parry in his 17. B. and 2. Chapter whenas he himself likewise took notice that the humor which generateth the Arthritis was a nature altogether different from those that are the Authors of the Phlegmone Oedema Erysipelas or Scirrhus he for his part determineth that the nature of this humor was neither better nor worse but the very same with that from whence the Plague French Pox or the Epilepsie have their Original and this he endeavoreth to prove 1. Because this humor never cometh to a suppuration as do all the rest of the humors 2. Because that it produceth pains far more sharp and bitter than the other humors insomuch that the sick Persons often complain that they feel the part affected to burn as they think 3. Because that it is changed into hard knobs or knots which doth not happen unto any other of the humors 4. because that it wil very hardly give place or remove for any Remedies whatsoever but is rather more stird up exasperated and enraged by them so that the Patients are ready to tell us that it is far better with them when they are without any remedies at all than when they have them applied 5. Because Galen himself in his B. of Theriaca to Piso Chap. 15. saith that Treacle is very useful for all Arthritick Persons whatsoever as that in Paraeus his Opinion which dulleth and blunteth the malignity of the humor In this indeed Paraeus his Opinion is right that the common ordinary humors Choler Flegm and Melancholly do not produce the Arthritis but that the humor which is the Cause of the Arthritis doth obtain and hath in it somwhat that is proper and peculiar and this is sufficiently proved by the Reasons above alleadged by him but indeed there is no need at all that we should here have recourse unto any peculiar Malignity and occult quality neither do the Reasons alleadged prove it For there appeareth here nothing that is Malignant but the vehemency of the pain proceedeth from the Acrimony of the humor the which happeneth likewise somtimes in the pain of the Teeth Ears and other parts And although that Galen commend Treacle as good against the Arthritis yet this doth not at all argue nor make that it should subdue the Malignity of the humor but rather that it should consume the vitious humors and many other Medicaments of this nature are also before propounded in the Cure of the Arthritis But yet in the mean time we do not deny this that the humor which is the cause of the Arthritis may somtimes likewise obtain a peculiar Malignity like as we see it to be in the Scurvy and the Polonian Plica And yet notwithstanding we say that it doth not produce the Arthritis as it is a Malignant humor but as it hath that disposition which other humors also exciting the Arthrtitis do obtain that yet are altogether void of any the least Malignity Whether the
as Platerus rightly calleth them and distinguisheth them from the Arthritick pains although he be mistaken in this that he determineth that these pains and Defluctions are only in the fleshy parts of the Muscles whereas indeed they are equally about the Joynts may be excited in the fleshy places and Membranes of the Muscles but yet I cannot perswade my self that the Arthritis properly so called returning by certain intervals and having alwaies one time of duration should thence be generated For if the humor should fall down betwixt the Flesh and the Skin it must first of all seiz upon the parts nigh unto the Head and upon the Joynts seeing that as Galen expresly teacheth in his 2. B. of the Difference of Feavers Chap. 11. those fluxions that are from the Head are wont in the first place to infest the parts neer unto the Head as the Ears Eyes Teeth Gums and the Glandules that lie next or the Breast and Lungs and the Muscles of the Back whereupon such like pains from a Defluxion presently in the very first beginning of the descent of the humor from the Head are perceived in the neck before and behind and in the Shoulder blades but they scarcely ever descend into the Toes which indeed are most of al infested by the Arthritis that same thin serous humor vanishing by the way which happeneth not in the Arthritis in which the pains are wont first of all and that very suddenly to be excited for the most part in the very ends of the Toes For what Solenander writeth concerning a certain noble person as we may find it in the 24. Consil of his fourth Section who being troubled with the Arthritis about the latter end of the Winter had as he saith the humors therefore moved from the Head because they were not suddenly augmented but encreased by little and little and running from Joynt to Joynt from Foot to Foot and from thence into the Knee and that from hence they ascended and seized upon the Hands and after this insinuated themselves into the Joynts of the Elbow this I say seemeth unto me a thing very improbable For if the Humor had flown from the Head it ought first of al to have infested the Elbows and then the Hands first the Knees and then the Feet whereas here the quite contrary was done It seemeth more agreeable to truth that this was done from the nature of the humor and the great abundance thereof For when it was more thick in the Winter time it is was moved the more slowly but when once there was great store thereof heaped up Nature first of al drives it forth unto the extream parts which when they could not