These things being granted we affirm that in the first Case the inequality of the distribution of the bloud doth not principally depend upon the weaknesse of the Pulsifical vertue for as much as concerns the heart and the reason hereof is plain For the heart as we have already said doth emit the bloud indiscriminatly or equally and with one continuation from it self into the Aorta or chief artery even at such time when as the Pulse is most weak This artery doth exonerate or disburthen it self again with al possible expedition and from hence proceedeth the inequality of the diffusion of the bloud as the bloud is more easily impelled from on rivelet then from another This inequality notwithstanding must not properly and primarily be attributed to the heart but to the recipient parts and to the particular transmitting arteries For any primary affect of the heart is necessarily universal and communicated to al the parts of the body wherefore although we grant this enequality of the Circulation of the bloud to be in the secondary Essence of this Disease yet we exclude it from the primary Moreover in the Second Case propounded we say that there is a great disparity between the cases of extream necessity and ordinary cases Neither indeed do we know whether in the said cases the circulation in the inward parts howsoever it be granted be of any moment And for so much as concerneth the present businesse we deny any such debility of the heart in this affect that the Pulse should be defective in the outward parts yea we have not observed that any one afflicted with this Disease hath been prone to fal into an extacy or a swouning which would readily happen if the origin of the Disease were rooted in the debility of the heart it self Besides when we have seen such as were sick in their tender age to endure without any loss of strength sometimes a liberal eduction or flowing forth of the bloud from the opened veins of their ears yea and seen it sometimes reiterated with good successe Finally When also they have very wel endured purgations with respect had to their age it doth not appear to us how the first root of the evil can be ascribed to the weakness of the vital constitution In the Third Case it is evidently manifest that the first cause of this unequal circulation of the bloud is some disposition of an outward part as in an inflamed member laboring under some private Disease there happeneth a more ful and impetuous Pulse by reason of the accidental heat of the artery infused by the immoderation of heat which is in that outward part Therefore seing that the Essence of this affect cannot be primarily rooted in the animal nor the vital Constitution of the parts as we have now shewed it followeth which shal be the Third Conclusion That the primary Essence or first root of this affect consisteth in the proper or inherent constitution of the parts But because the natural Constitution as we have said above consisteth partly in the common qualities and the temperament and partly in a just plenty and disposition of the inherent Spirits and again partly in the organical construction and continuity our next enquiry must be to find out in which of the prementioned constitutions it lodgeth and whether it be rooted in one alone or in many or in altogether Be the Fourth Conclusion therefore this This affect is not radicated in the Organical Constitution of the parts For although in progresse of time the Organs themselves are divers wayes affected in respect of their conformation quantity and site as it is sufficiently manifest from the encreased bulk of the head liver c. from the tumours of the bones unto the wrests the ankls and the extremities of the ribs from various obstructions and the extenuation of the outward parts seing neverthelesse that al these things depend upon a higher origin and howsoever also we may necessarily admit these things in a Disease confirmed and now variously compounded yet in the original Essence we presume for the subsequent reasons they are to be rejected First Because the depravations aforesaid in the Organical parts do not appear presently in the beginning of the Disease but encrease afterwards by little and little And although perhaps some of these may be said from the beginning to have taken root in the body notwithstanding they cannot as yet be immediatly discerned by the sense neither do they manifestly hurt any actions and for that reason they cannot appertain to the first Essence of the Disease Secondly Because the Organical vices aforesaid are not the Causes but the Effects rather of the chief Symptoms which from the beginning exhibit themselves in this affect For the augmented figure of the head liver c. the standing out of the bones and the leannesse of the external parts are more rightly refered to the inequality of the nourishment then on the contrary the inequality of the nourishment should be ascribed to them For when one part doth excessively encrease and another is defrauded of a due decent augmentation there is a necessity that a disproportionate and an unequal nourishment must not only be present in the parts but also have had a preexistence in the body whereby one part is nourished and another neglected beneath a mediocrity But seeing this unequal nourishment is a depraved action and so a Symptom presupposing some preexistent Disease and yet withal as we have said doth precede as a cause the organical vices aforesaid it is manifest that those organical vices are not the first root of this Disease As for the obstructions which indeed are for the most part conjoyned with this affect yet neverthelesse there is a great deal of reason to exclude them from the first Essence of this Disease because they neither specificate the Disease neither can any reason of the Symptoms be rendered from them neither do they perpetually besiege some certain and determinate noble part Some man perhaps who hath respect to the excessive magnitude of the liver may object that in this affect that is perpetually obstructed and thereupon the sanguification being vitiated the other things are preposteriously derived but if this swelling of the Liver did alwayes proceed from the obstruction of it then a palenesse of complexion a cachexia or indigestion and by the advantage of time the Dropsie it self should necessarily and perpetually accompany this affect Moreover The Liver should alwayes be seen to be vitiated in the colour and at the dissection hard tumors and knots should be observed in the substance of it especially in an inveterate affect and that which killed the Patient but seing these things do not frequently much lesse perpetually occur in dead bodies the augmented bulk of it must rather be refered to the irregular nutrition Moreover we deny it not but that we have observed by Anatomy in those who have perished of this Disease obstructions various tumours and knotty excrescencies in
waterish as in the sperm of almost all Creatures and ripe fruits The Saltish likewise is rarely simple although there is a man that contendeth it is to be found in salt of Tartar But the compound saltish lubricity is frequently obvious as in Soap and Salt of Tartar dissolved with waterish and oyly substances The Earthy even mixt is scarce worthy of observation unless it be in respect that it concurreth to the thickning of fluid bodies as in white clayish Mud and Fullers Earth dissolved But in this place we have regard chiefly to that lubricity which is waterish as being that alone which can be guilty of the crime in this affect we now handle And these things may suffice in general of the internal or similary lubricity The next enquiring must be whether the first affected parts of this Diseas be affected beyond a due proportion with an internel or similary lubricity And at first indeed it seemeth very probable that there is such an extream lubricity in the said parts becaus moisture doth superabound in them which ever favoreth the said lubricity be it conjoyned either with heat or cold Every one knoweth that the Sperm of Creatures by how much it is moister than the creatures produced by it by so much also it is the more slippery in like manner that the yong flesh of Creatures is more slippery than that of old Seeing therefore that humidity and lubricity of this kind are so inwardly converted Seing also that in the parts first affected there is manifestly an extream humidity certainly it may easily be granted that a lubricity likewise doth too much abound in the said parts And to the production of this the benummedness of those parts have no small share For the Spirits when they are in their exaltation contract a kind of acrimony and sharpness as may be seen by comparing Must with old Wine or with Spirit of Wine or with Aqua vitae For the Spirits of Must may truly be said to be benummed or stupified if they be compared with the Spirits of old Wine and by how much more they are stupified so much more lubricity they likewise contain and also so much the less of sharpness and acrimony From whence it is manifest that that benummedness and dulness in the Spirits lodging in the first affected parts doth favor that extrem lubricity for that dulness of the Spirits in the said parts is almost of the same degree with the dulness of the Spirits in Must And becaus the Spirits are defective in the parts first affected it is evident that this lubricity is an over-watrish lubricity Moreover laxity flaccidity and softness do also seem to conspire For unripe fruit as they are hard so till they wax ripe they grow softer and softer and withal acquire an internal lubricity in like manner the parts are loosned by relaxant baths and together they become more slippery also slippery things taken inwardly as the mucilage of Althea c. Do not only loosen the Parts but they also make the passages slippery for which case in the pains of the stone they are drank with good juyces Again this lubricity of the first affected parts seemeth to be much confirmed by this because in the dissected Bodies a manifest lubricity is observable by the touch and if they be squeezed a mucilaginous kind of blood inwardly besmearing them is crushed out with the fingers We say nothing of the skin which for the most part is slippery in this affect and is seldom felt to be rough to the touch but it is worthy to be noted that extream slippery Medicines either outwardly applyed or inwardly taken do usually more hurt then good in this Diseas And thus we absolve the former question of the manner whereby the Tone of the Parts is vitiated in this Affect The other now presents it self to our consideration Whether the Tone vitiated after that manner as hath been said be a Part of the Essence of this Diseas We suppose here that whatsoever is found to be vitiated in the Body is either a morbifical cause or a Symptom or the Diseas it self and therfore this Diseas either simple or compound or any part of a compound and that either primary or secondary We say first That the vitiated Tone above propounded is not properly a cause of the Diseas And this scarce need any proof For the said Tone is a preternatural Constitution rooted in the Parts themselves and by that reason it is most evidently distinguished from a morbifical cause properly so called For although one Diseas may be the cause of another nevertheless even then it is not properly called a morbifical cause but a primary Diseas and that other which it produceth a a secondary affect But every where there is a growing together of them both into one total Diseas the former wil be the primary Part of the Essence and the latter the secondary part of the Essence Secondly We affirm that the described Tone of the Parts is not a meer Symptom for it is not under the things secured and retained neither can it be comprehended under any depraved action or any changed quality not vitiating the action But that the vitiated Tone is not comprehended under the things secured and retained nor under any depraved action may by the same labor be proved by this Reason because those kind of Symptoms are not indeed Constitutions of the body but the said vitiated Tone without controversy is a preternatural changed constitution as we have already most playnly demonstrated Secondly That the said Tone vitiated after that manner is not contained under any changed quality not depraving the action is so clear and evident that it needs no proof For laxity and flaccidity hurteth the motion of the Parts and an extream lubricity is an impediment to the du quickning of the vital Spirits as shal hereafter be made manifest It may be Objected That some bare changed qualities which are comprehended under the Genus of Symptoms may also vitiate an action as the colour changed in the skin yeeldeth an unpleasant prospect to the beholder so that it begetteth deformity and defect of du comliness We answer That the changed colour of the Skin in as much as it vitiateth the beauty therof which is the proper action of the Skin doth in rigor in a large acception fall under the Notion of a Diseas But seing this action of the Skin is only Objecture and Ad extra and seing that altered color doth hurt no Internal action of that individual Physitians who in the definition of a Diseas have respect only to the Internal actions of that individual do usually exclude it from the Classis of Diseases Or if the vitiated color of a part do chance in some place to deprave an internal action which is known only to happen in the Tunicle of the Eye called Corura the best Physitians do ever reckon it for a Diseas although perhaps secondarily But that we may return into the
way from whence we have a little erred seing that the vitiated Tone may hurt as we have said the internal actions it doth not properly belong to that kind of Symptom which is wont to be called by the name of a changed quality Thirdly we say That this vitiated Tone seing it is neither a Morbifical caus nor a Symptom and yet is somthing preternatural must needs be the Diseas it self Moreover the same is clearly proved by the very definition of a Diseas For this vitiated Tone is a preternatural Constitution primarily or immediatly hurting the internal action therfore it is a Diseas For to what the definition is competible to that also the thing defined is competible That it is a preternatural Constitution is manifest by this because it is inherent in the solid parts of the body that it likewise depraveth the Internal actions is manifest from hence because an extream laxity lubricity and flaccidity of the parts being granted presently the agility is weakned no other cause approaching and a certain sluggishness deadeth the irritation of the vital Spirits In agility the matter is plain seing that firm and stretched bodies other things being answerable are more active and so on the contrary that the same thing also happeneth in the dulness of the irritation shal be shewed in its place for the present we labor to prove no other thing then that the vitiated Tone in this affect is a Diseas We say fourthly That this vitiated Tone in this Diseas is not any simple affect having an existence apart by it self but that it is so conjoyned and compounded in those same parts with the primary Essence that the whole Essence of the Diseas wherof we dispute may be said to consist of many Diseases united together in themselvs indeed simple if they be considered asunder and therfore that the vitiated Tone is only a part of the whol Diseas And this needeth no other proof then because the first Essence proposed above and the said vitiated Tone are both found in those same parts For that is properly called a compound Diseas which is produced by many simple Diseases conjoyned in the same Part. Fifthly We affirm that the vitiated Tone is not only a part of the whole Essence but such a part as hath some dependance upon the primary Essence and therfore that it is a secondary part of the Essence Before we proceed to the proof of this Proposition two grants or concessions are to be premised We grant first That the said Tone may be even immediatly vitiated in other causes perhaps and likewise by other causes although that happen not in this present Diseas For the inherent Tone of the Parts may be primarily loosned in the Animal Constitution and that suddenly as may be observed in the dead Palsy For the natural tensity and not the Animal only of the Paralytical member is loosned and indeed suddenly without any conspicuous intervention of any part of the aforesaid primary Essence After the same manner in a Lipothymy or defection of the mind loosness and languishing suddenly attatcheth al the parts Now we cannot in either of these two causes refer the cause of the loosness to the cold and moist distemper of the natural Constitution seeing that cannot be so suddenly and so sensibly changed Which let them consider that we may give warning of it by the way who wil have these common qualities to be always second and dependent upon the first alone yea on the other side let them in that cause observe how a cold and moist distemper doth afterwards by degree follow that loosness suddenly introduced Again as for the flaccidity of the parts that may be immediatly produced by large evacuations as a flux of the belly sweatings and the like immoderate vents the temperament being not yet considerably changed although we deny not but this may easily and doth usually follow Moreover an internal lubricity may be manifestly separated from coldness though very difficultly from moisture Secondly We grant that in the present Diseas the vitiated Tone doth not in any manner depend upon the first admitted Essence nor that in every respect is subordinate unto it For first the qualities of the Tone here vitiated do also ow somwhat to common causes namely to themselves and also to those that are common to the first granted Essence For extream moistening things by one and the same operation are apt to produce both too much moisture and also loosness In like manner from violent evacuations a want of Spirits and withal a witheredness doth arise Also from things too too slippery either outwardly administred or inwardly tataken or both an internal lubricity is augmented together with a moist distemper For there is so great a connexion of the whole Essence hitherto propounded with the common causes that there is scarce any thing which doth augment the first essence of the Diseas but at the same time more or less it hath an influence upon the vitiated Tone These things bring granted We say notwithstanding that in the present affect there is a very great dependance of the vitiated Tone upon the first Essence of this Diseas for which respect alone we have here referred the vitiated Tone to the secondary Essence If any list to contend That the said Tone in another respect may relate more clearly to the Secondary Essence because he may imagine that the primary Essence of every Diseas is necessarily similary and perpetually grounded upon the first qualities alone or because he may conceive that the qualities wherein the Tone consisteth are perpetually secondary and that they follow the first only as the shadow doth the Sun that man may take notice that we purposely decline such questions least we should straggle into an unwarrantable digression It remaineth therefore only that we prove the Dependance of the vitiated Tone upon the first Essence of this Diseas to be very great and that we shal do by parts We wil begin at the laxity We grant indeed that a laxity may be somtimes suddenly produced and in that cause a moyst distemper may often follow upon it Namely when the laxity primarily dependeth upon the fault either of the Animal or Vital Constitution but in this Diseas seing that neither the Animal nor the Vital Constitution are primarily affected there is a necessity that it must flow from other causes Moreover such is the condition of laxity and tensity that they are obnoxious to sudden alterations For the strings of a Lute may almost in a moment be stretched and loosned again the same thing likewise from some causes befalleth the Fibers of the Parts But in this affect the laxity stealeth on by degrees and slowly therfore necessary it is that it must begin be ruled and moderated by some caus leisurely and slowly augmented Although therfore we granted even now that the laxity doth own somwhat to the common causes of the Diseas yet the augmentation therof is chiefly restrained and moderated by
unless it be irradiated with light so those inherent faculties of attracting retaining concocting secreving and forming are dead as it were and meerly potential when they are deprived of the vivification and erogation of the Vital afflux This is most clearly conspicuous in a lipothymy for upon the defect of the Vital influx all those faculties suddenly fail decay languish But seing all the faculties are established upon some constitution which is both the cause and subject of them it might be demanded in which Constitution of the parts it is grounded We answer in respect of the potential Nature they are radicated in the Natural Constitution which we have before described but that in reference to the Actuated and Elivened Essence that they depend likewise upon the Vital influx And we declare in general that the participative Vital Constitution which we have already asserted to consist in Three things conjoyned with the Natural Constitution is the total and adequate both cause and subject of all those faculties But it would be a tedious degression and inconsistent with our purpose to make enquiry how those Constitutions can produce this or that faculty determinate in its Species For the present we will only run over those faults of the faculties aforesaid which occur in this affect First The fashioning vertue here erreth by an unequal purging out of the Vital Blood in divers parts as we have discoursed above Hereupon the Head and the Liver grow to an unmeasurable bigness the first affected parts are extenuated the ends of the Bones stick out and somtimes the Bones themselves which are otherwise straight wax crooked Secondly The Concoctive faculty is weak in this Diseas and in the first affected part by reason of the inherent cold distemper the penury and benummedness of the Spirits the brittle and slippery union of the Vital spirits with the Natural Constitution and by reason of the feeble imprinted Vital heat Thirdly The Attractive Retentive and Expulsive Faculties seem not to recede much from their Natural Condition yet the Attractive is somwhat more slow than ought to be the Retentive by reason of the internal lubricity is somwhat weaker and the Expulsive is more vehement for the same Cause And thus at length we have dispatched the faithful examination of the faults of the Vital Constitution in this affect The Animal Constitution should now undergo the next disquisition but that som faults of the Natural Constitution namly the Organical faults therof which have some dependance upon some of the recited faults of the Vital Constitution do challenge this place as most proper to themselvs CHAP. XIII The Organical Faults of the Natural Constitution in this Affect SEing that the Organical faults in this Diseas belong to the Inherent Constitution of the parts thos indeed by the Law of just Method should be immediatly after the similary vices of the same Constitution but as we have noted above the Reason and Caus of them must be derived from the faults of the Vital Constitution lately mentioned and therfore we are constrained to premise the examination of these and to reserv the consideration of the other for another place The Organical faults in this affect are fitly reduced to these Heads First To the extenuation and leanness of certain parts namly the parts first affected Secondly To the unreasonably augmented magnitude of some parts as the Brain the whol Head and the Liver Thirdly To the tumors or lanching out of certain Bones as of the Bones to the Wrests to the Ankles and the ends of the ribs Fourthly To the bowing of certain Bones as it frequently happneth to the Bones of the Cubit and the Shin Bone somtimes to the Bone of the Thigh and Sholder Fifthly To the poynted figure and narrowness of the breast And these faults are reckoned beneath among the Symptoms and signs of the Diseas not because they are indeed meer Symptoms but becaus they are obvious to the Senses and so do fitly supply the place of signs both in respect of the parts of the Essence of the Diseas more deeply retired and also in respect of the hidden causes therof For whatsoever is perceived by the sens and besides it self representeth somwhat els to the understanding that is obscure hath the formality of a sign For indeed these faults are parts of the secondary Essence of the Diseas seing that they are the vitious Constitutions of the Organs depraving the action and have a dependance upon the other parts of the Essence of the Diseas The common caus almost of al these recited affects seems to be an uneven or disproportionate nourishment or Alogotrophy of the parts Now this dependeth chiefly upon two causes in this affect The first is the unequal inherent Constitution of the parts irregularly nourished The disparity between the inherent Constitutions of the first affected parts and the Head and Bowels cannot be so wel collected by what hath been already said but that it may deserve a further inculcation The last ca us which is indeed of equal moment is the very unequal distribution of the Arterious Blood into the parts unevenly nourished That the Blood is unequally distributed in this affect we have already shewed here we only infer that that must needs produce an unequal nutrition of the parts Al Creatures the more liberally they feed the more fat and fleshly they are unless som oother impediment doth intervene but if the du quantity of aliment be substracted they grow lean and are daily more and more extenuated Why should we not suppose that the same thing happeneth in the Parts of Creatures the Blood or at least somwhat contained in the Blood is acknowledged for the last aliment of al the parts wher therfore that is liberally dispensed to one part and sparingly to another certainly it is no wonder if one part be excessively augmented and another extreamly extenuated But these things may suffice in general In particular First We assert that the first affected parts in this Diseas do dayly wax lean and fal away Proof of this assertion cannot be reasonably expected seing that dayly experience yeeldeth an occular demonstration of it But why those parts are so extenuated that may require som reasons and we offer these The first is deduced from the primary essence of the Diseas namly from a cold distemper a penury and inactivity of the inherent Spirits in the parts aforesaid For by this means the attractive retentive and concoctive faculty do execute their functions in those parts unduly and ineffectually The second is brought from the loosness softness and internal slipperiness of the same parts for hereupon the expulsive faculty is too much irritated the breathing is too easy and dissipative the circulation of the Blood is to slippery the retentive faculty through the weaknes of it parteth with the aliment too soon and with too much facility and this very thing almost happneth here in these parts which befalleth the Guts in a Lyentery Howsoever it be
as it were in a common Hypocaust or hot Hous Seing therfore that the first part of the Essence of this Diseas consisteth in an unequal cold distemper it is no wonder if these Defences and Fortifications of the Body do avert it at least for some short time The Third Reason may perhaps be the wholsomness of the Diet for Breast-Milk is the most solubrious and agreeable nourishment that tender age especially when it is sucked from the Breasts for it is a simple and uniform Meat full of nourishment easie to concoct and friendly and farmiliar to the constitution of Infants Therfore so long as they are conveniently nourished with it they incur the fewer errors of diet and are rendred the less obnoxious to this Diseas Yet it must be noted that if the Nurses milk be not laudable and good in it self or otherwise disagreable to the Constitution of the Infant then this reason is of no force Therefore if the Nurse be big with Child or immoderatly addicted to Venery or any ways sickly or given to drunkenness and inordinate feeding it is safer to hasten the weaning of the Infant unless you are provided of a better Nurse The fourth and last reason is the slowness of the motion of this Diseas in his first invasions For it stealeth on so slowly that it scarce bewrayeth any preparations to an assault til some months are expired unless the progress of it be advanced by some extraordinary and most vehement Causes as by some more violent Affect preceding or coming upon it Seing therefore that this Diseas doth so slowly take Root and seing that Children as we have formerly shewed are commonly born free from it it seldom hapneth to break out evidently into act til the sixth yea indeed til the ninth month And thus we have given the reasons why Infants newly born notwithstanding the weakness of their Constitution are for many months priviledged from this Diseas Secondly The causes why Children from the ninth to the eighteenth Month are every day more frequently infested with this affect are these First Becaus the first Caus even now propounded driving away this Diseas in those that are new born doth daily remit and before the ninth Month doth totally vanish Secondly In like manner the second propulsive Caus before alledged till that age doth every day grow more effectual For the hands of Infants after some Months if not before are usually set at liberty from the prison of their Blankets and perhaps their Feet also before they are six months old although at night they are swadled up again In the day time therfore at the least these outward Members are destitute of that common and comfortable warmth The Nurses likewise do many times er when they cloath the weak and feeble Infants too soon For they idly define the time of cloathing them by the number of the Months seing that they should rather give an estimation of it by the strength and activity of the motion of their Hands and Feet For when the motion and exercise of those parts doth avail more to excite and cherish their heat and to irritate their Pulses than the warmth of their swadling cloaths without all controversie that is the time to devest Infants from their swadling cloaths Moreover thirdly After the ninth Month Children usually are fed with other aliment besides Breast-Milk or other Milk and from that variety in feeding there easily resulteth some errors in point of Diet. Fourthly The slowness of the Motion of this Diseas doth not hinder but that it may break forth into act after the ninth Month. For the motion by reason of the unperceivable slowness of it at the end of certain months doth exhibit some effects and impressions Lastly the evils of breeding teeth do likewise contribute very much to the same purpose For the Teeth begin to breed commonly about the seventh Month and come accompanied with divers Symptoms which easily dispose tender Bodies to this affect Thirdly The Causes why this Diseas most frequently rageth when the Child is eighteen Months old are First Becaus the Causes before cited hastning this Diseas in the yonger Children are upon the approach of this age taken away or at least they operate with weak and ineffectual powers Secondly The evils of breeding Teeth although in respect of the immediate Symptoms which they produce perhaps before this time they nourish yet for the most part they leave behind them in the first affected parts a certain disposition which privily hiding it self within them after the term of some months produceth this Diseas But the breaking out of the Dog-teeth chiefly hath reference to this place seing that these break out a little before the Child is a year and an half old and their coming forth likewise is of al other the most painfull Thirdly Hitherto belong also those accidents which happen by reason of ablactation or weaning of the Child and at that time a great alteration befalleth Children in matter of Diet which they endure not without palpable molestation For herupon they are angry they cry the commotions of their minds makes them forsake the nourishment of their Bodies they are hard to be pleased neither do they sleep quietly All which things do easily imprint in the parts first affected at least a foregoing disposition although perhaps not till a long time after to this affect And so at length we have also run through this second Comparison namely of yong Children among themselves and we have briefly explained the Causes why those Children at one age are more and at another age are less exposed to this evil The Third part of the Question still remaineth which as we said we would reserve to be examined at the close of this Disputation namely Whether those that are of a greater age do somtimes fall though exceeding rarely into this Diseas We say first For so much as concerneth that part of the Essence of this Diseas which consisteth in a moist distemper that some difference must be expected to be between that distemper in yonger Children and those that are bigger in yong Men Men and especially in old Men for the same difference which we put before between the moist distemper of yong Children and old Men may according to quantity as more or less be observed between the middle Ages and therfore the humidity of the yonger Children will be better concocted and more genuine than that of the elder as it is obvious to collect mutatis mutandis from the same reasoning Secondly As for the organical faults we affirm that necessarily there concurreth a vast difference between Diseases of this kind incident to Children and perhaps to those of greater age for the tumors of the Bones in the Wrests and Ankles as also that narrowness of the Breast likewise that disproportionatly augmented bigness of the Head and Liver are either less conspicuous or altogether undescernable especially in those that are grown to full age For as the years encreas the Figure
subjects Let us now apply these things to the present affect We affirm therfore that six differences of this diseas do occur in respect of the times therof For it hath a beginning and may be called incipient it hath an encreas and may be said to be confirmed it hath a state and then it it may be termed consistant it hath an encrease beyond the state and may be called desperate it hath a tru declination and may be said to be an affect remiting or simply declining and it hath a spurious declination and may be called a change as when it chancheth into som other diseas Of al which we wil speak in their order First The Rachites is called a Diseas begining when the first Rudiments and impressions thereof are though very obscurely first observed and before there hapneth any manifest extenuation of the first affected parts Secondly This diseas is said to be confirmed when an evident and manifest extenuation of the first affected parts becoms obvious to the Senses And here the Reader perceiveth we do not distinguish thes two times from crudity and coction but from another alteration of the Body namly The Extenuation made in the parts first affected for the begining of this diseas can no ways be discerned from the encreas therof by crudity and coction But otherwise so far as the nature of the thing is capable of it we shal willingly follow the example of Galen and as he distinguisheth the encreas from the begining by the manifest coction so we also put a different between thes times in this affect from a manifest alteration namly the extenuation made in the said parts Thirdly This diseas advanced to its consistence is that which having attained the highest vigor and exhaltation is arrested and for a time is neither sensibly encreased or lessened but continueth at a stand Fourthly This diseas exceeding the Mediocrity of the consistance is called desperat namly Becaus in magnitude and vehemence it surpasseth the very state of the same diseas in another Patient indifferently affected and withal is continually encreased neither is there any hope but that it will daily encreas til it hath altogether subdued and dissolved the Patient For which caus this condition of a diseas is termed desperat Fifthly This diseas is said to be truly remitting or declining when the Essence therof is by little and little diminished and when the Signs and Symptoms of it are daily mitigated Sixthly This diseas is said to be illegitimatly declining or passing into another diseas of a divers species when the Essence Signs and Symptoms therof are so lessened that new ones of a different kind and perhaps more outragious appear in their stead Thus the Rachites frequently degenerat into a Consumption a Hectick and somtimes perhaps into a slow putrid Feaver yet for the most part the same diseas doth accompany thes supervening affects to the dissolution of the Patient And let this suffice concerning the differences of this diseas deduced from the Essence This diseas in like manner in respect of the Causes is as it were taken into pieces or divided into parts namly into a natural affect and into an after-coming or newly contracted malady Again This diseas may be termed natural in a twofold sens In the first properly As when the Sick is born actually affected with this diseas In the later improperly when the Patient at his birth is not actually affected with it but strongly disposed by his native principles to fall into it If it pleas the Reader to summon those things to his memory which were said above concerning the causes of this Effect on the Parents parts he wil easily conceive the reason and foundations of this difference and consequently that wil excuse us from any further explication Only we ad that this difference is of great use in the judicial part of cure which consisteth in applications antidotal and preventive but it is not of so great moment in the Method of Cure In like manner this Affect is meerly coming after when being fomented by no Natural disposition it is newly contracted after the birth here also it is twofold For it either succeedeth som foregoing Diseas or it is immediatly produced by an erroneous use of the six non-Natural things We have sufficiently discoursed of both where we hammered out the causes of this Diseas after the birth and thither we direct the Reader Again this Diseas admitteth som differences by reason of other Diseases wherwith it is conjoyned in the same subject It must not be expected that we should give in a Catalogue of all Diseases wherwith this Affect may possibly be conjoyned we shal only reckon up those which ate the usual Companions of this Malady Som wherof have a certain dependance upon this Diseas and the causes of it others have not any or at least not any worthy of a distinct consideration Of the former kind are a Hydrocephalus the faults of breeding Teeth an Asthma the Ptysick an Hectik feaver a slow and erratical Feaver and the Ascites which is that kind of Dropsy when water hath gotten between the flesh and the Skin The Hydrocephalus hath a great correspondence with this Affect seing that this Affect also doth for the most part suppose an increas of the Head preternaturally encreased and an overplentiful afflux of the Blood unto the Brain by reason of the largeness of the Arteries thither extended And hereupon it easily coms to pass that the Brain being oppressed w th the abundance of the Blood must somtimes needs suffer the more serous portion therof as being the most permeable to evaporate or sweat out into the Ventricles and cavities within the Menynges and by consequence to produce the Dropsy of the Brain But this as we have already noted doth always appear The faults of breeding of Teeth also are somtimes justly ascribed to this Diseas going before For it is well known that they who are affected with this Diseas do commonly breed Teeth with extream pain and many times the Teeth themselvs fal out by pieces But we have above reduced this fault to the unequal nourishment of the parts and there the Reader may find further satisfaction In the mean time it must be observed that a painful breeding of Teeth may likewise precede this Diseas and sustain the force of a caus in reference to this subsequent evil as we have likewise shewed above Moreover An Asthma or difficulty of breathing doth familiarly follow upon this Affect because the Blood is somwhat cooled in his circulation thorow the first affected parts and is rendred more thick viscous and sluggish in motion neither is it always perfectly corrected before its return to the right Ventricle of the Heart Wherupon being unapt for passage it is powred back from the right Ventricle thorow the Arterious Vein into the substance of the Lungs and for that Reason doth easily introduce obstructions hard tumors difficulty of breathing somtimes inflammations impostumes Ulcers the Ptysick the
