These things being granted we affirm that in the first Case the inequality of the distribution of the bloud doth not principally depend upon the weaknesse of the Pulsifical vertue for as much as concerns the heart and the reason hereof is plain For the heart as we have already said doth emit the bloud indiscriminatly or equally and with one continuation from it self into the Aorta or chief artery even at such time when as the Pulse is most weak This artery doth exonerate or disburthen it self again with al possible expedition and from hence proceedeth the inequality of the diffusion of the bloud as the bloud is more easily impelled from on rivelet then from another This inequality notwithstanding must not properly and primarily be attributed to the heart but to the recipient parts and to the particular transmitting arteries For any primary affect of the heart is necessarily universal and communicated to al the parts of the body wherefore although we grant this enequality of the Circulation of the bloud to be in the secondary Essence of this Disease yet we exclude it from the primary Moreover in the Second Case propounded we say that there is a great disparity between the cases of extream necessity and ordinary cases Neither indeed do we know whether in the said cases the circulation in the inward parts howsoever it be granted be of any moment And for so much as concerneth the present businesse we deny any such debility of the heart in this affect that the Pulse should be defective in the outward parts yea we have not observed that any one afflicted with this Disease hath been prone to fal into an extacy or a swouning which would readily happen if the origin of the Disease were rooted in the debility of the heart it self Besides when we have seen such as were sick in their tender age to endure without any loss of strength sometimes a liberal eduction or flowing forth of the bloud from the opened veins of their ears yea and seen it sometimes reiterated with good successe Finally When also they have very wel endured purgations with respect had to their age it doth not appear to us how the first root of the evil can be ascribed to the weakness of the vital constitution In the Third Case it is evidently manifest that the first cause of this unequal circulation of the bloud is some disposition of an outward part as in an inflamed member laboring under some private Disease there happeneth a more ful and impetuous Pulse by reason of the accidental heat of the artery infused by the immoderation of heat which is in that outward part Therefore seing that the Essence of this affect cannot be primarily rooted in the animal nor the vital Constitution of the parts as we have now shewed it followeth which shal be the Third Conclusion That the primary Essence or first root of this affect consisteth in the proper or inherent constitution of the parts But because the natural Constitution as we have said above consisteth partly in the common qualities and the temperament and partly in a just plenty and disposition of the inherent Spirits and again partly in the organical construction and continuity our next enquiry must be to find out in which of the prementioned constitutions it lodgeth and whether it be rooted in one alone or in many or in altogether Be the Fourth Conclusion therefore this This affect is not radicated in the Organical Constitution of the parts For although in progresse of time the Organs themselves are divers wayes affected in respect of their conformation quantity and site as it is sufficiently manifest from the encreased bulk of the head liver c. from the tumours of the bones unto the wrests the ankls and the extremities of the ribs from various obstructions and the extenuation of the outward parts seing neverthelesse that al these things depend upon a higher origin and howsoever also we may necessarily admit these things in a Disease confirmed and now variously compounded yet in the original Essence we presume for the subsequent reasons they are to be rejected First Because the depravations aforesaid in the Organical parts do not appear presently in the beginning of the Disease but encrease afterwards by little and little And although perhaps some of these may be said from the beginning to have taken root in the body notwithstanding they cannot as yet be immediatly discerned by the sense neither do they manifestly hurt any actions and for that reason they cannot appertain to the first Essence of the Disease Secondly Because the Organical vices aforesaid are not the Causes but the Effects rather of the chief Symptoms which from the beginning exhibit themselves in this affect For the augmented figure of the head liver c. the standing out of the bones and the leannesse of the external parts are more rightly refered to the inequality of the nourishment then on the contrary the inequality of the nourishment should be ascribed to them For when one part doth excessively encrease and another is defrauded of a due decent augmentation there is a necessity that a disproportionate and an unequal nourishment must not only be present in the parts but also have had a preexistence in the body whereby one part is nourished and another neglected beneath a mediocrity But seeing this unequal nourishment is a depraved action and so a Symptom presupposing some preexistent Disease and yet withal as we have said doth precede as a cause the organical vices aforesaid it is manifest that those organical vices are not the first root of this Disease As for the obstructions which indeed are for the most part conjoyned with this affect yet neverthelesse there is a great deal of reason to exclude them from the first Essence of this Disease because they neither specificate the Disease neither can any reason of the Symptoms be rendered from them neither do they perpetually besiege some certain and determinate noble part Some man perhaps who hath respect to the excessive magnitude of the liver may object that in this affect that is perpetually obstructed and thereupon the sanguification being vitiated the other things are preposteriously derived but if this swelling of the Liver did alwayes proceed from the obstruction of it then a palenesse of complexion a cachexia or indigestion and by the advantage of time the Dropsie it self should necessarily and perpetually accompany this affect Moreover The Liver should alwayes be seen to be vitiated in the colour and at the dissection hard tumors and knots should be observed in the substance of it especially in an inveterate affect and that which killed the Patient but seing these things do not frequently much lesse perpetually occur in dead bodies the augmented bulk of it must rather be refered to the irregular nutrition Moreover we deny it not but that we have observed by Anatomy in those who have perished of this Disease obstructions various tumours and knotty excrescencies in
way from whence we have a little erred seing that the vitiated Tone may hurt as we have said the internal actions it doth not properly belong to that kind of Symptom which is wont to be called by the name of a changed quality Thirdly we say That this vitiated Tone seing it is neither a Morbifical caus nor a Symptom and yet is somthing preternatural must needs be the Diseas it self Moreover the same is clearly proved by the very definition of a Diseas For this vitiated Tone is a preternatural Constitution primarily or immediatly hurting the internal action therfore it is a Diseas For to what the definition is competible to that also the thing defined is competible That it is a preternatural Constitution is manifest by this because it is inherent in the solid parts of the body that it likewise depraveth the Internal actions is manifest from hence because an extream laxity lubricity and flaccidity of the parts being granted presently the agility is weakned no other cause approaching and a certain sluggishness deadeth the irritation of the vital Spirits In agility the matter is plain seing that firm and stretched bodies other things being answerable are more active and so on the contrary that the same thing also happeneth in the dulness of the irritation shal be shewed in its place for the present we labor to prove no other thing then that the vitiated Tone in this affect is a Diseas We say fourthly That this vitiated Tone in this Diseas is not any simple affect having an existence apart by it self but that it is so conjoyned and compounded in those same parts with the primary Essence that the whole Essence of the Diseas wherof we dispute may be said to consist of many Diseases united together in themselvs indeed simple if they be considered asunder and therfore that the vitiated Tone is only a part of the whol Diseas And this needeth no other proof then because the first Essence proposed above and the said vitiated Tone are both found in those same parts For that is properly called a compound Diseas which is produced by many simple Diseases conjoyned in the same Part. Fifthly We affirm that the vitiated Tone is not only a part of the whole Essence but such a part as hath some dependance upon the primary Essence and therfore that it is a secondary part of the Essence Before we proceed to the proof of this Proposition two grants or concessions are to be premised We grant first That the said Tone may be even immediatly vitiated in other causes perhaps and likewise by other causes although that happen not in this present Diseas For the inherent Tone of the Parts may be primarily loosned in the Animal Constitution and that suddenly as may be observed in the dead Palsy For the natural tensity and not the Animal only of the Paralytical member is loosned and indeed suddenly without any conspicuous intervention of any part of the aforesaid primary Essence After the same manner in a Lipothymy or defection of the mind loosness and languishing suddenly attatcheth al the parts Now we cannot in either of these two causes refer the cause of the loosness to the cold and moist distemper of the natural Constitution seeing that cannot be so suddenly and so sensibly changed Which let them consider that we may give warning of it by the way who wil have these common qualities to be always second and dependent upon the first alone yea on the other side let them in that cause observe how a cold and moist distemper doth afterwards by degree follow that loosness suddenly introduced Again as for the flaccidity of the parts that may be immediatly produced by large evacuations as a flux of the belly sweatings and the like immoderate vents the temperament being not yet considerably changed although we deny not but this may easily and doth usually follow Moreover an internal lubricity may be manifestly separated from coldness though very difficultly from moisture Secondly We grant that in the present Diseas the vitiated Tone doth not in any manner depend upon the first admitted Essence nor that in every respect is subordinate unto it For first the qualities of the Tone here vitiated do also ow somwhat to common causes namely to themselves and also to those that are common to the first granted Essence For extream moistening things by one and the same operation are apt to produce both too much moisture and also loosness In like manner from violent evacuations a want of Spirits and withal a witheredness doth arise Also from things too too slippery either outwardly administred or inwardly tataken or both an internal lubricity is augmented together with a moist distemper For there is so great a connexion of the whole Essence hitherto propounded with the common causes that there is scarce any thing which doth augment the first essence of the Diseas but at the same time more or less it hath an influence upon the vitiated Tone These things bring granted We say notwithstanding that in the present affect there is a very great dependance of the vitiated Tone upon the first Essence of this Diseas for which respect alone we have here referred the vitiated Tone to the secondary Essence If any list to contend That the said Tone in another respect may relate more clearly to the Secondary Essence because he may imagine that the primary Essence of every Diseas is necessarily similary and perpetually grounded upon the first qualities alone or because he may conceive that the qualities wherein the Tone consisteth are perpetually secondary and that they follow the first only as the shadow doth the Sun that man may take notice that we purposely decline such questions least we should straggle into an unwarrantable digression It remaineth therefore only that we prove the Dependance of the vitiated Tone upon the first Essence of this Diseas to be very great and that we shal do by parts We wil begin at the laxity We grant indeed that a laxity may be somtimes suddenly produced and in that cause a moyst distemper may often follow upon it Namely when the laxity primarily dependeth upon the fault either of the Animal or Vital Constitution but in this Diseas seing that neither the Animal nor the Vital Constitution are primarily affected there is a necessity that it must flow from other causes Moreover such is the condition of laxity and tensity that they are obnoxious to sudden alterations For the strings of a Lute may almost in a moment be stretched and loosned again the same thing likewise from some causes befalleth the Fibers of the Parts But in this affect the laxity stealeth on by degrees and slowly therfore necessary it is that it must begin be ruled and moderated by some caus leisurely and slowly augmented Although therfore we granted even now that the laxity doth own somwhat to the common causes of the Diseas yet the augmentation therof is chiefly restrained and moderated by
the primary Essence of this Diseas For moistning Medicines although they loosen withal yet they scarce loosen more than they moisten becaus for the most part they loosen by moistning Seing therfore that the common causes of this Diseas do flow into the Tone chiefly by the Mediation of the first Essence of this Diseas And seing that neither the Animal nor the Vital Constitution can here supply the vertue of a caus we may Lawfully infer that the laxity of the Tone doth chiefly depend upon the first Essence of the Diseas This is further confirmed there is of it self a certain proness and tendency of the Body to be through wet so that the fibers of the parts must needs be loosned by it Moreover the defect of the Spirits and the stupefaction of them doth caus a remission of the Tone by diminishing the vigor of the part Therfore we may conclude that the Diseas laxity principally dependeth upon the primary Essence of the Diseas As for the flaccidity because it comprehendeth the laxity it springeth from the same causes as that doth but in as much as it includeth also a subsidence and a certain emptiness it evidently dependeth upon the defect and benummedness of the inherent Spirits the plenty and vigor whereof being augmented the lank and flagging member is easily rendred turgid and swelled In the interim we deny not but that that subsidence doth withal depend upon the extenuation and atrophy of the parts Lastly How the slipperiness doth proceed from these causes is sufficiently manifested by what hath been said above That we may at the length put a period to this matter it may be observed for the higher confirmation of those things already spoken that there is such a strict dependance between the Tone and the first granted Essence that throughout the whol cure of the Diseas they are intended remitted together almost in equal pace For at firstthe Children that are afflictedwith this affect do only go slowly leisurely whilst the Tone of the parts is yet but a little loosned but in the progress they scarce and with much ado trust to their feet then they play only sitting or as thay are carried about Afterwards they can scarce sit upright and at the last when the Diseas hath attained the highest exaltation the feeble neck cannot without much difficulty support the burden of the head all which things as they attest the primary Essence of the Diseas to be gradually augmented so also they make it manifest that the vices of the Tone are intended by an equal pace And so all these things being rightly weighed we refer the viciated Tone to the secondary not the primary Essence of this affect and by consequence we conclude indeed the thing that was in question that that depraved Tone is a secondary part of the Essence of this Diseas CHAP. VIII The Secondary Essence of this Disease in the Vital constitution WE have already propounded that part of the Secondary Essence of this Diseas which is radicated in the natural constitution in as much as it comprehendeth the common qualities it remaineth now that we examin the organical vices and the faults of continuity if any such be found out But seing that no proper faults of continuity do accur in this affect and seing that the organical vices do depend partly upon the Essence above given and partly upon the vital constitution being viciated it seems necessary in the next place to search into these faults of the vital constitution The vital constitution is aptly distinguished into the original or that which maketh an influx and the participative or that which is produced by that influx The subject of the original vital constitution are the Spirits themselvs excited in the blood of the Arteries You will say The heart rather seemeth to be the subject of this constitution But it is not so for the heart it self through the coronary Arteries receiveth the vital Spirits brought down with the Arterious blood from its left Ventricle But it is absurd to suppose the wals of the Heart to be the first subject of the vital heat and in the mean time for those to receiv that heat from the Arteries We must say therfore that the solid substance of the heart is indeed the first principal subject of his natural and inherent constitution but seing that receiveth the Vital Spirits as hath been said it cannot be accounted the first subject of the Vital Constitution which is imprinted in it by those Spirits and continueth no longer than the substance of the Heart is shedded and besprinkled with the Vital Spirits For neither can life subsist in any place without the Vital Spirit Wherfore the substance of the Heart doth so far participat of the Vital constitution as it is wash'd and bedew'd with the Vital Spirits and by Consequence thaâ— Constitution in the substance of the heart is not original or influent but participative or produced by that influx This is also confirmed in that becaus the vital heat of the blood in the hollow Parts or Ventricls of the Heart which heat is at least a part of the Vital Constitution is for greater and more intensiv than that which is within the wals of the Heart as any man may observ by the opening of the Bodyes of living Creatures the Ventricle of the heart being wounded and the Finger presently thrust in For he shall feel a far more augmented heat in the blood than in the very substance of the Ventricle however it be handled Moreover the vital Constitution is a thing transient and consisteth as the Phylosophers Phras is in motu fieri therfore it is rooted In the movable and decaying Spirits such as the Vitals which are contained in the Arterious Blood for som Member being cut off the Life vanisheth almost in a moment and by Consequence the vital constitution but the natural as we have already insinuated continueth though not in such an exaltation as when the Vital remaineth for a while after death And indeed the Life and the Vital constitution is suddenly taken away in the case aforesaid not by any positive contrary Cause But by a meer privation of the Conservant and Continent CAUSE This is most evidently confirmed because the Vital constitution is suddenly intended remitted and altered in al the parts in respect of the model or measure of the Vital Constitution excited in the Ventricles of the Heart so in a Lipothymy the heart fainting the life of the parts presently vanisheth at last languisheth but assoon as the Ventricles of the heart are refreshed with Spirits by some proper cordial applications straight way we behold the vital Constitution to be suddenly in some measure repaired in all the Parts In the suppression of the breath sudden death followeth the torrent of the vital Blood from the right to the left Ventricle being intercepted In the opening of a Vein or in any other immoderate profusion of Blood there happeneth a swouning by the sole
Persons of a Chollerick Constitution are lean and of an extenuated habit becaus of the Reasons aforesaid Secondly A Melancholly humor whether you understand the Earthy Portion of the Blood or that saltish or tartar like matter excreted in and with the Urin and when the Urin groweth cold incorporating into little Sands or that sowr humor powred into the Ventricle perhaps by the Spleen though not through that short Veiny Vessel as the Ancients beleeved or those terrene Parts of the assumed Aliment which are evacuated by siege with the other Excrements understand either or any of them if this humor aboundeth and be not purged out after a due manner may be blamed as a caus of this Diseas For first that humor which is the more Earthy part of the Blood if it exceed a just proportion in the Mass of Blood it rendreth it unapt to nourish the Parts especially those that are first affected for the first affected parts are of a more noble texture than the substances of the Bowels or the bony parts and therfore we have already noted how the Parenchymata of the Bowels and the Bones do easily admit nutrition and by a way like unto digestion but those former parts do require a far more exquisite secretion elaborated assimilation And this is the Reason that the fleshy parts of the Bowels are rightly imputed among the impure and grosser aliments namely Becaus they are nourished with a cours Blood and not accurately elaborated before the Union Secondly Any great accumulation of Saltish and Tartar like matter is an Enemy to Nutrition and is rather dissipative and devouring than favoring augmentation Thirdly The sowr Humor of the Ventricle is totally ravenous and as it were hungerstarved and perhaps where it aboundeth it easily communicateth to the Blood such another Depredatory quality Fourthly and lastly The Terrene Dregs of the Belly may if they be inordinately retained taint and infect the Chylus and render it unapt for the nourishment of the part Finally we grant that every propounded kind of Melancholly superfluously coagumented or preternaturally retained doth not primarily properly and directly concur to the production of this evil but nevertheless we are of opinion that indirectly and after rhe manner propounded it may contribute somthing to the generation of it Thirdly Flegm whether it be taken for the moister and colder part of the Mass of Blood or for the wheyish part therof or for the slow humor of the Stomach and Guts or for the Spettle or for the Snot of the Nostrils or Jaws or for that peculiar humor which perhaps the new Vessel of the Sweet-Bread doth use to evacuate however you take it if it be retained or abound in the Body it hath a direct reference to this Diseas and properly deserveth to be called the caus therof For this humor is cold most slow thick benummed little spiritous lost and affected with an internal slipperiness all which things do exactly comply with the primary and secondary Essence of this Diseas as they have been propounded Wherfore upon a superfluous accumulation of this humor seing that there succeedeth a conspiracy to the production of this affect it ought justly to be esteemed a proper caus and a Primary Agent Besides these humors undue Transpiration as also immoderate or defective sweating may be somtimes numbred among the causes of this affect For excessive Sweating as also immoderate Transpiration doth dissipate the Spirits and withal dissolveth the parts especially the external which in this Diseas are the first affected and the inherent Spirits being consumed it easily leaveth a cold distemper behind it For to a just excitation and conservation of the heat of the parts there is required a certain due and regular strife of the exhalations between breathing which if it prove deficient the actual heat also becaus it partly consisteth in this strife becomes very feeble and languid and the parts are easily exposed to a cold distemper But we have already spoken of this matter at large On the contrary Sweat preternaturally restrained as also a very smal or lesned Transpiration doth easily kindle a Feaverish heat and therfore it likewise injureth the Spirits and dissolveth the parts and rendreth them afterwards easily obnoxious to a cold distemper Finally That we may comprehend all in a word Any humor excerned above Reason or Measure doth easily introduce a colliquation of the parts and a dissipation of the inherent Spirits and consequently disposeth the Body to this affect And let this suffice to have been spoken of non-Natural things and the causes of this Diseas thence arising CHAP. XVII Precedent Diseases which may be the Cause of this Disease THese Diseases in respect of their proper Essence ought only to be called by the name of Diseases but in respect of this Diseas they may rightly pass under the notion of causes of Diseases becaus they leave it behind them as one of their Effects Yet although many of them as they relate to the Parents and so imprint a Natural pollution in the Off-spring are rehersed above nevertheless by right they here deserve their consideration yet in a different respect and order These Diseases we reduce to three Kinds or general Heads First To Diseases that have some affinity with this affect Secondly To Diseases that extenuate the Body Thirdly To Diseases inducing a stupor and dulness in the first affected parts Of the First Kind Diseases having an Affinity or holding Congruity with this we call those who at least in part consist in the same with the Essence of this Diseas of this kind are any cold distemper or any moist distemper also any cold and moist distemper For a part of the first Essence of this Diseas includeth a cold and moist distemper and so those distempers do partly agree with this Affect Hither also belong a Phlegmatick Cachocymy a Melancholy and a mixt an obstruction proceeding from such like humors a Cachexia and a Dropsy Yea we may likewise refer hither in regard of their affinity those Diseases wherein the inherent Spirits are somwhat consumed for a part of the Essence of this Diseas consisteth in a scarsity of those Spirits but otherwise they are more aptly referred to the second kind In like manner the Diseases wherin the first affected parts are benummed stupified may likewise in respect of their affinity be hitherto referred although they belong more properly to the third kind of Diseases Moreover those Diseases wherin the Tone of the parts is infeebled and loosned must here be listed for they include a part of this Diseas namely that which consisteth in the loosnesse litherness internal slipperiness and softness of the Tone as they are above described The Philosophers say that the Elements which agree in like qualities are easily changed one into another by the same reason that these Diseases which partly agree in the same Essence do easily admit a reciprocal change from one to the other So we see a quotidian Ague which agreeth
