may make it to stinke 4. The qualitie either of diet or drugs as hath bene said of the good smell of vrines may likewise procure vnto it an euill smell Looke at large what Sauonarola saith of this point if thou be disposed to see further But what certaintie doth the smell of the vrine affoord vs whosoeuer shall thinke to helpe his vncertaine coniectures by the same should leape out of the frying pan as the prouerbe saith into the fire In the first place it is to be obserued that as well in sicknesse as in health vrines may offer no pleasing smell to the nose and yet the party may be free from any danger at al. But because healthfull folkes seldome send their vrines to the Physitian we will let them passe and come to the sicke I will let Scribonius speake for me Concerning the sicks vrine saith he most do teach vs that stinking vrines signifie putrefaction of humours in so much that by the difference of the smels they take vpon them to iudge of the seuerall humours so putrified O wise woodcockes I willingly yeeld to them that stinke or strong smell doth argue putrefaction in such vrines but of which parts shall this putrefaction be whether of the bladder onely or of the Liuer also of the chest or other members Nay so farre off is the stinking smell from giuing vs any particular notice of the disease that it cannot so much as affoord vs any certaine generall knowledge of the same For many sweet smelling simples saith Montanus may cause a most stinking vrine Cholericke and hote complexioned men void often very strong smelling vrines howsoeuer free frō any disease as I haue often obserued in my selfe And by what meanes I pray thee shouldst thou from the stinking smell of the vrine know putrefaction or how can this putrefaction procure this stinking smell If this were so then would it necessarily follow that whosoeuer were seised with a feauer proceeding from putrefaction of humours should voyd stinking vrines the which is most false The truth of this assumption may from hence appeare that for the most part among an hundred sicke of such feauers scarce shalt thou find one of their vrines so to smell nor yet their bloud at the opening of a veine And for this cause well said Sauonarola in his treatise of Vrines that there are other signes also to be obserued in the annoying of putrified members if we purpose well and orderly to examine trie and finde out any skill concerning vrines And indeed a thousand causes there are which may alter and change their smell By the smell then onely there can neuer be any certaintie collected to informe our iudgements concerning any disease But I am afraid the Reader will take it ill that I so long detaine him among so vnpleasing smels and my selfe begin to waxe wearie of so vnworthie a thing and as I neuer tooke any pleasure in the same so here I leaue it to them that like it better But if I should yet enter vpon the tast I feare I should be worse taxed I can tell no man their tast by mine owne experience Salt they haue alwayes bene counted as the teares likewise If any be incredulous I will not hinder him If our vrinemongers had no better beere allowed them they would not so much adore the pissepot as some of them do But yet if any purpose to practise this point I wish him to go to the Arabians who haue written so curiously concerning this point and it may be in regard of their aromaticall drugs their vrines may be of better taste then those of our Europaeans who feed on grosser food As for the other two qualities the sound and touch we will send them all in one ship to Arabia with their fellowes and now we come to the colours CAAP. III. Of the colours of Vrines how deceitfull they proue and first of the colour commonly called palew or light saffron IF euer vrine proued a strumpet it is of all other parts of the vrine most apparently to be seene in the colour For as sometimes some of the most infamous stewes strumpets infected it may be with the poxe do most curiously decke and adorne by curious painting sumptuous apparell and such other enticing trickes their lothsome and filthie carkasses to the end they may more easily deceiue such as will be caught in their snares doth it not often fare euen so with the colour of the vrine For oftentimes when they make the fairest shew doth not euen death knocke at the doore My purpose is not here to make any phylosophicall discourse concerning the causes of colours in generall and then to apply the same to vrines in particular and so to insist vpon each seuerall colour for this might proue too tedious and perhaps not so pertinent to the purpose we haue in hand And yet notwithstanding I will say something of each of the chiefe and principall colours by the which it may more easily be conceiued that the like deceit may be seene in the others like vnto them Now my purpose is to begin with that colour which is the best of all others being as it were the rule and square whereby we do discerne and iudge of the failings and defects of all the rest This colour is called in Latin Subrufus subaureus or subcroceus and in English palew or light saffron This colour our Physitians do generally account the best of all others and that it best betokeneth exact concoction Neither yet must this first and best colour arguing good concoction be simply and in it selfe so considered but restrained to flourishing age For in old men women and children whose vrines especially childrens do commonly decline towards white and pale it doth betoken that their bodies are too hote either by reason of diet exercise or some other meanes But if one should bring vnto thee such an vrine how couldst thou tell whether it were an old or a yong mans a womans or a childs the messenger not acquainting thee with the particular circumstances It may be thou wilt say the contents will make the case cleare I answer that many causes may depriue them of contents in part or altogether as hereafter shall appeare in the contents and how the substance may alter hath bene said alreadie The common opinion is the higher the colour is the greater heat is argued which opinion to be most false erronious shall hereafter in other colours appeare Besides may not a little extraordinarie watching fasting rheubarb saffron madder roots or such like colour the vrine without any excesse of heat And will the seuerall seasons of the yeare produce no alteration in the vrine that I say nothing of an infinite number of other causes which may in like manner alter them But one signification of such a coloured vrine I cannot here passe by which I remember I once read in an English vrine booke to wit that a maide
red yet saith Galen all are coloured with a greater or smaller portion of bloud therewith mingled Neuerthelesse that this same colour of vrine is procured by the mixture more or lesse not of bloud alone but also of an high coloured choller ioyntly or seuerally according to the greater or smaller quantitie thereof is not by a small number of learned Physitians maintained as also that this same colour of vrine is often and vsually seene in hote and acute diseases is not vnknowne to the very vulgar and vnlearned sort of people Now a many causes may bring foorth this effect this colour of vrine higher or lower appearing in a many hote and acute diseases which would puzzle a good Physitian by the bare sight of such an vrine to know what disease it were But yet is not this rule so infallibly true that it admitteth of no exception as is the opinion of many And therefore most erroneous and dangerous is the practise of such as vpon the bare sight of an high coloured vrine presently without any further deliberation or enquiry of circumstances both prescribe Phlebotomie and administer all maner of cooling medicines to the great ineuitable danger and preiudice of the patient from the which errour also the learned Arabian Auicenna is not free as our learned late writers haue well obserued And as I deny not but that this may often prooue true so on the other side it is most certaine that the vrine may be of such a colour and yet either proceed from a cold cause or else from some imbecillitie and weakenesse as cometh somtimes to passe in Dropsies c. But lest this should seeme stuffe of mine owne braine and hatched at home heare from the mouth of a worthie Author something concerning the same purpose It is not seldome obserued that the vrine by reason of a commixtion of bloud with it doth appeare of a red colour but by reason that it is either thicke