weaknesse of the body which comes by watching proceeds from a losse of spirits those being restored wearinesse then leaves a man But by concoction plenty of the nourishing humour is afforded to the internal parts which moistens them very much as Hipp. taught 6. Epid. Exercise is meat to the joynts sleep is nourishment to the bowels Lastly it conduces much to old men because there is nothing more which heats and moistens their cold and dry bodies and so it restores the moist substance being lost Whence that of Homer cited by Galen de san tu As soon as he hath bathed and eaten let him sleep for his age requires Immoderate sleep loosens the members causes an ill colour and habit of body makes the head heavy filling it full of vapours and humours duls the natural heat and renders all the parts of the body more unapt to exercise This proceeds from an over long retention of the excrements which are caused by immoderate sleep for 't is most true that fleep hinders all evacuations but sweat so that after concoction perfected if the excrements which ought to be presently after evacuated are kept in the body it makes it subject to all the above mentioned inconveniences In going to sleep three things are to be regarded the time space and manner of lying The most convenient time for sleep is the night an hour or two after supper a gentle walk preceding that the meat may the better descend The night is fittest for sleep through the moisture and tranquillity thereof and it affords time long enough to finish concoction so that it is not necessary to break sleep for businesse sake as fals out in day-naps Sleep at noon is very hurtfull especially to those that have not used it For the time wherein a man sleeps by day suffices not to finish concoction Hence it comes to passe that they who sleep after dinner being raised out their sleep because of an interrupted concoction feel a heavinesse in their stomack belch sowre belches are fill'd with wind and have no appetite at supper Besides sleep by day filling the brain with over-much moisture begets Catarrhs and other diseases of the head for it fils the brain with moisture which is done sufficiently in the night time so that there is no reason to oppresse the head in the day time with moisture but rather by waking to dry up that moisture which for the most part is excessive But if any one by reason of their labour in the morning or a weaknesse of the body as in sickly people become weary as also not having slept the night before he may sleep then in the after noon without danger Nay an afternoon-nap may be profitable if very short which may only serve to recall the heat to the internal parts for the better perfecting concoction For if it last not long it cannot fill the head with vapours and yet it recreates the strength and rather dissipates the vapours in the brain then gathers it the heat being for a small while drawn inward Also in long and hot daies sleep in the afternoon is lawful to those that do use it For the nights being short and oft-times unquiet it is lawful to sleep at noon especially to those that have used it that the want of sleep in the night may be recompensed by sleeping after dinner Beside that the spirits which the heat dissolves are restor'd by sleeping But such sleep profits them most that are us'd to it as among the Italians who all the summer sleep in the afternoon and receive great benefit thereby As often as a man indulges to that afternoons sleep it ought to be very long or very short Why it ought to be very short the reason is given before why very long is because if the sleep be interrupted before full concoction the concoction is disturb'd which causes many diseases Yet sleep at noon hurts lesse if it be taken with the body upright and not lying down for so the vapours have a freer passage to ascend Neither must a man sleep presently after dinner but after a short space and some gentle walking that the meat may descend to the bottome of the stomack The space appointed for sleep is taken from the perfection of the concoction in the stomack and liver and that from the concoction of the urine and cheerfulnesse of the body Now some having a quicker some a slower digestion those ought to sleep lesse these more So gluttons men full of humours flegmatick women and those that have weak stomacks require longer sleep because they need a greater retraction of the heat A shorter sleep suffices fat temperate thick and well concocting persons Lastly a moderate sleep must be us'd by those that are sound and in good temper which is commonly allowed to be for seven or eight hours space The manner of lying in the bed ought to be with the head highest on either side but first on the right then on the left lying on the belly helps concoction but it hurts the sight lying on the back hinders the evacuation of the excrements being very dangerous for those that are subject to the Stone A more erected manner of lying makes the head freer from excrements lying on the right side causes the meat to descend to the bottom of the stomack and is easier for respiration lying on the left forwards concoction through the nearnesse of the liver to the stomack To this Aristotle adds that a man must not lie straight but with his limbs gathered up for the warmth of the belly Moderate watchings quicken the senses diffuse spirit and heat into all the parts of the body help the distribution of the nourishment and further the evacuation of the excrements But immoderate watching consumes and dissipates the spirits dries up the body but chiefly the brain increases choler inflames and is the cause oft-times of hot diseases Sometimes also of coldnesse the heat being dissipated and consumed CHAP. XXIX Of Excretions and Retentions TO Excretions and Retentions are referred the excrements of the belly urine insensible transpiration the flowres and seed which if they come forth seasonably preserve health but being retained beyond their time beget several diseases The excrements of the belly if they do not come forth in due time binder concoction deprave the appetite and beget nauseousnesse putrid vapours arising from the retained excrements to the stomack that cause colick pains the wind being hindred from coming forth together with giddinesse and head-ache the fumes arising to the head But coming naturally forth they are soft of a middle substance of a brown colour yet not stinking very much the quantity corresponding with the quantity of things received Natural urine is of a moderate substance of a brown colour either with or without a sediment white smooth and corresponding in quantity to the liquor taken in Insensible transpiration if it be prohibited by a stoppage of the external pores by the ambient cold or of the internal
that is juyce which is absolutely necessary that the aliments being prepared by that first coction may passe freely thorough those narrow veines which usualy conduct them to the Liver and also those smal veines which are dispersed thorough the substance of the Liver But when the Liver hath discharged its duty in sanguifying there is not further necessity for so much moisture therefore nature segregates the greater part of it which it hath designed to be attracted by the Reins and from thence is excluded to the bladder where it is called Urine but before while it confines it self to the veines it is called Serum Part of which remaining still in the veines is confused with the masse of blood to be the vehicle of the humors which being made more thin and fluid may have an easier accesse to every particle of our body but when this portion of Serum hath performed its office part of it retires to the Reins and accompanies the other Urine part inclines to the bulk of the body and is purged by sweat The office of it is to be a conduct to the alible humors for their easier transmigration thorough the body It is called to this duty as long as it is lodged in the veins but when it hath broke up house there it is useless in the body as choler and melancholy The differences of it are four viz. sanguinious bilious pituitous and melancholick Every humor hath its Serum properly and peculiarly appertaining to it and assimilated to its proper nature and temper so the Serum of the blood is held to be hot moist and somewhat red the Serum of choler hot dry and somewhat yellow the Serum of flegme cold moist and somewhat white and the Serum of melancholy cold dry and of colour dark CHAP. XI Of Excrementitious Flegme Excrementitious flegme is an excrement of the third concoction Cold and Moist of colour white as to the taste insipid or something sweat generated in divers parts but principally in the brain PArts of a cold and moist temper derive their nutrition from pituitous blood from whence proceed many excrements caused either by the coldness of the part it self unapt to concoct perfectly or by the humor it self which being the more crude part of the blood is of a difficult concoction and a great part of it converts into excrements Which is very evident in the brain for that copiously gathers excrementitious flegme which is purged out of the mouth and nose But the brain collects not this flegme solely by the concoction of its proper aliment but by reason of its advanced situation which is the cause that many vapors from the ventricle Liver and other bowels make upward to the head and by the frigidity of the brain are condensed into a waterish matter which is the original of this flegme Hence by reason of the copiousness of flegme congregated in the brain these two wayes Hippocrates and other Physicians have termed the braine The Metropolis of Flegme and Author of all defluxions It is differenced by the taste and consistency of it In relation to the tast it is four-fold Insipid Sweet Acide and salt Insipid proceedes from moderate cold which causeth no tast This is the most natural being an excretion in well disposed bodies conveyed away by the spittle The Sweet is produced from the insipid by a smal alteration of heat When the insipid is concocted by a moderate heat it is sweetned for sweetness is the produce of heat but yet hence we must not inferre that sweet flegme is hot because indeed an intense sweetness signifies heat but not a sleight and moderate one so fruit and milk of a cold temper yet are much sweeter then any flegme The Acide is caused by intense cold inducing Acidity When the smal heat of the flegme is extinguished or dissipated the necessary consequence is acidity no otherwise then as the juyces of many fruites meanly hot being infrigidated become easily acide which fares not so with hotter which do usually retain their soundnesse longer as appears by wine Salt Flegme is produced either by putrefaction or the permixtion of salt serous moisture As Galen in Book 2. of the diff feb cap. 5. It becomes salt by putrefaction because when putrefaction makes a separation between the siccity and humidity and that siccity being parched by a putredinous heat falleth again into conjunction with the humid substance it causeth a salt taste But it proceeds from the permixtion of salt serous humidity which being too much brin'd by intense heat is mingled with the sweet flegme but the serous humidity becomes salt when the action of heat upon it produceth scorched vapours which by permistion with it cause saltnesse Observe that these two species of flegme viz. the acide and salt are preternatural but the sweet and insipid natural As to its consistency it is also four-fold Thin Thick Vitreous and Gypseous The Thin is of a watery consistency very fluid and easily diffusing it self into divers parts Such is that which distilles from the brain thorough the nose and flowes thorough the mouth and is effused also in many parts thorough the middle intervals of the muscles Thick is when this thin hath acquired incrassation and clamminesse by heat The heat by resolution incrassates the thinner parts whence this flegme being gluish is properly called Snot Vitreous flegme is still thick but transparent as liquefied glasse or the white of a raw Egge It is a sturdy doubt and resolved to my knowledg by no Auther why vitreous flegme and that which is termed crasse are for the most part equally crasse yet one is very transparent and diaphanous the other very obscure This in my opinion proceeds from the diversity of the efficient cause which of crasse flegme is heat but of the vitreous cold In the crasse the heat resolves the thinner more airy and waterish parts which cause perspicuity hence it is clouded with opacity but in the vitreous being incrassated by cold not by heat while it is so condensed nothing is resolved but the diaphanous parts remain from whence it seems transparent as is manifest in ice But it will be objected That flegme cannot acquire such a degree of cold in our body that by the force of it it may be condensed and incrassated all our body being actually hot therefore whatsoever is cold is necessarily heated by the part in which it is contained To this I Answer That that flegme to which the vitreous owes its production is exceedingly crude and out-vying the strength of nature therefore it is banish'd her dominious as contumacions and insuperable and remised to its proper nature viz. coldness communicated to it by water and invincible by the weak heat of the parts in which it is contained as the intestines which are the head quarters of this vitreous flegme and doth not seldome torture them with most painfull fits of the Collick for by its glewy nature adhering to the intestiness by its cold it bites
and nips them for coldness is biting according to Hipp. it is cold to such extremity that the expurgation of it is actually cold by the testimony of Galen by a near experiment in himself as in his 4. book of affected parts Gypseous flegme is the production of crasse flegme emulating Limc or a stone almost in hardnesse This rejects the name of humor being consolidated therefore improperly placed in the classe of humors It proceeds from heat pillaging all the humid parts so that there is nothing left but earthy parts which are indurated into a Tophaceous matter almost resembling lime this often perplexeth the joints causing the knotty Gout The Fourth Section of Physiology Of the Spirits and innate Heat The First CHAPTER Of the Nature of Spirits Thus much of the Humors the Treatise of Spirits succeeds which are generated out of them but chiefly out of Blood THE Spirits of our bodies being of substance so thin that they are imperceptible to the quickest glance of sense and by this means reason only can confirm us in the truth of their existence it will not be amisse therefore to inform that our bodies have such attendents before their nature and essence be proposed First Therefore the context in Hippocrates 6. Epid. sect 8. is very convincing where he reckons three things which constitute the composition of our body viz. things containing contained and causing motion by the containing he signifies the parts by the contained the humors by those that cause motion the spirits according to the explanation of Galen himself for such is the tenuity and nobility of the spirits that with wonderfull swiftnesse they can shoot themselves to any place and insinuate themselves into all the parts of the body Secondly Platonicks do thus demonstrate the necessity of spirits nature doth not usually joine two contraries or things of wide distance without the help of a medium but the soul and body differ in the whole latitude of their genus for the soul is incorporeal and immortal but the body corporeal frail and mortal therefore such a dissiliency in natures cannot be forced to unition but by some medium and common obligation leaning as it were to both natures such are the spirits which indeed are material but in tenuity ambitious of the nature of things immaterial Thirdly This appears by prolifical seed which is wholly spumous and inflated with spirits which disappearing leave nothing but a waterish and unfruitful liquor Fourthly We are nourished by the same things of which we are conflated but attraction of breath or aire is necessary to our conservation therefore we comprehend in us some such substance Lastly This is evident by those great and empty cavities which are found in the ventricles of the brain and arteries of men deceased which are observed in the living swelled to a palpitation which clearly convinceth that those vacuities could not be repleat with any other thing then such spirits But a Spirit is a substance thin clear and etherial proceeding from the exhalation of pure blood and the inspiration of aire necessary for the due performance of all duties the body is engaged to It is called a thin substance because with incredible subtility and clerity it penetrates and courses thorough the whole bulk of the body and steals into the narrowest pores of the least particles and intervals of the muscles it is called clear and bright not according to the vulgar opinion as Argenterius fansies but because it excels in splendor and perspicuity which is easily seen in the observation of the eye the ball of which is very clear and we may spin an argument for the probation of it out of this that when some vapours of the melancholick humor or of over-swelling in drunken men are predominant the mind is in a present perturbation by reason of the dulness of these fogs which suffocate the spirits And of this Avicenna's demonstration is beyond all exception because saith he our soul which transacts every thing by her servants the spirits loves light and no darkness and the spirits do their duty with much more alacrity in a serene then in a cloudy day hence it is plain that they are excited by similitude They are also called Aetherial because the matter of them is by long elaboration so defecated that it stands in competition with that higher Element which is next neighbour to the celestial bodies and is called the Element of fire or etherial But that the spirits start out of the permixtion of blood and aire shall appear in the explication of their differences The uses of them are declared in the end for the soul cannot in the least operate upon the body without the officiousness of the spirits because they have the honour to be immediately and principally subservient to her CHAP. II. Of the Differences of Spirits Spirits are two-fold Inbred and Adventitious Inbred is the relict of the first principles in every part IT is called inbred innate or implanted according to the Greek Connate but while our parts are composed out of the first principles of our generation viz. seed and blood that spiritous substance which is contained in the seed constitutes the inbred spirit But this reason convinceth that this spirit is communicated to every part because the adventitious cannot be brought forth without the midwifery of this every production being like to its Author And also the prolifical seed issuing from every part argues that a spiritous matter is derived from every part from the sound parts sound from morbous parts morbous which in the issue represent their dispositions Adventitious is that which flowes and is sent in from some other place for the nutrition and conservation of the Inbred The Inbred spirit continually laborious in the performance of the functions of the parts would easily be consumed unlesse it were preserved and refreshed by the continual influence of this stranger therefore nature hath contrived some parts which should be the forge of great plenty of spirits which by their allotted courses influx into all the parts of the body to defend the inbred spirit This spirit is three-fold Natural Vital and Animal The Natural is produced in the Liver out of the thinner part of Blood tempered with a little Aire whose influence is thorough the veins into the whole body for the due exercise of the natural faculties This Natural spirit hath caused much dissention among Authors because some upon the ground of pregnant reasons deny nature the assistance of any such spirit First Because Galen was not resolved of it book 12. method cap. 5. where he thus discourseth If any spirit be natural it is contained in the Liver as its fountain and in the veins as its instruments And his first book of parts affected last chap. the natural faculties are by him differenced from the animal by this distinction that the natural are implanted in the parts but the animal are sent in from some other principle as light from the Sun whence it
happens that animal actions do not seldome perish in the parts though they receive no hurt but only the principle of them but the natural are never hurt while the parts are free from harme Secondly Aire is the matter of all spirits for out of it and clear exhalations from the blood they are produced But there is no passage thorough which the air may be conveyed to the Liver Therefore that can be no seat for the generation of spirits Thirdly The spirits are according to Hippocrates the causers of motion therefore if the veins harbour spirits they should beat no lesse then the Arteries But the principal argument to confirme the assertion of natural spirits is this Three actions specifically distinct are exercised in our bodies viz. Animal Vital and Natural but the exercise of action is the duty of the spirits as Galen very often affirms therefore we must necessarily constitute three spirits differing in species viz. the Animal Vital and Natural If you object that natural actions are exercised by the inbred spirits I Answer that the adventitious are absolutely necessary for conservation of the inbred which bear a similitude of nature to them the production of which is acknowledged from the Liver I Oppose therefore to the first argument established by the authority of Galen in opposition to this that the rudeness obscurity and non-purity of this spirit created sometimes in Galen a doubt it being more caliginous and terrestrial then the Vital and proportioned to those actions which it is designed to performe But though the faculties be implanted in the parts they want the help of the adventitious spirits for exercise and to hinder the dissipation of the implanted spirits To the second I Answer That the natural spirits want but little aire which by insensible transpiration by the Arteries knitted to the veins of the Liver and by the continual ventilation of the Diaphragma are easily imparted to the Liver To the third I Answer That the beating of the Arteries is not caused by the spirits but by a pulsifick vertue communicated to them from the heart But the Liver being not endowed with such a faculty the veins which have a dependence upon it do not beat for it is not necessary because the blood and natural spirits want no such ventilation but are well enough preserved only by transpiration The Vital is generated in the heart by the natural spirit and the attraction of the air by inspiration and by the help of the Arteries flowes into the whole body for the preservation of natural heat and defence of life It stands better with reason that the vital spirits which surpasse in tenuity should be generated out of that spiritous substance prepared and attenuated in the Liver rather then out of the venal blood only which is destitute of spirits for as the animal owes its production to the vital so it may be supposed the vital is related to the natural Therefore that natural spirit being conveyed to the left cavity of the heart with the purer part of the blood is intermixed with aire arriving thither by the inspiration of the Lungs thorough the venal artery whence by the inbred force of the heart and innate heat by joynt elaboration the vitall spirits are generated which being after transported to the Arteries are conducted thorough the whole body that they may nourish and preserve the whole body by their vigorous heat The Animal is generated in the brain by the concurrence of the Vital and the aire attracted by the mouth and nostrils whose influence on the whole body is by the nerves for the exercise of animal functions A portion of the vital spirit is conducted to the brain by the Arterie Carotides whose course is thorough the neck and in the ventricles of the brain is mingled with air attracted thorough the high-way of the mouth and nostrils where by the idiosincracy of the brain it is changed and acquires a new form and becomes Animal spirit fit for the performance of animal actions for during its continuance in the veins it is the principal officer and chief instrument in the execution of these actions but while it flowes thorough the nerves into the various parts of the body it compleates and perfects the motion of the senses A COROLLARY THE reasons following will sufficiently evince that there is no Animal spirit First The cold and moist substance of the brain cannot be convenient for the generation of spirits which are hot and thin since there must necessarily be a relation of similitude in all productions Secondly All vapors which ascend to the brain by the frigidity of it are condensed to a concretion and turned into water Therefore if the spirits which are of a like nature were contained in the brain they would in like manner be infrigidated to a concretion Thirdly If there were such spirits their chief place of residence would be the ventricles of the brain but that is impossible because those ventricles are continually feculent with excrements to the expurgation of which they are designed but they would infect the spirits Fourthly If these spirits were lodged in these ventricles of the brain they would easily make escape thorough those passages which are appointed for the evacuation of the excrements Fiftly If these spirits were housed in the brain sensation and cogitation would alwayes be quick because the faculties of the soul give constant attendance and are alwayes in action till they want instruments To the first I Answer That the brain is not in such a measure cold but that it is actually hot which heat is sufficient for the generation of the Animal spirits which are not simply the production of heat but of the very idiosyncracy of the brain which must necessarily incline to coldness that the heat of the vital spirits might be allayed that our cogitations and sensations may be constant and firm which otherwise those incendiaries the spirits would blow up to a deliration and madness as we see in men phrenetical To the second I Answer That the spirits are not concrete in the brain as the vapors because they are not the chief constitutions of a waterish nature but rather of Aery or Aethereal one To the third with Aristotles consent 2. of the soul chap. 8. I Answer That Nature can imploy the same thing in the business of divers offices as the tongue primarily for the taste secundarily for speech the nostrils primarily for smel and inspiration of aire but secundarily for the conveying away of mucous flegme so the ventricles of the brain are primarily contrived for the generation of spirits secundarily for the expurgation of excrements but these excrements by reason of their continual purging and effluxion cannot be infectious to the Animal spirits as long as the brain squares to Nature To the fourth I oppose That the spirits break not forth thorough those channels in which the excrements stream being retained by the friendly nature of the part and familiarity of the