rather indeed confirms it For the unity of an Art consisteth in some community which may be attributed to all the parts therof and this union is to be esteemed so much the more firm as all the parts of art are reciprocally conjoyned among themselvs by more communities If therfore there are two general Actions and those common to all the parts of Medicine so much the more firmly will those parts conspire the advancement of the Art Wherfore he contradicts not Galen that affirms conservation also to be a general Action of all Medicine seing that the scope of Galen was only to shew the unity of the Medical art by the community of that general Action namely Correction now he might as easily have shewed it if the nature of the thing had required it by the community of Conservation For in the Hygienal part of the most noble circumstance is the Conservation of the whol concrete action and therupon the whol action is denominated from the more principal part and the Art it self an Art conservative Although otherwise as hath been said it also includes Correction But in the Prophylactical part the principal scope of the Medical Action is preservation namely the correction of the caus of the imminent Diseas yet this is so performed and by such means which the present spirits can allow but in no wise by such things as may destroy them And therfore also in the Prophylactical part regard is had to the Spirits and their conservation is Indicated Now after the same manner the whole concrete Action although as hath been said it also includeth Conservation is called Preservation and Precaution from the more Noble part Finally In the Therapeutical part although in like manner the whol concrete action be called Curation and the art it self a Curative Science from the principal part of the action yet to speak properly and truly all this action of cure may be divided into three abstracted parts and evidently distinct namly into the Cure of the cause the Cure of the Diseas and the conservation of the Spirits For the Vital or Conservative Indication doth evidently and by the unanimous grant of all Physitians belong also to this part of Medicine and must be consulted of in every curative action before it be undertaken From whence it is manifest that this part likewise of Medicine doth perpetutually conserve that is provide and foresee in every Cure least the Spirits should receive more detriment than profit from the prescribed remedies Al these things therfore being thorowly weighed we conclude That a general Indicate is a certain concrete thing and may be properly distinguished into two general abstracted actions which are exercised in every part of Medicine and that in the work of art they pertually make one compleat or complicated action Moreover The general Indicant namely the State of the Body as frail and in motion may be divided besides the parts or obstracted considerations already proposed into three kinds or rather three succeeding kinds equally and alike concrete namely into a sound state a diseased state and a neutrality These three Species are the subjects of the three kinds of Method to Practice namely the sound state of the Hygienal part the diseased state of the Therapeutical and the Neutral of the Prophylactical part These three states are also concrete Indicants and respectively Indicate what is particularly to be done or what the Physitians Duty is in all those Arts namely a sound state indicateth the conservation of health a diseased state the removal of some affect and the Neutral state that the caus of an imminent malady ought to be corrected least it break out into a Diseas Now these three Indicates are alike concrete and each of them as we have proved above abstractively includeth both Conservation and Correction Finally In a Diseased state the action of correcting is dissolved into two Species into the correction of Caus and the correction of the Diseas and so here may be discovered three kinds of abstracted actions For a diseased state brancheth it self into three Species evidently abstracted into the Essence of a Diseas the causes of a Diseas and the Spirits or those things which remain in this state according to Nature For those things which are preternatural and indicate correction in general are here separated as hath been said into two parts namely into the Essence of a Diseas and the Causes of a Diseas and therfore there are three parts of this state each of which do formally and distinctly Indicate Three kinds therfore that we may put an end to this matter of Indications are to be considered in this state namely from the Essence of the Diseas the Curative from the Causes the Preservative and from the Spirits the Vital or Conservative To the Causes we refer all impediments of cure as also vehement Symptoms and such as divert the Progress of the Cure to themselvs for in this respect they are invested with the Nature of Causes And thus much of Indications in general CHAP. XXV Indications Curative WE have already affirmed that these Indications are deduced from the Essence of the Diseas we shall therfore in this place slightly run over all the parts of the Essence of this Diseas that the Reader may perceive what every one insinuates to be done First Therfore the Essence of this Diseas partly consisteth in a cold and moist distemper this Diseas therfore in respect of this part of its Essence Indicateth not only that all those things are to be avoided which are in any wise endued with a faculty to cherish and augment that distemper but also that the aid of such things ought to be implored which may subdue the same namely hot and dry Secondly This Diseas partly also consisteth in the want of inherent Spirits therfore not only all those things are to be avoided which can any further scatter and consume the Spirits but such things must be elected which are vertuous to restore cherish and multiply them Strong discussing remedies are therfore in this case to be declined becaus withal they consume the Spirits in like manner such as are extreamly hot for they caus them to evaporate and vanish into air but much more such as have power to dissolve the parts as violent Catharticks But the best nourishment must be chosen and Medicines that are easy of Concoction as much as may be and amicable and benign to the Spirits Thirdly The Essence of this Diseas consisteth partly in a numbness or astonishment of the Spirits this numbness insinuates a prohibition and abstinence from all such things as vehemently make thick and fix the Spirits or any other waies stupifie them as narotical remidies and many Minerals which participate of the nature of Lead as Cerus Litharge Sinople or Vermilion and all such things as have power to excite the Spirits to expel their stupefaction and to render them active and agile are to be made choice of as exercises motions Frictions
A Treatise of the RICKETS Being a Diseas common to CHILDREN Wherin among many other things is shewed 1. The Essence 2. The Causes 3. The Signs 4. The Remedies of the Diseas Published in Latin by Francis Glisson George Bate And Ahasuerus Regemorter Doctors in Physick and Fellows of the Colledg of Physitians at London Translated into English by Phil. Armin. LONDON Printed by Peter Cole at the sign of the Printing-Press in Cornhil near the Royal Exchange 1651. The Preface to the Reader Courteous Reader BEfore the space of five years we have mutually communicated by written Papers somthing concerning this Affect in privat meetings which som of us Physitians use somtimes to have for Exercise-sake in the works of Art When thes things had opened a way in some sort to the deeper enquiry and search after the condition and cure of this Diseas We thought it might prove a very succesful undertaking to recal those Papers once again to a Review and those things being called out which might be best accommodated to this use to prepare a perfect Tractate of this Diseas That Care by common suffrage was entrusted to Dr Glisson Dr Bate and Dr Regemorter who purposed at first to divide this business among themselvs according to the parts of the future Tractate and to assign to each one his proper task But when Dr Glisson in the judgment of the rest had accuratly interweaved his part which comprehended the finding out of the Essence of this Diseas and in that had propounded many things different from the common Opinion of Physitians though perhaps the less different from the truth we altered our Resolution and committed the first Stuff of the whol Work to be woven by him alone lest at length the parts should arise deformed mishapen and heterogeneous to themselvs He accepted the offer but with this condition that whilst he was employed in beautifying and adorning this part the other two should often hold consultation with him and confer unto the Wouf their Covenanants of free commerce by their own observations concerning this Affect and that those things which should be delineated and shaped by his labor and study should presently undergo the examination and judgment of the rest as if they had been fashioned by their hands And so at the length we have brought this Work such as it is to perfection and have offered it to the publick view being by no means moved therunto by an itch of writing which is the Epidemical ill custom of this age but by this Consideration only That becaus we are not born for our selvs we might make these such as they are common which in som measure may advance the health of Infancy and tender age in which for the present a great part of Mankind but for the future all Mankind is comprehended and likewise propagate an Encreas unto Learning with this hope also That by this Example we may invite the Wits of other most learned men to make inquisition into the Essences of Diseases and their Causes and to examin these our Labors that posterity may enjoy them yet more perfect But the obscure Essence of this Diseas and this our daring to tread in unbeaten paths were we silent might obtain a pardon and modestly chalenge a candid interpretation for all defects lapses and errors in these our Endeavors Finally expect no flashes of Rhetorick and Courtly-Language Nobis non licet esse tam dicertis Musas qui colimus severiores And indeed the condition of the matter forbids all such Painting in such a manner Ornari res ipsa negat contenta doceri Farewel kind Reader and peruse them as we dedicate them that is with an ingenious and candid mind F. G. G. B. A. R. The Names of those Doctors who by written Papers contributed their Observations to our first Exercise upon this Affect Dr Francis Glisson Dr T. Sheafe Dr G. Bate Dr A. Regemorter Dr R. Wright dead Dr N. Paget Dr J. Goddard Dr E. Trench Fellows of the Colledg of Physitians at London The Names of several Books printed by Peter Cole at the sign of the Printing-Press in Cornhil by the Exchange LONDON Three several Books by Nich. Culpeper Gent. Student in Physick and Astrology 1 A PHYSICAL DIRECTORY Or a Translation of the Dispensatory made by the Colledg of Physitians of London Whereunto is added The Key to Galen 's Method of Physick 2 A DIRECTORY for Midwives or a Guide for Women 3 An EPHEMERIS for the year 1651. Amplified with Rational Predictions from the Book of the Creatures 1 Of the State of the Year 2 What may probably be the effects of the Conjunction of Saturn and Mars July 9. 1650. in Scotland Holland Zealand York Amsterdam c. and about what time they may probably happen To which is joyned An Astrologo-Physical Discours of the Humane Vertues in the Body of Man A Godly and Fruitful Exposition on the first Epistle of Peter By Mr. John Rogers Minister of the Word of God at Dedham in Essex An Exposition on the Gospel of the Evangelist St. Matthew By Mr. Ward Seven Books of Mr. Jeremiah Burroughs lately published As also the Texts of Scripture upon which they are grounded 1 The Rare Jewel of Christian Contentment on Phil. 4. 11. Wherin is shewed 1. What Contentment is 2. It is an holy Art and Mystery 3. The Excellencies of it 4. The Evil of the contrary sin of Murmuring and the Aggravations of it 2 Gospel-Worship on Levit. 10. 3. Wherin is shewed 1. The right manner of the Worship of God in general and particularly In Hearing the Word Receiving the Lords Supper and Prayer 3 Gospel-Conversation on Phil. 1. 17. Wherin is shewed 1. That the Conversations of Beleevers must be above what could be by the Light of Nature 2 Beyond those that lived under the Law 3. And sutable to what Truths the Gospel holds forth To which is added The Misery of those Men that have their Portion in this Life only on Psal 3. 20. 4 A Treatise of Earthly-mindedness Wherin is shewed 1 What Earthly-mindedness is 2 The great Evil therof on Phil. 3. part of the 19. Vers Also to the same Book is joyned A Treatise of Heavenly-mindedness and walking with God on Gen. 5. 24. and on Phil. 3. 20. An Exposition on the fourth fifth sixth and seventh Chapters of the Prophesie of Hosea An Exposition on the eighth ninth and tenth Chapters of Hosea An Exposition on the eleventh twelfth and thirteenth Chapters of Hosea Twelve several Books of Mr. William Bridg collected into one Volumn Viz. 1 The great Gospel-Mystery of the Saints Comfort and Holiness opened and applied from Christs Priestly-Office 2 Satans Power to Tempt and Christs Love to and Care of his People undar Temptation 3 Thankfulnes required in every condition 4 Grace for Grace or The Overflowings of Christs Fulness received by all Saints 5 The Spiritual Actings of Faith through Natural Impossibilities 6 Evangelical Repentance 7 The Spiritual-Life and In-Being
But in the second place we affirm that the implanted heat doth differ frō the hot implanted temperament for the implanted heat is only a part of the hot implanted temperament for not only a Spirit but sulphur also and salt or perhaps choler contribute their heat to the constitution of the whole hot implanted temperament wherof the implanted heat is only a part Wherefore it is fasly suggested in the propounded argument that a plenty of Spirits is the sole cause of a hot distemper and a paucity of a cold distemper for a pound of the flesh of an infant containeth more implanted Spirits then a pound of a yongmans flesh yet it is most evident that the temperament of a yong man is far more hot then that of an infant a hot temperament cannot therefore depend upon the sole plenty of the Spirits nor a cold temperament upon a want of Spirits Moreover in many maladies a hot distemper is consistent with a paucity of Spirits as in a Hectick of the third degree in like manner of a cold distemper with a competent plenty of Spirits as in the Green sickness We say thirdly That a plenty or paucity of Spirits is not perpetually a sufficient cause to determine the temperament either hot or cold as on the contrary neither doth a hot nor a cold temperament certainly and necessarily demonstrate a plenty or paucity of Spirits as is manifest from the instance given So that the temperament is no sure sign of the quantity of the Spirits nor the quantity of the Spirits a sure sign of the temperament and therfore purposeth not without just cause these things come to be considered and examined as contradistinct if we wil procure a certain and inconfused knowledge of them Fourthly we answer That although it were granted that the implanted heat is subjected in the implanted Spirits yet notwithstanding that heat is not intended nor remitted according to the sole plenty or paucity of Spirits for the Spirits howsoever sufficiently copious yet if they be too much fixed torpid and as it were frozen they exhibit not any implanted heat worthy of consideration As for example the white of an egge swelleth with copious Spirits yet are they so benummed and the inward heat is thereupon so small that it obtaineth not the formation of a chicken unless it be first excited by incubation or some such other heat therefore we may lawfully conclude that a consideration from the want of Spirits is sufficiently distinct from the consideration of a cold implanted temperament although the objected argument doth seem to insinuate the contrary Moreover from this fourth article of our answer there resulteth a fourth assertion of the essence propounded Namely That beside the distemper and want of Spirits a certain benumdness of them must be added as a distinct part also of the essence of the disease This benumdness of the engraffed Spirits appeareth chiefly by the defective nutrition and aversation from exercise which proceed not primarily as we have proved above from any defect of the influx of the brain It is also manifest from hence because all those things which drive out that stupefaction of the Spirits although they do not altogether drive it away yet they conduce very much to the cure of this disease as exercises of any kind augmented by degrees frictions anoyntings c. and things inwardly taken of a heating cutting purging and gently opening quality But that this benumdness is sufficiently distinct from the want of Spirits besides that which we have said in the 3. article of our Answer is sufficiently manifest from hence because an excessive excitation contrary to a benummednes is often conjoyned with a penury of Spirits as it commonly falleth out in a Hectick feaver in dissolving fluxes and the like diseases in which howsoever there be a want of Spirits yet no benummedness is consociated but on the contrary that vehement excitation propensity to motion must be restrained On the contrary copious Spirits may consist with a benummedness as in wheat or meal For although it may seem to have but little Spirit because the Spirits of it do yet lurk in their fixation and benummedness yet indeed the Spirits do abound in it and may be summoned out by a simple fermentation and excited to a manifestation of their activity As strong Beer made thereof doth plainly declare In like manner juice newly pressed out of immature grapes is very mild and pleasant containing in the mean time plenty of Spirits which afterwards the due fermentation being finished reveal themselves in generous wine Let us conclude therefore that the benummedness of the Spirits in this affect deserveth a particular and distinct consideration CHAP. VI. Of the Part first affected in this Disease WE have already propounded the first Essence of this Disease it remaineth now that we enquire after the first Subject in which that Essence is radicated The heart and the brain do here seem rightly to be excluded for the reasons before alleadged the repetition whereof for brevity sake we shal omit The liver and the Lungs are not as yet exempted from all suspition of this fault we wil therfore examine these bowels apart and first we demand Whether the Liver be the subject of the first essence of this Disease The principal Argument is for the Affirmative because this Disease may seem to proceed from a vicious sanguification the Shop and Work-house whereof at least in probability the Liver is supposed to be but that a viciated sanguification is the first origine of this disease seems to be made manifest by many signs First because this disease for the most part followeth after many other great diseases either acute or chronical which in great measure have beforehand weakned the sanguifical vertue of the Liver Secondly Because this disease doth not only depend upon outward but inward causes namely the vicious humors And seing the vicious humors are generated in and with the mas of blood in the liver the first essence of this affect seemeth to be referred hither Thirdly The Liver is perpetually observed to be bigger than ordinary in this affect which manifestly witnesseth the Liver to be affected Fourthly those internal Medicines which have a faculty to putrifie the blood are requisite to the cure of this disease and being exhibited are found to be very profitable 5. The missian of blood from the veins of the ears which is not the meanest help to vanquish this affect doth more than sufficiently argue some fault to be in the blood which seemeth to be ascribed to the constitution of the Liver in as much as it doth sanguificate These Arguments have so far prevailed upon some very famous Physitians that thereupon they have attributed the first essence of this disease to the Liver alone But we conceive that these things may be sufficiently answered if we shall first grant what can be further or what hath already been rightly said concerning this matter and then dissolve those things
which are inferred by bad and invalid consequence First Therefore we grant that the mas of blood is viciated in this affect and that from thence is conveied a continual â—â—â—â—editatiâ—◠〈◊〉 the disease We grant also for the present that the Liver is the Officin of sanguification but we deny that every viciosity of the blood doth depend upon the viciated sanguification constitution of the Liver For first the blood may be corrupted by unwholsom aliment the Liver in the mean time remaining sound in like manner if the first concoction in the ventricle by any cause whatsoever be rendred imperfect yet it cannot be fully corrected by the second concoction in the Liver be that bowel never so sound Besides although the generation of vicious blood should be solely ascribed to the Liver yet the other parts should necessarily concur to the conservation of that which is generated as the Kidneyes the Spleen the Pancreas the Womb c. yea and it seemeth undeniable that all the parts which the blood washeth in his circulation do variously alter it whilst according to the capacity of the subject they imprint their qualities in it for they are natural agents and act by necessity and continually without any suspention of their actions or intervenient pauses unless they be estrained by some predominant power therfore if these be il affected they give a greater or a less tincture of pollution to the blood which passes through them as may be seen in a contagion gotten by an external contact communicated to the inward parts Moreover sometimes a great pollution from the other diseased parts is insinuated into the blood the liver in the interim being safe as hath been sometimes observed in opened bodies that have perished by a Dropsie in whom the Liver was found to be sufficiently sound and whol Moreover We grant that the faults of the Blood do frequently derive their beginning from the depravedness of their sanguifical constitution of the Liver and that that depraved constitution is an affect of the Liver But we deny this to be the same Disease whereof we now treat because it differs from it in the whol Species For that same depraved constitution of the Liver is alike common to men of full age to Boys and Children but this disease is solely apropriated to boys and infants Again We grant that a vicious constitution of the Liver may by generating a corrupt blood be a common cause and foment the augmentation of this affect but we deny that to be the disease it self whereof we now speak or any part of the first essence thereof For it is one thing to produce a common cause of a disease and another thing to be of the first essence of a disease We deny also that to be the continent cause of this disease or to be a sufficient cause of it self alone or to be alwaies a cause For the vicious constitution of the Liver of what kind soever you will suppose it doth not produce this affect in those that are come to ripenes of yeers nor perhaps always in yong boys and this our answer in general to the argument we proceed now in a like method to the confirmation of it First Therefore we grant that this affect doth often follow other diseases be they either acute or chronical but not so much because they had hurt the sanguiffical constitution of the Liver as because they had left the outward parts cold and benummed the ingrafted Spirits exhausted Although we may easily admit the viciated liver to be able to foment the evil by reason of the depraved sanguification Secondly We grant that this affect doth not only depend upon outward causes but also upon inward namely the faults of the blood it self but that all these faults have their beginning from the Liver that we flatly deny for the Reasons before alleadged Thirdly We grant that the mole or substance of the Liver is augmented in this affect but we deny that to be the first essence of the Disease for the reasons above rehearsed where we reject the organical vices from the primary essence of this evil Yet we admit this and the like diseases in a secondary essence of this affect as we shal see hereafter Fourthly We grant that internal Medicines can both alter and purify the blood but in the present Affect they conduce to the cure in this regard principally because they facilitate the distribution of the blood to the outward members attenuating the thicker and cutting the viscous parts thereof and because they also do impregnate the blood with a copious and benign Spirit whereupon it happens that the implanted Spirits of the parts before languishing are cherished augmented and excited In the mean time we acknowledge that general benefit which accrew to the whole body by the purging of the blood by siedge vomit urine or any other ways of evacuation Only this is it which we affirm that the more specifical part of the cure is wrought by way of alteration with the medicines aforesaid as we have intimated already Fifthly and lastly We grant that the opening the veins in the ears doth somewhat attenuate the blood and conduce to the renovation of it as also to the distribution of it to the external parts and the withdrawing of it from the internal parts oppressed with too much plenty and in that respect very much to advance the cure yet we deny that it can from thence be rightly inferred that the first Essence of the disease is radicated in the Liver And thus we suppose we have satisfied the reasons brought for the confirmation of this opinion We wil now produce some arguments that seem to perswade the contrary The first is this The first Essence of a disease doth Specificate the Disease But the vitiated sanguifical constitution however it be conceived doth not specificate this Disease For seing that this Disease doth appertain to infants only and children it behoveth them who adhere to the contrary opinion to design some certain way of the depraved sanguifical Constitution of the Liver which may be proper to the tender age alone but no depravation of the sanguifical Constitution of the Liver can be imagined which is not also common to those of ripe years If therefore the first Essence of this Disease should consist in that this Disease would at least sometimes be observed in those of ripe years which notwithstanding hath never been hitherto observed Secondly The subject of the first essence of a Disease is so long affected with that Essence as the Diseas continueth For neither can the Diseas Exist without its Essence neither can that Essence wander from one part to another If therefore the Liver be the subject of the first Essence of this Diseas then should it be affected thorowout the whole progress of the Diseas which nevertheless doth not seem credible seeing that the Livers of those who have died of this Diseas and have been dissected have excepting the augmented bulk thereof
the primary Essence of this Diseas For moistning Medicines although they loosen withal yet they scarce loosen more than they moisten becaus for the most part they loosen by moistning Seing therfore that the common causes of this Diseas do flow into the Tone chiefly by the Mediation of the first Essence of this Diseas And seing that neither the Animal nor the Vital Constitution can here supply the vertue of a caus we may Lawfully infer that the laxity of the Tone doth chiefly depend upon the first Essence of the Diseas This is further confirmed there is of it self a certain proness and tendency of the Body to be through wet so that the fibers of the parts must needs be loosned by it Moreover the defect of the Spirits and the stupefaction of them doth caus a remission of the Tone by diminishing the vigor of the part Therfore we may conclude that the Diseas laxity principally dependeth upon the primary Essence of the Diseas As for the flaccidity because it comprehendeth the laxity it springeth from the same causes as that doth but in as much as it includeth also a subsidence and a certain emptiness it evidently dependeth upon the defect and benummedness of the inherent Spirits the plenty and vigor whereof being augmented the lank and flagging member is easily rendred turgid and swelled In the interim we deny not but that that subsidence doth withal depend upon the extenuation and atrophy of the parts Lastly How the slipperiness doth proceed from these causes is sufficiently manifested by what hath been said above That we may at the length put a period to this matter it may be observed for the higher confirmation of those things already spoken that there is such a strict dependance between the Tone and the first granted Essence that throughout the whol cure of the Diseas they are intended remitted together almost in equal pace For at firstthe Children that are afflictedwith this affect do only go slowly leisurely whilst the Tone of the parts is yet but a little loosned but in the progress they scarce and with much ado trust to their feet then they play only sitting or as thay are carried about Afterwards they can scarce sit upright and at the last when the Diseas hath attained the highest exaltation the feeble neck cannot without much difficulty support the burden of the head all which things as they attest the primary Essence of the Diseas to be gradually augmented so also they make it manifest that the vices of the Tone are intended by an equal pace And so all these things being rightly weighed we refer the viciated Tone to the secondary not the primary Essence of this affect and by consequence we conclude indeed the thing that was in question that that depraved Tone is a secondary part of the Essence of this Diseas CHAP. VIII The Secondary Essence of this Disease in the Vital constitution WE have already propounded that part of the Secondary Essence of this Diseas which is radicated in the natural constitution in as much as it comprehendeth the common qualities it remaineth now that we examin the organical vices and the faults of continuity if any such be found out But seing that no proper faults of continuity do accur in this affect and seing that the organical vices do depend partly upon the Essence above given and partly upon the vital constitution being viciated it seems necessary in the next place to search into these faults of the vital constitution The vital constitution is aptly distinguished into the original or that which maketh an influx and the participative or that which is produced by that influx The subject of the original vital constitution are the Spirits themselvs excited in the blood of the Arteries You will say The heart rather seemeth to be the subject of this constitution But it is not so for the heart it self through the coronary Arteries receiveth the vital Spirits brought down with the Arterious blood from its left Ventricle But it is absurd to suppose the wals of the Heart to be the first subject of the vital heat and in the mean time for those to receiv that heat from the Arteries We must say therfore that the solid substance of the heart is indeed the first principal subject of his natural and inherent constitution but seing that receiveth the Vital Spirits as hath been said it cannot be accounted the first subject of the Vital Constitution which is imprinted in it by those Spirits and continueth no longer than the substance of the Heart is shedded and besprinkled with the Vital Spirits For neither can life subsist in any place without the Vital Spirit Wherfore the substance of the Heart doth so far participat of the Vital constitution as it is wash'd and bedew'd with the Vital Spirits and by Consequence thaâ— Constitution in the substance of the heart is not original or influent but participative or produced by that influx This is also confirmed in that becaus the vital heat of the blood in the hollow Parts or Ventricls of the Heart which heat is at least a part of the Vital Constitution is for greater and more intensiv than that which is within the wals of the Heart as any man may observ by the opening of the Bodyes of living Creatures the Ventricle of the heart being wounded and the Finger presently thrust in For he shall feel a far more augmented heat in the blood than in the very substance of the Ventricle however it be handled Moreover the vital Constitution is a thing transient and consisteth as the Phylosophers Phras is in motu fieri therfore it is rooted In the movable and decaying Spirits such as the Vitals which are contained in the Arterious Blood for som Member being cut off the Life vanisheth almost in a moment and by Consequence the vital constitution but the natural as we have already insinuated continueth though not in such an exaltation as when the Vital remaineth for a while after death And indeed the Life and the Vital constitution is suddenly taken away in the case aforesaid not by any positive contrary Cause But by a meer privation of the Conservant and Continent CAUSE This is most evidently confirmed because the Vital constitution is suddenly intended remitted and altered in al the parts in respect of the model or measure of the Vital Constitution excited in the Ventricles of the Heart so in a Lipothymy the heart fainting the life of the parts presently vanisheth at last languisheth but assoon as the Ventricles of the heart are refreshed with Spirits by some proper cordial applications straight way we behold the vital Constitution to be suddenly in some measure repaired in all the Parts In the suppression of the breath sudden death followeth the torrent of the vital Blood from the right to the left Ventricle being intercepted In the opening of a Vein or in any other immoderate profusion of Blood there happeneth a swouning by the sole
defect of the Vital Spirits Therefore seing the Vital constitution is transient and fugitive in any of the solid parts and seing it dependeth upon the proportion of the vital spirits flowing into them from the Ventricle of the heart we may rightly infer that in the solid parts it is not original but participative But in the Vital Spirits themselves by whose function the Vital constitution is diffused and transmitted into all the Parts it must necessarily be original For there is no other original subject of it to be found in the Body Yet we grant that the solid substance of the heart by his Natural Constitution especially being watred by the Vital is the assistant caus of the excitation of the Vital Spirits in the blood included their Ventricles although it cannot be the first subject of that same Vital Constitution as we have even now abundantly proved And these things for the present may suffice in general concerning each vital constitution the original and the participative and to prov that that must properly be ascribed to the Vital Spirits this to the solid Parts as the immediate Subjects of the inherence Three kind of vices belonging to this Constitution do stil await our examination The two former wherof relate to the Original And the third pertaineth to the participative Constitution The first vice concerneth the Generation of the Vital Spirits The second hath reference to the distribution of them And the third appertaineth to the participation of the Vital Constitution Of these we shal make enquiry in their order CHAP. IX The vitiated Generation of the Vital Spirits in this Affect and whether that fault be a Part of that Secondary Essence THe Vital Spirits are first excited or generated within the Ventricles of the Heart namely in the very mass of the Blood and properly they discriminate the Blood in the Arteries from that in the veyns after that they are generated they are cherished and conserved within the cavities of the Arteries until they are distributed into the habit of the Parts Yea they are not only cherished in the Arteries but in them also rightly disposed perhaps som new ones are excited though with less efficacy then in the heart This being Preadmonished We say first That in the very Substance of the heart there doth not occur any fault repugnant to the Generation of the Vital Spirits which properly can be a part even of the secondary Essence of this Diseas For the heart it self for his doth rightly perform his function in this Diseas and if any imperfection happen in the Generation of the Vital Spirits it cannot be properly ascribed to the heart but to the ineptitude of the matter to receive the form of the Vital Spirits As the ingested aliment if it be extreamly crude it may frustrate the perfection of a laudable concoction the Stomach being otherwise sound and faultless So the unapt and unprofitable blood exported to the ventricles of the Heart may render the action therof imperfect in respect of the operation and effect how sound soever it may be in it self In which case the ascription of the fault is usually and truly attributed to the indisposed matter and not to the Heart You wil reply a Feaver is somtimes complicated with this affect and at such time the heart doth unaptly Generate the Vital Spirits But that Feaver is a Diseas of a different kind and by no means either the whol or any Part of the Essence of this affect Secondly We affirm that the lesser Arteries inserted into the first affected Parts are in some degree really cooled and benummed by them through their adjacency and contact and for that caus they do unaptly conserv the Vital Spirits contained in them wherupon the Vital Constitution of them is rendred somwhat imperfect before they can be effused into the Parts themselvs And this fault of the little Arteries seemeth by very good right to be ascribed to the Generation of the vital Spirits For although it be not the function of the Arteries to propogate the Vital Spirits according to the first signification of the word yet for this very reason that they are obliged to conserv them when they are propagated namly by such a conservation as in a manner includeth a certain continuate Generation of them their faults are rightly to be referred to the Generation of the Vital Spirits For the Vital Constitution is a certain transient action as we have shewed before which while it lasteth is in a continual flux and motion and which like a flame when the continual fomentation and reparation of it is suspended and suppressed suddenly extinguished Therfore are the Arteries as a continuate Heart to all the parts of the body unto which they transmit and powr out their contained Spirits and what faults soever of the Spirits happen before the effusion of them into the habit of the Parts seing that they necessarily belong to the Original Vital Constitution and cannot otherwise be ascribed to the distribution of the Spirits they must be referred to the very Generation of them namely a continuate Generation in the Arteries wherby they are continually preserved from a sudden extinction Moreover This fault of the Vital Spirits is the depravation of the Vital and Original Constitution and seing that it is somwhat preternatural first hurting the action from whence the participative constitution floweth in like manner depraved and seing that it meerly dependeth upon the primary Essence aforesaid and is complicated in the same parts it will be a part of the secondary Essence of this Diseas Thirdly We say that the matter of the Vital Spirits to wit the Blood of the Veins impregnated with his Natural spirits returning in his circulation from the first affected parts towards the Heart is somwhat disabled by them to admit the form of the Vital Spirit For it is necessary that the Blood whilst it passeth through the parts affected with a cold distemper want and benummedness of inherent Spirits must also thereupon affected with some kind of frigidity benummedness and perhaps with a thickness and viscous quality beyond the usual degree of Nature For as the blood doth give a tincture of his qualities to the parts thorow which it glideth So on the contrary the parts themselves bequeath also as much as they can of their qualities to the flowing blood But here likewise we must grant withal that this indisposition in the parts first affected especially when it is light and smal in the return to the inward parts is very much corrected by their heat before it ariseth at the Ventricles of the heart nay that it is somtimes subdued or if any such contracted fault remain it is commonly totally abolished by the length of the journy before the return of the Blood to the left Ventricle of the heart whilst it floweth down by the right and the substance of the Lungs the same thing also may be thus confirmed becaus if that indisposition should continue till the
meet we may easily beleev that they become likewise more slender so in any cooled member we see the Veins and the Arteries become more slender then they were wont to be and it cannot be denyed but that actual cold doth straighten the Vessels But it is more then probable that a Potential coldness such as perhaps that may be said to be which is of an inward distemper doth likewise make the Veins and Arteries more slender So we see cold Complexions and also cold and moist to have less Veins and Arteries then the hot Corpulent bodies women children have narrower Vessels then lean men or youths Besides the very heat it self is an expansive quality that it may enlarge the Vessels and cold a contractive quality that it may restrain and straiten the Vessels Finally one of us observed that upon the dissection of the Bodies perishing by this affect He hath somtimes found the Veins and the Arteries tending towards the first affected parts to be of an undue slenderness but that those Arteries called Carotides and the Iugulary Veins were disproportinatly amplified and in is credible that this might have been perpetually observed had they that opened the bodies minded it with a attentive contemplation But this we peremptorily affirm not but leave it to future inquiry in the interim seing that it sufficiently appeareth by what hath been said that the circulation of the Blood in the first affected parts is diminished it is likewise agreable to reason that the Vessels also of those parts are straitned And seing that the left Ventricle of the Heart doth pour so great a quantity into the Aorta as may suffice al the parts and seing that so many parts primarily affected do sparingly sip that blood it is very probable that it is distributed with an unusual liberality thorow the other parts and namly thorow the Head and Liver and therefore the Vessels of these parts are somwhat dilated and amplified Concerning the lesned circulation of the Blood in this affect We ad this experiment only a ligature being wound about the arm or thighs of a yong boy grievously tormented with this Diseas the Veins did not so easily swel beyond the ligature neither did the habit of the part ful of Blood appear in that place so swell'd and colored as it usually doth in those that are sound From whence apparent it is that the transition of the Blood thorow those parts is more dul and less plentiful then it ought to be as a river stopped by a dam or wal doth sooner or later overflow the Banks according to the various swiftness and magnitude of the Torrent So likewise it happneth here the retiring of the Blood thorow the Vein to the inward parts is intercepted by the force of the ligature which if it were violent would in a short time fil the Veins and the habit of the parts beyond the ligature as we see it to happen otherwise in sound Persons but because in this Diseas it filleth them slowly and very dully we must conclude that the circulation of the Blood in those parts is extreamly lessened and slow and that the Arteries inserted into those parts are more cold and slender then they ought to be as we have most abundantly proved that the Arteries of the first affected parts are vitiated by a defect of just magnitude Fourthly As for the irritation of the Heart and Arteries which perhaps is the principle caus of many differences in the pulses it is manifestly found to be weak and ineffectual in the Arteries of the first affected parts We purpose not at this time to discourse of the nature causes differences and effects of irritation in the pulses only we observ in general that it may be either natural or violent and that each of them may be universal or particular and withal may arise either from within or from without And lastly that it may be excessive or defective In the handling of the present Diseas it wil suffice to touch upon the particular Irritation of the Arteries and afterwards to accommodate our Diseases to the present business 1. Therfore we affirm that the Arteries impel the Blood into the substance or habit of the parts by a certain labor and contention and that the parts which receiv that Blood do make som resistance and opposition that by reason of this conflict the Arteries are Irritated to make stronger resistances or pulses and that that Skirmishing is of so great moment to fortify the pulse and render it more vigorous that when it is weak the Puls can scarce be strong but where the contention is somwhat more increased yet so that it doth not overcome the opposition of the Arteries the pulse becomes more strong and lively provided that no impediment from som other caus doth intervene This we might illustrate by divers instances but we wil exemplify it only in a few in the winter the pulses are more ful hard strong and constant then in the summer but it is certain that at that time the outward parts of the body being bound up with cold are more firm and less passable and therfore that they do more strongly then at other times resist the Blood contending to pass thorow the substance of them in his circulation wherupon the Arteries when no other intervening matter hindreth must needs move more vigorously and drive the Blood more forcibly if they perform their office in perfecting the circulation of the Blood Hereupon those Arteries are irritated unless they be totally supprest or by some other means charmed and by degrees yeeld stronger strokes and withal the Spiritous Blood being pent in striving for more room they do wax a little more hot and are somwhat enlarged and somtimes having a little triumphed over the subdued opposition they drive forward the blood into the parts with a more swift copious torrent then before This is further confirmed by the heat augmented by handling snow for although at the first the Hands wax presently cold yet in a short time after they grow hot withal they are died colored with Blood as the intensiveness of the heat doth justify For upon the first contrectation or touch of the snow the parts are bound up and strongly resist the circulation of the Blood the Arteries also in those parts are at the same time contracted But unless the cold prevail to a total suppression of the Spirits contained in those Arteries and to a stupifying of the Arteries themselvs or at least a benummedness those Arteries are by degrees irritated and the interrupted Blood more forcibly contends for wider room and so at length by this counteropposition the Arteries wax hot and are dilated and the puls being increased they extrude the Blood more plentifully into the part before overcooled On the contrary in the summer when less resistance is opposed against the passage of the Blood the pulse becomes more feeble more languid and more soft From whence it appears that the defect of a
