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
abroad to preserve his strength or when the stomach is weak Yet there may also be prepared out of this Root pouders Electuaries extracts as are from Guajacum CHAP. XV. Of China Root THe Portugal Merchants brought over in the former Age China root from the Country of China a certain Root for the cure of this disease which they called China Root for when as the Venereal disease had invaded that Country also as the Americans shewed the use of Guajacum for the destroying of this disease so the people of China used this Root to cure the same disease and taught others the use of it But the Root is a handbreadth long somtimes pretty thick somtimes thinner knobbed somwhat reddish pretty weighty which being newly digged up they report is so tender that it may be eaten raw and boyled as turnep and rape Roots are with us the which seems not to be very credible whenas our Turneps Rape Roors dryed never attain to so great a hardness they are brought to us divided As concerning its vertues 't is neither strong in smel nor tast and therefore there is no excess of it in heat and cold but 't is rather temperate or if there be any excess in it 't is rather in cold yet 't is dry in the second of thin substance yet with a certain astrictive power and a kind of substantifical moisture so that by the use of it men do grow Fat Whence also the decoction of it doth easily sowr When it was first brought over by the Portugals into France and the neighbouring provinces it was wonderfully cryed up by the Merchants as being of thin parts and having power to digest to more urine and sweat to consum Excrements of al sorts to clense the Bowels free from obstructions clear the blood from corruption to cake away pains in the Joynts to be good for the Venereal disease and because 't is temperate it may safely be given to any age sex any time of the year and to those that are feaverish al which faculties whenas they are not in Guajacum by some of that time it was made use of not only for the cure of other diseases but also for the cure of the pox it was preferred before Guajacum Which very thing caused that Charles the fifth Emperour being sick of a most grievous Gout was the first almost that would make tryal of the use of this Root upon the advice of some Physitians But experience afterwards lessened that same and Jul. Palmarius writes of this business de lue Vener Cap. 14. that many to their great detriment have preferred this root before Guajacum and that he hath found by experience that also in a very strict diet it hath been uneffectual against this disease oftentimes also the stomach is seen to become so moist with the use of its decoction and the Native heat opprest that a great Lientery and crudity hath often followed in those who had but weak Fuell for their implanted heat Besides these discommodities and faults he writes also that it doth oftentimes cause swelling of the Spleen and hardness in those that use it long neither doth he grant it to have extraordinary vertue against this disease either by its whol substance or occult quality when as after the use of it they who thought themselves wel do dayly fal into a relapse of the same Disease The same also is confirmed by Gabriel Fallopius Lib. de Morb. Galli Cap. 60. who writes that he hath used this Root again and again for the Cure of this Disease but could do nothing with it in the interim he writes that he hath used it with happy success for the dropsie to moderate the mobility of the Humors in hot bleared Eyes and in a hot distemper of the stomach and Liver And other Physitians also agree in this that this Root for the Cure of the French Pox is far in feriour to Guajacum and Sarsaparilla although it be profitable to preserve and strengthen the heat of our body and therefore for other diseases And if by chance any one who could not be cured neither by the decoction of Guajacum nor by the unction of Quick-silver hath recovered health by the Decoction of China Jul. Palmarius thinks this is the Cause of it because Nature rejoycing in the Variety of Remedies and weary of the stronger at length is easied by those that are less effectual Yet Garzias ab Horto relates of the Root being fresh that it doth so exceedingly heat that if any one use the pure Decoction of it or drink it hot by reason of the too great heat of the Medicine he wil fal into exceeding heats of the liver Erysipilaes and Phlegmons and other most grievous Symptoms But when as 't is brought over to us insipid and somtimes dusty there is no cause to fear any such thing Neither doth this only happen in this plant but also in many others that the Alimental juyce hath far other vertues then the dryed Plants and therefore though perhaps this Root being fresh in China may have great vertue to Cure the Venereal Disease yet it is not necessary that it retain the same with us But divers prepare the decoction of this root diversly The decoction of China Jul. Palmarius writes that the common way of preparing it is this that to two ounces of the root cut into rounds and put in an earthen pot there is poured four pound of water and let them steep twelve houres afterwards boyl with a gentle fire to the consumption of the one half Fallopius boyles two ounces of the root in twelve pound of water to the consumption of half but according to the nature of the disease the proportion of the root and water may be varied and the root may be boylled from one to three in twelve pound of water Yet Septalius adviseth us here that this decoction is most commodiously prepared if one ounce of the root fresh and not rotten be boyled in ten pound of water two ounces in twelve pound of water For he writes though many physitians to save charges whenas many cannot take al that decoction in one day and they feare if they should keep it another day it would grow sowre do boyl half the portion of China in half the quantity of water and boyl away the half or two thirds thinking that so they have both saved their purse and prepared the decoction as strong yet they are very much deceived and if they have not lost their taste they shal easily know that that first decoction is much more powerful than the second and the reason is ready because 't is not enough to give a proportion of the root to the water but the time of boyling is cheifly to be considered and the action of the heat of the fire and the reaction of the water For whenas foure houres space imagine ought to be allowed to extract the vertue out of a most hard root and communicate it to
so poured forth into the Teeth that it hath there caused a pain and in others in whom it hath been poured forth unto the breast it hath there excited a spurious and bastard Pleurisie But now this Malady is not wont to continue long at a time but to afflict the party by certain intervals and Periods whiles the matter heaped up is thrust forth unto the Joynts by certain intervals which indeed in the beginning are somwhat longer so that the Diseased persons are often free for six months and somtimes likewise they are free from this Gout for a whole year together but then afterwards the Bowels and the Native heat being much weakned and impayred and many vitious Humors being heaped up together the Malady returneth by shorter intervals The period of the gout somtimes after three months and somtimes every month Yea and some there are whom it doth continually afflict and make them to keep their beds Now Arthritis or the Gout is in the general defined to be The definition of the Gout in general A pain of the parts about the Joynts excited from the defluxion of a serous and sharp Humor and poured forth into them out of the Veins and Arteries Or if it please you rather to define it in any other manner when a swelling doth now concur with it you may then say that it is a Tumor or Swilling about the Joynts arising from a defluxion of the serous or wheyish and sharp Humor by the Veins and Arteries unto the place affected and by reason of the extension of the Membranes about the Joynts and the Acrimony of the Humors Twinging and pulling them it hath Joyned with it a pain and hinderance of motion And because that the Nature of this Disease is such Whether it be proper to the gout to return by intervals that when it hath once begun to infest and trouble a person the Body can hardly ever be so carefully looked unto and well ordered but that upon every sleight cause and upon the least occasion given it will again return and indeed by certain Periods somtimes once a year somtimes every six Months and now and then once every Month many therefore of the most learned Physitians do likewise add this in the definition that it is a pain or swelling returning by certain intervals and Periods But if there be any one that thinketh it therefore to be omitted because that he who is at the first troubled with the Gout and so hath not suffered many Paroxysms returning by intervals yet may be truly said to be affected with the Gout yet Notwithstanding he cannot deny this that the very Nature of the Disease is such that even in the very first Paroxysm the Disease is in it self naturally fit to return by intervals like as he who is at first taken with a Tertian or Quartane Feaver is truly said to be troubled with a Tertian or a Quartan albeit that he hath not yet undergone many Paroxysms or sits returning every Third or Fourth day Franciscus India indeed blameth those that define the Gour by a pain in regard that neglecting the Disease they define this Malady by its Symptoms But it is no new thing to define some certain Affects in the which the Symptom and the Disease concur by the Symptoms as more urgent more troublesom and grievous unto the Diseased party and more manifest in themselves And so the Phrensy is defined by a Deliry and the Pleurifie by a pain although that there be in both places present a Disease to wit an inflammation And therefore there are many of the ablest Physitians both Ancient and Modern who inscribe their Tracts touching this Affect of the pain of the Joynts Neither again may be Gout be here alwaies so fitly defined by a Tumor or swelling in regard that oftentimes there is no swelling evidently appearing in the External parts and yet nevertheless the pain is then greater and more vehement then when there is a swelling in the part But India himself is very much mistaken and greatly erreth whiles he defineth this Malady by a deflux And moreover Whether every pain of the joynts ought to be called the Gout although that every Gout that happeneth about the Joynts may be called a pain and in this manner this name may be also attributed unto pains that happen in disjoyntings Contusions or bruises and blows wounds that which is in the French Pox that which happeneth unto Virgins while their Courses are flowing from them or such as happen unto the Hips of great Bellyed Women that are neer the time of their Travail or in general unto all pains whatsoever that happen about the Joynts yet notwithstanding we do not here take the word Gout in so large a sence but in a more eminent and especial manner we here by this Name understand that peculiar kinde of pain which the Germans cal Das Zipperlein arising from a sudden influx of a Humor into the Joynts insinuating it self into the more hidden and inward parts of the Joynts and returning by intervals and Periods The subject of the Gout if it be defined by pain are only the Membranous parts The subject of the Gout and those parts about the Joynts that are endued with a quick sense and feeling For a Membrane being the Adequate subject of the Touch even here also those parts that are grieved with pain do suffer it as they are membranous Whether al the Ligaments want sense from which nevertheless we may not exclude the Membranous Ligaments For although that Galen teach us that all the Ligaments want sense yet notwithstanding we are not to deny sense unto the Membranous Ligaments which as we finde by experience are very sensible of pricking and the Gout it self doth evidence it Neither is that Reason they commonly alleadg to the Contrary of any great weight and moment to wit that a Man should be alwaies Obnoxious unto pains and never free from excruciating Tortures if the Ligaments that are sensible of pain should dash and strike against the bones for Nature hath so fenced and guarded those parts and so admirably ordered it that no such thing can happen And hence it is that we daily lay hold on with our hands and walk upon our Feet in which there are very many Tendons Nerves and Membranes and yet nevertheless we are not sensible of any pain But if it be defined by a Tumor or swelling then all the parts that joyn together the Joynt and lie round about it may be said to be the subject of the Gout But now that these pains are excited more about the Joynts then elsewhere the Cause is this to wit that the Veins and Arteries pour forth in these places in the which there is a Concourse of the Membranes and Nerves those Sharp Humors which Nature endeavoreth to expel and which cannot flow forth in the middle Channel of the said Veins and Arteries and because that the Humors arriving at the
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
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
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
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
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
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
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
at Venice who by his abstaining from wine by the space of five years was delivered from the Arthritis or Gout during his whole life even unto the very day of his Death And we likewise related unto you before out of Franciscus Alexander of one Francis Pecchius a man much troubled with the Gout who being cast into prison and there detained for twenty years was in the end freed both from his imprisonment and all his Arthritick pains and so continued free from all fits of the Gout for ever after during his Natural life And Marcus Gattinaria in that Chap. of his Book touching the Cure of the pains of the Joynts from a hot Cause writerh as concerning himself that when he first began to suffer the fits of the Gout this was the Course he took for the recovery of his health and ease from his fits to wit first of all he imposed upon himself an abstinence from Wine for two years and every month he emptied his Body by Evacuations and then he took some Pill or other for the diverting of the Humor the cause of his distemper and this he made use of twice in the week that so Nature might be diverted in her transmitting the matter unto the Joynts and that so she might rather evacuate it by the way of siege and by using this course for a while he was so throughly Cured that he was never after that troubled with any such like pains And Carolus Piso also in his Book of Diseases from Serous or Wheyish impurities in his Consil touching the Arthritis writeth that a certain man who had lived all the time of his youth infested with perpetual pains of the Arthritis and making his moan and continual complaints thereof by the counsel and advice of Nicolaus Piso in the flower of his Age he wholly denyeth unto himself the use of Wine although he were the principal of those that were set over and had the charge of a Wine-Cellar a rare example indeed of admirable temperance and so by thus doing he kept himself for thirty years together al the time of his life after altogether free from those pains And Histories likewise testifie that some even by a due and orderly regularing of their lives and others again by their being reduced unto poverty and so necessitated unto a frugality in point of Dyet have thereby been wholly freed and delivered from the Gout And this withal is a thing most strange and wonderful of which Guilbelm Fabricius relateth three examples in his First Cent. and 79. Observat that some certain Arthritick persons there have been who upon suspition of some Notorious Offences by them committed have been oftentimes set upon the wrack and put upon the extreamest of all exquisite Tortures but when they have constantly maintained their own innocency they have at once been absolved and for ever set free from their Crimes and withal from the fits of the Gout with the which they had formerly been most grievously afflicted And wonderful also is that example which the same Author in his first Cent. Epist 47. relateth of a certain envious and malecontented Person that lay sick of the Gout who though he were fastened unto his sick Bed by his painful Disease could not yet refrain from traducing and speaking ill of others Which when a merry conceited Fellow there present perceived