incomprehensible by sense which yet our mind knows to be certainly true This is the head of all sciences which by the efficacious vertue of this faculty are usually learned and taught Memory is that operation of the soul which retains and preserves the received species of things The species of things when they are once hedged in to the mind are there long detained so that after a large space of time when they have been entertained by the senses they are represented to the mind and imagination This caused the invention of a third faculty distinct from the rest which might preserve all those species as a treasury out of which they may be fetched as occasion serves The Philosophers create another operation different from the memory viz. reminiscency which summons up those things that are run away from the memory rallying them together by the help of those which are yet retained But yet we are inclinable to assert with Galen that reminiscency is an operation of the memory reflecting upon it self For it is not as some conceive the only business of the memory to retain the species for by this means it would be a vertue not knowing but only lodging the species but it is the office of the memory to record things as they are transacted and so reminiscence is a progressive motion not a differing action of the memory A COROLLARY A notable question is usually debated among Physicians whether the principal faculties are locally distinguished in the brain in which for satisfaction I referre you to Laurentius by whom quest 2. book 10. it is admirably well handled CHAP. VIII Of Sleeping and Waking To the internal functions of the Brain are referred Sleeping and Waking we must therefore now treat of them ALL the Philosophers referre Sleeping and Waking to the common sense Positively asserting sleep to be the cessation of the common and exterior senses but watching to be the action and exercitation of them Hence when wee comprehend the common sense under imagination when also dreams of which we shall after treat may be circled into imagination strictly accepted therefore this place will be convenient for this Treatise But Sleep is a quietation or cessation of the internal and external senses appointed for the recreation of the body Watch is nothing else but the free exercise of the same senses By the Interior senses we chiefly understand that internal action by the help of which the species are received which by the external senses are conducted to the imagination for that operation sleeps with us but not the action of imagination ratiocination or memory which are not seldome exercised in sleep Nay the senses themselves do not wholly compose themselves to cessation for in sleep we receive violent objects as noyses ratlings and such like and so though sleep be called a privation and watching an habit yet it is no total privation but such an one which easily gives way to a retreat from it self to the habit and by this means it comes short of the essence of true privation The next and immediate cause of sleep is the locking up of the spirits and prohibition of their influence into the instruments of sense and motion But the influence of the spirits is block'd up by swarmes of vapors suffocating the brain which barricadoe the passages thereof The cause of natural and quiet sleep is a gentle and as it were roride vapour exhaling from the aliments into the brain stopping up the ventricles and passages of it for the retention of the spirits and quietation of animal actions But that sleep is induced by such like vapors mounting into the brain it is evident because the copiousness of meat and drink wine especially casts us into a long and deep sleep but these send up many vapors into the brain But they who are very sober and fast sleep little by reason of the paucity of vapors making to the brain which are soon dissipated for the sleep ceaseth when the native heat hath dispersed those vapors For those things stop the influence of the spirits which either much dissipate or dull them or any other way fix them The principal cause of sleep prohibiting the influx of the spirits is the plenty of vapors randezvouzing in the brain Yet there may be afforded many other causes producing the same with less efficacy or at least not so naturally for instance when the animal spirits are so tyred by the labour of the day more serious thoughts of the mind studies and cares so that all their forces rallyed together will not be able to effect an ordinary influx but nature retains them and the influent heat to repair the loss of the spirits So also cold things taken or applyed intercept and solidate the spirits as it were to a congelation And the spirits do not seldome make a stop at such things as delight the mind as pleasant Songs the allusion of bubbling waters an intermission of cogitations security of the mind and such like Lastly the end of sleep is the instauration of the animal strength and of the whole body The chief designe of sleep is to restore the animal powers to their vigour because they being over-wrought by a tedious and various sensation are by the help of sleep enlivened and the spirits exhausted by watching are strengthned the members wearied with motion return to their former nature and functions Secondarily also sleep conduceth to the better effecting of natural actions which by animal operations are in watching in a manner hindred For in the time we repose our selves to sleep the heat retires to the inner parts which is advantagious to concoction and now new matter is afforded for generation of spirits the excrements are mitigated diminished and better concocted CHAP. IX Of Dreams A Dream is a glancing apparition of some sensible thing represented to an animal in the time of sleep WHile an animal wakes and exercises the external senses representations from sensible objects are conveyed to the brain that there being imprinted by the virtue of the animal spirits they might be preserved When therefore this animal sleeps and releases to his external senses then these representations unless the animal spirits be obscured and obliterated with some dregs or disturbance of violent motion do again present themselves and appear in sleep This is the cause that the animal judgeth it self really to know by the outward senses those things which are objected onely in shadow Dreams usually visit us in the morning because then after perfect digestion the animal spirit is more pure the crass vapors being resolved and dispelled by native heat now therefore the species of things are presented and stated before the imagination more clearly and perfectly for as in troubled waters we perceive either none or a very uncomely effigies so the brain muddied with such plenty of vapors gives place to the effigiating of no dreams or of very confused and broken ones But Dreams are either supernatural or natural Supernatural
occult from the senses yet all of them are understood by symptomes which are their effects and most of all by labefacted action which immediately and by it self depends upon disease and so essentially that if we assert action hurt we necessarily imply a disease on which it hath dependence But it may be objected That action is often hurt immediately by the very morbifick causes for aliment too copiously burdensome to the ventricle is hurtful to concoction without the interposing of a disease Therefore all action hurt depends noton a disease I answer That the coction of the ventricle is not therefore hurt because it cannot concoct a great plenty of aliment for it being requisite that there should be a certain proportion between the Agent and Patient for the right exercise of action if the Aliment be too copious or of quality troublesome the action of the ventricle is not hurt though it cannot master it as it is not troubled though it cannot concoct Iron This defect therefore depends on the disproportion of the object It is again thus objected Some symptomes may primarily and by themselves hurt action as the quality changed in the eye viz. the yellow colour of the cornea tunica of men troubled with the Jaundies caused by the effusion of yellow choler into it which immediately produceth sight for they can discern no colour but their own but no disease can be impeached of such treason against the eye Therefore that colour which is the symptome doth immediately injure action I Answer in the eye peculiarly a preternatural colour may be termed a disease for the eye in its natural constitution ought to be without any colour that it may be the fitter for the reception of the species of external objects pure and inconfused and their various colours for that colour of the eye may be referred to diseases in number because the number of qualities which ought naturally to be in the eye is increased The same may be held of an extraneous taste in the tongue and sound in the eare which are impediments to the due perception of taste and sound hence it appears that in these peculiar instruments of sense peculiarly constituted we may admit a peculiar kind of disease Here ariseth lastly cause of objection That in Sympathetick affects the actions of the parts are hurt without the violence of any disease for if a disease were in the sympathizing parts we should endeavour remedy for the which is not done neither when the action of the nerves is hurt by the obstruction of the brain can we impute a disease to the nerves but only to the brain I oppose to this That Therapeutick Physicians number not the sympathetical affects with the diseases because we apply no remedies to them but if we consider more seriously we shall find they may be referred to some genus of disease viz. the influence of animal spirits into the nerves is block'd up by the obstruction of the brain by the defect of which motion and sense decay but this defect may be reckoned among diseases in the number of deficients and so we may hold of many others CHAP. II. Of the Kinds and Differences of Diseases Hitherto of the Nature of disease it followes now that we discourse of the Differences thereof GAlen confounds the genus species and differences of diseases in 2. of his method and useth them for one and the same for he is not precise in their strict and logical consideration though either of them may be truely predicated in a diverse respect viz. in relation to the disease it self which is the principal genus they must be called species or differences in relation to the subordinate species into which they are subdivided they are honoured with the Title of genus But the differences of diseases are some essential some accidental The Essential are taken from the very essence of the disease and are otherwise called specifical because out of them the genus and species are constituted But they are three viz. similar organical and common The whole essence of accidents depends upon subjects therefore their essential differences must be derived from the differences of their subjects but the subjects of diseases are the parts of our body which are properly called such viz. which cohere to the whole mass and partake of life in common for although by Hippocrates the parts be divided into the containing the contained and those that cause motion where by the containing he understands the living parts designed for the exercise of actions by the contained the humors by those causing motion the spirits there the name of part is tentered to the widest sense for nor humors nor spirits can be the subjects of diseases nor do they communicate of life but they are rather the causes of diseases when they are extravagant in quality or quantity Therefore seeing those living parts branch out into two differences viz. similar and organical diseases also shall be divided into similar and organical but because in both the forementioned parts there is required another common disposition besides their due temper and conformation that they may behave themselves according to the rule of nature viz. a natural continuity or union of these parts the corruption of which is the generation of another species of disease termed Common CHAP. III. Of the species of a similar disease Every similar disease is called Intemperancy THE similar Parts are composed of Elements onely and their actions are executed by the symmetry of the foure first qualities and the allaying them to a due fixation of temper For the similar Parts as similar are voyd of any action nutrition excepted by reason of which they retaine convenient aliment when it is attracted concoct it and thrust out superfluities all which are in them performed by the temper alone As long therefore as a due temper is preserved in the similar parts they regulate themselves according to nature But when they are intemperate they are in a morbous condition and so every disease affecting the similar parts will be intemperateness But intemperateness breaks out into other differences of which some are essential some accidental Again the Essential are some simple some compound the simple are foure 1 Hot 2 Cold 3 Moist 4 Dry. The Compound are the same in number 1 Hot and moist 2 Hot and dry 3 Cold and moist 4 Cold and dry These intemperatures are called morbous when they swell to such an excess that they do manifestly hurt the actions otherwise they confine themselves to the prescripts of health for instance though a man of a bilious temper be hotter and dryer than is convenient for the moderation of a fit temperament yet as long as in the exercise of his actions he is not irregular as to the prescript of his innate temperament he is not said intemperate to disease till transgressing the proper limitation of health he falls for example into a feaver or some other hot affect The accidental differences
these causes for that first the formal cause is nothing else but the proper essence of every thing but we have at large explained the nature and essence of diseases before Next there is no material cause in diseases for disease being an accident needs no matter out of which it should be produced but in which it should exsist which is nothing else but the subject thereof or the parts of our body As for the final cause though the lesion of actions may be termed as it were such yet this is by accident as it follows the generation of the disease but diseases by themselves and properly have no final cause as neither all those things which are constituted in a kind of imperfection therefore the efficient cause remains onely considerable in this discourse which is here taken by the Philosopher not only for that from which the effect is first produced but in a wider signification as appears by our description for all that which is in any manner conducible to the generation of the disease CHAP. II. Of the Differences of Causes The cause of a disease is either by it selfe or by accident The cause by it self is when by its own proper and implanted strength without the intervening help of any thing else it produceth a Disease But the cause by accident is when any thing else is summoned as auxiliary to the production of a morbous disposition SO cold water sprinkled upon our body by it self and naturally causeth a chilness but by accident upon the densation of the skin and contraction of the vapors within it heats So Scammony being an extreme hot Medicine by it self over-heats the bowels but by its powerful expurgation of choler and hot humors by accident it refrigerates and cures a feaver And there are causes of diseases some principal some helping some without which nothing could be The principal cause is that which either gave the first motion to the effect or is able alone to excite it The helping cause is that which produceth not the effect alone but is auxiliary to the principal The cause without which nothing could be is that which neither causeth the affection it self nor performs any thing else but without it nothing can be transacted The Gout is exemplary in all these three causes for the cold constitution of the air and the copiousness of excrementitious humors is the principal cause of a defluxion into the joynts the auxiliary cause is the tenuity of the humors but the cause without which nothing could be is the infirmity of the joynts and laxity of the passages There is also one cause of a disease remote the other nigh The remote is that between which and the disease others intercede The near cause is that to which the disease owes its immediate production The proposed differences of causes are of frequent use in the Art of Medicine but the succeeding are most frequent and of great validity in the explication of all diseases therefore in them we shall act the curious Scrutinists The causes of diseases are some external some internal The external causes are those which either outwardly applyed or differing from the constitution of our body usually cause diseases The term of external seems not very convenient because sleep waking and the passions of the mind are comprehended under it which yet seems to be contained among internal things yet because it hath found much acceptance with Physicians therefore we also reject it not averring those causes to be external because many of them are outwardly applyed as the air meat drink c. But the rest as sleep waking and the passions of the mind are so manifest that they are granted without any dispute for external positions Celsus therefore calleth them evident by a very apposite term Others call them procatarctick precedent and primitive because from them the first original of diseases flows But of them some are necessary some are unnecessary The necessary are those which do necessarily affect us and inevitably light upon us Yet though they necessarily affect us they do not necessarily introduce diseases but they are neutrals fluttering in an indifferency between health and disease for by the orderly use of them health is preserved but by the abuse and immoderateness of them it is destroyed But they are six 1 Air 2 Meat and drink 3 Motion and rest 4 Excretions and Retentions 5 Sleeping and Waking 6 The Passions of the mind They are vulgarly called the six not-natural things because by themselves they are neither agreeable to nor disconsonant from the nature of mans body but are made hurtful or useful according to the mode of well or bad using them They are peculiarly handled in that part of Medicine which treateth of Dyet therefore we omit the discourse of them The unnecessary are they which happen fortuitly and not concurring to the ordinary use of life All fortuite things are comprehended under these as the strokes of swords or stones the bitings of wilde beasts c. The internal causes are those which lurk within our body imperceptible to sense and discoverable only by an artificial conjecture So the humors spirits excrements flatulency vapors particles of the parts themselves and whatsoever is contained in them or agnate to them are circled into the nature of internal morbifick causes But they are either antecedent or concomitant The antecedent cause is that which is before the concomitant and moveth it and by the mediation of it effects a disease So in continuall feavers the antecedent cause is the matter fitted for putrefaction the concomitant which actually putrefies So in swellings caused by humors the flowing humor is accounted the antecedent cause the flux the concomitant The Concomitant cause is that which immediately and by it self produceth the disease Examples of this are after proposed in the explication of the antecedent But it is observable that external causes are sometimes concomitant as the sword which immediately makes the wound and therefore all the causes are not seldome divided into procatarctick antecedent and concomitant omitting the consideration of internal and external The concomitant cause is again simply concomitant or containing Simply concomitant is that which if it be the disease is but if it be taken away the disease remains So supposing the action wounding the wound is supposed but taking away the action that remains Continent cause is that which being supposed a disease is supposed and being taken away that follows So supposing the stone or some other matter causing obstruction we must suppose obstruction which if we take away obstruction removes also So taking away a sixth finger making an excess in number the error depending on that is taken away Hence it appears that all diseases have not a containing cause but some onely but all the rest have necessarily a concomitant cause CHAP. III. Of the Causes of Similar Diseases Thus far of the Causes of Diseases in their genus it followes that we handle them in their species
parenchyma's have a dull sense So when the stone presses the the substance of the reins it causes a gravative pain but when it crowns the head of the ureter a pungitive So likewise in the pleurisie when the matter seiseth on rib-surrounding membrane it raiseth a pungitive pain but when it makes a transition to the lungs the pain is changed to gravative Pulsatory The pulsatory pain shews an artery or some adjacent part to be affected therefore in all the inflammation of the parts wherein the artery is lodged there is caused a pungitive pain Excrements But those excretions which are conveyed thorough several parts of the body do usually discover the part affected in this manner Of the essence of the part A cartilaginous substance expelled by cough speaks an affection in the aspera arteria or the concavities of the lungs but a minute part of fungous flesh excreted shews the lungs themselves to be affected but a crass substance proceeds from crass parts Naturally contained If meat or urine or dregs be expelled by a wound we know that the ventricle bladder or intestines are wounded Preternaturally contained If small stones or sand be excreted by urine the reins or the bladder are affected Maw-worms expelled by the mouth or the gut shew the intestines affected Quality of excrements Air too hot sent forth by expiration discovers the heart or lungs to be hot but too cold shews the heart to be much refrigerated and next neighbour to death First second third The blood too hot too thin and too yellow and issuing as it were by leaps shews an artery wounded Tenuity and colour Small dejections of the belly and red like the water in which raw flesh hath been washed shew an infirmity in the liver Spumosity and manner Spumous excretions expelled by coughing shew the lungs affected They whose excrements in the effluxions of their belly are spumous have a defluxion of flegme out of their head Aph. 30. Sect. 7. For flegme flowing from the brain mingled in the intestines with flatulencies is become spumous Taste Acid belching shews the ventricle to be replenished with crudities Quantity If a great quantity of blood be expelled in coughing the vessels of the lungs are affected those which are in the aspera arteria being too narrow for a plentiful effusion of blood The excretion of blood in urine if it be not much may be conjectured to proceed from the bladder if much from the reins or superiour parts where it is more copious Manner Excrements rejected by spitting signifie the mouth by sneesing the jaws by coughing the lungs or the aspera arteria by vomiting the ventricle affected Order If white corruption usher out urine there is an ulcer in the yard it self if it issue after urine there is one in the bladder or reins In a dysenteria if such corruption or pure blood flow out before the feculency it is credible that the intestinum rectum is rather ulcerated than the rest but if after it or much confused with it it shews the superiour or middle intestines to be affected Qualities changed The qualities changed do sometimes discover the part affected for instance whatever part of the body is possessed by heat or cold there is a disease Aph. 39. Sect. 4. Colour A leaden or pale colour thorough the whole body shews the liver to be refrigerated an orange colour the bladder of the gall to be obstructed blackish the milt to be so affected A lasting red in the cheeks and of a deep grain shews an inflammation in the lungs Taste A bitter taste in the tongue signifies the ventricle replete with choler But a salt taste shews the defluxions of salt flegme from the brain Sound A tinckling and hissing of the ears whispers an affection there A rumbling in the belly speaks the intestines troubled with flatulency CHAP. VI. Of the signes of a part primarily diseased or by consent IN all preternatural dispositions it happens for the most part that they confine not themselves to the narrow limits of one part but overspread many because that which is at first affected infects by sympathy those parts that have any commerce with it where a Physician must be very accurate in distinguishing sympathetical from idiopathetical affections For the better performance of this we must derive the signes from the mentioned heads of which some give occasion onely of a slight conjecture but some of better assurance but our united collection of all together is infallible The heads therefore of these signes may be taken out of the following table marked with the letter C. C. A Table of the signes shewing a part primarily or by sympathy affected The signes shewing a part to be primarily or by consent affected are drawn either from The Essence to which is referred The temper in the qualities First heat cold moisture driness Second hardness softness thinness thickness Vicinity Kinde Office Connexion The Causes which are either Helpful Hurtful The Effects or symptomes in which is considered Magnitude Time Order Duration The linkes of this chain of signes will be unlocked by the following theorems illustrated with examples The Essence The hotter parts are more compassionative to a sympathy then colder First qualities because they easily attract the noxious humors and vapors so the heart and liver do more easily sympathize with the other parts then the ventricle bladder or womb c. Parts thin and soft do more easily sympathize Second qualities then thick and hard because they easily receive the noxious causes and do not make resistance So the skin by reason of its rarity easily receives the humors flowing from the inner parts so the lungs are often attempted by the defluxions of humors from the head Neighbouring parts incline to sympathy more then remote ones Vicinity So the hand communicates a sense of its evils to the arm the bones to the adjacent flesh the ventricle to the liver the pleura to the lungs the lungs to the heart and so round Parts placed under the same genus Genus and possessing the same nature are easily excited to a mutual compassion So the nervous parts sympathize with the nervous the carnous parts with the carnous The whole body sympathizeth with those parts which are publick officers in the body Office So when the brain heart or liver is affected the whole body is ill Those parts which execute the same office in the body do mutually sympathize so the breast with the womb the bladder with the reins Those parts which are directly superiour or inferiour to others Situation easily receive their affections So the head easily receives the vapors ascending from the inferiour parts and the lungs the humors descending from the head Parts united by connexion are mutually compassionate Connexion So the affections of the nerves are communicated to the brain of the arteries to the heart of the veins to the liver and so on the contrary The Causes Secondly from causes helpful and