only most hard and solid and naturally of a white colour but they consist of a certain earthy and clammy substance which conditions differ very much from Marrow Again Marrow cannot by any art be sublimated to the firmness of a Bone Moreover Marrow melteth and is dissolved with a moderate heat of the fire but the Bones endure the most ardent flames of fire without any melting Besides Boil the Bones as long as you please they resolve into a gelly not into the substance of or like Marrow Again Bones may be worn to pouder so cannot Marrow Certain therfore it is that the marrow is not the Aliment of the Bones but a kind of excrement or rather secrement of them profitable indeed and therfore to be preserved in those receptacles For the Bones being otherwise dry cold and rough would be unapt for motion were they not moistned and made slippery by the exundations and exhalations of the Marrow and cherished by their gentle heat All these things are confirmed by this single experiment In yong Creatures the greatness of the Bones being considered there is less Marrow in the Bones and more Blood than in greater Creatures In the Embrion there are scarce observed any signs or appearances of Marrow destinct from the Blood But after the birth the medullary substance is daily augmented and it is visibly perceived to be less and less intermingled with the Blood again in the maturity of years the Bones are filled almost with pure and sincere Marrow without any considerable commixture of Blood but in the approaches of old age it is credible that the Bones are less and less watered with the circulation of the Blood and perhaps the Marrow it self upon the suspension and cessation of the nourishment is rather augmented than diminished in which respect the propounded experiment must be peradventure limitted Thirdly the Bones the Teeth perhaps excepted cannot want their nervs at least very little neither are they supposed to be otherwise sensible then by reason of the Periostium or the Fibers therof fastned into the Orifices of the Bones In like manner the substances of the Bowels seem to obtain that dul sense which they possess rather by the Membranes and vessels then from their own substance From hence we collect that the Bones in this affect are not much otherwise affected than the substance of the Bowels in respect of nourishment We have already shewed that the Bones are not to be reckoned among the first affected parts as likewise neither the Parenchymata only we here further affirm that all the Bones universally considered are not perhaps less sparingly nourished in this Diseas than they usually are in sound Bodies for if they be nourished by way of coaugmentation or joyning together as the Parenchymata are and with such facility also if they possess Arteries and Veins delated unto them and Cells and Cavities to receive the Blood if they be not in the number and condition of the first affected parts and if they receive not Nerves from the spinal Marrow it is very credible that they do duly receive laudably retain and perfectly concoct their Aliment Moreover If you will consult experience Children afflicted with this Diseas a regard being had to their age and the magnitude of their parts weigh heavier than others for the most part as we have somtimes observed which very thing seemeth partly to be ascribed to the greatness of the Bones Although in this case we wish more frequent certain and accurate observations which others who are befriended with opportunity may oblige the world withal in the mean time we suppose in general that the Bones are not illiberally nourished in this Diseas Some may reply That what hath hitherto been spoken doth concern the nourishment of the Bones in general but that they yield not a reason of the protuberances in them We deny it not but seing that these faults of the Bones depend upon their unequal nourishment as we have already proved we supposed it would not be unprofitable to purpose some reason of their nourishment in general now we draw neerer to the aforesaid swellings of the Bones And we observe Secondly That those tumors of the Bones are not of a different kind in respect of the other parts of the same Bone but that they are parts altogether similary and of the like kind with the rest and that they are not faulty in respect of the similary Constitution but in respect only of their greatness and figure From hence it followeth thirdly that these swellings are not produced by any illegetimate matter of the Bones or by any other vertue than the same by which and from which the other are generated Fourthly That the said swellings are produced by an unequal nourishment of the Bones as by a more liberal nourishment of the swelling parts and a sparing nourishment of the other parts of the same Bone And these Three last observations we have already abundantly proved where we treated of the affected parts Fifthly We observe the Epiphyses of the Bones in the Wrests and Ankles and perhaps in some other places to be more soft and spongy than in the other parts of the same Bones And peradventure they receive into themselves greater Arteries and Veins although indeed we are not yet fully assured of this The tops of the Ribs are also much more soft and spongy than the other parts of them From whence we infer that those more soft and spongy parts of the Bones may more easily and freely admit the circulation of the Blood and therefore be more plentifully nourished than the rest of the parts of them You will say That softness and sponginess of those parts is observed to be as well in healthful Children as in those affected with this Diseas We grant it but yet it must needs be that those parts which are of a more compacted substance and with difficulty admit the circulation of the Blood must be affected and obstructed upon lighter causes then those parts that are more open and more easily receive it But the Blood in this affect is transmitted to the external parts somwhat more cold viscous and thick then it ought to be therfore those parts which are unapt to admit the circulation of it those are more apt to be somwhat obstructed and less liberally nourished But Why also are not those soft and spongy parts more liberally nourished in sound Bodies seing that they as hath been said do more plentifully receive the Blood We answer Because as in health those parts do in a larger measure receive the Blood thorow the Arteries so they remit the same more plentifully thorow the veins which certainly doth preserve them from that excessive augmentation unto which otherwise they would grow But in this affect the same parts by reason of the coldness thickness and viscosity of the Blood do perhaps more sparingly and more slowly remit it then it is poured in to them and therfore from that abundance and excess of the
consequence the Breast should be then most straightned and on the contrary being lifted upwards they should appracch neere to a straight Angle with the Spine and so extend the sides of the Breast We conclude therfore that the Ribs in this affect ar drawn somwhat downwaads and that the Breast is contracted on the sides by reason of the plenitude and tensity of Hypochondrical parts although we grant as we have intimated above that this cause is not so considerable that we should attribute any great part of this Diseas unto it Be this therfore the third The Caus of this vitiated Figure of the Breast Is a lateral growing of the Lungs in the Pleura in this Diseas especially being confirmed it is most frequently observed to happen Doubtless such an adnascency doth restrain and interrupt the motion of the Ribs outwardly wherby the Breast is laterally dilated For if the Rib under which this adnascency lieth should endeavor forcibly to remove it self from the center of the Breast there would be danger of pulling the Lungs that grow to it or the Pleura it self from the ribs with intollerable pain For although the Lungs upon the ingress of the ayr admit an easy extension according to al the parts therof yet when they fal down or are stuffed with thick humors which most frequently happneth in this case they scarce admit any notable distention without dissolving the unity either of som Vessel Membrane or the substance of the Bowels themselvs Moreover whilst we consider that in sound bodies the Lungs are very rarely laterally divided from the Pleura and but in those parts only of the chest which were to be exposed to motion at a considerable distance namely the Back the Stern the Mediastinum that is the Membranes that divide the middle of the Belly and perhaps the middle parts of the Diaphragma c. We conceive that wise nature did this deliberatly and with design namly least their connexions should either offend the dilitations of the Breast or render the Lungs themselvs obnoxious to those kind of calamities However it be it is scarce conceivable but that preternatural growing together of the Lungs with the Pleura more or less must hinder and retard the free spreading of the Ribs towards the sides and therfore it conduceth a little at least to occasion the narrowness of the Breast A B E C F D E B F D A B F C E D A B C F D This bending of the Ribs here cannot be made either upwards or downwards because the Ribs in regard of their latitude are unapt to be bowed either way Ad also because that they are firmly restrained by the Intercostal Muscles in their position so that without offers of violence to these Muscles they can scarce be bent either upwards or downwards That that elongation cannot or indeed very scarcely can bow the Rib inwards may thus be proved because the greatness of the Liver is repugnant to such a motion For we have proved before that the greatness of that Bowel doth somwhat lift up the Bone of the Stern outwardly or forwardly Then the very figure of a Circular Rib doth evidently contradict the inward making of any plication or bending Lastly because that elongation doth not many ways bend the Ribs it may from thence also be inferred that such a bending would infer a compound Figure and should necessarily contain som of the simple figures before rejected Wherfore we conclude that that unequal length of the Ribs on the forepart must needs change their outward Figure elevating the Bone of the Stern and then pointing forwards the Figures of the Breast otherwise almost even The following Scheams do lively express the manner of it A C D B A C D B Let A be the Bone of the Stern B the turning Joynts of the Back C and D the two opposite Ribs which as we have said do make a kind of Ring Therfore if the forepart of the Ribs namly between C and A and between D and A be lengthned and yet the parts between C B and D B are no way answerable to this elongation the figure of the Ring must needs be outwardly changed Therfore seing that the Rib is as we have already shewed unapt to be bent either upwards or downwards or inwards it must needs be outwardly bowed as it is exprest in the second Figure wher the stern A by reason of the elongation of the part of the Rib CA and D A is represented as if it were outwardly pointed which is the very vitiated Figure of the Breast in this Diseas Beside the causes of the narrowness of the Breast hitherto commemorated we can here ad the smal increase of the Ribs between C and B and also between B and D. For the Just Latitude of the breast doth chiefly depend upon a du augmentation of those parts of the Ribs For if those parts of the Ribs do grow to a just length they must necessarily dilate the Breast unto the Ribs almost in a just proportion that little of the narrowness only being taken away which the former causes alone were able to introduce For by how much the more those parts of the Ribs are lengthened by so much the more also the Lateral part of the Rib D and the part C wil be distant from the Back-Bone B and wil make the Breast so much the broader On the contrary when upon the increas of the other parts of the Body those parts of the Ribs are but little or not at al augmented they must of necessity be laterally less distant from the center of the Breast then is meet and therfore the Breast must be straightned towards the sides For the sides of the rib C and D are so much the less distant from the Back-Bone and the center of the Breast as the parts of the Ribs between C B and D B are less lengthned And let these things suffice to have been spoken concerning the narrowness and acumination of the Breast in this affect With which we put at last an end to this disquisition of the Organical vices occurring in this Diseas CHAP. XIV The Secondary Essence of this Diseas in the Animal Constitution HAving put an end to the examination of the Natural and Vital Constitution vitiated in this affect it now remaineth that we make enquiry into the Animal Constitution And we have already affirmed that no primary fault doth here occur and that it is a part of the primary Essence of this Diseas But whether there lurk in it any secondary vice that we shal now examin But seing that neither the Ancients nor the Modern Writers who have written of the Animal Faculty have made any mention of the Animal Constitution nor indeed so much as once attempted a description of it It may very justly be expected from us who acknowledg such a Constitution And seing som wise men do dissent from that description which may be deduced from the opinion of Antiquity and the common opinion
reckoning up of those causes which on the Parents parts may produce this Diseas Som of these faults in the Parents relate to the Generation of the seed wherof the Embryon consisteth others have reference to the Embryon now conceived and yet born about in the Womb. The faults of the Generation of the seed proceed either from the man or the woman or from the whole Body or from those parts onely which are dedicated by nature to Generation The faults of the Parents depending upon the whole Body have the strongest influence into the Child because it transmitteth such matter to the Generation of the Seed as is unapt for those parts dedicated to that office We purpose not here to particularize the several faults of the matter of the Seed but to instance in those alone which conspire to entitle the Progeny to this Diseas These we reduce to four Classes The first Classis containeth a cold and moist distemper of the matter wherof the Seed is Generated This chiefly resulteth from a cold and moist distemper of the Parents unto which we also refer a predominancy of il juice especially that which is Phlegmatick and waterish also a Cachexia and Dropsy and perhaps the Green-Sickness which som cal the white Feaver not sufficiently subdued before conception al which affects manifestly help to constitute a waterish matter both cold and moist in the Genital Parts which is not only in general less apt for the Generation of the Seed but it particularly inclineth to a condition of this Diseas a part of whose primary Essence consisteth in that very cold and moist distemper as we have already proved Moreover we may perhaps hither reduce the Scurvy the French Pox the Jaundice in which affects the Blood also is polluted with filthy excrementitious humors and corrupt exulcerations which cannot easily be changed into laudable and fruitful Seed The second Classis containeth containeth the penury of Natural Spirits wherby the good Seed should be Generated For a Spirituous Seed cannot flow from such a kind of matter The causes which suppeditate that impure matter to the Parts of Generation are the dried and extenuated Bodies of the Parents wasted either by long abstinence or by som vehement evacuation as by vomits lasks Lienteries Dysenteries Hepatical Flures of long continuance by an excessive Hemorrhage from any part by violent sweatings or any Chronical Diseases which wasteth the strength and is not repaired before Coition especially a Consumption a Hectick Feaver an indigestion from any kind of Caus Lastly from a defective and imperfect Concoction of the last aliment or the fault of any part For in such cases the matter which is separated to the parts subservient to Generation is destitute of a competent plenty of Natural Spirits wherupon the Parts preparing and concocting the Seed cannot perfectly correct this defect and ejaculate such Seed as is sufficiently abounding with Spirits Seing therfore that a considerable part of this Diseas consisteth in the paucity of Natural Spirits it cannot otherwise be but that the issue propagated by such a crude and almost Spiritless Seed should be tainted with a certain Natural Propension to this affect even in their first rudiments which afterwards upon the concurrence or other causes is easily deduced into Act. The third Classis containeth the benummedness or stupour of the matter transmitted to the Generative Parts wherof the Seed is produced For not only the solid parts but also the whol Mass of Blood and the humors therin contained are obnoxious to that same stupour And from hence it is that Physitians being to render the causes of Diseases do use to say that the humors and also the Blood are too fluid and moveable and unduly vehement somtimes on the contrary that they are unapt for motion less fluxible and unactive beneath a Mediocrity in respect of this thing also a certain Mene is most wholsom but more things relating hither may be seen above We will here only prosecute those faults of the Parents from whence this defect of vigor and activity in the matter of the Seed doth arise These therfore are first the fost loos and effeminate Constitution of either or both the Parents indisposed to strong and Masculine exercises Secondly an overmoist and full diet and epicurison obnoxious to frequent crudities Thirdly A delicate kind of life abandoned to eas and voluptuousness slothful and rarely accustomed to labor danger and care Hither you may also refer a total defect of manly Exercise immoderate sleep especially soon after mate and any kind of sleepings whatsoever a sedentary speculative life intent upon soft and queint Arts and Sciences as Poetry Musick and the like to these may be further added a dayly frequenting of Comedies and other Plays an assiduous reading of Fables and Romances and instead of manly and laudable Recreations a loos expence of time in Carding and Dicing Hither also belong the neverfailing fruits of a lasting peace and plenty such as security indiligence and the like All these enumerated faults do manifestly contribute a share to introduce a laziness and Effeminateness in the parts Seing therfore that the Blood together with the humors contained in it doth in its circulation wash all those stupified parts it cannot otherwise be but that as it glideth along it must participate some such alteration and seing that some portion of the transient Blood affected with this stupefaction is transmitted to the Generative Parts with the very matter wherof the Seed is Generated it is easie to infer that that Child which springeth from such principals must inwardly contract at least some propension conformable to the sluggishness and stupour of its Native matter and that that propension after-Birth when the preservation is taken away by the equal cherishings of the Womb is by divers causes without difficulty deduced into act wherfore seing that such a dulness is a part of the Primary Essence of this Diseas it followeth that in such vitiated principals there lurketh a propensity to this affect derived from one or both of the Parents The Fourth Classis containeth the vicious Dispositions if any such occur of the Parents who in their Childhood were infected with this Diseas For these would transmit into the Children a continuation of an hereditary Diseas properly so called But because as we have said it is not yet manifest whether the Parent afflicted with this Diseas in their infancy shall beget children therewith affected besides becaus the faults of the Parents may be conveniently referred to any one of these Classes aforesaid or to many or indeed to all of them it will be fruitless to insist longer upon them Therfore having reckoned up the faults of the Parents which depend upon the whol Body in the next place we proceed to their faults which peculiarly reside in the Genital Parts These faults are somtimes a cold distemper somtimes a moist when by reason of too much humidity they are loosned or weakned wherupon they ejaculate
either an unfruitful deed or such as is propense to this Diseas somtimes those parts are infested with a virulent vicious or waterish Gonorrhea and they excern a Seed not sufficiently elaborated the same must be said of the white and red Fluxes of Women Again some things outwardly applied to those parts have reference hither as Ointments of Hemlock and other Narcotical things especially if they be often anointed with them in like manner Oyntments that are incorporated with white or red Lead Chalk of Lead Litharge Sugar of Saturn and the like dayly and for a long time adhibited to those parts For such as these blunt the activity of the inherent Spirits in those Parts and introduce a certain dulness in them which being communicated to the Seed prepared in them disposeth the progeny to this affect At length we have finished our intended enumeration if not of all yet at least of all the most principal causes which happen before Conception about the Generation of the prolificative Seed and have any concurrence to produce this Diseas or to dispose to the production therof Now follow the faults and errors of the Mother in the time she beareth the Embryon in her Womb which also must be reputed among the causes of this Diseas before the Birth First There hapneth a cold and moist distemper of the Womb it self which as were we silent is easily manifest to every one may most readily be communicated to the Embryon by the perpetual contact of the Womb. In the Second place All those things offer themselves which suppeditate to the Embryon crude and impure Juyces converted by excrementions and corrupt humors instead of laudable aliment Hitherto principally belongeth the unwholsom and preposterous diet of Women with Child especially inclining to moisture coldness and the heaping together of crudities The same things also happen by the imperfection and defect of the first or second Concoction especially when they are not excerned by vomit or some other evacuation of the Crudities from thence proceeding but are at length transmitted with the Mothers Blood for the aliment of the Embryon Besides if a moist and cold Diseas as a cold and moist distemper with the matter an ill digestion a Cachexia or Dropsy c. do invade a woman with Child after Conception it may thereupon easily happen that the impure aliment also which nourisheth and cherisheth the Seeds of this Diseas be dispensed to the Embryon In the third place are to be reckoned al those things that defraud the Embryon of du aliment as any excessive evacuation especially a lashing flux of Blood in any part also a rash opening of a Vein or Phlebotomy that exceeds in quantity The suckling of another child may also divert the afflux of sufficient aliment from the Womb towards the Breasts Hitherto likewise belongeth inordinate fasting or any indigestion in the Mother any inappetency after meat or defect of concoction Moreover an acute Feaver hapning to a woman with Child besides other inconveniences may also defraud the Child of du aliment so also an Hectick Feaver All these things do not only infer to the Embryon a dejection of Vital Spirits and a defective nourishment but also they cause a want of natural Spirits For the Naturall Spirits are wasted and dissipated without due nourishment and are also destitute and disappointed of necessary reparation Seing therfore that a part of the Essence of this Diseas consisteth in the defect of Natural Spirits som disposition to this affect must need be bequeathed to the off-spring from the causes aforesaid 4ly lastly excessive sleepines of women with child slothfulness eas any vehement labor and exercise after Conception do also contribute their share For although violent motions and actions of any kind are forbidden to women in such causes yet moderate labors watchings and exercises which offer no violence to the womb or provoke to abortiveness do not only conduce to the health of the Mother but in som degree they drive away that dulness from the Embryon and augment the heat vigor and activity of it And thus we put an end to the first Chapter of the causes of this Diseas before the Birth Those which happen after the birth shall be the subject of our next examination CHAP. XVI The Causes of this Diseas incident to Children after their birth WE have noted in the precedent Chapter that Infants from their first Origin are seldom afflicted with this Diseas but by reason of the Causes there rehearsed that they are frequently affected with a natural disposedness and propension to the same We shal now prosecute those causes which are apt to actuate that Natural disposition after the birth or newly and fully to produce this Diseas For it must be known that the same causes which may actuat that predisposedness to this Diseas may produce this Diseas a new if they be sufficiently intensive in their degree And therfore we confess that those children which are prone to this Diseas from their Nativity are easily affected but that other which are free from al Natural corruption fall not into the same but upon more potent causes and yet those causes are the same for their kind and differ only in the degree We therfore thought it needless to speak of these things distinctly and apart it may suffice that we have spoken of them indescriminately and together At the very entrance a Question there is which importunes a Resolution namely Whether Contagion may be numbred among the causes of this Diseas and therfore whether this Diseas in a proper and right understanding be a contagious Diseas indeed he that considereth this Diseas unknown to the Ancients how it first invaded the Western Parts of England and in few years hath been since dispersed all England over will at the first thought easily judg it to be contagious and to have been spread so far and wide by the infection of it But the matter will seem to be otherwise to him that will consider it more intentively For although this Diseas may in some manner endeavor to imprint an affection like unto it self in other Bodies yet it scarce advanceth so far that it can totally produce a Diseas of the same kind For perhaps it may in one some slight inclination in another Body yea somtimes perhaps it may accelerate or hasten the invasion of an affect in a Body highly predisposed unto it yet it cannot therfore deserve the Name of a Diseas properly contagious For all Diseases conspire to change and assimilate those Bodies which are neerest to themselves yet that is not sufficient to denominate Diseases contagious For to constitute a contagious Diseas properly so called it is further required that out of it self it propagate a certain Seminal fermentation of it self which secretly insinuating it self into other Bodies may by degrees introduce into those Bodies a Diseas of the same Species But this Diseas containeth no such fermentation in its essence neither is it secretly propagated
by a precedent emission of Seed from it self which may imprint a Diseas of the same Species in the adjacent Bodies For we have already often said That the first essence of this Diseas consisteth in a cold and moist distemper and in a dulness and paucity of inherent Spirits which affections if they endeavor to assimilate any Bodies that are neer them they attempt and undertake it by open violence and not by snares and fraudulence or a preimmission of secret little fires In like manner if you reflect upon the Secondary Essence therof neither the viciated Tone nor the depraved Vital nor Animal Function nor the Organical faults are found apt and fit in this affect to insinuate themselves into other Bodies and to propagate their own Species Finally if we will consult experience the matter will quickly be vindicated from all doubt For we frequently observe Children either of the same age or very neer to the same age be brought up in the same House wherof one or other of them is perhaps afflicted with this Diseas whilst a third or many amongst them do escape it Yea We have known Children not only educated under one common Roof and delighting in the continual and mutual society of one another but dayly meeting at one Board and lying together in one Bed wherof one who hath been ill affected with this Diseas hath not infected any of his companions either by feeding or lying together Which could scarce possibly happen in a Diseas properly contagious Wherfore Contagion being excluded from the Catalogue of this Diseas we will address our selves to the finding out of such as are more true and unquestionable We divide the causes which produce this Diseas after Birth into two Classes The first containeth the errors which procure it in the use of the six nonnatural things The latter comprehendeth the precedent Diseases of divers kinds which are wont very often to leave behind them some Inclination to this affect As for the former Classis concerning the abuse of the six non-Natural things so far as they relate to this Diseas seing that children are seldom discomposed with any vehement passions of the mind and can thereupon very difficultly fal into this Diseas Again in regard that the use of Venery appertaineth not unto them we wil reduce and limit these cases to the five subsequent heads To the Air also to what things soever extrinsecally occur or are applyed to the body to meat and drink and such things as are inwardly received to motion and rest to the kind and manner of life to actions and exercise to sleep and watching lastly those things which are preternaturally retained in or severed from the body These several things we shal examine in the propounded order with al convenient brevity Of the Air and such things as happen outwardly A cold and moist Air doth powerfully contribute to this Diseas For seing that it doth more easily steal into the external and first affected parts in this Diseas then into the hidden and fenced bowels it directly helpeth to imprint in those parts that unequal namely that cold and moist distemper The constitution of this kind of Air is chiefly predominant about the beginning of the Spring at which time the Nurses ought to be cautious and circumspect How they too confidently expose their children which are subject to this affect to the injuries of the Air as also when the Air is cloudy thick rainy and ful of vaporous exhalations Hereupon places neer the Sea great Marishes that are obnoxious to much rain and showers and fed with a great number of Springs are wont to be caeteris paribus very fruitful of this affect In like manner houses neer the banks of great Rivers and Ponds or Meers are for this purpose condemned Moreover frequent bathing and washings with sweet water although they be applied actually hot yet in regard that they are potentially cold and moist they are also justly culpable for they do in som sort communicate their distemper unto the parts whereunto they are adhibited and more or less caus a softness and loosness in those parts and make the circulation of the Blood too slippery Hither we may also refer cold and moist liniments as also such as are loose and slippery being too often continued in that tender age especially about the Spine or the Origin of the Nervs lastly soft linnen cloaths if they be not wel dried they cherish the roots of this Diseas For this caus amongst others it hapneth that the Children of poor people are the less obnoxious to this Diseas because namely for the most part they are enwrapped in course cloaths and woolly integuments each of which doth rub and tickle the parts thereby exciting and augmenting the inward heat and irritating a more copious afflux of the Vital Blood unto the habit of the Body and are therefore very effectual to banish this Diseas But the softned fine linnen doth neither irritate the heat into the external parts nor laudably cherish it For if they chance to be for som short space of time removed from the touch of the parts they presently loose their warmth and at the next touch they conveigh a sense of coldness into the parts Wherefore such linnen cloaths being in the number of those things which are dedicated only to extrinsecal application and seing that they are hurtful by their sole coldnes softness we have referred them to this first Classes of causes the first part therof which containeth cold and moist things outwardly occurrent In the second place the Air being infected with any particular infection as noxious Metalline exhalations which for the most part sight against the inherent Spirits of the parts by a kind of venemous malignity and do either extinguish them or drive away and dissipate them withal they dissolve the Bone of the parts and the pulsificative force especially in the parts external where they first happen they at least diminish if they do not weaken it and affect it with a languidness These things are principally caused by exhalations from Lead Antimony Quick-silver and the like Moreover ointments made of the same are almost alike perillous if the first affected parts be frequently and unseasonably anointed therewith although perhaps these things do also belong to the fouth title of this Classis Finally we have observed som Children who have been anointed with Mercurial Unctions for the Scabs to have fallen afterwards into this Diseas In the third place an Air vehemently hot and subtle extreamly attenuant and dissolvent may likewise be numbred among the causes of this Diseas because it allureth forth dissipateth and consumeth the inherent Spirits In like manner hot liniments and especially discussive withal Chymical oils distilled and not sufficiently corrected by the commixture of things temperate for these in such a tender constitution of the parts do easily melt and resolve the Spirits into a volatile and Airy thinness and by consequence infer a penury of
Inherent Spirits Hither also belong sharp saltish hot and discussive Baths especially if they be unseasonably and unmeasurably used for these no less then the former do wast and consume the Spirits Fourthly and lastly An Air filled with Narotical vapors or exhalations and baths fomentations and Liniments made of Soporiferous and Narotical ingredients as Hemlock Henbane Opium Nightshade and the like and externally applied are very fitly reducible also to this Classis For they easily introduce a benummedness into the first affected Parts into which they first conveigh their force Which benummedness is not only it self a part of the first Essence of this Diseas but it also easily dulleth and diminisheth the Vital influx in those parts and consequently is also a caus of that part of the Secondary Essence of this Diseas which consisteth in the Vital Constitution which thing we have already explained more at large And thus much of things outwardly occurring Secondly Of Meat and Drink and things inwardly taken To this Title there belong first aliments of any kind which are too moist and cold for these things manifestly cherish the distemper wherin a part of the Essence of this consisteth Hither therfore we refer most kind of Fish and crude Meats which are not well prepared by Coition also all those things whatsoever they be which caus a defect of concoction in the Ventricle Therfore the feeding upon new Meat before the former Aliment is concocted is very hurtful for Children disposed to this affect and in this respect a plentiful Diet is altogether to be abandoned and a thin spare Diet ought to be observed for too liberal feeding doth overwhelm and choak the heat and therfore must needs accumulate many crude and raw humors And perhaps this one may be reputed among the especial causes why this Diseas doth more frequently invade the Cradles of the rich then afflict poor mens Children In like manner cold moist Medicines taken inwardly and also such as are laxative and endued with an internal slipperiness do manifestly relate hither For these things do not only infer a like distemper but they produce a Relaxation in the Tone of the parts and affect them with an internal slipperiness and in a word they render the current of the Blood through the first affected parts over slippery and easie Secondly Nourishments that are too thick viscous and obstructive belong hither especially becaus they interrupt the equal distribution of the Blood Hither we refer flesh hardned with smoke and seasoned with much Salt in like manner Salt Fish and Cheese almost of any kind plentifully fed on Bread newly taken out of the Oven and not yet cold also almost all sweet things condited with Sugar unless they are withal tempered with Wine or cutting or attenuant Obstructive Medicines likewise of any kind belong hither unto which we may further ad such as are Partotical and whatsoever being drank induce a benummedness into the parts Thirdly Nourishments that are of an extream hot and biting quality sharp corrosive as old strong Wines especially being drank upon an empty Stomach Meats also that are seasoned with much Pepper and aromatical Sawces must be connumerated among the reputed causes of this affect For these things in such a tender consistence of the Parts do easily feed upon and devour the inherent Spirits The same thing is also affective by Medicines that are immoderately hot and discussive yea these are far more powerful to hurt becaus they more quickly and forcibly spoil the inherent Spirits than the prementioned Nourishments Thirdly Of Motion Rest Exercises and Actions Motion and Exercises if they exceed a mean they dissolve the Body of a little Child into a profuse Sweat and withal they somwhat dissipate the inherent Spirits of the Parts and therfore for that reason they may conspire the introducing of this Diseas although we conceive it falleth out exceeding rarely that Boys are infested with this Diseas wherof we discours But a defect of Motion and want of Exercise doth most frequently yea and most effectually concur to the production of this affect For the Spinal Marrow and the Nerves from thence arising and the other first affected parts serve chiefly for Motion and Exercises A stupidity therfore and sluggishness of those parts is a caus that neither their inherent heat is sufficiently cherished nor that heat extenuated nor the cold distemper stealing in banished nor the excrementitious and superfluous moistures expelled by a due transpiration but it permitteth them to be affected with a certain softness loosness and internal lubricity wherupon the Arteries also destributed unto them are faintly irritated yield a dull and slothful Pulse neither do they render the parts somwhat turgid or swelled but leave them lank and subsiding By which means the circulation of the Blood becomes slow and lesned and more slippery than is meet the production also of the vital heat must thereupon be necessarily be feeble and weak all which considerations do sufficiently evince that this is an efficacious caus of this Diseas Fourthly Of Sleeping and Watching We grant that Children should sleep oftner and longer then Men yet if it be excessive even in Child-hood the matter is the same as in defect of exercise and motion For sleep is a certain rest and privation of watchings or of the exercise of the senses But watchings consist in the very exercise of the senses according to Aristotle in his Book de Som. Vigill Wherefore the evils that we have described to arise from the defect of motion and exercises the same also must needs happen from immoderate sleep On the contrary in that tender age inordinate watchings are no less noxious For they do not only retard the concoction of the aliment but they likewise taint the Blood with a kind of acrimony and consequently dissipate the Principals of the Natural Constitution of the first affected parts and without difficulty introduce a defect of inherent Spirits Fiftly Of things preternaturally cast out and retained All the internal causes of Diseases might be perhaps not incommodiously reduced to this title For any thing whatsoever contained in the Body and preternaturally altered as they are preternatural they indicate their ablation and may so far forth be reputed among things to be cast out which are nevertheless preternaturally retained But we more rightly grant that all internal causes may be distinguished into two kinds one wherof containeth those things which are preternaturally retained and cast out the other such things as are contained in the Body being preternaturally altered For these latter are not only taken away by casting out but also by Alteration they may be reduced to an agreeable proportion of Nature However it be there is a great affinity between the Humors vitiated by Alteration and the excrementitious Humors which are retained For there are so many and such various ways of casting out in the Body that scarce any humor can be imaginably produced by Alteration which doth not