as it were in a common Hypocaust or hot Hous Seing therfore that the first part of the Essence of this Diseas consisteth in an unequal cold distemper it is no wonder if these Defences and Fortifications of the Body do avert it at least for some short time The Third Reason may perhaps be the wholsomness of the Diet for Breast-Milk is the most solubrious and agreeable nourishment that tender age especially when it is sucked from the Breasts for it is a simple and uniform Meat full of nourishment easie to concoct and friendly and farmiliar to the constitution of Infants Therfore so long as they are conveniently nourished with it they incur the fewer errors of diet and are rendred the less obnoxious to this Diseas Yet it must be noted that if the Nurses milk be not laudable and good in it self or otherwise disagreable to the Constitution of the Infant then this reason is of no force Therefore if the Nurse be big with Child or immoderatly addicted to Venery or any ways sickly or given to drunkenness and inordinate feeding it is safer to hasten the weaning of the Infant unless you are provided of a better Nurse The fourth and last reason is the slowness of the motion of this Diseas in his first invasions For it stealeth on so slowly that it scarce bewrayeth any preparations to an assault til some months are expired unless the progress of it be advanced by some extraordinary and most vehement Causes as by some more violent Affect preceding or coming upon it Seing therefore that this Diseas doth so slowly take Root and seing that Children as we have formerly shewed are commonly born free from it it seldom hapneth to break out evidently into act til the sixth yea indeed til the ninth month And thus we have given the reasons why Infants newly born notwithstanding the weakness of their Constitution are for many months priviledged from this Diseas Secondly The causes why Children from the ninth to the eighteenth Month are every day more frequently infested with this affect are these First Becaus the first Caus even now propounded driving away this Diseas in those that are new born doth daily remit and before the ninth Month doth totally vanish Secondly In like manner the second propulsive Caus before alledged till that age doth every day grow more effectual For the hands of Infants after some Months if not before are usually set at liberty from the prison of their Blankets and perhaps their Feet also before they are six months old although at night they are swadled up again In the day time therfore at the least these outward Members are destitute of that common and comfortable warmth The Nurses likewise do many times er when they cloath the weak and feeble Infants too soon For they idly define the time of cloathing them by the number of the Months seing that they should rather give an estimation of it by the strength and activity of the motion of their Hands and Feet For when the motion and exercise of those parts doth avail more to excite and cherish their heat and to irritate their Pulses than the warmth of their swadling cloaths without all controversie that is the time to devest Infants from their swadling cloaths Moreover thirdly After the ninth Month Children usually are fed with other aliment besides Breast-Milk or other Milk and from that variety in feeding there easily resulteth some errors in point of Diet. Fourthly The slowness of the Motion of this Diseas doth not hinder but that it may break forth into act after the ninth Month. For the motion by reason of the unperceivable slowness of it at the end of certain months doth exhibit some effects and impressions Lastly the evils of breeding teeth do likewise contribute very much to the same purpose For the Teeth begin to breed commonly about the seventh Month and come accompanied with divers Symptoms which easily dispose tender Bodies to this affect Thirdly The Causes why this Diseas most frequently rageth when the Child is eighteen Months old are First Becaus the Causes before cited hastning this Diseas in the yonger Children are upon the approach of this age taken away or at least they operate with weak and ineffectual powers Secondly The evils of breeding Teeth although in respect of the immediate Symptoms which they produce perhaps before this time they nourish yet for the most part they leave behind them in the first affected parts a certain disposition which privily hiding it self within them after the term of some months produceth this Diseas But the breaking out of the Dog-teeth chiefly hath reference to this place seing that these break out a little before the Child is a year and an half old and their coming forth likewise is of al other the most painfull Thirdly Hitherto belong also those accidents which happen by reason of ablactation or weaning of the Child and at that time a great alteration befalleth Children in matter of Diet which they endure not without palpable molestation For herupon they are angry they cry the commotions of their minds makes them forsake the nourishment of their Bodies they are hard to be pleased neither do they sleep quietly All which things do easily imprint in the parts first affected at least a foregoing disposition although perhaps not till a long time after to this affect And so at length we have also run through this second Comparison namely of yong Children among themselves and we have briefly explained the Causes why those Children at one age are more and at another age are less exposed to this evil The Third part of the Question still remaineth which as we said we would reserve to be examined at the close of this Disputation namely Whether those that are of a greater age do somtimes fall though exceeding rarely into this Diseas We say first For so much as concerneth that part of the Essence of this Diseas which consisteth in a moist distemper that some difference must be expected to be between that distemper in yonger Children and those that are bigger in yong Men Men and especially in old Men for the same difference which we put before between the moist distemper of yong Children and old Men may according to quantity as more or less be observed between the middle Ages and therfore the humidity of the yonger Children will be better concocted and more genuine than that of the elder as it is obvious to collect mutatis mutandis from the same reasoning Secondly As for the organical faults we affirm that necessarily there concurreth a vast difference between Diseases of this kind incident to Children and perhaps to those of greater age for the tumors of the Bones in the Wrests and Ankles as also that narrowness of the Breast likewise that disproportionatly augmented bigness of the Head and Liver are either less conspicuous or altogether undescernable especially in those that are grown to full age For as the years encreas the Figure
Fourthly The Tone being over soft loos flavid and withered indicateth an avoidance of such things as are wont to mollifie loosen and weaken the parts and that such Medicines are to be outwardly applied and inwardly given as may render them more firm and solid The same Tone as it is internally too brittle brings a suspicion upon all such things as abound much with an inward slipperiness and seemeth to desire some roughness or indeed astriction in those things applied or taken Fifthly The corrupted Vital Constitution on the part of the Generation of the Vital Spirits is not so considerable but on the part of the distribution of the Vital Spirits the inequality therof is of great importance and indicateth a caution to be had of those things which promove the flux of the Blood towards the Head as also of such things as retard the passage therof to the first affected parts but that choice must be made of such things as stir the Pulses of the Arteries in the parts first affected and temper those that are in the Head A slow and diminute current of the Blood through the first affected parts indicateth the same things namely an evocation of the Puls to those parts But an over facile and slippery passage of the Blood through the habit of the parts is coincident in its indication with the slipperiness of the Tone lately recited A defect of the Vital Constitution on the part of the union sufficiently vigorous and pleasant between the Vital and the Natural Spirits indicateth an election of such things as can both nourish and cherish the Spirits and also excite them to a greater activity and that their contraries ought to be avoided The Vital heat as deficient indicates almost the same thing as a cold distemper provided that regard be had withal to the strength of the Heart and Arteries and to the vigor of the Vital Spirits Sixthly The unequal Nutrition Indicateth those things which promove the even and impartial distribution of the Aliment and Heat Or indeed that which is too liberal to the parts that are nourished beyond a due measure the extenuation of the parts requireth a fuller Nourishment The irregular magnitude of the Head chiefly things extenuant and such as are of the flux from the Head The Tumors of the Bones indicate the same thing the crookedness of the Bones require such things as attract the Aliment to the hollow side as moderate rubbings but things repressing chiefly on the gibbous and bunched side as strong bindings The bending of the Joynts insinuateth an Artificial erection of them as much as is possible The narrowness of the Breast pointeth to Pectorals and such things as have a faculty to dilate the Breast but the sharpness therof indicateth such things as have a dilative Vertue Sevently The imperfect distribution of Animal Spirits and somwhat defective in the first affected parts indicateth Cephalicals and such things as facilitate the distribution as exercises rubbings and the like A defect of due stretching in the Nerves or Nervous and Fibrous parts indicateth those things as Corroborate the Nerves and strengthen the parts Thus much of Indications Curative the Preservative follow CHAP. XXVI Indications preservative THese Indications are deduced either from the Antecedent or the present causes of a Diseas Those which flow from the former kind of causes concern the Prophylactical Part here we only propound those which proceed from causes that are present and contained in the Body namly from common causes or such as are proper to this Diseas Now although that common causes do not seem immediatly to attain to the production of the Essence of a Diseas yet even in this respect that they are esteemed an impediment and may retard the cure they Indicate their taking away These causes are either impurities or excrementitious humors collected and impacted in the first passages which unless they be taken away do not only infect the nourishment inward but they somwhat dul or otherwise hinder the appropriate Medicines They indicate therfore an evacuation either by a gentle vomit or by a lenitive purgation as occasion shal rather perswade to this or that or they are common causes deeper imbited into the Parts of the Body and these also require an evacuation But seing that according to this kind of common causes it is at the same time driven away and almost with the same Medicaments as are the causes which are proper to this Diseas we shal conjoyn both the kinds of them in this present consideration The causes therfore which are proper to this Diseas as also the Common causes which have a deeper penetration into the Body may be divided into Blood and Cacochymical humors The Blood indeed although it be rather deficient than redundant in the first Affected parts yet in the Head for the most part it requires a particular evacuation which usually is performed by scarification of the Veins in the hollow of the Ear. Hither likewise we may partly refer blisters raised between the first and second turning Joynt of the Neck although these perhaps may relate over and above in part to the Cacochymical humors Cachochymical humors are divided into those which stil flow in the channel of the Veins and into those which are impacted in certain parts of the Body The causes or humors flowing in the Veins do primarily and intentionally Indicate their evacuation But if they be unapt for motion as to the execution then they require som previous preparation But because it happens for the most part that not al the humors are equally unapt but that som are sufficiently flexible and others not so but resist the Medecines in this case they indicate a less evacuation and then a preparation Moreover These humors in the chanel of the Veyns may be subdivided into Feaverish namly if there be a putrid Feaver and not Feaverish The Feaverish humors are either swelling or not swelling The swelling that is those which are unquiet or impetuously agitated do Indicate a sudden evacuation at least a lesser unless perhaps they are carried of their accord to the external and more ignoble parts as it happens in the small Pox the Meazels and the like Affects But if a Feaver be present and that acute and yet the humors are not swelling they chiefly Indicate that peculiar preparation which they cal coction that by this means they may be obedient to the Medecine to be aftergiven and than evacution but if the Feaver not be acute but Chronical although the matter be not irritated and yet som part of it be sufficiently flexible in this case a lesser evacuation is first indicated at any time of the Diseas and afterwards the coction of the relicts that they also in their time may be evacuated The humors contained in the Veins which are not Feaverish if they are fluxible they first indicate evacuation but because in this Affect slow gross and clammy humors are almost perpetually present preparation at least wher a lesser
of Christ in all Beleevers 8 The Woman of Canaan 9. A Vindication of Ordinances 10 Grace and Love beyond Gifts 11 The Saints Hiding-place in time of Gods Anger 12 Christs Coming is at our Midnight Six Sermons Preached by Dr. Hill collected into on◠Volumn Dr Sibbs on the Philippians The Best and Worst Magistrate by Obadiah Sedgwick◠The Craft and Cruelty of the Churches Adversaries b◠Matthew Newcomin A sacred Panygrick by Stephen Marshal Barriffs Military Discipline Dr Ponnet's Treatise of Politick Power The Immortality of Mans Soul The Anatomist Anamized Cum multis aliis A Treatise of the RICKETS CHAP. I. The Antiquity and first Origine of this Disease the Name of it and the Derivation of the Name THAT some new Diseases altogether unknown to the Ancients have for some Ages lately past invaded divers parts of Europe is a known undoubted truth whether we attribute it to the vicissitude of things or impute it to the Sins and Impieties of men and their corrupt manners as the French-pox the Scurvy the Plica and the like in which number this very affect we are now about to handle may be justly Registred For if we examin al the diseases of Infants children described either by the Ancients or Modern Writers in their Books of the Diseases of Infants we shall meet with none which with a sufficient exactness doth delineate the condition and Idea of this evil For although it may seem to hold a correspondence or to have some affinity with a chronical Feaver a Consumption the extenuation or leannesse of Infants and the Hydrocephalos yet to speak truth it is an affect evidently different from them in the Species For you may observe many to be vehemently afflicted with this Malady without any Feaverishdistemper or any cause of such suspition in like maner although a Consumption doth frequētly supervene upon this Disease before the dissolution of the Patient yet is it seldome seen to accompany the first invasion thereof as for the meagerness or leanness although some parts are perpetually observed in this affect to be made lean yet this doth not happen in all alike as in a right and true leanness but you may perceave the parts about the head and face to be in a thriving condition as to outward appearance and well complexioned even to the last day of life Finally The Hydrocephalus is very frequently complicated with this affect yet we have dissected some whose Brain hath been sufficiently firme and not over-moistned with this superfluous humour Some have conjectured that this Disease is an imp or fruit of the French-pox or Scurvy descending from the viciated Bodies of the Parents upon the Children For we deny not but the Parents being infected with the Scurvy or the venerous Pox may propagate and bring forth an Issue not only affected with that Pox Scurvy but likewise infected with this evil and this even hath also faln under Observation yet for the most part this Disease in the propriety of its Essence hath neither affinity nor familiarity with those affects and besides it requireth a different progress of cure we have sometimes likewise observed a strumatical and swelling Malady to be complicated with this but we have also many times beheld this to be well distinguished from that and that from this But why do we dwel so long upon this inquisition seing that he who wil accurately contemplate the signs of this affect as in their due places they shal be propounded may most easily perswade himself That this is absolutly a new Disease and never described by any of the Ancient or Modern Writers in their practical Books which are extant at this day of the Diseases of Infants But this Disease became first known as neer as we could gather from the Relation of others after a sedulous enquiry about thirty years since in the Counties of Dorset and Somerset lying in the western part of England since which time the observation of it hath been derived unto other places as London Oxford Cambridge and almost all the Southern and Western parts of the Kingdom in the Nothern Counties this affect is very rarely seen and scarcely yet made known among the Vulgar sort of people The most receaved and ordinary Name of this Disease is The RICKETS But who baptiz'd it and upon what occasion or for what reason or whether by chance or advice it was so named is very uncertain However it obtained that Name yet in so great a variety of places through which it hath ranged it hath not to this day been known by any other Denomination But it is an accident well worth our admiration That this Disease being new and not long ago nameless at least not known by this Name neither spreading so much in remote as in adjacent places yet no man hitherto could be found out who knew or could shew either the first Author of the Name or the Patient to whom the appellation of the Disease was first accommodated or the peculier place where it was don or the maner how it cam to be dispersed among the common people for the inhabitants having gotten a Name for the Disease receave it with acquiescence as a thing done with diligence and deliberation and are not at all further solicitous either about the Name or the Author of the Name But because they which are expert in the Greek Latin tongues may peradventure expect a Name from us wherof some kind of Reason maybe given we have made fit together divers Names to this Disease yet we conceave it somewhat unnecessary to make a particular rehearsal of them in this place Nevertheless it may perhaps be proper and profitable to commemorate the Rules which we propounded to our selves in the designation of the Name The First therefore was That the Name should comprehend some notable condition of the Disease The Second was That it should be sufficiently distinct from the Names of other Diseases and Symptoms The Third was That it should be sufficiently familiar easie of pronounciation accōmodated to the Memory of no undecent length and not studiously and laboriously compounded Whilest we bend our employments to the satisfaction of these Rules One of us by chance fell upon a Name which was complacenceous to himself and afterwards pleasing to the rest now this was 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or indeed 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 for that termination is not altogether abhorrent from the common Gender the Spinal Disease also 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the disease of the Spine of the Back For the Spine of the Back is the first and principal among the parts affected in this evil Then no other Malady or Symptom did by the prerogative of time vindicate this appellation from it besides the Name is familiar and easie And finally The English Name Rickets receaved with so great a consent of the people doth by this Name seem to be excused yea justified from Barbarism For without any wracking or convulsion of
yet indeed by degrees and little and little For first the influent heat is manifestly an actual heat but the heat of the natural constitution is only potential wherefore we affirm that a cold distemper in respect of a natural and potential heat may consist with a hot distemper in respect of an actual and influent heat For indeed an actual heat is not so directly averse to a cold distemper which is so called by reason of a defect of the potential heat but it may the cause persevering consist for a good while with it As for example there is an actual heat in Simple Water Barly Water diverse Juleps and the like being made hot although at the same time they are potentially cold So that to be actually hot and potentially hot differ not in the Degree but in the Species neither are they so directly contrary to one another that one must presently expel the other out of a subject Moreover Secondly The influent hot distemper doth not so much correct the inherent cold distemper as by accident it augmenteth it namely by a wast and dissipation of the Natural Spirits wherein chiefly the natural and potential heat resides Just after the same manner as the actual heat introduced by the fire diminisheth the potential heat of the Wine Whereupon any kind of Feaver supervening upon this Disease usually brings more damage than advantage to the sick Secondly We affirm a moist distemper to be lodged together in the parts first affected this is manifest from the laxity and softness of the said parts and this sign likewise doth more strongly confirm the same thing because the said parts are extenuated so that unless there were a redundancy of moisture in them a certain rigidity and roughness would assault the touch again a cold distemper doth very rarely continue long without a moist and lastly things helpful and hurtful attest this truth for drying things are helpful and moistning things are hurtful Thirdly we affirm That in the parts first affected there is a penury of natural spirits This is proved by the very same arguments which we produced to evince it to be a cold distemper For first the unequal and imminute nutrition of the parts first affected doth not only argue a coldness of temper but withal a want of natural spirits for otherwise this defect of nutrition might be easily corrected For the cause of that coldness wherewith the defect of the spirit is conjoyned or some peccaut humor is not impacted is easily cashired and sooner then is wont in this disease as may b◠seen in the parts grown extream cold in the winte season for example sake in the handling of snow the parts so extreamly cooled provided that they be rightly handled wil return to their pristine temperamēt in few hours but wher there is a distemper with the matter of it as a case conjoynd or where ther is a defect of the inherent spirits such a distemper indeed is not so soon nor so easily removed But in the present affect we cannot affirm that a conjoyned or impacted matter of any note is at the least alwise caused in the parts first affected because they are observed to be more withered feeble and extreamly extenuated and seeing this affect is very different from Cachexia and the Virgins disease in the which for the most part it is not the want of Spirits but the conjoyned matter that cherisheth the cold distemper wherefore we may rightly infer that the pertinacity of this evil doth chiefly depend upon the defect of the natural Spirits Secondly The same is proved after the same manner by the second argument before alleadged for the cold distemper namly from sloth and aversness to excercise For activity hath not only a dependance upon the temper but chiefly upon the fulness of the Spirits as may be seen in strong and heathful men who in winter time and hardest frost are more prompt and inclinable to violent exercises then in summer when the inherent Spirits are wont to be somwhat dissolved Thirdly Feavers and long extenuating diseases as they often introduce a cold distemper so they evidently diminish and dissipate the inherent Spirits To these we ad that argument which is deduced from the constitution of the Parents the Parents that are more strong and lusty experience witnesseth it and accustomed to labour seldom bring forth children obnoxious to this disease on the contrary such as are weak sickly idle tender delicate very prone to immoderate premature or decriped Venery such as are troubled with a Gonorrhea c. for the most part beget children subject to this affect Namely because the Seminary principles are furnished only with a deficiency of Spirits We should now proceed to the fourth assertion but must first remove a remora that cometh in the way Object For some may object That the natural cold distemper is subordinated to the want of Spirits and not contradistinguished to it as is here supposed For the paucity of the Spirits seemeth to be the very cause of the cold distemper and the natural heat be it more intense or more remiss seemeth respectively to follow the proportion of the natural Spirits as being radicated in them as their first subject We answer First That the inherent heat is indeed first grounded and subjected in the inherent Spirits Moreover as the inward heat is divided into two par s namely the natural and the acquired heat so the inward Spirit must be also conceived to be twofold the primigenial or seminal derived from the Parents in the seed and the acquired Spirit contracted from a perfect assimilation of the aliment the former Spirit is the basis of the engrafted natural heat the latter of the inward acquired heat we mean not that these heats and Spirits are in themselves distinct in the species but only in their origin and degree of perfection which is sufficient to invest them with a various appellation For in nutrition the assimilation of the aliment proceedeth even to a specifical identity and not an individual although sometimes also it attaineth not the degree of original perfection For which cause it seemed sufficient to us to have named the implanted heat and the implanted Spirit without any higher distinction and therefore we grant that the implanted heat is first subjected and rooted in the Spirits and that it is nothing else then a certain modification of the said Spirits whereby they being irradiated by the vital heat do delight to indeavor to diffuse themselves and to enlarge their dominions by attracting retaining assimilating the aliments like unto themselves by severing the excrements and lastly by disposing the things acquired in due places we say likewise that this endeavor wherin we place the essence of heat by reason that it is diffusive doth somwhat dissipate and wast the implanted Spirits which because of this effect are vulgarly called by the name of radical moisture continually devoured and consumed by the heat Thus far we grant the argument