cold sweat on the sixth again she was extreme cold with an universal sweat yet coldness of the extreme parts fondness convulsions followed it and she died the same day because that coldness happened not on a critical day but on the sixth day which by Galen is termed tyrant so that Hipp. deservedly said Aph. 29. Sect. 4. If coldness happen the sixth day to febricitating persons an hard judgement followes Yet it may be objected that Larissea a maid whose history we find in 3. Epid. Sect. 3. aegr 12. was on the sixth day upon a coldness which was seconded by a copious flux of bloud and universal hot sweat perfectly judged To which we must answer with Galen in the comment that this is one of those rare examples in which Hipp. observed judication to be sometimes made on even daies which so rarely falls within the compass of example that it will no way disorder the common method of good Crises To this adde that her months then first flowing from her were very advantageous for the solution of the disease If coldness do happen without the intermission of the Feaver the sick person being now infirm it is deadly Aph. 46. Sect. 4. Galen in his comment saith that it signifieth not the same to say if it shall happen and if it do happen for the word shall happen denotes one assault of cold do happen many therefore upon cold happening once we may sometimes presage good sometimes bad as appeareth by the precedent theorems but for cold to happen often without any deficiency of the Feaver being otherwise not good is in infirmity more pernicious for if any evacuation follow the coldness which causeth no intermission both conduce to a mans dissolution as well because by reason of imbecillity the body cannot bear the agitation of the cold as because the strength is by evacuation dissolved but if coldness alone happen without the attendance of evacuation it is both waies bad for as a bad cause it tries the strength of a man and is a bad signe shewing his imbecillity which did usually evacuate the noxious humors in colds but now it is not able Coldness often coming in a long disease or rather shakings without any order or type signifie an internal suppuration Hipp. in Coac Or they may signifie plenty of depraved humors by which sharp vapors are usually elevated See Hipp. 1 Coac Apn. 10.13.16 Shakings frequently appearing in the beginning of acute Feavers are bad For they shew a very great pravity of humors vellicating the sensible parts and the infirmity of nature spending her labour in vain to move the humors Such shakings do usually appear in the beginning of malignant and pestilent Feavers Frequent tremblings of the loyns with a quick return of heat are dangerous for it signifies a painful suppression of urine and for it to sweat out there is perillous 1. Coac Aph. 18. For it signifies an inflammation of the spinalis medulla or the membranes thereof which parts by the violence of preternatural heat are scorched and by the want of native heat they are refrigerated as it happens in a sudden and frequent mutation of the parts into both This also is not seldome found in an Empyema but the suppression of urine followes because by frequent cold the native heat of the bladder is extinguished and so its expulsive faculty destroyed and sense of irritation lost Shaking after sweat is not good Aph. 4. Sect. 7. Iudicatories which judge not are bad so sweat breaking forth on a Critical day if it be not beneficial to the sickperson but shaking followed it is a bad signe for it shewes that either the useful humors onely were evacuated by sweat and the vseless and copious keep their station or that a part onely of these depraved humors was evacuated by sweat but the rest dwell within and vellicate the sensible parts and so cause shaking It is therefore evident that either nature is so weak that she cannot rid her self of the morbifick matter or the humors so strong that they give nature the foile Sternutation It is observed that if a sick man sneese onely once that he will yeild up to the ferocity of the disease but if he sneese twice the disease will lose the day and he recover But the contrary is noted in women if any of them dangerously sick sneese twice this is destructive and exitial if the sneese be once it is an healthy sign Forest obser 487. distillations of the head and sneesings precedent or subsequent in the diseases of the lungs are bad But in other even exitial diseases sneesings raise hopes of solution Hipp. 2. progn chap. 16. In a phthisis pleurisie and peripneumony by that concussion of the brain sneesing the parts of the breast are lacerated and violently torn which increaseth much the inflammation and so there is no vacuation of the morbifick matter But in other diseases the morbifick cause may be dissipated and dispelled by the strength of nature sallying upon it by that violent motion therefore sneesing signifies that nature resumes strength and is excited to expulsion whence we may conjecture that it is the beginning of a recovery Galen in his comment on this place affirms that sternutation without rheume in the declination of a disease or after the sickness is past is alwaies a good sign though the sickness be pernicious Sternutation happening to a woman in hysterical fits or when she brings forth with difficulty is good Sneesing is very commodious in hysterical suffocations dissicult labour and retention of secundines both as a signe and as a cause as a signe because it shews that nature is mindful of her proper motions and that being before dulled she is now excited and revived because she casts out some superfluity as a cause for that by vehement concussion and fervour it partly rouses up nature partly causeth excretion of those things which adhere to the parts of the body Vital actions Good and easie respiration conduceth much to health in acute diseases Hipp. 1. progn Respiration For as Galen instructs us in his com good respiration signifies that the breast heart lungs ribs midriffe and all the parts subservient to spiration are in good case And when they are so we need fear no danger from an acute discase unless it be malignant and pestilent For such feavers do often as it were surprise us by an ambuscado so that we cannot be sensible of any injury offered to respiration though in their progress they are deadly affections When in a not intermitting Feaver difficulty of spiration and desipiency happen it is a deadly signe Aph. 50. Sect. 4. Because the two grand Patrons of life the heart and brain are vehemently hurt and sympathize to destruction but both passions viz. desipience and difficulty of spiration must last long that they may be called mortal for both sometimes do happen healthfully in a critical perturbation Great and unfrequent respiration in an acute Feaver is very bad For this shews
pencil by him described 2 Coac and 1 prog in these words His countenance was of this nature his eyes hollow his nose sharp his temples fallen his ears cold and contracted the skin of his forehead hard stretched and dryed the colour thereof pale or black blew or leaden all which things proceed from most pernicious causes for the parts of the face are either truly lean the substance thereof being consumed or else it hath a seeming leanness caused by a withdrawing of the spirits and blood For they give a lively and fresh colour to every part and a moderate moisture which falls away when these are withdrawn then also there is an external cold that presses down the several parts causing a greater extenuation The heat which is most intense and malignant causes a consumption of the flesh But the withdrawing the spirits and blood from the several parts is caused by the great weakness of the natural heat that it cannot recruit it self again or by reason of the great fire within which draws the bloud and spirits to it like a cupping-glass And therefore all those great causes of extenuation which appear in the face are very bad and those particles which Hipp. hath reckoned up are most capable of extenuation For the eyes are very fat and full of spirits which causes them to swell and hang out if therefore that fat be consumed and the spirits be exhausted the eyes fall down leaving the places which they did possess for the most part empty which makes the eyes hollow In the nose the end or point onely somewhat thick for the other parts are bones gristles and skin without flesh In the tip thereof onely are certain thin and fleshy fibers produced from the muscles that move the cheeks and therefore in that part of the nose doth chiefly appear the extenuation caused by the disease the hollowness of the temples are full of very moist muscles which is the cause that greyness begins usually at the temples which moisture is quickly diminished by the above mentioned causes The cars are not without reason cooled though the weakness or retreat of the natural heat both because they are extreme parts remote from the fountain of heat and also because they are without flesh being onely composed of gristle and skin the tips of them also are contracted and the skin of the forehead stretched drie and hard by reason of the drought caused by consumption of the moist parts as skins which being dryed are contracted and shriveled up together The pale colour black or blew proceeds from the withdrawing or exolution of natural heat and spirits whence these refrigerated parts receive that colour In the last place take notice that this death resembling face that shews it self by the abovementioned signes is most pernicious if it be produced by the internal causes before described for if it pro ceed from procatarctical causes it is less dangerous as Hipp. notes in this theorem where he reckons only watching and loosness of the belly but we may adde to that other procatarctical causes as the effect of nourishment sadness and fears And it may be easily discerned whether it depend on these outward causes for then the symptome lasts but one day presently the patient returns to his former state In the eyes You must well consider how the eye is affected when the patient sleeps for if there do appear any thing white under the eyelids being half shut if it proceed neither from physick nor any loosness of the belly t is an evil signe and very mortal Aph. 52. Sect. 6. When the sick person sleeps with his eyes half shut so that you may perceive underneath a certain whiteness it shews a very great weakness of the animal faculty for if the eyes the closing of which is the easiest work of the faculty be shut in sleeping it sign fies a very great impoverishment of the animal spirits Therefore it is a deadly signe if such a resolution be produced by the strength of the disease but if it proceed from any evacuation either natural or procured by art or any outward cause by reason that that may be repaired again this half shutting of the eyes is not so dangerous Hipp. also adds another caution in 1. prog That is if the sick person were not wont to sleep in that manner for it is usual with some to sleep with their eyes half open This symptome is of great use in acute diseases of the head whether with or without a feaver because the eyes are next the brain and as it were joyned to them and so consequently most certainly declare the affections thereof but in other diseases they denounce not danger so surely For children that are troubled with the worms do frequently sleep with their eyes open and are easily recovered This affection proceeds not alwayes from an impairing of the strength but sometimes from a convulsion of the muscles moving the eyes as Galen teaches in his Comm. on this Aphorisme If in an acute disease one eye groweth less then the other t is mortal Hipp. 1. progn For it is caused by a weakness of the faculty governing the eye which now begins to desert its office but it would be much worse to see both the eyes extenuated by reason of the weakness of the same faculty But this extenuation begins to appear in one of the eyes for seldome it is that both eyes are in the same condition For so a consumption that is about to afflict the whole body uses to begin to take its rise from one or two members and thence to creep to the rest and thence to the rest as they are more or less prone to receive it Yet you must observe whether this extenuation proceed from any particular disease in the eye and not from a weakness of the faculty then it speaks no danger at all If in acute diseases the white of the eye appear red t is evil Hipp. 1. progn For it shews either blood or choler translated to the brain whence an inflammation and phrensie the product thereof is to be expected which threaten much danger to life For the tunicle that constitutes the white of the eye arising from the membranes of the brain the inflammation of them is easily communicated to the tunicle If in an acute disease the veines of the eyes appear black or blew it is a mortal signe 1. prog For either it signifies that adust and atrabilary humors abound in the brain or else an extinction of the natural heat which hath caused the blood to lose its native colour and to acquire concretion If the eyes are perverted in an acute disease it is evil 1. prog The eyes are said to be perverted when they move out of order and decorum that is either more upward then they ought or more downward or more to one side then the other as also if one move upward and the other downward or if one be drawn to one corner and the other
substance To the fifth I Answer That the concurrence of three things cause cogitation Faculty Instrument and Object all which being supplyed the mind operates indefatigably for not only waking but often also sleeping we exercise our cogitations because we use the object of the internal senses but both failing cogitation ceaseth as also in default of the Instrument viz. Animal spirit which is tyred with many operations whence the careful ingeniety of nature hath provided sleep for living creatures by the benefit of which as it were by a truce the Animal actions keep high Holy-day and the spirits are refreshed CHAP. III. Of Innate Heat Innate Heat is the primigenious moisture diffused thorough all the parts of the body and every where replete with implanted spirit and native Heat HEat is a concrete term which signifies not only an accident but the subject to which it inheres There are therefore three things concurring to the constitution of innate heat viz. primigenious moisture implanted spirit and native heat in the spirit is constant heat but this implanted spirit is alwayes in conjunction with this primigenious moisture and confused with it and from them so united results the innate heat The true understanding therefore of these three will cause an easy knowledg of the nature of innate heat and the implanted spirit was at large explained before the primigenious moisture and native heat only rest for explication Primigenious moisture is a humid fat and oily substance diffused thorough all the body by preying on which as its proper food the native heat is preserved Aristotle defines life to be the dwelling of native heat in certain moisture that therefore this heat the Author and preserver of life may long continue in the parts it wants certain fuel no lesse than our fire to keep it from extinction But moisture being two-fold in our body one waterish the other fat and aiery this vivifying heat cannot be fuelled by the waterish but by the fat and aiery moisture as a lampe or candle lighted is not inflamed by waterish but oily and pinguedinous liquor or some such like substance so Trees and other Plants which abound in this fat substance are of long continuance and excellent fuel when they are burned But on the other side green wood in which waterish humidity is as copious or wood of too much growth in which this fat humidity is exsiccated make no good fire But when we discourse of oily and fat substance we understand not that fat or grease which most commonly in women or idlers is collected about the skin and membranes but hardly comes nigh the substance of the bones nerves and bowels for those are not the subjects of vital heat but are rather by their over-growth an impediment to actions But this native and genital humidity according to its copiousness is more useful and commodious to the exercise of all functions and the prolongation of life It derives its original from the first principles of our generation viz. from the seed and maternal blood The first upstart of our generation is abundantly furnished with this radical moisture hence it is that when this is substantialized into the parts of our body the whole masse in the preface of life is very well stock'd with this moisture which afterward by the continual action of the native heat is by degrees as our Age posts away wasted and dryed till it arrives to the last stage of exsiccation whose consequence is the extremity of Age and natural death But the fat and oleous moisture of Aliments is the cause of preservation While this moisture continually suffers under the insulting activity of heat it would quickly fall into a consumption unlesse the losse were recompenced by the accesse of new aliment At the charge of this reparation are fit aliments prepared by divers coctions in which we find two-fold moisture one fat and aiery near related to the nature of the primigenious moisture and makes up the losse of it the other waterish keeping in repair the common humidity of the parts which breaks the force of heat lest it should consume this fat and aiery moisture as appears in Sugar Honey or Oyle when they are boiling that the water mixt with them encounters the forces of the external fire and is vanquished when they remain in their integrity or with smal diminution And though the loss caused by heat is continually repaired by new aliment yet that which is acquired in the place of what is lost is much worse and more impure and deficient both in quantity and quality otherwise it were possible for life to be stretch'd to infinity but this primigenious moisture by degrees decaying and it being impossible to equalize this diminution with any aliment it inferres an absolute necessity of death Native heat is a quality proper and familiar to all living creatures by the help of which they live and act It is in our bodies twofold one the consequent of the first mixtion of the body and parts which after the destruction of the creature removes not as long as mixtion keeps its dwelling which is made out of the foure Elements guarded with the retinue of their qualities the other proper onely to living creatures termed Vivifical because by it as long as it is our guest we obtain the advantage of nutrition growth conservation and life whence Aristotle defines Life as is before mentioned the conservation of this heat in certain moisture It is derived from the first principles as is the primigenious moisture The first principles of generation seed especially is well fraught with many spirits and much heat hence this heat in our first conception exactly commensurates all the parts and as long as it sojourns with us afterward increaseth and preserveth them Conservation proceeds from the primigenious moisture by the ambiency of air and influence of heat The primigenious moisture is the subject of native heat and its ordinary fare which it continually devours for its own safety as a Lamp alwayes needs Oyl for its conservation and Fire the continual addition of Fuel of which as plenty causeth the inflammation to rise higher and withdrawing it a diminution so native heat is increased or diminished according to the proportion of the primigenious moisture But as is before alledged this moisture never increasing but wasting from the very Prologue of our life it happens that the heat also is perpetually diminished to the Epilogue of our life And as our Fires lack not fuel alone for their preservation but also the kind embraces of Air by which they may be refreshed to refocillation for being confined to a narrow circumscription though they have sufficient fuel yet they are suffocated which is evident in Medical Cupping-glasses So our native heat wants the ambient air for commodious eventilation But this air by the benefit of the Lungs is conducted to the Heart which is the principal furnace of heat but to other parts by insensible transpiration by the defect of which the
conservation of it will be the conservation of life hence this faculty is significantly termed Vital or the preservative of life And so life is an action depending upon this faculty as an effect upon its cause The Vital faculty is attended by two servants Pulse and Respiration It is ignorantly asserted by some that the Pulse is the chief of Vital actions and immediately to depend upon the Vital faculty for life as we before affirmed immediately depends upon that but the pulse is only a subservient action to it caused by a pulsifick faculty whose vertue is only to cause systole and diastole in the heart by which means it performs its duty to the Vital faculty Pulse is a function of the heart and Arteries composed of Systole and Diastole with some interposition of rest caused by the pulsifick faculty of the heart to further the generation of the Vital spirits and effect the distribution of them thorough the whole body The Pulse of the heart and Arteries is composed of three parts viz. diastole systole and the intercession of a pause By Diastole the heart and Arteries are impregnate When the heart dilates it selfe it attracts the Aire from the Lungs by the help of the Arteria Venosa and the blood from the Vena Cava that from the commistion of them in the left closet of the heart the spirits may be generated but the Arteries being strtech'd to a dilatation attract the spirits from the heart and are tumid with them as also the external Aire entertained by those orifices which are terminated in the skin and in this manner is transpiration caused which by this intromission of external aire fixes the internal heat to a due temperament and cherishes it for all heat is preserved by a moderate compliance of cold according to Hippocrates By Systole or contraction the heart by the assistance of the Arteria venosa purges out at the Lungs all the fuliginous excrements left in the generation of spirits For the Arteries by an insensible transpiration drive out the fuliginous vapors contained in them and send the spirits more copiously to the parts Lastly there mediate between the systole and diastole and intercessive quiet because a transition from one contrary to another cannot be effected but by a medium A doubt may be moved whether the spirit and blood contained in the heart moves upon its coarctation I Answer that there are two doores in the heart one in the right corner another in the left which are dilated when the heart is contracted and are so filled viz. the right with blood contained in the right cavity but the left with spirits contained in the left Three things are requisite to cause pulsation Faculty Instrument and Use The first necessary is a pulsifick faculty which is the primary and principal agent Secondly instruments disposed to pulsation viz. the Heart and Arteries moved by that faculty Thirdly use and necessity forcing the faculty to action viz. the generation of spirits and conservation of native heat Respiration is an action partly Animal partly Natural by which the Aire is ushered in thorough the mouth to the Lungs by the distention of the breast and by the contraction of the same the smoaky vapors are excluded for the conservation of Native heat and the generation of Vital spirit The parts of Respiration and of Pulsation are three Inspiration expiration and immediate quiet By inspiration the breast is dilated by the muscles destin'd to this office and in compliance with the dilatation of the breast the lungs are also dilated lest there should happen a vacuity in that cavity and the lungs are filled with air as bellowes the inspiration of which aire tempers the violent heat of the heart and thence the vital spirits are generated as is before urged But by expiration the breast and lungs are contracted which by their contraction turn out of doores the hot aire and fuliginous vapors issuing from the heart The concurrence of three things is necessary for expiration Faculty Instrument Use First Animal faculty concurs moving the muscles of the breast as also the natural implanted faculty causing motion in the lungs that they might be helpful to the heart Secondly There is a concurrence of instruments as all the parts designed for Respiration And Lastly use or necessity of Respiration for the ventilation of the heat in the heart A COROLLARY It is much disputed whether Respiration be purely Animal or mixt viz. partly Natural partly Animal Which being ingeniously disputed by Laurentius question 20. book the ninth I referre the Reader to him CHAP. VII Of the Animal faculty and function and first of the Principal faculties The Animal faculty is that vertue of the soul which moveth a man to the exercise of sense Auction and other principal functions of the mind The principal are three Imagination Ratiocination and Memory Imagination is that action of the Soul by which the species of every object offered to the external senses is made perceptible and distinctly discerned EVery sense enjoyeth its proper and peculiar object as shall after appear whose species it entertains in its proper organ without passing judgment of it for this is the prerogative of the Imagination only to which the spirits presents the species conveyed by the nerves from the brain to the instruments of the senses The brain therefore being the Court of the principal faculties while the objects of divers senses promiscuously resort to it they are first represented and distinguished in the imagination which the peculiar senses are not able to perform for instance the whiteness of milk is only represented to the sight but not the sweetness of it on the contrary the sweetness is represented to the taste not the whiteness But they are both together perceptible to imagination which rightly distinguisheth to what sense they be related Besides imagination apprehends not only things present as the senses but things absent also and represents them to the mind composing many things never existent yet in Analogy to those which are apparent to the senses The Philosophers divide those operations of the mind which we consenting to Galen include under the notion of imagination into two species viz. into the common sense and into fantasy or imagination commanding as it were the common sense to welcome only the species of present objects but the imagination to propose to it self things absent as if they were really present as also things not in being and impossibilities But seeing that they differ only in the method of their operation it is not necessary that they should depend upon faculties differing in species Ratiocination is that action of the soul by which a man discourses understands and reasons This is appropriate to man the others being enjoyed also by brutes But this receives the species of things from the imagination dividing and compounding them and unravelling their nature by the help of discourse distinguishing good from bad truth from falsity drawing out of them many things
