in the encrease of certain parts or from an unprofitable and Excrementitious which happens in divers kinds of tumours Magnitude is lessened by weakness of virtue Diminished and want of sustenance or by cutting burning gnawing putrefaction refrigeration Lastly parts change their places by reason of the loosenesse Of changing place or solution of unity of those parts wherein they are conteined or contraction of ligaments or when they are violently put out of their places The vicinity and connexion for the most part is hurt by the same means namely Of Connexion if the parts by whose intervening they are knit together are loosened broken or wounded CHAP. XIIII Of the causes of Diseases of Solution of Unity THe causes of Diseases of Solution of Unity Causes of Diseases of Solution of Unity Of cutting although they are very many yet all may be reduced into five ranks for all things that dissolve the continuity of any part either cut or gnaw or knock or bend and break or burn those that cut are all sharp bodies which whether edglings or wound with the point as all kinds of weapons and darts thorns the biting of living Creatures and such like All sharp things erode as humours Eroding and all sharp eroding putrifying burning medicines Those that are heavy and great and blunt knock as stones woods Knocking and breaking Eating dashing the body against hard things which if they happen to a part that can give way to it they bruise it if they happen to a hard part which cannot yeild they break it they knock and break those things that fill the part as plenty of humours and store of wind or they powerfully dry or violently dilate the part as dancing and all loud singing and heavy burthen oppressing to which belong immoderate cold Lastly hot Irons burnt Burning and other mettals and hot and fiery things The end of the Second Part of the Second Book Book II. PART III. OF SYMPTOMES SECT I. Of the Differences of Symptomes CHAP. I. What a Symptome is THE name of Symptome The word Symptome although sometimes it be taken generally for every thing which befals the body contrary to nature so that both Diseases and causes of Diseases are comprehended under the notion of Symptomes Yet Physitians take not this name so generally But by Symptome understand something different from a Disease and a cause of a Disease and so a Symptome is an affect or accident contrary to nature in those things which are necessary to perform natural actions without the constitution of the parts some other thing contrary to nature following It s definition or 't is an accident different from natural and changing the natural constitution of the body which to perform natural actions is no necessary whether the action it selfe be hindered or some accident contrary to nature in the humours and excrements or even in the living parts so that it hinder not their actions for a Symptome may consist even in the living parts For example heat caused by a Bath or exercise so that there be not any effect which can hinder action CHAP. II. Of the causes and differences of Symptomes in general SO that in respect of the causes It s division a Symptome is properly divided into a Symptome of a Disease a Symptome of a Cause and a Symptome of a Symptome for they labour in vainâ— who endeavour to draw all Symptomes from Diseases A Symptome of a Disease is that which immediately follows a Disease A Symptome of a Disease A Symptome of a Cause no other affect contrary to nature comming between as when an ill concoction follows a distemper of the stomach which is called in Greek Cylosis A Symptome of a cause is when the action is hurt although the faculty and its organ be well the faculty being hindered by an external fault as when the Liver though sound cannot sanguifie by reason of vitious chyle Whether hurt by external meanes be Symptomes they trouble themselves exceedingly here who endeavour to deduce every Symptome from a Disease and actions hindred which happen without a Disease no way worthy the name of a Symptome but think them worthy to be called certain natural differences or imbecilities since that they are accounted to perform nothing beyond their own strength but they plainly erre in the matter for that any work may be perfected not onely the agent and that rightly disposed but also the patient which receives the operation of the agent is required For as in voluntary actions as for example in gesture or lifting of a weight the businesse is in the free will of man but that some work may be performed in the body as for example Sanguification Nourishment It is necessary that the patient be joyned and coupled with the agent but since the action of him that moves and the patient moveable is but one motion and differ onely in reason as Aristotle teacheth in the second Book of his natural Philosophy Chap. 3. Title 23. Diservedly therefore in natural actions when that is not performed which ought to be especially in natural concoctions all that which either is hurt or frustrated is deservedly called a Symptome whether it be done by reason of the agent or of the patient for although in respect of the agent it be impotent Yet some fault doth happen by reason of the patient and therefore it is the office of a Physitian if he will govern a mans body aright to govern as well the patient as agent in such actions A Symptome of a Symptome is that which follows another preceding Symptome A Symptome of a Symptome A division of Symptomes no other affect contrary to nature comming between Moreover there is a common division of Symptomes into an action hurt errours of excretion and retention and qualities changed namely such as doe not hinder the actions of our bodies Actions hurt are of two kinds Manner of actions hurt the one is so called when the faculty is hurt The other by reason of some external fault as is said When the faculty is hurt the action is said to be hurt How many ways are actions hart when the faculty is hurt since the agent is not right or since the instrument for the faculties of the mind cannot be hurt is affected contrary to nature That the natural constitution of the part which is the next instrument of the faculty is vitiated which being spoyled the mind cannot perform its actions Again some divide the faculty hurt into the faculty hurt alone by its selfe and into certain actions hindred The faculty hurt by it selfe they say is when the next instrument which it useth in performing whereof that action is ill affected as for example when the Bladder doth not expel Urine by reason that the Fibers which are used in expelling are ill disposed Again to the good constitution of the instrument is required not only as abovesaid constitution of the part as
dyet generates pituitous humours and so more lasting Diseases great strength of nature in a Disease that is not mortall Strength of nature shewes that the Disease is short but weaknesse shewes it will continue longer but strength in a disease that is mortall shewes that it will continue longer but weakness signifies that it will be shorter Thirdly From the course of fits in the fits the houre is to be considered in which the Paroxysme returnes the time of duration and the vehemency of Symptomes for if the fits returne sooner and the latter be longer then the former and more vehement it is a token the disease is increased on the contrary if the latter fits return slower and endure a shorter time and are not so violent it is a signe the disease abates but sometimes Paroxysmes enveigh equally and all of them return at the same houre which most commonly is a sign of a long disease but sometimes they come not equally but at severall houres which shewes that the disease will be shorter and is neerer to the state Moreover if the fits come sooner and that equally the signs of concoction not appearing it is the beginning but if they anticipate more hours then before it is in the increase when they observe equality again a good while it is the state when lastly the omitting or abating of the fits happens to be various it is the declination If the order of the fits so that sometimes they come too soon sometimes too late and sometimes equally and at certain times When the fits do equally invade without the signes of concoction t is the beginning but when they anticipate not t is the augmentation when they observe equality it is the estate And lastly when the coming late happens again t is the declination but if the order of fits be various so that sometimes the Paroxysmes invade equally sometimes anticipate and sometimes come later when the fits equally invade without signes of concoction the beginning is when they come too soon no more the state is but when they come too late the declination is As for the longitude and magnitude of fits In longitude if the time of intermission or declination be short and they are neither plainly intollerable nor altogether free from Symptomes it is a signe of the increase On the other side if the abating or the intermission be long easie to be indured and free from all Symptomes absent declination is shewn But the most certain signes of the times of diseases are digestion and crudity for whensoever a sign of concoction appears suddenly it shews the disease will be short and terminate in health but a signe of crudity shews the disease will continue long or even prove deadly and if grievous Symptomes grow upon the sick so that they come with signes of concoction they need to trouble no man but if they happen without signes of concoction and with crudity they portend danger CHAP. III Of the signes of times of Diseases in particular ANd that we may speak something peculiarly of knowing of the times of Diseases the beginning of a disease is as long as the disease is crude Signes of the beginning of a disease of augmentation of the height An evident and manifest concoction is a most certain signe that the beginning is finished And in the beginning the Symptomes are hitherto more mild but in the augmentation all of them increase and in the state when the greatest contention is betwixt the matter and the disease all of them are most vehement but this comes to passe sometimes soon sometimes late for in very acute diseases immediatly they have extream pains 1. Apho. 7 but in Chronick the times are extended longer CHAP IV. Of the signes by which we may foretell the event of a disease ANd these things are spoken of Prognosticks in generall now we are to speak of those three The event of a disease fourefold which use to be presaged namely the event of a disease the time of the end and the manner but the event of a disease is fourfold for some diseases kill the diseased others plainly leave them off so that the sick returne to their perfect health others neither kill the sick nor leave them off but accompany them even to deaths doore others are changed into other diseases and somtimes into worse somtimes into milder The event of a disease is known by comparing the strength of nature with the disease and by the longitude of a disease When it may be known or the state with the time to come for if the sick passe over the state there is no need that he should any more feare the danger of death by that disease because after the state no man dyeth in the declination by the power of that disease The signes of strength and weaknesse of nature are sought principally from causes and effects Signes of strength and debility of nature the proximate cause of the strength of nature is a natural constitution of the parts And this by how much the neerer it is to the naturall temperature constitution and naturalll unity by so much it signifies the firmerstrength by how much the more remote by so much the weaker For strength of nature principally depends upon a naturall temperament whereunto belongs age also and sex for in men and youths the strength is firmer in women old men and boyes weaker Remote causes are all those things which by whose intervening the strength of a naturall constitution is increased or preserved or diminished such are those things that are taken in which are carried about which happen externally and that are evacuated and retained for if all these things have been moderate heretofore and are moderate it shewes strength of nature if immoderate imbecility Amongst the effects are first actions which by how much the more they are observed according to nature by so much the more they signifie health on the contrary by how much the more or more noble they are or by how much the more they are hurt by so much the more they shew the strength to be weakned Secondly Excrements signifie nature to be powerfull when in their substance quantity and quality they are most like to naturall but they signifie the contrary if they are contrary Lastly qualities changed by how much the neerer they shall be to the qualities of sound men by so much they shew the greater strength in the diseased by how much they differ from them by so much the more imbecillity The strength of a Disease is known from things essentiall Signs of a strong discase inhering causes and effects or consequent Symptomes As for what belongs to a constitution contrary to nature the difference which follows the form of a Disease or the causes or the subject afford signes of the event if the Difease be great it indicates danger and death if little health and by how much the fewer and more gentle those Symptomes
They are in number three a Disease the cause of a Disease and Symptomes in the handling whereof the Pathological part of Physick is delivered And first for what belongs to a disease Although as the name of health is generally attributed to all things that happen to a man according to nature so the name of a disease is given to all things that befal a man contrary to nature and those are said to be morbifick yet if we may speak properly these three a Disease the cause of a Disease and Symptomes as they differ in the thing so they may be discerned by their names also But whereas a disease is conrrary to nature The formal reason of a disease but health is that power of acting which is to be performed according to nature a disease is an impotency of performing natural actions and as those who are apt to do those things which are according to nature are said to be sound so those are deservedly said to be sick who are unapt to perform those actions Moreover the Subject of a disease as also of health The Subject of a disease is only the living parts of a body as being those to which alone a power of undergoing natural actions is given But all those things which are not in the number of the living as humors and other things which are not able to perform natural actions in a man cannot be the subject of a disease The cause of a Disease or of impotency to perform actions is an ill constitution of the parts The causes of a disease The definition of a disease The Galenicall definition of a disease as the cause of health is a right disposition of the same Hence a Disease is defined to be an impotency of the living parts of man to perform natural actions arising from their constitution contrary to nature Although according to Galen also to be sick is not to be able to operate and so this definition is not contrary to the sense of Galen yet that out of the definition of diseases differences and profitable observations may the better be drawn Galen retains the same terms of the definition but places them otherwise and in the second Chapter of the differences of Diseases defining a Disease saith That a constitution of a vitious function contrary to nature is the cause thereof and in his first Chapter of the differences of Symptomes calls it a disposition contrary to nature by which action is hurt Namely as health is a certain quality or harmony in the qualities in magnitude number figure and other things neceslary for the constitution of each part by reason whereof the body is disposed and made fit to perform natural actions So a Disease is such a quality by reason of which the same body is rendred unfit to perform the same actions Diathesis what it is For the word Diathesis taken generally signifies every quality according to which a man is well and ill disposed whether it be easily or difficultly taken away And therefore as certain later Physicians will have it A Disease is not only a privation a Disease is not simply the want of health and nothing positive but such a want as proceedeth from a disposition contrary to that disposition on which health depends which is wholly something positive and when a part is wounded or diminished a quality and disposition is brought into it contrary to that which was present there before in time of health as a hand that is wounded is otherwise difposed then that which is well and that which hath four fingers otherwise then that which hath five In brief a Disease consisteth not only in privation of a good constitution but in a contrary and vitious constitution CHAP. II. Of the differences of Diseases THE differences of Diseases are two-fold The Essentiall differences of diseases Essential or Proper which are taken from the essence it self of a disease and so agree to one kind that they cannot be common to another or accidental which are taken from those things which follow the essence of a disease and from other circumstances But because as 't is said before there is one natural constitution of the similar parts as they are such and another of the organick and a common Unity in them both the regression from that natural constitution of every one affords several kinds of Diseases First therefore Diseases of the similar parts the proper Diseases of the similar parts are Diseases of Intemperature when that due proportion of the primary qualities is not observed but when one doth excell the other three or two overrule the other two contrary to nature Moreover there are found in similar parts Diseases of hidden qualities or of the whole substance as they call them when there is not only in the constitution of the similar parts a due congruity of the primary qualities but a certain disposition also of the occult qualities is requisite Secondly Diseases of Organick parts there are so many signes of Organick Diseases as we have said are requisite for the composition and constitution of an Organ namely four Diseases of Confirmation of Number Magnitude and Composition Lastly the third kind of Diseases Common to both which are common to them both They call solution of Unity or continuity CHAP. III. Of Diseases of Intemperature DIseases of Intemperature as is said Diseases of Distemper are when that due proportion of primary qualities is not observed which ought to be but either one overcomes the other three or two the other two Whence one distemper is said to be simple another compound Simple is that wherein one quality exceedeth and this according to the number of the four qualities is quadruple hot cold moist dry Compound is that wherein two qualities exceed and this according to the quadruple mixture of the primary qualities is four-fold hot and moist hot and dry cold and moist and cold and dry And so in the whole there are eight Diseases of Intemperature But these distempers are again distinguished divers wayes Distemper without and with matter which distinctions neverthelesse produce not new kinds but differences which are found in many differing in kind For first one distemper is with matter another without matter Intemperature with matter is when it hath a humour joyned with it and is cherished by it Distemper without matter is that which is cherished by no preternatural humour as when heat is sent into any part from the fire or heat of the Sun Moreover one distemper is equal another unequal Equal intemperature equal is that which is a little and equal in all living parts and affects them all alike Unequal and equally Unequal is that which is more intense in one part and more remisle in another and affects one more another lesse For since that the members of our body are constituted of many particles it may come to passe that all may not be equally affected by