waterish as in the sperm of almost all Creatures and ripe fruits The Saltish likewise is rarely simple although there is a man that contendeth it is to be found in salt of Tartar But the compound saltish lubricity is frequently obvious as in Soap and Salt of Tartar dissolved with waterish and oyly substances The Earthy even mixt is scarce worthy of observation unless it be in respect that it concurreth to the thickning of fluid bodies as in white clayish Mud and Fullers Earth dissolved But in this place we have regard chiefly to that lubricity which is waterish as being that alone which can be guilty of the crime in this affect we now handle And these things may suffice in general of the internal or similary lubricity The next enquiring must be whether the first affected parts of this Diseas be affected beyond a due proportion with an internel or similary lubricity And at first indeed it seemeth very probable that there is such an extream lubricity in the said parts becaus moisture doth superabound in them which ever favoreth the said lubricity be it conjoyned either with heat or cold Every one knoweth that the Sperm of Creatures by how much it is moister than the creatures produced by it by so much also it is the more slippery in like manner that the yong flesh of Creatures is more slippery than that of old Seeing therefore that humidity and lubricity of this kind are so inwardly converted Seing also that in the parts first affected there is manifestly an extream humidity certainly it may easily be granted that a lubricity likewise doth too much abound in the said parts And to the production of this the benummedness of those parts have no small share For the Spirits when they are in their exaltation contract a kind of acrimony and sharpness as may be seen by comparing Must with old Wine or with Spirit of Wine or with Aqua vitae For the Spirits of Must may truly be said to be benummed or stupified if they be compared with the Spirits of old Wine and by how much more they are stupified so much more lubricity they likewise contain and also so much the less of sharpness and acrimony From whence it is manifest that that benummedness and dulness in the Spirits lodging in the first affected parts doth favor that extrem lubricity for that dulness of the Spirits in the said parts is almost of the same degree with the dulness of the Spirits in Must And becaus the Spirits are defective in the parts first affected it is evident that this lubricity is an over-watrish lubricity Moreover laxity flaccidity and softness do also seem to conspire For unripe fruit as they are hard so till they wax ripe they grow softer and softer and withal acquire an internal lubricity in like manner the parts are loosned by relaxant baths and together they become more slippery also slippery things taken inwardly as the mucilage of Althea c. Do not only loosen the Parts but they also make the passages slippery for which case in the pains of the stone they are drank with good juyces Again this lubricity of the first affected parts seemeth to be much confirmed by this because in the dissected Bodies a manifest lubricity is observable by the touch and if they be squeezed a mucilaginous kind of blood inwardly besmearing them is crushed out with the fingers We say nothing of the skin which for the most part is slippery in this affect and is seldom felt to be rough to the touch but it is worthy to be noted that extream slippery Medicines either outwardly applyed or inwardly taken do usually more hurt then good in this Diseas And thus we absolve the former question of the manner whereby the Tone of the Parts is vitiated in this Affect The other now presents it self to our consideration Whether the Tone vitiated after that manner as hath been said be a Part of the Essence of this Diseas We suppose here that whatsoever is found to be vitiated in the Body is either a morbifical cause or a Symptom or the Diseas it self and therfore this Diseas either simple or compound or any part of a compound and that either primary or secondary We say first That the vitiated Tone above propounded is not properly a cause of the Diseas And this scarce need any proof For the said Tone is a preternatural Constitution rooted in the Parts themselves and by that reason it is most evidently distinguished from a morbifical cause properly so called For although one Diseas may be the cause of another nevertheless even then it is not properly called a morbifical cause but a primary Diseas and that other which it produceth a a secondary affect But every where there is a growing together of them both into one total Diseas the former wil be the primary Part of the Essence and the latter the secondary part of the Essence Secondly We affirm that the described Tone of the Parts is not a meer Symptom for it is not under the things secured and retained neither can it be comprehended under any depraved action or any changed quality not vitiating the action But that the vitiated Tone is not comprehended under the things secured and retained nor under any depraved action may by the same labor be proved by this Reason because those kind of Symptoms are not indeed Constitutions of the body but the said vitiated Tone without controversy is a preternatural changed constitution as we have already most playnly demonstrated Secondly That the said Tone vitiated after that manner is not contained under any changed quality not depraving the action is so clear and evident that it needs no proof For laxity and flaccidity hurteth the motion of the Parts and an extream lubricity is an impediment to the du quickning of the vital Spirits as shal hereafter be made manifest It may be Objected That some bare changed qualities which are comprehended under the Genus of Symptoms may also vitiate an action as the colour changed in the skin yeeldeth an unpleasant prospect to the beholder so that it begetteth deformity and defect of du comliness We answer That the changed colour of the Skin in as much as it vitiateth the beauty therof which is the proper action of the Skin doth in rigor in a large acception fall under the Notion of a Diseas But seing this action of the Skin is only Objecture and Ad extra and seing that altered color doth hurt no Internal action of that individual Physitians who in the definition of a Diseas have respect only to the Internal actions of that individual do usually exclude it from the Classis of Diseases Or if the vitiated color of a part do chance in some place to deprave an internal action which is known only to happen in the Tunicle of the Eye called Corura the best Physitians do ever reckon it for a Diseas although perhaps secondarily But that we may return into the
defect of the Vital Spirits Therefore seing the Vital constitution is transient and fugitive in any of the solid parts and seing it dependeth upon the proportion of the vital spirits flowing into them from the Ventricle of the heart we may rightly infer that in the solid parts it is not original but participative But in the Vital Spirits themselves by whose function the Vital constitution is diffused and transmitted into all the Parts it must necessarily be original For there is no other original subject of it to be found in the Body Yet we grant that the solid substance of the heart by his Natural Constitution especially being watred by the Vital is the assistant caus of the excitation of the Vital Spirits in the blood included their Ventricles although it cannot be the first subject of that same Vital Constitution as we have even now abundantly proved And these things for the present may suffice in general concerning each vital constitution the original and the participative and to prov that that must properly be ascribed to the Vital Spirits this to the solid Parts as the immediate Subjects of the inherence Three kind of vices belonging to this Constitution do stil await our examination The two former wherof relate to the Original And the third pertaineth to the participative Constitution The first vice concerneth the Generation of the Vital Spirits The second hath reference to the distribution of them And the third appertaineth to the participation of the Vital Constitution Of these we shal make enquiry in their order CHAP. IX The vitiated Generation of the Vital Spirits in this Affect and whether that fault be a Part of that Secondary Essence THe Vital Spirits are first excited or generated within the Ventricles of the Heart namely in the very mass of the Blood and properly they discriminate the Blood in the Arteries from that in the veyns after that they are generated they are cherished and conserved within the cavities of the Arteries until they are distributed into the habit of the Parts Yea they are not only cherished in the Arteries but in them also rightly disposed perhaps som new ones are excited though with less efficacy then in the heart This being Preadmonished We say first That in the very Substance of the heart there doth not occur any fault repugnant to the Generation of the Vital Spirits which properly can be a part even of the secondary Essence of this Diseas For the heart it self for his doth rightly perform his function in this Diseas and if any imperfection happen in the Generation of the Vital Spirits it cannot be properly ascribed to the heart but to the ineptitude of the matter to receive the form of the Vital Spirits As the ingested aliment if it be extreamly crude it may frustrate the perfection of a laudable concoction the Stomach being otherwise sound and faultless So the unapt and unprofitable blood exported to the ventricles of the Heart may render the action therof imperfect in respect of the operation and effect how sound soever it may be in it self In which case the ascription of the fault is usually and truly attributed to the indisposed matter and not to the Heart You wil reply a Feaver is somtimes complicated with this affect and at such time the heart doth unaptly Generate the Vital Spirits But that Feaver is a Diseas of a different kind and by no means either the whol or any Part of the Essence of this affect Secondly We affirm that the lesser Arteries inserted into the first affected Parts are in some degree really cooled and benummed by them through their adjacency and contact and for that caus they do unaptly conserv the Vital Spirits contained in them wherupon the Vital Constitution of them is rendred somwhat imperfect before they can be effused into the Parts themselvs And this fault of the little Arteries seemeth by very good right to be ascribed to the Generation of the vital Spirits For although it be not the function of the Arteries to propogate the Vital Spirits according to the first signification of the word yet for this very reason that they are obliged to conserv them when they are propagated namly by such a conservation as in a manner includeth a certain continuate Generation of them their faults are rightly to be referred to the Generation of the Vital Spirits For the Vital Constitution is a certain transient action as we have shewed before which while it lasteth is in a continual flux and motion and which like a flame when the continual fomentation and reparation of it is suspended and suppressed suddenly extinguished Therfore are the Arteries as a continuate Heart to all the parts of the body unto which they transmit and powr out their contained Spirits and what faults soever of the Spirits happen before the effusion of them into the habit of the Parts seing that they necessarily belong to the Original Vital Constitution and cannot otherwise be ascribed to the distribution of the Spirits they must be referred to the very Generation of them namely a continuate Generation in the Arteries wherby they are continually preserved from a sudden extinction Moreover This fault of the Vital Spirits is the depravation of the Vital and Original Constitution and seing that it is somwhat preternatural first hurting the action from whence the participative constitution floweth in like manner depraved and seing that it meerly dependeth upon the primary Essence aforesaid and is complicated in the same parts it will be a part of the secondary Essence of this Diseas Thirdly We say that the matter of the Vital Spirits to wit the Blood of the Veins impregnated with his Natural spirits returning in his circulation from the first affected parts towards the Heart is somwhat disabled by them to admit the form of the Vital Spirit For it is necessary that the Blood whilst it passeth through the parts affected with a cold distemper want and benummedness of inherent Spirits must also thereupon affected with some kind of frigidity benummedness and perhaps with a thickness and viscous quality beyond the usual degree of Nature For as the blood doth give a tincture of his qualities to the parts thorow which it glideth So on the contrary the parts themselves bequeath also as much as they can of their qualities to the flowing blood But here likewise we must grant withal that this indisposition in the parts first affected especially when it is light and smal in the return to the inward parts is very much corrected by their heat before it ariseth at the Ventricles of the heart nay that it is somtimes subdued or if any such contracted fault remain it is commonly totally abolished by the length of the journy before the return of the Blood to the left Ventricle of the heart whilst it floweth down by the right and the substance of the Lungs the same thing also may be thus confirmed becaus if that indisposition should continue till the
return of the blood to the left Ventricle of the Heart the whol mass of blood in the Arteries would become crude and imperfect and seing that this blood thus abounding with imperfect Vital Spirits should be transmitted from the Aorta to al the Parts it would more or less affect them al which very rarely is observed in this Diseas For the head many bowels however som of them are found to be greater then ordinary yet they seem to be watered with a perfect Vital Spirit But although as we have said the slight indisposition of the Blood may be corrected before its return to the right ventricle yet when the contracted fault is great and more considerable it cannot be altogether overcome wherupon the Lungs in this Diseas are commonly afflicted with the most grievous Evil For when the less Spiritous and therefore the less passable Blood is continually transmitted thorow the Lungs cold and thick or viscous in process of time it must needs more or less infect and obstruct the weaker parts of the Lungs from whence proceed difficulty of drawing breath a stubborn cough hard tumors inflammations impostumes and the Ptysick Feavers also both Erratick and Hectick may from hence dirive their Origen But seing that fault may be suddenly introduced from the first affected parts it is credible although we have said the Lungs are often infected by it that it is for the most part overcome before the Blood can com to the left Ventricle And this may be the reason why the Head and the adjacent parts do look so well and flourishing namely becaus neither the Natural nor the Vital Constitution is hurt in them seing that the perfect Vital Spirits generated in the left Ventricle and distributed from thence do excite that fresh color in the face when on the contrary the Lungs do oftentimes labor under the faults aforesaid the viciousness of the Blood not being corrected before it enter the right Ventricle and the Arterious vein Moreover This imperfect production of Vital Spirits in the right Ventricle of the Heart by reason of the crudeness of the affluent Blood flowing in the Veins totally appertaineth to the secondary Essence of this Diseas and must be accounted a part of it for the Vital Constitution is vitiated wherupon the actions in the Lungs are depraved and it dependeth wholy and in every respect upon the primary granted Essence neither in the mean time doth it reside in the solid Substance of the Heart that it should therfore deserv the name of a a new diseas Here we note by the way That Physitians in the cure of this affect do ever intermingle such things with their remedies as have respect to the benefit of the Lungs and not without reason seing that it is apparent by what hath been said to how much danger that Bowel is continually subject And this may suffice concerning the faults in the Generation of the Vital Spirits Now follow the faults of the distribution of those Spirits CHAP. X. The vitiated Distribution of the Vital Spirits in this Affect and whether it be a Part of the Secondary Essence therof THis vitiated distribution seemeth to consist in three things Namly in the Dimunition Slowness and the Inequality of it The defective and also the slow distribution of the Blood and Spirits may be seen in some one Part and perhaps in all those that are first affected But the inequality cannot be observed in any one seing that it resulteth from a collation of a various swiftness and slowness greatness and smalness of the torrent of the Blood in respect of the other parts The defect and slowness of the distribution seing that they depend almost upon the same causes in the present affect they may be handled together and seing those differences are more simple then the inequality the handling of them seemeth deservedly and justly to be premised But first we must grant that the passages and circulation of the Blood thorow the first affected parts is not very difficult in this affect For although a cold distemper a want and benummedness of Spirits do seem very difficultly to admit a transition of the Blood thorow the parts affected with these qualities yet indeed other conjoyned qualities as moysture loosness laxity flaccidity softness and internal lubricity can at the least contribute as much power to facilitate the passage of it as the qualities aforesaid can oppose to the interruption of it Yea if you valu them by a just estimation perhaps they can do more but we wil not in this place assert it only we flatly deny the difficulty of the circulation to be greater For if we may compare hard bodies with soft low bodies with straight moist with dry slippery with rough we shal easily perceiv that the circulation of the blood is much more quick and expedite in those then in these And this is manifest in young Creatures in whom those qualities abound in such as are new born although the Heart be very tender the Arteries less firm the pulsificative vertu yet feeble and weak yet the passing too and fro of the blood are readily and easily exercised which in those that are older is not accomplished without a stronger pulse and an indeavor or a kind of labor of the Heart and Arteries Again according to the opinion of Galen and Hippocrates the Bodies of children are most passible namly by reason of their humidity laxity and softness Besides if we observ the formation of the chicken in the eg the matter wil be yet more plain Within few days after the incubation the Heart of the chicken is sensibly and evidently seen to beat and to begin the circulation of the Blood but if at the same time we consider the frailty of the Heart it self and how weak a coherence there is between the parts of it til in the interim it finisheth the circulation of the blood according to the manner of it such as it is we must necessarily grant that in that shapeless lump moisture and internal lubricity do expediate and facilitate that motion Some perhaps may object that in these cited cases the liberty and readiness of the circulation of the blood depends not so much upon the moisture softness and slipperiness as upon the plenty of the inherent Natural Spirits For in the Cachexia Green sickness and the dropsy the flesh is very soft moist and perhaps slippery when in the mean time the transition of the Blood is very difficult We answer those Bodies that wax tender and soft by a paucity of inherent Spirits are less indisposed and more apt to admit the circulation of the Blood then the other parts But it is not simply tru that such bodies which most abound with Spirits do perpetually obtain the most expedite and unrestrained circulation of the Blood for the Blood is more easily circulated in Fish then in Creatures of the Land as is manifest by the tender and frail Constitution of their Heart and Arteries yet
unless it be irradiated with light so those inherent faculties of attracting retaining concocting secreving and forming are dead as it were and meerly potential when they are deprived of the vivification and erogation of the Vital afflux This is most clearly conspicuous in a lipothymy for upon the defect of the Vital influx all those faculties suddenly fail decay languish But seing all the faculties are established upon some constitution which is both the cause and subject of them it might be demanded in which Constitution of the parts it is grounded We answer in respect of the potential Nature they are radicated in the Natural Constitution which we have before described but that in reference to the Actuated and Elivened Essence that they depend likewise upon the Vital influx And we declare in general that the participative Vital Constitution which we have already asserted to consist in Three things conjoyned with the Natural Constitution is the total and adequate both cause and subject of all those faculties But it would be a tedious degression and inconsistent with our purpose to make enquiry how those Constitutions can produce this or that faculty determinate in its Species For the present we will only run over those faults of the faculties aforesaid which occur in this affect First The fashioning vertue here erreth by an unequal purging out of the Vital Blood in divers parts as we have discoursed above Hereupon the Head and the Liver grow to an unmeasurable bigness the first affected parts are extenuated the ends of the Bones stick out and somtimes the Bones themselves which are otherwise straight wax crooked Secondly The Concoctive faculty is weak in this Diseas and in the first affected part by reason of the inherent cold distemper the penury and benummedness of the Spirits the brittle and slippery union of the Vital spirits with the Natural Constitution and by reason of the feeble imprinted Vital heat Thirdly The Attractive Retentive and Expulsive Faculties seem not to recede much from their Natural Condition yet the Attractive is somwhat more slow than ought to be the Retentive by reason of the internal lubricity is somwhat weaker and the Expulsive is more vehement for the same Cause And thus at length we have dispatched the faithful examination of the faults of the Vital Constitution in this affect The Animal Constitution should now undergo the next disquisition but that som faults of the Natural Constitution namly the Organical faults therof which have some dependance upon some of the recited faults of the Vital Constitution do challenge this place as most proper to themselvs CHAP. XIII The Organical Faults of the Natural Constitution in this Affect SEing that the Organical faults in this Diseas belong to the Inherent Constitution of the parts thos indeed by the Law of just Method should be immediatly after the similary vices of the same Constitution but as we have noted above the Reason and Caus of them must be derived from the faults of the Vital Constitution lately mentioned and therfore we are constrained to premise the examination of these and to reserv the consideration of the other for another place The Organical faults in this affect are fitly reduced to these Heads First To the extenuation and leanness of certain parts namly the parts first affected Secondly To the unreasonably augmented magnitude of some parts as the Brain the whol Head and the Liver Thirdly To the tumors or lanching out of certain Bones as of the Bones to the Wrests to the Ankles and the ends of the ribs Fourthly To the bowing of certain Bones as it frequently happneth to the Bones of the Cubit and the Shin Bone somtimes to the Bone of the Thigh and Sholder Fifthly To the poynted figure and narrowness of the breast And these faults are reckoned beneath among the Symptoms and signs of the Diseas not because they are indeed meer Symptoms but becaus they are obvious to the Senses and so do fitly supply the place of signs both in respect of the parts of the Essence of the Diseas more deeply retired and also in respect of the hidden causes therof For whatsoever is perceived by the sens and besides it self representeth somwhat els to the understanding that is obscure hath the formality of a sign For indeed these faults are parts of the secondary Essence of the Diseas seing that they are the vitious Constitutions of the Organs depraving the action and have a dependance upon the other parts of the Essence of the Diseas The common caus almost of al these recited affects seems to be an uneven or disproportionate nourishment or Alogotrophy of the parts Now this dependeth chiefly upon two causes in this affect The first is the unequal inherent Constitution of the parts irregularly nourished The disparity between the inherent Constitutions of the first affected parts and the Head and Bowels cannot be so wel collected by what hath been already said but that it may deserve a further inculcation The last ca us which is indeed of equal moment is the very unequal distribution of the Arterious Blood into the parts unevenly nourished That the Blood is unequally distributed in this affect we have already shewed here we only infer that that must needs produce an unequal nutrition of the parts Al Creatures the more liberally they feed the more fat and fleshly they are unless som oother impediment doth intervene but if the du quantity of aliment be substracted they grow lean and are daily more and more extenuated Why should we not suppose that the same thing happeneth in the Parts of Creatures the Blood or at least somwhat contained in the Blood is acknowledged for the last aliment of al the parts wher therfore that is liberally dispensed to one part and sparingly to another certainly it is no wonder if one part be excessively augmented and another extreamly extenuated But these things may suffice in general In particular First We assert that the first affected parts in this Diseas do dayly wax lean and fal away Proof of this assertion cannot be reasonably expected seing that dayly experience yeeldeth an occular demonstration of it But why those parts are so extenuated that may require som reasons and we offer these The first is deduced from the primary essence of the Diseas namly from a cold distemper a penury and inactivity of the inherent Spirits in the parts aforesaid For by this means the attractive retentive and concoctive faculty do execute their functions in those parts unduly and ineffectually The second is brought from the loosness softness and internal slipperiness of the same parts for hereupon the expulsive faculty is too much irritated the breathing is too easy and dissipative the circulation of the Blood is to slippery the retentive faculty through the weaknes of it parteth with the aliment too soon and with too much facility and this very thing almost happneth here in these parts which befalleth the Guts in a Lyentery Howsoever it be