who had also himself been lasht by the petulancy of the others Tongue about the dusk of the Evening taking his opportunity when the sick Person was left all alone by all his Family enters the sick mans House privily in a strange disguise that he had gotten like unto an Aeâ—hiopian or Blackmoor and thus disguised he goeth neer unto the Bed-side of the sick Person who astonished with the unusualness of the form his own solitariness and withall terrified with the darkness of the place it self that he lay in demandeth of him who he was and from whence he came The Whifler answering to none of his Questions but making his approach closer unto the Bed-side catcheth him by the Arms which were likewise much troubled and pained with the Arthritis and having thus laid hold on him he throweth him upon his back and to hanging upon the same and crying out with all the noise he could make he carrieth him out of the Chamber where he lay ever and anon crushing his Feet against the Stairs by which he was to go down When he was come into the Yard he there sets down his burden putting the sick Person upon his Feer speaking not a word to him all this while only staring him ful in the Face And then suddenly again he runs towards him and made as though he would once more have seized upon him and so have carried him out of the House But now he who before could not so much as set his Feet to the Ground by reason of his Disease nor walk at all upon plain Ground much less get up any whither by the Steps now runs as fast as he could up Staits and to the top of them he gets and so into his Bed-Chamber he comes and thorow the Window with the loud noise he made all the Neighborhood was raised and so come running in unto him to see what the matter was He out of Breath as he was and half dead with affrightment tels them that he was by a Ghost dragg'd out of the Bed where he lay and then being carried forth of his Lodging-room he was most miserably handled and that had he not often called upon and ingeminated the name Jesus he had without doubt been gone had there been no more men in the world And wonderful indeed it was that he who was before so sorely afflicted with the Gout should hereupon recover his health and strength and never after be troubled with any the least fit of his former Disease Fabricius hath there likewise another History of a certain Malefactor that had the Gout who being brought forth and led unto Execution his punishment being to have his Head cut off by that time be was come half way to the place of execution there was brought him an unexpected Pardon granted him by the Clemency of his Gracious Prince The miserable man was so affected with this good tidings that he who til now wanted the use of almost all his extream Members now on a suddain cast himself on his Feet with a quick and speedy motion and lived after this for many yeers wholly free from all kind of pain and trouble that formerly he had undergone by reason of the Gout And I my self remember likewise that we had here with us not long since a Noble Youth much troubled with the Gout this Youth the neer neighboring houses happening one Night to be all on Fire and the House wherein he was in danger to be burnt he suddenly for fear gets him out of his Bed and down a Ladder he runs and intending to fly into another House he fell with that Foot where
TWO TREATISES The First of the VENEREAL POCKS Wherein is shewed I. The Name and Original of this Disease II. Histories thereof III. The Nature thereof IV. Its Causes V. Its Differences VI. Several sorts of Signs thereof VII Several waies of the Cure thereof VIII How to Cure such Diseases as are wont to accompany the Whores Pocks THE SECOND TREATISE OF THE GOUT 1. Of the Nature of the Gout 2. Of the Causes thereof 3. Of the Signs thereof 4. Of the Cure thereof 5. Of the Hip-Gout or Sciatica 6. The way to prevent the Gout Written in Latin and English By Daniel Sennert Doctor of Physick Nicholas Culpeper Physitian and Astrologer Abdiah Cole Doctor of Physick and the Liberal Arts. LONDON Printed by Peter Cole Printer and Book-seller at the Sign of the Printing-press in Cornhil neer the Royal Exchange 1660. Culpepers WORKS SENNERTUS WORKS Sennertus of the Gout and Pocks Sennertus Natural Phylosophy OF THE FRENCH POX CHAP. I. Of the Name and original of the Veneral Disease AMongst contagious diseases next to the Pestilence and Leprosy of Arabians the French Pox doth challenge the first place but it is called by several names The Names of the french disease the most common name is the French Pox which was therefore imposed because it first of al in Europe appeared amongst the French For in the yeare of our Lord 1493. and 1494. When Charls the Eighth King of France waried with King Alphonsus at Naples this disease first appeared and began to rage in the Camps of the French and therefore by the Italians was first of al named the French disease For whereas Antonius Benivenius de abdit morb caus cap. 1. relates that it happened in the year of our Lord 1496. that doubtless is thus to be understood That now this disease did no longer contain it self in Italy but as he speaks had almost spread over al Europe and began to diffuse it self abroad through the rest of its provinces for al other Authors agree in this that this disease did first of al appeare at the foresaid time in the French Camp at Naples The French Disease The Italian The Neapolitan The Spanish The Indian and there was called the French disease But the French that they may remove this disgrace from themselves and retort the injury upon the Italian cal it the Italian and Neapolitan disease because it was first known in Italy at Naples Others because it was brought by the Spaniards into the Fench Camp cal it the Spanish disease and others the Indian for the writers of the Indies do report that in that part of America whose longitude ends towards the North and which they cal Florida this disease many ages ago was epidemical and they write that it did generally invade and suddenly seize on many without any manifest cause without contagion and especially if any one had copulation with a woman in the time of her Courses Fracastorius cals it Syphilis some the gout of the privicies Syphilis Pudendagra The great Pox. The Veneral Diseawses Whether it be a new Disease some the great Pox because pustles and swellings do every where break forth like those of the smal Pox. Most men now adays without any injury or disgrace to any Nation do cal it the Veneral disease because it is chiefly contracted by a contagion from Venery and lying with unwholsome bodies But Authors are wont here to make this Quaerie Whether that diseawse sprung up at Naples about the yeare 1494. were a new disease or whether it were known to the Ancients Franciscus Vallesius 1. Epidem com 1. And Hieron Rusnerus de Scorbuto exercit 1. and the some other moderns are of opinion this disease was unknown to the ancients and they think that Hippocrates did not shadow it out by his pencil but set it forth to the life in 3 Epid. Sect. 3. they are the words of Reusner whenas he reckons up there divers symptomes which are seen in the veneral disease as imposthumations and suppurations of the flesh the lying bare of the nerves and bones and great fallings forth fluxions collected not like unto matter but far worse a baldness of the head and chin with and without a Feaver St. Anthonies fire with smal Ulcers and inflamation filthy and putrid fluxes pains of the limbs swellings about the jaws inflamations of the tongue impostumations about the teeth stammering corrupt and perplext speech enterings into consumptions burning Feavers and which is worst of al ulcers about the pubes and privities But Hippocrates in that place never so much as dream'd of the Veneral disease but describes a most grievous pestilence according to the judgment of Galen and al interpreters and the evidence of the History it self witnessing the same For that disease for the most part invaded with a Feaver which is not so in the Veneral disease and was epidemical whenas the Veneral disease is disseminated only by contagion and no other way and the method of curing that disease was far different from the cure of the veneral Dodoneus also hath observ'd upon the alleaged place of Benivenius that a long time agoe some men have contracted some hurts from uncleane and filthy women as Guilielmus Salicetus Gordonius and Vallescus de Taranta do testify the last of which lived in the year 1418. but Salicetus flourisht in the yeare 1270. Gordonius in the time between them both Nay holy writ doth testefy that he that followeth harlots shal have wormes and moths for his reward but I do not think that those diseases were the same with the Veneral disease of this time which first of al appeared at the aforesaid time in Italy in the Camp of the French Therefore though Paracelsus lib. de tumorib et ulcer morb Gal. cap. 3. Writes that this hapned in the yeare 1478. The Original of the Veneral disease and lib. 1. de causa luis Gal. cap. 3. In the yeare 1480. yet he differs from the relations of al others since al agree in this that this disease was not known in Europe before the yeare of our Lord 1493. although it were endemious in the west Indies a long while before and was brought by the Spaniards out of India into Italy For when Christopher Columbus in the yeare 1492. in the month of September undertook his first voyage into the west Indies and spent almost two years in that expedition he returned into Spain in the yeare 1494. whose Souldiers being infected with that disease in India and afterwards serving in the Italian expedition did sow amongst them this disease For as Gabriel Falopius writes of this business de morb Gal. lib. 1. Who reports his Father was in that warre whenas the Spaniards by reason of the deareness of provisin did drive out the unserviceable multitude the French did privately entertain their harlots being allured by their beauty and so infected with their contagion contracted this disease which afterwards was first of al spred through their
camps hence throughout Europe Yet in some Countries it hath and doth yet spred more frequently in others 't is more rare to enquire into the cause whereof it being a thing hateful we shal forbeare yet this I think is certain that there are fewer sick of this disease in Germany than in some other Countries Gabriel Fallopius makes mention de morb Gal. cap. 76. Of Jacob Carpus who was the first almost that used the way of cure by unction of Quicksilver who by this cure alone grew so rich that he left befides Silver 40000. Golden * A Coin Scutatces And Capivaccius reports in tractat de lue Vener cap. 12. In fine that he hath gotten by the cure of the French Pox only above 18000 Crowns of Gold And L. Septal. l. 7. animad n. 186. writes that at Millaine in Brolius Hospital there is oftentimes cured seventy in the spring only and at other seasons alwaies two hundred But I confess ingeniously that within these 34 yeares which I have practised at Witeberge and by Gods blessing I do it not without profit that I have not gained by the cure of this disease so many Crownes as Capivaccius hath got thousands of them by reason of the fewness of them that are sick of this disease in this place Yet others differ concerning its original and think that this disease was not only disseminated by contagion from the Spaniards but think it was contracted by the fault of the Ayr as epidemick diseases are when as many every where in diverse countries began to be sick of this disease without any contagion of which hereafter Chap. II. A History of the Veneral Disease BUt concerning the original of this disease we shal speak more hereafter when we shal treat of its causes now let us enquire into its nature which that it may succeed more happily and that it may appeare where lyes the controversy iâ— wil first propound its description and history out of creditable Authors which then lived especially Hieron Fracastorius and Anton. Benivenius When this disease was first made known there rose pustles of divers kinds in the genital parts somtimes also the head principally in the hairy part somtimes also the forehead neck breast duggs armes and other parts and from thence did spred over the whol body in some indeed they were flat and low but rough on their surface when the scales were fallen off of a color somwhat red and the flesh under them appeared callous in others they were like to warts of a round figure which grew to the magnitude of an acorn cuppe whose figure also they resembled and from these the lighter scales fulling off did hang forth a more tuddy flesh from which did flow forth a virulent inâ—â—r and of a strong smel but some were taken with larger pustles which did â—otswel above the skin which had thicker scales from which also did flow a more pleuâ—â—ful virulent matter and the scales being cast the flesh appeared more dark and somwhat livid Some having white scales taken off there remained somwhat like unto a skar from which blood sometimes flowing did shew the difficulty of the cure and it represented the likeness of a dry scabb a disease worse than al the rest For though it did corrode less yet for spreading it was worse than the rest and was diffused into divers places Besides those external pustles there did rise others in internal places as in the mouth jawes nose and the obscene parts which turned to malignant and creeping ulcers which eat away the parts under them and in some eat up the Nose in others the lipps in others consumed the Uvula and perforated the palate which caused their voice to be hoarse neither did this evil spare the bones but caused rottenness in them whence some had their skul others other bones ful of holes Neither did those pustles and signs of the disease appear only in the external parts obvious to the eye but it was observed in some that those pustles filthy ulcers had possest their very bowels They that had this evil about their upper parts had vitious distillations which did sometimes eat their palate somtimes the jaws and consills in some their nose and in others their eyes Furthermore for the most part certain gummosities grew on their limbs in great deformity For oftentimes they were prominent the bigness of an egg oftentimes the size of a Loare which being opened there appeared a white mucilagmous mucous that tenacious callus happened most of al in the Arms and Thighs in some it was exulcerated somtimes it continued whole until their death There came also cruel pains with exceeding torment which were exasperated towards night but those pains did shew themselves about that part of the bones where is no flesh in the Leggs shoulder-blade about the collar-bone in the shoulders head about the forehead and temples somtimes also in the breast bone but not in the very joints but about the muscles and nerves In which case notwithstanding there was great variety For some had pains without pustles some pustles without pain the greatest part was affected with both and truly those pains somtimes went before the pustles somtimes followed and sometimes rose together with them in the interim al parts languished the body pined away the appetite was dejected watchings sadness and continual anger and desire of repose possest them sometimes a smal Feavor accompanied them but seldome their blood if a Vein were opened was mucous and corrupt their urine thick fat and somwhat red without a Feavor they went hardly to stool and the excrements were mucous and dry The shedding of the Hait is frequent in this Disease especially in the Head about the Temples and the hinder part also of the eybrows and of the beard in men oftentimes also Buboes break forth in the groin therefore called Veneral and Gallical which sometimes vanish again somtimes grow hard somtimes suppurate there rise also in the privities of Women knobs and in men in their Arie-hole besides somtimes there happen chops and clefts in the hands and feet and the thick Skin in the palme of the hands departs from the skin under it sometimes also the nails fal off At last there happens sometimes that in men a virulent matter flowes through their yard in women through their privities which flux of virulent matter is commonly called the Gallical or virulent running of the reins although indeed it is not feed by which flux of the yâ—rd the inward passage is exulcerated and certain caruncles do grow in the urinary passage whence they pisse â—ot and there is caused a dropping of the urine with pain And this was the face of that disease at its first fise which as Hieron Fracastorius relates since that time seems to be altered For almost twenty yeares after its original there began to appear fewer pustles but more gumoseties and the pustles became dryer and the paines more cruel Six yeares after again there was