possibly receive all of it she then afterwards thrust it forth likewise unto the more neer neighboring parts Neither indeed can I see any way by which this humor heaped up without the Skul should be carried down straight and directly unto the Feet and not ramble and rove up and down hither and thither like as do those pains from Defluxions And be it so indeed that the Brain doth likewise sometimes suffer certain symptoms and that the pain may first of all begin in the nook of the Neck and may after this seiz upon the Shoulder afterwards upon the Elbow and lastly upon the Hand yet notwithstanding that is not at all yet proved which ought to be to wit that this humor descendeth without the Skul betwixt the Skin and the Flesh For first of all how the Gout Podagra comes to be bred in the Feet is not shewn in this manner And moreover albeit the humor flow within the Veins and Arteries there may the very same symptoms be produced in the Brain which could not at all be if the humor were moved without the Skul under the Skin and also the same pain in the Nock Shoulder and Elbow Fot while nature is endeavoring to expel that vitious humor by the ascending Trunk of the great hollow Vein and Artery there may very easily by the Jugular Veins and Arteries somthing flow into the Brain which may there excite some kind of symptoms and before ever it come so far as the Hands it may easily happen that Nature may by those Branches that are dispersed throughout the Nook and the Shoulders thrust forth somthing into those parts And whereas all the Joynts in the whol Body as also the parts that lie about them receive their nourishment from the Veins and Arteries there is no Joynt in the whole Body into which likewise the humor the Cause of Arthritis may not flow in by the very same Vessels so that there wil be no need at all of seeking for blind and hidden waies and passages even from the most remote parts And that I may in the last place likewise grant this that it may possible be that such like serous humors abounding in the Veins may also be thrust forth into the Head and pouted out under the Skin and upon the approach of the Arthritick Paroxysm and Nature setting her self upon the work of expulsion they may likewise be moved and by the Neck may descend into the Back yet notwithstanding these are not those humors that breed Arthritis but descending under the Skin and pulling the Membranes in the outside of the Body they excite those roving and slitting pains yea and sometimes also they breed a spurious and bastard Pleurisie but they are very easily taken away by frictions discussing Medicaments and Sweats the Arthritis yet stil temaining Franciscus India a Philitian or Verona in his first B. of the Gout Chap 4 rendreth this thing very intricate whiles he writeth that the members that send forh these superfluities are various and very many and especially the Head the Stomack the Intestines the Liv and the Kidneys and that those Fluxions are indeed more especially from the Head and from the Brain because that although those humors draw their Original from the Intestines and from the Stomack and other Members before they flow unto the parts of the Joynts they first of al ascend into the Head and from it are afterwards transmitted unto the parts lying underneath it But yet he doth not indeed deny that those humors proceed from the whole Body For if faith he the Body were altogether free from superfluities no humor would at al slow in And yet nevertheless he denieth that the matter doth immediately flow from the whol Body unto the Joynts feeing it cannot possibly be that the humor which is found in the Stomack or the Intestines or in the Liver or Spleen should so suddenly from these parts flow unto the Joynts unless by the incitation of Nature it were driven forth by those waies that lead unto the Joynts Now he determineth that those waies are the Veins Muscles and Nerves The Veins to wit that are destined for the nourishing of the Hands and Arms do carry the excrementitious humors that have their existence throughout the whole Body unto the
but very few who wil be perswaded to keep an exquisite and accurate Dyet and they wil chuse rather to endure the Arthritick pains unto which they have been so long accustomed and inured than submit themselves unto the Laws and Rules of a more strict and severe courie of Dyet And very few there are of them that will deny themselves the use of Wine the drinking of which unless it be omitted there is an very many Patients no hope at al of a perfect cure And from hence it happeneth that there are more of the Rich and persons of Quality that are troubled with the Gouâ— than there are of the poorer sort of people and Peasants in regard that these last keep a very spare dyet and drink no Wine at al whereas those former guzzle in Wine too freely and in many other points of Dyet offend far more than the poor Neither yet notwithstanding is this at all to be denied That there are some who although they do not commit any notorious errors in the course of their Dyet yet they can hardly be freed from the Gout because that the greatest part of their Aliment by reason of the weakness of their bowels is converted into vitious humors like as we see that there are in others also virtous humors elswhere collected And therefore in regard that it is oftentimes impossible