or clotted it is no great difficultie to discerne the same But that so thinne a bloud should bemingled with it that not the substance of the vrine but the colour onely should be altered is but seldome seene Such a case befell a young man of 28. yeares of age or neare by This young man voided an vrine of an high red colour and thinne substance for many dayes together being very like to the vrines made in hote acute feauers The aforesaid patient had vsed the aduice of diuers ancient learned Physitians who had appointed him such meanes as are vsed for the cooling of hote Liuers At length he repaired to my selfe at that time but a young Physitian Looking on his vrine and withall seeing it of so high a red colour as also perceiuing him who was there present free from any feauer I asked him whether heretofore he had complained of any which he denyed adding moreouer that for some moneths by-past he had felt a chilnesse and coldnesse together with a great extenuation or leannesse and shortnesse of breath ioyned with a generall decay of strength as also that hitherto he had found no benefit by such meanes as he had vsed All which hauing attentiuely heard I thought good to keepe by me the said vrine vntill the next day and then to view the residence thereof the which was of a colour like vnto bloud as being indeed nothing else but bloud the vrine aboue it being but very little dyed with a pale yellow colour shewing no signe or token at all of any feauer For the which cause I did then collect that there was no exorbitant heate in his Liuer but a great weakenesse in the kidneyes by reason whereof the ends of the small veines being opened and loosened let some part of the bloud passe away And therefore I tooke a new course for curing of the same by vsing such meanes as were fit for the corroborating and strengthening of the kidneyes and veines not omitting fit and conuenient diet and among other things goats milke And so at length the vrine came to its owne naturall colour againe his bodie also enioying the benefit of nourishment as it was wont in former times and thus in a short time recouered his vigour strength and former perfect health againe Such an excretion of bloud which cometh thus to passe by reason of the loosenesse and widenesse of the mouthes of the small veines or yet of the thinnesse of bloud is commonly called Diapedesis that is as much as a streining through It cometh also to passe that some bloud is voyded by vrine many other wayes sometimes some great stone fretting the passages betwixt the kidneyes and the bladder called Vreteres bloud doth also accompanie the vrine but withall it is blacke and clotted The stone continuing for some certaine space in the bladder prooueth likewise sometimes the cause of this inconuenience and that especially after riding or some other violent motion of the bodie In women also some part of their menstruous fluxe is sometimes intermingled with it Sometimes againe the bloud issuing out of the gummes being suddenly stopt doth search for it selfe a passage through the bladder The kidneyes being wounded first doth bloud issue out by the vrines and afterwards matter mingled with it as it befell that woman which was stabbed in the loynes with a dagger first voyding blouddie vrines then afterwards mingled with matter vntill such time as both the wound and the kidneyes were cured And that this was a wound in the kidneyes did plainly appeare by some portion of the same taken out of the wound The exulceration of the kidneyes is also accompanied with bloudie vrine after the which vnlesse remedie be in due and conuenient time procured matter doth follow It is likewise sometimes seene that decrepit old men do voyd vrines mingled with bloud which are of a blackish colour accompanied with some red the which doth declare that the vigour and power of the kidneyes is almost quite abolished But I wish thee yet to lend thine eare a little to the same Author yet againe in a storie or two more which will adde not a little light to this matter The vrine doth appeare of a reddish colour not onely when the Liuer is surprised with a Gangrene or the bodie with any hote or acute disease such as are Tertian agues burning feauers inflammation of the internall parts but often also in the debilitie weakenesse and coldnesse of the Liuer or stomach proceeding from long and lingring diseases The like tincture it receiueth now and then in the extreame pinching Collicke passion when as some tough and clammie humours possessing the guts do hinder the passage of the faecall excrements A Gentleman of account saith he voyded vrine of a very high red colour howbeit free from any feauer being at the same time much tormented with the Collicke accompanied with a retention of the faecall excrements After the iniection of an anodine or mitigating glister the paine was much eased and withall
say something of the blacke which may seeme to threaten greatest danger Such dust falling to the bottome either blacke or of a leaden colour proceeding of melancholie is thought to signifie fluxe of the Emeraudes present or shortly to follow and sometimes vomiting of bloud As also sometimes paine in the reines loynes c. and stopping of the Flowers and at other times paine and diseases of the Spleene c. In the beginning of the yeare 1623. my counsell and personall presence was craued for a Ladie in Northampton-shire of good account In the bottome of the vrinall wherein her vrine was put for certaine dayes together some such blacke dust might be seene which a graue Diuine there present thought to be so dangerous that he told me he had seldome seene them liue many dayes after the sight of such coÌ„tents in their vrines And howbeit some strange and troublesome accidents did terrifie the spectators who beheld her with vulgar eyes yet did her pulse put me in better hope which was shortly seconded by a happie and prosperous issue the Ladie recouering her former health againe Neither heard I any complaint of such things as these contents are said to signifie But hauing now finished both colours and contents with other things belonging to this subiect it is perhaps now exspected I should say something of the manner of pissing as concerning not a little the matter in hand CHAP. IX Of the manner of pissing the retention or stoppage of vrine totall or in part as also of inuoluntarie pissing both in sicknesse and in health THe manner of pissing is either hard and vneasie or else inuoluntarie As for the first the action is interessed three manner of wayes as witnesseth Hollerius and others First there is a great desire to pisse but cannot be effected without force and hard straining sometimes not without paine Secondly there is the like desire but the vrine passeth away but by drops Thirdly there is a stoppage or obstruction of the vrine that it is not voyded at all or else so little that it is to small purpose Painefull and vneasie pissing may come to passe either by the acrimonie and sharpnesse of the humour or by the imbecillitie or weakenesse of the retentiue facultie proceeding for the most part from cold the which painfulnesse may in like manner be procured by reason of some inflammation clotted or congealed bloud an vlcer a stone c. Suppression of vrine proceedeth from diuerse causes sometimes by meanes of the obstruction or stoppage of the guts and sometimes againe by meanes of the emulgent or sucking veines and that againe two manner of wayes to wit either by reason of the weakenesse of the drawing or sucking qualitie or else by obstruction This suppression is likewise procured by the obstruction or stoppage of the Kidneys and Vrine-pipes and by meanes of the weakenesse thereof By reason of the obstruction of the aforesaid passages it cometh also diuerse wayes to passe as either by meanes of an inflammation knob or bunch of either of these parts or others adioyning or else by reason of a stone clotted or congealed bloud or some tough phlegme impacted and cleauing fast to the place as also sometimes howbeit seldome by reason of some holes in the kidneyes and that after the voyding of some stones as Mercatus hath obserued Suppression of vrine is likewise sometimes caused by meanes of the bladder or parts thereto adioyning it being also thereby interessed And in the first place by reason of the want of the sense of feeling the sinew descending from the loynes and the hucklebone being loosened Secondly by reason of the failing of the expelling power of the bladder