the declination for no man ever dyed in the declination of a disease In the same manner Particular times may be limited Particular times and every course hath its fit which course Remissness or an Intervall follows A fit hath its beginning increase state and declination which Particular times may happen during the Universall times The end of the first part of the second Book THE SECOND BOOK PART II. Of the Causes of DISEASES CHAP. I. Of the Causes of Diseases SEeing that nothing can perfectly be known unless the causes thereof are known whither can diseases be avoided unless the causes are shun'd neither can the same be taken away unless the causes if they are present be first taken away We will now treat of the causes of Diseases Although by the Philosophers there are rightly constituted four kinds of causes The sorts of causes the Materiall Formall Finall and Efficient yet here we are to speak onely of the Efficient causes of diseases for the form such as accidents have is already explained Diseases have not matter unless it be the subject wherein they are inherent The Physitian treats of efficient cause The causes of diseases are fourfold The proximate The remote the end also is not since they arise from the want of perfection and therefore Physitians when they handle the cause of diseases understand the efficient cause onely But Efficient causes of Diseases are considered either in respect had to a disease and a body or absolutely and as they are things which can take upon them the nature of mortifique causes If causes as they are referred to a disease or its effects they are considered thus first one cause is proximate and immediate another remote The proximate is that cause betwixt which and the disease nothing intercedes The remote is that betwixt which and the disease there comes another neerer cause The proximate since nothing can come to pass without a cause is in all diseases but the 〈◊〉 is not so Secondly since that of those causes which conduce to the generation of a disease and indeed such as some matter doth exeite Containing some are neerer others more remote and oftentimes there is a long rank of them Physicians call some causes containing others antecedent others primitive A cause containing which is also named consummative Containing is that which proximately adheres to a disease in a body and cherisheth it and which being put the disease is being taken away the disease is taken away so a stone is the cause containing of obstruction of the bladder A humour in a turnour is the cause of increasing of Magnitude but a cause containing and immediate is not absolutely the same for as much as all diseases have a proximate cause since nothing can be done without a cause but they have not all the cause containing namely thesâ— oke of a sword is the proximate cause of a wound but not the cause containing And those diseases only have a cause containing which are joyned with matter and are cherished by it as tumours obstructions putrid Feavers Yet you are here to be admonished that these things which are here spoken of a cause containing as also of the differences of other causes are all spoken of in respect of a disease defined by Galen per dispositionem or casually as they say for in respect or this not all but some diseases only have a cause containing But if a disease be defined formally and through impotency all diseases whatsoever have a cause containing namely some vitious dispâ—sition of body The antedent The antecedent causes are certain dispositions lying hid in the body which go before a disease and out of which a disease may arise For although that be most properly called a cause which doth now act yet Physitians call those things causes which as yet produce not any disease so that they may produce them Antecedent causes are defined not by the act but by the power of effecting so some vitious humour which lyeth lurking in the body produceth not a disease as yet yet it may gonerate one The primitive How causes differ The manifest evident The manifest externall that is called the antecedent cause thereof The primitive causes which anciently they called Prophasis are such as move the antecedent in a body and give occasion that they may become proximate causes such are watchings cares ange too much exercise and motion and such like But primitive causes and evident are not the same for every Proâ—atarcktick is evident or manifest but every evident and manifest is not a Primitive as a sword is the evident cause of a wound but not the primary for an evident or manifest cause is whatsoever produceth a disease in a manifest manner whether it be immediate or remote but the primitive can never be the proximate but alwayes requires preceding preparation of the body and a neerer cause in the body which it may move Nor is the primitive cause the same with the external for externall is only in respect of the body and every thing which is without the body after what manner soever it produceth a disease it is called an externall cause but Primitive is spoken in respect to other causes and is that which stirreth up and moveth the hidden causes of the body either within the body or out of the body whence Sleep Watchings Passions of the mind and other causes which are in the body are named primitive not externall Thirdly Evident causes Occult. some causes are evident others hidden and obscure evident and manifest are such as are obvious to the senses neither is there need of any other signes to know them by Occult and hidden are such as lurk in the body and require signes to be known by Fourthly Internall Externall some causes are internall others externall internall are such as are within the body externall are such as are without the body Fifthly Perse By accident some causes are by themselves others by accident Causes by themselves are such as produce dieases by their own proper force and violence and not by the assistance of other causes so fire heateth water cooleth A cause by accident is when it performs ought by the intervening of another cause and not by its own force so cold water by accident is the cause of heat whilst by its binding and closing the pores of the skin the hot exhalations are detained within which otherwise would evaporate by insensible transpiration Also some causes are common Common Proper Positive as Air Meat and drink when many use them in one place others are proper which are peculiar to certain men Lastly some causes are positive others privative positive are such as by their presence produce an effect like themselves Privative after which sort water cooleth Privative are such as by their absence produce an effect like themselves so heat returning to the internall parts and leaving the externall is the cause of
humors and vapors are elevated in the brain which often happens in Fevers and Delitiums The same causes also for the most part have a power of stirring up the common sense and besides those principally grief which in what part of the body soever it is when it violently affects the sense of touching it also stirs up the common sense which once moved irritates also the rest of the senses and so it is necessary that over much watchfulness must ensue Cause of too much sleep The causes of too much sleep and first the cauâ—es of non-natural are all those things that hinder the spirits from being sent forth to the external parts Non-natural in due manner and season such are those which dissipate and consuâ—ne the heat of the spirits beyond measure or they are called back too much into the internal parts or hinder the spirits that they cannot go out to the remote parts as too much exercise paines taking too much watching baths and such like which fill the braine with halituous vapours Moreover the causes of a preter-natural and diseased sleep so called are also against nature namely Preternatural those things which detaine the spirits against nature so that they cannot freely passe to the Organs of the senses The cause of a Coma Coma and Cataphora or a dead sleep is a plentiful vapor whether cold and moist or hot and moist either generated in the brain or sent thither out of the whole body or part of it but principally stupifactive rendring the animal spirits heavy and drowsie When there is too greedy desire of sleep Coma vigil the same stupifactive vapor is the cause but because hot and sharp vapours are mingled with it and many various and absurd imaginations are brought to the fancy the sleep is troubled and interrupted The causes of immoderate dreams are impure vapours Of immoderate dreams black and melancholy arising from food and humors causing exhalations of the same nature and stirring up the animal spirits or a distemper of the brain stirring the vapors ascending from the inferiour parts and spirits in the brain A natural extasie hath for the most part the same causes Of an extasic for those which are troubled therewith have in their deep sleep various shapes and images represented to their fantafie about which the imagination being too much busied and fixed the rest of the senses ceasing when they awake they account those dreams by reason of the too much intentiveness of the fantasie for truths and think and say to themselves that those things did really happen The cause of such as walk in their sleep Sleep walkers is a stronger imagination from an internal object represented by a dream the fantasie being violently affected stimulates the desire and thence the motive faculty to perform something the senses for the most part being bound and the rational faculty obscured but the imagination doth depend either on some vehement diurnal disease which hath gone before or on the disposition of the spirits which the vapours thicken which are not onely mingled with the spirits but also have force of binding all the spirits and set before you many cleare dreames The memory Abolishing and diminishing of the mentory fantasie as the imagination is either abolished or diminished principally through the fault of the instrument which is the brain through its too cool a distemper thereof whereunto belongs not onely innate heat but default of spirits the default of innate heat is either native and contracted from our birth or happening afterwards from our birth Heat is deficient to those who have too great heads or a brain weak and cold by nature and mixt with too much moisture or a head too little and therefore little brains or a figure too concise the figure also it self of the head may hinder these actions After a mans birth the native heat is deficient through old age and what other causes soever which may destroy and debilitate the innate heat and may cause foul spirits whether they be internal and diseases and vitious humors or external as cold meat moist thick corrupt and impure air over-much watching stroaks and wounds of the head Besides the defect and cold distemper of the native heat the memory also is weakned yea and taken away sometimes by too much moisture of the brain the same also is hurt sometimes by external error namely through the fault of objects whilest in certain diseases it is confounded and distracted by almost innumerable objects which may likewise happen to such as are well who whilest they are busied in telling any story by reason of some object happening by chance they are so called aside that they cannot make an end of their story But the reasonable faculty is not diminished nor abolished of its self nor by reason of its instrument but because the fantasie is hurt and sometimes the memory and sometimes both The depravation of the imagination and ratiocinatination happens in divers kinds of Deliriums and all have their rise from some default of the animal spirits which being ill disposed represent objects so disposed to the fantasie and whereas for the most part the imagination and ratiocination are both affected in a Delirium and the imagination useth a corporeal Organ with its Spirits but the ratiâ—â—ination useth none but onely beholdeth fantasms In every Delirium the next cause of the hurt of the imagination is the vitiousnesse of the animal spirits but the depravation of the rational faculty is caused by the fantasms The imagination and understanding hurt called Paraphrosune hath its beginning from hot vapours which in burning Fâ—ve s and inflammations of the interiour parts are elevated to the brain and disturb the animal spirits yet moderately which thing also may happen if any one should take in his meat or drink that which may trouble the spirits On this manner commeth sottishness and such as is caused by Wine the weed Darnel Hops and such like A Frensie is caused by a hot Tumor of the Brain and its Membranes from whence the hot vapours being advanced continually trouble and stir the spirits in the brain A Frenzy The cause of offending the imagination in Melancholy Of Melancholy is dark animal spirits but the causes of depraving of the rational faculty are dusky fantasms but the animal spirits are become dark and black two ways first when the spirits themselves are pure in their own nature but some strange foul and blackish matter is mingled with them Secondly when the spirits themselves are darkish in their own nature and geneâ—ate such the former is caused three wayes the first is when the matter dark and impure clouding the spirits is contained in the vessels in the head Secondly when the matter is communicated to the brain from the whole body and principally from the greater veins Thirdly when it is transmitted principally from the Hypocondries which is thence named Hypocondriacal Melancholy the
shall come to passs and that they may not rail against the best Medicines being given to those that are desperately sick By the name of Signs we do understand all those things which signifie any thing A Sign what ' t is or all evident things which lay open a hidden matter or as the Author of Physical definitions speaks A sign is a manifestation of somewhat hidden or every thing that shews any of those things which are in the Method of healing and can demonstrate them and make them manifest CHAP. II. Of the differences of Signs OF Signs of this kind there are certain differences Differences of signs wholesome and unwholesome first according to varieties of Bodies some Signes are counted wholesome which shew soundnesse and health others unwholesome which shew unsoundnesse others are neutral which shew a disposition to neither Secondly certain Signs are called Diagnosticks and Deloticks demonstrating and demonstrative Diagnostick which demonstrate those things which shew the present constitution of the body whether it be according to nature or contrary to nature certain are Prognosticks Prognostick which foreshew what shall come to passe Anamnestick certain are Anamnesticks which call to memory the state of the body which is newly past Thirdly Proper Common some signs are proper others common proper are such as agree to one disease onely Common are such as are found in many diseases Galen in the first of the differences of Fevers appoints three kinds of proper Signs and the one he calls unfeparable another proper in its kind a third proper and inseparable also he calls those unseparable which cannot be separated from the effect which they shew and agrees to every such effect but not onely proper are such as agree to those alone but not to all Proper and inseparable are such as agree to such an effect alone and to all Out of this division there ariseth other differences of Signs they are called by the Greeks Pathognomonick Synedruors Epiginomens Epephanomens in English â—â—separable sociable concomitant subservient and such as appear afterwards Pathognomonicks are such as follow the disease also and necessary inhere in it Pathognomonicks and therefore prefently in the beginning of a disease is present and cannot be separated from it and agrees to every such disease and alwayes where they are they shew the disease that must necessarily be there present yet it seldom happens that there is one Pathognomonick sign but for the most part the Pathognomonick signs are constituted of more joyned together which if they are taken severally are not Pathognomonicks Synedruons Synedruons that is sociable ones are such as are not inseparable from a disease nor do they necessarily cohere to the essence of a disease nor are alwayes present but besides the Pathognomonicks sometimes they appear presently at the beginning sometimes they follow afterwards and sometimes they are not present at any time of the disease and therefore they do not shew the disease it selfe or its kind but signifie some condition thereof Epiphanomenaes and Epiginomenaes are such as neither shew the kind of a disease Epiphanomenaes and Epiginomenaes nor the condition thereof but shew onely its mutation and they are threefold some signs are of concoction and crudity others signifie health and death others are Critick or decretory which foretell the termination of a disease CHAP III. Of the heads of Signs OF the heads of Signes although there are many Fountains of signs 1 Essentially inhering yet they seem to be reduced to theee the first are taken from the nature and essence its selfe of the thing or as Galen speaks from things essentially enhering in the substance whether it be a disease or a cause of a disease or a Symptome namely when a thing in its own nature is so manifest to the senses that there needs no other signes Secondly signs are sought from diseases that is From the effects from all things which follow health a disease and the causes of diseases accidents and Symptomes whether they be actions or excrements and retentions or qualities of the body Thirdly from causes whether they be external From the cause or internal by themselves or by accident or what other soever Whereunto belongs ability and disposition of body and from hence t is easie or difficult to fall into this or that disease for this shewes alike temper that a contrary such as helpe also and such as hinder as those which encrease a disease are an argument that the disease hath an agreement with the thing which increases it but that which delights and profits is a token that there is in nature something contrary to the disease To these heads of signes some adde such as are alike and disalike understanding by those things Things alike and unlike either a body which is compared to another body or a part which is compared with another part or with it selfe yet others think that similitude and dissimilitude is not a peculiar head of signes but rather a reason of fitly câ—mparing other signes among themselves but the comparison may be right the manners properly and nature of the sick should be known wandring diseases commonly belong to these when if many happen to be sick of one common infirmity and he which is sick begins to be so as the rest were it is to be suspected that he hath the same disease Sect. 2. Of knowing the Temperature of Mans Body and of his Principal Parts CHAP. I. Of the Signs of a wholesome Body AFter we have spoken of the Signs in general we come now to handle the several kinds and because bodies are two-fold Sound and Sick and there is a certain difference and latitude of a sound body which embraces neither of these first we are to speak in what manner the various constitutions of a sound Body and of its parts are to be known and going back from thence even from a natural state may be understood how a diseased and 't is not difficult to discern a sound from a sick and all those that are to be accounted for sound who can perform all those actions which belong to a man Yet how such counterfeit diseases are to be found out Galen teaches in a peculiar Book but since there is a great latitude of health first of all the signs are to be proposed of the best constitution of body which is as it were a rule for the rest and to which as to the statue of Polycletus the natures of men of all of Ages Sexes Countries and Conditions are to be compared The signs of such a Constitution as also of others differing from it Galen in his art of Healing and fifth Chapter draws from two heads first from those which essentially inhere and which according to the nature of the essence are in them Secondly from those which necessarily follow those in their operations and accidents First Signs of a sound body therefore it is