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
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
the Indies also Andreas Caesalpinus lib. 4. de morb Cap. 3. Andreas Caesalpinus writes that he hath another History of the original of this disease delivered by them who were present to wit from an Atetine soldier who served in that war he related that there is a town in the Vesuvian Mount which is called Suma where there is plenty of generous wine which is called Caudy wine which was privately left by the Spaniards in the night when the French had besieged it but they infected their wine by the mixture of blood which they drew from them which were sick in the hospital of St. Lazarus and the French men entering in when they had filled themselves with that wine began to be sick of diseases and symptomes like unto the Elephantiasis But if this were true rather the Elephantiasis than the veneral disease had been thus raised Aurelius Minadous Aurelius Minadous de Virul Vener Cap. 30. propounds a peculiar opinion holds that this virulency did first break forth from the most filthy wombs of most impure Harlots and for this cause because no body that hath lived cleanly or that hath conversed with a cleane woman is taken with this evil but he thinks this evil proceeded first when women were made very unclean when they had received a various mixture of seeds For as saith he one sort of meat is the cause of health in a good stomach but variety of meats doth oppress the stomach and breeds an acid and nidorous crudity and every where heaps up excrements so one seed only is familier and wholsome for one womb and causeth fruitfulness on the contrary the multitude and variety of seeds doth so affect the womb that by its corruption it produceth bad nay the worst of excrements and from that sordid substance there is a corruprion hard to be explained or putrefaction which doth generate such venenate excrements But when as he might easily understand that those rambling lusts were in use not only in the war at Naples but long before when there was publique Brothel Houses at Rome and yet there was no such disease raised he would have his opinion to be understood not of any women but only of the Indian For they by the mediation of the Heaven Air Waters and those places by their peculiar form of feeding did contract this poyson which afterwards by Columbus and the Spanish Army was disseminated in France and hence through the whole world But though it must not be denied that the constitution of bodies is divers in divers Countries and I remember that I have read in the Histories of Navigation That when certain people of Europe had found certain Ethiopian lasses playing on the sea shore and had layn with them presantly some of them died yet how the business is in America is worthy of further inquisition and if there be any such fault in those women 't is probable that comes to pass not so much from the commistion of divers seeds but rather as many Authors report from this That if any one have to do with a woman in India whiles she hath her courses he his taken with that disease for that whenas 't is every where un wholsome and therefore also was peculiarly and severely forbidden the Jewes by God in holy Writ may in a special manner be hurtful in the Indies Therefore lecting these pass let us hold fast this which is granted by al The Veneral disease is contracted only by Contagion that this disease at this day is no otherwise contracted but by contagion and chiefly by lying with those that are infected whence deservedly doth Gabriel Fallopius de morb Gallic Cap. 13. Wittily deride those women who when they were sick of the Veneral disease nevertheless did bost themselves to be chast and said they contracted this disease by sprinkling themselves with the holy water which was infected But this contagion by which only now adayes How many waies the contagion may be contracted we say this disease is disseminated is received divers waies For sometimes 't is transferred with the seed and menstruous blood from the Parents to the Child Somtimes 't is Haereditary and the Disease become Haereditary for when the blood out of which the Seed is generated is infected and vitious the like Diseased seed is generated also the Mothers blood being impure with which the Child is nourisht it Pollutes that which pollution afterwards in those brought into the World doth sooner or later shew it self according to the greater or lesser strength of that virulency which manner of original of this Disease if any one wil deny to be properly by contagion because it is not by the contract of two bodies viz. a sound and a sick he may for al me yet let him know this that then that malignity in the body of the infant is not generated but from the infected parents by the seed or the Mothers blood is communicated to the off-spring But by those that are born into the world the same evil may be contracted two waies the first is when with the nourishment and milk the evil is communicated to infants by impâ—ute Nurses which way indeed is the powerfullest of al for whenas the milk they suck is changed into blood and that is the nourishment of the whol body the poyson this way is dispersed into the whol body and insinuates it self most intimately with it and therefore those that are this way infected are seldome cured and not without a great deal of Difficulty The other way is by contagion so called properly and in specy where first of al 't is enquired whether there be any contagion in the Veneral Disease at a distance so that if one do neither touch with his body one infected nor the fuel which conteins in it the contagion yet nevertheless may be infected with the Veneral Disease truly there is no example given of this cause but what Manardus teacheth Lib. 7. Epis 3. and also some others affirme that there is a French Ophthalmy but when as this Disease of the Eyes in other cases is oftentimes contagiout it is no wonder if one conversing with a sick man that is troubled with a French Ophthalmy and earnestly look upon his Eyes Whether it can infect at a distance that he also may contract luch an Ophthalmy Yet this cannot be granted that as the Plague may be transferred by the Air to others in distant places so also the Veneral Disease may be communicated for dayly experience doth Testesie that Physitians and many others do familiarly converse with those infected with this evil yet are not infected by them Therefore this evil is chiefly contracted by contact and truely most frequently by whorish Copulation when that virulence is communicated to the naked genital parts being soft and porous from the genitals of the other infected person after which manner this Disease was first brought out of the Indies by the Spanish Souldiers infected by
the part which receives the contagion is affected and hurt hence through that the evil creeps into the Veins and by them penetrates to the Liver which when it hath put on an evil disposition and contracted a Malignant Disease it generates vitious blood containing in it the Seeds of the veneral Disease which whenas it is an enemy to the body by the expulsive faculty 't is driven from the more noble parts to the Circumference of the body And from thence the nourishment in the whol body is hurt from whence are raised spots Tumors and divers bunchings out Ulcers falling of the hair pains and other evils At length out of al those things which have been said hitherto of the Nature and causes of the veneral disease The definition of the veneral disease we make this definition of this Disease The veneral evil is an occult Disease and peculiarly Malignant taken by infection and is infections chiefly an enemy to the Liver and nutritive faculty and therefore nutrition being hurt in the whol body it raiseth divers Diseases and Symptomes CHAP. V. Of the Differences of it BY some indeed there are reckoned up very many Differences of this Disease The Differences and by Brassavola 234. but many of them unprofitable the most necessary and profitable are these First of al as concerning the very essence of the Disease whenas that is unknown from that of it self we can raise no difference yet because its activity depends on that essence and occult quality these differences are fetcht from thence because the activity of this disease is somtimes greater somtimes less And Physitians have observed that somtimes after unwholsome Copulation the French Symptoms have presently come upon men but somewhat gentle and a little while after have ceased again without the administration of any remedy but somtimes most grievous Symptoms have presenly come on them and the evil hath been rebellious and could by no means or very difficultly be cured At its first rise this disease was more grievous And the writers of this disease report That this Disease when it first appeared had far more grievous Symptomes than now it hath but what was the Cause of this business is not so clear That might happen first of al from the disposition of the bodies that were infected For whenas it appeared first in the Camps at Naples and there was a great scarcity of provision and a famine doubtless in those bodies also there was provision of evil Humors for Diseases on which when this contagion fel there it took strength and increased besides this might make somwhat to that business that in the beginning the cure of this Disease was not sufficiently known whence it came to pass that this malignity alwaies grew worse This happens also in the Plague of which the more there die the poyson alwaies grows the more vehement For the malignity is fermented as it were and exalted in the bodies of the sick unless it be opposed and overcome by Alexipharmacal means Secondly its Differences are taken from the causes and manner of contagion while somtimes the Veneral Disease is haereditary and is derived with the seed and blood from the parents to the Issue but somtimes after the birth is communicated by Copulation Kissing Milk Garments and the like Thirdly the third Difference is taken from the Diseases and Symptoms supervenient that this Disease is somtimes with Buboes somtimes with running of the Reins somtimes with falling of the hair somtimes with pains of the joynts somtimes wich other Symptomes neither do the Symptomes which follow it and shal afterwards be reckoned up amongst the signs alwaies appear the same in al people and Eustachius Rudius writes Lib. 5. de Morb. occult Cap. 9. That he hath observed a thousand times that many young men have on the same day copulated with one and the same whore and yet notwithstanding one hath been taken with the running of the Reins another with a Bubo another with rottenness another with pain in the Head another with falling of the hair and another with another different preternatural affect which doubtless happens by reason of the various indisposition of bodies and weakness of parts and variety of Humors For weak parts do more easily receive vitious Humors than the strong And one body is more clean another more foul and abounds with these or those Humors which when they are cotrupted by the venenate Humor do cause these or those Diseases and Symptomes therefore if we should number up the Differences according to the variety of Diseases and Symptomes which are somtimes joyned together and complicated somtimes Fewer somtimes more we might make very many indeed of which as was said even now Brassavola reckons up 234. more Nicely than profitably Fourthly the fourth Difference is from the time that the Disease is somtimes new somtimes inveterate one in the beginning another in the augment another in the state and another in the declination Out of which and especially from the Difference of time and the variety of Diseases and Symptomes that accompany this Disease Julianus Palmarius Degrees of the veneral disease doth commodiously constitute four dergees of this Disease de lue Vener Lab 1. cap. 4. The First and lightest degree is when only the hairs of the Head and beard do by little and little fal off without any other hurt of the body The Second degree is worse when the whol Skin is spread over with many spots not bunching out and those somtimes smal like to a lentil speck somtimes much broader and both somtimes red somtimes yellow The Third degree is yet more grievous when not only spots but true pustles and bunches break forth first of al indeed about the forehead and Temples and behind the Ears then every where in the Head and at length in the rest of the body The Fourth degree is when now the Disease being inveterate it assaults and corrupts the solid parts the bones Ligaments Membranes and Nerves In which there are collected many thick glutinous and maligne Excrements which when they rest about the tendons or the Periostia and prick and pul the Membranes from the bones there are wont to be caused implacable pains growing worse towards the night from which Excrements also by degrees do grow hard knobs with far greater torment which are equally hard as the bones Which if they be fixt in the bones they do so enlarge and distend them that the bones oftentimes become of a monstrous bulk and figure moreover that malignity and Acrimony doth by degrees eat away and with rottenness consume the bones and for the most part not hurting the Skin that lies over them and Palmarius writes there that he hath seen many in whom the Pericranium and the Skul under it hath been found wholly eaten away with putrefaction and consumed with rottenness as far as the dura mater the Skin of the Head not being hurt at al without any Feaver and without
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
the brain more slowly but the life is longer protracted when the natural actions are hurt and though the veneral disease be also malignant and is not undeservedly reckoned amongst poysons in its kind yet its power in acting is fat slower than that of other poysons yet the vehemency or weakness of this poyson in this or that body and the disposition of the body may make somewhat to the length or shortness of this disease for if the poyson be more vehement the disease is the more dangerous as shal be said by and by if also the body before did abound with vitious humors the evil is increased and made longer and indeed sometimes the stubbornness of this disease is such that though it seem sometimes to be wholly extinct yet it hath been observed that it hath sometimes grown fresh againe after many nay thirty years as was said before 2. But whether this disease wil be hard or easie to cure in any patient must be judged from the greatness of the disease and strength of the patient as in other diseases First of al as concerning the nature of the disease it self though this disease be far more gentle than other venenate diseases yet because it is not of the number of them which depend on manifest distempers but malignant and contagious it may infect al the humors in the whole body nay it may pollute al the Similar parts and hence it is hard to be cured 3. Yet this disease when 't is new is easier to cure than when 't is inveterate for in that new malignant quality it only affects those parts by which 't is propagated and for the most part the privities but in the inveterate disease that very malignant quality is imprinted also on the liver and from the liver again is communicated to the blood and by the blood to al similar parts for it is false as appeares out of those things which have been formerly said of the nature of this disease that the liver here is hurt in sanguification by no disease but only by reason of an evil object which mixt with the blood and other humors does pollute them deprave and make them vitious and convert them into its own nature indeed 't is not to be denied that vitious humors also do corrupt the good in the interim from good chyle also in a liver evil disposed is generated bad blood which appears even from this that through every part the nutrition a little while after is infected through the whol body which could not be unless the liver were hurt 4. Epiph. Ferdinandus writes Hist 17. That he hath learned by experience and that other physitians have observed the same that those who being once cured are again infected with this disease are either never or with a great deal of difficulty recovered 5. Although the nature of this virulency doth not consist in any manifest distemper yet if it light on a body hot and dry and especially endewed with a hot distemper of the liver 't is more difficultly cured For whenas pock-wood Sarsaparilla and the like are hot and dry that hot and dry distemper is increased and so though this very disease