the quantity and manner are considerable In respect of the quantity of motion or duration one disease is called long another short So a day-expiring feaver is a short disease because it is quickly at an end as dropsie long because it persists a long time In respect also of the quantity of motion or duration one disease is called acute another chronical Acute disease is that in which magnitude and brevity are companions Therefore it moves nimbly with vehemence and danger The Chronical is commonly opposed to this though it be not totally contrary to it For Chronical and Long speak the same and it is so called only because it is of long continuance although it be usually great as the palsie dropsie and the like to which the short ones are truely and properly opposed Observe That some diseases are in respect of their proper essence Chronical in respect of their paroxisme Acute as the Epilepsie which is a disease very long and hath paroxismes very acute Acute disease is threefold the first peracute the second acute simply the third acute by dilapsion or decidence The Peracute is again divided into extremely peracute and simply peracute Extremely peracute is that which is so vehement and swift in motion that the third or fourth day it ends either in health or in death Simply peracute determines the seventh day But acute simply so called is either exactly or not exactly such Exactly such ends with the fourteenth day Not exactly such continueth to the twentieth or further Lastly acute by decidence reaches the fortieth day and after its arrival to that it is called a long and continuing disease And these are the differences hewn out from the quautity of motion those follow to be proposed which result from the manner of motion In respect then of the manner of motion some disease is called continual some intermissive Continual disease is which troubleth without cessation and in its whole duration is impatient of mitigation by any intervening pause But intermissive is that the fury of which in its career is usually allayed by perfect intermissions And so much of the Motion now follows the manner of Disease 3. In respect of the Manner a disease is called gentle or malignant A gentle disease is that which is very remiss and induceth no dangerous symptomes But that is malignant which comes accompanied with some malignant and venemous quality attended by dangerous symptomes Malignant is again threefold the first venemous the second pestilent the third contagious A venemous disease is that which is intimated with a quality that is a desperate antagonist to our life produced by assumption or application of poyson or from noysome humors internally generated Pestilent disease is that which is malignantly and deleteriously qualified and is impartial to all Lastly Contagious is that which riseth to an high accompt in multiplication and usually infects many others with the same kind of disease So far of the Manner of disease the Event thereof follows 4. In respect of the Event some disease is healthy some deadly some dangerous Healthy disease is that which threatens the life with no danger Deadly disease is that which brings along with it assured destruction Lastly Dangerous is that which hovers in a doubtful event sometimes tending to health sometimes to death And these are the differences proceeding from those proprieties which are concomitants to essence those now which are derived from the causes remain to be proposed But those causes are either material or efficients or helps without the advantage of which nothing could be produced To the Material we refer the subject to the Efficient the humors to those without the help of which nothing could be the place There are many other kinds of Causes which here we propose not because we have determined to spin the accidental differences of Diseases out of these alone as also neither to lay down all that may be pick'd out from them but only the most useful 1. In respect of the subject some disease is called Idiopathetick some Sympathetick The Idiopathetick is that which is primarily produced in the part by its cause and hath in it a place of duration So a Pleurisie Inflammation of the lungs and Phthisis and others are termed Idiopathetick Sympathetick is when the affect of one part idiopathetically diseased is communicated to another Yet the affection is so communicated to this compassionate part that upon the ablation of the former viz. the Idiopathetick the Sympathetick is also taken away otherwise if it should remain by it self it would become Idiopathetick and then Physicians term it Deuteropathetick or secondary But the primary is called Protopathetick because the affection owes its first production to that part But a Sympathetick disease is usually generated by five causes First because of vicinity Secondly because of the society of the genus Thirdly because of the community of office Fourthly by reason of situation Fifthly by reason of connexion Because of vicinity the hand sympathizeth with the arm the bone with the neighbouring flesh the ventricle with the liver the ribs with the lungs the lungs with the heart and so on the contrary By reason of the society of the genus the nervous parts sympathize with the nervous and the carnous with the carnous as being constituted under the same genus and partaking of the same nature By community of office the breasts with the wombe the bladder sympathizes with the reins because they are designed to the same employment in the body By reason of situation the head is easily compassionative with the inferiour parts as the ventricle liver wombe and the like as being in a direct eminency to them and so the vapors by them elevated are with ease conveyed to its reception So also the ventricle and lungs easily sympathize with the head as lying directly under it and so easily entertaining the defluxions of humors streaming from it By reason of connexion the nerves are compatible with the brain the arteries with the heart the veins with the liver and on the contrary as bordering upon them Again all sympathetical disease is caused two wayes viz. positively or privatively Positively when any thing is conducted from one part to another So the vapors steaming from the ventricle to the brain produce aches vertigoes and such like sympathetical affections which are termed positive Privatively when there is no influence where there ought to be one So in the apoplexy the sense and motion of the whole body decayes by the non-influence of the animal faculty and spirits from the brain caused by the obstructions of the ventricles thereof And so it is said to proceed from the privation of matter or faculty 2. In respect of the efficient causes or the humors operating diseases some are called legitimate some spurious The legitimate is which is graved with that impress of Nature which is proper to its species and the cause of whose usual production is whole and sincere The spurious is that which
upon parturition depends upon the error of the birth therefore for the most part computation is to be made from the birth But it is seldome found that when the birth is natural a feaver should arise which at that time cannot proceed from any thing but a procatarctick and external cause In Head wounds and any other the computation of the Critical dayes must be made from the day of the wound not of the feaver The same reason holds in a wound as in preternatural birth for the feaver succeeding it is symptomatical but the wound is the primary disease from which the number of critical dayes must be deduced In relapses the computation of the critical dayes must be instituted from the beginning of the disease not the relapse Recidivation is caused by the reliques of the precedent disease which were not wholly evacuated and therefore is taken for the same disease the matter being the same in which indeed there happens a remission of the feaver between the root of it and the relapse but not a true intermission as appears by the symptoms observed by Hippocrates when he saith If any thing of that which is effused be left within it inclines to relapse thirst left within exsiccation of the mouth and insuavity by the same reason as all the rest are signes of the imperfect solution of a disease Therefore because he that is surprised with a relapse is not yet fully freed from those accidents the computation must be one for that the solution of the former affection was not total but partial only So Hipp. in Epid. perpetually numbers the days from the precedent disease never from the relapse as appears in the Histories of Hermocrates Anaxion Herophon Cleanactis Wife to Epicrates and others CHAP. VI. Of the causes of a Crisis and Critical dayes A Crisis is a kind of a compound comprehending Conturbation Evacuation and sudden mutation to health Conturbation is a plenty of critical symptomes arising from the agitation of morbisick matter But this agitation proceeds either from an external cause such as of the Heavens and the motions and influences of the stars or from an internal as from nature her self HOw the influences of the Stars effect critical motions shall be after explained But now nature in a critical conturbation agitates the morbifick humors because they being separated from the laudable and gentle matter provoke nature more which upon this irritation is excited to expulsion for though those humors be concocted yet they are not wholly reduced to gentleness and therefore by molesting nature with their acrimony and some malignant quality they cause her to ease her self of this trouble by excretionr The cause of Evacuation is the expulsive faculty which excited either by the copiousness or the quality of the matter critically expels all molestations The expulsive faculty is one of those which are termed natural subservient performing its duty by the help of native heat and spirits as also by the fibres implanted in every part But why Crisis or critical evacuation happens in the septenary and quaternary dayes rather then at other times depends upon the motion of the Moon as its principal cause The cause of a Crisis and the cause of critical dayes are to be distinguished as things differing in the whole latitude of the genus For the cause of a Crisis is the expulsive faculty thrusting out that which is troublesome But when we enquire after the causes of critical dayes we observe not what expels the vitious humors out of the body but why the expulsive faculty doth not use indifferently all but some solemne dayes on which it expels these troublesome things more frequently and easily but this depends upon the motion of the Moon effecting these motions by her various aspects The Moon is very predominant over these inferiour bodies especially over humid ones causing in them notable mutations chiefly in conjunctions appositions and quadratures in which Crises usually happen What changes the Moon causeth by her various aspects in this inferior world and how by this means the winds and tempests are changed how seed thrives how crabs and shel fish are sometimes full sometimes empty is well enough known to Mariners Husbandmen and ordinary Women But the chief subjects of this domineering Planet are humid bodies whence it is no cause of wonder that it should have so much authority over the humors of our bodies that it can move them on certain dayes and by that excite a Crisis This it most commonly does in its aspects by whose Arithmetick the critical dayes are numbred for the first aspect of the Moon is the Sextile or left hexangle happening on the fourth day The second quadrate or the left tetrangle on the seventh day The third called the left triangle on the eleventh The fourth called opposite or diametral on the fourteenth day The fifth the right triangle on the seventeenth day The sixth the tetrangle or right quadrate on the twentieth day The seventh the sextile or right hexangle on the foure and twentieth day The eighth in conjunction on the seven and twentieth day But these days are extended to some latitude as we shall hereafter inform it will suffice here to note that the Aspects of the Moon and the Critical days have the same computation which was proposed in the precedent Chap. The Motions of Critical dayes depend not on the Aspects which the Moon hath with the Sun but from those which she hath with the Signes of the Zodiack and that place in heaven in which it was in the beginning of the Disease If the Crises were moved by the appearances of the Moon with the Sun there would be no order observable in Critical dayes because all sick persons whatever day they began to be sick would on the same day be subject to a crisis for instance in the beginning of a full Moon when she opposeth the Sun or in new Moon when conjunction is caused or in the quaternions Therefore we must think that the crises depend not on such aspects but rather from the aspects of the Moon to that Signe and to that place of the Zodiack in which it was in the beginning of the disease and so on the seventh day of the disease the Moon is in a quadrate aspect to that place and on the fourteenth in an opposite and so of the rest The computation of Critical dayes is not to be instituted according to the Synodical Month which is also called the Moneth of Conjunction nor according to the Moneth of Apparition or Illumination nor according to the Medicinal Moneth but according to the Periodical Moneth or the Moneth of Peragration The Synodical Moneth is that time which intervenes between two conjunctions of the Sun and Moon consisting of twenty nine dayes and thirteen hours and so three weeks constitute not twenty but two and twenty dayes and three hours therefore according to this Moneth the computation of the Critical dayes cannot be made The Moneth of Illumination or
Five causes of a hot intemperature are alleaged 1 Motion 2 Putridity 3 The vicinity of an hot thing 4 Constipation 5 Meat and Drink over-hot as Galen ch 2. Book 2. of the Causes of Diseases First Motion heats the body by attenuating and violently hurrying the spirits MOtion doth not onely heat things animate but inanimate also as Aristotle 2 of Meteors ch 3. inanimate things by rarefaction because that disposition is previous to heat by which it effected the last preparation of the matter for production of heat potentially out of it But animals do more easily get heat by motion not only by reason of that attenuation but also because the spirits and heat which are actually in them are diffused thorough the whole body and thrust out to the superficies thereof Whence if motion be immoderate it produceth an hot intemperature To motion are also referred anger watching and all other things able to move the humors and spirts Secondly putridity heats the body by external heat which is alwayes introduced in its company Putridity is defined by Aristotle The corruption of native heat in every humid body by external heat But it is necessary that this heat should be very intense that it may corrupt the native heat whence in our bodies it will easily produce a hot distemper Thirdly The vicinity of hot things heats the body by a Physical and Mathematical contact So by fire or Summer sun the body is heated by a Physical contact by things hot applyed as plaisters baths c. and by a Mathematical contrary Fourthly constipation causeth a hot distemper by accident by reason of obstructed transpiration This is chiefly produced by swiming in alluminous water by the application of emplastick and obdurating medicines and other things increasing heat by antiperistasis while they hinder the dissipation thereof Fifthly hot aliments heat the body by producing in it hot humors As the use of onyons garleek spices and such like The causes of a cold distemper are six 1 Vicinity of cold bodies 2 The quality and quantity of things assumed 3 Constipation 4 Rarity 5 Over-much idleness 6 Immoderate motion As Galen ch 3. Book 2. of the Causes of Diseases First the body is refrigerated by external cold meeting with the concurrence of a fit disposition c. in the Patient So in Winter a body is often congealed by over-much cold So bathing in cold water cools the whole body Secondly the excess defect and incomplying quality of aliments can induce a cold distemper Excess of aliment chokes the native heat whence arises a cold distemper so an epile psie or apoplexy is the result of frequent drunkenness The defect of aliment causes the dissipation of heat in the parts as having not food sufficient for its conservation Whatsoever is assumed naturally too cold as lettice poppy mandrakes and the like do very much cool the body by themselves Thirdly much constipation chokes the heat whence proceeds a cold distemper Slight constipation causeth an hot distemper by hindring the dissipation of heat but much immoderate constipatiō causeth a contrary affection by suffocating heat Fourthly rarity dissipates and resolves heat whence by accident it induceth cold Fifthly idleness refrigerates the body for that the native heat languisheth for want of exercise Sixthly the native heat is dissipated by immoderate motion whence by accident it refrigerates Of a dry temperature the causes are two 1 Alteration 2 Resolution First those things dry by alteration which have strength enough to exiccate the body So drying aliments medicines a dry constitution of the air do dry the body Secondly those things dry the body by resolution which cause a greater dissipation of the humidity of our body than can be counterpoised by restauration So violent exercitation the embraces of over-heated air immoderate watches resolves the humidity of the body So humidity is dissipated by the hindrance of due reparation which is caused by care and anxiety hunger or food affording small nutriment such as is very excrementous and astringent because it hinders the distribution of nutritive humor thorough the members Humid intemperatures are ascribed to two causes 1 Alteration 2 Retention of humid things First those things introduce a moist intemperature by alteration which are very prevalent in moistning the body So the immoderate use of moist meats copious tipling of water a moist constitution of the air a bathing in warm water and such like the usual product of which is a moist distemper Secondly a moist distemper is said to be introduced by retention of things humid when some customary evacuation is suppressed Amongst the usual evacuations are numbred not those onely which are sensibly made but those also which are made insensibly viz. by insensible transpiration And these are the causes of simple distempers But the causes of compounded distempers may easily be gathered from those before named viz. by joyning all the causes which the two peccant qualities are able to produce But the immediate causes of compounded tempers are principally peccant humors and these distempers are like the peccant humor for choler causeth the hot and dry flegme the cold and moist and so of the rest But those humors become copious in the parts two wayes 1 By fluxion 2 By congestion Fluxion is caused two wayes viz. when either the humors are expelled by the mission of the parts or when they are attracted by the reception of them In fluxion which is caused by expulsion two conditions are requisite viz. first the strength of the part expelling secondly the imbecility of the part receiving So the liver by its strength expels preternatural humors to the groin or the skin parts naturally infirm producing in them swellings itch and other affections In fluxion caused by attraction two conditions principally concur viz. the heat or pain of the attractive part Attraction is proper to heat therefore the hot parts are prevalent in attraction but being sensible of pain they seek help therefore they attract the humors and spirits to their rescue which after by reason of their copiousness they cannot keep in good order which is the cause of divers affections Secondly by congestion the humors become copious in the parts in default of the nutrition of them So when in some part the aliment is not well assimilated or the expulsion of excrements generated in assimilation then superfluities abound in it by congestion CHAP. IV. Of the Causes of Organical diseases The natural shape of the parts is perverted either in the first generation or after it In the first generation when the formative virtue is unable to fashion all the parts aright which is caused upon three grounds 1 By reason of the imbecility of the formative virtue 2 By the defect in matter 3 By an hereditary disposition First the parts are ill-shaped by default of the formative virtue when a mans parents are of a very infirm nature Secondly by default of the matter viz. when it is peccant in quantity or quality