plenty thereof as may render the Vrine thick A pale and thin Vrine is made when a small portion of choller is mingled with an aqueous Urine A pale and thin A pale red thick but a pale red and thick when choller is mixt in greater plenty but if any choller be mingled with a thick white Vrine the Vrine is dyed pale CHAP. VII Of the causes of smell quantity and such like accidents THe Urine which obtains the natural and usual smell Cause of the smell of Vrine signifies that the natural heat is right and concoction is well performed but if the Vrine smell not or lesse then the Vrines of those that are well use to do it is a token that the native heat is weak and almost no concoction performed Of no smel nor is the serous and excrementitious humour mingled therewith Sweet Vrine Of smelling well or that which smells well doth not proceed from any internal natural causes but if any such be found it hath acquired that smell from meats or medicines taken inwardly Stinking Vrines are caused first from meat and drink Of Faetid and certain medicines taken also from crudity and corruption of meats erosion and especially from putrifaction Fourthly from daily retention of Vrine in the Bladder Vrine naturally ought to answer to the drink Of store of Vrine but it is made more plentiful then is fit First if meats are administred which are full of aqueous humidity Secondly if the aqueous and serous excrements which use to be discussed by motion or evacuated other wayes be retained in the body Thirdly if nature from the other parts or the whole body expels the vitious humours through the passages of Vrine which useth to happen in Critick and Symptomatick evacuations as in a Diabetes or incontinence of Vrine Fourthly if Dyuretick medicine be taken On the contrary little Vrine is caused by contrary causes Of little Vrine namely not only by reason of small quantity of drink taken but of dry meats moreover if the aqueous matter be consumed which useth to be in burning fevers as also by motion and too much exercise Thirdly if the Vrine be converted to other parts Fourthly by reason of the straitness of the passages by which the Vrine ought to be expelled CHAP. VIII Of the causes of Contents in Vrines of those that are sound THe matter of a Content The matter of a sediment in sound men or Sediment in the Vrines of such as are sound for in Vrines of those that are exactly well there is scarce any Content save onely a sediment is some part of aliment which escaped concoction for since it neither can be changed into perfect blood nor into the nutriment of any part after the third concoction it is sent to the Reins and cast cut through the Bladder and there is scarce found a Vrine of a sound man The causes of diversity of Contents wherein the natural sediment doth not appear because scarce any body is so exactly sound which doth not generate some such excrement and no nourishment is to be found which cannot afford matter for such an excrement Whence according to the diversity of meats and natures thereof there ariseth diversity of Contents For although the Contents settle in the bottome and in those that are exactly sound yet in those which do not enjoy most perfect health The cause of the quality of the sediment or do not eat the best meats it doth not enjoy its natural place but in some and those which eat grosser food more then is convenient it doth settle in the bottome in others it ascends higher then is fit by reason of the heat which cannot subdue it A Sediment is naturally white and takes this colour from the veins and parts which are wont to impress a white colour on those things which they change Equal and continued is not divided by reason of heat rightly concocting and rendring this excrement equal and obtains the figure of a Pyramid which although all parts seem to the senses to be equally thick yet in truth some are thicker which settle underneath others thinner which consist in the superiour part A great sediment is through plenty of crude juice which affords matter for a sediment Quantity whence boyes through much eating and those that live in idleness and those whose accustomed evacuations are suppressed and females also have a more plentiful sediment but men because they are hotter and have not so many crude humors have less sediment the same happens in Summer through fasting too great evacuations and other causes consuming the humors also obstructions and much and thin drinks which are distributed and cast forth before it can receive any mixture or digestion with meat CHAP. IX Of the causes of Contents in Vrines of those that are sick AGain in sick people the sediment consists of the more crude part of the aliment which cannot turn into nourishment â—f the parts The cause of a sediment in the Urines of the sick with which notwithstanding other vitious humors also are mingled nay sometimes vitious humors onely may afford matter for a sediment but by how much the more the Contents of those that are sick are like to those that are well by so much they are the better and shew great concoction but by how much the more they recede from those either in colour or other qualities by so much they are the worse and indeed the differences of colours of Contents are borrowed from the humour whereof they consist but as for what belongs to the diversity of substance that proceeds from the variety os burning heat and various disposition of matter a farenacious sediment as Galen teacheth is made from thick dried blood Causes of a fernacious sediment Frothy Bran-lik Pulse-like or flesh unequally consumed by a fiery heat but rough or scaly when the solid parts are unequally consumed and scaly particles are cast forth with the Vrine and bran-like sediment proceeds from a flamy and consuming heat of a Fever and a sore in the bladder or veins a sediment that represents pulse proceeds from melting as Actuarius teacheth when a Fever comes to the flesh and melts it but it is not thought credible by the late Physitians that by the melting or flesh any thing so thick can be mixed with the Vrine and moreover those sediments they account do proceed from a scabby and exulcerated bladder or from a crude and melancholy humor Small Sand and Gravel proceed from thick and feculent matter which sometimes contains in it selfe a principle of coagulation and a light occasion being offered Of sand and gravel it concreates of its own accord Clods of blood are discerned when either from an ulcer Of Clods of blood or otherwise from a hurt broken or open vessel in a part through which the Veine passeth blood is cast out Quitture appears in the Vrine when an imposthume Of quitture in Urine or
the place wide and the bodyes next over it are heavy Of a thin the cause of a thin pulse is a weake faculty and a hard artery the concomitant causes are leanness of body and thinness and driness of the skin The cause of a swift pulse is the use increased Of a swist the vertue indifferently strong and the instrument soft the cause of a slow pulse is weake power or the use diminished Of a slow or the joyning of both these together The cause of a frequent pulse is the use increased with debility of vertue or hardness of the arterie Of a frequent Thin of a thin pulse strength of vertue with use diminished is the cause Of a vehement pulse Of a vehement weak strength of vertue is the cause of a weake pulse languishing strength proceeding from what cause soever A soft pulse proceeds from the softnesse of the Artery Soft hard a hard from the hardnesse of the same from what cause soever it come CHAP XI Of the causes of the respective differences of Pulses NOw followes what belongs to the respective differences of pulses The causes of inequallity of pulses Of a singular inequality and of an intermitting pulse and first for inequality the cause thereof is a weake faculty and an Artery either obtruded or pressed or too hard or too soft The reason of an intermitting pulse is because the use requires dilatation and the faculty is ready and prepared that it may satisfie the use but either t is loaden with plenty of humours or it is hindred by obstructions or compressure of instruments the same causes of inequality in motion of swiftnesse and slownesse are rendred but they are lighter The cause of Dicrotus or double striking pulse is an unequall distemper of the heart and Arteries Of a Dicrotus or the faculty varied by reason of an unequall distemper which striving by a contrary cause in the middle of its Journy is compelled as it were to begin a contrary motion Unequall pulses under many fingers do proceed either from weaknesse of the faculty or plenty of humours or softnesse of Arteries Declining pulses which are called Myouroi Of Myourey proceed from weaknesse of the faculty whose action by how much the more remore it is from the heart by so much it is the weaker or from the placing of the artery part whereof is more remote from the heart and is placed more in the outside The cause of a congregation of many in equalities together are weaknesse of the faculty whither is oppressed A Sistematicall inequality or distracted or irritated and the fault of the instrument when the artery is either compressed or obstructed or filled pulses are made unequallyunequall from the faculty not weake by its selfe but rather burthened and oppressed Myourei Reciproci Of a deficient and moreover from the ill disposition of the artery and t is either pressed by some body that lyeth on it or some humour or tumour but unequal equally are made by an infirme faculty and indeed reciprocall Myouroi do proceed from a faculty not so weake as those which are deficient Intermitting and intercurrent pulses proceed from the same weakness of the faculty Of the intermittent intercurrent and the instruments compressed and obstructed yet the faculty labours more in an intermitting then an intercurrent and in it doth almost lye still Concerning the causes of unequall compound pulses Caprizantes the cause of an uneven pulses is when the faculty otherwise strong enough but now is oppressed by too great plenty of humours or is hindered by obstruction The causes of surging pulses are weaknesse of the faculty or plenty of humours or exceeding softnesse of instruments Like waves and the faculty is so burthened and oppressed with its load that it staggers and becomes unconstant From the same causes proceeds a vermicular pulse Vermicular formicant only that in a vermicular the faculty is not oppressed but is weak of its selfe but in a formicant t is very faint and the use striving and softnesse of the instrument being joyned therewith The causes of a serrine or serrate pulse is a strong faculty and the use increased Serrate together with hardnesse of the arterie and this pulse is familiar in inflamations of the internall membrances Trembling A trembling pulse is made whilst either the pulse is not perceived by reason of the trembling of the part or it goeth out trembling or when the heart trembles and communicates that affect to the artery The cause of a hectick pulse is somewhat that is fixed and stable and sticks to the solid parts also weaknesse of strength Hectick Rhythmorum The harmony is not changed unlesse the magnitude and celerity of the dilatation and contraction be altered but these are not changed except the use be changed so all the causes of Harmony depend upon the use for if the Diastole be swifter then the systole there is a great heate present then and a great necessity of refrigeration or expulsion of fuliginous excrements but if the systole be swifter and greater then the Diastole there is more necessity of protrusion of fuliginous vapours then of cooling CHAP. XIII Of the causes of varying of Pulses ANd in like manner divers differences of Pulses proceed from causes containing Of the Temperants of a Pulse which are secundary causes and first naturall things those which are hot by nature have a hotter Pulse and that comes from the use increased those which are cold the contrary the Pulses of such as are dry and leane are greater and thinner by much and somewhat more vehement but in grosser bodyes when the Artery is covered with much flesh and cannot be freely distended the Pulse is made somewhat smaller and more frequent Men have a greater Pulse for the most part then women Sex a little duller and thinner women on the contrary have lesse Pulses swifter and more frequent but if a woman be hotter then a man she will have a greater and more vehement Pulse The Pulses of boyes are great Of age very swift frequent in vehemency moderate of youth they are very great and vehement in celerity and frequency moderate Pulses of old men are the least slowest thinest and weakest As for the times of the yeare Time of the yeare in the Spring Pulses are greater more vehement in celerity and frequency moderate in the Summer they are fainter small swift frequent in Autumne weake in magnitude unequall in celerity and frequency in Winter small and moderate slow thin and weake Meate and drink immoderatly taken cause great Meat and drink how to change the pulse swift frequent too vehement unequall and Inordinate Pulses moderate lesser and weaker and in the beginnings swifter and more frequent afterwards slow and thin the use of wine especially makes great Pulses swift frequent and vehement and mutations which proceed from wines suddenly comes and suddenly goes
of a Synocha with putrifaction OF the Nature of a Fâ—ver Chap. 1. p. 1. Of the causes of Fevers in general ch 2. p. 3. Of the Symptomes of a Fever in general ch 3. p. 4. Of the differences of Fevers in general ch 4. p. 5. Of the Cure of Fevers in general ch 5. p. 6. Of the Fever Ephemera ch 6 p. 6. Of an Ephera of more days and of a Synocha without putrifaction ch 7. p. 10. BOOK II. Of Putred Fevers OF putred Fevers in general ch p. 12. Of the differences of putred Fevers ch 2. p. 15 Of the signâ— of putred Fevers in general ch 3. p. 16 Of the Cure of putred Fevers in general ch 4 p. 17. Of breathing of a Vein ch 5. p 18 Of Purging ch 6. p. 19 Of co-coction and separation of Humors ch 7. p 22 Of Sudoâ—ificks and Diureticks ch 8. p. 23 Of Diet in putred Fevers ch 9. p. 24 Of the differences of putred Fevers ch 10. p. 27 Of a continued putred primary Fever and first of a Synocha in particular ch 11. p. 28 Of a Causus or Burning Fever ch 12. p. 31 Of continued periodick Fevers in general and of a continued Tertian ch 13. p. 33 Of a continued Quotidian ch 14. p. 36 Of the Fever Epiala p. 38 Of the â—yncopal Fever p. 39 Of a continued Quartan ch 15. p 40 Of Symptomatical Fevers ch 16. p. 41 Of Intermitting Fevers in general ch 17. p. 46 Of Intermitting Fevers in particular and first of an Intermitting Tertian ch 18. p. 55 Of a Quotidian Intermittent ch 19 p. 61 Of an intermitting Quartan ch 20. p. 62. Of compound Fevers and Semi-tertians ch 21. p. 67 BOOK III. Of a Hectick Fever OF the nature of a Hectick Fever ch 1. p. 71 Of the signs of a Hectick Fever ch 2. p. 72 Of the Cure of a Hectick Fever ch 3. p. 73 BOOK IV. Of the Plague and of Pestilential and malignant Fevers OF the Nature of the Pestilence ch 1. p. 75 Of the causes of the Pestilence ch 2. p. 77 Of Contagion ch 3. p. 79 Of the signs of the Plague ch 4. p. 81 Of preservation from the Pestilence ch 5. p. 82 Of the Cure of the Pestilence ch 6. p. 85 Of the nature of a pestilent and malignant Fever and the difference of them from the Plague ch 7. p 89 To what kind of Fevers pestilent and malignant ones pâ—rtain ch 8. p 90. Causes of a pestilent malignant Fever ch 9. p 91 Signs of malignant and pestilent Fevers ch 10 p. 92 Of the cure of malignant and pestilential Fevers in general ch 11. p 93 Of a malignant Fever with the Measles and Small Pox ch 12. p. 97. Of the Spotted Fever ch 13. p. 105 Of the English Sweat ch 14. p. 108 Of the Vngarick Disease ch 15. p. 110 Of a malignant Fever with the Cramp ch 16. p. 114 Of a malignant Fever with a Catarrh and a Cough and the Squincy ch 17. p. 116 Of the Cure of Symptomatical Fevers ch 18. p 118 Book I. Of Fevers in General and of an Ephemera and of a Synocha with Putrefaction CHAP. I. Of the Nature of a Fever THat which is called by the Latines a Fever The name of a Fever by the Greeks from fire is called the fiery distemper Hippocrates plainly calls it fire if it be very vehement as being by the consent of all men a hot distemper For although some Germans call it Daskalte yet that appellation belongs not to every Fever neither doth it express the nature of a Fever but only signifieth Cold An intermitting Fever may be so called A Fever is a hot distemper of the whole body atising from heat kindled contrary to nature in the heart It s definition and nature and by the mediation of the Blood and Spirits conveyed through the veins and arteries to all the parts and hindring natural actions unless it be prevented For a Fever is generated when as Galen 1. Aphor. 14. hath it The native heat is become fiery Generation of it For seeing that all the parts of the body have a certain temperature and all of them are actually hot every one according to its own degree and thereby are rendered fit to perform natural actions If in the heart from whence the vital heat is diffused over all the parts of the body each part receiving its due temper from thence a certain preter-natural heat be kindled and spread over the whole body so that to the natural temperature of the parts some degrees of preter-natural heat are added and that actual heat shall be increased a certain excess of heat and a hot distemper is kindled in the whole body which is called a Fever Which distemper indeed formaliter as some say is contrary to nature and is called a Fever but materialiter 't is not altogether contrary to nature for unless there had been before some degrees of natural heat extant the supervenient heat could not constitute this degree of heat And indeed a hot distemper only constitutes a Fever Driness is no part of the Essence of a Fever for although all fevourish heat tend to driness yet that driness is not sickness in all Fevers neither is the body by fevourish heat rendred unfit to perform its natural actions it is so by driness in every Fever that the natural actions are hindred but although the fevourish heat always tend to driness yet oftentimes the disposition of the body wherein that heat acteth and moisture therewithal hinders the production of a disease by driness The adequate Subject of a Fever is the whole body The Subject or certainly most of its parts but the principal is the heart as being that wherein that heat is first kindled and from thence communicated to all the other parts of the body unless it be hindred nor can a Fever be generated unless the heart first become hot Indeed the whole body is the Subject of a Fever in regard of the similiar parts and as it is indued with actual heat which is as it were kindled by the innate and influent heat For this heat when it is changed and converted into a fiery heat from a temperate and moderate a Fever is stirred up The immediate cause of a Fever is heat kindled in the heart contrary to nature The proximate cause and diffused over all the body For as the heart whilest it is well and according to nature is the fountain of natural heat and disperseth the same over all the body so if it grow hot contrary to nature it distributes that unnatural heat over all the parts For although a Fever may be kindled by the inflamation of other parts likewise yet that happens not unless that heat be first sent to the heart and afterwards from thence to all the parts of the body whence it comes to pass that in every Fever the Pulse is changed Nevertheless every kind of heat in the heart is not sufficient to