reckoning up of those causes which on the Parents parts may produce this Diseas Som of these faults in the Parents relate to the Generation of the seed wherof the Embryon consisteth others have reference to the Embryon now conceived and yet born about in the Womb. The faults of the Generation of the seed proceed either from the man or the woman or from the whole Body or from those parts onely which are dedicated by nature to Generation The faults of the Parents depending upon the whole Body have the strongest influence into the Child because it transmitteth such matter to the Generation of the Seed as is unapt for those parts dedicated to that office We purpose not here to particularize the several faults of the matter of the Seed but to instance in those alone which conspire to entitle the Progeny to this Diseas These we reduce to four Classes The first Classis containeth a cold and moist distemper of the matter wherof the Seed is Generated This chiefly resulteth from a cold and moist distemper of the Parents unto which we also refer a predominancy of il juice especially that which is Phlegmatick and waterish also a Cachexia and Dropsy and perhaps the Green-Sickness which som cal the white Feaver not sufficiently subdued before conception al which affects manifestly help to constitute a waterish matter both cold and moist in the Genital Parts which is not only in general less apt for the Generation of the Seed but it particularly inclineth to a condition of this Diseas a part of whose primary Essence consisteth in that very cold and moist distemper as we have already proved Moreover we may perhaps hither reduce the Scurvy the French Pox the Jaundice in which affects the Blood also is polluted with filthy excrementitious humors and corrupt exulcerations which cannot easily be changed into laudable and fruitful Seed The second Classis containeth containeth the penury of Natural Spirits wherby the good Seed should be Generated For a Spirituous Seed cannot flow from such a kind of matter The causes which suppeditate that impure matter to the Parts of Generation are the dried and extenuated Bodies of the Parents wasted either by long abstinence or by som vehement evacuation as by vomits lasks Lienteries Dysenteries Hepatical Flures of long continuance by an excessive Hemorrhage from any part by violent sweatings or any Chronical Diseases which wasteth the strength and is not repaired before Coition especially a Consumption a Hectick Feaver an indigestion from any kind of Caus Lastly from a defective and imperfect Concoction of the last aliment or the fault of any part For in such cases the matter which is separated to the parts subservient to Generation is destitute of a competent plenty of Natural Spirits wherupon the Parts preparing and concocting the Seed cannot perfectly correct this defect and ejaculate such Seed as is sufficiently abounding with Spirits Seing therfore that a considerable part of this Diseas consisteth in the paucity of Natural Spirits it cannot otherwise be but that the issue propagated by such a crude and almost Spiritless Seed should be tainted with a certain Natural Propension to this affect even in their first rudiments which afterwards upon the concurrence or other causes is easily deduced into Act. The third Classis containeth the benummedness or stupour of the matter transmitted to the Generative Parts wherof the Seed is produced For not only the solid parts but also the whol Mass of Blood and the humors therin contained are obnoxious to that same stupour And from hence it is that Physitians being to render the causes of Diseases do use to say that the humors and also the Blood are too fluid and moveable and unduly vehement somtimes on the contrary that they are unapt for motion less fluxible and unactive beneath a Mediocrity in respect of this thing also a certain Mene is most wholsom but more things relating hither may be seen above We will here only prosecute those faults of the Parents from whence this defect of vigor and activity in the matter of the Seed doth arise These therfore are first the fost loos and effeminate Constitution of either or both the Parents indisposed to strong and Masculine exercises Secondly an overmoist and full diet and epicurison obnoxious to frequent crudities Thirdly A delicate kind of life abandoned to eas and voluptuousness slothful and rarely accustomed to labor danger and care Hither you may also refer a total defect of manly Exercise immoderate sleep especially soon after mate and any kind of sleepings whatsoever a sedentary speculative life intent upon soft and queint Arts and Sciences as Poetry Musick and the like to these may be further added a dayly frequenting of Comedies and other Plays an assiduous reading of Fables and Romances and instead of manly and laudable Recreations a loos expence of time in Carding and Dicing Hither also belong the neverfailing fruits of a lasting peace and plenty such as security indiligence and the like All these enumerated faults do manifestly contribute a share to introduce a laziness and Effeminateness in the parts Seing therfore that the Blood together with the humors contained in it doth in its circulation wash all those stupified parts it cannot otherwise be but that as it glideth along it must participate some such alteration and seing that some portion of the transient Blood affected with this stupefaction is transmitted to the Generative Parts with the very matter wherof the Seed is Generated it is easie to infer that that Child which springeth from such principals must inwardly contract at least some propension conformable to the sluggishness and stupour of its Native matter and that that propension after-Birth when the preservation is taken away by the equal cherishings of the Womb is by divers causes without difficulty deduced into act wherfore seing that such a dulness is a part of the Primary Essence of this Diseas it followeth that in such vitiated principals there lurketh a propensity to this affect derived from one or both of the Parents The Fourth Classis containeth the vicious Dispositions if any such occur of the Parents who in their Childhood were infected with this Diseas For these would transmit into the Children a continuation of an hereditary Diseas properly so called But because as we have said it is not yet manifest whether the Parent afflicted with this Diseas in their infancy shall beget children therewith affected besides becaus the faults of the Parents may be conveniently referred to any one of these Classes aforesaid or to many or indeed to all of them it will be fruitless to insist longer upon them Therfore having reckoned up the faults of the Parents which depend upon the whol Body in the next place we proceed to their faults which peculiarly reside in the Genital Parts These faults are somtimes a cold distemper somtimes a moist when by reason of too much humidity they are loosned or weakned wherupon they ejaculate
properly relate to the secretive and excretive faculty of some Bowel or some other partt and is destinated to be severed and evacuated from it and therefore though the errors of the first concoction are scarce corrected in the second or third by Alteration yet they may be mended by local motion or excretion made from some part of the Body the unprofitable parts being separated and rejected In like manner the mass of blood being any ways preternaturally altered or infected with some Humor the peccant matter which cannot be otherwise subdued by Alteration is quickly exterminated perhaps by excression made from some part or Bowel unless withal the secretive or expulsive faculty thereof be hindred therefore it must needs be of great moment for a Physitian to know what Humors are particularly predominant in any Diseas and by what determinate ways they may be most properly spied out according to the intent and purpose of Nature For there are as many subordinate species of things spied out as there are distinct substances of the Bowels and other parts destinated to that office in the Body For it is credible that the Liver doth cast out one thing the Kidnies another the Sweet-Bread another the Spleen another the Stomach and Guts another the Lungs another the Brain another the Stones the Matrix the Kidnies the Kernel under the Canel Bone the glandulous parts of the Larynxes the Throat and Jaws another the scarf Skin and the Skin another For it seemeth scarce admittable that Nature should build and prepare for her self Organs of different kinds and yet should make use of divers of them for the performance of one and the same action Therfore when the excretion of any of the said parts hapneth to be restrained a certain peculiar filth will flow out from thence into the mass of Blood and so there wil be so many differences of things preternaturally retained as there are kinds of parts inservient to particular casting out and in like manner there wil be as many kinds of vitious excretion either by excess defect or depravation as there are divers wais thorow which the excretion may be made If any man demand Whether the several kinds of things excerned be sufficiently discovered and understood by us We answer that an exact knowledg is desired of that particular humor which is to be cast out thorow the new Vessel of the Sweet-Bread then in the next place what is cast out by the Kidnies the Kernel under the Canel Bone and the glandulous parts of the Larynx yea perhaps it is yet scare sufficiently known what is rejected by the Spleen For this cause therefore amongst others it seemed good unto us to supersede in this place any high and accurate disquisition of things secerned and retained either in relation to the parts and ways whereunto they belong or in order to the present affect and rather to insist on that fourfold division of Humors made by Galen namely into Choler Phlegm Blood Melancholy adding only undue transpiration and sweating For although we may doubt whether this division can deduce the humors to the subordinate Species as we have noted above more then four parts distinct in the species are evidently dedicated to the casting out of the humors yet seing that this division of the Humors is not only approved by al Classical Phisitians but that it is likewise profitable in it self and at least reduceth the Humors to certain Heads or Kinds however perhaps every kind may comprehend under it several species we are resolved for the present to insist upon it and so much the rather because under a general notion it very fitly conjoyneth and containeth both things altered and preternaturally contained within and also things to be spied out which are not yet excerned and in that respect it will eas our burden and contract our work For whilst we make our proceedings in this manner it will be needless to institute any other peculiar Chapter of the Causes of this Diseas namely of this altered which are preternaturally contained seing that they are comprehended as we have said under this Title We reduce therfore the internal Causes of this Diseas whether they be excrementitious humors retained or viciated by alteration either to Choller or to Melancholly or to Elegm and a Waterish humor or an undue Transpiration and sweating for the Blood properly so called is in this affect scarce observed to be faulty You may object That Practical Physitians do in this Diseas commonly prescribe the opening of a Vein in the hollow of the Ear observing that Evacuation to be very profitable which Reason could hardly admit unless the Blood were in some degree peccant We answer That this Remedy is available not in respect of the universal plenitude of the Blood but by reason of a peculiar plenitude of the Head it self For we have already shewed how that the Blood is uneqally dispensed to the parts of the Body and indeed illiberally to the first affected parts but to the Head superabundantly Therfore although there be not an universal redundancy of the Blood in this Diseas yet in respect of the particular Plenitude of the Head it self such a particular emptiness is perhaps profitably instituted those outward and smal Veins of the Ears being cut You may reply that we by this Answer do indeed decline the universal Plethora but that we grant a particular one of the Head which ought no less to be esteemed a caus of sickness We answer That we have at large explained this fault of the Blood when we discoursed of the unequal distribution of it unto which place it properly belongeth seing that it is a caus of the Secondary not of the Primary Essence of this Diseas and therfore a vain and superfluous repetition therof ought not in this place to be expected We will now therfore proceed to our purposed disquisition of the Humors and likewise the Transpiration aforesaid First Choller whether by this word you understand that excrementitious humor in the little Bladder and the Chollerick pore or a hot dry sharp and bitter part of the Mass of Blood or that unsavory humor that tasteth like stinking Oyl begotten and flowing in the Stomach by some corrupt aliment especially that which is fat addust or salt or certain sharp and corrosive Excrescences produced in the Body by corrupt Blood if it abound and luxuriate in the Body very probably be a caus of this affect For although it may rather seem to impugn that cold and moist distemper which is a part of the first Essence of this Diseas yet in regard that it is apt in some sort to hinder the nourishment of the Parts either by a vehement irritation of the expulsive faculty or by attenuation of the aliment and to extenuate and wast the very inherent constitution of the Parts and by consequence to consume and dissipate the Natural Spirits it may not unjustly be numbred among the causes of this Diseas For every one knows that
labor with a moist distemper yet it is manifest withal by what hath been said how great a difference there is between this of aged persons that of Yong children Morover that this moist distemper of old men is less Homogeneal to the present affect then that of children appears plainly from hence because it produceth not that softness and tenderness of parts in old men as we see it doth in Children neither doth it equally dispose them to a dissipation or colliquation of the inherent Spirits or any slippery passage either of the Blood or Exhalations which are supposed in this Affect But on the other side it rather rendreth them obnoxious to obstructions and the other evils recited before a comparison therefore being made between the cold and moist distemper incident to Younger Children and that which is wont to affect old men there resulteth a pregnant reason why aged people are not so subject to this Diseas as Children Thirdly Yong Children although they Naturally abound with inherent Spirits yet by reason of the easie transpiration of their Bodies becaus of the laxity tenderness and incoherence of the parts they are much more prone then Elder persons to dissipation and colliquation of the Inherent Spirits and by consequence upon less and slighter causes they fal into a want of them Fourthly Younger Children by reason of that very same weak consistance of the parts are also rendred more obnoxious to an astonishment than the Elder For to the vigor and activity of the parts there is required besides a just plenty of Spirits a strength of their coherence and consistence Fiftly it is not needful for us to ad any thing concerning the Tone of the parts seing we have so often insinuated the weakness of it in Younger Children in respect of the Elder and any man may observe that upon the increase of years the Tone is more and more confirmed Sixthly As for the diminute distribution of the blood to the first affected parts which we have already proved to be a considerable part of the secondary Essence of this Diseas We say that the Elder Children do use more strong and frequent exercises then the Younger and therefore that the pulses of the outward parts are more strongly stirred up in them and that a greater heat is raised and cherished in them and by consequence a cold distemper is more potentially driven out of them Seventhly as for the Organical faults namely the augmented magnitude of the Liver Head and their Vessels it is a known thing that the proportion of the parts is more stable and confirmed in the bigger Children and on the contrary that in the Younger they are easily moved and altered but the augmentation ceasing they are not any more afterwards altered without some unusual and weighty causes So that even in this respect the Younger Children are most subject to this Diseas Let us therefore conclude the parts of the Question That Young Children in respect of their Natural Constitutions and dispositions are more obnoxious to this evil then those that are Elder and so much the more the Younger they are But we must not wave an Objection that here we meet with which also doth very fitly conveigh an occasion of passing to the other comparison namly of Young Children amongst themselves For if Young Children as is manifest by what hath been said are more prone to this Diseas by their Natural Constitution and disposition and the Younger they are the more subject they are How comes it to pass that Children rarely fal into this affect before they are six months old and somwhat more For according to the Opinion delivered Children should seem to be principally subject to this Diseas immediatly after their birth which yet experience disappointeth yea rather indeed it witnesseth the contrary namely that Children before they are nine months old are seldom or scarce ever afflicted with this Diseas Here therefore it wil be needful for us to declare that other comparison of Young Children among themselvs For it cannot be that this Affect should so constantly spare Children chiefly disposed unto it and frequently invade those that are less disposed unless some difference did intervene which did in a diverse manner relate to those ages and which notwithstanding the propensity of Nature doth retard the invasion of the Diseas before the first twelve months were compleatly expired and yet afterwards either doth not at all or not so potently defend Children from this Diseas Here therefore we must find the very reason of the difference between these ages which that we may the sooner do it wil not perhaps be impertinent to take special notice by the way of those ages which upon the authority of experience are observed to be more frequently affected with this Diseas and likewise those ages which are least afflicted with it We affirm therefore that this Diseas doth very rarely invade Children presently after their birth or before they are six months old yea perhaps before the ninth month but after that time it beginneth by little and little daily to rage more and more to the period of eighteen months then it attaineth its pitch and exaltation and as it were resteth in it till the Child be two years and six months old So that the time of the thickest invasion is that whol year which bears date from the eighteenth month two years and a half being expired the Diseas falleth into its declination and seldom invadeth the Child for the reasons already alleadged But the reasons Why Infants newly born are rarely affected and why from the ninth to the eighteenth month they are frequently affected and why after the first eighteen months they are most frequently affected shall now all of them in their order be produced The First Reasons why Children newly born are very seldom invaded with this affect may be these The First is Becaus the Embryon in the Womb is by the equal heat and embracement of the Matrix strongly fortified against this Diseas as we have declared above and by consequence the same being brought to light doth for a time retain som of that muniment defence which it contracted from that equal warmth of the Womb and therfore presently after the Birth it doth not so easily fall into it The Second is Becaus the Midwives and Nurses do handle them so artificially when they are new born that their condition is not considerably different from that which they possessed in the Womb. For they enwrap the whol Body excepting the Head in one continual Covering wherupon the exterior and first affected parts of the Body in this Diseas are fortified against the injuries of the outward cold and the hot exhalations breaking out from any part of the Body are duly and equally retained by reason of that Covering which is two or three times double and bound about with swathing Bands and equally communicated to all the parts of the Body so that they are cherished with an even heat