sometimes from all which exercitation it self will easily discover Observe Secondly That most commonly we descry more and more infallible signs from the effects then from the two other heads Observe Thirdly That of the proposed signs as to indication some are of more some of lesse efficacy but yet by rallying up all we draw a conclusive demonstration of the thing which we enquire after Observe Fourthly That we must perfectly understand the nature causes and effects of all those things which are in our body or contingent to it that we may not erre in deducing signs from the proposed head And we must be so well furnished with the precepts of Physiology and Pathology that we may not here be destitute to shew them as often as occasion of use shall require Otherwise these Semeiotical instructions though they be laboured out to a prolixity wil all be but as waste paper The Second Section of the SEMEIOTICAL Parts Of the Diagnostick signs The First CHAPTER Of the signs of bilious Humor predominant in the whole body THE knowledge of the temperament and humor predominant in the whole body is necessary for the understanding the species of the affection and the productive cause thereof Therefore before we discourse of them we must first propose the signs of humor predominant in the body beginning with Choler But it is first observable that there are only two heads from which we take the signs of humors viz. the causes and effects for the essence in this case gives no light That therefore we may lance the skulls of these heads and see what they contain we must orderly run thorough their genus and species at least all those which may be usefull in directing us to the knowledg of humors which that they might not be burdensome to memory are digested into the following Tables To this referre the Table noted with the letter A. By the observation of this order we shall descry Choler predominant in the body by the indication of The Material Causes The Quality of Aliments Feeding on hot and dry meats drinking noble wine old or new which are easily convertible into Choler Quantity Order Defect of aliment as famine food very smal and sparing Sweet things eaten after a meale because by long coction they convert into Choler as experience instructs us that after some space of time they grow bitter by artificial coction Use of hot Medicaments as Spices c. which degenerate to Choler Medicaments Retentions Customary evacuation of choler thorough the belly by Urines Vomits or Sweats flowing either voluntarily or driven out by Medicines suppressed or intermitted The Efficient Causes Parts An hot and dry temper of the ventricle liver and heart Because these parts are able to disseminate an Affection thorough the whole body Descent Parents of a bilious temper Age. Youthfulness that space chiefly which intervenes between eighteen and thirty five Sex Virile sex for they are accounted more bilious as women more pituitous Region A Region hot and dry Time Summer season Aliment Meat and drink of a calefactory and exsiccating quality as onyons garlick all salt and peppered things which by overheating the liver cause a copious generation of choler Exercitation A laborious life toiled with much exercise Venery An over-vehement motion to venery which sets the whole body on fire Watching Too much watching by which the blood and spirits are inflamed Passions of the mind Anger cares and violent commotions of the mind They are helped by things cold and moist offended by things hot and dry and fasting The Effects Animal Actions Ingenuity A sharp and witty ready and quick of fancy Passions of the mind Teastiness rage boldness jactation desire of revenge Sleep and Watching Very little sleep and slight and much watching Dreams Dreams of fires flames contentions and tumults Senses Lively acute quick and expedite senses chiefly hearing to which siccity is very advantagious Swift and nimble but soon tyred motions Vital Actions A great frequent and hard pulse Natural Actions Appetency Want of appetite and nauseating of meat in summer especially Appetite to cold things A difficult toleration of hunger Thirst Much thirsting and frequent drinking Quick and speedy accretion and timely Age because the radical moisture is soon consumed A forward propensity to venery by reason of the acrimony of the seed Venery A speedy wearisomeness in venery because the spirits of bilious men are very dissipable by reason of their tenuity The Passions Bilious men have a propensity which disposeth them for diseases as burning feavers and tertians phrensy and pleurisy to bilious vomits Diarrhaea's Erysipela's blisters and pimples in the face c. Excrements By the mouth Vomiting of humor thin pale or yellow and bitter or a bitter tast in the tongue The ears Copious excrements of the ears and very yellow Belly Feculency very yellow Bladder Urine thin and yellow or also red and flammeous The Purgations of the womb somewhat yellow or orange colour The Habit of the body Skin first quality A skin to the touch hot and dry the heat of it sharp and biting especially in the hands Second A skin hard and rough The colour of the skin principally of the face and eyes pale and yellowish Haires Thinness of haire by reason of the rarity of pores which permits an effluxion of hairy matter Quantity Quality Yellow hair resembling choler and somewhat black by too much expulsion sometimes also curled by reason of the dryness which turns the hairround and bilious men become bald by reason of the siccity of the skin and consumption of the matter of haires Passion The hair soon growing and soon falling The Latitude of the vessels For dilatation is proper to heat and the veins in the eyes apparent Flesh A slender and lean habitude of body CHAP. II. Of the Signs of pituitous humor predominant in the body Flegm predominant in the body is discovered by The material Causes Quality of Aliments A customary feeding on meats cold and moist as fruits hearbs fish meats made of milk drinking of water c. for they are transmuted into flegme Quantity Too great a quantity of Aliment overwhelming the native heat and generating crudities Time Meats taken soon after sleep or before sleep before the concoction of the former Medicaments Too long use of cold and moist medicaments which as aliments degenerate into flegm Retentions The omission of a natural assuefaction to evacuate flegm by vomit or secesse or of an artificial custome by exercitation or use of both waters stewes or purging or diuretick Medicines by the intermission of which flegm is copiously generated The efficient Causes Parts A cold and moist temper of the ventricle liver heart and brain Descent Parentage of a pituitous temper Age. Old age which in defect of heat accumulates much flegme as also childish age by reason of gluttony and unwary institution of diet Sex Female sex Region A Country cold and moist abounding in pooles and marishes or drench'd with great rivers exposed
deliration be alwaies ominous yet by it we cannot confidently assert the death of the sick party unless this joyn with other bad and deadly signes in a destructive conspiracy as shall more clearely appeare by the following theorems When in a feaver not intermitting difficulty of spiration and deliration are companions this is deadly Aph. 50. Sect. 4. Both these symptomes proceed sometimes from the laesion of the braine then the spirits appeare big as hipp in his progn saith and as it were at a great distance that is big and thin But the difficulty of spiration proceeds from the affection of the spirital parts as a Pleurisy peripneumony and the like But all these are very dangerous A deliration succeeding upon effusion of blood obstruction in the guts Pleurisy or peripneumony is bad Aph. 9 10 11 12. Sect. 7. When it followes an effusion of blood it is caused by emptiness which is very dangerous when it so much debilitates the principal parts But in other affections when the braine is sick for company this signifies a very strong and dangerous affection If any sick person do any thing unaccustomed it is very bad 1. Coac Aph. 50. For this shewes that the mind is not sound and is a species of deliration An harsh answer given by a sober man and a gentle one returned by an angry man garrulity in a person not talkative and taciturnity in a pratler is bad Hipp. in Prorrhet For this denotes a great subversion of judgement To lament or weep unvoluntarily is a species of deliration and portends the danger of death For this signifies the supremacy of atribilary humor So in Hipp. 1 Epid. Sect. 3. aegr 2. Silenus among the other symptomes which are there recited grieved very much the eighth day and dyed the eleventh Deliration appearing about the beginning of a disease is more dangerous For this denotes the vehemence of the disease who at the first encounter nature being yet a strong antagonist exerts such symptomes Deliration accompanied with remarkable oblivion idleness and stupidity is a signe of destruction 2. Prorrhet For the refrigeration of the braine is the cause that they know not their familiars nor remember any transactions But this refrigeration which followeth heat is destructive But if the sick person upon this grow stiff and cold death is judged the inevitable attendant thereof as Galen 2 Prorrhet Deliration busied about things necessary is very bad and if it thence increase deadly 1 Coac Aph. 103. As if any sick person be averse to meat and drink he is much endangered as in 1 Epid. Sect. 1. aegr 2. doth appeare where one the tenth day denied drink dyed on the eleventh Deliration accompanied with laughter is more safe but with study more dangerous Aph. 53. Sect. 6. A phrensy with laughter is caused by blood but with meditation and fury by choler And both are dangrous but that which proceeds from blood much less Yet we must not presently assert health upon a deliration appearing with mirth for a phrensy caused by blood even in it self is not without danger and upon permanence of the disease that blood is scorched and naturalizeth it self into black choler which is evident by the consequent symptomes and by laughter converted into fury and sadness as we may find in 1. Epid. Sect. 1 aegr 2 where Silenus on the second day of his disease was a little foolish on the third he could not abstain from much talk laughter singing on the eighth he was much grieved Now therefore that humor which on the third day retained the nature of blood and caused laughter and singing was on the eight day converted into a trabilary humor by which sadness with grief is caused And therefore on the eleventh he died We may then assert that fondness with mirth promiseth some security if it continue through the whole course of the disease They who run beside themselves with silence being not speechless are dangerously affected Book 1. Coac Aph. 79. For this melancholick extasie is produced from the atrabilary humor fixt in the brain and often succeeds fury causing instead of clamors silence for jactation quiet for watching comatous and dead sleeps So in 3. Epid. Sect. 2. aegr 6. The daughter of Eurianax being sick of a great Feaver with which she died in the whole course of the disease saith Hippocrates she abhorred all meat not thirsty silent speaking nothing sadness and despair presently possessed her So also Sect. 3. of the same book In Thasus an horrid Feaver acute by sadness took the wise of Dealces lying in the plain but in the beginning she was covered and to the end alwaies silent she handled pulled scratched gathered the flocks then issued tears then proceeded laughter on the ninth day she talked much and was again silent on the twentieth day she died She had to the end spirit big and rare alike insensible to all things alwaies covered either very talkative or silent to the end Phrensie In a Phrensie a sudden repentance the acute Feaver remaining without any antecedent Crisis signifies the approching of death For it sometimes happens that phrenitical persons do so repent that they admonish the standers by of very grave and serious things and foresee future events which may happen to them and suddenly upon this dye viz. the native heat of the brain being now destroyed and struggling its last as a Candle when it is almost extinct seems to flame more In fondness the abolition of memory is mortal This is manifest when the sick person calls for a chamberpot and after forgets to exclude his urine or demanding water drinkes not when the cup is offered or does but onely taste it Of delirations these are accounted less evil which are gentle and slight and which hold not the sick person perpetually but are of a short duration and with good or at least not deadly signes Such fondness doth most frequently happen in the paroxysmes or exacerbations of bilious Feavers in which the choler being stirred and exagitated transmits vapors to the brain exciting a fondness which yet are easily and speedily dispelled nor do indanger life at all unless they appear with other deadly signes But this fondness must be gentle and slight for those that are joyned with fierceness though they be slight are usually bad As Hipp. affirms 1. Prorrhet aph 25. desipience efferated in a short time is like wildness And Galen explaining the same sentence When you see any one desipient with ferocity though it be soon allayed know that his mind is not thus iniured by the Feaver but there lurkes a phrenitical affection which being afterwards augmented seems to be wildness A phrensie succeeding a lethargy is healthy because it signifies that the matter is concocted A fondness happening on a critical day with full strength and other good signes is not dangerous For this denotes an imminent Crisis which usually brings the disease to a solution So in Hipp. 3. Epid. in a morose woman the convulsions
rested the third day a Coma and inclination to sleep again watching roused her she could not contain raved much was taken with an acute Feaver on the same night copious and hot sweat issued out of the whole body she slept free from her feaver and came to her right understanding Sleep and watching If either sleep or watching be excessive it is bad For this signifies a recess from the natural state and a morbous disposition in the principal part which is alwaies bad In any disease if sleep and waking keep their customary vicissitudes which they did in the health of the person now sick it is good For it seems impossible for a man to dye of any disease who hath a laudable and unchanged intercourse of sleep and waking Wakings in the augmentation or state of a disease appearing with the signes of concoction are good For they signifie the appropinquation of a Crisis whose forerunners are watchings and other symptomes caused by critical perturbations which yet upon the appearance of the signes of concoction are not to be feared as being the antesignanes of an healthy Crisis Immoderate watchings are more dangerous in young men but in old immoderate sleep Because the recess from the natural state is the greater for young men do naturally sleep more because their moisture is more copious but old men being more dry are naturally more vigilant Those sick persons which can neither sleep night nor day are in much danger Hipp. 2. progn For those continual watchings shew a very great hot and dry distemper of the brain and very much debilitate the strength multiply crudities by the resolution of native heat and at last cause fondness and convulsions Dead sleep in an acute Feaver is pernicious So in Hipp. 3. Epid. Sect. 1. aegr 2. Hermocrates was taken with a great feaver and after many symptomes began on the eleventh day to fall into a dead sleep which persisted and he dyed the twenty seventh day But the reason why a comatous affection is in acute diseases so pernicious may be learnt out of Galens-Commentary upon the mentioned History where he argues thus It remains therefore that some notable refrigeration of the brain or imbecillity of some faculty laid Hermocrates in a deep sleep the eleventh day but which soever of them two it be it is extremely dangerous for we have shewen that those colds are incurable which succeed hot and dry diseases But that which is caused by infirmity speaks a propinquity of destruction but when this dead sleep succeeds long watchings it is more pernicious for it signifies a total extinction of native heat so when phrenitical persons become comatous they have one foot in the grave That disease in which sleep causeth trouble is mortal but where it is advantageous not mortal Aph. 1. Sect. 2. We must not think that every trouble after sleep is deadly for if it be a light one as when sick persons raised from sleep are more anxious and unquiet this indeed is bad but not upon necessity deadly but if after sleep there appear any dangerous symptomes as fondness convulsion weakness cold of the extreme parts and the like then there is cause to think it a deadly affection When sleep allayes a fondness it is good Aph. 2. Sect. 2. For this signifies that the heat and acrimony of the vapors and humors causing fondness is mitigated by sleep and reduced to some mediocrity Those to whom upon a fit of cold a nocturnal exacerbation brings a vacancy of sleep are dangerously affected Book 1. Coac Aph. 20. For this signifies a retreat of the matter to the brain Whosoever is stupefied in a troublesome Feaver and affected as it were with a catoche is very badly diseased 1. Coac Aph. 47. As we said before that a Coma in acute Feavers is dangerous so a Catoche much more which is caused by a transmigration of the more dry matter into the brain and nerves hence the nerves are bound and therefore they who are troubled with this affection stand at the same pitch and remain stupid though their eyes be open and inconnivent and so they differ from Comatous persons whose eyes are alwaies shut Excitations from sleep with fear and turbulency are dangerous For they signifie copiousness of atribilary humor which produceth such like passions If in sleep when the eyelids hang any thing of the white part of the eye appear which is neither caused by a flux of the belly nor fasting nor hath it been usual for the sick party to sleep so it is a bad signe and very deadly Gal. in 1. progn For this signifies the extinction of the faculty moving the eyelids Dreams Dreams in a Phrensy remembred are good signes 1. Coac Aph. 91. There is nothing more to be desired in a phrenitical man then that he fall asleep and sleep sweetly But dreams are signes of sweet sleep But those not turbulent ones and tumultuous but gentle and quiet which are afterward remembred by the sick persons for this is a signe that they are come to themselves again and that the brain enjoyes again its formerly moderate temper In those who are dangeroussly sick dreams of dead men graves and priests denote immimennt death In dying persons the soul sometimes is before sensible of her separation from the body and represents it to the body by dreams veiled in the species of those things which can signify death The sight Eyes dimme or abhorring the light in acute diseases threaten death For this speaks a great dissipation of the spirits In a not intermitting feaver if the sick person see not or hear not his body being now debilitated death is at hand Aph. 49. Sect. 4. For this denotes a very great debility of the sensible vertue and very much exolution of the spirits Hearing Deafness proceeding from a Critical perturbation and accompanied with other decretory signes is usually healthy Those decretory signes which ought to attend surdity that it may be called healthy are principally those signes of concoction which usually appear in excrements and are perpetually good So 3. Epid. Sect. 3. aegr 7. There is a story of Abderitana a maid which from the eighth to the seventeenth on which a copious effluxion of blood was conveyed through her nostrills was affected with deafness which persevering the following days also denoted the first Crisis imperfect and shewed another to come for the resolution of the disease which after a second eruption of blood sweat and transition of the humor to her feet on the twentieth day followed By which evacuations the disease not being wholly taken away her deafness on the four and twentieth day returned in company of other symptomes which was a nuntio of a completely perfect Crisis on the twenty seventh day which will more clearly appear by the words of the story it self On the seventh day saith he proceeded thin but well coloured urine as to the excrements of the belly they were not troublesome on the eighth day she was deaf
taken with an acute Feaver waking anxious trembling in her own mind voiding the like urine on the ninth in the same condition and the daies following the deafness so persevered on the seventeenth large effluxions issued out of the nose little of the deafness remitted on the daies following surdity and fondness seised her on the twentieth a pain of the feet deafness and fondness took her some blood issued out at her nose she sweated without a Feaver on the twenty fourth the Feaver visites her again surdity again the pain of her feet remained with an alienation of mind on the twenty seventh she sweated much without a Feaver her deafness departed the pain of her feet remained but in the rest she was perfectly iudged Deafness succeeding an acute and turbulent disease is shrewdly bad 1 Coac cha 3. Aph. 2. As surdity in conjunction with good signes is good so with bad it is usually bad if therefore the disease be acute and turbulent that is joyned with fondness and other dangerous symptomes deafness following upon it threatens death So in Hipp. book 3. Epid. Sect. 7. aegr 2. Hermocrates was taken with a great feaver and began to be pained in his head and loynes a soft tension of the hypochondrium but his tongue at the beginning scorcht deafness presently followed want of sleep not very thirsty his urine thick red and separating subsided not yet excrements not a few scorcht were expelled by the belly On the fifth day his urine thin had an Enaeorema did not subside at night he raved the seven and twentieth day he dyed And his surdity persisted with him to the end So again Aegr 4. of the same section Philestes in Thasus vomited bilious matter a little yellow first after much eruginous but the excrements proceeded from his belly in the night with trouble on the second day he was deaf on the fifth in the morning he dyed Yet it is observable that surdity also joyned with bad signes is not perpetually deadly but dangerous onely and with it some escape As appears in the same Hipp. in 1 Epid. Sect. 1 aegr 3. where Herophon was troubled with an acute feaver had effluxions from the belly such as in a tenesmus at the beginning Afterwards issued thin bilious and subcontinuous excrements sleep was wanting The urine was black and thin On the fifth day he became in the morning deaf with a total exacerbation his milt swelled a contension in hypochondrium he excluded by the belly some few black excrements and was out of his senses on the ninth day he sweated was judged intermitted on the fifth day following he relapsed his milt was presently tumefied he taken with an acute feaver and deafness again But the third day after this recidivation his milt was asswaged his deafness diminished his leggs pained at night he sweated on the seventeenth day he was judged neither was he idle in his recidivation If after a Phrensy or other grievous disease of the head deafness succeeds upon the cessation or alleviation of the first disease the faculty being not debilitated it is a good signe For this is caused by the departure of the matter from the internal to the external parts of the brain and then as the result of this we may expect impostumations An humming and sound of the ears in acute feavers is deadly 1. Coac cha 3. Aph. 5. A tinckling of the ears and other sorts of sounds perceptible to sick persons in acute diseases shew a very difficult and dangerous disease because they are produced from thick flatulencies which proceed from thick matter and this matter being contumaciously rebellious nor subjugable in the short duration of an acute disease it followes that nature by this burdensome oppression must first fall and so the sick person dy Smelling and tasting If the meat drink and medicines offered seem putrid and of an ill savour it is bad For this signifies that humors very putrid and unsavoury are copious in the body whereas smelling and tasting are vitiated by vapors exhaling from various putrid humors to the tongue nose or brain and that smell or tast which is within keeps out any other external according to the Philosophers position and hinders its reception This is the cause that when the nose and tongue are infected by putrid vapors elevated from the inferior parts all things then smelled or tasted seem putrid Touch. Pains possessing the ignoble and farr remote parts from the bowells and long exercising them the signes of concoction appearing and those chiefly which begin on a decretory day are healthy For they hint to us that nature doth exonerate the principal members and excommunicate from its commerce the noxious humors But the ignoble and farr remote parts from the bowells are the groin the leggs the knees the thighes and feet as also the armes and hands But we must observe by such like paines that diseases are not alwaieâ—â—erfectly judged but sometimes imperfectly so that afterward a recidivation may succeed But diseases are perfectly discussed when evacuations convenient for such like pains succeed for instance by sweats effluxions of the belly and the like which may exhaust all the morbifick matter but if no evacuations follow such pains or insuficient ones the solution of the disease is imperfect and obnoxious to recidivation because that the whole morbifick cause can by no means be hedged into an ignoble part it is therefore necessary that the disease should be finished by other evacuations as appears in Hipp. 3. Sect. 3. aegr 9. Where Heropytus affected with a great and contumacious disease after divers symptomes and flux of bloud too which indeed did diminish but could not operate a solution of the disease he was troubled with pains in his inferiour parts and lastly he was totally freed by the effluxions of the belly Hippocrates words are these On the fortieth day bloud was copiously effused out of his nose and he was better in his senses he was indeed deaf but little the Feavers remitted bloud flowed on the following daies often and in small quantities But about the sixteenth day the effluxions of blood ceased but he was notably pained on his right hip and his Feaver was intense and not long after he felt pains in all his inferiour parts but it happened that either the Feaver was augmented and much surdity or that that was remitted and asswaged but the pains of the inferiour parts about the hips heightened But about the hundreth day his belly was much molested with many bilious excrements and many such did proceed in no little time then followed a dysenteria with pain 〈◊〉 a convenient state of the other members Finally his feaver left him his deafness cease on the hundreth day he was perfectly iudged So also Aegr 7. of the same Section on the seventeenth day copious effluxions proceeded from the nose of Abderitana a maid on the twentieth she was pained in her feet taken with deafness and fondness some bloud issued from her nose she sweated