which also a Synocha without putrefaction is referred and a putrid There is another thing worth the noting that one Fever is Primary another Symptomatical Primary is that which follows no former disease but depends on its proper cause Secondary or Symptomatical is that which ariseth from the inflamation of any member See Galen 4. Aphor. 7. But of Symptomatical this is to be noted that those which by the ancients were accounted Symptomatical were indeed primary many of them and inflamations of the parts of the Membrane that covers the ribbs of the lungs or chopps rather happened to those parts then the Fever to take it's rise from them Feavers accompanied Which Fevers may be called Comitatae or such as accompany the Fever CHAP. V. Of the cure of Fevers in general NOw to the cure Cure A Fever as it is a Fever being a hot distemper indicates cooling things are to be used Galen 8. Meth. Med. Cap. 1. But because there is no small difference amongst Fevers and that a Fever is often joyned with it's cause regard is to be had of the cause of the same Nay indeed because the cause often offends more then the Fever it self the Fever is so to be cooled as that the cause may not be cherished and those things be detained in the body which ought to be evacuated And oftentimes error is committed in this whilest regard is had only of the heat cold things are administred by which the cause of the Fever being detained the Fever is prolonged Whereas on the other side heating things as likewise either opening or sudocifick things without cooling medicines often with happy success cure the Fever For the cause being taken away the Fever it self ceaseth of it's own accord Whereof more particularly hereafter CHAP. VI. Of the Fever Ephemera THere are two sorts of Fevers whose heat are inherent in our bodies in habitude Feavers in habitude For that the hot distemper of the parts is cherished either by the heat of the Spirits or humors and the humors are inflamed either with or without putrefaction Those Fevers which are sustained by the heat of the Spirits and humours without putrefaction The name Ephemeros are called Ephemerae and Humorales without putrefaction Those which are kindled by putrifying humours are called putred Fevers That Fever which is cherished by the kindling of Spirits is called by the Greeks Puretos Ephemeros by the Lattines Diaria and Ephemera by a name not taken from the nature of the disease but from it's duration In respect of the Essence thereof it may be defined thus Definition It is a Fever arising from and depending on the heating and inflaming of the vital Spirits The proximate cause of this Fever is the heat of the vital Spirits kindled contrary to nature The next cause which being spread over the whole body through the arteries heats the whole against nature That heat is stirr'd up from all those causes before mentioned in the second Chapter only except from putrefaction Remote cause which sometimes immediately sometimes remotely by means of the natural and animal Spirits heat the vital to wit perturbations of the mind sadness fear sollitude anger over much watching too much intentiveness of the mind too much exercise of body grief hunger thirst hot meats and drinks drunkenness crudities in bodies cholerick heat of air fire hot Baths retention of the hot Effluvium inflamations of Kernels and Buboes from the which heat alone without putred vapours is conveyed to the heart according to the vulgar opinion Yet it seemeth not impossible but that those putred vapours by the veins and arteries next to the part affected may be communicated to the heart And so these Fevers should rather be Symptomatical then absolute putred then Ephemeral Those that are hot and dry easily fall into this Fever Disposition of body in whom many hot dry vapours are coliected which are easily inflamed by causes heating them more Amongst the Signs by which this Fever is known and discerned from others in the first place Galen 1 de differ Diagnostick signs Febrium c. 7. saith it beginneth from some procatartick or evident cause which indeed is an inseperable sign but not a proper sign for although a Fever that doth not arise from a manifest cause is not an Ephemera yet every Fever which ariseth from a manifest cause is not therefore an Ephemera 2. Moreover the Urine in substance colour and contents is most like unto the Urine of healthy men or at least recedes not much from them which in an Ephemera which proceeds from crudity it useth to do in which the Urine useth to appear more crude and whiter 3. The Pulse is neerer to a natural one then in any other Fever only that it useth to be extended in magnitude celerity and frequency Yet in regard of the cause which occasioned the Fever some change may be made in the Pulse 4. The heat of this Fever is gentle and weak in respect of other Fevers 5. Nay in the very state and height thereof it is somewhat more gentle and moderate 6. This Fever invades without shakings or tremblings it 's increase and augmentation in heat and pulse is free and equal 7. The declination is performed by moisture or moist evaporation by sweat like theirs who are sound in health which by a little exercise more then ordinary comes forth and a perfect apurexsie follows that moisture so that after the declination no footing is left for the Fever either discernable by Pulse or any other circumstances And in case any footing be left it is a sign that it will turn into another sort of Fever The causes are most perfectly to be known by the relation of the sick which may instruct the Physician whether from passion of the mind exercise of the body or any other evident cause this disease hath been occasioned These causes also affords some signs of themselves which the Physician cannot be ignorant of These Fevers are the shortest of all others Prognosticks and continue not above twenty four hours There is no danger in them unless some error be committed and for the most part they are conquered by nature wherefore Physicians are seldom called to their cures Yet according to the diversity of their causes some are cured more easily others with more difficulty For those causes which are hardly taken away and the humours are apâ— to corrupt a Fever introduced from such easily degenerates into a putred which happeneth when it is extended above four and twenty hours or no sweat appears and pain in the head be present and persevere And it degenerates either into a Synocha without putrefaction if the body be youthful and plethorick or into a putred if the body be cacochymick or into a Hectick if the body be hot dry and lean And the proper signs of those Fevers shew into what sort of them the transmutation will be made Moreover sithence this Fever
how the matter which is the cause of a new Paroxism is generated and so the cause of Paroxisms and the recourse of intermitting Fevers is explained But what the reason is why these Fevers return at set times some sooner some later is now another question and that most intricate which is easier to ask then answer But that we may here forbear to recite the opinions of others which are very many we will mention only that which seems most probable to us so far as in this humane dimness of our understanding in so obscure a business we are able to discover And first that Fevers keep such certain periods experience doth manifest whereby it appeareth that some Fevers return the third some the fourth day and that oftentimes it observes not only the same hour but minute of invasion although the fits may somtimes anticipate somtimes retard for certain reasons But the cause why paroxisms return at certain times we conceive is to be sought from the diversity of humours For those effects as Valleriola saith in any one sort of things which perpetually agree to the things and are made in the like manner into what body and at what time soever they happen to come these are to be referred to the proper substance of that of the which they are made but to make return through certain days and to irritate accessions both agrees perpetually to humors and the recourses in this manner alwaies at equal intervals unless a perverting of the order of periods happen from else-where are made Therefore it shall be from such or such a nature of humours that the recourse shall be made in the same sort namely the causes of periods and intermitting Fevers are excrementitious humours Choler Melancholy Flegme and those Fevers which return the third day proceed from a Cholerick humour those on the fourth from Melancholy those that come every day so that they are not double Tertians proceed from Flegme Yet the cause of periods cannot be drawn simply from humours but as they acquire a peculiar quality from putrefaction or corruption by reason whereof at a certain time they wax hot and begin to be moved For sithence this effect is definite and determinate which carries it self alike in all individuals 't is necessary that it have a certain definite and determinate cause in all individuals that are alike which since that neither disposition of parts nor quantity of humours for we see that although the store of matter decreaseth and the fits are become shorter nevertheless they do return at their usual time nor manifest quality of humour thickness viscidity tenuity or some such like which useth to vary can be a quality we must needs fly to a peculiar and proper quality and nature of a humour which also when it is changed the form of the Fever it self is changed for when Choler is turned into Melancholy the Fever which used to come the third day cometh on the fourth and this quality also may afterwards remain in the humour when the putrefaction ceaseth and the Fever depending thereon Whence as Fornelius in his to of Fevers witnesseth the torments of the Cholick Pains of the Joynts and such like diseases arising after long continued Tertians and Quartans do likewise keep certain periods by reason of that disposition which they have received from the corruption or putrefaction of the humours Yet if any one be willing to determine that the said occult propriety is derived Order of the fits not from corruption only but that celestial causes do also concur to its generation I will not much contend with him for we see that principally about the Solstices and Aequinoctials such Fevers especially the most durable of them do begin and end But although Fevers keep certain periods yet there is a certain difference in them also for somtimes the fit returns just at the expected time somtimes the following paroxisme returns sooner then the former which form is called proleptick somtimes the following fit comes later then the former and that form is called Hysterick and indeed somtimes through the whole course of the disease such a form is observed and oftentimes from the beginning of a Fever until the end of the same the paroxismes anticipate or come after the expected time but somtimes in some there is anticipation in some post pofition otherwise the fits comes at the same time For the most part they say The cause of anticipation and coming late that anticipation happens when the humours by some error in diet are augmented or are moved by medicines anger exercise and such like causes But the fits return flower when the matter is diminished or thickned Which indeed when the accustomary paroxisme is changed that it may be so as we do not deny so when the Fever keeps always some certain form either proleptick or hysterick the cause rather seems to be taken from the diversity of the humour for although Choler according to its manner being corrupted is the cause of a Tertian Melancholy of a Quartan yet Choler and Melancholy according to the diversity of Bodies and Temperaments do oftentimes vary somthing Hence also it happens that although that putred leaven or occult quality introduced by choler be the cause of the circuit of a Tertian Melancholy being brought in of a Quartan yet according to the difference of a humour it may happen so that the effervescence or fervency of humours may come sooner or later by some hours Concerning the longitude or brevity of some Paroxisms that depends on the paucity or plenty of matter The cause of the length of Fits disposition of the humours and body For a plentiful quantity of humours is the cause of a longer fit then a small so a thick humour causeth a longer then a thin since it cannot be so soon discussed as a thin If the strength of the body be great which can more easily discuss what is offensive then theirs who are weak the shorter fit followeth Also a thinner constitution of body as being more apt for the discussing of the matter is the cause of a shorter fit a thicker of a longer And when all the causes which occasion a short paroxism concur a very short fit is raised But when all those that produce a long are present the paroxism is extream long When certain causes are present which make a short fit and some are wanting of them an indifferent betwixt both happens And so much of the nature place and motion of the proximate cause which exciteth intermittent Fevers The more remote causes of intermitting Fevers But the more remote causes and those things which conduce to the generation and corruption of that matter in the Meseraick veins are meat and drink of evil juice but yeilding matter for peccant humours answering to their own nature and an ill disposition of stomack whereof meats turn into choler or become sour an intemperate constitution of Ayr for although divers humours are generated
and such like Sweat and Urine also should be provoked with medicines made of Fennel Movers of Urine and sweat Carduus Benedictus Salsa Parilla wood of Sassafras Treacle and Mithridate and lastly the Bowels but especially the Stomack and Liver are to be strengthned CHAP. XX. Of an Intermitting Quartan THe third sort of intermitting Fevers which ariseth from a Melancholy humour putrifying in the meseraick veins A Quartan and seizeth on the fourth day also whence it is called a Quartan The proximate cause of a Quartan Fever is a melancholy humour collected in the meseraick veins about the spleen and adjacent Bowels The cause and there putrifying and that somtimes natural by its own nature cold and dry and somtimes it participates with some adustion But the more remote causes are all those things which conduce to the generation of black and melancholy humours namely meats and drinks apt to generate this humour amongst the which is vinegar of the which Hypocrates 3. vich rat in acut t. 38. writeth it attenuateth melancholy humours raiseth them and frames many visions in the mind For Vinegar is a Leader or stirrer of Melancholy The time is principally in Autumn especially if a hot Summer have preceded This Fever is known by its quartane circuit Signs and signs of melancholy abounding in the body and it invadeth with a certain unequal disturbance of the body the which a cold shaking fit followeth which at the first is little or at leastwise instead thereof there is at the first refrigeration and horrour in the progress of the disease the cold paroxism is alwaies greater and at length most vehement with pain causing the bones to knock together The heat is kindled by degrees neither is it burning but somwhat milde The pulse is thin and slow and although in the vigour of the paroxism it become swift and frequent yet in comparison of Tertians it is thin and slow The Urines at first are thin and white but in the progress of time higher coloured and thicker Sweats in the beginning are not frequent but in the progress of the disease plentiful And thus things are in a pure quartan but in a bastard one tokens of some humour mixed do appear and heat thirst watchings and other symptomes are more grievous This Fever continueth the longest of all other Prognosticks and oftentimes is not only extended to some moneths but years and if it be not gone by the next solstice or aequinectial after it was first taken it lasteth for the most part till the next after and for the most part goes away in the Spring 'T is safe and without danger if it be legitimate and without any disease of any of the bowels But that which is joyned with black choler is more dangerous as also that which is with some grievous distemper of some of the intrals and casteth the sick into a dropsie the scurvie or a consumption As concerning the cure Indications if this Fever proceed from a pure melancholy humour that since 't is cold dry thick 't is to be moistned and attenuated or if it be also adust it is in some measure to be cooled afterwards to be purged with convenient medicines The causes generating are to be removed and in case other humours are mixed regard must be had of them The Fever it self indicates cooling and moistning yet regard of the strength must be had least by the duration of the disease that be impaired as also of the stomack spleen and liver least they are offended This Fever is to be handled gentlâ— at the first Cure neither are strong medicines to be used at the beginning of cure sithence the melancholy humour may be exasperated by the use of them and out of a simple Quartan a double or treble may easily be raised Galen 1. Opening a vein ad Glauc cap. 11. yet there is least danger in Vomits The first passages of the Body therefore are first to be evacuated with clisters lenitive medicines and vomits also afterwards in case blood abound therewith a vein is to be opened and in case it issue forth black and thick the greater quantity is to be taken that by this means both the plenty of blood may be diminished and that part of the melancholy humour which is poured out into the vena cava may be evacuated but if the blood coming forth appear to be thin and yellow 't is forthwith to be stopped And indeed where there is store of blood the first passages being cleansed a vein may be opened but if this Fever begin without store of blood a vein is not to be breathed presently at the beginning but when some of the peccant humour is drawn into the veins and mingled with the blood The Basilick or median vein either may be opened most commend the opening of the Salvatella yet they have not as yet rendered any sufficient reason why that should be preferred before others The blood being evacuated the peccant matter must be prepared and concocted Preparers and likewise that disposition of the body to generate vitious humours is to be corrected And indeed in case a Quartan Fever proceed only from natural melancholy moistning things are to be first used but heating things should be more moderate but if adust humours are mixed there will be use of things moderately cooling but in the progress of the disease there will be need of cutting and attenuating medicines If the pituitous humour be mixed therewith in the beginning there will be need also of attenuating and cutting things and it may be more safe to heat a little Hence are to be administred Burrage Bugloss Violets Maidenhair Cichory Fumitory Ceterach Hearts-tongue Germander Ground-pine Carduus Benedictus the Roots of Marsh-mallows Licoras Chichory the opening roots Polipody Gentian Fern the barks of Tamarisk Capparum Roots of Walnut Trees Flowers and seed of Broom of the Vine Ash Citron juice of Apples and compounds of these and somtimes this or that may be chosen or mixed according as the nature of the peccant humour requireth The concoction and evacuation of the matter must be by intervals repealed Purging Medicines and when the matter is in some measure prepared purging medicines are to be prepared of Polipody Epithynum leaves of Senna roots of Jalop black Hellebore lapidis Lazuli and compounds of these Syrup of Apples Regis Sapor Electuary called Diacatholicon Confection of Hameck with the compound powder of Senna and Diasenna Tartarious pills or pills evacuating melancholy of lapis Lazuli Armoniack beginning with the more milde or gentle ones A Vomit also is convenient by which oftentimes pertinacious Quartans are cured So Galen of Treacle ad Pisonem cap. Vomits 15. the day before the fit after Supper he gives a vomit the next day after early the juice or dilution of Wormwood and two hours before the paroxism Treacle the gentler Vomits are of the decoction of Dill and Radish with Oxymel the stronger are