to correct that weakness of the bowels the Arthritis likewise from thence proceeding wil scarcely ever be cured Quest 11. Whether it be fit to purge in the beginning of the Arthritick Paroxysm THere are divers and different Opinions of Physitians as touching this point For some there are who affirm that in the very first beginning of the Paroxysm purges are therefore to be administred that so by them the Humors may be drawn back from the Joynts and that so the pains may be lâ—ssened and the fits made somwhat shorter And they appeal likewise unto Experience by which it appeareth that upon the administring of Purgations in the beginning of the Paroxysm the sick person hath been delivered from al the pain that attendeth the fit like as before we told you of Petrus Bayrus who writeth of himself that he was so weak and impotent that he could move no part about him but only his Tongue and that he was carried and put upon his Close-stool by four men but having taken his Caryocostine Electuary and after that his belly had been thereby five times loosened and made soluble he found such ease from al his former pains that now he could go and ease himself without any help at all and so in like manner return from the Close-stool and that he was able also the very same day to walk from one end of his study unto the other But others there are that maintain the contrary Opinion and these tel us That if the humors be moved by a purging Medicament they then rush unto the Joynts and the part affected more vehemently and with greater force and violence as also in greater abundance and so they excite and cause the greater pains And these also refer themselves unto Experience by which it wil be found that by the use of Purging Medicaments the pains have not only been augmented but that likewise if the Purges were ever a whit mâ—â—â—â—o and stronger than ordinary the humors were then inflamed by them and drawn unto the internal and more noble parts and there excited burning Feavers that were both dangerous and deadly Ludovicus Septalius in the 7. B. of his Animadversions Numb 177. writeth That by forty five yeers Experience he had found that Purgaâ—â—ons admit 〈…〉 beginning of the Arthritis succeeded wel in some but that others again had â—o benefit at al by them and therefore he giveth us this distinction When there is saith he preâ—ent in the Arthritis both a fluent matter and a strength of the part expelling as also a weakness of the recipient or part receiving If the abundance of matter or the strength of the part expeling shall appear to be prevalent then without any further controversie that matter is with al speed to be evacuated and called away from the Joynts either by a Vomit or else by some purging Medicament But if the loosness and weakness of the Joynts be the cause or the fluxion so that upon every light occasion and whatsoever the quantity of the matter be Nature be still attempâ—ing to thrust forth the said matter so soon as it is collected in the body unto the Joynts then as he tels us upon the taking of a purge as the fluxion is thereby augmented so Nature is likewise thereby rendered more weak and infirm But in very truth this is a thing indeed most certain That the matter doth rush unto this or that part with somtimes a greater and somtimes a less violence and impeâ—â—â—â—sness but as for the cause of this fluxion it is never the alone weakness of the Joynts which only disposeth the part for the more easie receiving of the matter but never â—â—oweth â—â—â—â—lureth the humor unto the part affected but that it somtimes rusheth 〈…〉 unto this and somtimes unto that part this is rather to be ascribed unto the 〈…〉 which is accustomed now unto this and as soon again unto that way and part for the expelling forth of the peccant humor And therefore if there be any Fear of the 〈…〉 and violent rushing upon the part purgation is not thereupon presently to 〈…〉 but rather such a purge is to be administred that may not only move the humors 〈…〉 also wholly to evacuate them But yet nevertheless it is here the safeâ—◠〈…〉 lius perswadeth us to consult Experience For if we find that the pains are 〈…〉 exasperated upon the giving of a Purge once or twice and that thereupon they continue the longer we must then forbear to purge for the future But on the contrary it we find the pains to be hereby diminished and the Paroxysm made more easie and light we may then also even with boldness and confidence go on to purge as there shal be occasion But it is most fit and convenient to purge even at first in the very beginning of the Disease For whenas the impetuous motion of the humor unto the part affected is not as yet altogether so great the humor may easily be drawn another way whereas if it already with great violence rush unto the part affected it is the harder to be recalled But lest that otherwise some Feaver should be kindled the condition of the humors and the nature of the purges are wel to be weighed and considered and they are so to be tempered that no such thing may happen Quest 12. Whether Baths be good and useful for such as are troubled with the Gout BAths are by many Physitians commended unto Arthritick persons and many also thus affected betake themselves unto these Baths as unto the only sacred Anchor of their Hopes and a most sure Refuge as from whence they expect