then they are not produced from a fixt cause and they shew that the morbifick matter hath removed from the stock of the veins into the bulk of the body by the concussion and violent commotion of the body evident in a Convulsion So in Hipp. 3. Epid. Sect. 3. aegr 11. In Thasus a woman being froward with grief occasionally caused could not sleep and abhorred meats was thirsty and anxious in the beginning of the night she talked much was sick in mind troubled with a small Feaver in the morning with many Convulsions talked obscenely disturbed with many great continual pains on the second day she was in the same condition slept not had a more acute Feaver On the third day her Convulsions left her she fell into drowsiness and sound sleep and again waking she leapt up being unable to contain her self she talked much was taken with an acute Feaver and the same night she sweated much in a heat all over without a Feaver she slept understood every thing and was judged About which time her months issued copiously We may gather by this story that her Convulsion appearing in the beginning was caused by repletion not from the authority of Galen onely in his commentary on this place where heaffirmes that this womans months were surppressed but also by those evacuations by which she was freed viz. by copious and universal sweats and by the plentiful effluxion of her months according to the common axiome diseases caused by repletion are cured by inanition But if a convulsion appear in the state of a disease it is more dangerous for it is either generated by siccity introduced by a feaverish adustion or by the transition of the morbisick humor to the nervous parts Those which are caused by driness are wholly pernicious and deadly but those which are produced by permutation are sometimes curable as those which proceed from the bitings of the orifice of the ventricle and in hysterical women and those which happen critically Yet they are usually difficult and very dangerous as appears by the stories proposed by Hipp. in Epid. For in 1 Epid. Sect. 1. aegr 4. In Thasus the wife of Philinus being taken with an acute fcaver after divers symptomes was on the eighth day extreme cold much convulst with pain on the ninth convulst on the eleventh she in her convulsions expelled urine very copiously But about the seventeenth day she was speechless on the twentieth she dyed So Aegr 8. of the same Section Erasinus died on the fifth day about sun-set of a pernicious disease And to him saith Hippocrates about his death happened many convulsions with sweat So Aegr 11. of the same Section the Wife of Dromeada after divers symptomes on the sixth day in the morning she was stiffe cold but speedily again heated she sweated all over was cold in her extreme parts was fond respiration big and rare soon after convulsions began from her head and she died suddenly Lastly 3. Epid. Sect. 2. aegr 4. In Thasus Philestes being taken with a very acute feaver was convulst on the fourth day on the fifth in the morning he died In acute feavers convulsions and strong pains about the bowels are bad Aph. 66. Sect. 4. It is before noted in the exposition of Aph. 26. Sect. 2. that a convulsion in an acute feaver is bad But if strong pains of the bowels come in company with it it is without doubt very dangerous for these pains are caused either by great inflammations in those parts or by an hot and dry distemper produced by a burning feaver which must be very great that it may be able to cause such pains and so it threatens death to the sick person as is evident by the stories of the wife of Philius Erasinus and the wife of Dromeada before proposed for they did not onely suffer convulsions but also hypochondriacal pains and so died Convulsions in phrenitical persons signifie that death is near Galen 12. Meth. last chap. affirms that his experience could never inform him of any one so convulst that was recovered nor ever heard he such a thing by the report of any other For this convulsion proceeds from the siccity of the nerves occasioned by the inflammation of the brain which is therefore incurable Convulsions in children are less dangerous then in those that have arrived to a full age Because as Galen relates in his comm on 3. Aphor. children do more abound with crude humors which cause a convulsion by repletion which is less dangerous then that which proceeds from inanition with which those that are full grown are more frequently molested and likewise the nervous parts in children are infirm and so convulst by a smaller cause Those who are taken with a Tetanus die within four days in which if they escape they may be cured Aph. 6. Sect. 5. A Tetanus is caused by an emprosthotonos that is a tension to the interiors and an opisthotonos that is a tension to the posteriors for in it the convulsion of the opposite muscles is equal which do therefore so vehemently afflict nature that she cannot long endure those pains cheifly when the whole body and especially the neck is stiffe with cold for then besides those horrid pains which quickly dissolve the strength the diaphragma is also affected by sympathy whereas the nerves produced to the diaphragma make out from the fourth vertebra of the neck and so the neck being convulst respiration is hardened and the persons so affected die by suffocation within four daies But if they escape them upon the mitigation and dissolution of the disease by judication which happens in extremely acute diseases on the fourth day they are freed from this dangerous disease Convulsion upon a wound is deadly Aph. 2. Sect. 5. The succession of a convulsion to a wound proceeds from four causes First when the wound happens to fall upon the great veins and arteries upon which a large flux of bloud followes which causeth a convulsion and swouning but death is not alwaies the effect of this convulsion and Syncope Secondly when the wound is inflicted upon the stock of nerves by reason of which that convulsion of the nervous parts followes which is called Spasmus Thirdly when there is an inflammation in the wound which being extended to the nerves becomes a convulsion Fourthly when the ulcer is not well purged or closed before its time or when the orifice of the wound is too narrow as in the pricking of a nerve for then the sharp putrefaction being retained vellicates the nerves and excites a convulsion But this convulsion is deadly because it insinuates by sympathy into the brain the nerves being vehemently affected and because putrid feculency retained in the wound is sometimes transmitted into the noble parts And this Convulsion saith Galen in his comm on this Aph. is deadly not as implying a necessary consequence of death but as very often introducing it Which Hippocrates himself seemed to acknowledge who in his Coac progn proposing the
be satisfied with no drink is bad For this shewes a great dyscrasy and very intense scorching of the internal parts or consumption of the primigenious moisture so in Hippan 1. Epid. Sect. 3. aegr Philiscus was among other symptomes very thirsty and dyed on the sixth day So likewise 3. Epid. Sect. 3. aegr 3. Pythion in the whole course of his disease was troubled with very great thirst and on the tenth day dyed A very depraved thirst hankering after absurd liquors and such as are not fit to be drunk is bad There are some sick persons found who are not refreshed by water syrup tempered wine or any such usual liquour but desire strong drinke disagreeing both with the disease and their nature for instance if they desire to drink vineger juyce of limmons acquavitae or any other liquor not convenient to drink And they who are thus affected are in very great danger of their life because nature is now so far run beyond her bounds that she cannot again retire to a convenient state If any in a troublesome Feaver have an hiccough the disease is very bad 1. Coac Aph. 47. For this hiccough is caused by sharp and malignant humors vellicating the interior tunicle of the stomach and stimulating the expulsive faculty thereof and Valesius saith that he never saw any person saved whom being extenuated and taken with a burning or malignant Feaver an hiccough surprised So in Hipp. 3. Epid. Sect. 2. aegr 12. a woman on the twelfth day was troubled frequently with hiccoughes and on the fourteenth dyed Platerus observed that an hiccough succeeding a burning Feaver and persevering is usually deaths nuntio and in a semitertian Feaver he experienced it to be not deadly But he observed it also to be deadly in a dysenteria An hiccough and redness of the eyes after vomiting is bad Aph. 3. Sect. 7. These two signes if in acute diseases they succeed vomiting and last for some time are accounted deadly because they denounce an inflammation of the brain or ventricle which inflammation may not onely be the cause of the hiccough it self and redness of the eyes but of vomiting also for if vomit were caused by sharp humors biting the mouth of the ventricle and the tunicles thereof those humors being expelled by vomiting the hiccough and redness would cease nor would any sharp vapour be conveyed to the eyes after vomiting which should paint them in red But when vomiting is not onely unprofitable but also introduceth an hiccough and redness of the eyes it is infallibly true that those three vomit hiccough redness of the eyes do depend upon the inflammation of the brain or ventricle For the brain being inflamed squeezes out the bloud through the small veins of the eyes by reason of the copiousness of it and effuseth it into the outermost tunicle of the eye which is called adnate whence proceeds the redness of the eyes with which the ventricle sympathizing by the nerves which from the sixth conjugation make to the mouth thereof is easily impelled to a vomit and hiccough The ventricle also inflamed induceth vomiting and after vomiting an hiccough and with an hiccough a redness of the eyes by a concourse of bloud too hot to the eyes caused by a compassionative disposition which these parts one bear to another which easily appears in the beginning of suffusions and apparitions of images before the eyes happening most usually upon the viliation of the ventricle Whence Hipp. in his book of the places in man well said that the eyes were much injured by vomiting We have an example of this hiccough succeeding vomit in the mentioned history of the woman in whom it is probable that an inflammation of the ventricle was caused by the affluxion of depraved humors to that part for on the eighth day she vomited bilious thin yellowish matter on the ninth thin bilious on the eleventh virulent bilious soon after she was extreme cold her extreme parts were cold at evening she sweated was cold vomited much passed the night with disquiet on the twelfth she vomited much black stinking matter she passed it unquietly with frequent hiccough and thirst on the fourteenth day she dyed Hiccough upon an inflammation of the liver is bad Aph. 17. Sect. 7. An hiccough then succeeds an inflammation of the liver as Gal. in his comment on this aphorisme affirmes when the inflammation is made worse and increased for then a great inflammation in the liver is so far heightned that it doth vehemently oppress the superior parts of the ventricle so that induceth an hiccough upon copiousness of matter also sometimes an inflammation or an erysipelas is produced in the ventricle nevertheless a biting is caused by it imbibed by the tunicles of the ventricle Belching In laevities of the intestines an acid ructation proceeding which before was not is a good signe Aph. 1. Sect. 6. A lienteria is most commonly caused by a cold distemper of the ventricle by which the coction thereof is abolished that the aliments are speedily excreted before either their colour smell or any other quality is changed But if in such a lienteria long contracted an acid ructation succeeds which before was not it will be a good signe for it hence appears that the distemper begins to be restored and native heat again excited which by such a lienteria was so debilitated that it could not so much as attempt a mutation of the aliment For though an acid ructation shews a notable refrigeration of the ventricle yet to discharge some flatulencies though acid ones shews less refrigeration then to send out none Excrements through the eyes If a sick persons eyes in Feavers or other diseases drop tears voluntarily it is not absurd but if not voluntarily it is more absurd Aph. 51. Sect. 4. Those are called voluntary tears which spring from some manifest and external cause as sadness greif and sometimes joy which are not dangerous But involuntary ones are either caused by inflammation of the eyes or sharp fluxions into them and these also are void of danger or they proceed from a Critical perturbation and do chiefly presage a Crisis by flux of bloud which also threaten no danger and are known to be such by the precedent signes of concoction and absence of bad symptomes or lastly they arise from the resolution of the retentive virtue which is in the corner and other parts of the eye and these are exitious which Hipp. in this aphorisme mentions and they are distinguished from the rest by the cavity and extenuation of the eyes and other symptomes which are their necessary train By the ears In a troublesome affection of the head if purulent matter flow out of the ears there is a solution This theorem is spun from Hipp. Aph. 10. Sect. 6. When the head is disturbed with pain or sounds purulent matter or water or bloud flowing through the ears or mouth or nostrills causeth a solution of the disease For these are the ordinary conveyances
and passages by which the brain doth usually unburden it self But the chief and most troublesome affection of the brain is inflammation which if it proceed to suppuration and purulent matter be evacuated by the ears which in this case is the more ordinary way the consequent is the solution of the disease In children copious humidities issuing through the ears are healthy Such humidities are frequent in children according to the experience of Hipp. Aph. 24. Sect. 3. and they are healthy because in that age the brain being very moist and abounding with excrements purgeth it self healthfully not by the ears onely but by other passages also The feculencies of the ears which are naturally yellow and bitter if they sweeten or change colour it is very bad Hipp. 6. Epid. Galen in his comment affirmes this to happen by the colliquation of the brain in acute Feavers or we may say that upon much debilitation of the native heat these watrish humidities stream forth which were contained in the brain and being confused with those dregs they change the tast and colour of them Through the nostrills Bloud flowing well and copiously through the nostrills on a Critical day is healthy For then this evacuation is caused by the good operation of nature expelling the morbifick cause but we must diligently observe how the signes of concoction proceeded and whether there be any malignity lurking in the disease because in malignant diseases such fluxes of bloud are not seldome unprofitable Fluxes of bloud too copious and vehement are very bad for they cause convulsion For it sometimes happens that nature oppressed with the copiousness of bloud and moved to excretion becomes irregular and effects a supercrisis which Physicians are often forced to restrain Flux of bloud in the beginning of a disease is bad Because in the beginning of a disease no evacuation can be Critical but is meerly symptomatical yet it is not therefore deadly but onely useless and not commodious to the sick person as it happened to Pericles in 3. Epid. Sect. 3. aegr 6. out of whose left nostril on the third day bloud flowed afterward his Feaver was very intense and persevered to the fourth day in which by copious sweat he was judged A flux of bloud happening in a direct line to the part affected is good but on the contrary bad In the inflammation of the liver a Critical flux of bloud is healthy but with this caution that evacuation be made through the right nostril for if it proceed through the left it will not regulate it self to that rectitude so much applauded by Hippocrates and it will shew that nature upon a perturbation operates preposterously So in the inflammation of the milt the bloud must flow through the left not the right nostril Few drops of bloud distilling through the nostrills are bad For they signifie the imbecillity of nature and malignity of the disease for all excretions in acute diseases which are inchoate onely and not perfected are very much disliked by Hippo. because the security is greater in those Feavers in which nature expells nothing then in which it makes few and useless excretions for then this argues that she is industriously labouring coction To this adde that if no drop appear the benignity of the matter is declared which is unable to provoke nature before the time So in Hipp. 1. Epid. aegr 1 Phyliscus on the fifth day had few drops distilling from his nostrils and on the sixth day he died And Aegr 11. of the same Sect. on the fourth day some few distillations issued from the nostrils of the wife of Dromeada and on the sixth day she died Yet upon this signe we cannot positively assert death for in 3. Epid. Sect. 1. Aegr 2. He who lay in Dealces garden had on the second day some few sincere effluxions of bloud from his left nostril and again on the fourth few and sincere distillations out of the same nostril and on the fourtieth day he was judged Yet he struggled with a very dangerous disease as appears through the whole relation of the story therefore this distillation of bloud if it portend not death yet it shews very great danger of life if it be accompanied by other bad symptomes For this also is to be noted viz. that a small excretion of bloud appearing in an indicative day without dangerous signes antecedent or consequent is so far from being dangerous that it rather denounces that a Crisis will come the same way as happened to Meton in 1. Epid. Sect. 1. aegr 7. who on the fourth day without the precedency of any dangerous symptomes had twice a small effluxion of bloud out of the right nostril on the fifth one larger out of his left sincere he sweated and was judged and fell to a recidivation he escaped upon the copious and frequent profluxion of bloud By the mouth spetting and sneezing Spettle white even smooth not very thin or crass of a ready and easie excretion and without any pain or much coughing is healthy For it denotes that nature overpowers the morbifick matter and laudably concocts and sufficiently expels it being concocted For the mentioned qualities appearing in spettle are signes of very good concoction Spettle soon appearing in the beginning of a disease of the breast or lungs is good Aph. 12. Sect. 1. For this discovers a rudiment of concoction which if it proceed soon after the beginning of the disease there is hope of a speedy solution Spettle lightly red by the permistion of bloud and flegme is healthy This spettle is expelled in a pleurisy when nature changes the morbifick matter for it doth by degrees extenuate it to liquation and so the waies being freed by which the vapour should exhale the thinner part and most acceeding to vapor steals through the rarity of the pores into the internal and neighbouring spaces and is confused with flegme whence upon coughing and exclusion of spettle the default of coction appears and hence Gal. comment in 6. Epid. termes these most gentle pleurifies Yellow spettle mixt with some bloud in the inflammations of the breast or lungs expelled in the first invasion of the disease is healthy and very commodious but when the disease hath proceeded to the seventh day or made a larger progress it is less secure Hipp. in Coac and prognost In inflammations produced by choler and bloud such spettle usually happens which if it appear upon the beginning of the disease it shews that nature doth partly unburden herself whence proceeds a looseness in the part and remission of pain and so the beginning of sanation But if this spettle appear after the disease hath made some progress on the seventh or eleventh day onely it is a signe of less security because the faculties requisite to cause an anacatharsis are oppressed by the disease so that we cannot conceive hopes of a laudable operation as also because the morbifick matter is more rebellious the more thin and obedient part of which could not
loosness do stop as soon asit begins it shews that the evil humors which began their course through the guts are turned another way where they may do more mischief Of these speaketh Hippocrates in these words in 7. Epid. The bellies though by chance they were loosened yet presently were perniciously bound up Hence it proceeds that those fluxes and dysenteries which are suddenly stopped are wont very much to endanger the life of the patient The Quality A watry loosness which begins with an acute disease and tarries with it is evil For it signifies an abundance of the matter causing the disease or the malignant quality thereof which forceth nature to such an immature and unseasonable flux Thus Hippocrates speaks in 3. Epid. Sect. 2. aegr 8. of a young man whose belly flowed the first day with much cholerick and thin matter the second day sollowed a greater flux of matter more indigested and the seventh day he dyed Aegr 10. the same Sect. he speaks of a woman whose belly flowed the first day with much thin and crude matter the second day with much more of the same and the seventh day she dyed her belly remaining moist with much thin and undigested matter all the while A loosness of the belly happening to one taken with a pleurisie or a peripneumony or inflammation of the lungs is an evil symptome Aph. 1. Sect. 6. For when the organs serving for respiration are vehemently afflicted the liver and the stomach are thereby also strongly affected so that they being weakened there follows a loosness of the belly which for that reason uses to be mortal Therefore to make good this symptome the pleurisie or inflammation of the lungs ought to be exceeding vehement which Hippocrates seems to intimate as Galen observes in his Comment upon this Aphorism who doth not simply say that a loosness is evil in a Pleurisie or inflammation of the lungs but addes the words being vehemently taken with as if he should have said that a loosness of the belly seising upon a person detained and vexed with such diseases was an evil symptome Because a looseness of the belly happens to such men through a weakness of the liver that is not able to draw the nourishment to it nor to turn it into blood the stomach also oftentimes corrupting the said n ourishment but in a moderate pleurisie or inflammation of the lungs when a loosneses doth happen it may profit much by way of evacuation specially if the disease be so gentle that there is no great fear of any danger also if there do appear certain signes of concoction both in the urine and spettle Sometimes also at the beginning of a pleurisie or inflammation of the lungs the foresaid matter diverts it self to the guts and causes a wholesome and seasonable flux For one that is troubled with an Opthalmia to have a loosness is a good signe Aph. 17. Sect. 6. By such a flux of the belly in this case the humor is drawn down to the most distant opposite parts and from the upper parts to the lower which is therefore of all things the most efficacious and profitable The liquid excrements of the belly growing thick in the progress of the disease betoken well All concoction is perfected by thickening and those things which are concocted become more thick and therefore excrements which at first being thin and liquid do afterwards grow thick by degrees do shew that nature is strong that performs her work so well White fluxes appearing in any disease are evil For the fluxes of white matter are caused by undigested meats as white bread milke Ptissan or unhusked Barly Rice Almonds and such like or as Galen teacheth in 2 Progn when the choler can by no means come to the intestines which happens either through an obstruction of that pipe which conveyes it from the bladder of the Gall to the Guts as comes to pass in the yellow jaundise or because that the Choler is drawn upward with the blood by the heat of the head which is inflamed or lastly those white fluxes are caused by a melting of some soft and new made fat But these are few slimie and of an evil savour However they happen unless it be those that take the white colour from the colour of the meat in acute diseases they are not a little to be condemned but most of all those which happen when the brain is inflamed of which Hippocrates in Prorrhet In those who are phrenetick a white flux is naught because all the choler is then drawn up into the brain Moreover in cholerick feavers white fluxes are evil because the excrements ought to answer to the cause of the disease and therefore they signifie either an obstruction of the pipe through which the choler passeth to the guts which obstruction for the most part is mortal to such as are not in feavers of which Hippocrates speaks in Coac Persons troubled with the Kings evil whose feculencies flow forth in a great quantity dye and in them a white flux proceeds Or it signifies an inflammation of the brain and the upper convex part of the Liver which draws all the choler to them Lastly we have shewn that little slimy and ill-smelling fluxes are evil because they denote a mischievous colliquation or melting of the fat Vitelline eruginous green pale black variously coloured or very ill-savoured fluxes are evil 2. progn All these fluxes are evil for the same reasons which we have above rehearsed Yet sometimes they may be cast forth critically and advantageously if in the urine there do appear the signes of concoction as you may see in Hippocrates in 1. Epid. Sect. 1. Aegr 14. where Melidia who lay sick in the Temple of Iuno was first taken with a strong pain of the head neck and breast presently followed an acute feaver the sixth day she became comatous troubled and dismayed new raving fits with a redness in her cheek and some deliration the seventh she sweat the feaver remitted her pains remained and the feaver returned Her sleep was little her urine well coloured but thin to the end The fluxes of her belly cholerick acrimonious very little and those black and ill smelling a smooth and white sediment was in her urine she sweat and upon the eleventh day the crisis was perfectly made The manner of excretion Liquid excrements of the belly with pain and a dysenteria or a laborious and frequent dejection are evil For they signifie a very great sharpness of the humours which gripes prickes and gnaws the guts exceedingly Which Hippocrates observes in 1 Epid. in many who have died of malignant seavers of which he saith Their bellies were loosened and they often let forth little matter but cholerick sincere thin watry and full of acrimony a little after These diseases which afflicted these persons were dysenteries tenesmus lienteries and fluxes of the belly which he also observed in 3. Epid. Sect. 2. Aegr 6. of the daughter of Euryanax who the twelfth day