NINE BOOKS OF PHYSICK AND CHIRVRGERY Written by that Great and Learned Physitian Dr SENNERTUS The first five being his Institutions of the whole Body of Physick The other four of Fevers and Agues With their Differences Signs and Cures LONDON Printed by J. M. for Lodowick Lloyd at the Castle in Corn-hill 1658. THE INSTITUTIONS OR FUNDAMENTALS Of the whole Art both of PHYSICK AND CHIRURGERY Divided into five Books Plainly discovering all that is to be known in both as the Subject and end of Physick the Nature of all Diseases their Causes Signs Differences Events and Cures ALSO The Grounds of Chymistry and the way of making all sorts of Salves and preparing of Medicines according to Art nothing of the like nature in English before Written first in Latine by that Great and Learned Phycitian D. Sennertus Doctor and Professor of Physick Made English by N. D. B. P. late of Trinity Colledge in Cambridge London Printed for Lodowick Lloyd and are to be sold at his Shop next door to the Sign of the Castle in Cornhill 1656. To the Lovers of the Study of Physick especially those who desires to attain to the true knowledge thereof OF all the Arts and Sciences that the Sons of Men so much covet after there is none so pleasant and profitable as Physick Physick doth not onely teach thee to preserve thy selfe from the assaults of those manifold Enemies which Nature is liable unto but it teaches thee to restore Health when lost and to heal thy selfe though wounded by thy greatest adversary besides in the Anatomical part it entertains thy fancy with the wonderfull work of Nature where the unsearchable wisdom of the Creator is as legible as in those things we count more sublime and Celestial which if considered Physicians cannot be so Atheistical as the world reports them to be I undertook not this work out of design to prejudice the Colledge by making that English which they would have remain in Latine nor to advantage my self by any private gain but to benefit those who are unskilled in the Latine but lovers of the Study I say for the benefit of such have I put this into English Although by my Profession I am otherwise obliged it s something unsuitable to my spirit to have that Monopolized into the hands of a few which should be in common to all such is the practise of Physick yet would I not have those to Administer who are ignorant of the Institutions of Physick as too many have done of late to their own and others detriment He that can but well digest this Book his understanding will sufficiently be inriched in the very inside of the whole body of Physick and will need no other foundation to go upon being the best that ever the Doctors met with for their own informations I shall not need to acquaint thee with the Authors Method that thou wilt find by the Contents of Chapters before the Book nor of the Authors worth for that thou wilt sufficiently understand by his works which speaks aloud in their Masters praise whose fame and worth is well known to the Common-wealth of Learning throughout the world If thou meetst with any Errata 's in thy reading thou art desired to correct them the Translators absence sometimes from the Press occasioned them The Contents of the Chapters of the five following Books BOOK I. CHAP. I. OF the nature of Physick pag. 1 Of the division of Physick p 2 Of Health p 3 Of Temperaments p 6 Of innate heat p 10 Of Spirits p 12 Of the natural constitution of or ganick parts and the common unity of parts alike and not alike called simular and dissimular parts p 14 Of the faculties of the soul and of the differences of actions in Mans Body ibid Of the natural faculty and first of nutrition and augmentation p 15 Of Generation p 20 Of the vital faculty p 23 Of the animal faculty and first of the external senses p 25 Of the internal senses p 27 Of the intellective faculty p. 29 Of the desire and moving faculty ibid Book 2. Part. I. Of Diseases OF the nature of a disease p 31 Of the differences of diseases p 32 Of diseases of intemperature p 33 Of diseases of the whole substance or of the hidden qualities p 34 Of organick diseases p 35 Of diseases of confirmation p 36 Of diseases of number p 38 Of diseases of magnitude ibid Of diseases of composition p 39 Of diseases of solution of unity p 40. Of the accidental and common differences of diseases ib Of the times of diseases p 44 Book 2. Part. 2. O Of the causes of â—iseases p 46 Of things which are the causes of a disease and first of non-naturals p 49 Of internal causes of diseases and first of fullnesse of blood p 52 Of flegm p 53 Of choller p 54 Of melanâ—holy p 55 Of the serous humor and of wind p 56 Of humors according to the opinion of later Phisicians and of Chymists p 57 Of the generation of stones and worms p 58 Of the causes of diseases of intemperature without matter ibid Of the causes of distemper with matter p 59 Of the causes of Diseases of the whole substance p 60 Of the causes of organick diseases p 61 Of the causes of diseases of solution of unity p. 63 Book 2. Part 3. Sect. 1. OF Symptomes Of the difference of Symptomes What a Symptome is p. 65 Of the causes and differences of Symptomes in general p 66 Of the differences in general of actions hindred p 68 Of the Symptomes of the natural faculty Ibid Of the Symptomes of the vital faculty p 71 Of the Symptomes of the external senses p 72 Of the Symptomes of the internal senses p 73 Of the Symptomes of the motive faculty p 75 Of the Symptomes wherein all or most part of the animal actions are hurt p 77 Of the Symptomes of the changeable qualities of the body p 78 Of the Symptomes of excressions and retensions p 79 Book 2. Part 3. Sect. 2. Of the causes of Symptomes OF the cause of the Symptomes of the natural faculty p 81 Of the cause of the Symptomes of the vital faculty and of the hinderances of respiration p 95 Of the causes of the Symptomes of the external senses p 97 Of the causes of the Symptomes of the internal senses p 103 Of the causes of the Symptomes of the moving faculty p 108 Of the causes of Symptomes wherein all or most animal actions are hurt p 113 Of the causes of Symptomes which happen to qualities changed p 116 Of the causes of Symptomes in those things which are sent forth and retained p 118 Book 3. Part 1. Sect. 1. Of signes in general of the difference and Heads of Signs OF the Necessity and benefit of the method of signs p 122 OF the differences of Signs p 123 Of the Heads of signs p 125 Sect. 2. OF knowing the temperature of mans body and of his principal parts of the signs of a
faculty and why the Phantasie in the former the Rational in the middle and the Memory in the hinder part of the brain should be placed for the Imagination and Memory are conversant about the same things though after a different manner But although oftentimes one of these faculties being offended the others remain unprejudiced as oftentimes the Memory is lost the imagination and rational faculties not hurt and on the other side the apprehension and ratiocination offended and the Memory sound and perfect yet that cometh not so much to passe through the diversaty of organs parts of the brain from whence those actions arise as by the change of their proper dispositions and of those things which are required to perform those actions The affections of those senses hitherto explained are sleep and watchfulness The affections of the senses are two Sleep Sleep is a cessation of the natural and commonsense of the external senses ordained for the health of living Creatures by detaining of the Animal Spirits in the brain hindering them from flowing to the Instruments of sense and motion The causes that bring it to passe that the Animal Spirits flying into the brain are there detained and are as it were smitten and cease are several whereof some perform it by taking them away as watching labour and other things in the like nature or by rendring them lesse moveable and benumm'd or as others conceive by penning in and stopping their way as vapours ascending after taking of meat and drink or as it were pleasingly and contentedly stopping inviting from motion to rest which sweet melodies murmuring streams gentle rocking and the like occasion The end of sleep is the refreshing and strengthning of the Spirits and external senses by taking away their motions and operations and from hence comes a recovery of their strength and vigour Watchfulness is opposed to sleep Watching and it is nothing else but the efficacy or force of sense or solution rather of the senses proceeding from the hinderance of the free flowing of the Animal Spirits into all the members of the body Man waketh or is stirred up out of his sleep after a two-fold manner Either of his own accord when concoction is performed the vapours that hindred the Spirits coming forth are discussed and separated or sharp vapours are carried to the brain and trouble the Amimal Spirits that they cannot freely flow into the instruments of the senses or by an external cause when from a more violent external cause as Clamour or touch the sensitive faculty being stirred up converts its self to perceive Nor do the organs of the senses wholly want Animal Spirits in sleep but some stilâ— remain in them sufficient to discern more vehement objects CHAP. XIV Of the Intellective Faculty AT length we come to the understanding or rational faculty whereby a man is elevated above other living Creatures and is neer to and as it were like unto his maker The understanding abstracts things from their matter and without considerations of matter without quantity without figure knoweth things undersands things freed from their matter it is almost capable of infiâ—iteness it reflects back upon its self and knoweth it self and understandeth that it doth understand and because of that it hath an unatiable desire of the knowledge of eternity and blessedness It perâ—orms its functions without all corporeal instruments yet it hath â—eed of the Phantasie as its object to understand and the Imagination supplies the mind with intelligible matter And therefore although it have not its seat in the brain as in its organ by it self yet because it worketh by the help of the Phantasie and it behoveth the understanding to watch the Imagination by accident and by the consequence its seat is appointed where the imagination is namely the brain The reasonable soul comprehends two faculties The Understanding The Will the Intellect whereby we apprehend things and the Will whereby we are carried to chose things which we understand under the notion of good And things as they are beings we know them and as they are good we desire them CHAP. XV. Of the desire and moving faculty BEsides the knowing faculty Appetite two-fold sensitive rational there is given to man an appetite and force of moving The Object of mans appetite is good whether it be really so or seemingly so The appetite is two-fold sensitive and rational sensitive is that which desires that which seems good to the senses rational is that which desires that good that seems so to reason and the motions of the sensitive faculty are often resisted by the motions of the rational faculty and there ariseth strife discord betwixt the sensitive rational faculty Out of the appetite as its actions arise the affections and passions of the mind as we call them Voluntary Animal motion follows the desire Voluntary motion for after that an external object is brought by the external senses and common sense to the Phantasie it is known as profitable and acceptable or as hurtfull displeasing Love or hatred followeth this knowledge or thâ— desire of what is pleasing and flight of what is displeasing Motioâ— presently follows the desire in brute beasts but in man there is tâ—â— Judgment of the intellective faculty which values what is truly goâ— and what hurtfull The motive faculty Then the motive faculty follows that motioâ— which is commanded by the rational or sensitive faculty as the oâ— or the other over-ruleth by the contraction of the muscles the adâ— quate Instruments of motion which draw the tendons these tâ— bones and they being moved the members and whole body is caâ— ried from place to place either to accept of what is grateful or to resist and fly from what is hurtful But although a muscle be the adaequate instrument of motion yet the chiefest part of it consists of fibers or smal strings The Instrument of motion which being contracted the muscle is contracted and motion performed Although their are four different motions of the muscles whileâ— they are contracted or extended or moved transverse or remaiâ— streight as Galen says in his first Book of the motion of muscles anâ— eighth Chapter or as others explain it contraction conservation oâ— contraction or tonick motion relaxation and perseveration of relaxation yet contraction only to which tonick motion belongs is the proper action of the muscles but extension which is a passion rather then an action is not the immediate cause of motion for whilst a muscle contracted by its opposite muscle is extended it suffers it doth not act THE SECOND BOOK PART I. OF DISEASES CHAP. I. Of the nature of a Disease WHereas we have hither treated of those things that are incident to the body according to Nature Thingsprâ—ter-natural how many and so have discoursed about health now I will speake of those things that are preter-natural or contrary to Nature for I do not intend to make any distinction betwixt these
when there are more pores oâ— wayes then there ought to be according to nature Defect in number is when they are Fewer then they ought Excesse in magnitude is when any way or passage is dilated more then it ought Defect in magnitude is when t is become straiter then is fit To excesse belong those infirmities which are called Anastomasis Diapedesis and Diairesis Anastomasis is when the mouths of the vessels are opened and dilated too much Anastom Diaped Diairesis Diapedesis is when the Tunicles of the vessels are become so thin that the humours may as it were sweat through them Diairesis is when from some cause that happens by Erosion or by breaking some passage is opened which ought not That Diairesis which is made from some incident cause or by breaking is called in Greek Rexis that which happens by Erosion is called Diabrosis Defect on the other side according to the variety of causes that occasion it is five-fold Obstruction Constipation Coalescence The differences of narrowness of Vessels Obstruction Constipation Compression Descension All which in general are called straitness of passage Obstruction which the Greeks call Emphraxis is when some passage is stopped either by plenty of humours or thickness of them or clotted blood or Gravel or such like Constipation which the Greeks call Stenochoria is when a passage is stopped by some tumour in it Compressure which the Greeks call Thlipsis is when a part is pressed together by some external matter Coalescence is when after an Ulter the sides of the passage grow together Coalescence Subsidence in the Greek Sunizesis is Conjunction and Constriction when the parts of the vessels consent as it were in pressure and squeezing of themselves together to which no constriction is added when from some external causes or by reason of cold the passages are contracted Diseases of cavity are either in multitude or magnitude Diseases of Cavity in multitude it seldome happens unless from ones nativity there happen more or less passages in the body then there ought In Magnitude passages offend either in excess or defect excess of magnitude is too great dilatation of the receptacle or cavity defect in magnitude is when they are too strait which is either from our first original or afterwards from repletion compression subsidence or constriction Thirdly Diseases of the superficies Diseases of Superficies are ruggedness and smoothness for when according to nature some parts are rougher and others smoother if those which should be more rough become smoother or those that should be smoother become more rugged and so any action be thereby hindred from thence ariseth Diseases of the superficies Softnes and hardnes as we said before Softness and Hardness Rarity Density may be referred to these Diseases as when the bones which ought to be hard are become soft or the tendons are so hardned that they cannot be contracted Also Rarity and Density when a part which ought to be full of pores lose them and become thick Hitherto belongeth colour in the eye Colour in the face for although colour be not necessary for the conformation of other parts yet that the eye may become the fit instrument for sight it is necessary that it be so fashioned that it may be fit to receive for such there are visible species Therefore it is requisite that the horny coat and the watry crystal and glassy humors of the eye be not only cleer and transparent Darknesse but without colour If the eye lose this natural constitution and that those parts which ought to be perspicuous and void of colour are darkened or coloured the sight is hindred and visible species either are not received or are received in a colour differing from their own CHAP. VII Of Diseases in Number THE second sort of Diseases of Composition or Organick Diseases are Diseases in number Of Diseases in number for when there is a certain number of the parts compounding to make up the natural composition of every organ how often soever that is not observed a Disease in number doth arise A Disease in number is two-fold The difference of a Disease of number Abounding either in defect when that is wanting which should be present or in excesse when that is present which should be wanting That which aboundeth is either to nature as the sixth finger or preter-natural as stones and Worms are according to Galen which nevertheless is disputable Nor indeed are such things since they are substances as such Diseases but as some conclude causes by which an aptness and a certain disposition against nature is brought into the part whether it be in respect of number or passages about which authors disagree Deficiency in number Wanting is when there is a Disease by which either a whole part perisheth or is wasted those which are wholly wanting are cleerly according to nature nor can it be a defect against nature such a Disease may they be said to have who want their number of fingers or of teeth CHAP. VIII Of Diseases of Magnitude THirdly Diseases of magnitude amongst Organick Diseases are Diseases of Magnitude when the natural bignes of the part is so altered that for that reason it cannot perform its natural action Diseases of Magnitude are two-fold either when there is an increase or a Diminution of Magnitude according as the whole or part be increased or diminished To the increasing of magnitude belong all tumors and growth of parts contrary to nature to diminition belongs leanness and wasting of parts But because Diseases in Magnitude and in Number are sometimes complicate therefore they are thus to be distinguished If a whole part be wanting or abound it is properly called a Disease in number But if only some particles of a part be wanting or that it be bigger then it ought it is called a Disease in magnitude Secondly if with a portion of any organ many particles are taken away a Disease is deficient in number and diminished in Magnitude CHAP. IX Of Diseases of Composition THE last kind of Organick Diseases are Synthetical Diseases of Composition commonly called Diseases of Composition but although Avicen doth account all Organick Diseases Diseases of composition yet in this place we do not we only take them for a peculiar kind of Organick Diseases Since that two things are to be considered in Diseases of composition situation and connexion Twofold Diseases of composition are of two kinds the one is when the parts do change their situation Diseases in site In Connexion which is called a Disease of place The other is when they are not knit together as they ought but they are separated which ought to be joyned together and the contrary as when the eyebrowes grow together which are called Diseases of connexion or vicinity others call them Diseases of consent society colle iate The most common Disease in place is a loosing of a joynt Luxation the