and proportion of the Parts becomes more compact firm and stable neither doth it easily come to pass that one part doth much grow out more than another by true augmentation Thirdly We say that excepting the two premised conditions and that in that manner as they are propounded this affect according to the other parts of the Essence thereof although indeed very rarely and upon the highest causes only may happen to Boys Young Men Men and old Men. For first a cold distemper without al controversie may befal them though not so easily as Children Secondly A moist distemper may also invade them but yet only by the limitation propounded Thirdly A want of inherent Spirits may also befal them but then it must proceed from the most potent causes For Chronical Diseases and such as consume the habit of the parts or dissipate it into ayr or wast it by long fasting and an Atrophy do necessarily leave behind them a paucity of Natural Spirits We see the outward parts even in those that are grown to ful age when they are extenuated and consumed by such like causes to wax feeble to languish wither and become destitute of al sufficient Spirituosity Yet we grant that in those that are grown to full age the evil which causeth leanness being overcome the wasted Spirits may soon be repaired by the vigor of the Pulses and that the rudiments and impressions of this Diseas may be rooted out within one or two weeks and by consequence that they are seldom affected with it In the interim if it should so fal out that upon that consuming of the Inherent Spirits some impediment should intervene that might retard their reparation it is possible that this diseas may grow from thence in that manner as hath been said But a numbness of the Inherent Spirits must necessarily follow upon a fewness of them Fourthly The parts of the Secondary Essence seing that they have a strong dependance upon the Primary faults where these persevere long the Organical faults being excepted they may supervene in their order So that we do not doubt but this Diseas may happen to any age after childhood the restrictions which we have now propounded being granted and upon the urgency and perseverance of great and weighty causes One amongst us affirmeth that he had a Gentleman in cure about thirty yeers of age who by dayly immoderare use of Wine and Tobacco continued for some whole years having neglected the due receiving of his meat fel into such a weakness of Stomach that continually every morning he vomited and loathed al kind of Meat and if at any time he swallowed any with unwillingness he presently vomited it up again to appease this queziness of Stomach he was at last compelled to a continual use of ordinary Aqua vitae but afterwards his custome was to mingle it with stale Beer and a quantity of Sugar and with this drink alone he preserved himself alive for many months In the mean time all those parts which in this Diseas we cal the first affected were extreamly lean and became soft loose languid and withered so that he could neither turn himself in his bed nor rise nor walk nor stand upright yet he felt no pain neither was there any privation of sens and motion no cough no uneasy respiration his face was well colored and al the parts about his Head were in a good condition and wel habited so that had you judged of him by his countenance only you could scarce have suspected that he was sick As he lay in his bed he would chat with his Companions take Tobacco by turns and drink that mixture of Beer and Aqua vitae aforesaid The event of the Diseas doth not indeed belong to this place yet we shal set it down to gratify them who are desirous to know it The Physitian being sent for he strictly forbad al intemperance and amongst other remedies having given him one grain a half of Laudanum Londinensis he appeased the nauseous infirmity and tumult of his Stomach which part he likewise strengthned with internal and external applications and prescribed him such a diet as was most easy of concoction Instead of exercise he solicited the heat unto the outward parts with rubbing them every morning having first given a smal quantity of strengthning and opening Electuary made up with a little portion of Steel which he drank in two ounces of Wine composed of Wormwood and Mint a little Saffron being hung in it to give it a tincture three ounces of smal Beer being tempered with it and a quantity of Sugar to make the taste of it more pleasant Moreover he purged him by fits with gentle Medicines and in the evening comforted him with cordials Within twenty days he grew to such a degree of amendment that he could walk abroad for the space of an hour and could without any striving or much weariness climb ladders without any help But afterwards by a relaps into the like intemperance he died in the absence of his Physitian But let us return from this degression into the way direct our speech to our intended scope The Affect being now confirmed as it was upon the first coming of the Doctor Besides the faults of the Stomach it seemed to include a great part of the Essence of this Diseas we now treat of For in the parts subservient to motion namely those that are first affected in this Diseas there was a cold distemper either through defect of motion or by reason of the immunite afflux and dispensation of the Vital Blood Again the softness slipperiness laxity and litherness of those parts shewed that there was a moist distemper in them Also the extream leanness of those parts did sufficiently demonstrate a fewness of inherent Spirits and the unfitness to motion and affectation of rest and eas did strongly witness a numbness in those parts The ful and florishing habit of the parts about the Head when the other parts were extenuated was a forcible reason to prove the unequal distribution of the Blood But the peculiar cause of this inequality in this sick man might be his frequent vomiting whereby a more plentiful afflux of the Blood was driven to the parts about the Head the other being almost destitute of it Any man may perceive by what hath been said that at least the greatest part of the Essence of this Diseas was comprehended in this mentioned Affect From whence at length we may probably infer that it is possible for this Diseas to happen to those of ful growth being considered according to the propounded limitations although it very seldom coms to pass because great causes and length of time are required to the production of it And thus at last we have put an end to the search upon the former Question CHAP. XIX The latter Question Why this Diseas happeneth more frequently in England then in other Countreys And whether it be Natural to Englishmen IT is acknowledged by
suddenly break out and assoon vanish But in this affect the signs do invade by degrees and persevere or else they are dayly more encreased Now the primary Diseases of the Brain are distinguished by their proper Signs And thus much of the Signs which relate to the Animal Actions The Signs which belong to the disproportioned Nourishment of the Parts Of how great moment the Alogotrophy or unequal Nourishment of the Parts is in this affect we have already shewed we shall here therfore prosecute those signs which in some great measure depend upon it and we shall present them as if they were to be beheld at one View First there appeareth the unusual bigness of the Head and the fulness and lively complexion of the Face compared with the other parts of the Body But although this Sign may presuppose some motion of the Diseas before it shine out yet is the Diseas so obscure before the appearance of it that it is accounted in a manner unperceivable Therfore commonly this Sign sheweth it self more or less from the first beginning and continueth till the departure of the affect unless as we have noted before the pining of those parts supervene from some other caus Secondly The Fleshy parts especially those which are full of Muscles beneath the Head which we have listed among the first affected in the progress of the Diseas are dayly more and more worn away made thin and lean This Sign doth not presently shew it self from the begining of the Diseas becaus it pre-requireth some notable motion of the Diseas before it evidently appeareth yet in time it most certainly is exposed to the senses and accompanieth the Diseas to the last step be it either to life or death excellently demonstrating the motion and degree of the Diseas by its encreas Moreover this Sign being conjoyned with the former doth at least constitute a Pathognomonical Sign of the second kind that is such an one as is proper to this Diseas alone and where they are present together they infallibly denote the presence of this Diseas although upon their absence they do not equally signifie the absence of the Diseas Thirdly Certain swellings and knotty excrescences about some of the joynts are observed in this affect these are chiefly conspicuous in the Wrests and somwhat less in the Ankles The like Tumors also are in the tops of the Ribs where they are conjoyned w th grizles in the Breast We have noted abov in our Anatomical Observations that these tumors are not scituated in the Parts but in the very Bones although this consideration doth scarce belong to them as Signs seing that of themselves they are searce conspicuous This Sign doth also suppose some kind of motion of the Diseas neither is it emergent a Principio principiante as the Phylosophers phrase it yet it offers it self as an object to the senses sooner than any considerable extenuation of the parts But where it is present it constitutes a Pathognomical Sign of the Second kind and without dispute witnesseth the Species of the Diseas Fourthly Some Bones wax crooked especially the Bones called the Shank-bone and the Fibula or the small Bone in the Leg then afterwards the greater Shank-bone and the undermost and lesser of the two long Bones of the Elbow but not so much altogether nor so often somtimes also the Thigh-bone and the Shoulder-bone Again there is somtimes observed a certain shortning of the Bones and a defective growth of them in respect of their longitude This by chance was omitted above where we gave the Reason of the Organical faults Yet this affect doth seem to depend upon the same irregular nourishment namely so far forth as the nourishment taken in encrcaseth the Bones according to breadth and thickness more than length From hence it comes to pass that some Children long afflicted with this Diseas become Dwarfs Hither perhaps may be referred that folding in the Wrests the Skin it may be having better nourishment and more growth than the Bones of those parts wherupon it must needs be contracted in the Wrests into a folding or wrinkledness Finally to this place also may belong a certain sticking out of the Bones of the Head especially of the Bone of the forehead forwards For it concerneth the common kind of viciated Figure and the Alogotrophy of the Bones Yet this in the Bone of the Forehead doth evidently seem to depend upon the free nourishment of that Bone in his circumference wherewith it is coupled to the Bones of the fore part of the Head and constitutes that seam called Sâ—tura Coronalis which lieth in the foremost parts therof For herupon it must needs be thrust forwards And indeed in that place it is plentifully nourished without any difficulty becaus this Bone in Children is cartilagineous towards that Seam And this also was pretermitted above where we discoursed of the Organical faultiness becaus we have but lately observed it Fifthly The Teeth come forth both slowly and with trouble they grow loos upon every slight occasion somtimes they wax black and even fall out by pieces In their stead new ones come again though late and with much pain This kind of Sign as also that which we noted in the former Article may be referred to the Synedremontal Signs becaus neither of these is either perpetually present or if it be present it doth not undoubtedly confirm the presence of Diseas Some have imagined that the Bones in this Diseas are transfigurable like wax But we have never seen it neither have we received it from any eye witness who was not of suspected credit Wherfore we reject this Sign as altogether Fabulous Sixthly The Breast in the higher progression of the Diseas becomes narrow on the sides and sticking up foreright so that it may not be unaptly compared to the Keel of a Ship inverted or the the Breast of a Hen or Capon For on each side of the middle it riseth up into a point the sides being as it were pressed down If any demand whether this Sign be solely apropriated and peculiar to this affect We answer That the Breast may be a little encreased in an Atrophy or Phtisick and less than the other parts of the Body and so by consequence it may be narrower but it can scarce so fall out according to the change of the Figure without an Alogotrophy namely that which is proper to this Diseas Wherfore this Sign also when it is present although the invasion of it be tardy must be reputed a Pathognomonical Sign of the second kind becaus when it is present it certainly denoteth the Species of the Diseas though not on the contrary And thus much of the Signs which have reference to the unequal nourishment The Signs which belong to Respiration First The narrowness and sticking up of the Breast already mentioned must be hither referred wherof we then discoursed at large Secondly A swelling of the Abdomen and an extension of the Hypochondriacal parts which hindreth
retard the rooting out of the Diseas Yet in the interim whilst we are busie in the removal of the Causes the Essence of the Diseas must not be totally neglected as we have before admonished Yea when we have so subdued the Cause that it cannot for the present much interupt the Cure we may the Causes not being utterly over-come and cast out the more diligently and earnestly attempt the resisting of the affect yet with this condition That if the Causes revert and becom new impediments that then we are obliged presently to undertake the subduing and evacuation of them so that in this Chronical Affect somtimes the Causes somtimes the Diseas must be resisted by turns and the Spirits do better undergo this change of action than if we should continualy make our battery against the Causes till they were absolutely rooted out Moreover When the Causes of the Diseas in this Affect are unapt for motion by reason of their toughness grosness and perhaps setledness they must first be freed from this impediment and prepared before they are evacuated For according to the Rule of the great Dictator Quae movenda sunt fluida prius facere oportet In like manner that thickness toughness and setledness of matter if it be present indicate Remedies attenuant incident and opening But these things are not safly taken the impurities still flowing back into the first Passages for then perhaps they are carried along with the Medicines into the Veins and more defile the Blood or at least hinder the efficacy of the Remedies These therfore have the nature of an impediment and must be in the first place removed Lastly Universal Evacuants must be premised before Particular and Topical Remedies especially where it is not permitted at once to mind both intentions For the Universal Causes flowing in the Body are easily surrogated in the room of Particular Evacuations and renew the Afflux to the first affected part but the thinner part of Particular Causes and that which is most apt for motion is evacuated but the thicker perhaps is more impacted Wherfore Universal Causes yet flowing to and fro in the Body as considered are Impediments in respect of Particular Evacuation and by consequence must be first expelled The latter Rule was That we must releeve the more urgent and weighty Indicant first unless there be an interuption of som impediment That is termed an urgent Indicant which threatneth the most danger Now every such Indicant is supposed to induce great afflictions into the Body and not without manifest danger to wast the Spirits Therfore in this respect we must somtimes first help the Diseas the Caus being neglected Somtimes also we must neglect both the Diseas and the Causes and adress our endeavors to the pacification of the Symptoms as in a vehement Flux of the Belly long Watchings profuse and immoderat Sweating and the like But even in these cases we must have a prudent regard both to the Diseas and the Causes and when the urgent Symptom is corrected or the violence of the Diseas repressed then we must return to the regular Method of proceeding for this Rule belongs not to the ordinary and legitimate order of Cure but to the Method of Necessity Moreover to perfect the right administration of Indications there is required an exact and accurat knowledg of the Medical Matter whereof we shal discours in the subsequent Chapters CHAP. XXIX The Medical Matter answering to the Indications proposed and first the Chyrurgical THE Medical Matter must be found out by Experience and Analogismes or Arguments drawn by an answerable necessity from the Caus to the Effect although the truth is we conceive not any other Reasonings to be absolutly excluded It is vulgarly and not unaptly distributed into three kinds The Chirurgical the Pharmateutical and the Diatetical Of these in their order The Chirurgical commonly received and approved in this Affect and famous above the rest are chiefly two Scarification of the Ears and little Fountains or Issues But our enquiry as we shal see anon shal be extended to many more namly of Cuppin-Glasses Leeches Blisters Ligatures and Swathing-bands But the opening of a Vein the Spirits cannot brook as every one knows who but observes the frailty of the age the extenuation of the habit of the parts and the smalness of the Veins The Scarification of the Ears shal lead our discours The Empericks who undertake the cure of this Diseas make more of it than one would imagin For in their practice they celerate it with great vaporing and without it scarce hope for a happy cure But we although we disallow not this kind of remedy have seen many Children successfully recovered without the use therof And they themselves who attribute most unto it for the most part take away no considerable portion of Blood Yet some affirm that they have seen a large quantity of Blood drawn away with good event However it be it is credible that those Children do with most ease endure this remedy and obtain most profit by the use of it which are of a Sanguin complexion and wel habited and who are affected with an Alogotrophy rather than an Atrophy or a Consumption or any other remarkable extenuation of the parts Our Practitioners for most part repeat this operation two or three times in a week They seldom do it with an Instrument or sharp Pen-knife but most commonly with an ordinary blunt Knife taking no notice of the pain and crying of the Child Moreover For the most part they perform it in the hollow of the Ear but some extend it to the inward and outward circumference of the upper part of the Ear yea to the whol circumference No man hitherto as we know have attempted the Scarification of the hinder side of the Ear although indeed it is not easie to give a reason why it should conduce less being administred there than in the hollow part Yet it may be lawful for us to offer our conjectures why the hollow of the Ear should be chosen before the other parts for this operation which notwithstanding we will not confidently assert although we suppose we can at least probably assert it if that be true which the most diligent Chyrurgion Fubricius Hildanus hath written in his Observ 4. Centur. 1. de nervo quinti parts For this conjecture is grounded upon this Observation and if that be ruinous this perhaps must perish with it The Conjecture is this The distribution and use of the Nerve and of the fifth Pair before mentioned being supposed Scarification in the hollow of the Ear may very conveniently both free that Nerve from any kind of oppression and likewise shake off the numbness and give it vigor For the hollow of the Ear is the next place unto it which we can come at with an instrument Wherfore evacuation being here made may immediatly drive away the matter which commonly oppresseth the very beginning of that Nerve and withal causing pain and encreasing the
the Chyrurgion which have a primary relation either to the causes of the Diseas or the Diseas it self or the Symptoms It is divided into remedies Internal or External and each of them into Simple and Compound Again the Internal may be subdivided into such as clens the first passagss as Medicines Preparatory Into Electively evacuant and such as are Specifically alterant and Evacuant and finally into those that correct the Symptoms Among these the Internal obtain the precedency and of those again such as wash away the impurities of the first passages becaus these as hath been already observed are justly accounted an impediment in respect of the following remedies and simply ought first to be removed But in all the Titles as far as the Nature of the thing will licens or warrant us we will place the Simple before the Compound Moreover these washing remedies comprehend these three kinds namely Clysters Vomits and Lenitive Purgations The use of Clysters and some forms of them The Injection of Clyster-pipes before we more exactly and earnestly attempt the Cure is then chiefly pre-required when the Belly is costive and the Excrements are hardned or when some windy humors torment the Guts or some vehement pain in the Bowels afflict the Patient In which cases they may not only be injected before any preparation but also before a Vomit yea or a Lenitive Purgation These are frequently compounded of benign and gentle Purgers somtimes also of such as have only a faculty to make the waies slippery and to expel wind but never of Cathartical ingredients that are violent they are to be injected warm or lukewarm and after a long abstinence from meat We shall present some forms Take Cows new-Milk warmed four or five ounces Anis Seeds beaten to Pouder ten grains Cours Sugar one ounce one ounce and an half or two ounces The Yolk of one Egg mingle them and make a Clyster to these may be added half an ounce of new Butter Take a sufficient quantity of an emollient Decoction An Electuary lenitive half an ounce Syrup of Roses Solutive and Syrup of Violets of each six drachms Oyl of Chamomel one ounce mingle them make your Clyster and let it be injected lukewarm Take the Roots of Marsh Mallows beaten together half an ounce or in lieu therof the leaves or Flowers of Mallows half a handful Flowers of Chamomel one pugil Hemp Seeds two drachms boyl them in a sufficient quantity of Whey mingled with Beer To four or five ounces of the Decoction ad of Diacassia or Electuarium Passulatum half an ounce Syrup of Roses Solutive and Kitchin Sugar of each one ounce new Butter six drachms you may if you see occasion ad the yolk of one Egg. Take Stone-Horsdung that is new one ounce and an half The Seeds of Annis Fennel Mallows beaten together of each one drachm and an half Flowers of Chamomel one pugil Boyl them in a sufficient quantity of posset drink In four or five ounces of the Decoction dissolve ten drachms of Syrup of Violets common Sugar and Oyl of Roses of each half an ounce Mingle them and make your Clyster The use of vomiting remedies and some examples of them Emedical Remedies or Vomits do chiefly perform three things First they evacuate crude or corrupt humors and all manner of impurities contained in the Stomach and that by a shorter and more expedite way than if they were conveyed through the involutions and labyrinths of the Guts Secondly By an agitation and commotion raised in all the parts especially the Bowels they loosen the gross and viscous humors adhering unto them or impacted in them and frequently expel them especially those which are collected in the Stomach and Guts in which respect they are profitable against torments of the Chollick and very conducible to unlock Obstructions Thirdly They most effectually irritate the expulsive faculty of all the parts of the Body and especially of the Bowels and by this means many times upon a single application they compel forth the hidden and unappearing causes and fomentations of Diseases and especially of intermitting Feavers For by the very straining to vomit the Guts are also instimulated to cast out by siege The Liver powreth away the Choller by the Biliary Pore the sweet-Bread voideth his peculiar excrement by the new Vessel into the Guts the Spleen also perhaps unburdens in a plentiful manner his excrement into the Stomach by Vessels not yet throughly known The Kidneys exern through the Ureters the Lungs by a strong Cough eject their Flegm through the Windpipe The Brain emptieth it self of salt waterish Rhewms and matter by the Palate the Nostrils and the Eyes Finally the whol Body for the most part is rendred more prone to a Diaphoresis either by a manifest sweating or else by an occult and insensible Transpiration In the mean time it must be noted that not all gentle Vomits nor indeed the more vehement if they be given in too smal a dose wil presently and fully perform all these things yet in their operations they effect more or less according to the strength or quantity of the Medicine and indeed if the stronger be administred in a full dose they effectually attain to the three marks propounded It is obvious by what hath been said to the consideration of any Reader that strong Vomits prescribed in a full quantity are not competible to Children affected with this Diseas neither can their tender strength overcome and subdue so great tumults in the Body and such an Universal evacuation so suddenly wrought Wherfore this kind of remedy ought not to be prescribed to Children without diligent precaution and circumspection and both the strength quantity and efficacy of the Medicine are duly to be prepondred To this end therfore we shall set down some Cautious in favor of unexperienced Practicers First A Vomit is not to be provoked in this Diseas unless the humors tend upwards of their own accord but then indeed they may be expelled by vomiting remedies without difficulty Seeondly Not unless Children are naturally or customarily apt to vomit and do easily endure it Thirdly In Bloud-spitting the Ptisick and Consumption in any flowing of Bloud at the Nose or any internal opening of the Veins and the like cases abstinence must he enjoyned from this remedy Fourthly Vehement vomits exhibited in a larger dose are here forbidden For the fear is just and prudent that they may depopulate the Natural Spirits and further consume the very solid parts which before were over-much extenuated It is necessary therfore that the Vomits here prescribed be either in their own nature gentle or corrected if they be vehement and administred in a lessened dose You wil say If they be of a mild and lenitive faculty or exhibited in a diminute quantity they cannot compel the humors with any efficacy To this we answer Indeed where Nature contributeth little or no assistance it cannot be denied but in such cases we totally prohibit the administration of