the heart and principal bowels so that it cannot extend it self to the exteriour parts and therefore those who are in that manner cold are very weak neither do they receive warmth again but are approching to death which Hipp. testifies in Prorrhet As often as the patient finds himself cold after the cold fit of a Feaver and does not again wax warm he is in an evil condition This is confirmed in 1. Epid. Sect. 1. Aegr 1. where Philiscus the fifth day had all his extreme parts cold which did no more afterwards wax warm the sixth day he dyed So aegr 1. of the same sect Silenus the sixth day had all his extreme parts cold and blew the seventh day they recovered not warmth again and the eleventh he dyed So aegr 8. of the same sect Erasinus the fifth day about noon had all his extreme parts cold and somewhat blew and the same day about sunset he dyed Also 3. Epid. Sect. 2. aegr 11. The woman which after an abortion was taken with a Feaver had all her extreme parts cold from the fourth day to the seventh in which day she dyed yet sometimes that coldness of the extreme parts not lasting nor often returning uses to be good for it shews that the Crisis is at hand at which time the heat is called back to the internal parts to expel the cause of the disease as happened to him that lay sick in the garden of Dealces 3. Epid. Sect. 1. Aegr 3. who the seventeenth day had all his extreme parts cold afterwards an acute Feaver and a sweat over his whole body and recovered Coldness of the nostrills continuing all the time of the disease in little children is mortal Coldness of the tongue continuing some few dayes is mortal as was observed in three sick persons in whom no other extraordinary symptomes appeared but a certain languishing of the strength Those who are often hot and cold by turns are in danger 2. Prorrh text 32. For thereby is fignified an abundance of the morbifick cause and the malignant quality thereof against which nature enters the lists in vain whence follows a dissolution of the natural heat and at length death it self As. Hipp. notes in 3. Epid. Sect. 2. Aegr 12. where a woman was troubled with a shaking cold fit the seventh day had an acute Feaver about evening her extreme parts waxed cold she waxed warm no more at night she had a shaking fit again but yet her extreme parts waxed not warm the tenth day they received warmth on the eleventh they grew cold again on the fourteenth she dyed and so 3. Epid. Sect. 3. Pythion the second day had a refrigeration of the extreme parts after some time they waxed warm again on the third day they grew a little cold again the fourth day they grew cold and after that warm again on the eighth day he had a coldness in the morning at evening he waxed warm again on the tenth he was very cold had an acute Feaver much sweat and dyed The second Hardness The skin of the face and other parts being hard rough and squallid shew evil For in acute diseases it denotes a great driness caused by the heat of the Feaver but in diuturnal Feavers it shews a great consumption of the natural moisture as in Hecticks So 3. Epid. Sect. 3. aegr 15. in the wife of Dealces on the seventeenth day she had a dry stretching of the skin and the one and twentieth day dyed And aegr 16. of the same sect in the young man of Moelibea on the tenth day his skin was dry and stretched out and the twenty fourth day he dyed An extraordinary softnes of skin in any disease is evil For in acute diseases it signifies an extraordinary putrefaction which causes the parts of the body to flag as appears in corps killed with a pestilent feaver In chronical diseases it shews an abundance of flegme dispersed over the whole body as happens in a leucophlegmatia or dropsie arising from white flegme An intense redness of the face with sadness is evil 2. Prorrh The colour redness of the face simply considered is not evil for it shews sometimes the near approching of the Crisis by a flux of blood as Galen by this signe foretold of a Roman youth in presence of other Physicians But then the signes also of concoction ought to appear but if while the disease is raw the face appear very red there is much fear of an inflammation and especially of the head and brain for by this signe it is apparent that the blood is carried up into the head and there inflames it which causes sadness to precede the phrensie because that blood being burnt up by excessive heat turns to the nature of choler as Galen teacheth in his comm in these words When therefore the colour of the face appears fresh and the patient is very sad there seems to be a certain hot affection in the brain which burns up the blood and for that cause as is demonstrated begets black choler Intense and as it were erysipelatous redness appearing in the head and feet in acute diseases with good signes are good with evil bad If they appear with good signes they shew that nature is very strong and able to expel the noxious humors to the ignoble parts whence that is to be esteemed a laudable change which the ease of the patient necessarily followeth but if they appear with evil signes and the sick person be no whit alleviated it is to be thought that the humors are stirred up by access of new forces viz. by a multiplication of that phlegmonous quality which oppresses the entralls An extraordinary paleness chiefly in the face is evil For it shews either a violent withdrawing of the heat to the inner parts or an extinction thereof or want of blood which is the reason that that colour appears in the carcasses of deceased persons A blackness and blewness of the whole body face or extreme parts is evil For it is caused through an extinction of the heat in those parts as Hipp. teaches 2 prog if the body be in such a condition that the nails and fingers are blew death is presently to be expected But that blewness is alwaies accompanyed with a coldness of the extreme parts as you may see in the examples of Philiscus Silenus and others for the coldness of the extreme parts above recited Black and blew flesh on a bone diseased is bad Hipp. Aph. 2. Sect. 7. By a diseased bone Hippocrates means that which is affected with a wound ulcer or rotenness Now the flesh grows black and blew in wounds or ulcers either through the extinction of the heat some gangrene or syderation by reason of the greatness of inflammation or through some bruise And therefore when the flesh of a corrupt or violated bone looks black and blew not caused by any bruise or syderation it is a certain signe of putrefaction which extinguishes the natural heat and therefore that bone is
to the other Which distortions of the eyes are caused by the convulsions of the muscles that move the eyes as comes to pass in a fit of the epilepsie though there they are not dangerous But convulsions happening in acute diseases are very pernicious eyes dark muddy galled and not shining are evil For the cause of these evils comes from a defect and extinction of the animal spirits which are clear and cause a shining in the eyes also from an extraordinary driness of the tunicles that compose the eye but more especially of the corneous tunicle as Galen teaches 1. of the cause of symptomes and 10. of the use of the parts In the eyebrows nostrils and lipps If the eyebrow be distorted or black and blew or pale or the lipps or nose with any other bad symptomes know death is at hand For t is a mortal signe when the lipps hang loose and are cold and white Hipp. 1 prog Of the same opinion is Hipp. Aph. 49. Sect. 4. in these words In a Feaver that intermitts not if the lip or eyelid or eyebrow or the nose be distorted and the sick person do neither see nor hear the body being already weak death is near For all this is caused by the convulsion of the muscles moving these parts which in acute diseases are mortal as hath been shewn Now the eyebrows become pale or black and blew through an extinction of the natural moisture The hanging and loosness coldness whiteness of the lips do also shew a weakness of the moving faculty and an extinction of the natural heat The nostrils dilated more then ordinary in an acute disease portend danger For they signifie a great weakness of the animal faculty which not being able to dilate the breast sufficiently to temper the extraordinary heat endeavours to compensate that defect by widening the nostrils to let the air in more freely In the teeth To make a noise and greate with the teeth in feavers where it hath not been a custome from their youth portends phrensie and death 2. prog This very rule Hipp. repeats in 2. prorrhet in these words to make a noise with the teeth is pernicious where it was not used in time of health But Galen in 2. prog To make a noise with the teeth saith he where it hath not been before a custome is a signe of future madness but if the patient at the same time be mad and make a noise with his teeth believe him not to be far from death This noise of the teeth is caused by the convulsions of the muscles moving the jaw bones or a weakness of the moving faculty which soever it is in acute diseases it signifies a great distemper of the brain to which t is very likely that madness will succeed when as madness is nothing but a distemper of that faculty which is predominant in the brain which increasing death must follow of necessties But madness useth to succeed that noise of the teeth that makes a great sound sooner then that which causes but alittle sound For that may be through a weakness that may bring death without madness but the other is by convulsions which proceed from malignant vapours such as arise from black choler invading the brain and nervous parts Those who in feavers have a sliminess and blackness about their teeth are in danger For it shews abundance of crude and thick humors and a mighty heat of the feaver which dryes and burns up those crude and thick humors In the tongue A black tongue with driness roughness clefts and burning is mortal For all these proceed from a very hot and burning feaver through the force of which the tongue grows very dry and receiving those adust vapours that rise from the heat of the bowels it becomes like a chimney all sooted with blackness From aless heat proceeds driness and roughness but from a more vehement proceed the clefts as when the earth parched by the heat of summer revolts into chinks and divisions The tongue burnt and scorched at first shews an inflammation of some one of the bowels which is perceived by the pain hardness swelling and heat of the Hypochondriums A trembling tongue in acute diseases is mortal For it signifies aweakness of the animal faculty and a high distemper of the brain and therefore in mad people about to dy the tongue is seen to tremble in this manner Which Galen makes very apparent in 1. Prorrhet text 19. in these words Therefore a trembling in the tongue happens from a weakness in the animal faculty proceeding from a dry distemper The driness of the muscles thereof joyntly affected with the head succeeded by convulsions as the voice trembles through the weakness contracted from the imbecillity of these parts But all these foresaid symptomes which proceed from a more intense driness of the head portend a disturbance of the mind In the jaws When the jaws are exulcerated with a Feaver t is an evil signe and if there happen any other of these symptomes which we have said to be evil then conclude the person is in danger Hipp. 2. prog The jaws are wont to be exulcerated either by a sharp distillation flowing from the head or when the whole body is full of ill humors in a burning and pestilent feaver Whereby it happens to most of those who ly sick of the pox or leprosie that their jaws are exulcerated But in acute diseases of which we now onely discourse for the most part the seat of the evil is in the breast or Hypochondriums Now the jaws lying in the way that leads from the lungs and from the stomach they receive all the vapours that ascend from those places which if they be sharp they exulcerate them And therefore in those kind of feavers these places ought to be observed as much as the tongue for it shews the vehemency of the feaver in the same manner for as in a burning Feaver the tongue becomes dry divided into many clefts if it be vehement so likewise ulcers in the jaws are caused if the Physician in the heat of the Feaver be not the more diligent in the use of those things that allay thirst Now if the Physician omit not those helps and the jaws become ulcerated it is a sign of more violent heat And therefore well said Hip. that it was evil yet not so evil as to be a symptome of death without other signes For it may be that by reason of some distillation accompanying the Feaver that the jaws may be exulcerated which is not so evil as that death may be presaged from this onely signe but if the exulceration of the jaws proceed from any great distemper of the inferior parts it is very dangerous but then also there must of necessity be many other evil signes joyned with it And therefore you must observe the other signes and if any of them be evil you may then foretel death Valesius gives a great commendation of this symptome I saith he can
not and is without pain so is difficulty of breathing for should they continue obstinately and long they would rather portend an inflammation of the Liver CHAP. X. Of the signes of future Crisis by the moneths and hemorrhoids AFuture flux of the months and Hemorrhoids is known by the same signes yet here lyes the difference for if they appear in a woman wont to have monthly purgations the flux comes through the womb But if in a man accustomed to the Hemorrhoids then we may imagin that the Crisis will be by the Hemorrhoids But the signes common to either evacuation are these A pain and heaviness in the loyns and heat thereof A pain and distention in the hypogastrion A distemper at the mouth of the stomach When the blood descends to the lower parts filling and stretching vena cava it causes a pain heaviness and heat in them because the vena cava descending rests upon the loyns from which place very great branches thereof are carried to the hypogastrium which cause a pain and stretching in those parts Whence also proceeds a disturbance at the mouth of the stomach because of the great sympathy and agreement of the parts above the loyns and hypogastrium with the stomach CHAP. XI Of the signes of an ulcer THe following aphorismes do briefly declare when an ulcer will break out in any disease Such as are detained with long Feavers have long swellings and pains do arise in their joynts Aph. 44. Sect. 4. Those feavers are said to be long which last above forty dayes and are caused by a thick cold and contumacious matter and therefore because that matter cannot easily be evacuated by excretory cause nature often expels it to the weaker parts and there begets an ulcer Those who void crude and thin urine for a long time if other symptomes promise life an abscession is to be expected in the parts below the midrif Hipp. 2. prog It hath been said before that the signes of crudity remaining for a long time if the strength be impaired portend death because it is to be feared that the patient cannot hold out till the matter be concocted But if the strength of the body is in a good condition and other signes do promise a recovery it is to be hoped that the patient may be cured not by a perfect solution but by permutation or abscession When the urine stops with a coldness in such as are very sleepy it is a hopeful signe of ulcers near the ears Hipp. Coac For that sleepiness shews a great oppression of the brain at which time coldness coming on produces either an ulcer or a great convulsion Those who are sick of a Feaver having a weariness and faintness upon them may expect an ulcer in their joynts or about their jaws For a voluntary faintness in feavers proceeds from an abundance of thick and crude humors and those feavers are most difficultly judged and their judication is commonly by the breaking forth of an ulcer If on the patients recovery any part be distempered t is a signe that some ulcer will break out there Not onely the pain which afflicts any part at the declining of the disease but also all the symptomes that shew a weakness in the part are signes of an ulcer thereabout Note from Hipp. Aph. 74. Sect. 4. that while the signes of an approching ulcer appear if the urine be copious thick and white it takes away all fear of an abscession and that more certainly and speedily if there happen a bleeding together with this kind of urine CHAP. XII Of the signes of those things which will happen to one already sick or falling into a disease and first of the signes of approching madness MAny things usually fall out in diseases besides the Crisis as vehement symptomes the changing of one disease into another all which things if they can be foreseen by the Physician gain him a very honourable esteem and are of a special utility to the patient Therefore we shall endeavour to lay down their symptomes according to the foresaid method beginning from the signes of approching madness which are known by these rules Animal actions Principal Forgetfulness presently happening in acute diseases foretels a phrensie For it shews that the brain is affected and that the matter causing the discase is hurried up thither from the lower parts Less principal Sleep and waking Troubled and tumultuous sleeps foretel deliration This Hipp. taught in Coac in these words Turbulent and furious wakings out of sleep bring madness For they shew the brain to be very much affected and unsetled from its natural condition Continual watching brings madness Hipp. 2. prog For both of these affections are produced from the same cause viz. from a hot and dry distemper of the brain as Galen teaches in 4 of presage by pulse A more remiss distemper causeth watchfulness and a more intense one madness The hearing A thingling and sound in the ears or deafness often precedes madness especially if it appear with urine that hath matter lifted up and hanging in it Hipp. 1. prorrhet For these things do shew that the noxious matter is carried up to the brain which excites madness The sence of smelling too exquisite denounces madness For it shews an unwonted driness of the brain and an attenuation of the spirits which disposeth the brain to madness Feeling vehement and continual pain of the head in acute feavers portends madness especially when it is observed most in the ears or which is joyned with revulsions of the midrif for it signifies that the humors are copiously carried up to the brain and do vehemently distemper it Pain of the side which with cholerick spittle vanisheth away without any manifest cause is a signe of madness For it shews a translation of the cholerick humor from the side to the brain Pains in the leggs hasten madness and that as well at other times as especially if there is a bad enaeorema in the urine Hipp. in Coac There is so great a sympathy of the legs with the principal parts that as in a rupture of the heel there do happen peracute trembling sobbing feavers which last but little hot and mortal so in the pain of the legs which is caused by a malignant humor there is a feaver stirred up in the heart and madness in the brain the pestilent humors easily invading the brain Now although these pains not onely of the legs but also of the thighs back and other ignoble parts do portend madness yet they performe it more certainly if soon after appearance they withdraw again for they signifie a translation of the morbifick matter to the brain as you may see in Hipp. 3. Epid. Sect. 3. Aegr 5. where Calvus on a sudden had a pain in his right thigh and no remedies prevailed The first day he had a burning and acute feaver and the pain increased the third day the pain ceased and a madness with much tumbling and tossing ensued the fourth day about noon be dyed
by the bad humours retain'd causes very great diseases as Pleuresies Peripneumonies putrid Feavers c. but being according to nature it preserves the body in health Here we must observe what Sanctorius hath said of insensible transpiration l. de stat Med. where he affirms that more excrements are voided by insensible transpiration then by all other evacuations taken together which no Physitians till then ever knew yet this he saith he hath found by the experience of thirty years in several bodies exactly weighed both before and after meat and after voiding of their excrements which are all to be seen in the Author or in Sennertus in his Theory of putrid Feavers The flux of the Flowres ought to be moderate according to the temper and custome of the woman observing certain intervals and certain periods Otherwise being suppressed or immederately flowing they are the cause of many diseases To the excretion of seed is referred the use of Venery which if it be moderate offends not the health though a man may want it without hurt as experience teaches in Monks and Batchelors For in those the seminal matter is transmitted to several parts and consum'd in the nourishment of them but the seminal parts dry and are made incapable of their function The immoderate use of Venery hurts men more then women dissolves the spirits refrigerates the body weakens the brain eyes nerves stomack and joynts duls the senses and begets crudities and stinking breath The fittest age for Venery is youth and middle age it is hurtful to others especially old men and men of dry and weak constitutions Such intervals are to be observed as Galen teaches that a man may seem more light and nimble then before The Spring is a fitter time for Venery then the Winter Autumn lesse and least of all the Summer at which time it is better to abstain As to the parts of the day Venery is most usefull in the morning or after a mans first sleep the concoction perfected and not after meat 'T is most hurtful after hard drinking strong exercises in time of famine or after long evacuations CHAP. XXX Of the Passions of the Minde THE Passions of the Minde have a great influence upon the whole constitution of the body so that not only extreme sicknesse but death also sometimes happens from the immoderate excesse of them being moderate they preserve health He therefore that labours to preserve his health ought to seek tranquillity of minde and resist vehement passion For so the body is preserved in its natural state and the passions cause no change in it But because it is impossible to be free from all the passions a man must labour to resist them with all his force and to bridle their violence Now the effects of these passions or of the chief of them we shall briefly lay down Moderate joy chiefly conduces of all the other affections to the preservation of health for by that the heat spirits and bloud are diffused to the whole body exciting the vigour of the faculties nourishing and moistening the habit thereof and gracing it with a lively colour Hence that of the Wise man A cheerful heart makes age youthful But immoderate joy dissipates the substance of the spirits dissolves the strength of the vital faculties whence proceed convulsions and sudden death oft-times especially in old people women and weak constitutions Sadnesse weakens the natural heat cools and dries the body makes the face pale lessens the pulse and by a straightning of the heart oft times causes Feavers hindring the dilation thereof whence arises putrefaction in the humours Avicen l. de vir Cor. c. 6. saith that two things do proceed from sadnesse a weaknesse of the natural faculty through an extinction of the heat and a thickning of the spirits and humours through cold which increases the melancholy humour Fear cals the heat suddenly to the heart which causes the outward parts to wax pale cold and tremble the teeth to chatter an interrupted speech and decay of the strength sometimes it loosens the belly and causes an ejection of urine a weaknesse and resolution of the muscles death sometimes ensues abundance of bloud being call'd to the heart by which it is oppressed and the vital faculty extinguished Anger vehemently stirs the heat and spirits increases and quickens the pulse whets the choler and increases quotidian and putrefi'd Feavers If it be too outragious it overcomes the reason and moves it from its seat It profits cold natures for it excites the weaker heat and enlivens it THE FIFTH BOOK OF PHYSICAL INSTITUTIONS CONTAINING The Cure of Diseases THE PREFACE THE fifth part of Physick containing the Cure of Diseases is divided into two principal parts The first part contains the general Method of curing and proposes all the Rules necessary for the cure of diseases The second Discourses of the Materials necessary to fulfill those Rules Therefore this fifth Book shall contain the general Method of Curing and the second shall set down the Physitians Rules and Materials The first part of the Cure of Diseases Of the general Method of Curing THE PROEME THE Method of Curing is by Authors said to be twofold General and Particular The general Method is that which delilivers the common Precepts which are for the curing of all sorts of Diseases and shewes what Remedies are proper for similar what for organick and what for common Diseases The particular Method shews how every Species of diseases is to be cured hapning to every part from the head to the foot which Method is observed in their works which they call Practick And this universal cure of particular Diseases depends upon the common Precepts which are set down in the general Method and is nothing else but a practise of the general Method upon all the several Species of Diseases and the several parts of the body Now because the dogmatical Method of Physick proceeds alwaies by way of Indication therefore this our Tractate shall comprehend four Sections The first shall be of the Method of Curing and their several Indications The second of the Indications from Causes The third of the Indications from Diseases And the last of Indications from the Strength And so there shall remain no Precept touching the cure of Diseases which shall remain unfolded SECTION I. Of the Method of Curing and the Indications CHAP. I. What is the Method of Curing what is Curation and what are the conditions of it THE Method of Curing is that part of Physick whereby helps are found by Indications to restore the lost health Curation is the change of the present vitious habit of the body into its natural habit Now the cure of a Disease ought to be speedily safely and with as much delight as may be to the Patient Between the Method of curing and the Cure of diseases there is little difference The Method of curing being nothing but a rational way which the Physitian observes in the cure of diseases And by