c. Thirdly the exceeding great quantitie of vrine distending and stretching out of the bladder detained longer then is conuenient may bring this sometimes to passe Fourthly the resolution or loosenesse of the muscles of the neather bellie which haue likewise some interest in the furtherance of this excretion Fiftly by the totall ouerthrow of the expelling facultie as we see sometimes come to passe in burning Feauers as witnesseth Hippocrates Sixtly by the defect and fault of the vrine-pipes and that diuerse manner of wayes for sometimes the muscle which shutteth vp the bladder is clinged together by a conuuâ—sion the passage is likewise stopt either by the meanes of some tough clammie humours some clotted bloud matter knob or bunch or any tumour the outgrowing of some peece of flesh some wart or scarre and finally by reason of a stone stopping vp the passage by the neck of the bladder Seuenthly by the consent of the places adioyning the bladder and the vrine-pipes are sometimes so shut vp that they cannot freely deliuer the vrine which cometh often to passe in women by reason of the nearenesse of the wombe Eightly by meanes of a Palsie or resolution of the bladder The vncertaintie therefore of the vrine in diseases of this nature and kind may as euidently appeare as in any of the premisses And there being so many causes producing paine and difficultie in making of vrine to which of them wilt thou ascribe it Againe if there be a retention of the vrine what wilt thou send to the Physitian And if such an accident come to the cure of some Empiricke or vnskilfull Physitian his conceit will straightway leade him to some stone and so according to their ignorance in this art exhibite strong diuretickes or medicines prouoking vrine as I haue sometimes obserued which are so farre from procuring the intended good that they produce rather a contrary effect Of a suppression of vrine by meanes of clotted bloud I haue instanced alreadie This last Spring a young Gentleman of Leicestershire of good worth trauailing towards London thorow this Towne of Northampton was suddenly surprised with a suppression of vrine Being afraid of a stone in his bladder howbeit he had neuer heretofore complained of this infirmity yet tried he what the art of Surgerie could doe by meanes of a Catheter thrust vp thorow his yard towards the necke of his bladder together with some other meanes which notwithstanding tooke no effect The next morning about eight of the clocke I was sent for to the patient whose belly began to swell and some fumes to ascend into his head By meanes of a gentle opening inlep together with a Cataplasme applied to his share it pleased God to accomplish his desires howbeit a messenger had bene already sent away to bring with him an expert Surgeon to make incision He voyded that day abundance of vrine of a laudable colour and answerable contents so that none could find any fault in the same and the next day he went forward in his intended iourney towards London The passage of the vrine in this patient was somewhat narrow as seemeth and that by reason of some former infirmity and perhaps some wind gathered in the great gut might make some compression of the
and commeth by certaine turnes and set times and with such a one was troubled a certaine Nun mentioned by Musa who euery moneth vpon the suppression of her monethly disease did pisse bloud in abundance Archembault the Counseller by turnes did sometimes cast vp by the mouth and sometimes did voyd it downewards by stoole and againe at other times by the yard Some at the passing away of the Spring do pisse bloud and this I find written by Archigenes that some do by certaine turnes voyd great store of bloud by the yard being first collected in and about the kidneyes and that they find themselues much eased thereby I am very familiarly acquainted with one Donatus Arrigonius a merchant of our towne who in his iourney to the faire of Bohan which is held three or foure times a yeare in his iourney obserued that he was surprised with the Iaundise Afterwards as he was vpon his iourney homewards to Mantua and fast asleepe in his Inne being accompanied with another friend who lay in the same bed with him vpon the sudden there issued out at his yard of its owne accord great store of blackish bloud in so much that his companion being all wet with the bloud wakened him being almost halfe dead and with much ado at length brought him home to Mantua againe but withall quite freed from his Iaundise A certaine yong man after the eating of great store of garlicke pissed afterwards great abundance of bloud and after a little while signes of an impostume in the kidneyes might be obserued to wit some matter issuing forth from the same from whence I did collect that the sharpnesse of the humour had caused an excoriation in these parts by meanes of the opening of some veine I did see at Mothon a man who with a fall off a ladder filled halfe a chamber pot with the bloud he pissed who immediatly after the taking of a little Lemnian earth did recouer the bloud came without any vrine and that perhaps because the contusion was not farre distant from his yard About some nine or ten yeares ago an Inne-keeper of Northampton a fat and corpulent man hauing now and then voyded some small quantitie of bloud with his vrine did notwithstanding but little regard the same vntill such time as he fell into a totall suppression of vrine the paine whereof made him cast forth such pitifull cries and complaints that his sorrowfull neighbours did much commiserate his distressed estate His wife no lesse perplexed then amazed at this so sudden and vnexpected accident at his desire sent to intreat my ayde and counsell in this his so great extremitie Some halfe an houre or lesse after the administration of a diureticke drinke inwardly and a Cataplasme outwardly applyed to his share he filled almost a chamber pot with bloud some small quantitie of vrine being mingled with the same whereupon followed immediatly case and alleuiation of all his former annoyance The same night about an houre after he sent me a little wooden dish almost halfe full of gobbets of congealed and clotted bloud resembling the substance of the Liuerie selfe The next morning againe he sent me an vrinall almost full of bloud voyded at the same place no vrine to the iudgement of the eye at the first to be discerned mingled with the same I caused him bleed oftner then once besides other fit and conuenient remedies as well in diet as otherwise and yet this fluxe continued lesse or more for some few dayes after In the space of one weeke he lost in all aboue a gallon of bloud For preuention I wished him besides gooddiet hard to be obserued by people of that profession with corroboratiue and other medicines fit for that purpose with speciall regard to the Liuer not to neglect Phlehotomie at least euery Spring and Faâ—l which he duely put in practise for the first yeare and for anything I could euer heare was litle or nothing troubled after that time with this infirmitie After this he liued at least three yeares and then dyed suddenly of the cause whereof here to discourse were besides my present purpose Diuerse others haue now and then by me bene obserued troubled with the like euacuation without any great hurt or hinderance to their health whom to auoide prolixitie and tediousnesse I here willingly passe by onely one I will touch but in two words A little child aboue fiue yeares of age vsed at diuerse times to pisse pure bloud not keeping any certaine times or turnes This the Gentlewoman her selfe the childs grandmother dwelling not farre from the towne of Northampton told me who did likewise affirme that she had not discerned any hurt he had sustained by the same yet notwithstanding for feare of some future inconuenience and after ensuing danger was desirous to vse some meanes for preuention which being by some occasions then deferred the child afterwards departed out of these quarters into another countrey where what since befell him I cannot tell But now let vs proceed to some other colours of vrines for here I thinke hath bene found as small certaintie as in the former CHAP. V. Of blacke vrines and that they are not alwayes so dangerous as they are deemed as also of blew ash-coloured or leaden and greene coloured vrines together with their seuerall significations and vncertainties THe highest and intensest of all other colours is the blacke the which when it presenteth it selfe to the