the word the name Rickets may be readily deduced from the Greek word Rachitis or Rachites provided That we will but allow that consideration of change which in vulgar pronounciation usually happeneth to words transplanted from one Language to another Object You will say That they which imposed first the English name Rickets were peradventure altogether unskilful in and ignorant of the Greek tongue or that they never thought of the Greek word Rachites at least understood not that the Spine of the Back was the principal among those parts which were first affected in this Disease Answer We Answer It concerns not us whether they were ignorant of or thought not upon the Greek word or whether they did not understand the principal part that was first affected yet are thes things freely asserted For we knew many at that time when the Disease did first spring up and the Name was imposed indeed learned men and skilful in the Greek tongue to have their Residence in those places to whom it was not perhaps any difficulty to observe that conspicuous debility of the Spine in this affect and thereupon they might assign this Name unto it although t is very possible yea probable That the common people by the error of pronounciation might somewhat pervert the Name so given and expresse it as to this day they retain it by the word Rickets But whether it were or were not so we are not at al solicitous If the matter were so the imposed Name will as is manifest be altogether congruous and perhaps also at the last will most fitly correspond with it For suppose you should fall upon some Name received not so much by choice as chance yet so fit that a more comodious Name could scarce be devised by councel and deliberation nor one more consonant to Reason in such a Case What would you do Would you extirpate and banish the receaved word to introduce one that was new and nothing better This practice would usurp upon the priviledge of Conversation and be injurous to the custome of Speaking Words contract a value by their use and ought not to be denizen'd with rashness or innovated by timerity Or would you not rather confirm the Name receaved yet as a new one and from that time to be deduced from a new Origine for this would be at the least like a chosen Science inoculated upon a new stock which by reason of the affinity with the Root would without any difficulty receave strength and nourishment Or if this please you not suppose if you please That we now newly devised the English name of this Disease and deduce it from the Greek word Rachites the English word resulting from hence would be the Rachites and how little is the difference between that and the ordinary word Rickets Certainly so little That the vulgar pronounciation is not wont to be greatly solicitous about so smal a difference But we trifle too much in staying so long upon these trifles Let the Greek Name therfore of the Disease be nósos Rachitis or Rachites if the word may be allowed to be of the common Gender or tes Rácheos in Latin Morbus Spinaliâ— vel Spine Dorsi and by coyning a Latin Substantive out of the greek Adjective Rachitis idis let the ordinary English name Rickets be retained or in stead of it to gratifie more curious ears you may substitute the Rachites And thus much if not too much of the Name CHAP. II. Anotomical Observations collected from the Dissection and Inspection of Bodies subdued and killed by this Disease BEfore we attempt an enquiry into the Nature and Causes of this Disease we hold it convenient to premise some few certain and undoubted things as being obvious to the Senses which both demonstrate the real existence of this Disease and may also be cast for a foundation whereon to build the Superstructure of our judgment opinion concerning this new Disease For we would not have any man to imagine that we here treat of some Fictitious Imaginary Evil much less to expect that our Opinion should be credulously embraced without examination But this we rather aim at That the matter of our Discourse to all possibility may be known and preconceived in the very entrance that we may confirm those things which we shall propose by those things that are obvious to the Senses as occasion shall require and that the Reader being instructed in these may become a competent judge of our Reasons and with the more facility be able to interpose his judgment concerning each of them We attest therfore that many of us have been present at several Dissections of Bodies which have been separated by this Disease and that we will in this Chapter briefly and faithfully declare those things which we have hitherto Observed by long experience and frequent Dissections namely Those things which we have seen with our eyes and have handled with our hands In the mean time Two things are here to be premonished The former is That the Reader carry in his memory That the dead Bodies which we opened were most vehemently afflicted with this disease whilest they were animated for they are supposed for the most part to have yeelded to the very magnitude of the Disease and therefore he must not expect that magnitude of the Affect or Symptoms which we here describe in other Bodies yet living or newly besieged For every Disease is moved to a Consistence and then also Nature being oppressed and unable to maintain the conflict groweth worse and worse The latter is that the Reader take notice That almost all Diseases in processe of time do unite unto themselves other affects of a different kind and therefore that chronical Diseases are for the most part complicated before death Let him not therfore imagine that every preternatural thing that is found in dead Bodies though destroyed by this affect must of necessity belong to this evil for perhaps it may rather have reference to some other Diseaâ—e supervenient upon this before death then to this very Malady And the truth is Anatomists through inadvertency and want of due regard to this Caution have fouly ered in their Observations whilest they ascribe those things which concern another Disease to another wherewith it was complicated before the dissolution The best prevention therefore or rectification of this error is Not to make a rash judgment from the inspection of one or two bodies but first by a reiterated and sedulous experiment to be able to distinguish what things perpetually occur what for the most part what frequently and what but seldome in the dissected bodies that have perished of the same Disease for you must know That whatsoever is not perpetually conspicuous in the opened Bodies dissolved by the same Disease cannot appertain to the intimate and chief Essence of it for neither the Disease it self can have an existence being separated from its Essence nor the Essence being separated from the Disease But enough of these
things let us now proceed to the Observations themselves These our Anatomical Observations are distinguished into those which do extrinsecally occur the Body being not yet opened and those which present themselves only upon the Dissection of the Body I. These of the former kind are they which are outwardly visible upon the first appearance of the naked dead Body 1 An irregularity or disproportion of the parts namely The Head bigger then ordinary and the Face fat and in good constitution in respect of the other parts And this indeed hath appeared in al those whom hitherto we have beheld to perish by this affect one only excepted who together with this Disease had suppurated Lungs and was pined and disfugured with the Physick Yet he also throughout the whole progresse of the Disease was full faced and had his head somewhat big but for about fourteen dayes before he Deceased on a sudden all the fleshy parts about his head consumed away and his face was like the picture of Hippocrates not without the just wonder of all those who beheld so sudden a change 2 The external members and the muscles of the whole Body were slender and extenuated as if they had been wasted with an Atrophy or a Consumption This for so much as we know is perpetually observed in those that die of this Disease 3 The whole Skin both the true and also the fleshy and fattish Membrane appeareth lank and hanging and loose like a Glove so that you would think it would contain a far greater quantity of flesh 4 About the joynts especially in the wrests and ankles certain swellings are conspicuous which if they be opened not in the fleshy or membranous parts but in the very ends of the bones you may perceave them to be rooted in their appendances and if you will file away those prominencies of the bones you will easily perceive them to be of the same similary substance with the other parts of the bones 5 The articles or joynts and the habits of all the external parts are less firm and rigid and more flexible then at another time they are observed to be in dead bodies and in particular the Neck after death is scarce stiffe with cold at least much less then in other Carkasses 6 The Brest is outwardly lean and very narrow especially under the arms and seemeth on the sides to be as it were compressed the Stern also is somwhat pointed like the Keel of a Ship or the breast of a Hen. 7 The top of the ribs to which the stern is conjoyned with gristles are knotty like unto the joynts of the Wrest and Ankles as we have already said 8 The Abdomen indeed outwardly in respect of the parts continent is lean but inwardly in respect of the parts contained it is somwhat sticking out and seemeth to be sweld and extended And these have been our Observations before the opening of the bellies II. The Abdomen being opened we have Noted these things 1 The Liver in all that we have dissected hath exceeded in bignesse but was well coloured and not much hardned nor contaminated by any other remarkable vice We desire som bodies should here be excepted in which other Diseases before death were complicated with this as in a Dropsie an extream Consumption we remember to have hapned 2 The Spleen namely so far as hitherto it hath been lawful for us to observe for the most part is not to be contemned whether you consider the magnitude the colour or the substance of it notwithstanding we do not deny but it may otherwise happen in regard of a complication with other Diseases 3 We have sometimes espied a wheyish water to have glided into the cavity of the Abdomen but indeed not often nor in any great plenty 4 The Stomach and Guts are somewhat more infected with flatulent humors then sound bodies usually are which partly may be the cause of that extension of the hypochondriacal parts above mentioned 5 The Mesentery is sometimes faultlesse and sometimes affected with glandulous excrescences bigger then ordinary if not with swelling bunches But concerning the sweet-breadwe declare nothing for a certainty only we suspect that obstructions if not a schirrhus may sometimes invade that part But thus we delegate to the enquiry of others 6 The Kidneys Ureters and Bladder unlesse there be a concomitancy of some other Disease are laudably sound We observe in general of all the Bowels contained in this Belly that although the parts containing them as we have noted above are very much extenuated and emaciated yet are they as large and as full if not larger and fuller then those seen in sound bodies as hath been said of the Liver III. The Sterne being with-drawn these things have presented themselves in the breast 1 A certain adherence or growing to of the Lungs with the Pleura which hath been more or lesse discernable in all the Bodies which hitherto we have cut up Yet we suppose that this affect may happen without any such nourishment although in the advancement of the Disease for the most part it cometh before the Patient die 2 The stopings or stuffings of the lungs are no less frequent especially in those coadhering parts Hard humours also engendered by a thick viscous and blackish bloud sometimes in one sometimes in many of the strings of the Lungs yet are not these alwayes conspicuous many times also Imposthums and Ulcers 3 One amongst us doth attest That he once saw glandulous knobs and bunches so numerous That they seemed to equallize if not exceed the magnitude of the Lungs themselves They were scituated on both sides between the Lungs and the Mediastinum that is the Membrane that divides the middle belly and were extended from the Canel-bone to the Diaphragma 4 In the cavity of the Breast we have sometimes seen a collection of wheyish waters indeed more frequently then in the cavity of the Abdomen but not in all 5 One amongst us hath likewise seen this affect complicated with a great Impostume and with the Ptysick the Stern being removed all the Lungs on the left side were infected with an Impostume and on every side growing to the Pleura and the humour being lightly crushed a copious thick and stinking Matter of a yellowish colour flowed out thorow the sharp artery into the very mouth The outward Membrane of the Lungs whereby they firmly adhered to the Pleura appeared thicker then ordinary and by the mediation of it the strings on that side did so grow together that you could scarce distinguish them â—or such the same Membrane also involved both the Lungs and also the Impostume it self which being opened the magnitude of the Imposthume was discernable which by the estimation of those that were present contained at the least two pound of water 6 The kernel in the Canel-bone in Childhood is alwayes observed to be great and perhaps greater yet in those who have died of this Disease IV. The Skull being
But in the second place we affirm that the implanted heat doth differ frō the hot implanted temperament for the implanted heat is only a part of the hot implanted temperament for not only a Spirit but sulphur also and salt or perhaps choler contribute their heat to the constitution of the whole hot implanted temperament wherof the implanted heat is only a part Wherefore it is fasly suggested in the propounded argument that a plenty of Spirits is the sole cause of a hot distemper and a paucity of a cold distemper for a pound of the flesh of an infant containeth more implanted Spirits then a pound of a yongmans flesh yet it is most evident that the temperament of a yong man is far more hot then that of an infant a hot temperament cannot therefore depend upon the sole plenty of the Spirits nor a cold temperament upon a want of Spirits Moreover in many maladies a hot distemper is consistent with a paucity of Spirits as in a Hectick of the third degree in like manner of a cold distemper with a competent plenty of Spirits as in the Green sickness We say thirdly That a plenty or paucity of Spirits is not perpetually a sufficient cause to determine the temperament either hot or cold as on the contrary neither doth a hot nor a cold temperament certainly and necessarily demonstrate a plenty or paucity of Spirits as is manifest from the instance given So that the temperament is no sure sign of the quantity of the Spirits nor the quantity of the Spirits a sure sign of the temperament and therfore purposeth not without just cause these things come to be considered and examined as contradistinct if we wil procure a certain and inconfused knowledge of them Fourthly we answer That although it were granted that the implanted heat is subjected in the implanted Spirits yet notwithstanding that heat is not intended nor remitted according to the sole plenty or paucity of Spirits for the Spirits howsoever sufficiently copious yet if they be too much fixed torpid and as it were frozen they exhibit not any implanted heat worthy of consideration As for example the white of an egge swelleth with copious Spirits yet are they so benummed and the inward heat is thereupon so small that it obtaineth not the formation of a chicken unless it be first excited by incubation or some such other heat therefore we may lawfully conclude that a consideration from the want of Spirits is sufficiently distinct from the consideration of a cold implanted temperament although the objected argument doth seem to insinuate the contrary Moreover from this fourth article of our answer there resulteth a fourth assertion of the essence propounded Namely That beside the distemper and want of Spirits a certain benumdness of them must be added as a distinct part also of the essence of the disease This benumdness of the engraffed Spirits appeareth chiefly by the defective nutrition and aversation from exercise which proceed not primarily as we have proved above from any defect of the influx of the brain It is also manifest from hence because all those things which drive out that stupefaction of the Spirits although they do not altogether drive it away yet they conduce very much to the cure of this disease as exercises of any kind augmented by degrees frictions anoyntings c. and things inwardly taken of a heating cutting purging and gently opening quality But that this benumdness is sufficiently distinct from the want of Spirits besides that which we have said in the 3. article of our Answer is sufficiently manifest from hence because an excessive excitation contrary to a benummednes is often conjoyned with a penury of Spirits as it commonly falleth out in a Hectick feaver in dissolving fluxes and the like diseases in which howsoever there be a want of Spirits yet no benummedness is consociated but on the contrary that vehement excitation propensity to motion must be restrained On the contrary copious Spirits may consist with a benummedness as in wheat or meal For although it may seem to have but little Spirit because the Spirits of it do yet lurk in their fixation and benummedness yet indeed the Spirits do abound in it and may be summoned out by a simple fermentation and excited to a manifestation of their activity As strong Beer made thereof doth plainly declare In like manner juice newly pressed out of immature grapes is very mild and pleasant containing in the mean time plenty of Spirits which afterwards the due fermentation being finished reveal themselves in generous wine Let us conclude therefore that the benummedness of the Spirits in this affect deserveth a particular and distinct consideration CHAP. VI. Of the Part first affected in this Disease WE have already propounded the first Essence of this Disease it remaineth now that we enquire after the first Subject in which that Essence is radicated The heart and the brain do here seem rightly to be excluded for the reasons before alleadged the repetition whereof for brevity sake we shal omit The liver and the Lungs are not as yet exempted from all suspition of this fault we wil therfore examine these bowels apart and first we demand Whether the Liver be the subject of the first essence of this Disease The principal Argument is for the Affirmative because this Disease may seem to proceed from a vicious sanguification the Shop and Work-house whereof at least in probability the Liver is supposed to be but that a viciated sanguification is the first origine of this disease seems to be made manifest by many signs First because this disease for the most part followeth after many other great diseases either acute or chronical which in great measure have beforehand weakned the sanguifical vertue of the Liver Secondly Because this disease doth not only depend upon outward but inward causes namely the vicious humors And seing the vicious humors are generated in and with the mas of blood in the liver the first essence of this affect seemeth to be referred hither Thirdly The Liver is perpetually observed to be bigger than ordinary in this affect which manifestly witnesseth the Liver to be affected Fourthly those internal Medicines which have a faculty to putrifie the blood are requisite to the cure of this disease and being exhibited are found to be very profitable 5. The missian of blood from the veins of the ears which is not the meanest help to vanquish this affect doth more than sufficiently argue some fault to be in the blood which seemeth to be ascribed to the constitution of the Liver in as much as it doth sanguificate These Arguments have so far prevailed upon some very famous Physitians that thereupon they have attributed the first essence of this disease to the Liver alone But we conceive that these things may be sufficiently answered if we shall first grant what can be further or what hath already been rightly said concerning this matter and then dissolve those things
parts it be little and slow and in others great and swift that must be reputed unequal and disproportionate And this is the State of the present disquisition It is manifest by what hath been said That the stribution of the Blood thorow the parts first affected is extreamly sparing and slow It remaineth therfore only that we consider whether it be transmitted thorow the other parts with a quicker and more plentifull motion We have already affirmed that the root of this evil is not fixed in the Heart it self and that this Bowel of it self is not primarily il affected in respect of the left Ventricle therof It is credible therefore that the Heart unless perhaps som other Diseas be conjoyned or supervene doth rightly execute his function and expel a sufficient quantity of Blood for our turn by every stroke into the Aorta Seing therfore as hath been already proved that the Blood is niggardly dispensed from the Aorta into the first affected parts a superfluous portion of it must needs be distributed into other parts not so affected for otherwise the Aorta should not sufficiently discharge it self nor disburthen the Blood received from the Heart but it would be obstructed and oppressed with the plenty therof and this repletion upon every slight occasion would fly back even to the left Ventricle of the Heart and there kindle a Feaver And we grant indeed for this very caus among others that in this Diseas a Feaver is easily and frequently produced But seing that the Feaver is another Diseas conjoyned and separable and different from this and seing that this Diseas very often happneth without a Feaver it must needs be granted that by how much more sparingly the Blood is distributed to the first affected parts by so much the more plentifully convâ—â—ed to the other parts at least in the absence of the Feaver For seing that quantity of Blood as we said even now is extruded into the Aorta as may suffice the whole Body and seing al of it must be distributed into several parts it most plainly follows that the less is transmitted into one part the more is dispensed into another And thus it may be perceived that the inequality of the distribution of the Blood is inferred from the sole diminution thereof in the first affected parts above asserted at least probably namly from the smal and slow current of the Blood thorow the parts first affected there may be rightly collected à more quick and plentiful stream of it into the inward parts not so affected Now let us see whether the other appearances relating hither are correspondent to this Discours First It seemeth manifest by what hath been alleadged that the Head the Brain the Liver and the other Bowels are not afflicted with that cold distemper nor that stupefaction and penury of inherent Spirits wherwith the parts primarily affected are opprest For the bowels and the said parts do not receive their Nerves from the Spinal Marrow without the Skul but they are involved in the same condition with the other parts Moreover those parts as far as we can judg by the touch are at least outwardly moderatly hot and as far as we can guess by the sight they retain their native and florishing color besides they are more ful and fleshly then the first affected parts Moreover Children afflicted with this Diseas have an indifferently good appetite they do not il concoct the introsumed aliment and about the Head they retain their senses very acute they see they hear they tast they smel as subtily as others and as for their wit they many times surpass those of equal years with them unless an impediment from some other caus All which things put together do abundantly witness that a cold distemper nor a benummedness or penury of Inherent Spirits hath none or at least a very smal predominancy in those parts These things being granted we must likewise needs grant that a more liberal distribution of the Blood is dispensed to the said parts For as for the heat we have already shewed that that doth both amplify and stir up the Arteries to send forth a stronger pulsation and we have also noted above that the plenty of the Spirits doth not only cherish the pulsificative force of the Arteries and conserv the vigor of the Blood contained in them but that it doth somwhat enliven and excitate both of them and that by so much the more effectually by how much the less the inherent Spirits are affected with a stupefaction Secondly unless those parts were watered with a more liberal circulation of the Blood they would becom more soft loos and feeble then they are even as the parts first affected are observed to be For upon the defect or languishing of the Puls in any part the part presently becoms loos and weak as it happneth to al the Parts in a Lipothymy On the contrary when the Puls beats strongly the Part wherunto it belongeth is seen to be somwhat rigid and swelled For a ful Puls doth presently fil up those parts which were before sunk down by emptiness as the Lypothymy being driven away and the Puls being restored the Parts of the Body which were before loos and languid are not only wel colored but ful of vivacity and turgid seing therfore that those Parts are not affected with that softness loosness and weakness we must conclude that they are actuated with a full Puls Thirdly The very augmented magnitude of thes parts in comparison of the parts primarily affected in this Diseas doth witness that they are more liberally fed with their aliment namly the Blood which is reputed the common and last aliment of the Parts for otherwise scarce any sufficient reason can be imagined why when the first affected Parts are so extenuated these should be especially the Brain and Liver in so good a condition so ful and so plump The same thing is confirmed by the lively color of the same parts For if the Puls languish in any part somwhat of the fresh and amiable color presently retireth from that Part. Fourthly The Arteries called Carotides and the Jugulary Veyn which belong to the Brayn and the parts about the Head are observed to be very broad in this affect but the Vessels tending to the first affected parts to be unduly slender from whence we may clearly infer That the dispensation of the Blood to those Parts is unequal And here we intreat and beseech those who have an opportunity to open such Bodies as this affect hath destroyed that they would accurately contemplate whether the swelling Arteries inserted into the swelling parts of the Bones do more liberally and more commodiously transmit the Blood into those than into the other less nourished parts of the Bones and whether the Arteries of those parts are more broad than of these Although indeed we confess that this enquiry is most difficult both because of the slenderness of those Arteries and in regard of the obscurity of their