be not increased yet another damage is brought upon the body and whenas those proper medicines cannot safely be administred unless the body before were very wel purged by these means 't is heated and dryed the more 6. For the same cause a hot and dry season of the yeare as that of the summer is is not so fit for the cure of this disease whenas the strength is then Exhausted 7. If also the strength be seeble that it cannot undergoe those strong medicines which are necessary or if the sick out of custom or peevishness wil not admit of necessary medicaments 't is made hard to cure 8. If also a â—eaver or consumption or other grievous symptom or disease be joyned which may hinder the cure the disease cannot easily be removed as was said even now of a hot distemper of the liver and of the whol body 9. If there appear in the joynts callous Schirrous and hard tumors and those commonly called gummosities the evil is hard to be cured and is not rooted out by most powerful remedies for such tumors never appear unless the evil be inveterate and hath taken deep root most of which are sixt in the bones under them 10. Buboes in the groins if they be hard and are not easily suppurated and those which somtimes break forth sometimes vanish are hard of cure because they signifie a stubborn matter and a weakeness of nature in expelling it but if they be easily supputated and the strength be firm and especially the liver strong they are arguments of a more benigne Disease and matter and such Buboes if they be kept open along while may bring perfect health 11. A roughness of the jaws which is attended with hoarsness or an obscure or no voice do shew the evil to be antient and stubborn and which wil scarce be cured 12. Ulcers that are new in the Yard are easily Cured but in the Arsehole or about it made difficultly for they shew the evil is now inveterate and such Ulcers are continually moistned by the Excrements and Medicines cannot conveniently enough be applied to them 13. Ulcers also in the joynts and other parts are most hard to cure because they signifie an evil now inveterate and which hath invaded the whole body 14. Ulcers in the mouth and jaws are not easily cured because also they argue the evil to be ancient neither can convenient Medicines be applied to them and they are continually moistned by the Excrements falling from the brain 15. If the bones of the nose be eaten and there be also a slow Feaver it signifies an evil incurable whenas now the disease is communicated to the brain it self or its Membranes 16. Bunchings cut in this disease especially the broader are not easily cured and they argue an evil hard to be cured 17. The colour of the Skin depraved and the falling of the hair if convenient means be applied are not very hard to cure 18. Pains especially in the Head and upon the Shins are oftentimes very stubborn that they yeild to no Remedies or at least not under a long time 19. Vertigoes and falling sicknesses are most grievous and pertinacious for they shew that the Veneral Virulency hath now possest the brain it self 20. Distillations also are lasting because they also happen only when the evil is inveterate and the brain is affected the which are more dangerous and grievous if they fal on the breast and Lungs and exulcerate them 21. Also the noise in the Ears is for the most part lasting and scarcely removed whenas there are divers windings in the Eares and their expulsive faculty is weak neither can medicines penetrate thither 22. The running of the Reins also for the most part is lasting or if it be stopt grievous evils are wont to follow and most heavy pains of
of each an ounce and an half Make a Julep for two doses to be drank presently after the taking of a dram and an half of the Amulet in the morning and two hours before supper But whenas al those simple Medicaments which are in that Antidote are not proper to this Veneral Disease we must consult with experience whether their vertue be so great as Palmarius cries it up for CHAP. IX Of Indications THose Indications which are in other diseases Indications are found also in this to wit That which is taken from the Disease called in specy Curative That which the cause doth afford Preservatory whether also are referred urgent Symptomes and last of al the Vital for they deservedly challenge a place in this disease yet in the explaining of them Authors vary much and as every one thinks of the Nature of this Disease so also he teacheth concerning its indication and cure We insisting on those things which we have formerly preposed of the Nature of this Disease and have strongly proved think thus of indications in this Disease First of al whenas this Disease is occult and Malignant chief enemy to the Liver and nutritive faculty therefore it affords a kind of genercial indication but no specifical and profitable one can be had from thence and therefore only experience which hath found out Medicines working by an occult quality hath administred profitable Medicines in this Disease and unless the Spaniards had received from the Indians such Medicaments as Lignum Sanctum Sarsapartilla China Root and the boldness of Ciyrurgions and especially Jacob Carpus had not fallen upon the use of Mercury either by chance or by argumentation whiles they read that Avicen Mesue and Theodoricus made use of quicksilver in certain pustles and a crusty Scab perhaps even to this day the true Remedies of this Disease would lie hid But though the Remedies of this disease were not found out so much by indication as by experience yet a Method in curing of it is not wholly excluded but hath its place also whenas 't is necessary that those Medicaments found out by experience be rightly applied and besides also Tumors Ulcers and the like Diseases springing from the corruption of Humors have their Method by which they are cured Yet in this case we must have a care that we do not look more on the manifest qualities and known diseases than on the occult Nature of the disease in which business notwithstanding many do fail who are tedious in curing of divers distempers preparing the Humors and directing their cure to these or those diseases Whenas yet 't is plain by experience that in a hot and in a dry distemper and in an exustion of the Humors as they speak and in a Consumption it self we do most happily use pockwood and the like hot and dry things and the Malignity being overcome the rest do easily vanish Secondly as concerning indication preservatory Preservatory here we must chiefly have respect unto that Malignity and virulency imprinted on the Humors and that is to be destroyed by proper and Alexipharmacal Medicines Yet if there be any other faults in the Humors it wil not be unprofitable also to mend them And whenas the body is either burthened with a Plenitude or abounds with vitious Humors the malignity is the easier disseminated into it and there is more plentiful matter prepared for putrefaction and the force of the Alexipharmacal means is dulled it is expedient to empty either the superfluous blood or the vitious Humors that the other Medicines afterwards may be administred more safely more commodiously and with greater benefit Thirdly the Disease and various Symptomes Curative which supervene to the principal disease and arise from the corruption of Humors are al to be removed in their proper manner Fourthly the strength is to be preserved for as no other disease can be cured Vital unless there be strength of body so nor this and al attempts are in vain unless at leastwise we have Nature willing And so there are four things chiefly to be done in this disease First of al Four things to be done in the Cure of the Veneral disease if blood abound that must be diminisht and if any vitious Humors abound they are to be prepared and emptied and if there be any manifest diseases which may be an impediment to the proper Cure as obstructions and the like they must first of all be taken away Secondly the Malignity and virulency as wel that inherent in the humors as that imprinted on the parts and principally the Liver is to be destroied by the proper Alexipharmaca of this disease Thirdly the strength is to be preserved and confirmed and first of al chiefe care is to be had of the Liver which suffers in this disease Fourthly the diseases and Symptomes which are wont to be joyned to this disease are to be taken away Here we must clear a controversie to wit Whether the cure may be perfected without sweating Whether this disease may be cured without sweating Some are of this opinion That this disease may be taken away though sweat be not provoked And first of al they prove it thus Because this evil consists in a certain hidden quality which cannot be taken away but by alteration of the body whenas contraries are cured by contraries but that alteration may be affected by the proper vertue of antidotes and decoctious administred without sweating Next of al they alledge experience by which it is evident that by the taking of such Medicaments some have recovered without sweating Thirdly they urge this That those that drink the decoction of the wood are somtimes happily emptied by nature by urine by the stool and not alwaies by sweats Aurelius Minadous contends against these de Virulen Vener Cap. 39. And first of al he writes that he never observed that Physitians commanded the decoction to be taken without sweating to which al Alexipharmacal things of their own Nature do incline men neither is the matter it self unfit to be expeld this way being Vaporous and halituous neither was there ever any one who did throughly and wholly overcome this disease without the help of some sweating especially if it were inveterate but why he holds thus he brings this reason That in his opinion the essence of this evil doth not consist in a quality but in the body affected with an evil quality and therefore he holds as a quality doth indicate alteration so a body indicates Evacuation which though it may be many waies yet most commodiously by sweating whenas this very thing is a Vaporous body and is most rightly and easily discussed by sweat and he adds this whenas there is a great quantity of Excrements abounding in those bodies infected with this disease not only in one part but al over the body but sweat is an universal Evacuation they are most commodiously emptied by sweating and he holds that sweats do very much profit
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
is rasped and that being masticated doth bite and leave a bitterness behind it and whiles it is cut it appeare solid with an even superficies not rough and ful of holes the wood is good The Bark of this wood is endewed with great acrimony and bitterness The bark of Guajacum and therefore dries attenuates and digests more powerfully than the wood but because that occult vertue which is opposite to this disease is rather in that fatty and moist and balsamical substance the wood is alwaies preferred before the bark and besides the bark is not so conveniently given in hot and dry bodies As concerning the vertues of Guajacum it is hot and dry as may be perceived from its tast smel and acrimony and that in the second degree The vertues of Guajacum and 't is also of thin parts whence it hath power to attenuate crass things to cut and cleanse clammy humors to open obstructions to move sweat and urine and to dissipate and wast superfluous cold humors but this pockwood is not chiefly given for those qualities whenas there are found in Europe medicaments endewed with those qualities that there was no need to transport them out of the Indies but principally for that peculiar and occult power By which it is opposed to the Veneral virulency and truly al physitians almost doe agree that pockwood doth deserve the first place amongst the alexiplarmaca of the veneral disease for though Fernelius would somewhat lessen its vertue because al that are affected with this disease are not cured by the use of it yet this is no sufficient cause since there is found no such alexipharmacum or other medicine which can cure diseases past hope But this wood is by an occult quality and propriety opposite to the Veneral virulency it self and is a friend to the radical moisture and natural balsom which doth most of al suffer by this virulency inimicous to the nutritive faculty and doth so strengthen it that it hath been observed that those also who had a liver and whol habit of body hot and dry and who have been almost consumed with the veneral disease as was said before by the use of the decoction of this wood though by its heat and dryness adverse to them have been restored and become better habited and more corpulent Some indeed have dared to write that the decoction of this wood doth nourish as much as chicken broath but these seem to me to be excessive in the praise of this wood for though it be a vegetable and perhaps may leave some alimental juyce in the decoction yet I think no body that is in his right mind wil easily deny that a chicken hath not more convenient nourishment for a man than Guajacum Whether pock-wood do nourish but that some after this disease become more corpulent is accidental for whenas by reason of the Veneral virulency nutrition was hurt in the whol body when that is discussed and extinguisht the body begins again to be nourisht wel and to be augmented the like of which happens also in some other diseases especially in feavers before which whenas men were not wel flesht by reason of evil nourishment the vitious humors being waisted by the disease afterwards they begin to be nourisht wel and become more corpulent Fr. Arcaeus also lib. de curand vulner rat gives the †Whether the decoction of Guajacum sarsaparilla sassafras China root do fatten Decoction of Guajacum for ulcers of the Lungs and the ptisick and he writes that bodies though they be wasted are not offended by it but rather grow fat upon it nay there are some who attribute a nutritive power to Guajacum and write that it is no less nourishing than chicken broath The same vertues also others do attribute * The decoction of Guajacum Sarsa Sassasras China root nourish not but by accident to Sarsaparilla Sassafras and especially to China root but indeed though it be found by experience that in the ptisick Veneral disease scab and other diseases bodies extenuated have been restored again and made fat by the use of these decoctions yet this comes to pass not of it self because these decoctions have a nutritive faculty as other nourishments but by accident in as much as they take away the cause of leanness In ptisick bodies the case is plain for whenas that wasting of the body proceeds from an ulcer of the Lungs the ulcer being dried up by the use of Guajacum the body begins to be wel nourisht again the same happens in other diseases as the French the Scab and the like For whenas that leanness and consumption doth proceed from bad nourishment but bad nourishment for the most part from acrid and falt humors which do both consume the good blood and hinder the agglutination of it to the body those vitious humors being wasted by the decoctions and discussed by sweats the bodies begin to be nourisht wel again nay grow fat But this wood hath not only an alterative power and by its occult quality to extinguish that malignity of the Veneral virulency imprinted both on the humors and the solid parts but also to evacuate both sensibly by sweating and insensibly by insensible transpiration and therefore the way of curing the French disease by Guajacum and medicines of affinity with that is most in use For though by reason of the length of the cure and the pains of sweating and the slender dyet it cause some trouble to them yet it is far safer than that way which is by quicksilver where if there be an error the patient is in no smal danger But there are prepared out of Guajacum divers medicaments Medicines made out of Guajacum and those either in a liquid forme or in a solid and in substance but those given in a liquid forme are most effectual whenas they are easily deduced into act and penetrate into the whol body and do irritae the expulsive faculty of al parts to cast off what is hurtful but in a solid forme whenas that part in which the vertue of the medicine doth chiefly reside is not yet separated from the earthy and thick part 't is not so easily deduced into act The decoction therefore as most convenient is most in use yet if any by reason of the continued use of this medicine be weary of it and nevertheless do feare least there be some reliques of the evil humor remaining or their course of life wil no longer admit of the use of the decoction as it ought to be taken to such medicines made out of this wood may be given in another form Amongst which extracts and spirits as shal be said are most efficacious and far more excellent than pouders But the manner of boy ling this wood is various The manner of preparing a decoction of the wood Whether it ought to be boyled in Wine both in respect of the liquor in which the decoction is made and of the