Persons of a Chollerick Constitution are lean and of an extenuated habit becaus of the Reasons aforesaid Secondly A Melancholly humor whether you understand the Earthy Portion of the Blood or that saltish or tartar like matter excreted in and with the Urin and when the Urin groweth cold incorporating into little Sands or that sowr humor powred into the Ventricle perhaps by the Spleen though not through that short Veiny Vessel as the Ancients beleeved or those terrene Parts of the assumed Aliment which are evacuated by siege with the other Excrements understand either or any of them if this humor aboundeth and be not purged out after a due manner may be blamed as a caus of this Diseas For first that humor which is the more Earthy part of the Blood if it exceed a just proportion in the Mass of Blood it rendreth it unapt to nourish the Parts especially those that are first affected for the first affected parts are of a more noble texture than the substances of the Bowels or the bony parts and therfore we have already noted how the Parenchymata of the Bowels and the Bones do easily admit nutrition and by a way like unto digestion but those former parts do require a far more exquisite secretion elaborated assimilation And this is the Reason that the fleshy parts of the Bowels are rightly imputed among the impure and grosser aliments namely Becaus they are nourished with a cours Blood and not accurately elaborated before the Union Secondly Any great accumulation of Saltish and Tartar like matter is an Enemy to Nutrition and is rather dissipative and devouring than favoring augmentation Thirdly The sowr Humor of the Ventricle is totally ravenous and as it were hungerstarved and perhaps where it aboundeth it easily communicateth to the Blood such another Depredatory quality Fourthly and lastly The Terrene Dregs of the Belly may if they be inordinately retained taint and infect the Chylus and render it unapt for the nourishment of the part Finally we grant that every propounded kind of Melancholly superfluously coagumented or preternaturally retained doth not primarily properly and directly concur to the production of this evil but nevertheless we are of opinion that indirectly and after rhe manner propounded it may contribute somthing to the generation of it Thirdly Flegm whether it be taken for the moister and colder part of the Mass of Blood or for the wheyish part therof or for the slow humor of the Stomach and Guts or for the Spettle or for the Snot of the Nostrils or Jaws or for that peculiar humor which perhaps the new Vessel of the Sweet-Bread doth use to evacuate however you take it if it be retained or abound in the Body it hath a direct reference to this Diseas and properly deserveth to be called the caus therof For this humor is cold most slow thick benummed little spiritous lost and affected with an internal slipperiness all which things do exactly comply with the primary and secondary Essence of this Diseas as they have been propounded Wherfore upon a superfluous accumulation of this humor seing that there succeedeth a conspiracy to the production of this affect it ought justly to be esteemed a proper caus and a Primary Agent Besides these humors undue Transpiration as also immoderate or defective sweating may be somtimes numbred among the causes of this affect For excessive Sweating as also immoderate Transpiration doth dissipate the Spirits and withal dissolveth the parts especially the external which in this Diseas are the first affected and the inherent Spirits being consumed it easily leaveth a cold distemper behind it For to a just excitation and conservation of the heat of the parts there is required a certain due and regular strife of the exhalations between breathing which if it prove deficient the actual heat also becaus it partly consisteth in this strife becomes very feeble and languid and the parts are easily exposed to a cold distemper But we have already spoken of this matter at large On the contrary Sweat preternaturally restrained as also a very smal or lesned Transpiration doth easily kindle a Feaverish heat and therfore it likewise injureth the Spirits and dissolveth the parts and rendreth them afterwards easily obnoxious to a cold distemper Finally That we may comprehend all in a word Any humor excerned above Reason or Measure doth easily introduce a colliquation of the parts and a dissipation of the inherent Spirits and consequently disposeth the Body to this affect And let this suffice to have been spoken of non-Natural things and the causes of this Diseas thence arising CHAP. XVII Precedent Diseases which may be the Cause of this Disease THese Diseases in respect of their proper Essence ought only to be called by the name of Diseases but in respect of this Diseas they may rightly pass under the notion of causes of Diseases becaus they leave it behind them as one of their Effects Yet although many of them as they relate to the Parents and so imprint a Natural pollution in the Off-spring are rehersed above nevertheless by right they here deserve their consideration yet in a different respect and order These Diseases we reduce to three Kinds or general Heads First To Diseases that have some affinity with this affect Secondly To Diseases that extenuate the Body Thirdly To Diseases inducing a stupor and dulness in the first affected parts Of the First Kind Diseases having an Affinity or holding Congruity with this we call those who at least in part consist in the same with the Essence of this Diseas of this kind are any cold distemper or any moist distemper also any cold and moist distemper For a part of the first Essence of this Diseas includeth a cold and moist distemper and so those distempers do partly agree with this Affect Hither also belong a Phlegmatick Cachocymy a Melancholy and a mixt an obstruction proceeding from such like humors a Cachexia and a Dropsy Yea we may likewise refer hither in regard of their affinity those Diseases wherein the inherent Spirits are somwhat consumed for a part of the Essence of this Diseas consisteth in a scarsity of those Spirits but otherwise they are more aptly referred to the second kind In like manner the Diseases wherin the first affected parts are benummed stupified may likewise in respect of their affinity be hitherto referred although they belong more properly to the third kind of Diseases Moreover those Diseases wherin the Tone of the parts is infeebled and loosned must here be listed for they include a part of this Diseas namely that which consisteth in the loosnesse litherness internal slipperiness and softness of the Tone as they are above described The Philosophers say that the Elements which agree in like qualities are easily changed one into another by the same reason that these Diseases which partly agree in the same Essence do easily admit a reciprocal change from one to the other So we see a quotidian Ague which agreeth
with a putrid Feaver in a preternatural heat upon every slight Cause degenerate into it Yet it must here be noted That great Diseases are not so easily changed into smal as smal ones into great Besides not all Diseases which perhaps participate alike of the same Essence are with an equal facility reciprocally changed For some Diseases are more subject to change into others with whom in part they have some agreement than others And that for other Reasons beside the said agreement however it be if a cold and dry distemper should happen to a Child that would easily change into a cold and moist both in respect of the congruity of each Diseas to cold and also a peculiar inclination of that tender age to moisture For by reason of the coldness the digestion becomes imperfect and hereupon crudities or crude humidities are engendred which a cold distemper in so tender an age would easily and immediatly follow Moreover a cold and moist distemper in regard of the coldness would make a slow Pulse and in regard of the moisture would make it the more slippery and the less viscous wherupon the Vital heat being diminished a benummedness and dulness by little and little would steal upon the Vital Spirits Finally in respect of that slipperish retention arising from the internal slipperiness of the parts and by reason of the weak concoction the inherent Spirits of the first affected parts would also by degrees be diminished and so by little and little after this manner the perfect Essence of this Diseas wil be introduced Of the second kind Most Diseases making lean or any ways extenuating the Body although perhaps they no way participate of of the Essence of this Diseas like the Diseases of the first kind yet they do dispose the Body to the invasion of this affect and may also leave it after them For all great quotidian Diseases in process of time do extenuate the Body wast the inherent Spirits and dissolve the Tone of the parts and this attrition and attenuation of the parts doth chiefly refer to the first affected parts in this Diseas For as we have already asserted the substance of the Bowels are not so easily subjected to dissolution or dissipation But in the dissected Carcasses of those who have dyed of Chronical Affects the Bowels are observed to be no less yea many times much bigger when the external parts which in this Diseas are first affected are for the most part made lean with the vehemency of the affect And therefore seing that extenuating Diseases do chiefly communicate their force into the first affected parts it easily falleth out that in Children they help to introduce this Diseas For the inherent Spirits of the first affected parts being very much wasted a cold distemper must needs follow which by reason of the crudity is as we have said above received by a moist one and a benummedness because the heat activity and vigor of the parts do chiefly depend upon the plenty of Spirits And thus we have exhibited the manner wherby this Diseas doth follow and as it were tread in the footsteps of other foregoing affects of this kind which we now further subdistinguish into three Classes The first comprehendeth Diseases extenuating and consuming the habit of the body by ways insensible hither are referred almost al Feavers especially the Hectick and Consuming an Ulcer of Lungs with a putrid Feaver Also any continual Feaver that is violent as a burning malignant pestilential Feaver a Pleurisie and an inflamation of the Lungs also the smal Pox and the Meazels when they grievously afflict the Patient In like manner intermitting Chronical Feavers Lastly al Chronical Feavers that torment with vehemence do the same The second Classis containeth Diseases consuming by manifest passages and evacuating the solid substance of the parts Hither you may refer immoderate vomiting a Lyentery Dysentery Lask the Hepatical Flux the Diabetes any profuse Hemorrhage or Bloody Issue any excessive sweating any great Ulcer in any part eating deep and dayly casting out much matter For al these Affects do evidently extenuate the habit of the body and cause the introduction of this affect The third containeth the Diseases which are said to extenuate the substance of the parts not directly but by consequence as al Diseases interrupitng concoction or the distribution of the Blood For these prohibit the reparation of the parts continually fed upon by the Vital heat Hereupon several Diseases of the Ventricle Guts Mesentery Sweet-Bread Spleen Liver Yea Diseases in the Mouth Jaws or Throat which hinder only the assumption or swallowing of the Meat may in this respect be numbred among the causes of this Diseas As a distemper a tumor a nauseating a feeble appetite of the ventricle a distemper a tumor an obstruction Skirrhus of the Mesentery Sweet-bread or the Liver Spleen and the like effects of any of the said parts which by any means frustrate the due concoction and distribution of the nourishment and thereupon extenuate the parts by defect of nutrition Of the third kind Diseases that induce an astonishment to the first affected parts do also by a peculiar propriety conspire the production of this Affect For the Natural heat of those parts is somwhat dulled by them and is rendred less effectual whereupon a cold distemper stealeth in by degrees which is also as hath been said easily waited on with a moist distemper a softness and internal slipperiness Moreover the Puls of the Arteries reaching to those parts is secretly and by little and little weakned the distribution of the Blood and the Vital Heat is diminished the parts themselvs are sparingly nourished and at length there comes a defect of Natural Spirits So that from this Root also for some time persevering the Essence of this Diseas may at last bud forth The Apoplexy Palsy Lethargy and the like effects do chiefly belong hither Yet Children do exceeding rarely fall into this affect from these sleepy Causes and so rarely that we have not yet observed this Diseas to own its beginning to such affects If any demand a Reason of this rarity we say that the Bodies of Children by reason of their permeability and thinness are seldom subjected to those affects but if at any time they are invaded by them the Diseas doth not first assault the Natural or Vital but the Animal Constitution and consequently procureth for the most part a deprivation of the Animal Faculty before it interrupteth either the Natural or the Vital But the benummedness wherof we now speak belongeth to the Natural Constitution into which it cannot be presently transferred Moreover they are easily and speedily driven out by reason of the facility of transpiration in the Bodies of Children if peradventure those affects do gently invade them but if they rage and tyrrannize they easily and speedily dispatch and kil as being in their own Nature most terrible and grievous Diseases and the sooner because of the weakness of their Constitutions
labor with a moist distemper yet it is manifest withal by what hath been said how great a difference there is between this of aged persons that of Yong children Morover that this moist distemper of old men is less Homogeneal to the present affect then that of children appears plainly from hence because it produceth not that softness and tenderness of parts in old men as we see it doth in Children neither doth it equally dispose them to a dissipation or colliquation of the inherent Spirits or any slippery passage either of the Blood or Exhalations which are supposed in this Affect But on the other side it rather rendreth them obnoxious to obstructions and the other evils recited before a comparison therefore being made between the cold and moist distemper incident to Younger Children and that which is wont to affect old men there resulteth a pregnant reason why aged people are not so subject to this Diseas as Children Thirdly Yong Children although they Naturally abound with inherent Spirits yet by reason of the easie transpiration of their Bodies becaus of the laxity tenderness and incoherence of the parts they are much more prone then Elder persons to dissipation and colliquation of the Inherent Spirits and by consequence upon less and slighter causes they fal into a want of them Fourthly Younger Children by reason of that very same weak consistance of the parts are also rendred more obnoxious to an astonishment than the Elder For to the vigor and activity of the parts there is required besides a just plenty of Spirits a strength of their coherence and consistence Fiftly it is not needful for us to ad any thing concerning the Tone of the parts seing we have so often insinuated the weakness of it in Younger Children in respect of the Elder and any man may observe that upon the increase of years the Tone is more and more confirmed Sixthly As for the diminute distribution of the blood to the first affected parts which we have already proved to be a considerable part of the secondary Essence of this Diseas We say that the Elder Children do use more strong and frequent exercises then the Younger and therefore that the pulses of the outward parts are more strongly stirred up in them and that a greater heat is raised and cherished in them and by consequence a cold distemper is more potentially driven out of them Seventhly as for the Organical faults namely the augmented magnitude of the Liver Head and their Vessels it is a known thing that the proportion of the parts is more stable and confirmed in the bigger Children and on the contrary that in the Younger they are easily moved and altered but the augmentation ceasing they are not any more afterwards altered without some unusual and weighty causes So that even in this respect the Younger Children are most subject to this Diseas Let us therefore conclude the parts of the Question That Young Children in respect of their Natural Constitutions and dispositions are more obnoxious to this evil then those that are Elder and so much the more the Younger they are But we must not wave an Objection that here we meet with which also doth very fitly conveigh an occasion of passing to the other comparison namly of Young Children amongst themselves For if Young Children as is manifest by what hath been said are more prone to this Diseas by their Natural Constitution and disposition and the Younger they are the more subject they are How comes it to pass that Children rarely fal into this affect before they are six months old and somwhat more For according to the Opinion delivered Children should seem to be principally subject to this Diseas immediatly after their birth which yet experience disappointeth yea rather indeed it witnesseth the contrary namely that Children before they are nine months old are seldom or scarce ever afflicted with this Diseas Here therefore it wil be needful for us to declare that other comparison of Young Children among themselvs For it cannot be that this Affect should so constantly spare Children chiefly disposed unto it and frequently invade those that are less disposed unless some difference did intervene which did in a diverse manner relate to those ages and which notwithstanding the propensity of Nature doth retard the invasion of the Diseas before the first twelve months were compleatly expired and yet afterwards either doth not at all or not so potently defend Children from this Diseas Here therefore we must find the very reason of the difference between these ages which that we may the sooner do it wil not perhaps be impertinent to take special notice by the way of those ages which upon the authority of experience are observed to be more frequently affected with this Diseas and likewise those ages which are least afflicted with it We affirm therefore that this Diseas doth very rarely invade Children presently after their birth or before they are six months old yea perhaps before the ninth month but after that time it beginneth by little and little daily to rage more and more to the period of eighteen months then it attaineth its pitch and exaltation and as it were resteth in it till the Child be two years and six months old So that the time of the thickest invasion is that whol year which bears date from the eighteenth month two years and a half being expired the Diseas falleth into its declination and seldom invadeth the Child for the reasons already alleadged But the reasons Why Infants newly born are rarely affected and why from the ninth to the eighteenth month they are frequently affected and why after the first eighteen months they are most frequently affected shall now all of them in their order be produced The First Reasons why Children newly born are very seldom invaded with this affect may be these The First is Becaus the Embryon in the Womb is by the equal heat and embracement of the Matrix strongly fortified against this Diseas as we have declared above and by consequence the same being brought to light doth for a time retain som of that muniment defence which it contracted from that equal warmth of the Womb and therfore presently after the Birth it doth not so easily fall into it The Second is Becaus the Midwives and Nurses do handle them so artificially when they are new born that their condition is not considerably different from that which they possessed in the Womb. For they enwrap the whol Body excepting the Head in one continual Covering wherupon the exterior and first affected parts of the Body in this Diseas are fortified against the injuries of the outward cold and the hot exhalations breaking out from any part of the Body are duly and equally retained by reason of that Covering which is two or three times double and bound about with swathing Bands and equally communicated to all the parts of the Body so that they are cherished with an even heat
and proportion of the Parts becomes more compact firm and stable neither doth it easily come to pass that one part doth much grow out more than another by true augmentation Thirdly We say that excepting the two premised conditions and that in that manner as they are propounded this affect according to the other parts of the Essence thereof although indeed very rarely and upon the highest causes only may happen to Boys Young Men Men and old Men. For first a cold distemper without al controversie may befal them though not so easily as Children Secondly A moist distemper may also invade them but yet only by the limitation propounded Thirdly A want of inherent Spirits may also befal them but then it must proceed from the most potent causes For Chronical Diseases and such as consume the habit of the parts or dissipate it into ayr or wast it by long fasting and an Atrophy do necessarily leave behind them a paucity of Natural Spirits We see the outward parts even in those that are grown to ful age when they are extenuated and consumed by such like causes to wax feeble to languish wither and become destitute of al sufficient Spirituosity Yet we grant that in those that are grown to full age the evil which causeth leanness being overcome the wasted Spirits may soon be repaired by the vigor of the Pulses and that the rudiments and impressions of this Diseas may be rooted out within one or two weeks and by consequence that they are seldom affected with it In the interim if it should so fal out that upon that consuming of the Inherent Spirits some impediment should intervene that might retard their reparation it is possible that this diseas may grow from thence in that manner as hath been said But a numbness of the Inherent Spirits must necessarily follow upon a fewness of them Fourthly The parts of the Secondary Essence seing that they have a strong dependance upon the Primary faults where these persevere long the Organical faults being excepted they may supervene in their order So that we do not doubt but this Diseas may happen to any age after childhood the restrictions which we have now propounded being granted and upon the urgency and perseverance of great and weighty causes One amongst us affirmeth that he had a Gentleman in cure about thirty yeers of age who by dayly immoderare use of Wine and Tobacco continued for some whole years having neglected the due receiving of his meat fel into such a weakness of Stomach that continually every morning he vomited and loathed al kind of Meat and if at any time he swallowed any with unwillingness he presently vomited it up again to appease this queziness of Stomach he was at last compelled to a continual use of ordinary Aqua vitae but afterwards his custome was to mingle it with stale Beer and a quantity of Sugar and with this drink alone he preserved himself alive for many months In the mean time all those parts which in this Diseas we cal the first affected were extreamly lean and became soft loose languid and withered so that he could neither turn himself in his bed nor rise nor walk nor stand upright yet he felt no pain neither was there any privation of sens and motion no cough no uneasy respiration his face was well colored and al the parts about his Head were in a good condition and wel habited so that had you judged of him by his countenance only you could scarce have suspected that he was sick As he lay in his bed he would chat with his Companions take Tobacco by turns and drink that mixture of Beer and Aqua vitae aforesaid The event of the Diseas doth not indeed belong to this place yet we shal set it down to gratify them who are desirous to know it The Physitian being sent for he strictly forbad al intemperance and amongst other remedies having given him one grain a half of Laudanum Londinensis he appeased the nauseous infirmity and tumult of his Stomach which part he likewise strengthned with internal and external applications and prescribed him such a diet as was most easy of concoction Instead of exercise he solicited the heat unto the outward parts with rubbing them every morning having first given a smal quantity of strengthning and opening Electuary made up with a little portion of Steel which he drank in two ounces of Wine composed of Wormwood and Mint a little Saffron being hung in it to give it a tincture three ounces of smal Beer being tempered with it and a quantity of Sugar to make the taste of it more pleasant Moreover he purged him by fits with gentle Medicines and in the evening comforted him with cordials Within twenty days he grew to such a degree of amendment that he could walk abroad for the space of an hour and could without any striving or much weariness climb ladders without any help But afterwards by a relaps into the like intemperance he died in the absence of his Physitian But let us return from this degression into the way direct our speech to our intended scope The Affect being now confirmed as it was upon the first coming of the Doctor Besides the faults of the Stomach it seemed to include a great part of the Essence of this Diseas we now treat of For in the parts subservient to motion namely those that are first affected in this Diseas there was a cold distemper either through defect of motion or by reason of the immunite afflux and dispensation of the Vital Blood Again the softness slipperiness laxity and litherness of those parts shewed that there was a moist distemper in them Also the extream leanness of those parts did sufficiently demonstrate a fewness of inherent Spirits and the unfitness to motion and affectation of rest and eas did strongly witness a numbness in those parts The ful and florishing habit of the parts about the Head when the other parts were extenuated was a forcible reason to prove the unequal distribution of the Blood But the peculiar cause of this inequality in this sick man might be his frequent vomiting whereby a more plentiful afflux of the Blood was driven to the parts about the Head the other being almost destitute of it Any man may perceive by what hath been said that at least the greatest part of the Essence of this Diseas was comprehended in this mentioned Affect From whence at length we may probably infer that it is possible for this Diseas to happen to those of ful growth being considered according to the propounded limitations although it very seldom coms to pass because great causes and length of time are required to the production of it And thus at last we have put an end to the search upon the former Question CHAP. XIX The latter Question Why this Diseas happeneth more frequently in England then in other Countreys And whether it be Natural to Englishmen IT is acknowledged by
imprint som mark of a vitious Constitution to the place to which it is ascribed It is impossible that any Diseas can be attributed unto it as properly Common by reason of the commodity of the Region Wherfore that we may comprehend all in a word although this Diseas in respect of the coldness and moistness thereof have a fomentation in the very Constitution of the Country Although also that it borrow three other occasions of invading from the Country Yet seing that those distempers may be prevented by a due observation of the Regiment of Health appropriated to the place and seing that the three other occasional causes are not properly blamable but desirable we must affirm that this Diseas is not properly Common to England And so we have put an end to the search of the causes of this Diseas CHAP. XX. The differences of the Diseas called the Rachites THere are many differences of the Rachites in regard of the concourse of several evils and more than any man would easily imagine some wherof are of great importance and others less considerable we have resolved here briefly to propound the chiefest For the knowledg of them is not only profitable to define the prognostical causes wherby the various events of a Diseas are distinctly fortold according to those differences but it also much conduceth both to the prevention and the cure of a Diseas namly that by a consideration of them apt and fit remedies may be chosen Now these differences arise either from the Essence of the Diseas or from the causes therof or lastly from Diseases conjoyned with it The Essence of a Diseas may vary many ways First By reason of the parts of the Secondary Essence either present or absent Secondly In regard of the magnitude of it Thirdly In respect of the vehemence Fourthly in regard of the Spirits And fiftly in respect of the times We grant indeed That there is a certain agreement between som differences comprehended under these titles yet seing that the formal conceptions of them are distinct it must be confessed that they deserve distinct considerations For although a Diseas even in that very respect may be called greater because it containeth many parts of the Secondary Essence in the same Patient yet this is a different distinct consideration from that of the magnitude of that Affect For the magnitude properly hath respect unto the degree of recess from the Natural State and not to the Nature of the part of the Essence either present or absent for hereupon resulteth more then a gradual difference In like manner some of the other differences do perhaps signify the same thing in ◠concrete and restrained acception which notwithstanding in an abstracted and formal consideration denote a diversity But let us proceed The first difference of this Diseas is that which ariseth from the presence of few or many of the parts of the Secondary Essence therof For although all the parts of the Primary Essence are perpetuà lly present with the Diseas it self yet there is no necessity that all the parts of the Secondary Essence should be always present For these are after-comers to the first Essence and do by degrees come upon it Yea some of them may be so highly intercepted by the intervention of resisting causes that they may not at all appear Hither you may refer that difference which we propounded at the foot of the precedent disputation and which we shewed might possibly though indeed very rarely befal those that were grown to ful age But because our purpose here is only to handle the Diseas as it is incident to Children we shall be content to pass by that difference thus noted by the way But even in Children themselves there somtimes happen some parts of the Secondary Essence which have a most strict conjunction with the Primary Essence at least they succeed them in the order of Nature For the Primary Essence hath the efficacy of a cause which in Nature doth ever go before the effect But in order of time some parts of the Secondary Essence do conspire as it were and concur with the Primary Essence in the invasion and others again do come afterwards these we must here distinguish For the former sort are absolutely inseparable the latter sort separable from this Affect The inseparable parts of the Secondary Essence may be reduced to these Heads First to the afflicted Tone of the first affected parts Secondly to the unequal and imperfect distribution of the Vital Blood Thirdly to the too smal participation of the Vital influx in the first affected parts Fourthly to the Secondary faults of the Animal Constitution These faults are sufficiently unfolded above in our discourse of the Secondary Essence of this Diseas where likewise because of their strict carriage with the Primary Essence any man may perceive with eas though they have a casual dependance upon the Primary Essence that they begin together at the same time But al the Organical faults which we have also already recited are found to be separable and somtimes actually separate from this Diseas For the magnitude of the Head and the leanness of the Joynts the crookedness of the Shank-bone or the Elbow the inflexions of the Joynts the sharpness of the Breast do not necessarily accompany this Diseas presently from the beginning but in process of time they bewray themselves by degrees and supervene upon the Affect And although the Consumption of the parts which in some sort hath an influence into the said faults may be said to be present in some slight degree from the begining of the Diseas yet is it indeed only a Symptom and not a Diseas neither is it able presently to produce those Diseases of magnitude Figure and Place Moreover it is not necessary that these Organical faults should equally and at the same time invade one that hath the Rachites we grant indeed that the extenuation of the first affected parts when the Diseas is of some continuance doth alwaies and necessarily succeed it neither can it afterwards upon the perseverence of the Diseas be removed that it is likewise a principal part of the separable parts of the secondary Essence yea that the extenuation whilst it is making doth immediatly follow the smalness of nourishment of the first affected parts almost no otherwise than the smalness of nourishment immediatly followeth the primary Essence of the Diseas in the said parts but withal we affirm that the extenuation being made which is it self a secondary part of the Diseas wherof we discours doth necessarily presuppose the motion and time of the Diseas and that it cannot be in the first moment of the existence of the Diseas We say moreover that Physitians do not acknowledg any change made in the parts exposed to the sens which doth not yet appear to the sense and by consequence they affirm that extenuation befalleth the first affected parts til it be made obvious to the senses which certainly doth necessarily
suddenly break out and assoon vanish But in this affect the signs do invade by degrees and persevere or else they are dayly more encreased Now the primary Diseases of the Brain are distinguished by their proper Signs And thus much of the Signs which relate to the Animal Actions The Signs which belong to the disproportioned Nourishment of the Parts Of how great moment the Alogotrophy or unequal Nourishment of the Parts is in this affect we have already shewed we shall here therfore prosecute those signs which in some great measure depend upon it and we shall present them as if they were to be beheld at one View First there appeareth the unusual bigness of the Head and the fulness and lively complexion of the Face compared with the other parts of the Body But although this Sign may presuppose some motion of the Diseas before it shine out yet is the Diseas so obscure before the appearance of it that it is accounted in a manner unperceivable Therfore commonly this Sign sheweth it self more or less from the first beginning and continueth till the departure of the affect unless as we have noted before the pining of those parts supervene from some other caus Secondly The Fleshy parts especially those which are full of Muscles beneath the Head which we have listed among the first affected in the progress of the Diseas are dayly more and more worn away made thin and lean This Sign doth not presently shew it self from the begining of the Diseas becaus it pre-requireth some notable motion of the Diseas before it evidently appeareth yet in time it most certainly is exposed to the senses and accompanieth the Diseas to the last step be it either to life or death excellently demonstrating the motion and degree of the Diseas by its encreas Moreover this Sign being conjoyned with the former doth at least constitute a Pathognomonical Sign of the second kind that is such an one as is proper to this Diseas alone and where they are present together they infallibly denote the presence of this Diseas although upon their absence they do not equally signifie the absence of the Diseas Thirdly Certain swellings and knotty excrescences about some of the joynts are observed in this affect these are chiefly conspicuous in the Wrests and somwhat less in the Ankles The like Tumors also are in the tops of the Ribs where they are conjoyned w th grizles in the Breast We have noted abov in our Anatomical Observations that these tumors are not scituated in the Parts but in the very Bones although this consideration doth scarce belong to them as Signs seing that of themselves they are searce conspicuous This Sign doth also suppose some kind of motion of the Diseas neither is it emergent a Principio principiante as the Phylosophers phrase it yet it offers it self as an object to the senses sooner than any considerable extenuation of the parts But where it is present it constitutes a Pathognomical Sign of the Second kind and without dispute witnesseth the Species of the Diseas Fourthly Some Bones wax crooked especially the Bones called the Shank-bone and the Fibula or the small Bone in the Leg then afterwards the greater Shank-bone and the undermost and lesser of the two long Bones of the Elbow but not so much altogether nor so often somtimes also the Thigh-bone and the Shoulder-bone Again there is somtimes observed a certain shortning of the Bones and a defective growth of them in respect of their longitude This by chance was omitted above where we gave the Reason of the Organical faults Yet this affect doth seem to depend upon the same irregular nourishment namely so far forth as the nourishment taken in encrcaseth the Bones according to breadth and thickness more than length From hence it comes to pass that some Children long afflicted with this Diseas become Dwarfs Hither perhaps may be referred that folding in the Wrests the Skin it may be having better nourishment and more growth than the Bones of those parts wherupon it must needs be contracted in the Wrests into a folding or wrinkledness Finally to this place also may belong a certain sticking out of the Bones of the Head especially of the Bone of the forehead forwards For it concerneth the common kind of viciated Figure and the Alogotrophy of the Bones Yet this in the Bone of the Forehead doth evidently seem to depend upon the free nourishment of that Bone in his circumference wherewith it is coupled to the Bones of the fore part of the Head and constitutes that seam called Sâ—tura Coronalis which lieth in the foremost parts therof For herupon it must needs be thrust forwards And indeed in that place it is plentifully nourished without any difficulty becaus this Bone in Children is cartilagineous towards that Seam And this also was pretermitted above where we discoursed of the Organical faultiness becaus we have but lately observed it Fifthly The Teeth come forth both slowly and with trouble they grow loos upon every slight occasion somtimes they wax black and even fall out by pieces In their stead new ones come again though late and with much pain This kind of Sign as also that which we noted in the former Article may be referred to the Synedremontal Signs becaus neither of these is either perpetually present or if it be present it doth not undoubtedly confirm the presence of Diseas Some have imagined that the Bones in this Diseas are transfigurable like wax But we have never seen it neither have we received it from any eye witness who was not of suspected credit Wherfore we reject this Sign as altogether Fabulous Sixthly The Breast in the higher progression of the Diseas becomes narrow on the sides and sticking up foreright so that it may not be unaptly compared to the Keel of a Ship inverted or the the Breast of a Hen or Capon For on each side of the middle it riseth up into a point the sides being as it were pressed down If any demand whether this Sign be solely apropriated and peculiar to this affect We answer That the Breast may be a little encreased in an Atrophy or Phtisick and less than the other parts of the Body and so by consequence it may be narrower but it can scarce so fall out according to the change of the Figure without an Alogotrophy namely that which is proper to this Diseas Wherfore this Sign also when it is present although the invasion of it be tardy must be reputed a Pathognomonical Sign of the second kind becaus when it is present it certainly denoteth the Species of the Diseas though not on the contrary And thus much of the Signs which have reference to the unequal nourishment The Signs which belong to Respiration First The narrowness and sticking up of the Breast already mentioned must be hither referred wherof we then discoursed at large Secondly A swelling of the Abdomen and an extension of the Hypochondriacal parts which hindreth