Greeks call it Exarthrosis when the joynts or heads of the bones go out of their hollow places or cavities Yet other parts besides the bones go out of their places which happeneth in ruptures when the paunch or guts fall down into the Cods or when by great wounds the guts come forth also in the falling out of the womb or of an eye Another kinde of Disease of composition is when the parts are separated that ought to be joyned together which happeneth if the bonds by whose intervene they are linked together are loosened made longer or broken which happeneth sometimes in the womb and other parts of the body or it happens if those are joyned together that should be parted a sunder as when one is tongue-tyed or the eye-lids grow together or two fingers grow together or the fundament be closed CHAP. X. Of Diseases of Solution of Unity THE third kind of Disease is common to similar and Organick parts Diseases of Solution of continuity and is called Solution of Unity when the parts which ought to be one and continued lose their continuity and are divided There are many differences of Diseases of Unity principally taken from the part affected Their differences and the causes dissolving Unity Those things which dissolve Unity some of them cut and prick others erode others bow and break others beat in pieces But the parts which are dissolved are either soft or hard if a soft part be dissolved by a thing that cutteth A wound it is called by the Greeks Trauma by the Latines Vulnus i. e. a wound But if a soft part be dissolved by a sharp instrument pricking A puncture Contusion it is called a Puncture But if a soft part be offended by a blunt weapon and a hard one and be straitned within it self it is called a Confusion the Greek Thlasis and Thlasma If a soft part be broken by any thing that bendeth it Rupture 't is called a Rupture and in the nervous parts peculiarly it is called a Spasme But if there be solution of continuity in a hard part or bone from any other cause then Erosion Fracture namely from cutting or contusion it is called a fracture Caries in Greek Agma and Catagma but if by Erosion it is called Caries in Greek Teredon i. e. rottenness in bones If continuity be dissolved in soft parts by Erosion An Ulcer it is called Elkos in Greek in Latin Ulcus Anglice an Ulcer Lastly An Apospasme if there be solution of Unity of compound parts and those which naturally are different from each other in kind are nourished and grow together they are called Apospasmes as when the skin from a membrane the membranes from the muscles and a muscle from a muscle are separated CHAP. XI Of the Accidental and common differences of Diseases HItherto we have spoken of the effential differences of Diseases The accidental differences of Diseases there remains the accidental differences which are taken from those things which follow the essence of a Disease or from the subject and causes and other circumstances and are also common to many First a body sometimes is sick of one disease One disease sometimes of anther and that is said to be one disease which onely seizeth on one part and offends its actions or when one disease afflicts the whole body but there are many diseases Many diseases which in a different manner affect many and different parts of the body A disease which occupieth one part of a body is either simple A disease simple compound or compound Simple is when no other disease is joyned with it Compound is when it is coupled with one or more other diseases in the same part whether they are of the same nature or of some other but diseases which are knit together not with other diseases but with some grievous symptoms are not properly called complicate diseases Fernelius calleth them diseases of fellowship Diseases of fellowship Solitary even as he calleth those that are neither joyned with any other disease nor with any grievous symptom Solitary diseases As for diseases that are not joyned together in one part there are many they are divided by Fernelius into separated and implicite connexed and consequent Separated are such as consist in divers parts Separated which neither have common use nor action neither do they communicate the affect by turnes from one part to another as the Podagra or Gout in the foot the Ophthalmie or Inflamed Eye Those are called implicite diseases which afflict divers parts which have one common use and action Im plicite as if divers parts of the breasts are afflicted Moreover he calleth them connexed and consequent diseases Connexed when one disease is the cause of another which principally cometh to pass when one part communicates its effects to another Secondly from the manner of generation and subsistence Making some are called diseases Making others Made Diseases Making are such Made that although they are produced out of their cause and now are yet they cannot subsist without their efficient cause but their cause retreating they also withdraw from their subject Made diseases may continue though their efficient cause be taken away Thirdly in respect of the subject Universall Particular one disease is called Universall which afflicts the whole another particular which affects any part of the body another externall which occupieth the outward parts of the body another internall which possesseth the inward parts thereof Some diseases also are congruous such as are agreeable to the Temperament and constitution of the body Others are Incongruous and disagreeable to the Temperament and constitution thereof Of Age. Fourthly in respect of age some are diseases of Infants others of children Sex others of boyes others of youths others of young men others of middle aged men and others of old men as also in Relation to sex some of Males others of Females Fifthly By the being of a thing By consent diseases some are by Idiopathy or Essence others by sympathy or consent A disease by essence is that which hath its beginning from a cause begotten in that place wherein the disease is stirred up By sympathy or consent is that which is stirred up by matter severed from the part where the disease is Sixthly Lâ—gitimate Spurious some diseases are legitimate others Spurious Legitimate are such as proceed from one simple and onely cause Spurious are such as proceed from mixt humours Seventhly some diseases are inherent to man from his first beginning others happen to him after he is begotten Those which come from our first beginning Hereditary are twofold first hereditary whose causes and dispositions are derived from the seed and menstruous blood of the parents to their children and cause a disease in them which they were troubled with secondly from ill conformity some evill may happen to the child
and rest Exercise for idlenesse and too much rest fills the body with Excrements dulls the native heat and renders the body slow and feeble on the other side too much exercise dissipates the Spirits consumes the body and by consequence cooles the whole body hinders concoction the veins and vessels often break stirs up untimely humours heats them and causeth fevers and especially if the body be full of vitious humours they being stirred are carried through the whole body and stir up fevers and other distempers and symptomes Fifthly Passions of the mind the affections of the mind make great alterations in the body in anger the Blood and Spirits become extream hot and are hurried to the external parts from the internal whence they inflame the whole body and often kindle Fevers and raise other Symptomes Too much joy may so dissipate the Spirits that it is observed one may die therewith in fear and trembling the Spirits and heat desert the exteriour parts and fly to the heart and suffocate the heart sorrow by degrees dissolveth the Spirits cooleth the Body dryes spoils concoction causes watchings and begets melancholly diseases Lastly Excretions and retentions those things that are reteined in and sent out of our bodies are the causes of Diseases for if the profitable humors be untimely sent out it debilitates the body and consumes it but if the excrements are retained diseases are bred that are like unto them CHAP. III. Of the internal causes of Diseases and first of fulnesse of Blood INternal things which are the causes of diseases Internal things the causes of diseases either are generated in the body according to nature or are found in the bedy contrary to nature those which are generated according to nature are those three of Hypocrates conteining conteined and doing violence or as others would have it solid humid and spirituous those are called preternatural humours which are found in the body contrary to nature as stones gravel wormes and all things that are generated in the body differing from natural whereunto belongeth those things that are sent into the body and there stick and remain as darts bullets of lead and such like But these things are made to be the causes of diseases How many wayes either as they are in their whole kind contrary to nature or as they offend in qùantity quality motion or place The fault of humours in Specie is divided into Plethorick and Cacochimick The fault of humors twofold Plethorie for humours are either apt to nourish the bedy or not fit plenty of the one â—s called Plethorick of the other Cacochimick for Plethory is when blood and humours profitable for the nourishment of the body abound Plethorie towfold To the vessels To the strength and are beyond mediocrity This plenitude is twofold either as to the vessels when blood so abounds as that the vessels wherein it is contained are stretched beyond their ordinary bigness the other as to the strength when there is more blood then the strength can bear to which Horatius Augenius adds this mixt of them both to wit when there is so great plenty of blood as stretcheth and extendeth the veins and so great pains that the strength cannot bear it Chacochimy is an excesse of other humours besides blood Chachochimy namely when natural excrementious humours offend in plenty or preternatural excrementious humours abound and whilest either these or those putrifie and bring in a strange nature The seat of Plethory and Chacochimy Both pure and spurious Pure Plethory Pure Chacochimy Spurious The causes of Plethory The seat of Plethory is only in the veins but Chacochimy is not onely in the veins but also out of them and in the whole body or some parts especially the bowels But sometimes Plethory and Chacochimy are mixed whence both are divided into spurious and legitimate pure Plethory is when there is too great plenty of pure blood and humours without any vitious ones Pure Chacochimy is when there is too great plenty of ill humours and no good blood with them but when good juyce aboundeth and ill humours are mixed therewith it is called a spurious Plethory or Chacochimy according as blood and ill humours do more or lesse abound There are many causes of Plethory as plenty of Dyet supplies matter to cause it nourishment of good juyce and great plenty of such nourishment the Efficient causes are Constitution of the Body and principally of the Heart and Liver hot and moist and youthful age which may be occasioned in the Spring time and a temperate constitution of the Air idlenesse moderate sleep a life without care and paines suppression of accustomary evacuations of blood Chacochimy according to the variety of excrementitious humours is manifold The kinds of Chacochimy for sometimes phlegm sometimes choller sometimes melancholly and adust melancholly and sometimes serous humours abound of which humorsthere are again various differences CHAP. IV. Of Phlegm THere are divers kinds of Phlegm which are commonly divided into natural and preternatural The kinds of Phlegm Natural Phlegm Natural is a cold and moist juyce or blood not perfectly concocted but if we rightly observe the matter this humour is not properly to be reckoned amongst the excrementitious humours because the blood is crude and may be turned into the aliment of the parts Of the preternatural Phlegm there are four kinds unsavory The kinds of preternatural Plegm Unsavory sharp vitreous salt Unsavory Phlegm peculiarly and principally may be called a Crude Humour which for want of concoction hath not acquired that perfection which it ought in the stomach and therefore can no where in mans body be turned into good substance Acride Phlegm is also crude and called so from the taste it relishes of to them that void it Acride and proceeds from the defect of heat These two kinds proceed from the same causes which according to greater or lesser power they have of introducing coldness and crudity so sometimes this sometimes that kind is generated such are cold meates hard to be digested too great plenty of meat and drink and taken at unseasonable times a cold constitution of the stomach and the adjacent intrails which way soever occasioned Salt Phlegm Salt so called from the savour and is occasioned by the mixture of a serous humidity and a salt with Phlegm whence it is not simply cold but mixed with heat and drinesse and as there is more or lesse of the salt humour mixed so is it more or lesse hot Lastly Vitreous Phlegm is vitreous so called by Praxagorus because in substance and colour it somewhat doth resemble melted glasse this is exceeding cold clammy and thick CHAP. V. Of Choller CHoller is threefold The kinds of Choller Alimentary Natural and Contrary to Nature but the first is not an Excrement but the hotter and dryer part of the Masse of Blood of a different nature from that which is in
some happen to it from without Those which are in the body are humours and excrements Internal if they contein in them malignant and venomous qualities as putrified Blood Seed and other corrupt humours As for external causes External First venomous and malignant Aire Secondly Virulent and contagious Diseases Thirdly Poyson drunk or after what manner soever taken into the Body Fourthly Poysons which come by the smitings or bitings of venomous creatures or some other way communicated to the body externally Venom is either generated in the Air or else the Air receives it from some other thing Aire It receives it from some other thing by malignant exhalations and vapours from Cattel Marish grounds dead Carkasses and other such like exhalations Poyson is generated in the Aire by reason of its hot and moist constitution or the occult influences of stars Contagion is a Granary or if you please Contagion an Affect contrary to nature which is communicated to another body from a body affected likewise contrary to nature This Infection is twofold either by touch when the body which is infected toucheth that body which is next to it or at distance when a body far distant from another by that which it emits it infects the distant body Poysons taken into the body are either Plants Poysons taken Poysons from without or living Creatures or Minerals or poysonous Metals Poysons which happen externally to the body are the biting of venomous Creatures Stroakes Exhalations or venomous Unguents and Powders CHAP. XII Of the causes of Organick Diseases NOw for the causes of Organick Diseases and first the figure of Conformation is vitiated either by it selfe or by accident By it selfe it is vitiated first in the womb The causes of the figure vitiated through some error of the formative faculty Secondly out of the womb through violent motion either of those things that happen externally or those which are with us or in us or by the errors of our Midwives Nurses or Chyrurgions Thirdly by too great repletion and encrease and on the contrary by Inanition or Defect of Aliment and lesning the due magnitude or in default in number By accident the figure is hurt when any parts grow not as they ought but another way through loosening of Nerves Convulsion Inflammation or swelling a Scyrrhus or hard bunch on the Liver the cutting of a Nerve or Tendon or by some hard skin growing in them Moreover to what belongs to Diseases in the Channels of the Body Diseases in the Channel are either in excesse or defect Diseases of the passages in excesse the passages are too much dilated by something filling them contrary to nature and stretching them sometimes too much But straitness of the passages is either from our first formation when our stomachs are narrower then they ought or by repletion or when in an Empyema an Impostumation or Ulcer is generated in the brest and there broken and flowes and makes it narrower or whilest a stone groweth in some hollow part or by compressure when from what cause soever a hollow member lying under its Cavity is pressed too close or by the closing of its outsides or by constriction when by too much use of binding things the stomach is contracted Diseases of the passages since they are in excess or in defect The causes of Diseases of passages Anastomasis Diaresis An Anastomasis is caused first by the too great quantity or the quality of humours initating the expulsive faculty or the mouth of the vessels opening themselves moreover sometimes by Medicines and other things which have power to relax and loosen the mouths of the vessels A Devision is made by some gnawing or cutting cause such may be sharp humours or fretting Medicines either stretching them too much as too great store of humours Diapedesis or else breaking them as violent motion clamours heavy burthens knocking An opening the Tunicles of the vessels is by moistning and rarefying things The causes of defect and straitnesse of passages Obstruction Constipation Coalescence Compression The causes of the defect of passages or of narrownesse of them are five Obstruction Constipation Cealescence Compressure Subsidence The cause of obstruction is first that which is conteined in a passage and is not generated for such are thick or viscide humours clots of blood quitture hard dung stones worms and too great abouncance of humours The cause of Constipation is hard flesh as when there is a Tumour the flesh growes in the passage Coalescence is caused when after a wound the walls of the passages grow together Compression is made by things externally hapning which have power by weight and violence or otherwise to pâ—esse the passages and have strength to force them inward as divers tumours and bones out of joynt are amongst the internal causes amongst the external Bones Conâ—usions Stroakes and such like Subsidence Subsidence is when the outsides of the passages by too much moisture are made looser then they ought to which some adde Constriction by cooling and astringent things The causes of Diseases on the outside The causes of Diseases in the Superficies or extremities of the body are such as make it rough or smooth rugged things make it rough so does gnawing things and such as dry overmuch as sharp humours and medicines endued with such qualities sharp vapours Wind Smoak sharp Meates things endued with contrary qualities make the body smooth Moistâ—ning things make the body soft contrary to nature drying things make it harder the mixture of black humours and such as give a tincture spoyles the clearnesse of complexion The cause of Diseases of defect Causes of Diseases in number in number are either from a mans birth namely defect of matter or imbecillity of the faculty drawing matter being not able to retain and elaborate the same or error of formation Or else after one is born by outting burning gnawing putrefying and too much cooling either natural things abound contrary to nature and that from our beginning the cause whereof is either too great plenty of profitable matter and the strength and error of the formative faculty or after our birth as is a Membrane a Tubercle the cause whereof is plenty of good matter and by it occasion is given of breeding an Ulcer or somewhat contrary to nature aboundeth as Warts Stones and such like the cause whereof is peccant matter Magnitude is encreased contrary to nature Of Magnitude encreased either according to some dimensions only or according to all First it is encreased by things contrary to nature as by wind as in a Timpany and a windy Tumour or by water as in a Dropsie or by the falling of one part into another as when one is bursten Augmentation is made according to all the dimensions by the spreading of humours over all the substance of the body which comes to passe either by reason of profitable humours which happens to fat people and