view of the eye in any vrine it striketh no small feare and terror in the minds of most men yea and sometimes of those of no ordinarie vnderstanding That this feare was not altogether without some ground may be seene by some passages of our old father Hippocrates who doth peremptorily affirme that as well in men as in women blacke vrines are alwayes dangerous And of the like opinion and iudgement was once his trustie interpreter Galen confidently auouching that he neuer knew any one recouer whose vrine was altogether blacke howbeit the danger was the lesser if the residence onely were blacke lesse againe if the middle part or swimme and least of all if the cloud onely were of this colour Howbeit the same Galen in another place affirmeth That if there be a retention of a womans monethly fluxe of melancholicke bloud there is no cause of feare if in such a case the vrine appeare blacke to the eye And againe in the storie of that woman who being surprised with sicknesse the second day after she was brought to bed the third day she voyded thinne blackish vrines Galen speaketh of no further inconuenience to ensue vppon the same but maketh onely mention of a certaine commotion and agitation of the humours of the body ioyned with a a certaine conflict and yet of all sorts of blacke vrines this thin blacke is counted the best Blacke vrines may be voyded both in health and also in sicknesse especially by way
the humours in the veines to the end that in feuers they might find out the times of the same and so might more easily foretell the time of the future crise whether the same were like to be hopefull and healthfull or dangerous and deadly and withall to find out the fittest time for purging The which Galen Hippocrates his true interpreter doth intimate vnto young Physitians in these words The vrine giueth notice of these parts to wit the liuer kidneyes bladder and the strength of the vessels which containe the bloud and the weakenesse of the same as also that facultie which engendreth the humors but as concerning the infirmities of the braine the chest and lungs there be other signes and symptomes of the same whereby their diseases are discerned All these things therefore the wise Physitian is to enquire search and find out from the sicke himselfe and not from the vrine For this cause well said Damascenus in his Aphorismes Concerning diseases pronounce not rashly thine opinion neither yet looke thou vpon the vrine vntill such time as thou hast first seene the sicke and of him demanded and found forth euery circumstance belonging to the disease With him doth Rhazes an Arabian Physitian agree in his Aphorismes in these words It becometh the Physitian to aske diuerse questions of his patient to the end he may attaine to the internall cause of the disease that by such meanes he may afterwards be able to pronounce sound iudgement according to reason neither yet let him be ashamed to aske of the patient whether the disease be within or without the veine But our Physitians being like vnto the lazie sedentarie Physitians of Alexandria lest they should be by the vulgar people who do commonly beleeue that the Physitian knoweth all by the vrine taxed of ignorance are ashamed to aske of the patient the causes and symptomes of his disease And to the end they may the better accommodate themselues to the foolish humor of the simple and more ignorant sort they are not a whit afrayed to prate of diseases by the inspection of the vrine onely But would to God the truth were with them in greater esteeme then any popular applause and that they would be warned by the Poet Persius If troubled Rome do too much dispraise any thing then not to rest and relie vpon her iudgement and that they would both ingenuously confesse and tell the people how fraudulent and deceitfull pernicious and lying is this manner of inspection of the vrine brought in by some Physitians and impostors of later dayes to the great mischiefe of mankind Then for certaine would they be more carefull and diligent in searching out the natures of diseases by their causes the hurt and hinderance of the action as also by the Paâ—hognomonicke signes and then without all doubt should they cure a great many moe as also by this meanes should their names become a great deale more famous both among their owne friends and acquaintance and among strangers And by this meanes also should these wandring and cozening rogues impostors apostaticall monks perfidious Iewes enemies to all Christians the ignorant Parish-Priests alchymists and all the rabble of such rake-hels but I had almost forgotten those old trots fortunetellers be thrust out from professing physicke all the which offenders not hauing learned so much as the first grounds and principles of naturall Philosophie or Physicke do without controll or punishment trie their desperate remedies by the death of many a man Wherefore there could nothing be deuised more profitable and beneficiall for the good of the commonwealth then that at length all Christian people were freed from the tyrannie and mischiefe of these cruell impostors who by meanes of the secret obseruation of the vrine vnknowne to the vulgar sort do conceale their owne ignorance and haue as drones do into the Bec-hiue crept into this profession By the premisses I hope thou hast heard what is the cause that Physicke and the Professors of the same are not of so high an esteeme in these our countries at this time Of the differences of signes by the which Physitians do discerne and know diseases and do presage the future issue of the same As I heare these barbarous and wicked persons falsly assuming vnto themselues the name of Physitians do mutter and grumble against me because of condemning their mad rash and foole-hardie finding out of diseases by meanes of the vrine onely for whose slanderous backbiting I care not a rush For such as cannot helpe I see not how they can hurt me No more can I conceiue what the Physitian can performe as concerning the cure of the disease being ignorant of the nature and estate of the same For this cause the ancient Physitians did with great labour trauell and industrie search out the cause the nature and substance of the disease from the which the indications of remedies are deriued and not from the vrine onely but from the signes called Pathognomonicke and from the whole concourse of the symptomes or accidents who did likewise deuide Physicke principally into two parts to wit that which we commonly call Therapeuticke whose most large and common scope is to cure diseases by contrary remedies and into that part which we call Diagnosticke whose most common scope is to discerne the whole and sound from the like and the sicke and infirme from the whole being vnlike the one to the other And this part of Physicke doth farre excell the other to wit the Therapeuticke the which without the Diagnosticke is of small vse or profit And because it did lay open the perfect and absolute knowledge of the disease by meanes of the signes Pathognomonicke proper and peculiar to euery disease together with the concurrence of accidents which the Empiricks called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which were nothing else but the collection by obseruation of certaine accidents and circumstances of diseases the later Physitians therefore gaue it the name 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or that part of Physicke which handleth the signes of diseases Wherefore we cannot but much wonder at Galen a man of so great learning who besides two hundreth and fiftie bookes written of diuerse sciences and of all the other parts of Physicke aboue foure hundreth all being likewise written in so good order and method that notwithstanding he hath not brought to full perfection this so noble a part of Physicke called Diagnosticke but onely dispersedly here and there especially in that booke called the Constitution or ordering of the Art of Physicke hath as it were sowne some seeds of the same But yet Auicenna Rhazes and other Arabian Physitians and such among the Greeks as haue written of late after Galen as Paulus Aegineta Aetius Actuarius and Alexander Trallianus following the footsteps of the ancient Empiricks did collect and gather together in euery seuerall Chapter which did discourse of the disease a great number of the signes and seuerall accidents of the same but so