as they are found out by the force of Indication are the very indicated Actions so that the Scopes invented by the Indication and the Indicated Actions do really signifie the same things We say really becaus the Scopes even when found out differ in reason from them as they are Scopes seing that besides the Indicated Actions they seem to note together an intention of prosecuting the same Actions as the Scopes not yet found out do intimate an intention of enquiring into them Thus much of Indicates or things Indicated Thirdly The action of an Indicant is Objective and Indicant as an Object besides it self doth in som sort insinuate another thing to the understanding Perhaps som may wonder how an Object can represent any other thing besides it self We answer Such is the Nature of relatives that as such they cannot be conceived without an implication of their correlatives For one relative in his proper consideration doth at least obliquely involve the consideration of another and by that means it easily ushereth the understanding to the knowledg of the other Som may reply If the force of the Indication be built upon the meer relation of the Indicant to the Indicatum How coms it to pass that the use therof is restrained solely to the Art of Medicine To this we answer We deny not but this instrument may be extended to other Arts and Sciences as we have before insinuated For in moral Philosophy it is lawful to say that Vertu doth Indicate the protection of her self and Vice the suppression of it self But neither doth this kind of relation consist only between the States of things and the Actions therunto belonging but also between the terms meerly speculative as twice two are four a man is not a horse But here we consider the Indication and the efficacy of the Indicant only in order to the Method of Physick so as it wil not be here needful to extend the use of this instrument further neither indeed did Galen because it would contribute little to the scope therof Yet we affirm that every relation is not a sufficient basis of an Indication but it must be such as hath either an evident conformity and agreement between the Indicant and Indicatum wherby they may be fitly marshalled into a proposition of undoubted truth or a disparity and repugnance of them among themselvs that so they may aptly be divided from one another that is they may be disposed into a negative proposition equally certain Now because the propositions elected by this indication are certain and evident not needing any higher proof from thence it is manifest that every understanding that is Master of it self not clouded with a vail of prejudice nor wittingly ensnared with sceptical Sophisms and fallacies must necessarily pay an assent unto them so soon as he understandeth the terms Moreover the Scepticks themselvs though in their disputations they wil lie in wait to traverse any verity how manifest soever it be and busy themselvs to equal the most certain principles with things extreamly doubtful yet in performing the necessaries of life seing that they relieve hunger by food hoard up mony avoyd stripes and do these and the like things constantly and without any distemper of mind they plainly discover that they are led by som bad disposition of mind or governed by a desire of glory or tickled w th a hope of victory in the contention rather that they doubt really of the truth of such Propositions In the interim it must be observed that the very Indication is fallible and deceitful where the absolute nature of the Indicant or the Indicatum hath not been exactly understood before For in this art of Indications we do not presuppose only that a Physitian should always have learned before and duly known what al those things are which we cal according to Nature as also in what the Essence of a Diseas and all the parts therof consist and to have an exact knowledg of all the causes of an Affect Yea it is necessary that he understand all Medical actions and upon occasion be able to render a ready account what alteration is what heating what cooling c. what evacuation purgation and the section of a vein c. what conservation and the like For the Indication doth not make manifest the absolute nature either of the Indicant or the Indicatum but presupposing this as already known it representeth only a mutual relation namly either a strict connexion and conformity which they retain among themselvs or a disparity and opposition wherby they may be formed into an undoubted proposition but the certainty of the indicated proposition cannot exceed the certainty of the knowledg of the Indicant Therfore if at any time we scruple the certain knowledg of the Nature of the Indicant it is not safe to trust to the Indication alone til it shal better be confirmed by som other Reason or experience But this doubting must not be imputed to the Nature of the Indication but to the ignorance of the Indicant Moreover it must be considered that the relation of the Indicant in the Method of practice doth demonstrate besides the evidence somwhat of duty in respect of the Indicated action and that the propositions formed from the Indication do either explicitly or at least implicitly insinuate that duty As in this Proposition a Diseas doth Indicate the ablation of it self the ablation is decreed and resolved upon as a requisit action on the part of the Indicant that is a Diseas as if one should say a Diseas requireth or importuneth the removal of it self Yet this duty of the action is more frequently and indeed much more elegantly expressed by the Participle in dus as a Diseas is to be taken away which Proposition in the fulness of its signification hath a manifest coincidence with the former There remaineth stil an objection to be answered concerning the action of the Indicant and this it is If the Indication be the very action of the Indicant how can it be called an operation of the understanding For all writers refer the Indication to som generation of the understanding We answer The Indication is indeed an action of the Indicant but yet an objective action and that it is united to the intellective faculty and abideth in it as in its subject Moreover that the understanding a power both actuated and as it were informed by its subject Wherfore although the action of Indication be objectively attributed to the Indicant yet subjectively it is ascribed to the Soul and especially to the intellective part therof which is as it were the act and form of it And from hence it wil be most easy to reconcile Galen with himself who somtimes defineth Indication to be an Emphasis somtimes a Catalepsis Fourthly It must be examined whether that distinction of an Indicated action into an action helpful and hurtful may tend For som may urge that Galen doth perpetually
Fourthly The Tone being over soft loos flavid and withered indicateth an avoidance of such things as are wont to mollifie loosen and weaken the parts and that such Medicines are to be outwardly applied and inwardly given as may render them more firm and solid The same Tone as it is internally too brittle brings a suspicion upon all such things as abound much with an inward slipperiness and seemeth to desire some roughness or indeed astriction in those things applied or taken Fifthly The corrupted Vital Constitution on the part of the Generation of the Vital Spirits is not so considerable but on the part of the distribution of the Vital Spirits the inequality therof is of great importance and indicateth a caution to be had of those things which promove the flux of the Blood towards the Head as also of such things as retard the passage therof to the first affected parts but that choice must be made of such things as stir the Pulses of the Arteries in the parts first affected and temper those that are in the Head A slow and diminute current of the Blood through the first affected parts indicateth the same things namely an evocation of the Puls to those parts But an over facile and slippery passage of the Blood through the habit of the parts is coincident in its indication with the slipperiness of the Tone lately recited A defect of the Vital Constitution on the part of the union sufficiently vigorous and pleasant between the Vital and the Natural Spirits indicateth an election of such things as can both nourish and cherish the Spirits and also excite them to a greater activity and that their contraries ought to be avoided The Vital heat as deficient indicates almost the same thing as a cold distemper provided that regard be had withal to the strength of the Heart and Arteries and to the vigor of the Vital Spirits Sixthly The unequal Nutrition Indicateth those things which promove the even and impartial distribution of the Aliment and Heat Or indeed that which is too liberal to the parts that are nourished beyond a due measure the extenuation of the parts requireth a fuller Nourishment The irregular magnitude of the Head chiefly things extenuant and such as are of the flux from the Head The Tumors of the Bones indicate the same thing the crookedness of the Bones require such things as attract the Aliment to the hollow side as moderate rubbings but things repressing chiefly on the gibbous and bunched side as strong bindings The bending of the Joynts insinuateth an Artificial erection of them as much as is possible The narrowness of the Breast pointeth to Pectorals and such things as have a faculty to dilate the Breast but the sharpness therof indicateth such things as have a dilative Vertue Sevently The imperfect distribution of Animal Spirits and somwhat defective in the first affected parts indicateth Cephalicals and such things as facilitate the distribution as exercises rubbings and the like A defect of due stretching in the Nerves or Nervous and Fibrous parts indicateth those things as Corroborate the Nerves and strengthen the parts Thus much of Indications Curative the Preservative follow CHAP. XXVI Indications preservative THese Indications are deduced either from the Antecedent or the present causes of a Diseas Those which flow from the former kind of causes concern the Prophylactical Part here we only propound those which proceed from causes that are present and contained in the Body namly from common causes or such as are proper to this Diseas Now although that common causes do not seem immediatly to attain to the production of the Essence of a Diseas yet even in this respect that they are esteemed an impediment and may retard the cure they Indicate their taking away These causes are either impurities or excrementitious humors collected and impacted in the first passages which unless they be taken away do not only infect the nourishment inward but they somwhat dul or otherwise hinder the appropriate Medicines They indicate therfore an evacuation either by a gentle vomit or by a lenitive purgation as occasion shal rather perswade to this or that or they are common causes deeper imbited into the Parts of the Body and these also require an evacuation But seing that according to this kind of common causes it is at the same time driven away and almost with the same Medicaments as are the causes which are proper to this Diseas we shal conjoyn both the kinds of them in this present consideration The causes therfore which are proper to this Diseas as also the Common causes which have a deeper penetration into the Body may be divided into Blood and Cacochymical humors The Blood indeed although it be rather deficient than redundant in the first Affected parts yet in the Head for the most part it requires a particular evacuation which usually is performed by scarification of the Veins in the hollow of the Ear. Hither likewise we may partly refer blisters raised between the first and second turning Joynt of the Neck although these perhaps may relate over and above in part to the Cacochymical humors Cachochymical humors are divided into those which stil flow in the channel of the Veins and into those which are impacted in certain parts of the Body The causes or humors flowing in the Veins do primarily and intentionally Indicate their evacuation But if they be unapt for motion as to the execution then they require som previous preparation But because it happens for the most part that not al the humors are equally unapt but that som are sufficiently flexible and others not so but resist the Medecines in this case they indicate a less evacuation and then a preparation Moreover These humors in the chanel of the Veyns may be subdivided into Feaverish namly if there be a putrid Feaver and not Feaverish The Feaverish humors are either swelling or not swelling The swelling that is those which are unquiet or impetuously agitated do Indicate a sudden evacuation at least a lesser unless perhaps they are carried of their accord to the external and more ignoble parts as it happens in the small Pox the Meazels and the like Affects But if a Feaver be present and that acute and yet the humors are not swelling they chiefly Indicate that peculiar preparation which they cal coction that by this means they may be obedient to the Medecine to be aftergiven and than evacution but if the Feaver not be acute but Chronical although the matter be not irritated and yet som part of it be sufficiently flexible in this case a lesser evacuation is first indicated at any time of the Diseas and afterwards the coction of the relicts that they also in their time may be evacuated The humors contained in the Veins which are not Feaverish if they are fluxible they first indicate evacuation but because in this Affect slow gross and clammy humors are almost perpetually present preparation at least wher a lesser
retard the rooting out of the Diseas Yet in the interim whilst we are busie in the removal of the Causes the Essence of the Diseas must not be totally neglected as we have before admonished Yea when we have so subdued the Cause that it cannot for the present much interupt the Cure we may the Causes not being utterly over-come and cast out the more diligently and earnestly attempt the resisting of the affect yet with this condition That if the Causes revert and becom new impediments that then we are obliged presently to undertake the subduing and evacuation of them so that in this Chronical Affect somtimes the Causes somtimes the Diseas must be resisted by turns and the Spirits do better undergo this change of action than if we should continualy make our battery against the Causes till they were absolutely rooted out Moreover When the Causes of the Diseas in this Affect are unapt for motion by reason of their toughness grosness and perhaps setledness they must first be freed from this impediment and prepared before they are evacuated For according to the Rule of the great Dictator Quae movenda sunt fluida prius facere oportet In like manner that thickness toughness and setledness of matter if it be present indicate Remedies attenuant incident and opening But these things are not safly taken the impurities still flowing back into the first Passages for then perhaps they are carried along with the Medicines into the Veins and more defile the Blood or at least hinder the efficacy of the Remedies These therfore have the nature of an impediment and must be in the first place removed Lastly Universal Evacuants must be premised before Particular and Topical Remedies especially where it is not permitted at once to mind both intentions For the Universal Causes flowing in the Body are easily surrogated in the room of Particular Evacuations and renew the Afflux to the first affected part but the thinner part of Particular Causes and that which is most apt for motion is evacuated but the thicker perhaps is more impacted Wherfore Universal Causes yet flowing to and fro in the Body as considered are Impediments in respect of Particular Evacuation and by consequence must be first expelled The latter Rule was That we must releeve the more urgent and weighty Indicant first unless there be an interuption of som impediment That is termed an urgent Indicant which threatneth the most danger Now every such Indicant is supposed to induce great afflictions into the Body and not without manifest danger to wast the Spirits Therfore in this respect we must somtimes first help the Diseas the Caus being neglected Somtimes also we must neglect both the Diseas and the Causes and adress our endeavors to the pacification of the Symptoms as in a vehement Flux of the Belly long Watchings profuse and immoderat Sweating and the like But even in these cases we must have a prudent regard both to the Diseas and the Causes and when the urgent Symptom is corrected or the violence of the Diseas repressed then we must return to the regular Method of proceeding for this Rule belongs not to the ordinary and legitimate order of Cure but to the Method of Necessity Moreover to perfect the right administration of Indications there is required an exact and accurat knowledg of the Medical Matter whereof we shal discours in the subsequent Chapters CHAP. XXIX The Medical Matter answering to the Indications proposed and first the Chyrurgical THE Medical Matter must be found out by Experience and Analogismes or Arguments drawn by an answerable necessity from the Caus to the Effect although the truth is we conceive not any other Reasonings to be absolutly excluded It is vulgarly and not unaptly distributed into three kinds The Chirurgical the Pharmateutical and the Diatetical Of these in their order The Chirurgical commonly received and approved in this Affect and famous above the rest are chiefly two Scarification of the Ears and little Fountains or Issues But our enquiry as we shal see anon shal be extended to many more namly of Cuppin-Glasses Leeches Blisters Ligatures and Swathing-bands But the opening of a Vein the Spirits cannot brook as every one knows who but observes the frailty of the age the extenuation of the habit of the parts and the smalness of the Veins The Scarification of the Ears shal lead our discours The Empericks who undertake the cure of this Diseas make more of it than one would imagin For in their practice they celerate it with great vaporing and without it scarce hope for a happy cure But we although we disallow not this kind of remedy have seen many Children successfully recovered without the use therof And they themselves who attribute most unto it for the most part take away no considerable portion of Blood Yet some affirm that they have seen a large quantity of Blood drawn away with good event However it be it is credible that those Children do with most ease endure this remedy and obtain most profit by the use of it which are of a Sanguin complexion and wel habited and who are affected with an Alogotrophy rather than an Atrophy or a Consumption or any other remarkable extenuation of the parts Our Practitioners for most part repeat this operation two or three times in a week They seldom do it with an Instrument or sharp Pen-knife but most commonly with an ordinary blunt Knife taking no notice of the pain and crying of the Child Moreover For the most part they perform it in the hollow of the Ear but some extend it to the inward and outward circumference of the upper part of the Ear yea to the whol circumference No man hitherto as we know have attempted the Scarification of the hinder side of the Ear although indeed it is not easie to give a reason why it should conduce less being administred there than in the hollow part Yet it may be lawful for us to offer our conjectures why the hollow of the Ear should be chosen before the other parts for this operation which notwithstanding we will not confidently assert although we suppose we can at least probably assert it if that be true which the most diligent Chyrurgion Fubricius Hildanus hath written in his Observ 4. Centur. 1. de nervo quinti parts For this conjecture is grounded upon this Observation and if that be ruinous this perhaps must perish with it The Conjecture is this The distribution and use of the Nerve and of the fifth Pair before mentioned being supposed Scarification in the hollow of the Ear may very conveniently both free that Nerve from any kind of oppression and likewise shake off the numbness and give it vigor For the hollow of the Ear is the next place unto it which we can come at with an instrument Wherfore evacuation being here made may immediatly drive away the matter which commonly oppresseth the very beginning of that Nerve and withal causing pain and encreasing the
beat such things as are reducible to pouder make an Electuary according to art with syrup of Succory with Rhubarb a sufficient quantity Let the Sick take half a dram two scruples or a dram every morning either by it self or in a spoonful of Posset-Ale or som appropriated Syrup or else in Wine Take Conserv of Archangel flowers one ounce the flowers of Sage Clove-Gilliflowers Rosemary-flowers Myrobalans candied in India Citron Pills candied of each half an ounce red Sanders Cinnamon Spanish Liquoris of each half a dram Salt of Steel or els Saffron half a scruple with a sufficient quantity of syrup of Wormwood make your Electuary The dose and manner of using it is the same with the former CHAP. XXXIV Remedies that correct the Symptoms SOme Symptoms supervening upon this Affect do somtimes anticipate the legitamat Method of Cure and require a particular manner of proceeding Of this sort are the flux of the Belly the Lask wherwith somwhat of a Lientery is frequently joyned profuse Sweats laborious and painful breeding Teeth and the Toothach The flux of the Belly doth very much follow this Affect which if it persevere for any long time it is either very violent and easily watereth the Spirits consumeth the solid parts manifestly puts on the nature of a caus and as a caus indicates it s own correction A Bloody-flux rarely hapneth with this Diseas But a Lask with exulcerations in the Guts or complicated with a Lientery is very useful For in respect of the debility to the parts subservient to digestion a Lask or a Lyentery may easily supervene but not a Bloudy-flux Yet there is a frequent concurrence of other causes as of the indigested nourishment vicious either in quantity or quality som feaver watchings worms painful breeding Teeth c. al which things do likewise easily occasion a Lask or Lyentery rather than a Bloudy-flux As for the Cure it is partly perfected by Purgations partly by astringent Remedies partly by such as open and partly by such as strengthen the parts These Purgers are most proper which leave behind an evident binding after evacuation as Rhubarb Senna Tamarinds Myrobalans c. out of which for the most part we frame a Bolus or Potions becaus they are most easily swallowed under those forms As Take Conserv of Red Roses half an ounce Rhubarb in Pouder twelve grains with a sufficient quantity of syrup of Coral make a Bolus to be given in the morning Take of the Pulp of Tamarinds one dram Rhubarb in Pouder seven grains Sugar of Roses half a dram with a sufficient quantity of syrup of Quinces make your Bolus Instead of this Syrup you may use syrup of Coral or syrup of Mint or syrup of Myrtles or syrup of Pomgranats Take Senna half a dram Rhubarb one scruple Tamarinds a dram and an half Anniseeds bruised ten grains Infuse them in a sufficient quantity of fountain water boyl them very gently and to an ounce and an half of the Decoction ad syrup of dried Roses half an ounce mingle them together for a Potion Take Plantan or Succory water or Saxifrage water one ounce Rhubarb in pouder ten grains syrup Augustan syrup of dried Roses of each two drams Mingle them and make your Potion It must be observed That a more full evacuation is somtimes requisit namly when the flux hath not been immoderat or of long continuance and in the mean time the matter offending hath bin copiously collected in the Body In which case in lieu of the Syrup of dried Roses you may take som drams of syrup of Roses solutive syr Augustan or of Succory with Rhubarb or Manna But commonly the safest way is to augment the dose of Rhubarb or els of Senna not omitting the syrup of dried Roses In the evening after the Purgation you may administer ten grains of Diascordium boyled in Wine with Cloves and a little Cinnamon and mixed with a third part of Erratick Poppy water and some cordial Syrups as Syrup of Clove-Gilliflowers to strengthen the Spirits and to stay the Flux or if the Flux be stubborn you may mingle two drams of Diacodium for a dose instead of the Syrup aforesaid Or Take of Posset-drink made with white-Wine the Curd being taken off aromatize it with a little Saffron tied up in a rag crushing it gently between your Fingers Confectio Alkermes one scruple Pomgranat Pils in pouder seven grains Diacodium two drams mix them together to be taken when the Child is minded to sleep Or Take Laudanum according to the London Dispensatory half a grain Magister of Coral twelve grains Conserve of Clove-Gilliflowers or Red Roses one scruple with a sufficient quantity of Syrup of Quinces make a Bolus to be taken at bed-time If there be obstructions you may prescribe Crocus Mâ—rtis or Salt of Steel to be taken in the morning As Take Conserve of Roses one ounce the Roots of Succory preserved Myrobalans preserved in India of each half an ounce Salt of Steel half a scruple or Crocus Martis one scruple Cinnamon Liquoris red Coral of each eighteen grains Saffron a grain and a half Syrup of Succory without Rhubarb a sufficient quantity make your Electuary according to art wherof let the Child take half a dram each morning Red hot Iron may be quenched to the same purpose in its ordinary drink If the Child be troubled with a violent flux you may give it som binding Conserves imagin Conserve of Sloes and mix it with such things as the Child delights to eat but in so doing be sure you pleas its Palat. Somtimes a profuse and excessive sweating find a peculiar business for the Physitian in this affect for it very much wasts the Spirits and retards the cure of the diseas Yet caution must be used not to restrain it rashly if perhaps there be a Feaver or if any feaverish fit or immoderat heat hath gon before For in these cases it may be upon a critical time or at least it may bring more advantage to the Body by the mitigation of the Feaver than damage by the loss of the Spirits For we know not whether any thing doth more potently or indeed more sweetly expel the feaverish heat thaÌ„ sweating In the interim when it floweth inordinately and causlesly it argueth that the Body is oppressed with obstructions with crude juyces and unprofitable superfluities which whilst Nature striveth to master and to subdu by that very labor the openness of the pores withal concurring it is evaporated by sweat and indeed an unprofitable one very laborious and such as wasteth the Spirits which therfore as soon as possible must be corrected This Hippocrates meant where he adviseth That that sweat which floweth away without cause requireth purgation For what can more commodiously diminish and dissipate these superfluities Again this motion is contrary to sweating wherfore it meriteth the preheminence among the remedies opposed to this Sympton and seing that it clears the way for Medicines aperient and such as strengthen
the word the name Rickets may be readily deduced from the Greek word Rachitis or Rachites provided That we will but allow that consideration of change which in vulgar pronounciation usually happeneth to words transplanted from one Language to another Object You will say That they which imposed first the English name Rickets were peradventure altogether unskilful in and ignorant of the Greek tongue or that they never thought of the Greek word Rachites at least understood not that the Spine of the Back was the principal among those parts which were first affected in this Disease Answer We Answer It concerns not us whether they were ignorant of or thought not upon the Greek word or whether they did not understand the principal part that was first affected yet are thes things freely asserted For we knew many at that time when the Disease did first spring up and the Name was imposed indeed learned men and skilful in the Greek tongue to have their Residence in those places to whom it was not perhaps any difficulty to observe that conspicuous debility of the Spine in this affect and thereupon they might assign this Name unto it although t is very possible yea probable That the common people by the error of pronounciation might somewhat pervert the Name so given and expresse it as to this day they retain it by the word Rickets But whether it were or were not so we are not at al solicitous If the matter were so the imposed Name will as is manifest be altogether congruous and perhaps also at the last will most fitly correspond with it For suppose you should fall upon some Name received not so much by choice as chance yet so fit that a more comodious Name could scarce be devised by councel and deliberation nor one more consonant to Reason in such a Case What would you do Would you extirpate and banish the receaved word to introduce one that was new and nothing better This practice would usurp upon the priviledge of Conversation and be injurous to the custome of Speaking Words contract a value by their use and ought not to be denizen'd with rashness or innovated by timerity Or would you not rather confirm the Name receaved yet as a new one and from that time to be deduced from a new Origine for this would be at the least like a chosen Science inoculated upon a new stock which by reason of the affinity with the Root would without any difficulty receave strength and nourishment Or if this please you not suppose if you please That we now newly devised the English name of this Disease and deduce it from the Greek word Rachites the English word resulting from hence would be the Rachites and how little is the difference between that and the ordinary word Rickets Certainly so little That the vulgar pronounciation is not wont to be greatly solicitous about so smal a difference But we trifle too much in staying so long upon these trifles Let the Greek Name therfore of the Disease be nósos Rachitis or Rachites if the word may be allowed to be of the common Gender or tes Rácheos in Latin Morbus Spinaliâ— vel Spine Dorsi and by coyning a Latin Substantive out of the greek Adjective Rachitis idis let the ordinary English name Rickets be retained or in stead of it to gratifie more curious ears you may substitute the Rachites And thus much if not too much of the Name CHAP. II. Anotomical Observations collected from the Dissection and Inspection of Bodies subdued and killed by this Disease BEfore we attempt an enquiry into the Nature and Causes of this Disease we hold it convenient to premise some few certain and undoubted things as being obvious to the Senses which both demonstrate the real existence of this Disease and may also be cast for a foundation whereon to build the Superstructure of our judgment opinion concerning this new Disease For we would not have any man to imagine that we here treat of some Fictitious Imaginary Evil much less to expect that our Opinion should be credulously embraced without examination But this we rather aim at That the matter of our Discourse to all possibility may be known and preconceived in the very entrance that we may confirm those things which we shall propose by those things that are obvious to the Senses as occasion shall require and that the Reader being instructed in these may become a competent judge of our Reasons and with the more facility be able to interpose his judgment concerning each of them We attest therfore that many of us have been present at several Dissections of Bodies which have been separated by this Disease and that we will in this Chapter briefly and faithfully declare those things which we have hitherto Observed by long experience and frequent Dissections namely Those things which we have seen with our eyes and have handled with our hands In the mean time Two things are here to be premonished The former is That the Reader carry in his memory That the dead Bodies which we opened were most vehemently afflicted with this disease whilest they were animated for they are supposed for the most part to have yeelded to the very magnitude of the Disease and therefore he must not expect that magnitude of the Affect or Symptoms which we here describe in other Bodies yet living or newly besieged For every Disease is moved to a Consistence and then also Nature being oppressed and unable to maintain the conflict groweth worse and worse The latter is that the Reader take notice That almost all Diseases in processe of time do unite unto themselves other affects of a different kind and therefore that chronical Diseases are for the most part complicated before death Let him not therfore imagine that every preternatural thing that is found in dead Bodies though destroyed by this affect must of necessity belong to this evil for perhaps it may rather have reference to some other Diseaâ—e supervenient upon this before death then to this very Malady And the truth is Anatomists through inadvertency and want of due regard to this Caution have fouly ered in their Observations whilest they ascribe those things which concern another Disease to another wherewith it was complicated before the dissolution The best prevention therefore or rectification of this error is Not to make a rash judgment from the inspection of one or two bodies but first by a reiterated and sedulous experiment to be able to distinguish what things perpetually occur what for the most part what frequently and what but seldome in the dissected bodies that have perished of the same Disease for you must know That whatsoever is not perpetually conspicuous in the opened Bodies dissolved by the same Disease cannot appertain to the intimate and chief Essence of it for neither the Disease it self can have an existence being separated from its Essence nor the Essence being separated from the Disease But enough of these
things let us now proceed to the Observations themselves These our Anatomical Observations are distinguished into those which do extrinsecally occur the Body being not yet opened and those which present themselves only upon the Dissection of the Body I. These of the former kind are they which are outwardly visible upon the first appearance of the naked dead Body 1 An irregularity or disproportion of the parts namely The Head bigger then ordinary and the Face fat and in good constitution in respect of the other parts And this indeed hath appeared in al those whom hitherto we have beheld to perish by this affect one only excepted who together with this Disease had suppurated Lungs and was pined and disfugured with the Physick Yet he also throughout the whole progresse of the Disease was full faced and had his head somewhat big but for about fourteen dayes before he Deceased on a sudden all the fleshy parts about his head consumed away and his face was like the picture of Hippocrates not without the just wonder of all those who beheld so sudden a change 2 The external members and the muscles of the whole Body were slender and extenuated as if they had been wasted with an Atrophy or a Consumption This for so much as we know is perpetually observed in those that die of this Disease 3 The whole Skin both the true and also the fleshy and fattish Membrane appeareth lank and hanging and loose like a Glove so that you would think it would contain a far greater quantity of flesh 4 About the joynts especially in the wrests and ankles certain swellings are conspicuous which if they be opened not in the fleshy or membranous parts but in the very ends of the bones you may perceave them to be rooted in their appendances and if you will file away those prominencies of the bones you will easily perceive them to be of the same similary substance with the other parts of the bones 5 The articles or joynts and the habits of all the external parts are less firm and rigid and more flexible then at another time they are observed to be in dead bodies and in particular the Neck after death is scarce stiffe with cold at least much less then in other Carkasses 6 The Brest is outwardly lean and very narrow especially under the arms and seemeth on the sides to be as it were compressed the Stern also is somwhat pointed like the Keel of a Ship or the breast of a Hen. 7 The top of the ribs to which the stern is conjoyned with gristles are knotty like unto the joynts of the Wrest and Ankles as we have already said 8 The Abdomen indeed outwardly in respect of the parts continent is lean but inwardly in respect of the parts contained it is somwhat sticking out and seemeth to be sweld and extended And these have been our Observations before the opening of the bellies II. The Abdomen being opened we have Noted these things 1 The Liver in all that we have dissected hath exceeded in bignesse but was well coloured and not much hardned nor contaminated by any other remarkable vice We desire som bodies should here be excepted in which other Diseases before death were complicated with this as in a Dropsie an extream Consumption we remember to have hapned 2 The Spleen namely so far as hitherto it hath been lawful for us to observe for the most part is not to be contemned whether you consider the magnitude the colour or the substance of it notwithstanding we do not deny but it may otherwise happen in regard of a complication with other Diseases 3 We have sometimes espied a wheyish water to have glided into the cavity of the Abdomen but indeed not often nor in any great plenty 4 The Stomach and Guts are somewhat more infected with flatulent humors then sound bodies usually are which partly may be the cause of that extension of the hypochondriacal parts above mentioned 5 The Mesentery is sometimes faultlesse and sometimes affected with glandulous excrescences bigger then ordinary if not with swelling bunches But concerning the sweet-breadwe declare nothing for a certainty only we suspect that obstructions if not a schirrhus may sometimes invade that part But thus we delegate to the enquiry of others 6 The Kidneys Ureters and Bladder unlesse there be a concomitancy of some other Disease are laudably sound We observe in general of all the Bowels contained in this Belly that although the parts containing them as we have noted above are very much extenuated and emaciated yet are they as large and as full if not larger and fuller then those seen in sound bodies as hath been said of the Liver III. The Sterne being with-drawn these things have presented themselves in the breast 1 A certain adherence or growing to of the Lungs with the Pleura which hath been more or lesse discernable in all the Bodies which hitherto we have cut up Yet we suppose that this affect may happen without any such nourishment although in the advancement of the Disease for the most part it cometh before the Patient die 2 The stopings or stuffings of the lungs are no less frequent especially in those coadhering parts Hard humours also engendered by a thick viscous and blackish bloud sometimes in one sometimes in many of the strings of the Lungs yet are not these alwayes conspicuous many times also Imposthums and Ulcers 3 One amongst us doth attest That he once saw glandulous knobs and bunches so numerous That they seemed to equallize if not exceed the magnitude of the Lungs themselves They were scituated on both sides between the Lungs and the Mediastinum that is the Membrane that divides the middle belly and were extended from the Canel-bone to the Diaphragma 4 In the cavity of the Breast we have sometimes seen a collection of wheyish waters indeed more frequently then in the cavity of the Abdomen but not in all 5 One amongst us hath likewise seen this affect complicated with a great Impostume and with the Ptysick the Stern being removed all the Lungs on the left side were infected with an Impostume and on every side growing to the Pleura and the humour being lightly crushed a copious thick and stinking Matter of a yellowish colour flowed out thorow the sharp artery into the very mouth The outward Membrane of the Lungs whereby they firmly adhered to the Pleura appeared thicker then ordinary and by the mediation of it the strings on that side did so grow together that you could scarce distinguish them â—or such the same Membrane also involved both the Lungs and also the Impostume it self which being opened the magnitude of the Imposthume was discernable which by the estimation of those that were present contained at the least two pound of water 6 The kernel in the Canel-bone in Childhood is alwayes observed to be great and perhaps greater yet in those who have died of this Disease IV. The Skull being