animadv num 214. as shal be said also hereafter in the last chapter So if cruel paines molest the patient or gummous tumors or exceeding ulcers be joyned with them Sasaparilla is most profitable which doth discusse the french knobs and easier appease the pains then Guajacum Thus according to the constitution of the Patients and the Nature of the Diseases joyned with it 't is good somtimes to use Guajacum alone somtimes Sarsaparilla somtimes China Root and somtimes to mix al of them in a greater or lesser quantity and somtimes the bark of Guajacum is added somtimes three or four ounces weight to one pound of the wood and they are boyled in fifteen pound of water For examples sake Take Of the wood of Guajacum half a pound of the bark of the same of sarsaparilla each three ounces of China root one ounce and half Infuse them twenty four houres in twelve pound of water afterwards let them be boyled to the consumption of half for a sweating drink Poure on the remainder twelve pound of water let them stand and infuse eight houres afterwards boyl them to a consumption of a third part for drink at meales Or. Take of the Wood of Guajacum one pound the bark of the same Sarsaparilla of each thre ounces Boyl them in sixteen pound of water to the consumption of half Or. Take of the wood of Guajacum China root each one ounce an half Sarsaparilla one ounce infuse them twenty four hours in six poundof water afterwards boyl half away Poure on the residue ten pound of water boyl it to the consumption of three pound Strainit and give it for drink at meales Or Take of wood of Guajacum eight ounces of the bark of the same four ounces sarsaparilla sassafras wood each two ounces Boyl them in twelve pound of water to the consumption of two thirds that there remains four pound towards the end ad four pound of wine Poure to the remainder sixteen pound of water boyl it to theconsumption of half towards the end ad four pound of wine make a drink for meales In this place we must not omit a question concerning the use of purgers Whether purgers ought to be mixt with the decoction whiles the decoction is drank to wit whether they ought to be mixt with the decoction or to be used at the same time with the decoction For some do wholy reject them and hold that purgers are neither to be mixed with the decoction nor to be used apart for this reason because the bodies are wont diligently to be purged before they come to the use of these decoctions next of al because purgers and sweaters do cause contrary motions Others on the contrary do mix purgers with these decoctions that by benefit of them the blood may be purefied and the belly constantly kept loose others do not mix purgers with these decoctions but purge at certain intervals every eighth or tenth day or at a longer distance as need requires which last opinion seemes to me to be trewest For though the body be purged before the use of these decoctions yet some may easily remain and ever and anon be collected and sweating doth purge onely the thinner humors but leaves the thick neither after this manner are there caused contrary motions for that day that purging is ordered sweaters are not administred but if purgers were mixed with the sweaters then there would be contrary motions And besides by the admistion of purgers the decoction being to be used so many weeks it would become nauseous and ingratful Hercules Saxonia also holds de lue Vener Cap. 38. Whether purgers may serve instead of sweaters That purging may be ordered every day to wit in those in whom sweat cannot or ought not to be caused he thinks sweat cannot be provoked in them who either are of such a hard and thick Skin that they can by no means sweat or in those who fal into fainting and swouning fits as soon as sweaters are administred but he thinks they ought not to sweat in whom the Veneral disease possesseth not the Joynts nor the Skin nor the superficies of the body but hath rather taken up its seat about the bowels but this opinion seems not to me to be agreeable to truth for whereas he thinks that some ought to have purgers administred because they cannot sweat by reason of the thickness of their Skin or because they presently fal into swouning fits is agreeable neither to reason nor experience for scarce any one hath so thick a Skin that the pores wil no way open for sweat and though on the first daies sweat doth not prelently follow yet after that the Humors are attenuated by the use of the decoctions the passages and pores are opened then sweat succeeds especially if those Laconick Baths be applied as shal be said hereafter And the Patient may so moderate his sweating that he need not fal into fainting or swouning fits and they that cannot endure sweating wil not easily endure purging Last of al purgers cannot performe the same as those sweaters do But that in some bodies sweaters are not to be administred is salf for though the disease may have its principal seat about the Liver and bowels yet it cannot be but also vitious Humors do abound in the whol body whenas the Liver infected with this disease doth generate virulent blood and distribute it to the whol Body Chap. XIX Of the manner of using these Medicines AS concerning the manner of using these Medicaments The manner of using these Medicines The dose of the decoction first of al the decoction of Guajacum is administred for the most part in the morning and afternoon two hours before Supper In the morning 't is given from five ounces to eight or nine ounces before the evening from three ounces to six ounces the pouder is given to two drams the extract to two scruples Yet somtimes the evening drauft is omitted especially at the begining before the patient is accustomed to the Decoction For what was said above of moderating the quality of the decoction that also is to be observed concerning the quantity of the Decoction to be given that the sick be not offended and overcharged which too much of it which unless it be observed it happens somtimes that the sick fal into Feavers contract Crudities and there is caused a loosness ill habit of body and a Dropsie After the same manner we must give the Decoction of Sarsapatilla China Root and the compound decoctions For though some do prescribe here divers doses yet he shal not erre that shal administer them in the aforesaid manner And indeed after the mornings drauft Sweat we must endeavor that the Patient sweat for expetience teacheth that they that sweat not upon the taking of these Medicaments are â—carce clearly freed from this Disease but that sweat may flow the easier let the Patient sleep one hour after he hath taken the Medicine for so
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
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
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
time the Gout is most chiefly excited and then again in the Autumn by reason of the motion and change of the Humors that happeneth at that time And the truth is the Gout is wont in the Spring time most especially to infest the party because that the humors that have been al the Winter long heaping up are wont then to be poured abroad and moved up and down as Lucian telleth us in most elegant Verses making a description thereof in his Tragopodagra And the very same may likewise be somtimes effected by other distempers of the Air and like as the moist Constitution of the Air doth otherwise produce Catarrhs and Fluxes so it likewise oftentimes causeth the Gout And without doubt that Epidemical Gout of which out of Athenaeus we shal anon in the fift Question make mention was at first produced by some peculiar Constitution of the Air. And moreover the Course of Dyet that is observed doth make very much for the generating of the Gout and especially the drinking of strong Wines by which alone many have attracted the Gout unto themselves as Quintus Serenus writeth of Ennius And indeed there is no one thing that is more offensive and hurtful unto persons that are troubled with the Gout than the drinking of Wine as we find it to be true by common experience For there is nothing that obtaineth more of that Tartarous matter or call it what you please that is so apt and fit to generate the Gout than Wine Which matter although as we said a little before it may in some stronger bodies be separated yet nevertheless those that find themselves subject to the Gout having but weak and infirm bowels have no reason after the example of other insatiable Wine-drinkers to indulge themselves any liberty in the drinking of Wine but it is far more fit for them to abstain from it And so on the contrary many have been freed from the Gout by their abstaining from Wine The gout cured by abstinence from Wine And Trincavel in his twelfth Book and second Chapter of the way of Curing the several parts of Mans Body writeth that he knew a very aged Physitian at Venice who having been exceedingly troubled with the Gout al his life long even unto his old Age at length by abstaining from Wine for five yeers only he came to be so freed from all those troublesom and painful fits that attend the Gout that he was ever after even to the very last of his old Age and to the hour of his death altogether freed from these pains And Franciscus Alexander in Descriptione Diacorallii writeth likewise that one Francis Pechius a man fifty yeers of age and troubled with the Gout was cast into Prison by a certain Marquess and there kept twenty yeers and that he was ever after this freed from the Gout And Solenander also in his 5. Sect. Consil 1. relateth of a certain Widdow a Spaniard both that having omitted and left off the use of Wine which yet notwithstanding she had but very sparingly made use of after the custom of her Country and alwaies diluting it with Water she was never more after that troubled with the Gout And there are many other such like known Histories of them that have either been cast into Prison or else have been reduced unto poverty and so have of necessity abstained from Wine and thereby been freed from the Gout To wit whereas the next and most immediate Cause of the Gout as we likewise told ye before is some certain thing that hath as it were the Nature of a Mineral and this altogether unfit for the nourishing of the body such like as is to be found in al kind of Earths but yet in some more in some less the Vine attracteth it more powerfully than other Plants and that this is so appeareth even from that Tartar which is to be found more abundantly in the Vine than in any other Plant and in that Vines wil grow and thrive in those places wherein other Plants wil not prosper as not having aliment enough the Vines contenting themselves in a manner only with that very salt of the Earth which afterward together with the Wine although variously changed is derived into Mans body and being there heaped up it affordeth matter unto the Gout And yet notwithstanding there are likewise some kind of Meats and Drinks that make very much for the breeding of the Gout and there are somtimes Waters to be found that generate the Gout and in those places where the Gout is Epidemical not only the rich that drink Wine but the poor also that drink Water are afflicted with the Gout And so likewise Julius Alexandrinus writeth in his fifteenth Book of things that are wholsom and sixt chapter that he knew a certain person troubled with the Gout in whom by the eating of Carps and Breams the Gout was perpetually bred So that he could when he listed by this means bring the Gout upon himself And moreover The gout caused by the eating of Carps Wholsom Wines Wines they are not al of them of one and the same kind For some of them proceed from a sandy Earth and contain less of this Tartarous matter And such are those Wines that grow at Jassen a Town hard by called Gorubergensian Wines which although that they be drunk in great abundance by the Inhabitants of that place yet I never heard of any of them that was there troubled with the Gout And such Wines as these are likewise to be found in many other places Wines uxwholsom But on the contrary those Wines that grow in an Earth that is fat muddy clayish stony and that hath in it a Mineral Marl gravel stones or any thing else that is Mineral mingled with it are very apt and ready to generate the Gout and such are the Wines of Moravia Bohemia Hungary and most of the Wines of Austria And although that the Wines that do not generate the Gout leave oftentimes in the Vessel more Tartar than those Wines that do indeed produce the Gout yea and if they be distilled there is likewise more of the said Tartar found in them than there is in these like as at Vratislavia as that eminent and famous Physitian Doctor Doringius wrote unto me of twenty four measures of Renish Wine there were found almost three ounces of Tartar whereas in the distillation of as many Measures of the Tocavian Wine that is accounted the strongest of al the Hungarian Wines there were scarcely two drams of Tartar to be found yet nevertheless al this maketh nothing against what we have said For those Wines have that Salt or Tartar superficially only as I may so say and in a thick manner mingled together with them or that I may speak with the Chymists they have the Salt as yet fixed but these have a volatile Salt or Tartar most exactly mingled with them insomuch that this Salt and Tartar is in a manner made spiritual whereupon
the Joynts as suppose a Delity the trembling of the heart difficulty of breathing cold sweats and a weak pulse it is then a sign that the sick person will die the very same day or the day following III. But although the Gout be for the most part a Disease not Mortal yet nevertheless it is very hard to cure and it is commonly accounted the shame and disgrace of Physitians For albeit if the Disease be new it may be cured without much difficulty yet nevertheless if it be long delaied and that it often invade the party it may be more difficult to cure in regard that the soynts yea and the very Bowels are weakened by the pains and redlesness and likewise by the asslux of the Humors And the sick persons are themselves oftentimes the Cause that this Disease taketh such deep â—â—oot in them seeing they do not oppose and withstand the Disease at its first Invasion yea and oftentimes they conceal it and some there are that will pretend other Causes of their Disease as loath to acknowledg it to be the Gout But now this Disease proveth afterward very hard to cure both in regard of the many errors in Diet from which the fick persons wil not be perswaded to abstain and oftentimes also through the unskilfulness of the Physitians who are either ignorant of the true cause of the Disease or else they administer Medicaments that are very unfit and improper by which they do rather weaken the Joynts and the Bowels then any waies strengthen them But yet nevertheless in the mean time the Gout is not a Disease that in it self is altogether impossible to be cured and this we are taught by the examples of many that have been freed from the Gout of which more anon in the Tenth Question IV. Whosoever they be that being thus affected are grown in age or have gotten about their loynts Callous and hard knobs bunching forth or that live an anxions and careful life or have a dry and costive belly these can none of them be cured by the Art of Man or any human means so far as I could ever yet find Hippocrater in the Second of his Predictions V. If in the Gout there happen to be a loosening of the Joynt it is then very difficult in the curing or indeed altogether incurable For although the Joynt may possibly be set back again in its proper place yet nevertheless because that the Ligaments of the Joynts are made more loose a perfect Cure is scarcely to be expected And if likewise in the loosning that followeth upon the Gout the Cavity of the â—oynt be â—illed up with a hard knotty matter the Disease is then altogether incuteable for the Joynt cannot be put back again before that Tophaceous matter be taken away and this will hardly ever be removed VI. Among all the several kinds of the Gout the Sciatick pain is of all others the most grievous not only in regard of the greatness of the pain it self but by reason also of the grievousness of the Symptoms that follow thereupon For by reason of the most grievous pain it canseth watching and a restlesness kindleth feavers and somtimes a loosning of the Joynt happeneth upon which there followeth a lameness and a wasting