is cooled and the Feaver extinguished and that many by loosnesse and sweating have been clearly restored to health But this evacuation to swouning in our time is little in use and by the vulgar blemished by the name of rashnesse And therefore it is best to stop and to draw as much bloud as would bring the patient to swoun at two or three times without any fear of swouning and lesse hurt to the natural strength Causes also external and internal coindicate the quantity of bleeding The internal causes are the temperament habit and age A hot and moist temper endures more plentifull bleeding then a cold and dry An extenuated soft and slender habit of the body cannot endure a great evacuation of bloud but on the contrary a fleshy thick and firm A very fat habit of body very hardly sustains bleeding Though such a habit be not subject to dissolve yet because it hath narrow and slender vens which when they are emptied the fat easily straightens there is danger lest it extinguish the natural heat and therefore is prejudiced by bleeding A youthful age endures more bleeding then childehood or old age The external causes are the Countrey season posture of the heavens vacuation suppressed or else immoderate custome of diet manner of living or evacuating In a hot and dry Countrey men must bleed lesse Because such a Countrey consumes much of the natural heat bloud and spirits whence the strength is consumed and lesse quantity of bloud is left in the veins A cold and moist countrey endures more bleeding lesse that which is most cold but a temperate Countrey endures a larger then any A cold and moist temper of the air keeps in the humours and the natural heat and dissolves them not but in a very cold countrey the bloud being as it were congealed hardly gives way to evacuation then the internal parts if they remain destitute of their heat are in danger to be extinguished by the ambient cold As to the seasons of the year the Spring permits most bleeding next Autumn then Winter least of all Summer In the most hot and most cold posture of the heaven the bloud is to be sparingly let forth in a temperate more plentifully Any accustomed evacuation suppressed requires a larger emission of bloud A voluntary evacuation that takes not away the matter of the disease doth not exclude bleeding so the strength be not much impaired thereby but in respect of this the bloud is to be let out more sparingly and the evacuation to be suppressed if it will more impair the strength Spontaneous evacuation if it bring away the morbifick matter if it do ease the patient and is able to void as much as you require you must then leave it to nature if that be not able you shall vacuate so much bloud as that both evacuations joyned together may be able to do the work They that live frugally and sparingly either out of custome or by reason of some disease are more sparingly to be let bloud then those that live more intemperately Those that are accustomed to bleeding bear it with lesse danger then those who are not accustomed to it In such diseases as require bleeding there you must let bloud at the beginning The time of letting bloud is shewn by the presence of those Indicants that require such a remedy for in the beginning of a disease those Indicants do chiefly concur in respect of themselves and of the strength which then is more vigorous also because nature in the progresse of the disease being intent upon concoction and its contention with the disease is not to be called away from her work If the beginning of the disease be omitted or that then sufficient quantity of bloud hath not been taken away it is to be let forth at other times if the signs of fulnesse and crudity still appear and the strength can bear it and that other coindicants concur or at least hinder not Among those things which forbid bleeding at the beginning of a disease and at other times crudity of the stomack is not the least or the inconcoction of the meat in the first vessels This precept is propounded by Galen 9. Meth. c. 5. therefore unlesse the distemper of the bloud be very vehement bloud-letting is to be deferred till those humours be concocted lest being drawn to the liver they should beget obstructions and should do more harm then bloud-letting could do good In those diseases where there is either a certain remission or intermission Bloud-letting may be used either ie the remission or intermission In the fits and exasperations of Feavers there is the greatest conflict of nature with the disease at which time nothing is to be stir'd nor is the strength required for the conflict to be weakned by bleeding which is elegantly expressed by Celsus c. 10. l. 2. in these words If a vehement Feaver urge in the very vehemency thereof to let bloud is to kill the man When an affection urges vehemently a vein is to be opened at any hour but in those that intermit the fittest time to let bloud is the morning two or three hours after Sun-rising For then the meat eaten the day before is well concocted and the strength is more vigorous also in the morning the bloud is more full of power and is more thin and apt to flow CHAP. IV. Of Purgation PUrgation is an evacuation of the humours peccant in quality This definition is proposed by Galen Comm. in 2. Aph. sect 1. which that it may be rightly understood you must know that by vice of the quality is not meant a meer distemper for to that alteration only were sufficient but rather a Cacochymie or a redundancy of evil humours Of this sort are all excrementitious humours which being mixed with the bloud are contain'd in the veins or without them but those are of two sorts others natural others preternatural Natural are those which are generated according to nature as sweet flegm choler melancholy and the serous humour which if they are generated in due proportion and quantity need not any vacuation but if they abound in greater quantity are to be purged out but the excrementitious humours which are preternatural are those which are produced contrary to nature as yellow green eruginous glasteous and black choler as also sharp and salt flegm which humours when they ought by no means to be in the body the least quantity of them breeds a Cacochymia and indicates purgation if it cannot be removed by diet exercise and lighter labours But to every species of the peccant humour there ought to be corresponding a proper species of purging medicine And so for flegm medicines that purge flegm for choler medicines purging choler for melancholy things that purge melancholy for the serous humour things that purge aqueous and watry humours and for mixt humours mixt medicines are to be used Purgation is coindicated by the strength temperament habit age sex manner of living of the patient
and by the state of the air In all purgation it is necessary that the strength of the patient should be very lusty or moderate The strength is something impaired by purging and therefore if it be very much weakned purging is not to be attempted Hot and dry bodies as also cold whether they be moister or dryer endure purgation very hardly hot and moist more easily Those which are endued with a hot and dry temperament by purgation may be easily heated rarifi'd and dry'd and also fall into convulsions if the purgation be overmuch Cold and moist and cold and dry have a faint heat and little spirits which are easily dissipated by purgation but hot and moist have a greater heat to resist the force of purging a thin tender and loose habit is easily dissolv'd but a fleshy and well compact tolerates purgation but a fat habit not so well Fat people are diligently to be distinguished from fleshy for although both may endure purgation yet much lesse the fat because they are colder and have lesse spirits and narrower vessels Boyes and old men require gentler medicines in their middle age more forcible Women with childe in the 4 5 and 6 moneth upon urgent necessity and with great caution may be purged This is to be taken from Hipp. Aph. 1. sect 4. and it agrees with reason For when nature stirred up by the purging medicine endeavours to expel the excrementitious humours and the disease it self it shakes the womb and expels the birth unlesse it stick very close but if when she is with childe she is troubled with a disease that requires purgation it must be used but with milde and gentle remedies and the more confidently in those moneths wherein the birth is more strongly bound to the womb which is in the 4 5 6. moneth For as Galen elegantly saith the adhering of the birth to the womb is like the hanging of the fruit upon the trees For the fruit at first is held on with more tender stalks and therefore more easily fall off when the wind shakes them but being grown bigger they are not so easily loosened from the boughs and again when they are ripe they fall of of themselves So the birth at the first beginnings of its formation and when it comes to perfection are more easily shaken forth but in the middle time they cling faster to the womb The particular nature of the patient is diligently to be observed for some are purged easily and plentifully by weaker medicines others are hardly moved by stronger Those who are accustomed to purgations more easily endure them but in those who are seldome or never purged we must proceed more cauriously In a hotter or colder air purgations are more difficult in a temperate more easie A hotter air weakens the strength and begets hot diseases and therefore admits not purging which impairs the strength Therefore saith Hipp. Aph. 5. sect in the dog-daies and before them 't is bad purging The cold condenses the humours and stops up the passages rendring the body lesse fluid which makes purging lesse successeful Therefore Hipp. Aph. 47. sect 6. saith that purging is better in the Spring then at any time of the year The quantity of the purge is shewn by the quantity of the vicious humour for it is all to be purged out that the body may be freed If the noxious humour be not wholly taken away the disease is not cured or if it appear cured it is subject to a relapse Therefore Hipp. Aph. 10. sect 2. Those things which are left in diseases cause relapses but if but a little portion of that humour be left by exquisite diet by nature and the natural heat it may at length perhaps be overcome A small Cacochymie may be drawn all away at one time if the strength be vigorous and the matter be concocted and thin but if the strength be impaired both a small and great Cacochymie is to be drawn out by degrees This Theorem is confirmed by that of Hipp. Aph. 36. sect 2. Those that eat bad meat if they purge they lose their strength thereby The reason is because they abound with many and vicious humours and have little good juice so that their weak strength is much wasted by a strong medicament and then that sink of ill humours being mov'd by the purging medicins sends stinking and ill vapours to the heart stomack and brain which do cause swounings giddinesse and other accidents yet these humours are not to be left in the body but to be purged out by degrees and at several intervals of time and by Epicrasis without much agitation The most fit time for purgation is at the height or declination of the disease in which the humours are concocted and prepared for evacuation This rule is founded on Hipp. Aph. 21. sect 1. Physical cures belong to concected not to crude things But in the declination of the disease or at least at the end of the height thereof they are perfectly concocted This Theorem is to be limited with this restriction viz. if nature do not perform evacuation of it self For when the humours are critically evacuated there must be then no purgation unlesse the crisis be imperfect For then the reliques of the morbifical matter are to be drawn forth by medicines lest they breed a relapse At the beginning of diseases purgation is to be used if the humour be too superfluous and swell The humours are then said to swell when they are agitated with violence and provoke and pain the body But this swelling is proper to cholerick humours which are hot thin and acrimonious and most subject to breed acute diseases But thick and cold humours which generate long diseases are not wont to swell so much If therefore such humours swell it is lawful to purge them forth before they are concocted for it is to be fear'd that the strength may be impaired by the agitation of the matter and that the humours stirred up by that violence may fall upon some principal part but then those humours are easily purged although they be not concocted because being thin and movable nature being also excited by them and provoked by the purging medicins lends her helping hand to evacuate them her self So that the patient receives more good then harm by the purging away of those swelling humours before they are concocted Whence Hipp. Aph. 10. sect 4. It is good to administer cure in acute diseases if the matter swell the same day for to delay longer in such diseases is evil but this is to be performed with caution and premeditation for the most part the matter swels not as in Aph. 22. sect 1. and as the same Hipp. teaches in Aph. 24. sect 1. In acute diseases and at the beginning seldome use purgations but with premeditation for purgations by their heat and acrimony increase acute diseases and acute diseases are sooner wasted by a critical evacuation then by purging But those Crises are not rashly
doth coindicate or forbid the use of nourishment as that may be increased or fomented by it or nature intent upon Pepsis may be called away by Pepasmos for when nature is buried in the concoction of nourishment she is drawn away from concocting the morbifical humour whence upon consideration of the disease regard must be had to the measure of dieting CHAP. II. What those things are that concern Diet. IN every state of the body Diet or reason of dieting consists in six things not natural but especially in diseases regard must be had to meat and drink Meat and drink as they are the true objects of nourishment so are they the true instruments which preserve the strength but other things which are not natural are only the helping causes which being well or ill disposed produce good or ill nourishment from the meat for sleep and watching if they are excessive hurt the heat and spirits if they are within the limits of health they preserve them and forward concoction immoderate sleep cools and moistens the brain so that the natural heat wastes the animal spirits are sunk in moisture and the animal faculty is injured with which the vital and natural do easily sympathize Over much watching dissipates the heat and spirits but moderate sleep and moderate watching preserve the heat and spirits and so forward concoction So motion and rest if moderate excite the natural heat and cherish it repletion and emptinesse also being orderly makes a very good concoction But passions of minde if they be moderate make the natural heat vigorous and a good concoction but the excesse of them dissipates the natural heat and spirits or choaks them Lastly the ambient Air being temperate recreates all the functions of the body but intemperate very much prejudiceth them and hinders the cure of diseases CHAP. III. What are the kindes of Diet and which are most sutable in Diseases DIet is threefold full moderate and sparing Full is that which not only preserves the present strength but increases it And that is threefold the one most simple which is convenient for the sick according to Hipp. and consists of whole barly-broth another fuller and thicker which consists of fish and eggs the last fullest of all which consists of more solid flesh Sparing diet is that which preserves the strength though something impaired This is threefold one simply so which is by the juice of unhusked barly another sort thinner which consists of water and hony and the last most sparing of all which is meer fasting Moderate diet is that which preserves the strength in the same condition and was heretofore by bread in pottage or flesh of pullets Now a daies the diet of sick people is very different and never any thinner prescribed then broths of pullets and chickens The moderate consists of ptisans panada's c. And lastly the fuller sort of diet consists in the use of meats of good nourishment and solid as partridge capons doves and others of the same nature The diet of sick persons is to be proportioned by comparing the strength with the disease For by how much the more nature is imployed in the expelling of the disease so much the sparer diet is to be observed as the strength is able to bear it and the lesse work nature hath to do a more plentiful diet may be offered In long diseases a moderate or full diet is requisite and so much the fuller by how much the disease is longer For the strength is to be preserved that it may endure and prevail in the expelling of the whole disease which because it may last long it is not to be diminished by sparing diet Acute diseases require a slender diet and by how more acute the disease is so much the slenderer ought the diet to be In acute diseases nature is imployed in expelling the disease and therefore as little as may be to be disturbed by nourishment and therefore a thin diet is sufficient which although it do a little impair the strength yet it is able to bear up the whole course of the disease which is very short If the strength is not so well known to the Physician as to prescribe a just diet it is better to prescribe an over full then an over sparing diet This precept is taken from Hipp. Aph. 5. sect 1. Through a slender diet the Patient growes faint which harms them more for what error is committed is greater in a slender then a fuller diet and therefore an exact diet is dangerous to persons in health for that by reason thereof they bear errors in diet worse And therefore a very exact and slender diet is more dangerous then the fuller diet Yet Hipp. seems to contradict himself in this opinion 2 de rat vict in Acut. For the increase of nourishment saith he lesse care is to be taken for it is better to diminish it But this we may reconcile by saying that in the first Hipp. speaks of the form of diet which if it be more sparing then is requisite doth more harm then that which is fuller but in the latter he speaks of the quantity in which the same form being observed 't is better for us to be more sparing CHAP. IV. Of the quantity of Diet. THE quantity of Diet is threefold high indifferent least of all which may be used in all sorts of diet full moderate or sparing As in Medicaments there is a threefold quantity or dose viz. highest midling and lowest which are considered in more vehement more milde and more indifferent ones so is it in diet And after the Physician hath judged whether a thin moderate or full diet be most convenient for the disease proposed then he ought to observe whether they ought to be administred in the highest lowest or midling quantity which he may distinguish by the acutenesse of the disease or the greater or lesser strife of nature with the disease In the beginning of a disease the diet most requisite is to be given in a full dose For then nature contends not so much with the disease nor is yet imployed in the concoction and evacuation thereof and therefore can make use of more nourishment In the increase of the disease diet is to be given in a moderate quantity For then nature is employed in the concoction and evacuation of the morbifical matter more then in the beginning In the height of the disease the slenderest diet is to be given For then the contention of nature with the disease is most vehement and she is very busie in the concoction and evacuation of the matter and not to be called away from her imployment If the strength be impaired and the morbifical matter very oppressive the nourishment is to be given in a little quantity and often In respect of the cause which is very vehement little nourishment is to be given lest the morbifick cause be increased But in respect of the strength it is requisite often to reiterate it lest the
carried to them also the same effects often ending by that Crisis which is made by a Perirrhoea so the noxious humours are the more easily purged away by Diureticks Of these some are hot some cold The hot by melting the humours separate the more watry and serous parts which are afterwards attracted by the reins Those Medicines which are properly and truly called Diuretick are sharp and vehemently hot and dry therefore they drain the bloud and separate the serous humour from it they also melt flegm and thick humours and change them into a watry humour which is easily mingled with the serous humour and is together attracted to the reins and expelled with the Urine But the cold ones sometimes by cleansing and sometimes by increasing the watry humour move urine Some Medicaments cleanse the humours that are contained in the vessell and reins and do a little attenuate them because although they are cold yet they have thin parts and so do move urine Such are Grasse Asparagus Pellitory of the wall Maiden-hair c. Many other things are endued with a moisture which is afforded to the veins and afterwards attracted by the reins with which the humours in the veins are carried along Of this nature is Marshmallowes Cucumers the greater cold Weeds The matter of these Diuretick Medicaments as well hot as cold is this Hot Diureticks Simple Roots of Smallage Parsly Fennel Eringo's Valerian Asarabacca Cammock Radish Rindes the middle rinde of Broom and the middle rinde of Tamarisk Leaves of Saxifrage Burnet Smallage Nettles Fennel Germander lesser Centaury Water-mint Water-cresses Savine Seeds of Massilian Hartwort Macedonian Parsly Smallage Radish Nettles Lovage Millet of the sun white Thorne red Chiches Fruits Laurel and Juniper berries Flowers Broom Camomil Gums Turpentine Animals prepared bloud of Goats Cantharides Minerals Carabe Compounds Waters of Fennel Smallage Savine Syrups of the five Roots Venus hair Byzantine Oxymel simple and compound Conserves of Broom-flowers Chymicals Spirits of Sulphur Vitriol Salt Tartar Turpentine Salt of Tartar Ivie-berries Bean-husks Cold Diureticks Simple Roots of Asparagus Grasse Knee-holy Marsh-mallowes sharp pointed Dock Sorrel Leaves of Venus-hair Sorrel Pellitory of the wall Burstwort Marsh-mallows tops of Asparagus Seeds the four greater cold ones Sorrel Alkekengi Barly Fruits Gourds Pumpions Cucumers Strawberries Flowers of Althaea Succory Gums Caphura Juices of Limmons Sowre Pomegranates Chymicks Sal prunellae Spirit of Sulphur and Vitriol which although they be reckoned among the hot Diureticks yet have a very great refrigerating vertue and are usefull both in hot and cold affections by reason of their extraordinary thinnesse and penetrating quality which makes them the vehicles of other Medicaments Compounds Waters of Pellitory of the wall Grasse Sorrel Barley Syrups of Venus-hair Limons and Marsh-mallowes Conserves of Venus-hair Eringo roots the inside of a Gourd Troches of Caphura Corollary Among the evacuating Medicaments those things which move the months are to be reckoned which are better referred to the series of Hystericals where they may be found CHAP. XV. Of Medicaments called Errhines IN long diseases of the head proceeding from flegm after universal evacuations Errhines are used which draw it down and purge it away through the nostrils Those evacuations which empty the whole body of humours are said to be universal which are succeeded by those which evacuate only a particular part and are therefore called particular such is that that brings down flegm from the brain through the nostrils most convenient in many affections thereof for after most part of the excrement is drawn away by universal evacuation the remaining part is best evacuated through the near adjoyning places And that they may more easily draw down this thick and cold humour they ought to be hot attenuating and cleansing Such are these that follow Roots of Orice Cyclamine wilde Cucumer Leaves of Beet Colewort Pimpernel Marjoram Sage Betony Penny-royal Organy Horebound Ivie Tobacco Gums Euphorbium Juices of the roots and leaves of the aforesaid Herbs Elaterium CHAP. XVI Of Sternutatories STernutatory Medicaments by exciting the expulsive faculty of the brain through their acrimony draw flegm from the brain and rouse up the drowsie brain in comatous affections Such are these that follow Roots of Ginger wilde Pellitory Florence Orice white and black Ellebore Leaves of Marjoram Betony Sage Tobacco Gums Euphorbium Animals Castor Chymicks Spirit of Sulphur Vitriol Salt of Vitriol CHAP. XVII Of Masticatories APophlegmatizing Medicaments are those which draw flegm from the brain through the mouth which they do by their heat and acrimony by which they attenuate the humour and stir up the expulsive faculty They are of this kinde Simples Roots of Ginger wilde Pellitory Angelica Leaves of Sage Marjoram Hysop Organy Seeds of Watercresses Mustard Stavesacre Nigella White and black Pepper Fruits Raisins Cubebs Gums Mastick Compounds Vinegar of Squils Oxymel of Squils Treacle Confection Anacardina CHAP. XVIII Of Cephalick Medicaments CEphalick Medicaments are those which strengthen the brain and help the distempers thereof Many medicaments are given which by a specifical property and sympathy which they have with several parts of our body strengthen them and resist their several affections such are Cephalicks which are supposed to exercise their vertues peculiarly upon the brain They are twofold hot and cold Hot things heat and dry the brain cut and attenuate the flegm contained therein Cold things partly temper the hot distempers of the brain and partly incrassate the sharp and salt flegm and other thin humours which cause great defluxions from the head Because the brain is affected now with hot now cold distempers the Medicaments which concern it ought to be of two sorts that we may remedy all these diseases The matter of them is as followes Hot Cephalicks Simple Roots of Spikenard Calamus Aromaticus Valerian Florence Orrice Acorus Galenga Setwall Piony Woods Misleto of Oak Xyloaloes Barks Cinamon Leaves of Betony Marjoram Sage Rosemarin Laurel Calamint Pellamountain Seeds of Piony Cardamom Mountain-ofter Roman Nigella Fruits Berries of Laurel and Juniper Cloves Nutmegs Cubebs grain of Kermes Flowers of Betony Lavender Rosemary Sage Mace Camomil Liby of the Vally Tyletree Juices and Liquors Opobalsamum Wine Gums Frankincense Mastick Scyrax Benioin Things taken out of the sea Succinum Amber Animals Castor Musk Civet Compounds Waters of Betony Sage Marjoram Orange flowers Cinamon Treacle Imperial Celestis Aqua vitae Syrups of Stachas Mel rosatum Conserves of Acorus Ginger flowers of French Lavender Rosemary Sage candied Mirobalans Wallnuts candied Nutmegs candied bark of Citron Confections Alkermes Treacle Mithridate Aurea Alexandrina Electuaries Dianthos Diambra Diamoschum dulce Diaireos Aromaticum Rosatum Troches of Gallia moschata Carabe Externals Oyls of Castor Camomil Orrice Laurels Nard Rue Spike and of Foxes Unguents Martiatum Aregon Emplasters of Betony Laurel-berries Melilot of Mucilage Chymicals Distilled Oyls of Rosemary Lavender Sage Thyme Fennel Anise Cinamon Nutmegs Cloves Cold Cephalicks Simples Woods all the Sanders Leaves of Lettice Purslain Plantain Seeds