sawed thorow in a circular Figure and the little cover being removed we have observed these things 1 The Dura Mater hath been more firme and adhered to the Skul in more places then is usual in men of ripe years perhaps the same may be observed in other Children not affected with this evil although as we suppose not in so great a manner for certain it is That in new born Infants there are many and straight connexions between the Pericranian and the Dura Mater which are afterwards broken off and are scarce discernable 2 In some Bodies that we have dissected between the Dura and the Pia mater and in the very ventricles of the Brain we have found wheyish and waterish humours from whence it is manifest That this affect is complicated with the Hydrocephalus 3 We have found the Brain in others that we have opened to be firm and inculpable and not overflowed with any waterish congestions 4 Lastly We have observed in some Bodies lately opened That the Carotides have exceeded their just proportion and so also have the jugulary Veins but the Arteries and the Veins which are delated to the outward parts were of an unusual slendernesse But whether or no this be perpetual in this affect we cannot yet witnesse by an occular testimony yet we conjecture That it happeneth so perpetually but it came not sooner into our minds to examine it since the beginning of our Anatomical enquiries into this subject These things being premised our next Disquisition shall be to find out the Essence of the Disease CHAP. III. Certain Suppositions are proposed for the easier finding out of the Essence of the Disease First of the Essence of Health Secondly of the Essence of a Disease Thirdly of a threefold Division of Health and Diseases The Explication of the third Division and the Vse of the same The Description of a natural Constitution and the exaltation of it The Fourth Supposition of the Combination of three Constitutions in the same parts THat we may proceed the more distinctly and clearly in the finding out of the Essense of this Disease we judged it very advantagious to premise these subsequent Suppositions I That the Essence of Health doth consist in some Constitution of the Body according to Nature But seing this is twofold in the kind one Essential and necessary respecting the tò esse simply which during life continueth immoveable and immutable under various affections and is indivisible The other Accidental having reference to the tò bene esse which in respect of the whole Animal is both moveable and mutable and hath a great latitude and can be present or absent without the dissolution of the whole Health consists not in the former but in the latter Constitution II. That the Essence of a Disease in like manner consisteth not in the Essential Constitution For so the dissolution of the whole would by and by follow But in the Accidental Constitution namely such an one as in respect of the whole can be present or absent without its dissolution We have said and not without reason that this Constitution wherein Health and Sicknesse are founded is moveable and accidental in respect of the whole for even this also in respect of some part may be essential as for example a finger being cut off a Disease ariseth in the defective number of the parts which in respect of the whole is founded upon an accidental Constitution for that finger may be present or absent without the dissolution of the whole but in respect of the lost member it is founded upon an Essential Constitution for this Disease being supposed the Essence of that finger perisheth III. That the Constitution wherein the Essence both of Health and Sickness consisteth admits a threefold manner of division or distinction in the method of Discipline The first is somewhat thick and is resolved into parts altogether Concrete namely It proceedeth Kata topous according to the division of the parts from head to heel The second is purely abstracted and searcheth out all the Elements of the moveable Constitution from whence cometh the division of Diseases into similar organical and common and then again those various subdivisions into distempers faults of figure superficies cavities and passages of magnitude number site and continuity The third is as it were a middle manner and although it hath been hitherto neglected yet we dare avouch That it may have its use and that no contemptible one in the handling of Diseases and the finding out of the causes of the Disease and it is divided into a Constitution Natural Vital and Animal The first is proper to and inherent in every part absolutely competible to it and without any dependance upon the other parts according to the Essence of it simply This remaineth a while after death till it be resolved by Putrefaction Ambustion simple Exiccation Mummification Petrification and the like violent Causes This Constitution in respect of its simple Essence doth not depend upon those Members which minister an Influx but it dependeth upon them both in respect of its Conservation and likewise of its Operation For the vital influx ceasing after death which is as it were the salt and condiment of it quickly perisheth and as long as the creature liveth this is variously affected by the influxes and thereupon the actions are either promoved or interupted The Second is the Vital Constitution which is produced by that continual influx from the heart thorow the arteries into the parts of the whole Body This also it admitteth degrees and is often subject to variations more or lesse and sometimes also seemeth to suffer a kind of eclips as in a swouning a syncope c. yet it persevereth from the beginning to the last period of life at least in its fountain and in some other parts The Third is the Animal Constitution which is derived from the Brain thorow the Nerves into the Organs of Sense and Motion This is many times totally wanting in many parts the life notwithstanding remaining yea it might for a long time together be defective in several parts or all the parts did not respiration which is absolute necessary unto life depend upon it These Constitutions therefore keep such a connexion between themselves that the second doth eternally and continually presuppose the existence of the former and the third of the second but there is not back again so absolute a dependance between them because as we have even now said the former can for some time subsist without the second and the second commonly altogether without the third And these three Constitutions may in most bodies be manifestly perceived yet we affirm not that they may be found in all The Natural indeed and the Vital are wanting to no part but the Animal is defective in the Bones though the teeth will admit some doubt gristles perhaps ligaments and some substances as of the Liver Spleen c. we assert therefore this threefold Constitution to be in all those
Palsy the excrements are many times unduly retained by reason only of the astonishment and insensiblnesse of the guts the other constitutions being sound Therefore in these cases when some natural action is hurt we must not presently conclude that the natural Constitution is first vitiated but we must with dilligence enquire out that Constitution which is first vitiated for that is to be looked upon as the root and first essence of the evil in like manner if some vital action be depraved we must not presently infer that the vital Constitution is primarily vitiated because sometimes the first Origin is more rightly deduced from the natural or perhaps the animal Constitution as for example Through the intensivenesse of cold a finger is mortified by inflamation in this case it is true that the influx of the vital bloud is plainly intercepted yet the beginning of that interception must be sought out in the natural Constitution of that very part so benumned So also in a Convulsion the circulation of the bloud is perhaps something disturbed and interupted but the first depravation must be ascribed to the animal not to the vital Constitution On the contrary in a Feaver the Head is invaded but the source of the evil will peradventure be found out in the vital Constitution so perhaps the Flesh is wasted and al the natural Spirits are decayed yet the root of the evil wil be found out in the vital not in the natural Constitution So that any Constitution of the three before named may be in several Diseases sometimes the first sometimes the second and sometimes the third cause of vitiated actions Not only many other parts of the body yea simply al the sensible which exhibit not an influx neither are subservient as delatory parts do naturally admit this threefold Constitution but besides also even the Heart it self and all the arteries and the Brain and al the nerves so that the Brain excepting the fault in its natural Constitution may be cherished and helped by the vital Spirit which is transmitted thorow the veins and the arteries being wel affected or vitiated and hurt if that be ill affected And after the same manner also may the Heart by the animal Spirit which hath an influx thorow the recurent nerve of the sixth pair the arteries also by the animal influx thorow the nerves by a way perhaps not yet found out And Finally The Nerves also by the vital Spirit deduced thorow the Arteries CHAP. IV. That the Essence of this Disease consists not in the Animal or Vital but in the Natural Constitution not as Organical but as Similar Three Limitations are Propounded THese things being Presupposed We shal proceed to enquir in what Constitution of the parts the first Root or Essence of this affect is lodged Be the first Conclusion therefore this The First Root of this Affect is not in the Animal Constitution or in that which dependeth upon the Influx of the Brain into the parts Indeed we confesse that al the nerves which without the Skul proceed from the spinal marrow are found to be loose and weak in this affect yet this doth not here seem to arise from a defect of the influx of the Brain which we thus prove First the loosnesse and weaknesse of the nerves which cometh primarily from the Brain is almost alwayes consociated with somnolency and drowsinesse but this Symptom happeneth but rarely and by accident only in this affect Secondly As we remember we never knew the Palsy or the Apoplexy to supervene or follow upon this Disease but it ought necessarily so to do and that very often at least in the confirmation of the Disease if this loosnesse and weakness of the nerves should take beginning from a defect of the influx of the Brain Thirdly We have observed the Brain to be sufficiently firm and inculpable in many dissected after death Fourthly For the most part those that are afflicted with this evil are ingenious in respect of their age which doth evidently attest the vigour and vivacity of the Brain The Second Conclusion The first root of this affect is not in the Vital Constitution or in that which dependeth upon the Influx of the Heart into the parts An unequal distribution of bloud indeed almost if not altogether perpetual may be observed in this affect neverthelesse the chief reason of this inequality must be ascribed not to the inequasity of the influx of the Heart or Arteries but to the unequal reception and unaptnesse in the parts themselves to receive it for the Heart and the Arteries do for their part indiscriminately or equally distribute the bloud with the Spirits every way into the parts But if it so fal out that an Artery of some part be interupted in his function by reason of the benumnednesse and stupefaction of that part or the parts adjacent there is a necessity that the bloud must be minutely transmitted thither and so unequally in respect of the other parts which expeditely and aptly receave the bloud Therefore in this case this inequality of distribution doth properly and primarily depend upon a preexistent fault without the artery pertaining to the natural Constitution of the parts Object But some may Object Although perhaps the aforesaid inequality hath no dependance upon the Heart yet it may so happen that a weak Pulse may suffice to distribute the bloud thorow the lesser Circulations in the inner parts which nevertheless may not be altogether so sufficient to undergo that duty thorow the greater Circulations in the outward parts which are more remote from the Heart the fountain of bloud Answ We Answer That this Objection was formerly of so great importance with one of us that he supposed such an inequality of the vital influx did belong to the prime Essence of this Disease and did therefore endeavour to deduce the reason of the first Symptoms from it But after second thoughts the matter being more neerly and deeply examined he was of Opinion That this inequality of the vital influx had no relation to the primary but to the secondary Essence of the Disease But we return to the solution of the Argument And First we grant indeed that in this affect there is an unequal distribution of the bloud and that in the internal parts and in the head it is more liberal in the external more sparing Secondly we grant that the Circulation of the bloud may be kept in the inward parts even although no Pulse apear in the outward parts but this happeneth only in a vehement either weaknesse or oppression of the vital Spirits as in a swouning and a strong hysterical paroxism or fit of the Mother in which affect some that have been accounted for dead have been seen to revive again Thirdly we grant that a more liberal Circulation of the bloud may be in the internal then the external parts yea and in some one external part more then in another as it happeneth in the inflamation of some external member
the Lungs but we attest withal That we have seen some Infants yea Boys lightly affected with this evil in whom there was no suspicion of vitiated Lungs for there was no cough no impediment of respiration which necessarily is an individual companion of the obstruction of the Lungs Thirdly Because a sufficient reason of all the Symptoms proper to this Disease may more cleerly and easily be derived from other fountains as we shal see anon And thus we have sufficiently proved That this affect in respect of the first Essence of it consists not in the Organical Constitution of the natural parts The same arguments wil more effectually convince more might be produced but we judge accumulations unnecessary That this evil is not radicated in the continuity of the natural parts so that there needs no more words to prove it The Fifth Conclusion This Disease is primarily rooted in the similary Constitution of the natural parts And therefore in respect of the radical Essence therof it is a similary Disease And because a similary Disease as such is not perpetually Simple but somtimes variously compounded namely a Distemper is either Simple or Compound and this becomes such not only by the first qualities among themselves but perhaps by hidden qualities conjoyned together or which is more agreeable to our Conceptions especially in the present business by a kind of sure proportion and medification of the inherent Spirits We judg this to be a Compound Disease and we assert the prime and radical Essence thereof to consist in a cold and moist Distemper with a Defect and stupefaction of the inherent Spirits concurring in the inherent constitution of the parts primarily affected But before we proceed to an higher Explication of this Opinion we wil premise some Limitations of it The First shal be this That in this Disease some parts of the Body are Primarily and others Secondarily affected And truly to us the External parts seem sooner to be affected than the Brain and Bowels as we shall declare more at large when we come to speak of the parts affected The Second is this That in those parts alone which are Primarily affected do labor under a notable cold Distemper with penury and stupefaction of spirits For the Brain perhaps and the Bowels may be moderatly hot and sufficiently abound with Spirits by reason of the copious vital influx and moisture may exceed in them by reason of the affusion of our over-plentiful aliment but the other External parts are alwaies affected with a cold and moist Distemper and a benumedness of the natural Spirit c. Wherupon we assert that in this Disease they are primarily affected and that they alone are the seat of the first Essence of this Disease Be this the Third All the External parts and those first affected do not equally labor under a cold and moist Distemper and with benumedness of Spirits c. For the Ligaments Tendons and Nerves are in their own nature more cold and less moist the Muscles or fleshy parts are rather more moist and less cold the skinny parts usually retain a mediocrity yet al the said parts recede more or less from the natural towards a cold and moist temper And in like manner although some of the said parts do require a greater plenty and activity of Spirits than others yet al of them a just proportion being observed to the plenty and activity respectively due to each of them are defective and destitute of that just proportion CHAP. V. The preposed Opinion is examined by Parts First That this Disease is a cold Distemper An Objection and the Answer thereunto That it is moist That it consisteth in the penury or paucity of the Spirits An Objection with the Answer Finally That this Disease consisteth in the stupefaction of the Spirits NOw let us more neerly examin the Opinion proposed and assert it by parts First That the parts first affected do labor under a cold distemper may be proved First from the unequal and diminished nutrition of the said parts for as the inborn heat when it is augmented to a just proportion doth very much conduce to further the concoction of the Aliment so if it be too remiss it easily retardeth and lesseneth the same Secondly The same distemper is proved from the slowness and unaptness to motion and also from the aversation to exercise and desire to rest For as the activity and agility of the Body is attributed to the Heat so the tardity and slothfulness of it is in great part ascribed to Cold Namely supposing as before that this slothfulness hath no dependance upon the fault of the animal influx Thirdly It is further confirmed because this Disease many times followeth other accute Diseases whereby they end not seldom after the Wast or Consumption of the Natural heat in a cold distemper Besides It also receiveth Chronical Diseases which extenuate the Body and such as in any manner are prone to leave a cold distemper behind them as Pertinacious Obstructions the Scurvy Cachexy c. Moreover Because it succeedeth the importune suppression of Scabbedness and Impetiginous effects as we have often observed when the Scabs have newly broken out again and the Itch is revived such Boyes have been easily restored to health because by that means the Natural heat is reaugmented in the outward Members Lastly Because many times it happeneth after a continual use of cold thick and viscous aliment after surfeting and idleness and the like evident causes either diminishing or overwhelming the Natural heat Fourthly It is yet more plainly evinced because those helps which excite augment and cherish the heat in the outward parts as various agitations rubbings and anointing of the Body do contribute a large share to the advancement of this Cure These things being all cast together into a heap it is sufficiently conspicuous that a cold distemper of the Natural constitution of the parts first affected is contained in the primary essence of this Disease Object But here we meet with a specious Objection That a little Feaver especially a slow one or such as is erratical and wandering is frequently conjoyned with this affect which at the same time seemeth absolutely inconsistent with a cool distemper For all Feavers by all men are accounted to be a hot distemper which is diametrically opposite to the said essence We Answer that we may not here interpose any thing concerning the essence of a Feaver we freely grant for so much as concerns the present Question that a Feaver is a hot distemper but this doth not chiefly consist in the Natural constitution of the parts but in the vital constitution namely in the influent heat preternaturally affected For a Feaver is not some private Disease but universal and is diffused from the Heart through the Arteries in and with the vital Spirit be it either overheated or otherwise viciated For this preternatural heat hath only a respect to that inherent as a cause potent and able variously to alter it
du irritation proceeding from the weak resistance of the parts which receav the Blood from the Arteries doth diminish the vigor of the pulses Secondly The same is yet more evidently seen when the Pulse is augmented by the motion of the Body for in any violent motion almost all the Muscles are stretched by reason wherof they somwhat more resist the passage of the Blood hereupon the Arteries are provoked to contention their heat is encreased and therefore more nimble strong and full Pulses are emitted Thirdly As the inflamation of a part doth sensibly irritate the Arteries thereof so it exciteth a more vehement Pulse and bauseth a more liberal Flux of the Blood The same may be said of pain Fourthly Hither also must be referred the bruising of any part For a bruised part doth difficultly receive the Blood flowing to it hereupon the Arteries provoked they beat more strongly and swell the bruised part resisting them into a tumor This might be demonstred by many more examples but we conceive these to be very sufficient and satisfactory Moreover It must be noted that the parts caused by the reception of the Blood in the Arteries may be very great and yet not sufficient effectually to irritate the Arteries in which case it rather remitteth and disturbeth them encreaseth or facilitateth the force of the torrent of the Blood For that opposition of it self interrupteth the channel of the Blood thorow the substance of the parts but becaus it doth withal irritate the Arteries to emit more lively strokes it quickneth the torrent of it by accident Wherfore we are here compelled into another involuntary digression by distinguishing between the resistance of the part that irritate and that which doth not or doth very little irritate the instances already alledged will suffice for the former and to explain the latter we will ad a few First Therefore there is a resistance that totally suppresseth the torrent of the Blood Such a one is caused by a strong ligature which doth altogether intercept the pulse in those parts beyond it neither yet doth it irritate the Arteries on this side of it because it overcometh all the force of the Artery beyond the Ligature and doth wholly break off the action thereof The same is seen in the parts mortified with cold or by other causes corrupted with an inflamation and perhaps in some hard swellings contractures and some confirmed wounds Secondly There is a resistance pressing down the Arteries even by the compression of the Arteries and this happeneth in a ligature indifferently bound Also in the compression of an Artery by some tumor in the adjacent parts as in a raw swelling also in a compression from any outward cause many things which belong to the lying down on the right side especially and the left are referred hither so in tumors on the right side the lying on the left side is many times endured with the least patience by the compression of the sound parts by those that are swelled c. and this compression however it resisteth the circulation of the Blood yet it doth not seem much to irritate the Arteries because it doth no less intercept the very pulsificative force then it diminisheth the action thereof Although perhaps it may somtimes irritate in the Lungs by reason of their vehement heat just as it useth to do in aching and inflamed parts Thirdly There is a resistance in part repressing the circulation of the Blood but without compression of the Arteries nor yet totally suppressing them nor very much irritating the Artery Such an one occurreth in obstructions caused by cold slow thick and moist humors which although they may somwhat retard the free passage of the Blood yet they provoke the Artery very little because at the same time they superinduce a certain benummedness in them at least a cold distemper as also in the Blood which they contain The same almost may be said of paralytical members but that in these a benummedness is more evidently introduced in their Arteries and the channel of the Blood is less retarded in them Moreover We affirm secondly that the parts first affected in this Diseas do not sufficiently irritate the Arteries by which the Blood is distributed through them For although in these parts both by reason of their solidity and also in respect of their coldness we grant some kind of resistance yet it is extream feeble and slow and very little provoking First because in those paris a moist is conjoyned with the cold distemper which of it self tempereth and qualifieth all manner of provocations Secondly Becaus there is a penury of inherent Spirits which otherwise where they abound are wont to cherish the vigor of the Arteries and the blood contained in them Thirdly Because those parts are loos weak and soft and therfore more prone to receive with facility that which the Arteries send in than to exasperate them by resistance And that the Arteries do not conveigh the Blood by any vigorous and considerable force into these parts is manifest by this sign becaus after the influx of the Spirits and the Blood they still continue loos soft and feeble when on the contrary strong Pulses are wont to render the parts otherwise weak ful swoln and stiff on a sudden Fifthly becaus the first affected parts have in them a similary lubricity For as the superficiary or external lubricity suffereth any thing to pass by without attritition so also the Internal or similary lubricity facilitates the circulation of the Blood so that the passage is accomplished with very smal opposition We conclude therfore that the proirritation of the Arteries is in this Diseas deficient and therfore that the Arteries are very dully and ineffectually excited to strengthen the puls Having at the length weighed al things which we propounded concerning the causes which actuate and advance the Blood in his circulation it sufficiently appeareth that the circulation of the Blood in this affect is easy and expedit enough but that it is lessened and passeth dully thorow the parts first affected both by reason of the sluggishness of the Arterious Blood contained in the Artery of the said parts and also becaus of the defective heat and slenderness of those Arteries and finally in regard of their ineffectual irritation And let these things suffice concerning the two former faults belonging to the distribution of the Blood in this affect namly the diminution and slowness therof It remaineth in the next place to examine the inequality of that distribution CHAP. XI The Inequality of the Distribution of the Blood in this Affect THis inequality is to be estimated by a comparison of the greatnes swiftness of the current of the Blood made in divers parts For if the circulation of the Blood according to a Geometrical proportion be either equally smal and slow or equally great and swift that must be judged equal by the scope of the present enquiries on the contrary if in some
hath been said that the Tone of these parts is somwhat viciated in this affect by reason of their exceeding loosness slipperiness softness weakness and internal lubricity which qualities do most evidently enfeeble the just Tensity of the said Parts Although therfore that the Brain in this affect do for his part yield a due and just influx yet it is scarce possible nay it is altogether impossible that it should communicate that Tensity in a sufficient degree to to the Spinal Marrow without the Skull to the Nerves from thence proceeding c. because of the distemper benummedness and penury of the inherent Spirirs Thirdly The Symptoms in this Diseas that relate to the Animal faculty do most clearly confirm the same thing For Children afflicted with this Diseas do from the very beginning therof if they be compared with others of the same age move and exercise themselves very weakly and are less delighted in manly sports but upon the progress of the affect they are avers from any vehement motion as they stand upon their feet they reel wave and stagger seeking after somwhat to support them and can scarce go upright neither take they pleasure in any play unless sitting or lying along or when they are carried in their Nurses Arms Finally the weak Spine is scarce strong enough to bear the burden of the Head the Body being so extreamly extenuated and pined away All which things do abundantly demonstrate that the Tensity of the parts subservient to motion is less rigid in this affect than is justly requisite in time of waking If therfore that due Tensity in time of waking be a part of the Animal Constitution which we here suppose that being viciated must without all doubt necessarily constitute a Diseas in the Animal Constitution and seing that this fault hath no primary dependance upon the Brain it self but upon the inherent Constitution of the first affected parts it ought in all Reason to be reputed a Secondary fault in respect of the Animal Constitution Yet here we meet with a scruple Som may demand Why the sens as well as the faculty of motion is not vitiated in this affect The reason is plain a far greater tensity strength and vigor of the Nervs is required to exercise the motive then the sensitive faculty For almost the gentlest motion of the Nervs is sufficient for sense but not for motion So you may observe in the motion of any Joynt that the Muscles which move it are very hard and stiff but that hardness being remitted yet the sensation is easily performed Nor doth that any way hinder because that somtimes in the Palsy the sense is somwhat stupified and the motion remaineth for the Palsy is an affect very different from this for in that the primary fault resides in the very Animal Constitution therfore it may so fal out that both the sense and the motion may be equally affected Besides when perhaps one Nerve doth want the du influx of the Brain and another which is extended to the muscles of that part doth enjoy it it may be that for this cause also the sense may be abolished and yet the motion may continu although this case is not so frequent and that the motion is more usually taken away the sense remaining But we have said enough concerning this matter And thus at length we have produced those things which we have meditated of the integral Essence both primary and secondary of this Diseas and that with as much perspicuity as a matter so difficult and unsearcht into would bear In the next place we shal address our selvs to the examination of the causes of this Diseas CHAP. XV. The Causes of the Rachites And first those things which concern the Parents WE have largely explained above both the Primary and Secondary Essence of this Disease And indeed we have sufficiently demonstrated in the same place the dependance of the secondary upon the Primary Essence It may not therfore be here expected that we should again purposely and in particular discuss the causes of the secondary Essence which we have handled before It may suffice that we have found out the causes of the secondary Essence Yet if any cause do occur which at once hath an influx as wel into the primary or secondary Essence of the Diseas we shal not refuse to take notice of it by the way as we proceed But omitting al diligent search into the several kinds of causes we purpose to contract this our discours chiefly to two heads The former containeth the Infirmities and the diseased dispositions of the Parents which perhaps have so great an influence upon the Children that they suppeditate at least a proness to this affect and infer an aptitude to fal into it if they have not actually fallen into it from their very birth The latter comprehendeth the accessary causes of this Diseas namly those which happen to children after their birth Concerning the causes of the first kind we meet with a Question at the first entrance How and whether this Diseas may be said to be hereditary That we may the more succesfully proceed in the determination of this question an hereditary Diseas must be distinguished into that properly and that improperly so called And indeed an hereditary Diseas properly so called is ever supposed to be preexistent in both or one of the Parents and from thence to be derived to the Progeny But an hereditary Diseas improperly so called is not supposed to be preexistent in the same kind either in both or one of the Parents yet the same fault must always necessarily precede perhaps altogether of a different kind at least in one of them by vertu wherof a certain disposedness is imprinted in the children wherby they are made obnoxious to fal into this improperly hereditary Diseas Moreover An hereditary Diseas properly so called is twofold either in the conformation as when a lame Person begets a lame a deaf Father a deaf Son or a blind a blind or in the similary Constitution as when a Gowty Father begets a Gowty Child It is to be noted that in the first kind ther is an hereditary fault inherent in the first affected parts of the Conformation But in the latter there is no necessity that a Diseas of the same kind with the Diseas of the Parents should be actually inherent in the Embryon from the first formation But such a disposition imprinted by one or both of the Parents is sufficient which as the life is lengthened may be actuated into the same by the concours of other intervening causes Again an hereditary Diseas improperly so called may be likewise twofold namely either in the Conformation or in the similary Constitution In the formation as when neither of the Parents is blind pore-blind lame c. yet have begotten a Son blind pore-blind or lame by the very fault of the formation For in these cases that very fault which is sensible and conspicuous in the
Issu flowed from som fault in the Parents although perhaps of a different kind and so it may be called though improperly an hereditary Diseas In like manner in the similary Constitution of the Issu there may reside an hereditary Diseas improperly so called as when a Melancholy sedentary or an intemperate Parent begetteth a Child subject to the gowt or the Cachexia although perhaps the Parent was never troubled either with the one or the other These things being thus premised we approach neerer to the resolving of the Question And first we affirm that this Diseas is not comprehended under the former species of an hereditary Diseas properly so called For that consisteth in the formation but this Diseas according to its primary Essence is a similary Diseas as we have before demonstrated and very rarely bewrayeth it self from the very Birth much less from the very conception and formation And for the same Reasons we also affirm this Diseas belongeth not to the former kind of herditary Diseases improperly so called Which after a like manner consist in the formation of the parts and are begun presently after the first formation Secondly We say that so it may com to pass that this Diseas may fall under the second species ptopounded of an hereditary Disease properly so called namely that which consisteth in the similary Constitution Yet we cannot affirm this as certain and undubitable becaus the Children which we have hitherto known to be afflicted with this Diseas have not lived to such maturity of years as to beget Children and therefore we cannot otherwise suppose then by probable conjecture whether or no their progeny should be infected with this affect as it were by right of inheritance Thirdly We say that in many Children this Diseas doth directly fal under the second species of an hereditary Diseas improperly so called For according to the primary Essence of it is a similary Diseas and although it hath not yet been so long and sufficiently discovered unto us that we can determin the effects of it how they wil operate in the Progeny yet frequently in the present progeny we have observed certain Rudiments of this affect to have been derived to many from one or both of the Parents So that although neither of the Parents were in their infancy or child-hood afflicted with this Diseas yet som proness and disposedness to this Diseas hath presently appeared in their little Infants especially in those whose Parents before coition were predisposed by som vitiosity of body or error of life to transmit this pollution to their Issu but those defilements of the Parents which dispose them to propagate Children obnoxious to this affect we shal by and by reckon up in their order from whence also a higher confirmation of this assertion may be deduced Fourthly We say although the affects of the Parents do frequently imprint a certain propension in the Issue to fal into this Diseas so that this Diseas may be therefore reputed in the second acception of an hereditary diseas improperly so called yet it very rarely happneth that this Diseas doth actually break out before the birth of the child One amongst us attesteth that once and only but once he saw a Child new born invaded with this Diseas And in this Child the Back-bone and the neck were so weak that they could not sustain the weight and greatness of the Head within three months after it was born the Child dyed Wherby it is apparent that he was grievously affected It seemeth conspicuous by what hath been said that Infants however they may frequently borrow from their Parents a disposedness to this affect are most rarely and seldom troubled with it before they are born but if at any time they are so prematurely afflicted that then the affect is most vehement and grievous Now a reason of the event of both these may be demanded To the former therefore we say that this Diseas doth partly consist in a cold distemper of the first affected parts and indeed an unequal one as namly being very cold in the said parts respect being had to the temper of the Head and the Bowels and that hereupon that unequal coldness of those parts is of great moment in this Diseas and that also in respect of the very inequallity For this contributeth much to that unequal and deficient distribution of the Vital Blood to the parts first affected Seing therfore at such time when the Embryon is carried in the womb this inequallity of the temperament of the first affected parts may be much corrected and averted by an equal heat wherby the womb may on every side embrace and cherish the body of the Embryon it followeth that the gestation doth very much drive away this Diseas at least retard the invasion of it For the body of the Womb being all about equally warmed with an even heat and equally embracing and cherishing al the parts of the Embryon doth not easily permit one part to wax colder then the rest and by that means to be cherished with a defective and sparing afflux of the Vital Blood Wherfore seing that that very inequallity of heat and comfort are Essential parts of this Diseas and without which this Diseas cannot consist it is no wonder that the womb strongly resisting these parts of the Diseas and the invasion therof doth for the most part protract it at least during the impregnation As for the latter part of the question propounded namly Why Infants who before their birth were infested with this Diseas are more grievously and dangerously afflicted We say according to that Aphorism of Hippocrates that a Diseas which holdeth the least congruity with the condition of the Diseased is more dangerous then the contrary as a Feaver threatneth more danger to an old man than to a yong and in the winter then the summer For a Diseas that hath som correspondence conformity with the condition of the Diseased requireth a slighter caus for its introduction but that which is contrary therunto argueth the magnitude of the caus which notwithstanding resistance and opposition will produce his effects In the present Diseas therfore if the equal and impartial heat of the womb cannot restrain the propensity of the Embryon to this affect but it wil fal into it som vehement cause must needs be imprinted by the Parents and the seminal Principals extreamly weakned Therfore there is little hope when the Embryon laboring with this Diseas is born neither wil a prudent Physitian attempt the cure without som Prognostick of imminent danger Moreover instead of a Corallary we substitute another Rule having som affinity with the former although perhaps it be not yet certain and approved namly that Children by how much the sooner after their birth they are invaded with this Diseas so much the more difficulty caeteris paribus are they delivered from it And let these things suffice concerning the Question propounded We wil now apply our selvs to the division and
properly relate to the secretive and excretive faculty of some Bowel or some other partt and is destinated to be severed and evacuated from it and therefore though the errors of the first concoction are scarce corrected in the second or third by Alteration yet they may be mended by local motion or excretion made from some part of the Body the unprofitable parts being separated and rejected In like manner the mass of blood being any ways preternaturally altered or infected with some Humor the peccant matter which cannot be otherwise subdued by Alteration is quickly exterminated perhaps by excression made from some part or Bowel unless withal the secretive or expulsive faculty thereof be hindred therefore it must needs be of great moment for a Physitian to know what Humors are particularly predominant in any Diseas and by what determinate ways they may be most properly spied out according to the intent and purpose of Nature For there are as many subordinate species of things spied out as there are distinct substances of the Bowels and other parts destinated to that office in the Body For it is credible that the Liver doth cast out one thing the Kidnies another the Sweet-Bread another the Spleen another the Stomach and Guts another the Lungs another the Brain another the Stones the Matrix the Kidnies the Kernel under the Canel Bone the glandulous parts of the Larynxes the Throat and Jaws another the scarf Skin and the Skin another For it seemeth scarce admittable that Nature should build and prepare for her self Organs of different kinds and yet should make use of divers of them for the performance of one and the same action Therfore when the excretion of any of the said parts hapneth to be restrained a certain peculiar filth will flow out from thence into the mass of Blood and so there wil be so many differences of things preternaturally retained as there are kinds of parts inservient to particular casting out and in like manner there wil be as many kinds of vitious excretion either by excess defect or depravation as there are divers wais thorow which the excretion may be made If any man demand Whether the several kinds of things excerned be sufficiently discovered and understood by us We answer that an exact knowledg is desired of that particular humor which is to be cast out thorow the new Vessel of the Sweet-Bread then in the next place what is cast out by the Kidnies the Kernel under the Canel Bone and the glandulous parts of the Larynx yea perhaps it is yet scare sufficiently known what is rejected by the Spleen For this cause therefore amongst others it seemed good unto us to supersede in this place any high and accurate disquisition of things secerned and retained either in relation to the parts and ways whereunto they belong or in order to the present affect and rather to insist on that fourfold division of Humors made by Galen namely into Choler Phlegm Blood Melancholy adding only undue transpiration and sweating For although we may doubt whether this division can deduce the humors to the subordinate Species as we have noted above more then four parts distinct in the species are evidently dedicated to the casting out of the humors yet seing that this division of the Humors is not only approved by al Classical Phisitians but that it is likewise profitable in it self and at least reduceth the Humors to certain Heads or Kinds however perhaps every kind may comprehend under it several species we are resolved for the present to insist upon it and so much the rather because under a general notion it very fitly conjoyneth and containeth both things altered and preternaturally contained within and also things to be spied out which are not yet excerned and in that respect it will eas our burden and contract our work For whilst we make our proceedings in this manner it will be needless to institute any other peculiar Chapter of the Causes of this Diseas namely of this altered which are preternaturally contained seing that they are comprehended as we have said under this Title We reduce therfore the internal Causes of this Diseas whether they be excrementitious humors retained or viciated by alteration either to Choller or to Melancholly or to Elegm and a Waterish humor or an undue Transpiration and sweating for the Blood properly so called is in this affect scarce observed to be faulty You may object That Practical Physitians do in this Diseas commonly prescribe the opening of a Vein in the hollow of the Ear observing that Evacuation to be very profitable which Reason could hardly admit unless the Blood were in some degree peccant We answer That this Remedy is available not in respect of the universal plenitude of the Blood but by reason of a peculiar plenitude of the Head it self For we have already shewed how that the Blood is uneqally dispensed to the parts of the Body and indeed illiberally to the first affected parts but to the Head superabundantly Therfore although there be not an universal redundancy of the Blood in this Diseas yet in respect of the particular Plenitude of the Head it self such a particular emptiness is perhaps profitably instituted those outward and smal Veins of the Ears being cut You may reply that we by this Answer do indeed decline the universal Plethora but that we grant a particular one of the Head which ought no less to be esteemed a caus of sickness We answer That we have at large explained this fault of the Blood when we discoursed of the unequal distribution of it unto which place it properly belongeth seing that it is a caus of the Secondary not of the Primary Essence of this Diseas and therfore a vain and superfluous repetition therof ought not in this place to be expected We will now therfore proceed to our purposed disquisition of the Humors and likewise the Transpiration aforesaid First Choller whether by this word you understand that excrementitious humor in the little Bladder and the Chollerick pore or a hot dry sharp and bitter part of the Mass of Blood or that unsavory humor that tasteth like stinking Oyl begotten and flowing in the Stomach by some corrupt aliment especially that which is fat addust or salt or certain sharp and corrosive Excrescences produced in the Body by corrupt Blood if it abound and luxuriate in the Body very probably be a caus of this affect For although it may rather seem to impugn that cold and moist distemper which is a part of the first Essence of this Diseas yet in regard that it is apt in some sort to hinder the nourishment of the Parts either by a vehement irritation of the expulsive faculty or by attenuation of the aliment and to extenuate and wast the very inherent constitution of the Parts and by consequence to consume and dissipate the Natural Spirits it may not unjustly be numbred among the causes of this Diseas For every one knows that