Inherent Spirits Hither also belong sharp saltish hot and discussive Baths especially if they be unseasonably and unmeasurably used for these no less then the former do wast and consume the Spirits Fourthly and lastly An Air filled with Narotical vapors or exhalations and baths fomentations and Liniments made of Soporiferous and Narotical ingredients as Hemlock Henbane Opium Nightshade and the like and externally applied are very fitly reducible also to this Classis For they easily introduce a benummedness into the first affected Parts into which they first conveigh their force Which benummedness is not only it self a part of the first Essence of this Diseas but it also easily dulleth and diminisheth the Vital influx in those parts and consequently is also a caus of that part of the Secondary Essence of this Diseas which consisteth in the Vital Constitution which thing we have already explained more at large And thus much of things outwardly occurring Secondly Of Meat and Drink and things inwardly taken To this Title there belong first aliments of any kind which are too moist and cold for these things manifestly cherish the distemper wherin a part of the Essence of this consisteth Hither therfore we refer most kind of Fish and crude Meats which are not well prepared by Coition also all those things whatsoever they be which caus a defect of concoction in the Ventricle Therfore the feeding upon new Meat before the former Aliment is concocted is very hurtful for Children disposed to this affect and in this respect a plentiful Diet is altogether to be abandoned and a thin spare Diet ought to be observed for too liberal feeding doth overwhelm and choak the heat and therfore must needs accumulate many crude and raw humors And perhaps this one may be reputed among the especial causes why this Diseas doth more frequently invade the Cradles of the rich then afflict poor mens Children In like manner cold moist Medicines taken inwardly and also such as are laxative and endued with an internal slipperiness do manifestly relate hither For these things do not only infer a like distemper but they produce a Relaxation in the Tone of the parts and affect them with an internal slipperiness and in a word they render the current of the Blood through the first affected parts over slippery and easie Secondly Nourishments that are too thick viscous and obstructive belong hither especially becaus they interrupt the equal distribution of the Blood Hither we refer flesh hardned with smoke and seasoned with much Salt in like manner Salt Fish and Cheese almost of any kind plentifully fed on Bread newly taken out of the Oven and not yet cold also almost all sweet things condited with Sugar unless they are withal tempered with Wine or cutting or attenuant Obstructive Medicines likewise of any kind belong hither unto which we may further ad such as are Partotical and whatsoever being drank induce a benummedness into the parts Thirdly Nourishments that are of an extream hot and biting quality sharp corrosive as old strong Wines especially being drank upon an empty Stomach Meats also that are seasoned with much Pepper and aromatical Sawces must be connumerated among the reputed causes of this affect For these things in such a tender consistence of the Parts do easily feed upon and devour the inherent Spirits The same thing is also affective by Medicines that are immoderately hot and discussive yea these are far more powerful to hurt becaus they more quickly and forcibly spoil the inherent Spirits than the prementioned Nourishments Thirdly Of Motion Rest Exercises and Actions Motion and Exercises if they exceed a mean they dissolve the Body of a little Child into a profuse Sweat and withal they somwhat dissipate the inherent Spirits of the Parts and therfore for that reason they may conspire the introducing of this Diseas although we conceive it falleth out exceeding rarely that Boys are infested with this Diseas wherof we discours But a defect of Motion and want of Exercise doth most frequently yea and most effectually concur to the production of this affect For the Spinal Marrow and the Nerves from thence arising and the other first affected parts serve chiefly for Motion and Exercises A stupidity therfore and sluggishness of those parts is a caus that neither their inherent heat is sufficiently cherished nor that heat extenuated nor the cold distemper stealing in banished nor the excrementitious and superfluous moistures expelled by a due transpiration but it permitteth them to be affected with a certain softness loosness and internal lubricity wherupon the Arteries also destributed unto them are faintly irritated yield a dull and slothful Pulse neither do they render the parts somwhat turgid or swelled but leave them lank and subsiding By which means the circulation of the Blood becomes slow and lesned and more slippery than is meet the production also of the vital heat must thereupon be necessarily be feeble and weak all which considerations do sufficiently evince that this is an efficacious caus of this Diseas Fourthly Of Sleeping and Watching We grant that Children should sleep oftner and longer then Men yet if it be excessive even in Child-hood the matter is the same as in defect of exercise and motion For sleep is a certain rest and privation of watchings or of the exercise of the senses But watchings consist in the very exercise of the senses according to Aristotle in his Book de Som. Vigill Wherefore the evils that we have described to arise from the defect of motion and exercises the same also must needs happen from immoderate sleep On the contrary in that tender age inordinate watchings are no less noxious For they do not only retard the concoction of the aliment but they likewise taint the Blood with a kind of acrimony and consequently dissipate the Principals of the Natural Constitution of the first affected parts and without difficulty introduce a defect of inherent Spirits Fiftly Of things preternaturally cast out and retained All the internal causes of Diseases might be perhaps not incommodiously reduced to this title For any thing whatsoever contained in the Body and preternaturally altered as they are preternatural they indicate their ablation and may so far forth be reputed among things to be cast out which are nevertheless preternaturally retained But we more rightly grant that all internal causes may be distinguished into two kinds one wherof containeth those things which are preternaturally retained and cast out the other such things as are contained in the Body being preternaturally altered For these latter are not only taken away by casting out but also by Alteration they may be reduced to an agreeable proportion of Nature However it be there is a great affinity between the Humors vitiated by Alteration and the excrementitious Humors which are retained For there are so many and such various ways of casting out in the Body that scarce any humor can be imaginably produced by Alteration which doth not
over whom they prevail But which way soever they happen they scarce continue so long as with sufficient efficacy to imprint this benummedness in the Natural Constitution of the parts Yet we grant that these affects may if perhaps they persist longer with life affect the Natural Constitution with that benummedness so that this Diseas may follow thereupon although we can neither justify nor assert it upon the credit of a single observation But the Diseases which do most frequently introduce an astonishment in the Natural Constitution of the first affected parts are those very same which hinder Children any way from ordinary actions and due exercises especially from the use of their feet as the luxation fracture or som wound of a foot or thigh or the leg or the Back-bone also tumors and pains or the like affects whether they afflict the parts aforesaid or others provided that they hinder the Children so that they cannot walk or play standing upon their legs or use any Masculine Exercises For hereupon by degrees the rigor and heat of the external parts waxeth dul which in this evil are the parts first affected and from thence the other parts of the Essence of this affect follow by an uninterrupted and linked succession as whosoever wil may see above We have now run over the Causes of this Affect and should in the next place proceed to the differences therof but that two difficulties do here interpose themselvs which properly result from a higher consideration of the Causes propounded For al those Causes now alleadged seem as wel common to Boys of big growth as to Children whereupon it may very pertinently be enquired How it comes to pass that they which are grown to mans Estate are not infested with this evil as wel as Children Then again Seing that the Causes propounded are al of them almost common both to England and many other Countreys som of them to al Climats of the Earth It may be demanded in the second place Why this diseas is more frequent and rife in England than in other Countreys These Questions we shal examine in order and shal freely deliver our judgment concerning them CHAP. XVIII The Former Question WHy they which are elder in years are not equally obnoxious to this Diseas as Children The terms of the Question seem to insinuate that this Affect may happen though very rarely to those of big age But we reserve the solution of this doubt til the close of the present determination Therfore in the mean time the Constitutions or dispositions both of Children that are chiefly obnoxious to this Diseas and also of bigger Boyes which are rarely subject unto it must be opposed and every way considered and thought on also of Youths Men and Old Men and that in order and relation to this Affect For the Question is not absolute but comparative therfore the first and best way of determining it wil be by a mutual comparison between the different dispositions of the said Subjects how they admit the impressions of the propounded causes either with case or difficulty Then certain accidental and peculiar conditions of Yong Children under such an age must be likewise considered in respect of which they are under one age rendred more under another less obnoxious to this Diseas That we may the more succesfully declare the former comparison we will distinguish the ages of men Here we comprehend Children of six months of age a year old two three four years old there we understand those of five years of age or more Youths Men and old men and those we cal by the general name of Juâ—â—ors and these by the name of Seniors unless pâ—â—â—â—ps the matter may require a subdistinction of the gâ—â—â—â—er sort these things being premised we ad 〈◊〉 our sâ—lvs to the collation First The yonger Children are of a colder temperament than the Elder For the heat of the temperament is augmented from the time of the birth to mans estate at which time it standeth at a stay being far more intensive than that of Children but afterwards it declineth by degrees unto extream old age and a little before that extream age it falleth into the same degree as it held in the time of Child-hood but before the approach of this term of extream old age the temperament of aged men is more hot than that of Children for although yong Children may enjoy a greater plenty of Natural heat and abound with Natural Spirits yet there is no necessity that they therfore must be of a hutter temperament for there is required a concurrence of many things to constitute a hot temperament beside the inherent Spirits and the inherent heat as for example a large portion of Chollerick humors and withal or chiefly a strong endeavor of the Vital faculty namely in the pulses and the Vital Spirits in their circulation Seing therfore that the yonger Children are more cold it is no wonder if they be more subject to cold Diseases than others such as this is As for old men especially such as are inclining to extream old age we grant that they also are more cold and upon every light occasion obnoxious to cold Diseases Wherfore from hence namely from the coldness of the temperament we infer no difference between yonger Children these old men in respect of an aptitude to fall into this affect Secondly The yonger Children are more moist than the elder for to wax old if it be taken in a sound sence is to wax dry For although old men after their manner may be likewise obnoxious to moist affects as Cathars Obstructions a Cachexy a Dropsie a Palsie a Lethargy a loosness and trembling of the Nervs and the like evils yet really there is some difference between a moist distemper which happeneth to Boys and that which befalleth aged Persons For in Children an adventitious humidity constituting the distemper doth not only penetrate the most retired substance of the solid parts but they are totally incorporated with the same But in old Men the solid parts even then when it is endued with a moist distemper doth not seem to part with its earthiness but to be in some sort compounded of that Earthy Nature and a certain adventitious crude and moist Juice or else an excrementitious drunk into the pores or into the substance of the parts yet it is not sufficiently incorporated or united For as sand being drenched in much water retaineth al its Earthy substance however it be somwhat moist So also the Bodies of old Men however they may be moystened with crude and excrementitious humors yet do they not deposite that terrene substance or that part which by the Chymicks is designed by the name of a dead Head which they dayly accumilate unto themselves from their first beginning This distemper therfore of old Persons is spurious not genuine crude and not perfectly digested into the substance of the parts And therefore although we grant that old men may in their way
of the complexion wherby they maintained the former resistance may fall at last into some common Diseas For the Plica of Poland and the Scurvy are common Diseases to the Sarmatians Polanders and the Inhabitants of the Baltick Ocean and they are likewise new Diseases and as all men confess totally unknown to the Ancients But to this day it is not known that any notable or remarkable Change or Innovation hath hapned to those Regions before the breaking out of those Diseases to which you might probably ascribe the beginning of a new Diseas Wherfore we ought rather to say that those new Diseases did proceed from some ancient and original fault of the places and yet that they did not bewray themselves at first by reason of a peculiar resistance made by the Natural strength of the Inhabitants For to this very day some Families in those places are free from those Diseases and very credible it is that they may so persevere not yielding to the injuries or threatnings of the Region Secondly A new common Diseas may result from the altered or innovated constitution of the place Such kind of innovations happen in Countries either by Earthquakes or Inundations of Water or the bursting forth of some new pernicious Springs or perhaps of some new Mineral Exhalations from the Caveous of the Earth or from some malignant Aspect of the Stars and the like Causes Thirdly A new common Diseas may proceed from the incongruity of the Place with the complexion of the Natives Such kind of Diseases chiefly happen to Nations when they transplant themselves from one Region to another especially when the Constitutions of those Countries which they go to possess are very different from those they forsook So the English who first inhabited Virginia were frequently afflicted with a swelling of the Abdomen and the Hypochondriacal parts who upon their return to England were cured without any difficulty but they who continued in Virginia were not so easily restored to health Moreover National and common Diseases differ among themselves Becaus some of them totally depend upon the inclemency of the Region and others in part only The mortification of the parts seemeth to be of the first kind which befalleth men in the Northern Tracts near the Poles For the whol Essence of the Diseas may be ascribed to the cold and sharpness of the Place Of the second kind the Venereous Pox among the West-Indians seemeth to be For there it is conceived to be partly gotten by impure Copulation and partly to be contracted from the Insalubrity of the place In like manner the Bloody Flux is predominent in Ireland depending partly upon the constitution of the place partly upon an erroneous and preposterous diet And thus much in general be spoken of the differences of common Diseases In the next place we must enquire why this Diseas is more rife in England than in other Regions And by the way it must be observed Whether and how far forth this Diseas may be said to be Natural to English men First it must be observed that England is an Island which borroweth some humidity from the adjacency of the Sea and some frigidity from the distance from the Equator then that it aboundeth with innumerable fountains discovering their Springs almost in al places Lastly That it is watred with many and frequent showers of rain more than other Regions All which things do sufficiently attest the frigidity and humidity of the place Seing therfore that a cold and moist distemper is a part of the Essence of this Diseas we may easily infer that the bodies of the Inhabitants are here more inclined to those distempers then in other hot and dry Countries If therefore you demand Whether this Diseas at least considered in this part of it may rightly be said to be natural to English men We answer That in som sort it may although perhaps not properly namely so far forth as the same is attributed as natural to other Regions alike cold and moist although perhaps it may not yet be observed in them For those Countries are as readily disposed to imprint a cold and moist distemper as England it self Yet it must be observed that a cold and moist distemper is a common part of the Essence of this Diseas and that it alone doth not manifest the Affect for every cold and moist distemper doth not introduce this evil Wherfore although we grant that an excess of cold and moisture may be imputed as a fault to England yet we deny that from thence it can be rightly inferred that the whol Diseas is common and Natural to English men Moreover Some Countries may perhaps be found out far exceeding England both in cold and moisture as Scotland Holland Zealand Ireland and Denmark and the like wherin notwithstanding this Diseas hath not been observed to appear much Therfore if this Diseas be not rightly imputed to these Regions wherein that common cause is predominant namely the excess of cold and moisture Certainly neither can it justly be imputed to England by reason of that common Cause which is here less prevalent Again The coldness and moistness of this Kingdom doth not so far transcend a a mediocrity but that by outward and inwaad applications exercises and the like namely a right use of the six things not Natural they may be sufficiently corrected to the cashiering of that imputation Wherefore if these things be so namely if a cold and moist distemper be only a common cause of the Diseas if other Regions wherein this Affect hath not yet been observed to make any impression are at least equally obnoxious to cold and moisture Finally if those distempers may be prevented by a Regiment of diet appropriated to the place certainly the reason drawn from the coldness and moisture of the Climate which even now we produced to shew why English men should be more frequently invaded with this Diseas then others will be very weak and insufficient so that we can by no means place our content in that alone and therefore we intended nothing more by that assignation than that England doth more dispose the Bodies of the Inhabitants to this Affect than hotter and drier Regions do the Bodies of their Inhabitants And â—o we proceed to the search of the other causes of the rifeness and frequency of this Affect In the second place we can note that England is very ruitful and Child-breeding being sufficiently favorable both to Conception and Child-bearing and not ubject to cause abortions Now from hence it comes to pass that not only strong and able bodied men and such as are endued with perfect health but the weak and sickly persons do also generate weak unsound women likewise and such as are prone to a consumption do conceive carry their children nine months and bring them forth in a decent and laudable manner But it is no wonder if the Issue begotten by such matter and which oweth its life almost to the clemency
of the place alone should be feeble and languid and very subject to this Diseas For as much as the very benignity of the Region may in this respect be the occasion of some infirmity in the Issue For as barbarous People in time past by an inhumane experiment upon their new born infants namely by dipping their naked bodies in the coldest water destroyed the weak ones with the extremity of the cold and gave education only to the strong ones whose vigorous Constitutions overcame the injury of their cruel policies purposing by that inhumanity to have an universal race of strong lusty people So on the contrary the very clemency of the place promiscously preserving the languishing and weak Children together with the strong healthful doth minister an occasion of bringing forth a mixt kind of people some strong and some weak and sickly Yet least any should mistake we do not mean that all the Children in this Kingdom which are born of weak and sickly Parents are subject to this Affect For although if one or both of the Parents be infirm the Children will be infirm yet it is often seen that when the Parents have been very strong and healthful yet their Children have been very subject to this Diseas Wherefore neither do we rest in this second cause but another must yet be enquired out from whence we may derive a sufficient reason of the frequency of this evil We affirm therfore in the third place That the rifeness of this Diseas in England hath been much promoted by that long and secure peace which we enjoyed before the first breaking of it For by this the more wealthy families which were first invaded by this evil and which doth stil infest them more than others had addicted themselves to idleness and a loose and effeminate life and therupon they fel into a moister softer and degenerate Constitution and such as was less purged and cleansed from excrementitious humors and by consequence their Children were even procreated obnoxious to this Affect You wil say that Scotland and the Northern parts of England although they enjoyed peace and security yet they are seldome observed to fal under this Affliction We answer True it is that Scotland and the Northern parts of England are less affected with this Diseas than the Southern and the Western In the mean time peradventure the first impressions and rudiments of it are far more frequent in those places yea and in some forraign Countries then is commonly beleeved For although this evil be very familiar in the South and West parts of this Kingdom and very wel known among the Vulgar sort yet we have many times seen Children afflicted with it in a slight manner of whom neither the Parents nor others of the same family did suspect the least evil Yea we have known many whom none of their friends thought to be affected to be healed without any help of Physick by the sole benefit of the increased heat or by the increase of age or exercises How much easier therfore may the first rudiments of this Diseas be concealed from them to whom it is less familiar and among whom it seldom ascendeth to that degree that they need to implore the Physitians help We conjecture therfore that this Diseas is more frequent then is commonly beleeved both in Scotland and the Northern parts of England yea and in some Countries wherin the people are ignorant of it to this day but in those places they are so gently tormented with it that they are seldom condemned to the hands of the Physitian For that is the custome of the Vulgar sort not to send for the Doctor especially to Infants and yong Children unless the vehemency of the Diseas constrain them However the matter is we seem not yet to have given satisfaction to the objection propounded Why the South and West Country men of England are more grievously frequently conflicted with this Diseas then the Northern People and the Scots although both Kingdoms equally shared the blessing of the lasting peace and security Therfore we grant that a higher reason yet must be given for this difference Fourthly therefore and lastly we say That the cause of this difference is the affluence of all good things in these Southern and Western Countries of England For this part of the Kingdom is much the more fruitful rich and florishing and abounding with al manner of allurements to pleasure Therefore it is no marvail if the customs of men do first generate here their Spirits decay and the strength of their Bodies begin to dissolve now that this degenerate and delicate manner of living doth weaken families is a truth so solidly and constantly attested by Historians that it were an impertinence to offer any proof of it For you may observe that the most Noble and Gallant Families have been very much reproached for these very causes yea and sooner or latter somtimes totally extinguished and so much the sooner as they have the more refused to undergo labors and to innure themselvs to masculine exercises Neither are families ever plunged in a greater danger of degeneration then when they abound with al good things and lying open to plenty and security they are most powerfully invited to delicatness idleness and effeminateness without any labor care and solicitude Who was more rich secure and effeminate than Solomon He left Rehoboam a degenerate Son behind him And perhaps the family of Henry the 8th is extinct for the like cause We could heap up almost innumerable examples to prove this if it were needful However it be we see plainly that this Diseas doth more frequently and vehemently invade the families of the wealthy than the cottages of poor men and therfore it ought not to seem strange that it likewise infested the richer and more pleasanter parts of the Kingdom namly the South and West before the North parts But these things shall suffice to have been spoken concerning this matter It remaineth only that we enquire Whether and how far the three last assigned causes relate to the denomination of a Common Diseas and whether in respect of them this Diseas may be ascribed to England as common and Natural You must know then that these three causes in as much as they depend upon the Region are not properly causes neither by their own nature do they produce this affect but that they are only an occasion wherby this Diseas may accidentally arise For in themselves they denote the laudable conditions of a Country at least they infer not what is culpable in it For who can accuse his Country because it favoreth the procreation of Children much less make outcries against it because it enjoyed long and secure peace Finally least of all calumniate the pleasantness fruitfulness and affluence of all good things For all these things are in themselves blessings and conditions to be wished for in a Country Seing therfore as we have shewed above that a Disease properly common doth