one not without cause auouch that the vrine giueth notice of some infirmities of the place through which it passeth not primarily and principally but by accident to wit by reason of the contents thereof which are nothing else but excretions proceeding from those parts which do conueigh and carrie the vrine Wherefore Hippocrates witnesseth that if any do void by vrine either grauell or little thinne scurfe or matter like vnto scales or coursest dressings of bran little gobbets of flesh congealed bloud matter or small haires or threeds like vnto the small veines knit together vnder the creuices taile these things declare that the bladder is annoyed with a scab and the kidneyes with the stone suppuration the rupture of some veine or some other infirmitie But lest any should rashly apply the signes of vrine to any other then the aforenamed diseases this famous father of Physitians doth adde immediatly Take heed therefore lest thou be deceiued the party making such an vrine when the bladder is amisse for then such vrines belong not to the whole body but ought to be referred to the bladder onely There is yet another fearefull and dangerous disease belonging to the kidneyes called Diabete or Poldropsy being an extraordinarie fluxe of the vrine called of the Greekes by reason of this vnsatiable desire of drinking Dipsacus This disease is answerable to the disease called Lienteria and for this cause they are continually forced to drinke all which being nothing at all changed in colour substance or in smell they do voide forth againe as they receiued it and that by reason of the imbecillity of the returning and altering powers and faculties of the kidneyes Now that such an vrine is the proper and pathognomonicke signe of this disease no man of vnderstanding I thinke will denie Followeth now the third sort of signes of concoction of superfluities to wit the excretions of the bellie belonging to the first concoction the which being soft fashioned according to the concauitie of the guts and somewhat fastened or stiffe being also voyded at the accustomed time and answering in proportion to the food receiued then as saith Hippocrates they do shew forth and declare the strength of the naturall faculties of the stomacke together with the good digestion thereof These three sorts of superfluities then giue particular notice of the proper state and disposition of such parts of the bodie as they passe thorow together with the strength of the naturall powers and first the superfluities of the meate do argue and declare the force and strength of the stomacke For this cause the Emperour Antoninus his groomes of his stable did daily both taste and smell to the ordure of his stately horse knowne by his greene furniture to know whether he had well digested his food or not Now the vrines are signes of the state of the bloud in the veines and disposition of the Liuer which is appointed to be the hote harth or kitchin for concoction of the humours The spittle in diseases of the chest is vnto vs a signe and token of concoction or cruditie and those of the first sort to wit of cruditie are for the most part euill and often proue very dangerous the others againe are often messengers of an healthfull and long looked for crisis whence is this saying of Hippocrates Concoction doth portend and signifie both the speedinesse of the crise and assured health but on the contrarie cruditie doth menace and threaten either the breaking forth of some tumour or great swelling or else some great paine or griefe or yet a relapse into the same disease againe There are yet many moe decretorie signes which concerne the future crise as also diuerse prognosticke signes foreshewing life or death the full explication of which would rather require a great volume then an Epistle the which haue bene exactly described by Hippocrates but especially the intricate signes of prediction by the pulse as also the signes both of the disease it selfe and of the place affected or interessed the which also I willingly passe ouer by reason that their power force efficacie and signification doth depend vppon the signes of concoction neither are there any amongst all the signes of concoction more necessarie for the Physitians vse then these pathognomonicke signes And tell me I pray thee how shall the Physitian euer be able to cure vncouth and vnknowne diseases vnlesse the pathognomonicke signes first lay them open to his view and consideration in the finding out of which the ancients tooke so great paines as hath bene said alreadie But since it is not the worke of the Physitian but of nature to concoct and cure diseases it shall be very needfull for the Physitian to know assuredly the vigor and strength of the naturall power and force whether it be like to ouercome the disease or to faint vnder the burden of it by which meanes we shall attaine vnto more certaine and assured signes of life and death then euer did those soothsayers and wizards whom the Romanes did maintaine for the benefit of their sicke people whose prophecies and predictions no man of sound iudgement will euer beleeue to containe any matter of truth But such prognosticke signes as are collected from concoction are so firme and sure that Galen doth boast and brag that he was neuer by them deceiued Now our pisse-prophet Physitians are either vtterly ignorant of them or else notwithstanding set light by them who notwithstanding sitting idle at home are nothing at all ashamed by the vrine alone to deliuer their Delphian oracles concerniug all diseases who neuerthelesse haue neuer so much as tasted of this so noble part of Physicke called diagnosticke without the which the other to wit therapeuticke can neuer subsist yet are they neither ashamed to assume vnto themselues the cure of vnknowne diseases nor yet to arrogate and vsurpe the name of Physitians Farewell and write backe vnto me againe after what method and order this diagnosticke part of Physicke ought to be both written and taught Thus farre Langius We will now proceed to some moe authorities prouing the imposture committed by some assuming to themselues the skill of discerning any disease by the inspection of the vrine onely and then will we produce some authorities to tell vs what diseases may by the vrine be seene and how in the verie same we may sometimes be deceiued From the premisses it may plainly appeare how easily such Physitians are deceiued who trust too much to the iudgement of the vrine onely for such may well be compared to the vulgar sort of people who are of opinion that not onely the disease it selfe but euen the primitiue or externall cause may also be seene in the same as did appeare by that clowne who reproched a very learned Physitian because he could not discerne his cart and oxen in his vrine Now that this our assertion is true it may easily appeare in that the vrine may alter and change vpon diuerse
diuerse died among the rest my counsell was craued for a maid about twentie yeares of age suddenly suffocated by an Impostume in her stomach which after her death did appeare by the great abundance of bloud and matter cast out of her mouth At my coming to her I found her depriued as well of speech as of sense and reason and scarce liued aboue 2. houres after my departure But I will now relate a true historie of the deceitfulnesse of the vrine in a consumption of the Lungs In Aprill 1622. my counsell and personall presence for a Gentlewoman in Bedfordshire being desired I repaired thither where I found her infirmity to be a Quotidian feauer accompanied with some accidents which did somewhat amaze her During my abode in that place there was brought to me the vrine of a young Gentleman dwelling hard by to haue my opinion of the same Hauing well viewed it I found it both in colour and contents answerable to the most healthfull mans vrine But after certaine interrogatories I found that he had bene for a long time troubled with a cough Being desired to see the partie I found that he had bene for a long time vexed with this cough accompanying an vlcer in the lungs and seeing in him strength now decayed with an Hippocraticall face deaths trustie messenger I left him to the Prognosticke which within lesse then the space of three weeks was verified Now would I willingly demand of the most cunning Pisse-prophet what could he haue found out by either of these vrines or could he euer haue attained to the height and depth of these diseases by the bare inspection of the vrine onely And if he had bene beholden to the vse of the best perspectiue glasse that euer was made could he