of the complexion wherby they maintained the former resistance may fall at last into some common Diseas For the Plica of Poland and the Scurvy are common Diseases to the Sarmatians Polanders and the Inhabitants of the Baltick Ocean and they are likewise new Diseases and as all men confess totally unknown to the Ancients But to this day it is not known that any notable or remarkable Change or Innovation hath hapned to those Regions before the breaking out of those Diseases to which you might probably ascribe the beginning of a new Diseas Wherfore we ought rather to say that those new Diseases did proceed from some ancient and original fault of the places and yet that they did not bewray themselves at first by reason of a peculiar resistance made by the Natural strength of the Inhabitants For to this very day some Families in those places are free from those Diseases and very credible it is that they may so persevere not yielding to the injuries or threatnings of the Region Secondly A new common Diseas may result from the altered or innovated constitution of the place Such kind of innovations happen in Countries either by Earthquakes or Inundations of Water or the bursting forth of some new pernicious Springs or perhaps of some new Mineral Exhalations from the Caveous of the Earth or from some malignant Aspect of the Stars and the like Causes Thirdly A new common Diseas may proceed from the incongruity of the Place with the complexion of the Natives Such kind of Diseases chiefly happen to Nations when they transplant themselves from one Region to another especially when the Constitutions of those Countries which they go to possess are very different from those they forsook So the English who first inhabited Virginia were frequently afflicted with a swelling of the Abdomen and the Hypochondriacal parts who upon their return to England were cured without any difficulty but they who continued in Virginia were not so easily restored to health Moreover National and common Diseases differ among themselves Becaus some of them totally depend upon the inclemency of the Region and others in part only The mortification of the parts seemeth to be of the first kind which befalleth men in the Northern Tracts near the Poles For the whol Essence of the Diseas may be ascribed to the cold and sharpness of the Place Of the second kind the Venereous Pox among the West-Indians seemeth to be For there it is conceived to be partly gotten by impure Copulation and partly to be contracted from the Insalubrity of the place In like manner the Bloody Flux is predominent in Ireland depending partly upon the constitution of the place partly upon an erroneous and preposterous diet And thus much in general be spoken of the differences of common Diseases In the next place we must enquire why this Diseas is more rife in England than in other Regions And by the way it must be observed Whether and how far forth this Diseas may be said to be Natural to English men First it must be observed that England is an Island which borroweth some humidity from the adjacency of the Sea and some frigidity from the distance from the Equator then that it aboundeth with innumerable fountains discovering their Springs almost in al places Lastly That it is watred with many and frequent showers of rain more than other Regions All which things do sufficiently attest the frigidity and humidity of the place Seing therfore that a cold and moist distemper is a part of the Essence of this Diseas we may easily infer that the bodies of the Inhabitants are here more inclined to those distempers then in other hot and dry Countries If therefore you demand Whether this Diseas at least considered in this part of it may rightly be said to be natural to English men We answer That in som sort it may although perhaps not properly namely so far forth as the same is attributed as natural to other Regions alike cold and moist although perhaps it may not yet be observed in them For those Countries are as readily disposed to imprint a cold and moist distemper as England it self Yet it must be observed that a cold and moist distemper is a common part of the Essence of this Diseas and that it alone doth not manifest the Affect for every cold and moist distemper doth not introduce this evil Wherfore although we grant that an excess of cold and moisture may be imputed as a fault to England yet we deny that from thence it can be rightly inferred that the whol Diseas is common and Natural to English men Moreover Some Countries may perhaps be found out far exceeding England both in cold and moisture as Scotland Holland Zealand Ireland and Denmark and the like wherin notwithstanding this Diseas hath not been observed to appear much Therfore if this Diseas be not rightly imputed to these Regions wherein that common cause is predominant namely the excess of cold and moisture Certainly neither can it justly be imputed to England by reason of that common Cause which is here less prevalent Again The coldness and moistness of this Kingdom doth not so far transcend a a mediocrity but that by outward and inwaad applications exercises and the like namely a right use of the six things not Natural they may be sufficiently corrected to the cashiering of that imputation Wherefore if these things be so namely if a cold and moist distemper be only a common cause of the Diseas if other Regions wherein this Affect hath not yet been observed to make any impression are at least equally obnoxious to cold and moisture Finally if those distempers may be prevented by a Regiment of diet appropriated to the place certainly the reason drawn from the coldness and moisture of the Climate which even now we produced to shew why English men should be more frequently invaded with this Diseas then others will be very weak and insufficient so that we can by no means place our content in that alone and therefore we intended nothing more by that assignation than that England doth more dispose the Bodies of the Inhabitants to this Affect than hotter and drier Regions do the Bodies of their Inhabitants And â—o we proceed to the search of the other causes of the rifeness and frequency of this Affect In the second place we can note that England is very ruitful and Child-breeding being sufficiently favorable both to Conception and Child-bearing and not ubject to cause abortions Now from hence it comes to pass that not only strong and able bodied men and such as are endued with perfect health but the weak and sickly persons do also generate weak unsound women likewise and such as are prone to a consumption do conceive carry their children nine months and bring them forth in a decent and laudable manner But it is no wonder if the Issue begotten by such matter and which oweth its life almost to the clemency
of the place alone should be feeble and languid and very subject to this Diseas For as much as the very benignity of the Region may in this respect be the occasion of some infirmity in the Issue For as barbarous People in time past by an inhumane experiment upon their new born infants namely by dipping their naked bodies in the coldest water destroyed the weak ones with the extremity of the cold and gave education only to the strong ones whose vigorous Constitutions overcame the injury of their cruel policies purposing by that inhumanity to have an universal race of strong lusty people So on the contrary the very clemency of the place promiscously preserving the languishing and weak Children together with the strong healthful doth minister an occasion of bringing forth a mixt kind of people some strong and some weak and sickly Yet least any should mistake we do not mean that all the Children in this Kingdom which are born of weak and sickly Parents are subject to this Affect For although if one or both of the Parents be infirm the Children will be infirm yet it is often seen that when the Parents have been very strong and healthful yet their Children have been very subject to this Diseas Wherefore neither do we rest in this second cause but another must yet be enquired out from whence we may derive a sufficient reason of the frequency of this evil We affirm therfore in the third place That the rifeness of this Diseas in England hath been much promoted by that long and secure peace which we enjoyed before the first breaking of it For by this the more wealthy families which were first invaded by this evil and which doth stil infest them more than others had addicted themselves to idleness and a loose and effeminate life and therupon they fel into a moister softer and degenerate Constitution and such as was less purged and cleansed from excrementitious humors and by consequence their Children were even procreated obnoxious to this Affect You wil say that Scotland and the Northern parts of England although they enjoyed peace and security yet they are seldome observed to fal under this Affliction We answer True it is that Scotland and the Northern parts of England are less affected with this Diseas than the Southern and the Western In the mean time peradventure the first impressions and rudiments of it are far more frequent in those places yea and in some forraign Countries then is commonly beleeved For although this evil be very familiar in the South and West parts of this Kingdom and very wel known among the Vulgar sort yet we have many times seen Children afflicted with it in a slight manner of whom neither the Parents nor others of the same family did suspect the least evil Yea we have known many whom none of their friends thought to be affected to be healed without any help of Physick by the sole benefit of the increased heat or by the increase of age or exercises How much easier therfore may the first rudiments of this Diseas be concealed from them to whom it is less familiar and among whom it seldom ascendeth to that degree that they need to implore the Physitians help We conjecture therfore that this Diseas is more frequent then is commonly beleeved both in Scotland and the Northern parts of England yea and in some Countries wherin the people are ignorant of it to this day but in those places they are so gently tormented with it that they are seldom condemned to the hands of the Physitian For that is the custome of the Vulgar sort not to send for the Doctor especially to Infants and yong Children unless the vehemency of the Diseas constrain them However the matter is we seem not yet to have given satisfaction to the objection propounded Why the South and West Country men of England are more grievously frequently conflicted with this Diseas then the Northern People and the Scots although both Kingdoms equally shared the blessing of the lasting peace and security Therfore we grant that a higher reason yet must be given for this difference Fourthly therefore and lastly we say That the cause of this difference is the affluence of all good things in these Southern and Western Countries of England For this part of the Kingdom is much the more fruitful rich and florishing and abounding with al manner of allurements to pleasure Therefore it is no marvail if the customs of men do first generate here their Spirits decay and the strength of their Bodies begin to dissolve now that this degenerate and delicate manner of living doth weaken families is a truth so solidly and constantly attested by Historians that it were an impertinence to offer any proof of it For you may observe that the most Noble and Gallant Families have been very much reproached for these very causes yea and sooner or latter somtimes totally extinguished and so much the sooner as they have the more refused to undergo labors and to innure themselvs to masculine exercises Neither are families ever plunged in a greater danger of degeneration then when they abound with al good things and lying open to plenty and security they are most powerfully invited to delicatness idleness and effeminateness without any labor care and solicitude Who was more rich secure and effeminate than Solomon He left Rehoboam a degenerate Son behind him And perhaps the family of Henry the 8th is extinct for the like cause We could heap up almost innumerable examples to prove this if it were needful However it be we see plainly that this Diseas doth more frequently and vehemently invade the families of the wealthy than the cottages of poor men and therfore it ought not to seem strange that it likewise infested the richer and more pleasanter parts of the Kingdom namly the South and West before the North parts But these things shall suffice to have been spoken concerning this matter It remaineth only that we enquire Whether and how far the three last assigned causes relate to the denomination of a Common Diseas and whether in respect of them this Diseas may be ascribed to England as common and Natural You must know then that these three causes in as much as they depend upon the Region are not properly causes neither by their own nature do they produce this affect but that they are only an occasion wherby this Diseas may accidentally arise For in themselves they denote the laudable conditions of a Country at least they infer not what is culpable in it For who can accuse his Country because it favoreth the procreation of Children much less make outcries against it because it enjoyed long and secure peace Finally least of all calumniate the pleasantness fruitfulness and affluence of all good things For all these things are in themselves blessings and conditions to be wished for in a Country Seing therfore as we have shewed above that a Disease properly common doth
Dropsy of the Lungs a Hectick Feaver or els a slow erratical Feaver An Ascites is also somtimes consociated with this Affect But whether it proceeds from a copious flowing of the Blood to the Bowels of the Abdomen we dare not yet attest for an undoubted truth Yet certain it is that the flowing of the Blood to this Belly is very copious and sufficiently active in this Diseas For the Liver is great and the other Bowels are observed to be rather more ful than ordinary than pined away Wherupon it may happen that that watry moisture from the Bowels which are oppressed with a fulness may be carried into the hollowness of the Abdomen but we affirm this with a distrustful confidence because we have not yet given our selvs ful satisfaction in this matter Nevertheless these recited Diseases may happen to Children although the Rachites have not preceded and may be the caus to introduce it Yea they may likewise com upon this Diseas from other causes as for example by som errors in the Regiment of health although in this case also this Affect may be partly guilty if it went before And thus much of complicated Diseases of the former kind But of the latter kind namely such as have little or no nependance upon this Affect are a malignant Feaver the French Pox the Scurvy and the Strumaticall Affect First it is certain That a Malignant Feaver may come upon this Affect because for the most part it is produced by infection from which this present Affect leaveth not Children free we ad only that this Feaver doth seldom or never ow his Origin to this Diseas Secondly If the French Pox chance to be complicated with this Diseas it is either derived from the Nurses infection or from the Parents by Inheritance For it is a Diseas altogether Distinct from this and hath scarce any affinity with it Thirdly The Scurvy is somtimes conjoyned with this Affect It is either hereditary or perhaps in so tender a Constitution contracted by infection or lastly it is produced from the indiscreet and erroneous Regiment of the Infant and chiefly from the inclemency of the Ayr and Climat where the Child is educated For it scarce holdeth any greater commerce with this Diseas then with other Diseases of longer continuance wherin after the same manner the Blood in time contracteth for the most part this peculiar infection yet it must be granted that this Affect doth somwhat the more dispose to the Scurvy in regard of the want of motion and exercise Fourthly and lastly The Strumatical Affect doth somtimes associate this evil But it is credible that it oweth more to other causes proper unto it then to this precedent Diseas Although we deny not but this may minister som occasion of invading in as much as it rendreth the humors more viscous and gross Some other Diseases are peradventure somtimes complicated with this but because they happen exceeding rarely and have yet scarce fallen under our observation we pass them by for the present and proceed to the signs of the Diseas and the difference of the signs CHAP. XXI The Signs of the Rachites and first the Diagnostical Signs WE distinguish the Signs of the Diseas into three Chapters The first containeth those Signs which demonstrate the presence of the Affect and are called Diagnostical The second containeth those that distinguish among themselvs the differences of the Diseas and these are called Diacritical or Discrepant The third comprehendeth those Signs which presage the event of the Diseas and they are termed Prognostical In this Chapter we shall not treat of the first kind We divide the Diagnostical Signs into Pathognomonical and Synedreontal And here the Physical Authors seem to be more strict in the definition of the word Pathognomonical then the necessity of the nature of the matter doth require For they wil have it to be Inseparable and as Logicians speak Proprium quarto modo that is to agree omni soli semper Indeed it must be granted that such an Inseparable Sign or Proprium quarto modo must be according to the most proper sens a Pathognomonical Sign For whether it be present or whether it be absent it is ever demonstratively significant When it is present it certainly witnesseth the species of the present malady and being absent it sheweth that that species of the Diseas is not present But when we truly and seriously consider how seldom such Signs as these occur and of what useless consideration they will prove the knowledg of them being thus restrained we are induced to think of the amplifying of the usual signification of the word For although the Ancients to supply this defect did substitute 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in the place of one true Pathognomonicol Sign strictly taken and we our selvs do most willingly accept of and approve this very same 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 yet seing that this 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 doth seldom appear from the begining of the Diseas and by consequence seldom obtaineth the reputation of an Inseparable Sign it necessarily followeth that it also can but seldom perform the office of a Sign quarto modo propriè and therfore also that this notion is reduced to an extream narrow use We are compelled therfore that we may fully prevent or avoid this inconvenience to extend somwhat higher the signification of a Pathognomonical Sign yet so as that we wil abate nothing of the Nature and certitude of the signification Therfore we define a Pathognomonical Sign to be somwhat appearing about the Patient which certainly and infallibly demonstrates the Species of the Diseas And in this extended sens it may be divided into a Sign Inseparable or proprium quarto modo and a Sign Separable namely as being proper only Modo secundo to wit becaus it is competible only to one kind of Diseases although not always In like manner the Paththognomonical Syndrome or Concours of Symptoms may be divided into two kinds respectively Analogical to those aforesaid For somtimes it beginneth with the Diseas it self and doth inseparably associate to the very last period So the pricking pain of the side and acute Feaver the difficulty of breathing and the cough if they be taken collectively they are indeed a Syndrome but such an one as is always equivalent to one simple Pathognomonical Sign of the first kind and doth inseparably accompany a Pleurisie from the first beginning to the very end But somtimes the Syndrome or concours of Symptoms is not compleat and perfect from the begining of the Diseas yet afterwards it is made perfect by the intervention of the other Signs and doth infallibly denote the species of the Diseas For example in the smal Pox upon the first begining of the Diseas the Syndrome is so incompleat that it doth not yet certainly determine the species of the Diseas but afterwards the Pox breaking out of the Skin very thick and tending to maturation then the Syndrome is finished and
the species of the Diseas is put out of al doubt But that a Sign proper to one Diseas alone although not in the fourth manner whether it be simple and solitary or compounded of a concours of many together may suffice when it is present to make a Sign truly Pathognomonical It is manifest from hence becaus when it is present it doth as certainly and infallibly denote the species of the Affect as a Sign doth which is proper in the fourth manner For that which agreeth to one species only when it is present doth necessarily infer the presence of that species also Although therfore that a Sign proper in the second manner be not Inseparable and where it is absent doth not determine the absence of the Diseas as a Sign doth proper in the fourth manner yet when it is present it is as we have said of the same valu and certainty For Physitians do esteem the dignity of the Sign by the certainty of the signification For to that purpose they enquire out the signs of a Diseas that they may attain to a certain knowledg therof Therfore seing that Signs proper in the second manner are equivalent in respect of their certainty when they present to Signs proper in the fourth manner we shall here comprehend them under the extended signification of Pathognomonical Signs You may say after this manner many after appearing Signs may be reduced to the Pathognomonical and are confounded with them Be it so provided that they do infallibly denote the species of the Diseas For in this respect they are worthy to be severed from the other after appearing Signs neither wil any confusion follow hereupon in the method of the semeiotical art but rather the valu and dignity of the Signs wil by that means be more plainly and easily observed Of the Synedremontal or assident Signs we have nothing of moment to say but wil directly proceed to the Signs themselvs as they are to be reduced into order Yet no exact method must be expected from us because for the most part the Signs flow from so many several fountains that they wil scarce suffer themselvs to be marshalled into any accurate order Wherfore that they may be constituted which have some affinity among themselvs we have reduced the signs of this Affect to the subsequent Method We shal propound therfore First The Signs which relate to the Animal actions Secondly Those which have reference to the irregular Nutrition Thirdly Those that concern the Respiration Fourthly Those that appertain to the Vital Influx Fifthly Certain vagabond and fugitive Signs reducible to no Classis Under each of which we shal subjoyn the valu of the Signs First the Diagnostical Signs relating to the Animal Actions are these The loosness and softness of the parts The debility and languidness And finally the slothfulness and stupefaction First A certain laxity and softness if not a flaccidity of all the first affected parts is usually observed in this Affect The Skin also is soft and smooth to the touch the musculous flesh is less rigid and firm the joynts are easily flexible and many times unable to sustain the body Wherupon the Body being erected it is bent forwards or backwards or to the right side or to the left Secondly A certain debility weakness and enervation befalleth al the parts subservient to motion This weakness dependeth much upon the laxity softness and litherness of the parts aforesaid for which reason we have placed those Signs before this as also this before the slothfulness and stupefaction in the next place to be enumerated which ow much both to the loosness and softness Moreover this debility begineth from the very first rudiments of the Diseas For if Children be infested within the first year of their age or therabouts they go upon their feet later by reason of that weakness and for the most part they speak before they walk which amongst us English men is vulgarly held to be a bad Omen But if they be afflicted with this Diseas after they have begun to walk by degrees they stand more and more feebly upon their legs and they often stagger as they are going and stumble upon every slight occasion neither are they able to sustain themselvs long upon their legs without sitting or to move and play up and down with an usual alacrity til they have rested Lastly upon a vehement increase of the Diseas they totally lose the use of their feet yea they can scarce sit with an erected posture and the weak and feeble Neck doth scarcely or not at al sustain the burthen of the Head Thirdly A kind of slothfulness and numbness doth invade the Joynts presently after the begining of the Diseas and by little and little is increased so that dayly they are more and more averse from motion The Yonger Children who are carried about in their Nurses arms when they are delighted and pleased with any thing do not laugh so heartily neither do they stir themselvs with so much vigor and shake and brandish their little Joynts as if they were desirous to leap out of of their Nurses hands also when they are angred they do not kick so fiercely neither do they cry with so much fierceness as those who are in health Being grown greater and committed to their feet they run up and down with a wayward unchearfulness they are soon weary and they love to play rather sitting then standing neither when they sit do they erect their body with vigor but they bend it somtimes forwards somtimes backwards and somtimes on either side seeking som props to lean upon that may gratify their slothfulness They are not delighted like other Children with the agitation of their bodies or any violent motion yea when the Diseas prevaileth they are avers from all motion of their limbs crying as they are at any play that is never so little vehement and being pleased again with gentle usage and quiet rest In the interim unless som other Diseas Symptom or caus of sickness doth com between they are moderate in sleeping and waking they are ingenious not stupid but for the most part of forward wits unless som other im pediments arise their countenances are much more composed and severe than their age requireth as if they were intent and ruminating upon som serious matter These Signs being taken together unless they result from some evident wariness or proceed from some primary affect of the Brain which indeed hapneth very seldom in this tenderness of age do constitute a sufficient Pothognomonical Syndrom of the first kind where they are present together they certainly witness the presence of the Diseas when they are absent together they infallibly attest the Essence of this Diseas But if at any time a wearisomness do bewray any Feaverish or any other like Signs they may easily be distinguished from these both because the reasons of the weariness have gone before and also because the Signs from thence arising do
it presenteth a strong suspition that this Diseas hath taken root For although the Bulk of the Head which is evidently encreased and also the extenuation of the parts affected do pre-require some considerable motion and duration of the Diseas before they appear yet from the beginning a certain difference may be observed by an accurate attention or intuition in respect of the heat and the habit of these parts compared one with another Thirdly The Wrests and the extremities of the Ribs must be noted For before the end of the beginning certain rudiments of knurls or knots begin to appear in the Wrests and Excrescencies also in the tops of the Ribs Fourthly A kind of swelled fulness and stretching the Belly is conspicuous immediately after the beginning especially in the Hypochondriacal parts For the magnitude of the Belly compared with the magnitude of the Breast exceeds the just and due proportion Now these Signs collectively taken do assuredly demonstrate the presence of the Diseas even from the very beginning But if no sensible and manifest extenuation of the first affected parts do appear at the same time in that very respect it is cleerly distinguished from the encreas therof The Signs of the other times are with eas differenced from one another by the descriptions of those times already laid down yet becaus they may point to this place and be dispatched in a word we shall not decline the Annotation of them All those Signs which appeared at the beginning become more intense and evident in the encreas of the Diseas and many other and more grievous are daily accumulated This time as hath been said is distinguished by the manifest extenuation of the first affected parts but after the consistence by the continual aggravation of the Symptoms and Signs aforesaid In the State of the Diseas the Signs and Symptoms are most outragious and conspicuous But so long as this time lasteth it neither manifestly encreaseth or decreaseth In the encreas beyond the State the Signs and Symptoms exceed that condition which they retained in the indifferent State both in respect of their magnitude and vehemence and likewise in respect of the dejection of the Spirits and from that time forwards they dayly grow worse and worse for which considerations this time is distinguished as well from the ordinary encreas as from the means of the consistence But in a true declination A kind of simple remission of the Symptoms and Signs tending to a perfect restauration of health begins to discover it self no other Signs of the invasion of any other Diseas appearing On the contrary in a spurious and illegitimate declination Other Signs of a new and succeeding affect are involved and complicated with the Signs and Symptoms of this Diseas and these are distinguished according to the various condition therof and must be fetched from their proper Fountains and ought not to be expected here Moreover if any particular Signs of any of these times do occur which concern the event of the Diseas they must be reserved among the Prognosticks and thus much of the Signs of the Differences of this affect deduced from the Essence therof The Differences of the Causes distinguish the Diseas into Natural and Accidental and the Natural again into that which is properly so called and that which is so termed improperly A Natural Diseas properly so called becaus it is supposed to be actually present from the very Birth requireth no other Signs than the Diagnostical recited in the former Chapter For upon their appearance presently after the Birth the Diseas is certainly known to be Natural But if those Signs appear not presently after their Birth yet a Natural disposedness to this Diseas may be inherent from the Birth which afterwards actually breaketh out and the Diseas produced by it may though with some impropriety be termed Natural in regard of that dependance upon the Native faultiness A Natural Diseas in this sens requireth other Signs than those which we have recited above to distinguish it from the same Diseas when it is altogether and plainly Accidental The Signs of a Natural Diseas improperly so called First A weak and sickly Constitution and the Diseases of both or either of the Parents As a cold and moist distemper a Cacochymy especially the Phlegmatical a Cachexy a Dropsy an Atrophy the Phtisick the Gonorrhea the Whites the Venereous Pox the Scurvy and the like affects Secondly The Slothfulness Effeminacy and Sedentary life of the Parents Thirdly The Errors of the Mother during her going with Child all which things we have discussed above more at large when we examined the Causes of this Diseas in relation to the Parents Fourthly The Debility of the new born Infant when it proceedeth not from the difficulty and labor of the Birth Fifthly The invasion of the Diseas before he is exactly a year old for this argueth some Natural disposition to the same Sixthly If the elder Brothers or Sisters were before affected with the same Diseas for then it may well be suspected that some Infection was contracted from the Parents Seventhly If no remarkable error was committed in looking to the Child after the Birth and before the invasion of the present Diseas Of which we have spoken above in the Chapter of the Causes after the Birth Eighthly If this affect hath not succeeded some other which was apt to leave this behind it Of the Diseases of this kind we have also discoursed above The Signs of a Diseas newly and totally contracted after the Birth are in a manner contrary to these and therfore we shall only run them over First If the Diseas cannot be imputed to any weak or diseased Constitution of the Parents or their manner of life or the errors of their customs Secondly If no debility appeared presently after the Birth Thirdly If the Diseas began when the Child was above eighteen months old Fourthly If the Brothers and Sisters were free from the Diseas Fifthly If any notorious errors were committed about the Child after the Birth Sixthly If any Diseas went before which might occasion a suspition that this followed it If there be a confluence of most or all of these Signs they do sufficiently witness that this Disease must not be attributed to any Natural Infection but to the future Errors and Irregularities And thus much of the differences of this Disease in respect of the Causes Lastly Som differences happen to this Diseas by reason of other Diseases wherewith they are peradventure complicated in which case besides the Diagnostical signs already reckoned some other may be desired as peculiarly proper to the complicated Diseas Nevertheless an accurat Description of them cannot be here expected becaus for the most part they are the same which are every where artributed to those Diseases by practical Writers But becaus som Diseases do more frequently accompany this than others we wil briefly look into their Signs First therfore a Hydrocephalus or Dropsie in the Head being
Prognostical signs of a diseas that hemay be the better instructed to forsee the several events of it But in general those things which abet the Diseas that is all such things as war against Nature require a contrary consideration and as thes are the stronger and they the weaker so much the more grievous and pernitious is the Diseas But becaus it is not obvious to every one to give an accurate Judgment of Particulars from this General Admonition it will not be impertinent or unprofitable to insert som particular and special Rules and Observations hitherto belonging First This Diseas properly Natural or that which invadeth before the birth is the most dangerous and seldom if ever end in health For it argueth a deprivation of the Seminary principles and by consequence that the Spirits are very infirm besides it insinuateth a vehemency in the causes Secondly The more early the invasion is after the Birth the more dangerous caeteris paribus the Diseas is for the Spirits are so much the weaker In like manner The Elder Children and such as go up and down are more easily cured then yong Infants that cannot use their legs Thirdly A Diseas improperly so called namly that which in part dependeth upon the Natural Inclination is more dangerous than that Which is contracted by the meer error of the Nurse or Mother Fourthly This Diseas proceeding from som other fore-going Affects is more dangerous than that which is introduced by an erroneous Regiment of health For it implyeth a precedent dejection of the Spirits Fifthly Som have observed That Infants who have had red Haird women to their Nurses have been most obnoxious to this Affect Yet we indeed suspect this rule of som fallability Sixthly Some affirm That Girls are more frequently infested with this Diseas than Boys and more easily cured The truth is we have not yet had any unsuspected experience of this Yet we grant that Girls are of a more cold and moist temperament which holdeth the greatest correspondency with this Diseas and for that reason probable it is that the Female Sex may be affected with the lighter causes and for the same reason also be the sooner restored Seventhly This Diseas doth chiefly invade the Cradles of the Gentry especially of those who live at eas and fare deliciously then of the poorer sort by reason of the manifold and various errors which necessity introduceth as wel in the diet of the Parents as the Regiment of their Children but it findeth the most difficult access unto those who are priviledged from such assaults by a mediocrity of fortune and accustomed to undergo some pains-taking and labor and are not destitute of necessary means to sustain life and a healthful competency to prevent indisposition Eighthly By how much the more the first affected parts are extenuated so much the more difficult caeteris paribus is the cure of the Diseas Ninthly The greater the Head is the longer and the harder is the Cure When therfore the Bone of the Forehead sticks much out forwards it portendeth at least a long continuance of the Diseas the same also do the other irregular stickings out of the other Bones of the Head Tenthly The weaker the Back-bone the greater and more dangerous is the Affect Wherfore they which are unwilling to sit upright much more they which are not able to sit upright but most of all they whose feeble Necks cannot underprop the burden of the Head are in hazard of their lives Moreover by the Diuturnal weakness and bending of the Back-bone Children become Crook-back'd or some other waies incuruated and the trunk of the Body is afterwards scarce reducible to its Native Figure Eleventhly Great Swellings in the Bones of the Wrests and the ends of the Ribs presage the continuance of the Diseas Moreover The crookedness of the Shank-bone Shoulder-bone or the Bone in the Arm prognosticate no less Again The greater that the inflexion of the Joints is the more difficult and retarded will the restauration be Twelfthly They whose Thigh and Shank-bones are much encreased rather according to latitude and thickness then according to longitude for the most part becom dwarfs 13ly They who draw their Knees upwards and unwillingly suffer them to be extended recover not without som difficulty 14ly When the Teeth wax black or fal out by pieces there is som danger and so much the more the later they com again that is others in their room 15ly Al they who attain to the consistence of the Diseas escape the danger of it being carefully lookt unto unless perhaps som other Diseas be conjoyned with it or do accidentally com after and disturb the Patient with a higher encreas In like manner the declination of the Symptoms doth assuredly promise a restitution of health 16ly If an Hydrocephalus be complicated with the Rachites it ever importeth great danger But if it prevail far as that the Sutures of the Brain pan do gape and that som water gotten into the middle Spaces doth swell the Dura mater into a waterish and soft Tumor it is mortal 17ly A painful and laborious breeding of Teeth coms somtimes accompanied with most vehement Symptoms and even threatneth death But commonly it is violent and ceaseth in a short time however so long as it is conjoyned it much accelerates the motion of the Diseas But the Dog-Teeth com forth with more vexation than the rest and portend more danger 18ly An Asthma especially the Orthopny when the Patient cannot draw breath but with an erected neck and that difficulty of breathing when he cannot ly on either side is very dangerous For that prompteth to a suspition of som Tumor Imposthum Pleurisie or Inflamation of the Lungs or som growing too of the Lungs with the Pleura all which affects want not their danger 19ly If the Ptisick be complicated with this Affect it is for the most part mortal especially if one and the same ulcer of the Lungs continu above forty days 20. We affirm that if this Diseas be of any long continuance it easily changeth into the Ptysick or a Consumption or at least commonly brings a Consumption to the destruction of the Sick unless som other affect per adventure or grievous symptom do intervene and prevent the Consumption by hastning death as a Convulsion the loud Cough the swelling of the Lungs vulgarly called THE RISING OF THE LIGHTS a continual Feaver a Pleurisie c. In the next place We assert That if a Dropsy of the Lungs or an Ascites be complicated with the Rachites it portends a desperate and deplorable condition Again An Hectick slow putrid and especially a continual Feaver consuming the first affected parts doth vehemently hasten the motion of this Diseas and render it the more dangerous Also If the Venereous Pox be consociated with the Rachites b e it hereditary or contracted by infection it is almost uncapable of remedy The Scurvy likewise conjoyned doth very much retard the cure thoug h less than the Pox.