the species of the Diseas is put out of al doubt But that a Sign proper to one Diseas alone although not in the fourth manner whether it be simple and solitary or compounded of a concours of many together may suffice when it is present to make a Sign truly Pathognomonical It is manifest from hence becaus when it is present it doth as certainly and infallibly denote the species of the Affect as a Sign doth which is proper in the fourth manner For that which agreeth to one species only when it is present doth necessarily infer the presence of that species also Although therfore that a Sign proper in the second manner be not Inseparable and where it is absent doth not determine the absence of the Diseas as a Sign doth proper in the fourth manner yet when it is present it is as we have said of the same valu and certainty For Physitians do esteem the dignity of the Sign by the certainty of the signification For to that purpose they enquire out the signs of a Diseas that they may attain to a certain knowledg therof Therfore seing that Signs proper in the second manner are equivalent in respect of their certainty when they present to Signs proper in the fourth manner we shall here comprehend them under the extended signification of Pathognomonical Signs You may say after this manner many after appearing Signs may be reduced to the Pathognomonical and are confounded with them Be it so provided that they do infallibly denote the species of the Diseas For in this respect they are worthy to be severed from the other after appearing Signs neither wil any confusion follow hereupon in the method of the semeiotical art but rather the valu and dignity of the Signs wil by that means be more plainly and easily observed Of the Synedremontal or assident Signs we have nothing of moment to say but wil directly proceed to the Signs themselvs as they are to be reduced into order Yet no exact method must be expected from us because for the most part the Signs flow from so many several fountains that they wil scarce suffer themselvs to be marshalled into any accurate order Wherfore that they may be constituted which have some affinity among themselvs we have reduced the signs of this Affect to the subsequent Method We shal propound therfore First The Signs which relate to the Animal actions Secondly Those which have reference to the irregular Nutrition Thirdly Those that concern the Respiration Fourthly Those that appertain to the Vital Influx Fifthly Certain vagabond and fugitive Signs reducible to no Classis Under each of which we shal subjoyn the valu of the Signs First the Diagnostical Signs relating to the Animal Actions are these The loosness and softness of the parts The debility and languidness And finally the slothfulness and stupefaction First A certain laxity and softness if not a flaccidity of all the first affected parts is usually observed in this Affect The Skin also is soft and smooth to the touch the musculous flesh is less rigid and firm the joynts are easily flexible and many times unable to sustain the body Wherupon the Body being erected it is bent forwards or backwards or to the right side or to the left Secondly A certain debility weakness and enervation befalleth al the parts subservient to motion This weakness dependeth much upon the laxity softness and litherness of the parts aforesaid for which reason we have placed those Signs before this as also this before the slothfulness and stupefaction in the next place to be enumerated which ow much both to the loosness and softness Moreover this debility begineth from the very first rudiments of the Diseas For if Children be infested within the first year of their age or therabouts they go upon their feet later by reason of that weakness and for the most part they speak before they walk which amongst us English men is vulgarly held to be a bad Omen But if they be afflicted with this Diseas after they have begun to walk by degrees they stand more and more feebly upon their legs and they often stagger as they are going and stumble upon every slight occasion neither are they able to sustain themselvs long upon their legs without sitting or to move and play up and down with an usual alacrity til they have rested Lastly upon a vehement increase of the Diseas they totally lose the use of their feet yea they can scarce sit with an erected posture and the weak and feeble Neck doth scarcely or not at al sustain the burthen of the Head Thirdly A kind of slothfulness and numbness doth invade the Joynts presently after the begining of the Diseas and by little and little is increased so that dayly they are more and more averse from motion The Yonger Children who are carried about in their Nurses arms when they are delighted and pleased with any thing do not laugh so heartily neither do they stir themselvs with so much vigor and shake and brandish their little Joynts as if they were desirous to leap out of of their Nurses hands also when they are angred they do not kick so fiercely neither do they cry with so much fierceness as those who are in health Being grown greater and committed to their feet they run up and down with a wayward unchearfulness they are soon weary and they love to play rather sitting then standing neither when they sit do they erect their body with vigor but they bend it somtimes forwards somtimes backwards and somtimes on either side seeking som props to lean upon that may gratify their slothfulness They are not delighted like other Children with the agitation of their bodies or any violent motion yea when the Diseas prevaileth they are avers from all motion of their limbs crying as they are at any play that is never so little vehement and being pleased again with gentle usage and quiet rest In the interim unless som other Diseas Symptom or caus of sickness doth com between they are moderate in sleeping and waking they are ingenious not stupid but for the most part of forward wits unless som other im pediments arise their countenances are much more composed and severe than their age requireth as if they were intent and ruminating upon som serious matter These Signs being taken together unless they result from some evident wariness or proceed from some primary affect of the Brain which indeed hapneth very seldom in this tenderness of age do constitute a sufficient Pothognomonical Syndrom of the first kind where they are present together they certainly witness the presence of the Diseas when they are absent together they infallibly attest the Essence of this Diseas But if at any time a wearisomness do bewray any Feaverish or any other like Signs they may easily be distinguished from these both because the reasons of the weariness have gone before and also because the Signs from thence arising do
In like manner Strumatical tumors either internal or external do not very much suspend the hopes of cure though otherwise of themselves they are not easily subdued in this tender age For the external parts are exulcerated or inflamed with insupportable pain and do vehemently irritate Nature and wast the Spirits but the internal much more especially if they invade the more noble parts or bring molestation to the adjacent members with their weight and bulk Moreover Whosoever are not perfectly cured before the first five years of their age be spun out out they afterwards for the most part live miserable and sickly and being either Astematical or Cachectical or Pâ—ysical they dy before they arrive to the consistence of their age or else they grow deformed crooked and dwarfish If Scabs wheals pimples or the itch com after this Affect it doth hopefully expedite the cure Finally They which easily endure any kind of agitation of the Body caeteris paribus are cured without difficulty Thus at length we have finished the History of the three kinds of Signs according to the best faith of our observations hitherto In the next place we shal proceed to the Method of practice which comprehendeth the prevention and cure of this Diseas CHAP. XXV The Method to practice and Indications in general THE Method to practice is divided into the Therapeutical and the Prophylactical part or the Curative and the Preservative We shall discours of the former in this Chapter although perhaps we shal here also propound som things which are common both to the Prophylactical part and the Eugieihal But the Prophylactical in particular and uncommunicated we reserve for the close of this Tractate The Curative part is usually called the Meth od of Cure wherof as of every other art there are two general instruments namly Reason and Experience the uniting wherof comprehendeth the whol skil of the Artist Now by experience we understand not only the History of one or more Diseases and the success of Medicines but also the observation that is the application of the Histories unto those things which reason dictates in the same affect and that by way of comprobation or disallowance In like manner by reason we mean every operation of the mind so as we do not only comprehend the third namly ratiocination either demonstrative or probable and Analogal but also the first and second that is a simple apprehension comprehension and division For this part of Medicine includeth or rather presupposeth the Physiology Patholog y and Semeiotical part which certainly require a manifold exercise of every operation of the understanding Again no man can understand any proposition who doth not first apprehend the simple terms therof nor any Syllogism who is ignorant of the Propositions of which it consisteth so that it is manifest that every operation of the mind doth meet with an employment Indication That noble instrument of the Method of Cure by the use wherof the Dogmatical Physitians do principally glory to discriminate their Sect from the Empericks doth likewise vindicate a station among the parts of reason But because som things both difficult and obscure do occur concerning this instrument which have not received an unfolding and ful illustration from the Neotericks themselvs we judg it expedient here briefly to unvail them by an examination We wil enquire therfore First What is Indication Secondly Unto which operation of the understanding it relateth Thirdly Into what kinds and differences it is distributed As for the first although perhaps many significations of this word may be found among Authors yet that is the best and most proper which is delivered by Galen in his book de Method Meden Indication saith he is an insinuation or declaration of the consequence that is of somthing to be don In this sens Indication may be defined and described to be an objective action of the Indicant relatively considered which representeth to the understanding the thing Indicated that is what may be helpful what hurtful and by consequence what must be elected and applied what forsaken and avoided that this Description or Definition may be the better understood let us further examin what is here signified by the Indicant what by the thing indicated what the action of the Indicant is of what use distinction is of the thing indicated into helpful or hurtful into that which must be chosen and that which must be refused First Although those terms Indication Indicant Indicatum or the thing Indicated may peradventure be extended to other Arts and Sciences yet becaus it hath hitherto been only apropriated by the Industry of Physitians especially of Galen to the Method of Practice their definitions which we shall here declare shall have respect only to this Method all other use of them being pretermitted The General Definition therfore of the Indicant must be derived from the most general Nature which doth indicate in our Art The Indicant therfore may be defined in general to be a state of the Body as it is fluxible or movable or rather as it is actually influx or motion relatively considered namely as it intimateth what is to be done in that particular First We affirm that the Indicant doth perpetually imply some state or condition of the Body wherfore becaus that which is without the Body and doth not yet affect it is no state or condition of the Body it can scarce rightly be said to indicate The external caus therfore which doth not yet affect the Body is not the Indicant although the aversion of it may possibly be the thing indicated Secondly the state of the Body as it is frail or movable or rather as it is actually in motion is required to the Essence of the Indicant For as Galen most luculently proveth to Thrasyb If our Body were immutable and perpetual there were no need of Medicine but becaus the heat doth continually feed upon the moisture and becaus health it self in the most perfect state is frail and fluxible yea actually fluitant and in some measure is already flowed away manifest it is that the Physitians Art and the Practical Duty of the Physitian are both exceeding requisite For if the state of the Body and the alteration therof be only considered absolutely a bare and naked speculation only resulteth from thence but if it be considered in order to that which is to be done wherby the Physitian may rightly execute his duty concerning that state presently it meriteth the denomination of a Practical Instrument and is invested with the nature of an Indicant For such a state doth indicate as it is frail and in motion that care must be every way had of the health and that that care must be exercised and practised with all diligence and circumspection And consequently this very general Indicant doth point out that which the general scope of the Physitians sought after but it must not be expected that the consideration of the most general Indicant
unaptly be referred Moreover the Spirits also although they prohibit all extream hot things yet they allow of these as mōderat and very congruous to Nature In like manner there is little or no particular repugnance between these causes and the Indicates albeit in respect of time and the order of administration som dissent may be observed as we shall see afterwards in due place Wherfore in what respect and how far these agree together whilst we intend a cure we do at once respect not only the Spirits but in som sort the causes by choosing such curative remedies or by mingling such ingredients with them which are able both to attenuate the thick matter to cut into the viscous to open the obstructed passages and the like In like manner whilst we are chiefly imployed either in preservation or in the rooting out of causes we make choice of such evacuants or els we compound them with such remedies as are also partly contrary to the Diseas And all these things we do to that purpose as that as hath been said we may be subservient to the most intentions we can Now having found out the actions simply requisit in the Species in the next place we shal enquire out their du circumstances 1. In regard that this is a great Diseas it requireth a great quantity of the Remedy in respect of it self For a Remedy unequal to the Diseas cannot extirpate it It is necessary therfore that the dose of the Medicine be equally to the magnitude of the Affect But in this Diseas the Spirits permit not so great a quantity of Remedies to be given at once Wherfore that quantity must be divided given by turns For this is a Chronical Diseas and of slow motion neither doth it necessarily require an hasty Cure and although the Spirits cannot wel endure either vehement Remedies or such as are given in a large dose yet they permit the use of Evacuant Medicins by an Epicrasis Wherfore by turns we must somtimes make use of Remedies Preparatory somtimes Evacuant somtimes Alterant and somtimes strengthing Secondly For so much as belongeth to the place of administration the general Rule is that the remedy ought to arive at the seat and penetrate to the very Cause of the Diseas If therfore it must have a passage into the Vessels it must be taken at the Mouth but if it will suffice to touch only the thick Guts it must be injected by the Fundament If the humors be naturally ready to move upwards expel them by vomit if downwards evacuat them by siege In like manner you must humor the inclination of Nature and root out the causes by spitting by Urin or by sweating Particular evacuations must be instituted in the very affected parts or in the parts adjacent For so the force of the Remedy doth the more surely make way to the seat of the Diseas and the morbifical Caus And for the same reason external and topical Medicines must be applied to the next convenient place Yet you must know that there is a certain Sympathy between som parts in which case the remedies ar frequently administred to the part wherwith that consent intercedeth and neither to the affected nor the adjacent part Thirdly The form of the Medicament doth partly depend upon the Rule last propounded For if the scope be to lenifie the Jaws or the Windpipe we chuse a licking or lapping form that by degrees the remedy may slide over the affected parts and stay the longer upon them In like manner if the Stomach be affected we often prescribe Pils Pouders or Electuaries that they may the longer abide in the Stomach To the Kidnies we rather design liquid things that they may the more easily be carried down to them with the wheyish part of the Blood The forms do also in som part depend upon the very nature of the Diseas as in burning Feavers liquid things are for the most part convenient dry things are scarce admitted on the other side in moist Diseases and when the Belly is oversoluble more solid forms are preferred Finally the forms of the Medicines do also partly depend upon the nature of the Ingredients So Cassia worketh most effectually in the form of a Bolus Hartshorn Coral and the like in the form of a Pouder in like manner bitter things such as beget a vomiting and stinking things are concealed in the form of Pills somtimes also they are guilded or els they are enwrapped in Wafers and exhibited in the form of a Bolus Now it must here be noted that for the most part the form of the Remedy is not so considerable as it gives place to the more easie and commodious administration in respect of the Admission or Reception of the Sick For many cannot swallow Pills others presently reject their Potions by vomit others are perhaps avers from other forms In this Affect in regard that all Children almost are loth to take Physick that form is to be preferred before the rest which shall be observed to be least distastful to them Fourthly As for the time of action you must so endeavor to sit your administrations that they may as little as possible be interupted with times of eating exercise or sleep for at this age the Spirits are scarce preserved sound and perfect without an interposition of those things by just internals Remedies evacuant opening attenuate and incident must be taken early in the morning upon an empty stomach and if they must be repeated the same day four of the Clock in the afternoon upon an empty stomach likewise is the most seasonable hour Strengthning and astringent Medicines and such as provoke sleep are to be taken rather in the evening than in the morning but perhaps som of these are most agreable after meals Medicines that are mingled with the nourishment ought to be gratful to the Palat lest they subvert the stomach and hinder concoction or caus a loathing of the meat or els empair the Spirits As for the order of proceeding there occur two general Rules The former is That that must first be don which being premised makes way for the following Remedies and therfore that ought first to be removed which hath the consideration of an impediment in respect of what must follow The later is That we must ever give our first help to the more urgent and weighty Indicant unless som impediment intervene If the Question therfore be Whether the Diseas or the Caus of the Diseas doth first require the help of Physick The answer wil be obvious according to the first Rule For the causes are reflected upon under the notion of an impediment in respect of the Cure of the Diseas for they cherish it and infringe the vertu of the Medicins Wherfore before that we are intent upon the vanquishing of the Diseas we premise all possible endeavors to root out the Caus or at least to lessen abate and retund it that it may oppose no considerable force to
beat such things as are reducible to pouder make an Electuary according to art with syrup of Succory with Rhubarb a sufficient quantity Let the Sick take half a dram two scruples or a dram every morning either by it self or in a spoonful of Posset-Ale or som appropriated Syrup or else in Wine Take Conserv of Archangel flowers one ounce the flowers of Sage Clove-Gilliflowers Rosemary-flowers Myrobalans candied in India Citron Pills candied of each half an ounce red Sanders Cinnamon Spanish Liquoris of each half a dram Salt of Steel or els Saffron half a scruple with a sufficient quantity of syrup of Wormwood make your Electuary The dose and manner of using it is the same with the former CHAP. XXXIV Remedies that correct the Symptoms SOme Symptoms supervening upon this Affect do somtimes anticipate the legitamat Method of Cure and require a particular manner of proceeding Of this sort are the flux of the Belly the Lask wherwith somwhat of a Lientery is frequently joyned profuse Sweats laborious and painful breeding Teeth and the Toothach The flux of the Belly doth very much follow this Affect which if it persevere for any long time it is either very violent and easily watereth the Spirits consumeth the solid parts manifestly puts on the nature of a caus and as a caus indicates it s own correction A Bloody-flux rarely hapneth with this Diseas But a Lask with exulcerations in the Guts or complicated with a Lientery is very useful For in respect of the debility to the parts subservient to digestion a Lask or a Lyentery may easily supervene but not a Bloudy-flux Yet there is a frequent concurrence of other causes as of the indigested nourishment vicious either in quantity or quality som feaver watchings worms painful breeding Teeth c. al which things do likewise easily occasion a Lask or Lyentery rather than a Bloudy-flux As for the Cure it is partly perfected by Purgations partly by astringent Remedies partly by such as open and partly by such as strengthen the parts These Purgers are most proper which leave behind an evident binding after evacuation as Rhubarb Senna Tamarinds Myrobalans c. out of which for the most part we frame a Bolus or Potions becaus they are most easily swallowed under those forms As Take Conserv of Red Roses half an ounce Rhubarb in Pouder twelve grains with a sufficient quantity of syrup of Coral make a Bolus to be given in the morning Take of the Pulp of Tamarinds one dram Rhubarb in Pouder seven grains Sugar of Roses half a dram with a sufficient quantity of syrup of Quinces make your Bolus Instead of this Syrup you may use syrup of Coral or syrup of Mint or syrup of Myrtles or syrup of Pomgranats Take Senna half a dram Rhubarb one scruple Tamarinds a dram and an half Anniseeds bruised ten grains Infuse them in a sufficient quantity of fountain water boyl them very gently and to an ounce and an half of the Decoction ad syrup of dried Roses half an ounce mingle them together for a Potion Take Plantan or Succory water or Saxifrage water one ounce Rhubarb in pouder ten grains syrup Augustan syrup of dried Roses of each two drams Mingle them and make your Potion It must be observed That a more full evacuation is somtimes requisit namly when the flux hath not been immoderat or of long continuance and in the mean time the matter offending hath bin copiously collected in the Body In which case in lieu of the Syrup of dried Roses you may take som drams of syrup of Roses solutive syr Augustan or of Succory with Rhubarb or Manna But commonly the safest way is to augment the dose of Rhubarb or els of Senna not omitting the syrup of dried Roses In the evening after the Purgation you may administer ten grains of Diascordium boyled in Wine with Cloves and a little Cinnamon and mixed with a third part of Erratick Poppy water and some cordial Syrups as Syrup of Clove-Gilliflowers to strengthen the Spirits and to stay the Flux or if the Flux be stubborn you may mingle two drams of Diacodium for a dose instead of the Syrup aforesaid Or Take of Posset-drink made with white-Wine the Curd being taken off aromatize it with a little Saffron tied up in a rag crushing it gently between your Fingers Confectio Alkermes one scruple Pomgranat Pils in pouder seven grains Diacodium two drams mix them together to be taken when the Child is minded to sleep Or Take Laudanum according to the London Dispensatory half a grain Magister of Coral twelve grains Conserve of Clove-Gilliflowers or Red Roses one scruple with a sufficient quantity of Syrup of Quinces make a Bolus to be taken at bed-time If there be obstructions you may prescribe Crocus Mâ—rtis or Salt of Steel to be taken in the morning As Take Conserve of Roses one ounce the Roots of Succory preserved Myrobalans preserved in India of each half an ounce Salt of Steel half a scruple or Crocus Martis one scruple Cinnamon Liquoris red Coral of each eighteen grains Saffron a grain and a half Syrup of Succory without Rhubarb a sufficient quantity make your Electuary according to art wherof let the Child take half a dram each morning Red hot Iron may be quenched to the same purpose in its ordinary drink If the Child be troubled with a violent flux you may give it som binding Conserves imagin Conserve of Sloes and mix it with such things as the Child delights to eat but in so doing be sure you pleas its Palat. Somtimes a profuse and excessive sweating find a peculiar business for the Physitian in this affect for it very much wasts the Spirits and retards the cure of the diseas Yet caution must be used not to restrain it rashly if perhaps there be a Feaver or if any feaverish fit or immoderat heat hath gon before For in these cases it may be upon a critical time or at least it may bring more advantage to the Body by the mitigation of the Feaver than damage by the loss of the Spirits For we know not whether any thing doth more potently or indeed more sweetly expel the feaverish heat thaÌ„ sweating In the interim when it floweth inordinately and causlesly it argueth that the Body is oppressed with obstructions with crude juyces and unprofitable superfluities which whilst Nature striveth to master and to subdu by that very labor the openness of the pores withal concurring it is evaporated by sweat and indeed an unprofitable one very laborious and such as wasteth the Spirits which therfore as soon as possible must be corrected This Hippocrates meant where he adviseth That that sweat which floweth away without cause requireth purgation For what can more commodiously diminish and dissipate these superfluities Again this motion is contrary to sweating wherfore it meriteth the preheminence among the remedies opposed to this Sympton and seing that it clears the way for Medicines aperient and such as strengthen