away of the whole Leg and Thigh For if at any time a Joynt sal out of its place by reason of the multitude of the affluent Humors there is then a Necessity that an halting and lameness must follow upon it But because that the bone being fallen out of its proper place presseth together the Muscles Veins and Arteries the Aliment and Spirits cannot possibly flow into the lower parts whereupon there followeth a wasting and Consumption of them VII But although this Sciatick pain be of all others the most vehement yet notwithstanding it doth in the beginning more easily admit of a Cure then any of the other kinds of the Gout in regard that the strength and Virtue of the Medicaments may more easily penetrate unto the Vessels by which the Humor floweth into the Hip then unto the extream Joynts and so likewise the Humor that floweth unto them may the more easily be evacuated But if the Humor be once flown in so that it hath insinuated it self into the Hip it is then very hard to be cured because that the Discussing Remedies by reason of the flesh lying upon the Joynt cannot penetrate whither they ought to go VIII They that having been long infested with the pain in their Hips have the Hip falling forth of its place and again returning and falling into its place these have snotty Excrements following thereupon as Hippocrates telleth us in the sixth Section of his Aphorism Aphoris 59 these Mucous and snotty Excrements having their original from the weak heat of the Nervous parts IX They that having been long infested with the pain of the Hips have the Hip falling out of Joynt these have their Thigh wasting and they become lame unless they be burnt as Hippocrates tells us in the same place Aphorism 60. The Thigh indeed consumeth and wasteth away because it is but ill nourished by Reason of the weakness of the Native heat from the long continued afflux of the Vitious Humors and because that the Veins and Arteries are moved out of their places and pressed together so that they cannot rightly bring the aliment unto the Thigh But then they become lame and halt because that the Thigh for want of nourishment is destitute of strength and by Reason of the Luxation or disjoynting is become shorter then before and that by means of the loosness of the Ligaments the Thigh bone is not fast and firm X. Those unto whom the Gout is hereditary are scarcely ever wholly freed therefrom and if they desire so to be they have need to observe a far more exact kind of Diet and a more accurate use of Medicaments then do others that are either not troubled at all with this affect or if they be the grief descends not to them from their Parents or any of their Ancestours XI If the Varices happen unto such as are troubled with the Gout the Gout then ceaseth as Avicen tels us because that the Humors that were accustomed to flow unto the Joynts are now derived unto the exterior parts of the Thigh XII If the Gout that was wont to keep its certain Periods cease and return no more it proveth to be the Cause of most grievous and deadly Diseases unless the matter be drawn forth by way of prevention which is most difficult to be done For the matter that Nature was wont to thrust into the joynts if by Reason of the weaknes of Nature it can be now no longer expelled either it sticketh about the Bowels and principal parts or else being transmitted unto the Lungs Intestines or other parts it there exciteth most grievous Evils XIII Whether the Gout may not be finished in less then forty daies and why As for what concerns the
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
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
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
of the humors unto the external parts they may also very easily cause some inconvenience and make the pain longer since that the pain is wont to return again in a short time after As for example Take Barly Meal four ounces the Crumb of Wheaten Bread three ounces Milk as much as will suffice boyl them to the consistence of a Cataplasm and then add of the Oyl of Roses one ounce the Yelks of three Eggs Opium one scruple and mingle them Or Take the soft pith of white Bread as much as wil suffice pour thereon of Cream of Tartar a sufficient quantity and then add Saffron one dram Frankincense half a dram Powder of Earth-worms two drams the Yelks of four Eggs Henbane and white Poppyseed of each three drams let them boyl in a double Vessel for half an hour and make a Cataplasm Or Take Leaves of Henbane three handfuls the Berries of Nightshade one ounce let them be boyled til they be soft and then bruised to a Mash then strew upon it one ounce and half of Barly Meal and a little Oyl of Roses and so make a Cataplasm Or Take Barly Meal the soft Crumb of white Bread of each half a handful Leaves of Henbane Mallows Violets of each one handful Flowers of Camomile Rindes of white Poppy of each half a handful Oyl of Earth-worms and Poppy of each one ounce and make a Cataplasm If you think fit you may also add of Opium and Saffron of each one dram Or Take Roots of Mandâ—ake and Leaves of Henbane of each as much aâ— you think wil suffice boyl and bruise them all to a Mash and then add of Barly Meal and Bean meal with Oyl of Roses a sufficient quantity of each and make a Cataplasm Or Take Crude Vitriol two pound Spirit of Wine three pints the Water of the Elder Tree one Quart Mingle them all well together in a Glass Vessel well Luted and then puting to the Alembick and the Receiver in which there may be put the Seeds of Henbane bruised two ounces the flowers of Mullein Elder and Camomile of each two hand fuls let there be a destillation by degrees until the Glass be Fire hot After the distillation let the spirit with the flegm be separated from the Seeds and flowers and so let it be kept in a Glass for use Or Take Leaves of Henbane one handful Nightshade Sengreen the Heads of Garden Poppyes of each half a handful Mandrake Roots one ounce Flowers of Camomile and Mulleyn of each one pugil Seed of Fleabane one ounce and half of Henbane one dram Let them be boyled in Milk for a Fomentation then let the Remainders be bruised to a mash and then add of the Meal of Lin-seed one ounce Barley Meal and Oyl of Roses of each two ounces and make a Cataplasm And there are some also that refer hither the washing of the grieved part with cold Water and indeed this they do by the authority of Hippocrates who in his 5 Sect. 25. Aphorism writeth in this manner The Gout pains of the Joynts as also Convulsions and many more of these kind of pains are lessened and taken away by the large affusion of cold Water and plentiful pouring of it upon the part that is in pain for a Moderate stupifying and benumming removeth the pain And so likewife Donat. Antonius Ferrus in his 2 Tract of the Gout Chap. 9. writeth that he had oftentimes had experience of this Remedy and that when all other Remedies were to no purpose he betook himself unto the pouring of cold Water upon the part as unto his last shift and that the pain was forthwith asswaged thereby And the very truth is that it cannot indeed be at all denied that cold Water being poured forth upon the pained part doth not only drive back but likewise produce a kind of stupidity and benummedness and thereby asswage the pain but it is to be feared lest that by this means the innate heat of the part be destroyed and so a weakness brought upon the part by reason of which the Malady may afterward be rendred more grievous and moreover the Humor may be impacted into the part and there condensed and thickned or else haply by this violent Repulse the Humors may be made to rush unto the more inward parts Repellers or Medicaments that drive back But now as for Topicks Repellers that are directed unto the Cause and in the first place touching Repelling Medicaments we say that although they are by some commended yet alone they have here scarcely any place at all For seeing that Nature her self hath ordained this Motion and that she endeavoureth to drive forth the vitious Humors from the more internal unto the external parts that are less noble if this motion be hindered and the Humors driven back again unto the internal and more noble and principal parts this cannot be done without the extream hazard of the life and hereupon there will arise the worst and most dangerous Symptoms that will not cease unless Nature again expel forth the vitious Humor unto some other Joynt And moreover when the pain is a little mitigated in regard that the matter is diffused unto the external parts that are about the Joynt if by the Repellers it be driven back unto the internal parts the pain happeneth then to be increased and hence it is also that very many cannot so much as endure the cold Air from without neither yet somtimes the external Air although it be not so very cold but that there is a Necessity of covering the affected Member if they expect to have their pain Mitigated And furthermore if the matter hath already flown out of the part into the Joynt by the use of Medicaments that drive back and Cool it is made more thick and impacted into the part and so the Malady rendred more difficult to be cured But yet never the less if by the sudden and overgreat afflux of the humors especially such as are more hot the pain be much increased even in the very first beginning of the sit in so much that it seemeth to cal for all the Care and to require that al the means that are used may be for the removal thereof and that therefore we have a mind to moderate it and somwhat to drive it back we may then indeed make use of Repellers but not of them alone and by themselves but mingled with Anodynes Venefection and Purgation having gone before Like as on the Contrary we are not in the beginning to make use of those Medicaments that are over loosening since that they help forward the afflux of the Humors but we ought in the first place to make use of those Medicaments that do somwhat stop and stay the afflux of the Humors And therefore we may then lawfully add Lettice Sengreen Purflaine Violets Plantane Roses and such Compounds as are made out of them as also what Vinegar we think fit As Take Barly Meal three ounces boyl it in
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
as for the brine which at length he findeth melted in the pot he gathereth it all together and this he keepeth to anoint the joynts when they are pained But because that it vehemently drieth and discusseth and wonderfully strengtheneth the part that is made loose by the Humor he tels us therefore that it is best to use it in the very first beginning of the pain and before it hath gotten unto any heighth or else in the end and declining of the Paroxysm to consume the matter and to add strength and firmness unto the part and more especially if there be now and then interposed a fomentation and washing of the parts with the Decoction of Mulleyn Wormwood Camomile Bears-ears or French Cowslips Sage Ground-pine or Herb Ivy Mugwort Rosemary Melilot and others of this kind that have a power to cut cleanse discuss meanly to dry and strengthen And this Plaister is likewise very much commended Take Gum Caranna one ounce and half Gum Tacamahaca six drams the Oxycreccum Emplaster nine ounces White Wax five drams Powder of the greater Consound two drams With the Oyl of Camomile make an Emplaster according to Art which being applied unto the pained part doth greatly draw forth the matter and ease the pain And of such Kind of Medicaments as these there are many more in great abundance to be found in Platerus his second Book of Practice and elswhere in others And yet notwithstanding I think it not amiss here to give you notice of this that in the applying of all manner of Topicks we are diligently to heed the signs of those that benefit and those that hurt and offend For albeit the nighest Cause of the Gout be a wheyish salt and tartarous humor or cal it by what name soever you please yet nevertheless it is not for nothing that the Chymists give us notice as we shal further shew you below in the sixth Question that there are in the Earth and Plants divers kinds of Salts or as Platerus speaketh that the humor the Cause of the Gout is mingled with the Ichores of the excrementitious humors which render the same more vehement and violent And hence it is that not only in divers and several Persons but likewise in one and the same Person according to his several ages the nature of the pain is different and not evermore one and the same And then lastly for the discussing of the Reliques and Remainders there may be made fomentations of Mugwort Organy Wormwood Betony Calamint Flowers of Arabian Staechas Lavender Camomile Melilote boyled in Wine and Water which withal strengthen the part But here Crato doth rightly advise us in his Consil 240 that we weâ— the Feet as little as may be but that the vapor be only received by the Feet And indeed such like fomentations are most convenient And yet notwithstanding if there be a few more Plants boyled in the Water and a little salt added or else if a Lixivium or Ley be poured thereunto there is no discommodity to be expected from the humectation or if we do at all fear any hurt lest that the waterish humidity should after the hath be left in the part affected the following Trochisks may be cast upon the Coals of Fire and the smoak received by the part affected Take Gum Juniper and Frankincense of each two drams Ladanum and Benzoin of each one ounce Cinnamom Cloves and Nutmeg of each half a dram make them into a Powder and incorporate them with Gum Tragacanth and then make Trochisks thereof There is likewise very much commended a Bath of Juniper Wood as also of the Decoction of a whol Fox adding thereto Frogs and Earth-worms and the Heths before recited Or else let the Feet be anoynted with some convenient Liniment or Unguent Galen in his 2. B. of simple Medic. Chap. 18. as likewise many other Authors do much commed the Chafing and Rubbing of salted Oyl into the part affected For in all those saith Aetius tetrab 3. serm 4. Cap. 21. that are chafed in this manner the Natural innate heat is augmented that which is preternatural is dispersed the Excrements are consumed and the affected Members are rendred more strong so that they are no further obnoxious and subject unto pains especially if from day to day all their whol life long they be diligent in the use of this Remedy every morning and evening Touching which Philagrius very confidently and without doubt Hyperbolically is bold to pronounce as Aetius writeth in the place alleadged that even this one Remedy alone is sufficient for them that either most of all transgress in matter of Dyet or such as are immoderately cooled or sick with over hard labor or such as have been excessive in the use of Venery or such lastly as have run into any other error and excess But now because that the Oyl and Salt are not easily mingled the Salt is first of all to be moistened in hot Wine and afterward in a Mortar to be diligently mingled with the Oyl and alwaies before this Liniment be put unto use the Salt is throughly to be mingled with the Oyl Neither is it sufficient only to anoynt but the Joynts are also to be wel â—ubbed that so the force and virtue of the Medicament may the better penetrate Take Castoreum and Frankincense of each one dram and half Marrow of a Hart the fat of a Goose of each three drams Oyl of Mastich and Mints of each two ounces and half Bdellium and Galbanum dissolved in Vinegar of each half an ounce the meal of Linseed and Fenugreek of each three drams and half Wax as much as will suffice and make a Cataplasm The Remedy of Flavius Clemens by the use of which as it is reparted men that have been destroyed in their whol body by the Gout Podagra and Chiragra have been so well recovered that they have walked without any hurt or hinderance is described by Galen in his 7. B. of the Composit of Medicam according to their kind Chapt. 12. where he hath also other Receipts of this Nature and so likewise in his 10. B. of the Compofit of Medicaments according to the place Chap. 2. Or Take Gum of the Pine Tree one ounce black Pitch two ounces Wax one ounce and half the fat of an old Cock two ounces pouder of Hermodactyls and live Sulphur of each three ounces Let there be an Emplaster made thereof and renewed the third day These Remedies immediately following are prescribed by Henricus Stapedius in Consil Scholtzii Consil 238. Take Juniper berries and Marsh-mallows of each two ounces the Leaves of Lawrel Myrtil Sage Betony Cassidony or French Lavender Organy Calaminth Marjoram and Rosemary of each of these half a handful Linseed and Fenugreek of each two ounces Make a Decoction in the Lye of the tender shoots of the Vine adding thereto of common Salt one pound Afterward let them be anointed with the following Oyl Take Roots of Pellitory Nutmeg and Cloves bruised of each