euer haue seene any such matter in the vrine But concerning this point we will here surceasse and proceed to the diseases within the veines CHAP. III. That euen in diseases of the Liuer and within the veines the vrine doth often deceiue the most skilfull Physitian NOw it may seeme a small matter to instance in diuerse diseases without the veines the vncertaintie of iudgement in diseases by the vrine onely but it will perhaps seeme more pertinent to declare that the like vncertaintie sometimes is found in some such diseases as seeme to affoord vs greater certaintie as in feauers c. Now that the vrine is not alwayes a certaine signe in euery feauer may from hence appeare that often in that feauer commonly called Synochus cum vel sine putredine that is that kind of continuall feauer which proceedeth from the abundance of bloud with or without putrefaction the vrine differeth little or nothing from the vrines of such as liue in perfect health as witnesseth Paulus Aegineta The reason why such vrines proceeding of so hote a cause yet do not appeare of so high a colour is because of the same immoderate and excessiue heate which being increased by meanes of the feauer conuerteth the bloud it selfe into the nature of choler and thus are such vrines not of so high intense a colour as those which proceed of choler Hence also may the error of such Physitians easily appeare who neuer admit of Phlebotomie but when the vrine is of high and intense red colour thinking that this doth alwayes argue abundance of bloud which neuerthelesse is most false as hath bene said And besides in that the vrines affoord vs but some generall notice of the cruditie and concoction of the disease they can neuer informe our iudgement whether the feauer be primarie or a principall guest or symptomaticall accompanying the disease as the shadow doth the bodie as is to be seene in Pleuresiet and diuers other internall inflammations which is notwithstanding of no small moment for the methodicall curing of the disease And yâ—t moreouer how canst thou euer tell whether it be an intermittent or continuall feauer by this vncertaine signe Neither Hippocrates nor Galen did euer presume to know so much howsoeuer Aâ—â—uarius in this as in many other things concerning this point hath troubled himselfe more then he needed But againe what if the feauer be composed of diuers humours melancholy being one which will not alwayes colour the vrine Galen himselfe instructing vs what vrines accompanie a Quaâ—tane in the beginning of the same saith they are thin white and waterish and a little after he ascribes the like vrines to the beginning of a Quotidian And I know for certaine that sometimes in the beginning of a Quaâ—tane the vrine cannot be discerned from a sound and healthfull mans And handling hereafter the colours of vrines I shall make it appeare that these thin white waterish vrines do often accompanie other diseases It is also worth the obseruation that Galen himselfe where as of set purpose he handleth both the differences and signes of seauers maketh so small account of the vrine that he neither nameth it among the signes of the Quotidian Tertian Quartane nor yet of such as are continuall or without intermission And a learned Physitian borne in this kingdome setting downe all the signes of a Tertian not omitting the pulse yet maketh no mention of the vrine But what if any malignitie be ioyned with a feauer may it not marre thy iudgement It hath euer bene so agreed vpon by the learned and daily experience teacheth vs this truth that when greatest danger is nearest it is then there least of all to be discerned But concerning this point heare yet the authoritie of a learned man borne within this land speaking of that fearefull and terrible feauer called commonly the sweating sicknesse The vrine in this disease was somewhat coloured thicke in substance variable and inconstant in the swimme and sublimation for nature kept no certaine rule or order by reason of the violence of the venome and in all other parts kept within compasse Now to any vulgar eye so great danger in the like vrine could neuer haue appeared I my selfe haue viewed many more dangerous to the outward appearance and yet neither death nor danger was to be feared The vrines in maligne and pestilent feauers are very variable and hard to lay hold on In some the vrine differeth nothing from a healthfull mans sometimes againe but a little as in this last instance Againe in others it followeth the nature of the humour shewing onely the abundance and putrefaction of the humours as I my selfe obserued 1610. at London in a lustie young fellow seruant to a Gentleman a friend of mine and dwelling in the Strand neare to Charing-crosse This fellowes vrine was very high coloured with a copious residence of red and some yellow contents and the feauer kept the periâ—d of an intermittent Tertian ague as was related vnto me and was accompanied with a painefull swelling in the throate his bodie plethoricke and cacochymicke and of a strong constitution and in the Aprill of his age For this cause I prescribed
one and the same indiuiduall partie Others adde also the sexe the age and many moe which I here omitting will hasten to the accidents of vrine CHAP. II. Of the accidents of vrine the quantitie smell c. and that no certaine and assured truth can by them be presaged or knowne THe accidents of vrine are all reduced to two generall heads the quantitie and the qualitie The quantitie is either great small or meane which is the best Abundance of vrine in health signifieth 1. that the partie hath drunke store of Rhenish or other searching wine 2. abundance of moist meats 3. little euacuation by stoole 4. too liberall vse of diuretickes or such things as prouoke vrine 5. the concoction of crude and vndigested food 6. the retention of sweat menstruous fluxe or other moisture detained within the chest or stomacke vnburthening themselues this way Concerning the retention of the like humidities it may not seeme so straâ—ge that they may be turned towards the passages of the vrine but it may seeme stranger that the faecall excrements should produce this effect and yet Hippocrates witnesseth the truth hereof and besides Aristotle relateth that in Pirinthus there was a cow which neuer had the passage for her excrements open but that the same were conuerted into a statuous or windie substance and then into vrine and so expelled In sicknesse this abundance is likewise diuers wayes produced 1. By meanes of the excessiue heate of the kidneyes which draw abundantly such humidities as in the Diabeticall disease called by some a Pot-dropsie 2. Great euacuation of superfluous moisture 3. The wasting away of the whole bodie which commeth to passe in burning feauers and which was obserued by that famous Physitian Marcus Gatinaria in that maide of Millan about some eighteene yeares of age who voyded euery day for fortie dayes together fifteene pounds of vrine whereas the quantitie of euery dayes meate and drinke ioyntly did neuer exceed the weight of foure pounds 4. The ending of the disease And in acute diseases the abundance of vrine is procured sometimes 1. by meanes of the feauers relenting 2. By the change thereof into an Hecticke 3. By a Conuulsion And besides the premisses it may be yet procured by diuerse other meanes as I remember a yong woman then vnmarried who in the disease called the mither voyded abundance of vrine especially during the time of her fits being in the afternoones and that for the space of foure dayes together as hereafter shall appeare when we shall speake of the colours of vrines And often in the crises of acute diseases the vrine is multiplied A man of Sena saith Scribonius euery day did pisse foure or fiue iugs of vrine who scarce dranke halfe an English pint all the said space what could a Physitian haue iudged by this quantitie Thus then when thou seest so many causes or one and the same effect to which of them canst thou ascribe it vnlesse thou be well acquainted with the particular circumstances from the patients owne mouth Small quantitie of vrine is likewise procured 1. By dry diet 2. By the vse of tough and â—â—mie meates 3. By reason of obstructions 4. By reason of plentifull euacuation 5. By meanes of a violent feauer 6. By some hurt of the vrinarie vessels as commeth sometimes to passe by reason of the cold distemper of the bladder procuring a palsie to that part 7. By the decay of naturall heate as commeth sometimes to