affirm that one Indicatum only can be insinuated from one Indicant and that in his Method Med. he doth affirm That they vainly attempt the Method of cure who are ignorant that one thing is Indicated from one Indicant and that all who have written of this matter do seem to attest the same thing We answer That Galen must be understood of the three distinct kinds of Indicants which must by no means be confounded nor their Indicates that is the things indicated by them For that which a Diseas doth properly Indicate must not be attributed to the causes or the Spirits In like manner that which the causes Indicate must not be applyed to the Spirits or the Diseas it self Finally that which the Spirits Indicate must neither be ascribed to the Diseas nor the causes For in this respect one Indicate answereth to one Indicant and he that observes not this must unavoydably confound all things and in the employments of art makes an unsuccesful use of this instrument according to the judgment of Galen But it must be considered that in each of these kinds the Indicatum may be divided into two parts one wherof is an advantageous action and to be prosecuted the other is noxious and to be avoyded yet each of them belongeth to one and the same kind amongst the aforesaid three and is as it were a middle part of the whole Indicate For the Spirits direct to an election of such things as may cherish and protect them and to an avoidance of such things as may in a further degree empair them and both these actions concur to advance and ascertain the compleat and final conservation of them In like manner both in cure and restauration and also in caution and prevention there is found an action as well to be embraced as abandoned yet whether of them exceedeth the bounds of its kind so that no confusion can from thence be feared For whilst we cure we make choice of those things that wil demolish the Diseas and we deliver the application of such things as wil augment it In like manner when we preserve we take away the causes and withal we shun the use of thos things that may conspire either the continuation or future breeding of them And for this Reason in the definition which we have presented above of an Indication we distinguished the action indicated into that which ought to be prosecuted and that which ought to be waved which very thing also we were about to do in the enumeration of the particular Indications to this Diseas It is now time for us to proceed to the second enquiry propounded at the beginning namely Unto which operation of the Intellective faculty the Indication belongeth We say first That the Indication doth in som sort include the simple apprehension of each term both of the Indicant and the Indicate For he can never understand a Proposition who is ignorant of the Terms therof Yet this knowledg is only preparatory and presupposed in the art of Indications as we have already noted We affirm secondly That composition and division is an explicit operation of the Intellective faculty in the perception of an Indication For the Indicant by force of his relation doth represent the Indicate to be aptly continued together into a relative proposition Now that a Proposition thus constituted may in its own nature be so manifest and evident that no man can reasonably doubt of the truth therof or need any cleerer proof is expresly taught by Galen 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and again in another place 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Here som calumniate Galen as if he had devised an art separated from all experience and quarrelling with Reason but because Galen intended nothing else than that Propositions framed by Indication are of self credit and need not any comprobation from Reason or Experience thes Criticks may perceiv their own rashness and retract the scandal Senertus indeed objecteth that the Indication cannot belong to the second operation of the mind because the Indicate is neither affirmed nor denied of the Indicant But that learned man was herein mistaken For although peradventure that the Indicate be neither affirmed nor denied of the Indicant directly and by the bare Verb Substantive or Copulative est Yet indirectly and obliquely it is manifestly predicated of the same and after the same manner as it useth to be in relative Propositions As for example A sound State is the Indicant of its own conservation a sickly condition is the Indicant of som remedy c. And if any man wil express the Indicate with his relation to the Indicant by the participle in dus than the Predication will be direct As a sound State is to be preserved a diseased State is to be cured a Diseas must be removed c. If the Learned Senertus can deny these to be Propositions he may with the like facility deny that an Indication belongeth to this Operation of the Understanding but if he must needs confess that there is no room left for the denial of this Now we have said that the Indication doth belong to the second Operation of the Mind becaus the Understanding in reference to the order of time doth withal comprehend the mutual relation between the Indicant and the Indicate and thereupon frameth a Proposition which formation and contexture of the Proposition is the very Indication and explicitly a second Operation of the Understanding Now that the Understanding doth together at one time comprehend the Indicant and the Indicate in the Indication is elegantly expressed by Galen in a decompounded word which he useth in the definition therof 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 also in another definition 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 We say Thirdly That Indication may likewise implicitly be referred to the third operation of the Understanding Becaus in the order of Nature the Understanding seemeth first to perceive the evident relation of the Indicant to the Indicate before it can conclude of the certainty of the Proposition from thence resulting Although in the order of time the Mind as hath been said comprehendeth them together neither is it necessary to form an explicit Syllogism for the truth is The Understanding can comprehend those things together at one time which by the Institution of Nature are termed Successive as the Sun and Light Fire and Heat c. But in regard that this simultaneous comprehension of an Indication doth include a certain dependance of the knowledg of the Indicate from the perceived relation of the Indicant it supposeth also that the said relation is sooner perceived at least in the order of Nature and that the Indicate is later understood and by an implicit bringing in for a kind of transition in respect of the order of Nature doth seem to be here implied from the relation of the Indicant as the Medius terminus to the Proposition constituted of the Indicant and the Indicate as to the conclusion and this
unaptly be referred Moreover the Spirits also although they prohibit all extream hot things yet they allow of these as mōderat and very congruous to Nature In like manner there is little or no particular repugnance between these causes and the Indicates albeit in respect of time and the order of administration som dissent may be observed as we shall see afterwards in due place Wherfore in what respect and how far these agree together whilst we intend a cure we do at once respect not only the Spirits but in som sort the causes by choosing such curative remedies or by mingling such ingredients with them which are able both to attenuate the thick matter to cut into the viscous to open the obstructed passages and the like In like manner whilst we are chiefly imployed either in preservation or in the rooting out of causes we make choice of such evacuants or els we compound them with such remedies as are also partly contrary to the Diseas And all these things we do to that purpose as that as hath been said we may be subservient to the most intentions we can Now having found out the actions simply requisit in the Species in the next place we shal enquire out their du circumstances 1. In regard that this is a great Diseas it requireth a great quantity of the Remedy in respect of it self For a Remedy unequal to the Diseas cannot extirpate it It is necessary therfore that the dose of the Medicine be equally to the magnitude of the Affect But in this Diseas the Spirits permit not so great a quantity of Remedies to be given at once Wherfore that quantity must be divided given by turns For this is a Chronical Diseas and of slow motion neither doth it necessarily require an hasty Cure and although the Spirits cannot wel endure either vehement Remedies or such as are given in a large dose yet they permit the use of Evacuant Medicins by an Epicrasis Wherfore by turns we must somtimes make use of Remedies Preparatory somtimes Evacuant somtimes Alterant and somtimes strengthing Secondly For so much as belongeth to the place of administration the general Rule is that the remedy ought to arive at the seat and penetrate to the very Cause of the Diseas If therfore it must have a passage into the Vessels it must be taken at the Mouth but if it will suffice to touch only the thick Guts it must be injected by the Fundament If the humors be naturally ready to move upwards expel them by vomit if downwards evacuat them by siege In like manner you must humor the inclination of Nature and root out the causes by spitting by Urin or by sweating Particular evacuations must be instituted in the very affected parts or in the parts adjacent For so the force of the Remedy doth the more surely make way to the seat of the Diseas and the morbifical Caus And for the same reason external and topical Medicines must be applied to the next convenient place Yet you must know that there is a certain Sympathy between som parts in which case the remedies ar frequently administred to the part wherwith that consent intercedeth and neither to the affected nor the adjacent part Thirdly The form of the Medicament doth partly depend upon the Rule last propounded For if the scope be to lenifie the Jaws or the Windpipe we chuse a licking or lapping form that by degrees the remedy may slide over the affected parts and stay the longer upon them In like manner if the Stomach be affected we often prescribe Pils Pouders or Electuaries that they may the longer abide in the Stomach To the Kidnies we rather design liquid things that they may the more easily be carried down to them with the wheyish part of the Blood The forms do also in som part depend upon the very nature of the Diseas as in burning Feavers liquid things are for the most part convenient dry things are scarce admitted on the other side in moist Diseases and when the Belly is oversoluble more solid forms are preferred Finally the forms of the Medicines do also partly depend upon the nature of the Ingredients So Cassia worketh most effectually in the form of a Bolus Hartshorn Coral and the like in the form of a Pouder in like manner bitter things such as beget a vomiting and stinking things are concealed in the form of Pills somtimes also they are guilded or els they are enwrapped in Wafers and exhibited in the form of a Bolus Now it must here be noted that for the most part the form of the Remedy is not so considerable as it gives place to the more easie and commodious administration in respect of the Admission or Reception of the Sick For many cannot swallow Pills others presently reject their Potions by vomit others are perhaps avers from other forms In this Affect in regard that all Children almost are loth to take Physick that form is to be preferred before the rest which shall be observed to be least distastful to them Fourthly As for the time of action you must so endeavor to sit your administrations that they may as little as possible be interupted with times of eating exercise or sleep for at this age the Spirits are scarce preserved sound and perfect without an interposition of those things by just internals Remedies evacuant opening attenuate and incident must be taken early in the morning upon an empty stomach and if they must be repeated the same day four of the Clock in the afternoon upon an empty stomach likewise is the most seasonable hour Strengthning and astringent Medicines and such as provoke sleep are to be taken rather in the evening than in the morning but perhaps som of these are most agreable after meals Medicines that are mingled with the nourishment ought to be gratful to the Palat lest they subvert the stomach and hinder concoction or caus a loathing of the meat or els empair the Spirits As for the order of proceeding there occur two general Rules The former is That that must first be don which being premised makes way for the following Remedies and therfore that ought first to be removed which hath the consideration of an impediment in respect of what must follow The later is That we must ever give our first help to the more urgent and weighty Indicant unless som impediment intervene If the Question therfore be Whether the Diseas or the Caus of the Diseas doth first require the help of Physick The answer wil be obvious according to the first Rule For the causes are reflected upon under the notion of an impediment in respect of the Cure of the Diseas for they cherish it and infringe the vertu of the Medicins Wherfore before that we are intent upon the vanquishing of the Diseas we premise all possible endeavors to root out the Caus or at least to lessen abate and retund it that it may oppose no considerable force to
heat and may drive out all stupidness from within it and ad vigor unto it If this Nerve therfore as that famous Chyrurgion affirmeth or a part therof be distributed unto the Marrow of the Back and never forsakes the Marrow of the Back but shooteth out little Branches with the Nervs of the Marrow of the Back to the ends of the very Legs and Feet it may easily be granted that this Nerve thus delivered from obstruction thus excited and having gotten vigor may likewise in some manner excite the Marrow of the Back it self and all the Nerves from thence arising which by that opinion it doth accompany to the very end of the Body and imprint some vigor in them Wherfore Scarification being made in that place must needs be of greater efficacy than if it were instituted in any other part of the same Ear more remote from the aforesaid Nerve The same may almost be said concerning the little wound here made by a blunt Knife For some Practical Physitians affirm that the excellency of this operation relats not so much to the quantity of the Blood to be drawn as to the stirring up of pain in that part which any man may easily reduce to the stirring up of the vigor of the Nerve of the Fifth Pair But omitting this Conjecture we will propound some other Considerations in respect wherof this Scarification may be useful in this affect First By this means we obtain a certain particular evacuation of the Head which part if any other is in this Affect oppressed with a particular fulness Secondly By the very evacuation of the Blood we somwhat correct the thickness and toughness therof and by consequence we promove the more equal distribution of it and a more regular and equal Nourishment of the Parts Thirdly By this means we in some sort drive away the astonishment of the parts It must be noted that this operation when it performeth a particular and local evacuation doth not simply deserve the first place in the Method of Cure but must follow in its order Universals being premised Lastly It seems to be ridiculous and superstitious which some are busie about when they administer this Scarification whilst they fasten the Blood of the right Ear suck'd up into Wool to the left Hypochondry and the Blood of the left to the right Thus much of Scarification Issues in this Diseas are much approved and we have known some Children cured only by the help of this means For it doth not only perform all those things which even now we ascribed to the Scarification of the Ears but more particularly it is a powerful remedy against the Hydrocephalus both Curative and Preservative and very much conduceth to lessen the unusual magnitude of the Head and to evacuate the superfluous watriness therof And lastly to repress the inordinate encreas of the Bones Also it manifestly drieth up the too much humidity of the Spinal Marrow exciteth heat strengthens the Nerves and expelleth the astonishment Now becaus this kind of remedy is properly a little Ulcer and causeth some small pain to the Child that hath it and bringeth dayly some trouble to the Nurs it ought not to be prescribed unless the greatness of the Diseas be such that we despair to conquer it by other remedies without the concurrence of this This little Fountain must be made between the Second and Third turning Joynt of the Neck Some Burn it with actual Cauterising but we disapprove of this way in regard of the vehemence of the pain Some effect it with a potential Cauterising but neither do we like this becaus all Causticks are advers to the Nature of an Infant insinuating some venemous quality and at least do too much dissipate the Spirits and weaken the parts Therfore we allow rather of an Issue made by Simple incision with a sharp Penknife Some make use of Iron tongues contrived for this purpose wherwith they take hold of the Skin the place of incision being first mark'd with ink and by a moderate compression they dull the sens of the part and then they thrust in the Pen-knife through the middle of the tongs which is pierced with a longish hole and so they make the incision Having made the wound they stop in either an Artificial or a Natural Pease putting upon it a digestive Plaister upon this they wrap a Paper or a linnen cloath divers times doubled and fasten to it as it were a Buckler made of some solid matter unto which four swathing bands are sewed thus much of Issues In the next place we shall examin some other kind of Chyrurgical Operations And first Leeches offer themselves Truly we have not yet sufficiently tryed how beneficial the application of them may be in this Affect But if we consult Reason we suppose that more hurt than advantage may be expected from this remedy For if they are applied to any part of the Head by reason of their continual sucking they would easily caus a more violent afflux of the Blood to those parts And if they be applied to other parts they draw the Blood from the parts which before had too little Secondly Cuppinglasses are not we conceive so dangerous as needless indeed we altogether reject those that are ministred with Scarification not only for the Reasons just now deduced from the Leeches but being moved both by fear of dejecting the Spirits by reason of the pain and also in regard of the troublesomness of the administration Cuppin Glasses without Scarification as we began to say seem not refusable either by the Spirits or the Diseas or the causes of the Diseas But these are very little effectual and we leave it to be perpended whether the profit arising from the use of them whatsoever it be can recompence the trouble of the application Nevertheless it may happen by reason of the complication of some other Diseas that the use of them may be of some moment as in a Pleurisie a Phrensy and wher som dangerous Flux is iminent against som principal part in which case those perhaps that are adhibited with Scarification may be admitted in great and strong Children But then you must apply them to the turning Joynts of the Neck the Shoulders the Hanches to the inner parts of the Thighs to the soals of the Feet and to other places as the peculiar complicated affect shall require In the mean time it must be noted that in an age so tender you must make use of very smal Cuppin-glasses and that they must be applyed with a less flame then they are wont to be in others of mans estate and that the scarification if at all it be admitted must be don with a gentle hand Thirdly As for Blisters although hitherto we have not had sufficient trial of them and although we banish from this Diseas both septical applications becaus they dissolve the parts and also caustical because they penetrate deeper and produce a crusted substance yet we conjecture that those
Pyrotical remedies which only raise Blisters in the Skin may be somtimes profitably admitted You wil say that Cantharides wherwith they are commonly made are extream hot and besides suspected to be of a venemous quality We answer That we may not here insert any thing of the qualities of Cantharides we grant that which is asserted But becaus they are administred only to the outward little Skin and only to a little part therof not much extended and becaus as soon as the blisters are raised they are removed the excess of their heat and their poyson scarce penetrates deeper into the Body than the bottom of the Epidermis and therfore this remedy may be applyed without any notable harm or danger But then you may demand what profit can arise from hence We affirm that it doth effectually correct a cold and moist distemper and potently dissipate the astonishment of the Marrow of the Back the Brain Nervs and the Nervous parts and withal that they make all the parts more firm and steady and stir up a stronger Pulse in the external parts al which things are of no smal moment in the cure of this Diseas One amongst us affirmeth that among other things he prescribed this remedy to a Child of two years old who was troubled with the Rachites and was also fallen into a continual and malignant Feaver and grown almost frantick Hereupon the Child found present and manifest eas and after a few days was delivered from his Feaver Afterwards having purged him twice or thrice with an infusion of Rhubarb c. Beyond the expectation of all that saw it he also subdued this Affect almost without any other remedies But as you can scarce find any commodity without a discommodity so neither is this remedy exempted from al inconveniences For it is unpleasing ful of pain and molestation to Children Moreover for a time it interrupteth their exercise and pastime in respect of which things unless perhaps som other complicated affect do point at an interdiction of exercise it may do much more prejudice than advantage Again the force of it suddenly wasteth and afterwards by degrees is consumed which doth not in all respects keep touch with a Chronical Diseas Finally an Issu which is proper to Chronical Diseases may very wel supply its place in this affect Wherfore we scarce admit the application of blisters in the cure of this malady unless som acute Diseas be complicated which may require this kind of Remedy as it fals out in the Cause propounded Now wher this administration is requisit it is most commodiously performed upon the turning Joynts of the Neck unless som Issu have prepossessed the place in which case you must administer them either behind the Ears or four Fingers below the Issu We deny not but it may be fitted to several other places in respect of the complication of other Diseases But we here design the place which a peculiar reference to the present Diseas Fourthly Ligatures also may be referred to this Title and indeed we grant that somtimes they are not altogether unuseful in this affect namly if they be very moderate and adhibited by just distances and unto convenient places but you must beware that they hinder not the growth of that part wherunto they are applyed which is don if they be sufficiently loose and made of soft wool if in the Day time or for som part of the Day they are tyed up and unbound at night if they be fitted to the Thighs and Legs upon the Knee and to the Arms upon the Elbow Yet Ligatures do here seem to conduce much to the stoppage of the Blood from flowing to the Head and that it ought to be fastned to the outward parts that are extenuated besides this Remedy is good to retard the over slippery return of the Blood in those parts unto which the Ligature is applyed Fifthly Hitherto also belong the Fasciation or swathing of certain parts for this hath an affinity with Ligatures For som use to enwrap the weak parts in wollen blankets therby to strengthen them and to cherish their heat namly the Feet the Legs the Knees and the adjacent parts of the Thighs But you must be careful that the overstraightness of them hinder not their growth F C B A C D D G A B C D A B Two Iron rings C D The Diameter of the Joynts of the Splents F G The two Splents Instead of the Splents you may more commodiously use thin plates of Iron and the whol Instrument may be made of Iron The two Axel trees or Diameters C D upon which the Shingles or Splents are bended F G are fastned with two rings or hoops But the hoops themselves A B C are made of plates of Iron of an exquisit thinness that they may not be burthensom and withal they ought to be wel smoothed and polisht that they hinder not the motion of the Splents These rings must be of an equal Latitude suppose about two fingers a cross and they must be so fitted together that on every side they may be paralels only let there be so much distance between them that they may fitly receive the tops of the Splents Moreover Those hoops must not only be coupled with a double Axel C and D but also with five smal Iron Nails Lastly The whol composition of the Instrument must be so made that it may be fast and fitly tied to the side of the bended knee sticking out and withal that it may serve as well for the extension as the ordinary bending of it but let it restrain the deflexion of it to either side especially to the part sticking out Which is the caus why the Axels are fastned with a double Hoop namely lest the Joynts should be loos and yield to the deflexion of the Knee In like manner the torsion and mishapen writhing of the Feet is also frequently corrected with Swathing Bands If the Toes are outwardly distorted they must every night be bound up little balls of Cotton being put between the Heels and the Ankles But if the Toes bend inwards then you must bind the Ankles and put a little Cotton between the great Toes Lastly To straighten the trunk of the Body or to keep it straight they use to make Breastplates of Whale-bone put into two woolen Cloaths and Sewed together which they so fit to the Bodies of the Children that they may keep the Backbone upright repress the sticking out of the Bones and defend the crookedness of them from a further compression But you must be careful that they be not troublesom to the Children that wear them and therfore the best way is to fasten them to the Spine of the Back with a handsom string fitted to that use CHAP. XXX Of the Pharmacentical matter and first of such things as clense the first Passages THis matter is of manifold and most noble use and satisfieth very many Indications For it comprehendeth al Medicaments those only accepted which concern
the Chyrurgion which have a primary relation either to the causes of the Diseas or the Diseas it self or the Symptoms It is divided into remedies Internal or External and each of them into Simple and Compound Again the Internal may be subdivided into such as clens the first passagss as Medicines Preparatory Into Electively evacuant and such as are Specifically alterant and Evacuant and finally into those that correct the Symptoms Among these the Internal obtain the precedency and of those again such as wash away the impurities of the first passages becaus these as hath been already observed are justly accounted an impediment in respect of the following remedies and simply ought first to be removed But in all the Titles as far as the Nature of the thing will licens or warrant us we will place the Simple before the Compound Moreover these washing remedies comprehend these three kinds namely Clysters Vomits and Lenitive Purgations The use of Clysters and some forms of them The Injection of Clyster-pipes before we more exactly and earnestly attempt the Cure is then chiefly pre-required when the Belly is costive and the Excrements are hardned or when some windy humors torment the Guts or some vehement pain in the Bowels afflict the Patient In which cases they may not only be injected before any preparation but also before a Vomit yea or a Lenitive Purgation These are frequently compounded of benign and gentle Purgers somtimes also of such as have only a faculty to make the waies slippery and to expel wind but never of Cathartical ingredients that are violent they are to be injected warm or lukewarm and after a long abstinence from meat We shall present some forms Take Cows new-Milk warmed four or five ounces Anis Seeds beaten to Pouder ten grains Cours Sugar one ounce one ounce and an half or two ounces The Yolk of one Egg mingle them and make a Clyster to these may be added half an ounce of new Butter Take a sufficient quantity of an emollient Decoction An Electuary lenitive half an ounce Syrup of Roses Solutive and Syrup of Violets of each six drachms Oyl of Chamomel one ounce mingle them make your Clyster and let it be injected lukewarm Take the Roots of Marsh Mallows beaten together half an ounce or in lieu therof the leaves or Flowers of Mallows half a handful Flowers of Chamomel one pugil Hemp Seeds two drachms boyl them in a sufficient quantity of Whey mingled with Beer To four or five ounces of the Decoction ad of Diacassia or Electuarium Passulatum half an ounce Syrup of Roses Solutive and Kitchin Sugar of each one ounce new Butter six drachms you may if you see occasion ad the yolk of one Egg. Take Stone-Horsdung that is new one ounce and an half The Seeds of Annis Fennel Mallows beaten together of each one drachm and an half Flowers of Chamomel one pugil Boyl them in a sufficient quantity of posset drink In four or five ounces of the Decoction dissolve ten drachms of Syrup of Violets common Sugar and Oyl of Roses of each half an ounce Mingle them and make your Clyster The use of vomiting remedies and some examples of them Emedical Remedies or Vomits do chiefly perform three things First they evacuate crude or corrupt humors and all manner of impurities contained in the Stomach and that by a shorter and more expedite way than if they were conveyed through the involutions and labyrinths of the Guts Secondly By an agitation and commotion raised in all the parts especially the Bowels they loosen the gross and viscous humors adhering unto them or impacted in them and frequently expel them especially those which are collected in the Stomach and Guts in which respect they are profitable against torments of the Chollick and very conducible to unlock Obstructions Thirdly They most effectually irritate the expulsive faculty of all the parts of the Body and especially of the Bowels and by this means many times upon a single application they compel forth the hidden and unappearing causes and fomentations of Diseases and especially of intermitting Feavers For by the very straining to vomit the Guts are also instimulated to cast out by siege The Liver powreth away the Choller by the Biliary Pore the sweet-Bread voideth his peculiar excrement by the new Vessel into the Guts the Spleen also perhaps unburdens in a plentiful manner his excrement into the Stomach by Vessels not yet throughly known The Kidneys exern through the Ureters the Lungs by a strong Cough eject their Flegm through the Windpipe The Brain emptieth it self of salt waterish Rhewms and matter by the Palate the Nostrils and the Eyes Finally the whol Body for the most part is rendred more prone to a Diaphoresis either by a manifest sweating or else by an occult and insensible Transpiration In the mean time it must be noted that not all gentle Vomits nor indeed the more vehement if they be given in too smal a dose wil presently and fully perform all these things yet in their operations they effect more or less according to the strength or quantity of the Medicine and indeed if the stronger be administred in a full dose they effectually attain to the three marks propounded It is obvious by what hath been said to the consideration of any Reader that strong Vomits prescribed in a full quantity are not competible to Children affected with this Diseas neither can their tender strength overcome and subdue so great tumults in the Body and such an Universal evacuation so suddenly wrought Wherfore this kind of remedy ought not to be prescribed to Children without diligent precaution and circumspection and both the strength quantity and efficacy of the Medicine are duly to be prepondred To this end therfore we shall set down some Cautious in favor of unexperienced Practicers First A Vomit is not to be provoked in this Diseas unless the humors tend upwards of their own accord but then indeed they may be expelled by vomiting remedies without difficulty Seeondly Not unless Children are naturally or customarily apt to vomit and do easily endure it Thirdly In Bloud-spitting the Ptisick and Consumption in any flowing of Bloud at the Nose or any internal opening of the Veins and the like cases abstinence must he enjoyned from this remedy Fourthly Vehement vomits exhibited in a larger dose are here forbidden For the fear is just and prudent that they may depopulate the Natural Spirits and further consume the very solid parts which before were over-much extenuated It is necessary therfore that the Vomits here prescribed be either in their own nature gentle or corrected if they be vehement and administred in a lessened dose You wil say If they be of a mild and lenitive faculty or exhibited in a diminute quantity they cannot compel the humors with any efficacy To this we answer Indeed where Nature contributeth little or no assistance it cannot be denied but in such cases we totally prohibit the administration of
swelled and this stretching hardness and swelling would not yeild to a Purgation though rightly administred then you must proceed to Local Remedies As Take Oyl of Capers Wormwood Elder of each one ounce of the general Ointment first described one ounce and an half mingle them and make a Liniment Or Take Ointment of the opening juyces Foesius three ounces the first general Ointment two ounces mix them together and make them one Ointment also Oyl of Saxifrage made of a manifold infusion and boiling of the bruised Herb in common Oyl is much to be commended to be mixed with it In the time of using it this and the like Liniments or Unguents may be mingled for penetration sake with som appropriat liquor As Take the flowers of Elder the flowers of red Sage Bay-berries bruised white Sanders slightly beaten to pouder of each two drams white Wine two pound steep them for three days in a cold place in a glass vessel accuratly stopt with Cork and shake it twice a day when you use it strain as much as will serve your present occasion then stop your vessel again Or if you desire a stronger Take the roots of white Bryony well dryed and sliced Bay-berries Goos-dung of each two drams Cummin-seeds one dram the leavs of red Sage the flowrs of Elder of each one pugil boil them in one pound and a half of Rhenish-wine to a pound keep the Decoction in a cold place diligently stopped These and the like Liquors mingled with the Oyntment and heated at the fire must be rubbed upon the Abdomen and especially the Hypochondries even to driness Let the Nurse also having well warmed her hands handle those parts gently somtimes pressing the Bowels upwards somtimes downwards somtimes to the right hand and somtimes to the left according to our former Directions The most galent thing of all is the Balsom of Tolu mixed with any Oyntment or Plaister and so applied to the Region of the Back either in form of an Oyntment or Playster Plaisters also seem to contribute somthing As Take three ounces of Ceratum santalinum Gum Ammoniacum dissolved in Rhennish Wine or in som other medicated wine above described purified and boyled again to a thickness one ounce make your Plaister according to art Spread part of this upon Leather and lay it upon the right Hypochondry or els the left if the hardness be there most sensible which indeed is very seldom Or Take the Juyces of Brooklime Watercresses Garden-Scurvygrass Wormwood the bark of Elder the roots of the male Fernbrake of each one ounce Let the Juyces be purified with a gentle heat and being extracted reduce them to a thick body then ad one dram an half of Mace and two drams of yellow Sanders in pouder Take of this Mixture one ounce and an half Gum Ammoniac dissolved in Wine and boyled to a body four ounces Mingle them bot and stir them continually till they begin to wax cool and hard and make a Plaister to be applied as the former Moreover when the Lungs are il affected many times a peculiar pectoral Plaister is very useful As Take Oyl of Violets white Lillies and the Ointment of Orenge flowers of each one ounce Mingle them and make a Liniment to be rubbed with a hot hand upon the Breast laying a Lawn Paper over it lined with Wool or linen cloth To this Liniment you may ad a smal quantity of Natural Balsom Or Take two ounces Unguent Pectorale an ounce and an half of simple Ointment of Liquoris one ounce of Oyl of Violets Mingle them and make a Liniment to be used after the same manner The Ointment of Liquoris is thus made Take new and Juycy Liquoris four ounces new unsalted Butter washt in Rose water one pound slice the Liquoris and beat it wel with the Butter in a stone Morter afterwards fry them then strain and squeeze them and repeat the same labor thrice with a new quantity of Liquoris Again Som Plaisters may be prepared proper against the weakness of the Back which very frequently hapneth in this Affect In the Shops you may have the Plaister of Betony and Diachalcitheos unto which nevertheless when you use them you must ad Mastich and Olibanum in pouder of each half a dram the Plaister also which is called Flos Unguentum may hither be referred provided that you omit the Camphire in like manner also Emplastrum Nervinum Or Take two ounces of the first general Oyntment five of the Herbs that are contained in that Composition cut and chopped very smal Yellow Wax four ounces the purest Rosin eight ounces the Oyntment Rosin and Wax being melted ad the Herbs and according to art make a Plaistrr Or Take fifteen ounces of the third general Oyntment Litharge of Gold beaten smal and sifted nine ounces boyl them together continually stirring them to the consistence of a Plaister then ad Wax Burgundy Pitch of each three ounces Oyl of Nutmegs by expression three drams Mastich Olibanum Mirrh of each one dram and an half Costorium half a dram white Vitriol in pouder half an ounce make your Plaister according to art In like manner some commend a Liniment for the weakness of the Back-bone which consisteth of Gelly of Harts-horn made with such things as strengthen the Sinews adding the Flowers of Sage and the Roots of our Ladies Seal In the time of anointing mingle therwith a little Oyl of Nutmegs by expression or Oyl of Worms or Mans Grass And thus much of external Remedies FINIS A Table of the Chapters contained in this Treatise CHAP. I. THE Antiquity and first Origin of this Diseas the Name of it and the Derivation of the Name Pag. 1 CHAP. II. Anotomical Observations collected from the Dissection and Inspection of Bodies subdued and killed by this Diseas p. 8 CHAP. III. Certain Suppositions are proposed for the easier finding out the Essence of the Diseas First of the Essence of Health Secondly of the Essence of a Diseas Thirdly of a threefold Division of Health and Diseases The Explication of the third Division and the Use of the same The Description of a Natural Constitution and the Exaltation of it The Fourth Supposition of the Combination of three Constitutions in the same parts p. 17 CHAP. IV. That the Essence of this Diseas consists not in the Animal or Vital but in the Natural Constitution not as Organical but as Similar Three Limitations are propounded p. 26 CHAP. V. The proposed Opinion is examined by Parts First That this Diseas is a cold Distemper An Objection and the Answer thereunto That it is moist that it consisteth in the penury or paucity of the Spirits An Objection with the Answer Finally That this Diseas consisteth in the stupefaction of the Spirits p. 36 CHAP. VI. Of the Part first affected in this Diseas p. 45 CHAP. VII Of the secondary Essence of this Diseas p. 57 CHAP. VIII The secondary Essence of this Diseas in the Vital Constitution p. 72 CHAP. IX The viciated Generation of the Vital spirits in this Affect and whether that fault be a part of the secondary Essence p. 75 CHAP. X. The viciated Distribution of the Vital Spirits in this Affect and whether it be a part of the secondary Essence thereof p. 80 CHAP. XI The Inequality of the Distribution of the Bloud in this Affect p. 94 CHAP. XII The faults of the Vital Participativ Constitution in this Affect p. 99 CHAP. XIII The Organical faults of the Natural Constitution in this Affect p. 108 CHAP. XIV The secondary Essence of this Diseas in the Animal Constitution p. 144 CHAP. XV. The Causes of the Rachites And first those things which concern the Parents p. 151 CHAP. XVI The Causes of this Diseas incident to Children after their birth p. 163 CHAP. XVII Precedent Diseases which may be the Cause of this Diseas p. 180 CHAP. XVIII The former Question p. 187 CHAP. XIX The latter Question Why this Diseas hapneth more frequently in England than in other Countries And whether it be Natural to English-men p. 202 CHAP. XX. The Differences of the Diseas called the Rachites p. 215 CHAP. XXI The Signs of the Rachites and first the Diagnostical Signs p. 228 CHAP. XXII The Signs of the Differences of the Rachites or the Diacritical Signs thereof p. 241 CHAP. XXIII The Prognostical Signs in the Diseas of the Rachites p. 251 CHAP. XXIV The Method to Practice and Indications in general p. 257 CHAP. XXV Indications Curative p. 279 CHAP. XXVI Indications Preservative p. 282 CHAP. XXVII Indications Conservative or Vital p. 284 CHAP. XXVIII The Use and right Administrations of the Indications aforesaid p 302 CHAP. XXIX The Meddical matter answering to the Indications proposed and first the Chyrurgical p. 310 CHAP. XXX Of the Pharmacental matter and first of such things as clense the first Passages p. 322 CHAP. XXXI Remedies Preparatory and their Use p. 330 CHAP. XXXII Remedies Electively Evacuant p. 335 CHAP. XXXIII Specifical Alterent Medicines p. 340 CHAP. XXXIV Remedies that correct the Symptoms p. 349 CHAP. XXXV External Remedies p. 357 CHAP. XXXVI Things to be Externally Applyed p. 366 FINIS * A most loathsome and horrible Disease in the Hair unbeard of in former times bred by modern luxury and excess It seizeth specially upon Women and by reason of a viscous venimous humour glues together as it were the hair of the head with a prodigious ugly folding entanglement somtimes taking the form of a great Snake sometimes of many little serpents full of nastiness vermine and noysome smel And that which is most to be admired and never eye saw before pricked with a needle they yeeld bloody drops And at the first spreading of this dreadful Disease in Poland all that cut off this horrible and snakie hair lost their eyes or the humor falling down upon other part of the body tortured them extreamly It began first not many years ago in Poland It is now entered into many parts of Germany H Saxo Professor of Physick in Padua ‡ A Disease in the head coming frō Rhewm ‡ That part of the brest where the ribs meet ‡ A thin and smooth skin which cloatheth the ribs in the inner side
do cherish and strengthen certain parts You wil say These are indeed Alterants and do belong to the kind of contraries We answer That in a divers respect they may be referred to each kind but in as much as they obtain qualities like unto the du Nature of the parts although otherwise they alter som smal matter yet they are to be referred to the similaries For the very nourishments do in som degree alter and are directly contrary to emptiness and conservation it self doth implicitly include a certain correction as we have shewed above Now these indeed in regard of a middle nature which they have between similaries and Alterants are not called Medicaments but Strengthners Conservants and Cordials Again these are Indicated as Conservants by the peculiar debility of the Spirits and as to be elected and not only permitted and so they are esteemed in the Books of Practical Authors The Permission of a remedy somwhat contrary to Nature doth likewise belong to this Indication For such is the dignity and valu of this Indication as it summons both the Curative and Preservative Indicates to an examination before they are reduced into practice and doth not only moderate and limit the quality and quantity of the remedy but also the very time of repeating it yea whatsoever appertaineth to the use therof or the manner of using it and al this least in any wise it should exceed the Spirits of the Patient or be injurious to them nor is the excellency of it thus circumscribed but it requireth more namly that more profit and advantage may accrue to the things according to Nature by impugnation of the Diseas then hurt or detriment by any violence offered to Nature And under this Law and Condition Vital Indication permitteth many things to be don which of themselvs are contrary to the Spirits yet always in favor of health never to the prejudice of Life A prohibition of a contrary is altogether a commanding Action of this Indication and by a kind of Authority dictates this or that thing not to be don although it were otherwise Indicated becaus perhaps it endangers life it self or brings more disadvantage than benefit of health to the parts And this is the third and last force and use of this Indication We shall now in one word apply these things to the present Diseas All Constitutions in this Affect are very weak and infirm and this is manifest from the bare consideration of this tender age But the Natural doth yet further suffer by the force of the first Essence of the Diseas and from hence also the Vital is somwhat weakned and indeed neither doth the Animal escape wholly free as was shewed above Wherfore both a general and also a particular regard must be had to these Constitutions as wel in the Election of Similaries as in the permission or prohibition of contraries First Therfore in this Affect you must make choice of the best nourishments such as are easy of concoction and as neer as you can agreable to the custom and age of the Patient to the time of the year c. the contraries must be abandoned namly such things as nourish little are difficult of digestion and incongruous to the custom age and season Secondly Those things must be chosen which cherish and strengthen the weaker Constitutions and the parts that are most Affected and these must be either exhibited severally or they must be mingled with nourishments or Medicines but such things as are neither serviceable to this scope nor otherwise Indicated must be totally avoyded Thirdly Benign and gentle evacuants or othertherwise sufficiently corrected must be allowed in a moderate quantity just and du interval of time being observed But the contrary things namely violent and fierce purgers especially such as are apt to dissolv the parts or are exhibited in an undu quantity or too often repeated are forbidden Fourthly Remedies alterant or such as prepare the humors or correct the Diseas must be permitted such also as are friendly and familiar to Nature or such as may be made such by good company that is by composition or sufficient correction Remedies violently alterant extream hot and vehemently discutient or any other which in any wise resolv and dissipate the parts CHAP. XXVIII The use and right administrations of the Indications aforesaid HAving propounded the three kinds of simple Indications and deduced them into their lowest species we shal in the next place consider the right use administration of them The exact knowledg wherof seems impossible to be obtained without rode and experience For it descendeth unto Individuals and comprehends not only the Election of a thing among so many Indicates simply to be don in the Species but also the invention of quantity place form time order and matter of the remedy to be exhibited The Consent and Dissent of Indications do contribute much to this invention Now the Consent may be twofold of Coindication and Permission Permission may be either an Advantage or a Loss to him that permitteth or neither of them A Permission that cannot be granted without hurt must never be allowed without the greatest circumspection and so much the greater as the damage may be the more to him that permitteth For although the Permittent may part with somwhat of his private right to advance the publick good yet in respect that he is a member of the whol he is supposed to be a gainer The Dissent of Indicants is twofold namly either Contradictory or Contrary The Contradictory among the Books is called Interdiction or Prohibition and for the most part it is appropriated to the Spirits unto which in this respect we must always yeeld obedience The Contrary is called Contra-indication and this doth not simply forbid but so far forth as it undergoeth the Nature of an impediment or som more urgent Indicate First Where Indicants consent either by Coindication or Permission satisfaction if it be feasible must be given to al the Indicates But if this cannot be performed Medicines of that Nature are to be preferred before the rest which are correspondent to most or at least to the most urgent Scopes But if such simples cannot be found out then you must institute an apt composition of diverse simples one with another The Essential parts of this Diseas although they are very various yet is there not any considerable disagreement among them and nothing hindreth but in a great part they may be considered together For Medicines temperatly hot and dry may at once cherish the Inherent Spirits and perhaps conduce to the scattring of the numbness in them and withal somwhat fortify the Tone of the parts and facilitate the equal distribution of the Blood and consequently the equality of the Nutrition also it may increase vigor in the Vital and Animal Spirits proritate the Arteries in the first affected parts and strengthen the Nervs unto which Heads almost al the Indicates of the Essence of a Diseas may not