be understood of an insufficient Purgation And here Vomitories seem to be more commodious then Purgers by the Belly in regard that they evacuate the vitious Humors by a place more remote from the part affected But Repellers have here no place at al because that it may Justly be feared lest by the use of these the blood and other Humors may be driven back toward the part affected and may be there heaped up Having first made use of General and Universal Remedies we come then to the imposing of Medicaments that attract and resolve and these ought to be of the stronger sort that they may call forth into the Superficies the Humor that is gotten into a deep place which kind of Medicaments are provided of Herbs that discuss viz. The Leaves of Eldern Danewort or Wallwort Lawrell Rue Betony Camomil Ground pine Rosemary Melilote Mustard Seed and Stavesacre as also the flies Cantharides Pitch Sulphur Turpentine Ammoniacum Galbanum Bdellium Opopanax and Euphorbium Excellent likewise is that Medicament that is made of Sciatica Cresses of which we made mention above as also of Water Cresses and the Herb Piperites or Pepper-wort as some call it As Take Sciatica Cresses Dittander or Pepperwort and Water Cresses of all or one of them four handfuls boyl them in Wine and sprinkle upon them the Meal of Lupines Beans and the bitter Vetch Orobus of each one ounce the powder of dry Rue two drams Flowers of Camomile one dram Costus Root a dram and half Oyl of Turpentine half an ounce Oyl of Earth-worms as much as will suffice and make a Cataplasm Or Take Mustard seed dissolved in the sharpest Vinegar two ounces sharp and sowr Leaven half an ounce Powder of Hermodactyls two drams Honey three ounces Turpentine four ounces Oyl of Lawrel and Spike of each two ounces the meal of Fenugreek seed one ounce and half Earth of the Antâ—hill with the Ants Eggs one pound Leaves of Lawrel Sage Rue and Rosemary of each half a handful Earth-worms prepared half a pound let the Ants Earth and Eggs with the Earth-worms and Herbs be boyled in white Wine and then being strained let the rest of the Ingredients be mingled therewith Or Take Roots of our Ladies seal which being cut and applied to the Hip are much commended for the removing of the Ischiadick pain six drams the Emplaster Diachylon simplâ—x half an ounce Saffron dissolved in the Spirit of Wine two drams Turpentine one ounce Oyl of Spike as much as is sufficient and make a Cataplasm Or Take Citrine Wax and Turpentine of the Fir Tree of each three ounces let them dissolve together when they shal be cold ad the Powder of Nettle seed and Hermodactyls of each two drams Roots of round Aristolochy or Birthwort Camomile Flowers and Florentine Flower-de-luce of each two drams and half Mirh two drams Saffron four scrupleâ— let them be moulded with the hands being first anoynted with Hogs Grease and make an Emplaster Or Take Wax Missletoe of the Oak Turpentine dry Orrace Mirrh and Galbanum and with the Oyl of Earth-worms make a Cerot Unto which it he pain give not place but stil continue then apply Cupping-glasses with much flame or else Vesicatories But if the Malady wil not yet by these be taken away then we are according to the counsel of Hippocrates in the sixth Sect. of his Aphor. Aphor. 60. to burn the part affected and Celsus likewise approveth of this advice whilest in his 4. B. and Chap. 12. he writeth in this manner It is saith he the last shift and in old diseases also a most efficacious Remedy with glowing hot Irons to exulcerate the Skin in three or four places above the Hip. This Remedy by heating the part dissolveth and evacuateth the thick and viscid humors and if the Ulcers be kept open as they ought to be the vitious matter floweth forth by them As for the manner of burning see more in Paul Aegineta his sixth Book and Chap. 76. and Albucas Part 1. Chap. 43. And some there are likewise that make mention of the Gout of the Verrebrae of the Back in special and we grant indeed that now and then some such kind of Gout there is and this hath also the very same Causes and so requireth the same kind of Cure with the other Gouts But we are here to look wel about us and to have a care that we be not deceived in mistaking every pain of the Back for the Gout For oftentimes it so happeneth that from the serous and wheyish matter flowing down from the Head and descending along the Back and especially according to the Conveyance of the Cucullar Muscle and sticking at the Spina Dorsi in the end of the said Muscle a pain may be excited which yet nevertheless is not the Gout in regard that it happeneth not in the parts pertaining to the Joynt and it is oftentimes likewise of a very short continuance and afflicteth the sick Persons in their sleep but when they awake and arise from their sleep it leaveth them and vanisheth which never happeneth in the true Gout Chap. 7 Of the VVay and Means to prevent the Gout MAny there are that mind only this one thing to wit The way to prevent the Gout that they may be freed from the present pains of the Gout but being freed they take no care at all how they may obtain that they be no more troubled with the same pains neither do they make use of those Medicaments by which they might prevent this Evil nor at all refrain from the Errors of their Dyet and so they suffer the Malady again to arise and so to continue and grow old with them and therefore it is no wonder that there are so few perfectly recovered of the Gout But a precaution and prevention is altogether as necessary as the Cure in special so called Now this Consisteth in three things In what things it consisteth The first is this that there be care taken that there be no matter suffered to gather together which may flow unto the Joynts The second that if any matter be gotten together it be taken away before it rush unto the Joynts And the third is this that the Joynts may not easily receive the same Now if as many do any one shal make it his business only to strengthen the Joynts and in the mean time shal permit the heaping up of the vitious matter in the Body the Patient shal hence reap more burt than good For if there shal be a vitious Matter present in the Body and this not thrust forth unto the Joynts after the usual and accustomed manner being retained in the Body it may flow unto other of the more noble parts and be the Cause of most grievous Diseases And therefore we are here first of all to commend unto the Patient a good course of Dyet and Medicaments that correct the distemper of the Bowels the first intention being best performed by this The second thing
to exercise themselves even until they sweat But then after this motion and exercise of the Body Let him neither Eat nor Drink before such time as the heat contracted by the motion be wholly vanished And if there be at any time an Error committed in the excess either of rest or motion better it is that it should be in motion then in idleness and Rest For by Idleness and slowth the heat is much diminished and the strength of the Body made to languish the Concoctions to be depraved and the Excrements not evacuated and driven forth of the Body Whereupon it is that Galen in the Sixth Sect. Ephorism 28. tels us that ease and idleness is as much the Cause of the Gout as Epicurism and Satiety And we may see by experience that Men addicted to labor and exercise are seldom or never taken with the Gout And instead of the Morning exercise the Patient may likewise somtimes use frictions or Rubbings so soon as he is up in the morning To stand much as also to walk overmuch or to ride long Journeys is greatly hurtful for such as are troubled with the Gout And in the like manner as Exercise and Rest so also ought the Patients sleep and abstinence therefrom to be moderate and alwaies in a mean And yet of the two extreams better it is to want sleep then to exceed therein provided that the strength of the Body be hereby nothing impaired nor Crudities bred Neither may the Patient accustom himself to sleep presently after meals As for fulness and empriness Care must be taken Repletion or fulnâ—ss that the Belly be made every day to discharge its office and that the Humors may not be heaped up in the first waies Eccoprotick or Cutting Medicaments are somtimes to be made use of for these do gently case and empty the Belly Sweats in the morning are very useful and convenient for the prevention of the Gout in regard that they take out of the Body the serous or wheyish Humors And therefore the sick persons are by all manner of means to accustom themselves unto these sweats and to this end they ought wel to cover themselves with Bed-clothes at night when they go to Bed that so in the morning if they sweat not yet they may have a Moistness all over their Bodies The Patient ought likewise to abstain from excessive Venery Venery which together with Bacchus or Wine is the Parent of the Gout as begetting and breeding it for as Scaliger turns it out of the Greek of Loyn-loosening Venus and Loyn-loosening Bacchus there is born and bred the Loyn-loosening Gout For by the overmuch use of Venery the whole Body is debilitated and the spirits and Native heat dissipated whereupon all the Concoctions are hurt and many Excrements are treasured up The immoderate affections of the mind Affects of the mind and especially Anger and Fear are to be shunned and the Patient is rather to give himself unto Mirth and Cheerfulness And that kind of Diet which is observed by Rich persons Why the Rich are more troubled with the Gout them the poor and people of rank and quality is the true Cause why these are more frequently taken with the Gout then poor people and such as live in the Country For the Rich aboundeth with store of al kind of Meat and dainty dishes and thereupon they usually eat of many dishes at one and the same meal and not only so but they also exceed in the quantity and take too much thereof even more then they can Concoct and hereupon Crudities are generated and especially they too much indulge themselves in the use of Wine And then again they want those Laborious exercises by which the excrementitious Humors in the Body and chiefly the serous might be evacuated And moreover for the most part they abhor all manner of Medicaments and they wil not at all make use of them unless they be fitted for their Palates And so in general those things that are by the Physitians in other Cases commanded as touching a good and orderly Diet they are here especially to be observed by such as are troubled with the Gout concerning which Alexander Trallianus largely treateth in his Eleventh B. and 1. Chap. and so also Andraeas Gallus in his Consil Collected by Scholtzius Consil 270. And Petrus Andraeas Matthiolus ibid. Consil 220. and Antonius Ferrus in his Tract of the Gout And yet notwithstanding besides a good course of Dyet The distemper of the bowels to be corrected it is likewise necessary lest that the vitious Humors should be heaped up that there be no notable distemper suffered to be in the Bowels And therefore if there be any distemper of the Liver or Spleen or that the Stomack being colder then ordinary cannot rightly Concoct those distempers are in a fit and convenient manner to be Corrected as we have further shewn you in its proper place For unless those Bowels be wel constituted although there be little or no Error committed in point of Dyet yet notwithstanding good food albeit it be taken in a just quantity is converted into a vitious humor or supplieth such a Blood that is not pure but hath likewise vitious humors mingled therewithall Whereas on the contrary Those that have their Bowels wel constituted and strong which exactly separate from the useful Blood that which is faulty in the Meat and Drink and evacuate it forth by convenient waies may overcome many Errors of Dyet as we see many greedy gluttonous Persons stuffing themselves with abundance of food and guzzling in dayly great store of Wine and this not alwaies so wholsom as it should be and yet notwithstanding all this they are not at all troubled no nor so much as subject to the Gout But because that it is altogether impossible but that he which lives not unto himself alone but hath his dependance for the most part upon others and is a Servant unto the publique or is set over and imployed in other kind of affairs and is somtimes necessitated to live in an unhealthy Air or to ride Journeys or to sojourn with others it being impossible I say that they can keep themselves from all kind of Errors in point of Dyet and that thereupon Excrements should be collected in the Body it ought therefore to be one main part of the Physitians care that he prevent in this respect the heaping up of those Excrements in the Body lest that they afterwards excite the Paroxysm which is done if they be maturely taken out of the Body Venesection And therefore in the first place Venesection although the Gout doth not immediately arise from the Blood as such yet notwithstanding in regard that it may in its own manner concur unto the generating of the Gout whiles it either maketh for and furthereth the extream and boyling beat of the wheyish humor if it aboundeth or else may be an impediment in the exhibition and administring of those
more conveniently also given in Autumn then in the spring time and therefore in Bodies that are more hot Succory is wont to be intermingsed with the Mersicament and as touching Succory Adrian Spigelius likewise writeth that he had been taught by experience how that in a hot Cause there was nothing more convenient then the Leaves of Wild Succory gathered in the month of May and dried in the shade and then given one dram thereof for the Dose And yet nevertheless the Roote of the said Succory are likewise very useful if they be pulled up in the first beginning of the Spring and the same may also as well as the Leaves be mingled together with those other Medicaments that we mentioned before But now in what manner these pouders and Artipodagrick Medicaments commonly called Antidotes do benefit those that are troubled with the Gout is well worth our consideration and as touching this very thing Thomas Erastus moveth a Question How the Antipodagâ—ick Medicaments do benefit such as have the Gout which is this viz. how those Medicaments can correct the cold and moâ—t disten pee of the Head or dissipate humors bred therein But the truth is he moveth the Question one of an Anticipated Opinion and Hypothesis whiles he presurposeth that the humors the Cause of the Gout do fal down out of the Head which that it is false we 〈◊〉 thew you in the seventh Question Whosoever he be that righth understandeâ—â— the Cause of the Gout may easily perceive what the Physitians main scope is here in the 〈◊〉 of the Antidotes For seeing that those Tartarous humors are generated in the first and secutal Concoction and then are derived in to the Veins and at length in their own time 〈◊〉 forth into the Joynts in the administring of the Medicaments the 〈◊〉 the 〈◊〉 here propoundeth unto himself is this to wit that he may promote and help forward the Concoctions of the Stomack and Liver and if there be any excrements guterated in the Stomack as Erastus also confesseth that there are and in the parts heer adjoyning â—o wit the Meseraick Veins the Spleen and the Liver these do cleanse them away 〈◊〉 them and dissolve them into exhalaâ—ons and evacuate them by Sweats and thines and â—â—rolus Piso writeth most truly that the potes and breathing places of the Skin whether sensible or else even insensible is so greatly to be accounted of that in it alone 〈…〉 to be placed the whol business of preventing all kind of Arthrick fluxions And this 〈◊〉 excellencly done by those Medicaments if they be continued But now here it may not without Cause be demanded Whether the Decoction of Guajacum and the like do perform the same that the Antipodagrick Medicaments de whether or no the very same may not be performed by the Drcoction of Guajacum Wood Sarsaparilla China and the like seeing that even those also do exceedingly provoke Sweats whateupon the 〈…〉 these Decoctions is by many prescribed in this Disease of the Gout But yet leaving every man to enjoy his own Opinion for my own part I am altogether unsatiâ—fied in this point For as Crato saith truly in his 25. Epist those Sudorifiques especlally such as are made of Guajacum Wood if they be frequently administred do very much consume and wast the Radical moisture which is not in the least done by any of the afore cited Medicaments which do only cleanse the humors and discuss them by a moistness and dewiness all the Body over in the morning or by