stomach doth not perceive its want of drink as it often comes to passe in Frensies and burning Fevers Again the Thirst is encreased through want Of encreased and drinesse of humours which proceed from those things which have drying faculties and such as consume the primogenial humidity of the stomach such are all drying and heating things as hot humours sharp and salt a hot and dry distemper in the mouth of the stomach proceeding either from the whole which is in Fevers or in some part neer to the stomack which either sends hot and dry vapours and humours to the stomach or by reason of the communion of the Tunicles and Membranes which cover the stomach the orifice of the stomach the Wind-pipe and the neighbouring parts communicating a hot and dâ—y distemper to the Oâ—fice of the stomach external causes which are evident perform the same as those which have a power of heating drying and consuming the humidity in the Oâ—ifice of the Ventricle Vitious thirst is caused by some vitious humour in its whole kinde contrary to nature Vitious thirst sticking in the mouth of the stomach The swal owing is hurt either when the faculty is offended Of swallowing hurt or through some external error and indeed the faculty either natural or animal may be hurt the natural is hurt whilest either the attractive faculty cannot draw meat through the strait fibres of the internal Pannicle into the parts or the expulsive through the Transuerse fibers inserted into the external Tunicle cannot thrust food which is drawn into the mouth of the stomach farther down into the stomach which is caused through the relaxation of the fibers of the Orifice of the stomach by reason of a cold and moist distemper when the matter flows from the head to the chops or by reason of their driness occasioned by some Tumour Ulcer or Excoriation The animal faculty is hindered when the Muscle which is before the gullet either is inflamed which use to be in the Quinsie or 't is contracted either by Convulsion or Palsie it is hindered also by reason of the straitness of the entrance into the stomach which proceeds from divers causes as Tumours in the Throat Relaxation of the Vertebraes of the Neck and Back external things being swallowed as when Fish-bones Pins and other things stick in the mouth of the stomach as also Wormes The swallowing is hindered by some external error when any thing hard dry sharp rough viscid or ungrateful is swallowed The retention of meat swallowed is hindered when it is abolished The causes of Retention of meat hurt diminished or depraved Retention taken away and diminished proceed from the same causes the one from the greater the other from the lesser and this comes to pass if the Retentrix be weak The Oblique fibres loosned by a cold and moist distempers or if any Tumour as an Inflammation or Ulcer be present The cause of windiness in the stomach is windy meats and a stomach not cold enough but the cause of floating with a noise is when the stomach is freed from that which might be turned into wind yet still remaining full of drink or extreamly cooled But the retentive faculty is depraved when the stomach doth not â—ightly infold the meat Of Palpitation and indeed a Palpitation with floating and noise happens through the weakness of retention and thick winds pen'd into the stomach Of Convulsion which arise either from the causes or crudity or from flatulent meat or yellow or black choller spread over the stomach But a constriction and a certain sighing or Hiccock happens when after emptinesse and defect of aliment the stomach too violently contracts it self having newly received meat Tâ—embling is caused by the imbecility of the retentive faculty from a cold distemper and the wait of the meat oppressing Of trembling Of Shaking The cause of abolishing and diminishof concoction in the stomaâ—h Faculty hurt External error and a certain Quavering when the Ventricle is molested by any biting thing especially choller For as much as what belongs to the concoction hurt is either abolished or diminished in the stomach they both proceed from the same causes they onely differ according to Major and Minor and the concoction is hindered either primarily and by it selfe when it cannot do its office withour the hurt of the rest of the faculties Or secondarily and by accident when it is vitiated by the retentive or expulsive faculty For unlesse meat can be retained so long as it ought The concoction cannot be rightly performed The concoction is hurt by its self either when the faculty is hindered or by some external error the faculty being hurt is hindered through some distemper of the stomach from what cause soever ariseth or other diseases of the stomach tumours ulcers and such like which hinder concoction the concoction is hindered through external errors first by reason of Excrements which if they abound in the stomach and offend with cold they are the cause of abolition and diminition thereof Secondly by meats which offend either in quantity or else divers and various kinds are taken or in quality if the meats are cold or hard and clammy and hard to be concocted Thirdly by reason of the time of taking food namely if meat raw betaken before it is boyled Fourthly after the taking of meat if a man watch the whole night or sleep very little or exercise himselfe violently or suffer the passions of the mind The corruption of meat is two-fold the one nitrous Depraved the other acide the nitrous hath its beginning from a hot distemper of the stomach the chollerick excrements being collected in the ventricle by hot aliments which are obnoxious to corruptions such as are sharp oyly pinguious things Milk Mushrooms garden Fruit and such like but crudity produceth acidity through the cold distempers abounding with cold aliments cold pituitous and melancholy humours in the stomach We have said the Symptomes of the expulsive faculty of the stomach are Hiccock Loathing Vomiting Choller Belching The immediate cause of Hiccock is something troublesome to the superiour part of the stomach Hiccock especially to the Orifice thereof which it endeavours by that motion to put away and expell but the causes which trouble the stomack on this manner are either in the Stomach it selfe or in the parts which can draw the Ventricle by consent The cause of Hiccock in the Stomach it selfe is matter either oppessing by its plenty or offending in quality as sharp meats and biting and such like humours sharp medicines malignant and foul vapours either generated in the stomach or sent thither from elsewhere Worms an immoderate cold distemper and those things which outwardly press the stomach which may happen by the pressing and bending the extremities of the ribs to the stomach But Hiccock by consent happens when the nerves of the sixth conjugation suffer together in an inflammation and percussion of the braine as also
inflammations of the Midriff the Eungs the Liver the Gutflion Loathing and Vomiting have their rise from the same causes differing according to Major and Minor Causes of loathing and vomiting either in the stomach it selfe ill affected and weak or from something contrary to nature tearing the stomach The stomach is ill affected by a cold and moist distemper or by conformation thereof or by a certain native straitnesse thereof by reason of drynesse and leannesse swelling an Ulcer whereunto belongs frequent vomiting which indeed it selfe disposeth the stomach to more frequent vomiting as also the shutting of the inferiour Orifice of the Ventricle by some tumour as an obstruction also of the Guts and mesentary and inverted motion of the fibres of the Guts The diseases called the Chollick and Stone by the communion of the Membranes and lastly wounds and hurts of the Braine and its Membranes But the matter which Irrirates the stomach to expel either loading it with its plenty or twitching it with its sharpnesse or moilifying the superior Orifice or by stimulating it with a malignant quality it doth it whether it be meat and drink or medicines poysons worms blood quitture choller effused into the stomach which happens to those which have a vitious implantation of the Pores or the Vessel that carries the Choller into the bottom of the stomach The evident external causes are too much exercise of the body and the sight of loathsome things The cause of Choller is offensive Moist Choller and sharp matter irritating the expulsive faculty of the stomach by its plenty and its quality to expulsion and stimulating it to evacuate upwards and downwards Such is Choller collected about the Liver Pancreas and parts adjacent also sharp adust humours salt nitrous and other peccant humours bred of corrupt food as Mushrooms Garden-fruits and such like strong purging Medicines and Poysons do the same and stir up this matter As for the difference betwixt the other Choller and this Dry Choller which we have newly explained that is dry this is moist the cause is a flatuous and sharp spirit stirred up by yellow black and adust Choller spread over the stomach Belching is occasioned by thick and fuming vapours breaking out upward and stimulating the stomach to expulsion Belching Concerning a loosenesse Alientary and Celiack affects the causes of a Lyentary and Coeliack affects are for the most part the same differing onely in magnitude And in this also that a Coeliack is rather a Disease of the Guts then of the Stomach although its name seems to signifie otherwise For in a Lyentary as hath been said the meat is cast forth crude In a Coeliack the Chyle is ejected contrary to nature and therefore the cause of a Lyentary is the hurting of the retentive faculty of the Ventricle and Intestines by reason whereof the meat before it be perfectly concocted descends into the Guts and is cast out And indeed in a Lyentary the retentive faculty of the stomach is principally hurt Nor can it be that meat unconcocted can be cast forth out of the Panch unless it be sent too soon into the Guts by reason of some fault of the retentive faculty of the stomach but the Coeliack is occasioned rather by some hurt of the retentive faculty of the Intestines because Chyle generated in the stomach ought to remain some time in the Guts that it might there be in some manner elaborated and be conveniently drawn by the meseraik veines and the ordure should be throughly elaborated If the retentive faculty of the Intestines be hurt all these things cannot be performed but the Chyle untimely and in some as measure crude is cast out of the Panch but the retentive faculty of the Stomach and Guts is hurt either of its selfe or by accident of it selfe through a cold and moist distemper and that either alone or joyned with a phlegmatick humour as also by cicatrising after a disentary and the immoderate use of fat things and such as cause Lubricity By accident it is hurt when the expultrix being stirr'd up exceedingly drives the meat presently downward by reason of the ulcerous disposition of the Stomach and Guts caused by biting and sharp humours sometimes also by a hidden quality or from hurtful and poisonous meats or ill disposition of air A Diarhaea proceeds from the expultrix of the Guts stirr'd up by plenty of humours A Diarhaea crudity or pravity whether they proceed from corruption in the stomach and guts or flow from the wholebody or any part to the guts from what cause soever they are generated and collected The more remote causâ—s of Diarhae a are imbecility of concoction and distribution through the distemper of the stomach and parts adjacent ill diet untemperate air omitting exercises of the body or taking a strong purge The cause of a Dysentery improperly so called or of voiding of blood without exulceration of the Guts are the opening of the mouths of the Mesentary Veines A Dysentary either by too great plenty of this blood or by crudity by reason of the concoction of the Liver or being retained too long in the Liver Veines and by a burning with a preternatural heat But as for Dysentery properly called the causes are sharp and biting humours whether they flow from the whole or from some part to the Guts or are generated in them and are peculiarly troublesome to them of which kind also are sharp gnawing drugs â—speciplly violent purges sharp quitture and poysons A Tenesmus or desire to go to stoole and cannot void any thing but blood A Tenesm comes for the most part from the same cause yet principally salt phlegm and a sharp humour clammy thick closely sticking to the skin of the Gut called Rectum The Belly on the contrary is suppressed either because the expulsive faculty of the Intestines is hurt Suppression of the helly or because the Muscles of the belly do not help to expel or because the ordure doth not stimulate or because the Guts are not alwayes sensible of pricking and stirring up the expulsive faculty doth not expel either because it is hurt or frustrated by some external error or fault in the object 'T is hurt either because it is weakened by a cold and dry distemper or it is hindered by the strength and driness of the retentive faculty or by the narrownesse of the Guts which proceed first from astringent and drying things Secondly from their inflammation or a Tumor bred in them Thirdly from growing together especially of the Fundament Fourthly from the going out and turning of them which happens in a Rupture Fifthly from obstruction by reason of the hardnesse of the siedge Worms Stones viscous Phlegm Sixthly from the Muscles refrigerated and straitned shutting the Gut Rectum The belly is supprest through default of the object when the Ordure is too thick viscid and hard the Muscles of the Panch do not help to expel either because they are
weak or because they or the parts under them endure pain the Ordure doth not stimulate when either there is but little or when there is no mordication or it hath no sharpnesse or by reason of eating of cold meats or because yellow Choller is not mingled therewith The Guts are not sensible of stimulation either because their preception is dull or becavse through long retention they are accustomed to and become familiar with the Ordure or because they are stopt with phlegm The Illiack passion hath its original from the inverted motion of the fibres of the Intestines Illiack which proceed from some inflammation or obstruction from hard dung or from a Rupture or from Exulceration or a Canker or from a high flowing of humours Moreover for what belongs to elaboration of blood Sanguification hurt that is hindered either primarily and by its selfe or secondarily and by accident Primarily it is offended either when the faculty is hindered or by some external accident when the faculty is offended 't is done by reason of some diseases of the Liver distemper by reason of which alone without any other manifest disease of the Liver those which are troubled with its imbecility are called Hepaticks obstructions tumors ulcers But it is hurt by some external error when either the Chyle is not rightly elaborated in the stomach or when it is throughly elaborated some peccant matter is mingled therewith Secondarily or by accident it is hurt either when the attractive faculty is hindered by reason of diseases of the Liver or obstâ—uction of the Mesentary or because the retentive faculty in like manner is hindered through some disease of the Liver and especially through its moist distemper opening and gnawing of the ressels and thinnesse of Chyle or by the expulsive faculty principally by cold distemper and obstructions of the gibbous parts of the Liver by reason whereof the blood cannot be distributed But as for the Symptomes which happen in making of Urine The cause of an Iscury and of little Uria the first is an Iscury or suppression of Urine and making of lesse Urine 't is properly to called when the Urine is in the Bladder and is not ejected or very little is cast ouâ— which Symptomes arise from the same causes differing only according to Major and Minor but the Urine is suppressed or little is made because the xepulsive faculty is either hurt and weakened or hindered It is hurt whilest either the sensitive faculty oâ— the Bladder being hurt doth not perceive the pricking of the Urine namely when the proper Nerves of the Bladder are affected either by some stroak sliding loosening of the Vertebraes in that part wounds of the spinal Marrow and Tumors as also stupefactive Medicines being applied thereto or it may happen when the expulsive faculty is hurt and the transverse fibres of the Bladder appointed for expulsion or affected with some cold moist distemper or are extended over much that they lose their tune or note so that afterwards they cannot be contracted which comes to passe when the Urine is too long retained or the Muscles which help and assist the Bladder to expel Urine are affected so that they cannot be contracted But the expulsive faculty is hindered whilest the Neck of the Bladder and Urinary Passages are not open and is either stopt by a little Flesh or Callous Substance in the passages or is obstructed by Gravel clotted Blood Quitture or thick humours or it is comprest by a Tumour in compassing the Neck of the Muscle of the Bladder or of the neighbouring parts or it is shut by contracting of the Muscle of the Neck or it is pressed and wreathed by the falling of the Bladder out of its place Urine also is not made when too great plenty thereof is long retained too much dilating the fibres of the Bladder so that afterwards they cannot contract themselves nor cannot squeeze out nor expel Urine which comes to passe either when the Urine mens businesse being urgent of its own accord is retained long or when the pricking of the Urine as is said before is not perceived Lastly Urine is not cast out through its accustomed passage if by some Wound Ulcer Fistula of the Bladder and Urinary passages the Urine which ought to passe through them goes out by a way opened elsewhere There is another Iscury lesse properly so called or suppression of Urine when little or no Urine is sent and comes into the Bladder which happens when the attractive faculty of the Reins is hurt through distemper especially cold or is hindered by obstruction and straitnesse of the emulgent vessels or when the Urine is carried to another place and is cast out of the Panch or by Sweats or is collected in the Panch and stayes in the first passages as in a Dropsie But a Dusury properly so called Difficulty of making Urine or difficulty of making Urine is when the time of making water and the quantity is a little altered yet in the very making water the Urine doth not passe out freely but is made with great striving pain and burning which comes to passe by some fault of the Urinary passage namely whilest it is affected with some Ulcer and is eroded or the Vrine it self being sharp doth it or the passage was formerly ulcerated The cause of a Strangury is either some sharp thing which stimulates nature continually to expel Of a Strangury but because nature is sensible of pain it hinders free emission the Urine is made drop by drop and dribling which is caused by crude Urine unconcocted or having a sharp humour mixt with it by Gravel sticking in the neck of the Bladder or some fault of the Urinary passage whereunto belongs Intemperature of the Bladder and inflammations of the same and of the parts neer thereunto hot humours also exulceration of the neck of the Bladder and Urinary passage Involuntary pissing Of Involuntary pissing which happens both to those that are sleeping and waking is caused for the most part when the contractive power of the Muscle Sphincter of the bladder is taken away which is occasioned by a Palsie proceeding either from a cold and moist distemper of the same or by hurting of the Nerves which come to this Muscle by compression in loosening the turning joynts of the back neer the Hucklebone by a stroak a fall or some tumor or obstruction or by hurting of the same Muscle or certain fibres in cutting the stone of the bladder yet sometimes Urine is made against our wills when the Muscles of the Panch are exceedingly drawn together so that the Urine by reason of their constriction and compression of the belly is as it were forced out of the bladder as also sometimes it happens to those that are great with Child in their last months For the same reason they cannot contain their Urine But if a man contain his Urine waking Of pissing in ones sleep and in his sleep let