passe in such as are readie to dye 8. Because the moisture is detained in some other part as commeth to passe in a Dropsie 9. By reason of some impostume in the fundament the necke of the bladder or in the wombe which may straiten the said passage that the vrine cannot come away in any great quantitie 10. The abundance of crude and raw humours may be a meanes of this so small a quantitie But I will yet adde some more out of the aforenamed Scribonius because his words are so sutable for our purpose The like verdict may we also giue forth saith he concerning the small quantitie of vrine taking often its originall cause from the defect or scarcitie of meate and drinke as also by meanes of some other euacuations such as are sweat excretions by stoole and such like which carrying the matter of the vrine another way hinder the passage thereof into the bladder and by consequent the expulsion from thence For this same cause such as be troubled with any laskes or fluxes do voide but a small quantitie of vrine as Galen himselfe declareth Againe a little after he addeth these words In the obstruction of the Liuer and mesaraicke veines experience it selfe doth often teach vs that a very small quantitie of vrine is voyded Now if any ones seruant should bring vnto thee such an vrine not acquainting thee with any other circumstance why wouldest thou giue sentence for an obstruction rather then a laske or for a laske rather then an obstruction Besides the premisses in the Stone the Dropsie and such other diseases which hinder the generation of vrine no certaine iudgement can be collected from the small quantitie of the same And that thou mayest yet be more rauished with admiration Rufus Ephesus in his booke of the infirmitie of the reines maketh mention of one who as saith Praxagozas aboue the space of twelue yeares voyded all his vrine by the bellie and not by the ordinarie passage What then could a man haue iudged concerning this mans bladder and the other parts depending thereupon And this shall suffice for the quantitie of vrines with the vncertaintie of the same now come we to the qualities obserueable in them The next accident of vrine is the qualitie and the qualities as witnesseth Mercuriale according to the doctrine of the Arabian Physitians are fiue the smell the tast the sound the touch and the colour As for the smell vrines haue little or no smell or else a sweet and pleasing smell or finally a stinking smell No smell saith Mercuriall proceedeth from no other cause then from the extinguishing of naturall heate howbeit it may sometimes proceed from drinke of a cold qualitie like as we see in cold countries and the like complexions the smell of the vrine is not so much to be discerned Vrines smell well either in regard of diet or drugs but especially by meanes of a temperate heate concocting well Stinking vrines come by foure seuerall meanes 1. By meanes of cruditie and indigestion of the food 2. By reason of putrefaction Galen witnesseth that whatsoeuer thing is putrified hath an euill fauoured smell Wherefore in Pestilentiall feauers the vrines are most commonly of a stinking smell As also if the vrines passe through any place oppressed with putrid vlcers or yet if any purulent matter be mingled with them they become stinking 3. The too long retention of vrine in the bladder
the vrine became of a remisse and light colour such as it was wont to be in his former health After a short space his vrine reassumed againe its former high colour vntill such time as by frequent reiteration of glisters the vrine at length persisted in that laudable state and condition once before begun the bodie also without any artificiall meanes performed its ordinarie functions A Citizen of good account about fiftie yeares of age being freed from a Quartane ague which had held him for the space of foure or fiue moneths fell into that kind of laske which we commonly call Lienteria His excretions by stoole were very liquid and crude and no remainder of the heate of the Ague to be discerned His vrines also were of as high a red colour as is at any time to be seene in the most violent burning feauers or inflammations of the inward parts But yet did I not build vpon any so rotten a foundation but hauing a more watchfull eye on other matters I thought it necessarie in the first place to haue a care of the stomach and in the next place of the Liuer both being by meanes of the former Quarterne ague not a little weakened For this end and purpose I prescribed his diet in qualitie hote and drie allowing him for his drinke the best and strongest wines such as are Sacke and Canarie Physicall meanes were Diagalanga Diatrion-pipereon and such like By continuance of which meanes this much at length was obtained that the saecall excrements did now shew forth good concoctiō the vrines also as in his former perfect health After all the premisses the aforementioned patient assuring himselfe of perfect health did secretly fall againe to the too liberall drinking of beere Immediatly after this disorder the colour of his vrine was againe altred into an high deepe red vndoubtedly declaring vnto vs that sometimes the vrines receiue an high and deepe colour by reason of the cruditie and coldnesse of the stomach After that time therefore he refrained againe from beere vpon the which his vrine returned to its former laudable condition neither did he after that vse any beere vntill such time as he had perfectly recouered his former health againe These things haue I related because of the ignorance and error of many who are perswaded that the vrine cannot be died with so high a colour any other way then by heate who whensoeuer they see such an vrine brought to them the patient being tormented with the Collicke they very vnaduisedly and rashly haue recourse to the cure of a feauer neglecting the cure of the Collicke which by these meanes they are so farre from curing that they do rather much increase the paine of the same But if these men had read Galen to Glauco they could not be ignorant y ◠vrines sometimes do appeare of a reddish colour in cold diseases or at least such as are not very much distempered with heate For writing of the Quotidian ague which hath for materiall cause crude and raw humours thus he writeth In Quotidian agues the vrines are either white or thicke and muddie or else of a red colour Martinus Akakia in his Commentarie addeth that the vrines then become of a reddish colour when as by weaknesse of the Liuer or the veines the red waterish substance issueth out with the vrine Fernelius also lib. 6. pathol cap. 13. writeth that they are not a little deceiued who do ascribe bloudie vrine or that which is of a red windie colour resembling the washings of raw bloudie flesh vnto the imbecillitie and weaknesse of the Liuer for he cannot conceiue how that bloud can come from any other part of the bodie without some indisposition of the kidneys But yet by the leaue of so learned a man many things there be which make against this assertion For oftentimes by experience we see many plethoricke young men feeding on abundance of daintie dishes liuing in ease and idlenesse to pisse bloud by meanes of a relaxation of some veine who by the onely meanes of Phlebotomie together with the application of some Emplasticke remedie to the region of the Liuer about the which place they say they find some weight ioyned with some distention reaching vp to the right shoulder are perfectly cured And who can here I pray thee accuse the kidneyes there being no paine nor trouble at all felt in the making of his vrine And thus may the deceit and vncertaine iudgement had by the varietie of these red vrines in hote or cold diseases easily be conceiued for the which cause I will here surceasse from insisting any more vpon them but now because mention hath bene made of some small quantity of bloud issuing foorth with the vrines we will say something of the abundant pissing of bloud illustrating it by some authorities as heretofore we haue done Now as these vrines of an high and intense red colour do strike a terrour often in the beholders much more doth this liquor of life the bloud it selfe I meane issuing out of the vrinarie pipes and passages cause no small amazement to the eyes of the ignorant and sometimes of the more iudicious beholder of it And yet doth not this alwayes portend so infallible and vndoubted danger as by many is deemed Sometimes indeed the danger is so great that not onely a meane and