a gentle and light Sweat or else also disperse them insensibly And besides such Decoctions as these when they are taken in a great quantity do very much dry the Bowels which of themselves are for the most part over dry in those that are afflicted with this Malady Add to this that those Antipodagrick Medicaments before spoken of are most of them bitter and thereupon they obtain a virtue and power of cleansing away those tartarous humors and Cholerick Ichores that are collected about the Liver and Spleen which virtue and faculty these Deoctions last mentioned do want since they do only extenuate dry scatter the humors and provoke Sweats And hence it is that Johaâ—â—es Crato in his 253. Consil not without good Cause tels us that to follow the Vulgar Opinion is no less to be deceived than by placing any hopes and expectation in those potions of China Sarsaparilla and the like Decotions For if they at any time seem to benefit and yield any help this they do by means of the exact and strict Dyet that is then observed and the most of those Persons of quality that have â—o often drunk those Decoctions have been greatly deceived by the perswasions of others and therefore they may do wel to see to it that they may stumble no more at the same Stone And therefore at all times it there be any vitious Constitution in the Bowels and a power generating that humor we ought carefully to look to it lest that by the use of such like Medicaments that aforesaid power should be augmented as it is most certain that that disposition unto the Stone that is in the Reins may be greatly increased by hot and dry Medicaments unsousonably given to break the Stone And Monardus likewise in the 16. B. of his Epistles writeth that Guajacum doth wonderfully dry and therefore must needs be very hurtful for such as are of a dry tempetature The Chymists do here likewise commend their Medicaments and some of them write that the Arcanum or Secret of Tartar doth remove and by the very Boots take away the Gout Now it is made in this manner Take Salt of Tartar depurated The Arcanum of Tartar or partified from this draw away a distilled Vinegar again and again alwaies receiving the new until such time as it leave behind it no more at all of its sharpness and Tartar And then unto one part of this Salt add three parts of common Bole and so distill from thence the Spirit by a Retort of Glass wel Luted and sitting thereunto a Vessel to receive and let this be big enough Vnto one part of this Spirit pour in two parts of the Spirit of Wine an eighth part of the Oyl of Sulphur and a sixteenth part of the Oyl of red Vitriol All of these being wel mingled together in a Glass Sealed after the Hermetick manner let them for three months be continually circulated Fryar Basil Valentine doth with great Praises extol the Spirit of quick or unslaked Lime But as the Composition of this is very difficult and troublesom The Spirit of quick Lime so we have likewise just Cause to fear and wel to consider whether or no it doth not easily offend the Bowels seeing that there is in the Salt of quick Lime a notable and manifest Caustick quality which appeareth even by the potential Cauteries that are made out of the Ley that cometh from the said unslaked Lime And so indeed
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
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
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
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
Ligaments of the Fingers the Tendons and the Joynts But the Muscles that arise from the Shoulder-blades and the very top of the Spina and that are implanted into the Shoulders do receive the same excrements from the inserior parts of the Body and derive them unto the Ligaments of the Fingers But as for that matter which floweth from the Head Nature thrusteth it forth unto the Joynts of the Fingers by those Nerves that descend from the Head And yet notwithstanding afterward he denieth that the humor it carried from the Head alone unto the inferior parts of the Body as for Instance unto the Knees the Thighs and the Ligaments and Joynts of the Toes but that by the consent of the Veins and Nerves of the Spina or Back-bone and by reason likewise of the consent betwixt the Kidneys and the Knees Thighs and Feet it is somtimes also carried from the said Spina of the Back and from the Kidneys unto the Ligaments of the Knees and unto the Joynts of the Toes But in this Opinion there are contained many things that are false For first of all whereat it is said that the matter floweth from the whol body unto some one place we are not hereby to understand al and every part of the body she stomack the Intestines the Liver the Kidneys and other parts but only those kind of parts in the whol body that are filled with Veins For although that the excrementitious humors may be generated in the stomack Intestines Liver and Spleen yet when they are heaped up they are then distributed into the great hollow Vein as also into the Arteries with that perpetual flux and passage to and again of the blood and from hence they are thrust forth unto the external parts of the body as in the Scabies we may see and so likewise in very many other Affects And therefore if vitious humors be heaped up in Arthritick persons there is no need at all that they should be derived unto the Joynts by so many turnings and windings by the Muscles and by the Nerves seeing that there is a neer and direct way through the Veins and Arteries from which as al other parts of the body so likewise the Joynts receive their nourishment And furthermore it is no way agreeable to truth that the humors should flow unto the Joynts by the Nerves for neither do the Nerves easily admit of and receive so great an abundance of humors neither were impossible if that matter were received by the Brain and should flow unto it through the Nerves but that it should first of al excite most grievous Maladies before ever the Arthritis could arise and appear India indeed seeks by al means to avoid al these inconveniences whiles in his sixt Chapt. he writeth that the matter which floweth doth not fill the Nerves within but only distend the same cutwardly But this is not to flow through the Nerves neither doth he in this manner shun those inconveniences whiles he doth not shew us how by a continual passage from the Head according to the progress of the Nerves this matter may flow so that yet notwithstanding it may in its way and passage excite neither Convulsion nor Palsey nor any other pain And indeed to what end is there any need of those ambages and turnings and windings about this way and that way by the Muscles when as we have already often said there lieth a direct and straight way out of the Veins and Arteries into the Joynts Adrian Spigelius in his B. of the Arthritis hath a peculiar Opinion as being held by him alont who when he would acknowledg that this afflux is altogether made by the Veins and Arteries and yet nevertheless would not altogether desert that Opinion which determineth that the humors flow down from the Head and would withal give us nonce that that flux cannot possibly be either without the Skul or within it and so from the Brain he therefore determineth that the fluxion is both from the Head and from the Liver but then in this he dissenteth from all others that he teaceth us that the aforesaid fluxion which he conceiveth to proceed from the Head is very seldom under the Skin as Fernelius tels us it is and never by the hole of the Spinal Marrow by which the Spirits are kept together or by the hole of the Nook above the external Membrane of the Spinal Marrow but that by the Veins and Jugular Arteries not only the external but likewise the internal by the which from the lower parts especially the Liver the humor is carried into the external and internal parts of the Head it floweth back again into the great hollow Vein and the great Artery or its branches that have their existence under the Throat and that so from thence they are devolved into the Joynts And the very truth is that Spigelius his Opinion is indeed right That the flux of humors in the Arthritis is by the Veins and Arteries which he might wel learn even from this by observing that if before the universal evacuation of the body there be applied unto the Foot or the Hand any external repelling or cooling Medicaments that then the matter flowed back unto the noble parts and excited acute Feavers and other Maladies But that the matter doth from the Brain first of al regurgitate into the Veins and Arteries this he doth not at al prove but produceth it without any firm ground and reason For on the contrary rather those things that happen unto Arthritick persons do testifie that this humor is neither generated in the Brain nor heaped up there nor thence regurgitates into the Veins and Arteries since that if this should happen a humor so sharp as this is and able to effect so great pains must needs excite the most grievous Affects in the Brain Spigelius here seeks for shifts seeing that many things teach us that these humors are bred in the Liver and Spleen the places and store-houses of Sanguification and that from thence they are heaped up in the Veins and Arteries and by them at length thrust forth into the joynts so that there is no need at al of deriving them from the Brain Some there are who determine that the humors are poured forth unto the joynts from the whol body But these by the whol can here understand nothing else but the Veins and Arteries dispersed throughout the whol body But that we may at the length conclude this long and tedious disputation and contract it into a few words this in the first place is certain that the matter the cause of Arthritis is generated in the Bowels of the lower belly yea and that oftentimes it is long stabled up as it were about the Spleen the Intestines and the Liver until at the last it is transferred into the great hollow Vein And Mercatus writeth most truly that as he himself had seen when the pains of the joynts had arisen from the pains of the belly so he
his grief lay into a pit which the Winters Ice had made it being now ful of Water and so by this means was freed not only from the present fit but likewise from al other pains of the Gout for the future and so he lived many yeers after Neither have we only examples of those who either by an exact and accurate Diet or by affrightment or Joy and the like means have been delivered from the Gout but we have examples of them likewise who have been recovered by the help of Medicaments Cardanus in his B. of admirable Cures Numb 16. relateth four examples of such as he himself had recovered of the Gout And we have likewise other examples mentioned of which we find certain of them in Schenkius his fifth Book of Observat And Solenander also in his 5. Sect. Consil 1. writeth in this manner As we have saith he known many that have been cured by others so we have also our selves set many free from the Gout for divers yeers together and this we have done by curing them without any great ado who before every half yeer and somtimes oftner were greatly afflicted with the Gout of whom some are yet alive to testifie the truth of what I say And very remarkable is that which Carolus Piso in the place alleadged relateth in this manner One Cornelius Perdeus Picardus a man well skilled in Rhetorick was subject unto the Gout from the seventh yeer of his age and so forwards the Arthritis returning oftentimes every yeer aâ—â— much hindering him in the prosecution of his studies This Patient advising with Caâ—olus Piso and beseeching him to afford what ease he could unto his intollerable pain had so comfortable on answer from him that it much cheered the yong man for he promised him his desire if he would but only yield obedience unto these few Precepts of 〈◊〉 to wit If he would indeed by degrees with-hold from himself a third part at the least of his daily allowance and more especially in that of his Drink and in the first 〈◊〉 chief place if he would altogether abstain from Wine and then in the next place if 〈◊〉 would alwaies as carefully and exactly keep himself from the injuries of the Air and especially from the cord and moreover also if in the night be would cover himself sufficiently with 〈◊〉 so that constantly every morning about the 〈◊〉 his second sâ—eep 〈◊〉 might appear upon his body if not a sweat yet at least a 〈◊〉 and 〈◊〉 as it were and if 〈◊〉 be would with the Syrup of white Roses taken three or four 〈…〉 out of his body all the serous or wheâ—ish superfluities The yong man yieldeth 〈…〉 unto these Precepts for two yeers and somwhat more and by this means beyond 〈◊〉 expectations he prevented and cut off all the matter and fowel of his Disease and so lived altogether free from all pain whatsoever in his joynts And 〈…〉 certain it is from dayly experience and the observations of Physitiâ—◠〈◊〉 that many there have been troubled with the Arthritis who have not been recovered and cured thereof and on the contrary likewise that very many have been perfectly recovered of the said Disease Now who they be that are Curable Hippocrates teacheth us 〈…〉 I am confident saith he and I speak it so far as I know or ever yet 〈…〉 those that are troubled with the Gout that whosoever 〈◊〉 them are either 〈…〉 Calious and hard knobs and knots growing about their joynts or such 〈…〉 carefull and sorrowful lives having their bellies hard and costive that 〈…〉 are 〈…〉 I know altogether incurable by the art of man Indeed we 〈◊〉 if it chance to happen upon it is the best curer of those sick persons and so indeed also are other scourings very beneficial and profitable in this case if they reach unto the lower 〈◊〉 But 〈…〉 such as are yong and have no hard knots as yet growing about their Joynts if they 〈◊〉 accurately and carefully in point of Dyet if they be such as love to stir by laboring and exercising themselves and such as have a good mind to obey the Prescripts of Physicians every one as he is able according to his several employment and 〈◊〉 these without doubt if they advise with an understanding and expert Physitian may be perfectly cured Thus Hippocrates Yet nevertheless we may very tightly and deservedly account the heredâ—â—ar Arthritis among those Gouts that are altogether incurable For as al other Diseases that are Hereditary so likewise the Hereditary Arthritis is not to be removed and overcome without much difficulty if ever it be done Now there are many Reasons to be given why divers of those that are of themselves â—â—able are yet never cured For first of all the cause is oftentimes in the 〈…〉 sufficiently expert in the Nature of this Disease and the cause thereof For 〈…〉 are so many Physitians that think amiss of the Nature of this Disease 〈…〉 themselves false and erroneous Opinions touching the same it is 〈…〉 do not rightly cure it since that of a Disease unknown and the nature 〈…〉 understood there can be no right and methodical Cure expected And 〈…〉 Physitians likewise that with Leaden Weapons as I may so say 〈…〉 werful and obstinâ—â—e And then again secondly the cause may be in the sick 〈…〉 selves who usually offend in three things For most of them are 〈…〉 these Malady is incurable and therefore they never trouble their 〈…〉 an or Physick neither wil they advise with the skilful Artist but 〈…〉 that at first might have been cured to take such deep root that it is 〈…〉 rable And secondly As for such of them who do consult the 〈…〉 send in three things the first whereof is this That for such as are 〈…〉 they for the most part sleight these and give credit unto Empericks 〈…〉 Mountebank they meet withal by whose tempering with 〈…〉 worse and the harder to cure And secondly they 〈…〉 ments long enough For that that vitious disposition in the body 〈…〉 for the augmenting and confirming of the Disease as also that the 〈…〉 may be taken away after they have by degrees been collected and 〈…〉 is not sufficient that the sick person be purged once or twice every yeer but it will be very needful to continue the use of the Medicaments according to the Physitians prescript and therefore we find the Ancients giving their Arthritick Pouders for a whol yeer together And thirdly another thing wherein they offend is this That most of those that are Arthritick desire only the mitigation and asswagement of their present pain and so that they may but be freed from the Paroxysm they lie under they think that the worst is now pasâ— never so much as troubling themselves in advising how and by what means they may prevent the like fits for the future And lastly this is also a chief and almost the principal cause of Arthritis its being so seldom cured That there are
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