ordinarie vnderstanding but a more refined iudgement may iustly feare the future danger as in the rupture of some great veine neare the Liuer or the kidneyes after which doth an vlcer often ensue and after a long torturing and tormenting paine Death most commonly maketh an end of their so miserable and painfull life Sometimes againe this fluxe prooueth very safe and secure as in criticall and periodicall excretions But heare I pray thee an ancient Author deliuer his opinion concerning this point Some men there are who by certaine turnes and at certaine times do pisse bloud abundantly being a disease not vnlike to the haemorrhoides or piles The state and constitution of their bodie also is not vnlike for they are very pale dull sluggish and lumpish they loath their food and after this excretion of bloud there followeth a certaine resolution and faintnesse of their ioynts their head notwithstanding becometh much lighter and better But if at this accustomed and wonted period of time there shall happen a suppression or stoppage of the aforesaid fluxe they are presently surprised with a great head-ach their eye-sight waxing dim seconded with a giddinesse and swimming in the head Vpon which occasion it commeth to passe that many of them fall into the falling sicknesse some of them againe being puffed vp and swollen with their eye-sight somewhat darkened do resemble Hydropicke persons others are oppressed with melancholicke diseases and some againe with Paralyticke passions All these inconueniences do follow vpon the suppression of any former fluxe of bloud Sometimes pissing of bloud saith Hollerius is criticall
confusedly and indistinctly that hardly couldest thou discerne one manner of signe from another insomuch as thou mayest not without cause call their Diagnosticke Physicke the confused chaos of Democritus And further they do not instruct vs sufficiently what signe of the disease doth argue or shew foorth the greater or smaller strength But there is in Germanie at this day a sort of idle prating fellowes more foolish then any others who as if all the signes of euery disease were to be seene in the vrine are not ashamed by the sole and bare inspection thereof to prate and pronounce sentence concerning the substance of the disease and the life and death of the diseased as hath bene said alreadie To the end therefore that their impudencie may be made manifest and layd open to euery one I purpose to insert something in this Epistle concerning the differences of signes to the end that I may minister occasion to some others more learned then my selfe to handle the same by an absolute exquisite method the which taske I will also willingly vndertake for the good of the sicke if I may obtaine so much time and leisure that at length this so hainous a fault and worthy of no small punishment may be banished from among the companie of all honest and ingenuous Physitians and a right and perfect method as well for discerning as for curing may be set downe Now it is granted as well among Phylosophers as Physitians that the effects and accidents do indicate and declare their causes It is likewise well knowne that the accidents are nothing else but the effects of the disposition of the disease No man therefore can deny that the accidents of which number are also the actions interessed and some things which essentially do adhere thereunto do indicate and declare as well the disease as the place affected as being the harbour and receptacle of the same and vnto which the remedies ought to be applyed Now as concerning the accidents some of them are called by the Greekes Epiphaenomena that is such as do appeare indeed but vanish away againe before the disease be at an end others againe called Pathognomonica which being of the essence of the disease do both begin and end with the same And these be inseparable and certaine signes of the disease the concourse of which doth more certainly and truly declare vnto vs the nature manner and kind of the disease then any vrine can do As a continuall feauer together with a pricking and stinging paine in the side a great cough and shortnesse of breath when as they concurre together and come as it were all at one instant are euident and certaine signes of a Pleuresie But other accidents which do after succeed are called Epiphaenomena or Synedreouonta as if thou shouldest say assessors or assistants to the disease vnto the which also they are not inseparably annexed nor yet haue their originall together with the same but for the most part either seldome or after a doubtfull manner do accompanie the disease not making vp the substance but certaine differences of diseases As in a Pleuresie a red bloudie or yet yellowish spittle a paine extending it selfe to the breast bone or neather part of the midriffe watching deliberation and terrible dreames these accidents are called assistant or accompanying and do declare either the difference of the disease or else the mildnesse or malignitie of the same Now it behooueth the Physitian to ponder and expend with himselfe in such a concourse of accidents equally the strength of euery accident apart and to compare together such as be dangerous with the other which do promise greater securitie For if those which are dangerous do vanquish and ouercome the strength and vigour of nature either by their force or number then mayest thou boldly pronounce that danger is not farre from the doore And againe on the contrary if such as do promise securitie be of greater power then the former then shall the sicke escape out of the deepe danger of Scylla and Charybdis and by the vertue and power of a happy Crisis saile forth into the hauen of health and that yet more assuredly if in the meane time perfect signes of concoction shall appeare Amongst such signes some are called Decretorie or Iudicatorie other signes of cruditie and concoction others againe do foretell the securitie or danger of the disease Now the signes of concoction after the beginning of the disease is past ouer and the humours by meanes of the naturall heate well concocted sequestred and separated from that which is putride and corrupt do appeare about the time of the increasing or vigour of the disease in the vrine spittle suppuration of Impostumes which is not vnlike vnto concoction performed in the veines as also in other excretions for the excretions of euery part of the body as also of the humours which are nothing else but the superfluities and relickes of concoction do shew foorth the indisposition of the same Wherefore in the infirmities of the chest and instruments of respiration a spittle white euen of an equall consistence is alwayes a good and laudable signe of concoction But if the sicke be not at all able to spit out any thing then doth it shew foorth absolute cruditie and if he should chance to spit a spittle without any mixture being thin waterish of a leaden colour or of the colour of verdigrease it doth not onely argue cruditie but doth also portend the vtter ouerthrow of the patient But the vrine being an excretion of the second concoction doth certainly shew foorth the crudity and concoction of the humours contained in the veines guts liuer and places adioyning the said parts being annoyed either with feauer inflammation Scirrhus or yet any other distemper whatsoeuer For if the same both in colour and substance be like vnto such vrines as are vsually seene in perfect health hauing a residence white euen and like vnto well concocted matter it doth truly witnesse vnto vs not onely the concoction of the disease especially in feauers but also that the naturall force and power is a great deale stronger then the disease and therefore that it is like to obtaine the victorie in the conflict with the crisis But by this meanes the vrine is no Pathognomonicke signe and yet a necessarie signe of concoction and cruditie and worth the obseruing in feauers diseases of the neather belly or intrails and places adioyning to them Wherefore Galen in the exposition of the predictions of Hippocrates doth grant that the vrine doth shew foorth and demonstrate the state and disposition of the parts of the liuer kidneyes and bladder as likewise of the strength or weaknesse of the vessels containing the bloud and of the naturall power and vertue which is the ingenderer of the humours howbeit the same Galen againe affirmeth that there are other Pathognomonicke signes belonging to the braines lungs mother sinewes c. And yet notwithstanding might