Convulsion of the Fibres and nervous parts in the Muscles by reason of something troublesome which draws the part joined to it into consent and stirs it up to this motion whereby the Fibres being contracted the Muscle is drawn back to its original Emprosthotonos Emprosthotonâ—s Opisthotonos is made in the Muscles which bends the body of such as are affected forwards Opisthotonos by the Muscles affected bends the body backward Tetanos is from an equal contraction of the Muscles Tâ—tanos Spasmus Cynious The Spasmus Cynichus or troublesome Cramp ariseth from a convulsion of the Muscles of the Mouth Trismos from contraction of the Muscles of the Jaws Also the cause of convulsive motions is a humor Of grinding Teeth Of convulsive motions or a vapor an enemy to the whole generation of Nerves irritating the expulsive faculty in them and stimulating them to expulsion yet is not fixed but hath various motions through all nervous parts and so the member is agitated in various motions and for the most part it happens that the braine is affected and matter is seâ—â— from thence into all the Nerves When the Cramp and Palsie are complicate Of the complication of the Crump and Palsie Privation of speech the â—â—mour is of a mixt nature which hath force partly oâ— loosening Nerves partly of vellicating and twitchiâ—â— them Privation of speech happens through default either 〈◊〉 the Spirits and Nerves which carry them or of the parâ— which are necessary for the bringing forth of a word The spirits are deficient in an Apoplexy Epilepsie anâ—â— Dumnesse properly so called Men are become duâ—â— through the fault of the Nerves when either the Nerveâ—â— of third pair are affected from whence the tongue also receives its Nerve which defect if it be native for the most part the hearing is abolished by reason of the communion of the Nerves of the tongue and the ear that felowship is hurt or when the Nerves of the sixth and seventh conjugations and those going back and vocâ— Nerves are either cut or stretched or cooled or intercepted or hurt by what means soever The voice is hurt through organick diseases thereof if either the Membranes of the Larinx or top of the Wind-pipe are filled with some humour and grow soft or some chink thereof be shut by what means soever or if the tongue be cut about or maimed or the Muscles which move the Larinx Tongue or Throat are hurt or relaxed or knockâ— or wounded or any other way affected contrary to nature or lastly through desault of the wind-pipe if that be cut exulcerated or closed The same causes are if they are lesse Of the voice and speech diminished diminution of voice and speech is occasioned yet more frequently the cause remains in the tongue namely if the ligament be too long from one birth so that it extends to the extremity of the tongue or if after a childs birth it be wounded exulcerated swoolen or be affected with a Palsie on the other side The cause of depravation of voice and speech Of stammering and first of stuttering and stammering is principally a moist distemper of the instruments of voice and speaking and sometimes a dry also an ill framing of the Tongue and its Muscles a Tumor borne under it as also the fault of a swelling at the entrance into the Throat and want of the fore teeth Hoarsenesse ariseth from over much humidity of the outsides or the instruments for speech Of hoarsenesse whether that matter flow from the head or be cast out of the brest from loosenesse and inflammation of the Columella or a fleshy substance in the entrance into the throat as also from external and evident causes first from air violently straining the voice daily which causeth inequality of the Wind-pipe All the causes of the Cough are those which hinder the instruments of breathing whether they be internal Of a cough or external causes either by Idiopathy or by Symptothy stir up the Cough by Idiopathy an unequal distemper principally cold causeth the Cough which is the greatest enemy to the brest sometimes also distempers hot and dry moreover the roughnesse of the Wind-pipe which happens either through distemper or through biting humors flowing from the head or by Medicines or sharp drinks or obstruction by a humour thick or thin a pimple gravel worms a little hard swelling clod of blood By Sympathy the Cough is raised if the other parts which can draw the Organs of respiration into consent be affected namely the Midriff Liver Spleen Stomach which by reason of the common Tunicle they have vellicate the instruments of breathing or send vapors to them or presse the Midriffe by reason of some Tumor ot obstruction But the external causes are cold air dry cold water too much desire of drink cold medicines applied to the brest dust smoak sharp vapors soure aliment sharp things and whatsoever contrary to the order of nature slide into the wind-pipe straying or wandring in the gullet if it intercept the way or stop it or exasperate the Artery or any way molest the Wind-pipe Those things cause sneezing whatsoever doth stimulate the Nostâ—ils Of sneezing and the fore part of the Brain to excretion whether generated in the body as humours flowing from the Brain or those things which affect the Nostrils by communion with the interior skins by Sympathy which comes to passe when worms stick in the Guts or whether they happen from without as whatsoever sharp things are dâ—awn by the nose smells also and sharp vapours the splendor of the Sun and over much light Gaping Of yawning or Yawning is when â—alitious vapours stick in the Muscles appointed for chewing and moving the lower chop which nature endeavours by this motion to cast off but some times imagination is the cause thereof Stretching ariseth from such vapors as may be emitted through the Pores Of stretching which neverthelesse are not sharp but being store of them they cause trouble in the spaces of the Muscles of the whole body stirring up the expultive faculty to expel which the nature may discusse it useth such a motion of the Muscles by constriction of them Lastly Shaking fits and trembling Horror and Trembling which are Symptomes neer alike as also are vehemency and greatnesse of motion and so is the difference of the cause they are stirred up by something that offend in the circumference of the body suddenly vellicates the sensitive parts and stimulates them to expulsion which it strives to perform by a natural concussion But the causes which bring forth that twitching are either external and evident as whatsoever befalls the body or vellicates the sensitive parts or cause the sharp humours contained in the circumference of the body to be stirred and moved as a spark of sire cast on scalding water thrown upon a biting medicine applyed to an Ulcer piercing cold and such like for internal as humors or sharp vapors either
were degenerated from their nature and are made altogether unfit to perform animal actions bring forth vapors which contain in them a stupefactive power moreover the effusion of animal spirits by deep wounds and troubling of them by a stroak and by a great fal and commotion of the Brain may take away all sense and motion from a man but that Apoplexy which ariseth from a pituitous and stupefactive power is the chief and is understood for the most part when mention is made of a perfect Apoplexy to wit which is occasioned by its sefe when the other Apoplexies by reason of the differences of causes either are occasioned by some external and violent cause as by a stroak by a fall or they follow other diseases An Epilepsie is occasioned from a vaporous and thin matter Of an Epilepsie whether by its acrimony or venomous and malignant quality vellicating and molesting the Brain and all the Nerves and together afflicting the animal spirits darkning and troubling of them and there are to help this matter forward not onely certain humours corrupted in a peculiar manner and fit for an Epileptical disposition but also parts of the body corrupted in like manner as Worms After-birth and such like An imperfect Epilepsie hath the same cause with the perfect Epilesie but mote gentle and less store of humours which otherwise could not vellicate all the Nerves yet may trouble them all but cannot trouble and darken the animal spirits in the Brain CHAP. VII Of the causes of Symptomes which happen to qualities changed ANd these are the causes of the actions hurt Causes of colour changed or of the first kind of Symptomes which conâ—ist in the actions hurt the second kind or colour of the whole body or of its parts changed contrary to nature are humors of the body such are the colours of the whole body or its parts as are the humors in them so in the yellow Jaundice by reason of yellow choller effused into the body the whole body is coloured with the yellow choller in a Dropsie by stegm it waxeth pale The teeth grow black either through default of aliment Causes of change of the colour of teeth or when any slimy matter flowing from the Stomach Brain or elsewhere or also from meat left behind sticks to the teeth and putrifying corrupts and make them black The Nailes change their colour through peccant matter nourishing them Of Nails Fifthly Of stinking smells smells and exhalations are breathed out of the whole body when hot and moist bodies produce plenty of crude humours which when they cannot be overcome by heat become putrid and send forth a stinck from the whole body A stink is sent out of the mouth Of stinking breath when either many crudities are heaped together in the Stomack which are corrupted and send forth putrid and stinking exhalations by the Pallate or when filthy vapours exhale from the putrifaction in the Lungs or when such matter cleaves to the Teeth Gums or Pallate and infects the air which is breathed out with its stink The smell of the Arm-pits which they call Goats smel Stink of the Arm-pits proceeds from excrementitious humors which are sent from the heart and internal parts in such aboundance to these places and emunctories that all of them cannot easily be discussed but corrupt and send forth filthy smells The faetid smell of the Groin comes from the same cause namely Of the Groin too great plenty of excrements which are sent out from the Liver and Veins to those emunctories The foul smell of the Nostrils is caused by excrementitious humours there collected and putrifying by a Polipus a Canker or an Ulcer in the Nostrils Of the Nostrils The ears stink by an Imposthume and Ulcer in the internal Ear or by vitious humours sent out of the Brain Of the Ears Lastly Of the Feet the Feet send forth an ill smell when the moist excrements in them which are of a hot and moist constitution and given to surfeit are collected and putrifie in the Feet being drawn thither by their motion especially when they are covered with such garments that they cannot freely expire vapours The câ—uses of tactil qualities changed Of tactil qualities changed appears by those things which are spoken of the Causes of Diseases when sometimes they are referred to the rank of Diseases sometimes to the number of Symptomes namely as sometimes the actions are hindered by them sometimes they hinder not the actions but onely cause trouble to the touch CHAP. VIII Of the causes of Symptomes in those things that are sent forth and retained AS for what belongs to excretion and those things which in their whole kind are contrary to nature Causes of excrements contrary to nature and may be generated in the body as stones worms since the same belongs to the causes of Diseases they are spoken of before in the second Part and the ninth Chapter but artificial things as instruments of Iron Knives and such like cannot be generated in mans body but by the inchantments of the Devil are insinuated into the body or are fitted to parts without through which they cannot come back and are there shewen as it were going back If those things which are wont to be cast forth naturally are cast out another way â—â—eressions through unaccustomed passages which comes to passe because the accustomed ways either are grown together or obstructed or some way or other shut for then nature by reason of plenty of matter which it was wont to evacuate through the usual ways they being shut it wearied seeks new ways either more open or otherwise to which some pricking humor leads it or which it chuseth of its own accord Thirdly the effusion of blood contrary to nature through what place soever happens because the Veins and Arteries are opened contrary to nature Of bleeding contrary to nature for those reasons which before in the Second part and thirteenth Chapter are explained and particularly sweating of Blood happens through the thinnesse of the Blood rarity and laxity of the skin and debility of the retentive faculty Small paâ—cels are cast out of the body when from any internal part which was wont to be evacuated that way or in that way by an Ulcer Putrifaction and eroded by a sharp humour and separated from the body As for the causes of excretions offending in quality hot ordure is cast out if choller and hot humours are mingled If the Liver and Guts are too hot if hot meats are used The siege is cold by the extinguishing of the native heat the use of cold meats and the mixture of cold humours Moist Excrements are cast out either through crudity when the meat is not concocted or by obstruction of the Meseraik Veins Causes of excretions peccant in quality Hot. Cold. Moist Hard. by reason whereof the Chyle cannot passe to the Liver and therefore being mingled with the ordure
to be so exact and happening by some occasion from the external air or the heat vanishing of its own accord the vitious matter is separated from the other humors But if Vrine be made thick Troubled which grows clear and afterwards become thin that happens because the natural heat begins to perform and concoct the matter and to stir it and mingle it which notwithstanding since it is not exactly mingled the heat afterwards ceasing the Heterogeneal parts are separated of their own accord and the thicker reside in the bottome The same comes to pass if the Vrine be thin but some matter may be mingled therewith in its passage but since it is not exactly mingled with it but only confused afterward of its own accord it settles in the bottom Lastly Troubled which remains so if the Vrine be made thick and remain so it signifies great confusion of humors is made in the Veins by the heat stirring the humors but not rightly concocting them nor is there good concoction made which the excrements elaborate to make after their manner and indeed if such a Vrine appear in the beginning of such a disease wherein no concoction seems hitherto to be made by the natural heat it is a token that 't is caused by the fiery heat contrary to nature agitating and troubling the humors in the veins but if the Vrine in the beginning is not made thick but clear and afterwards becomes turbulent it is a sign that the disease grows worse and that the heat acting upon the matter contrary to nature is encreased yet always this and also other signs must have regard to the rest of the conditions of the Vrine and hence it is to be collected whether such signs be made by the strength of nature working upon the vitious humors or by the encrease of the preter-natural heat and putrifaction or debility of strength CHAP. V. Of the causes of colours in Vrines COncerning the causes of colours in Vrine The causes of a golden colour in Vrine a golden colour which agrees to the Vrines of sound men proceeds according to the vulgar opinion from some portion of yellow choller or rather from a serous and salt excrement yet that also something tinctured with choller which is mixt with the Vrine A white Water is made Of a whit either because nothing is mingled with it which may colour it which is properly called aqueous or because some white body is mixed therewith The first cause of aqueous Vrine is Crudity and weakness of the native heat by reason whereof this excrement is left Of an aqueous as it were imperfect Secondly obstructions of the passages through which the matter useth to flow to the Vrine Thirdly if choller and therewith that salt humor be carried to another place as happens for the most part in acute Fevers and Phrensies with them Fourthly much drink Fifthly heat of the Reins and Liver which plentifully draw drink to them but do not concoct it Sixthly Gravel in the Reins or Bladder too much of that which is salt and thick adheres but the aqueous flows out Vrines of another kind are made by the mixture of some white substance whether it be flegm or quitture or seed Of milky and these Vrines we call milky yet for the most part they are made thick and afterwards become clear and the matter setling in the bottome of what kind it is may be easily discerned A Vrine is somewhat pale Of palish Of pale when pale choller in a sufficient quantity or a little of yellow is mingled with the Urine but if much pale choller or yellow in an indifferent quantity be mingled with the Vrine a pale colour ariseth If yellow be mixed in greater quantity Of yellow the Vrine becomes yellow yet some times other causes besides internal external may give a tincture to the Vrine as Rhubarb Saffron the leaves of Senna and such like A ruddy colour in Vrine is caused by choller and blood Of blood red and indeed if the Vrine be coloured with blood it doth not look clear and is properly called Vrine dyed with blood and has a colour like water wherein the flesh of animals newly slain have been washed and is made either in some open vessel for what cause soever or by the weakness of the Liver and Reins by reason whereof they cannot contain blood and assimulate it to themselves or because nature at set times evacuates the blood abounding in the whole body with Vrine but the blood which is mingled with the Vrine is either thin and the Vrine is made red or reddish or thick which if much be mingled the Vrine is made exceeding red but if little either simply red or of a pale red but that Vrine which is coloured by store of choller the choller colouring it and and making it redder it shineth and is as it were like flame sometimes also it is made red and thick by plentiful mixture of adust choller like wine of a blackish or deep red Wine like Vrine is made by the mixture of ceruleous choller Of Vine colour Of grape colour or representing the colour of Woad as also by the mixture of plenty of red choller Grapy by the mixture of yellow choller exceedingly dryed and as it were changed into a Violet colour and degenerating towards black A green Vrine is caused by plenty of Aeruginous Of green and Leck-like colour Yellow and black Vrine are sometimes caused by the mixture of external things Of yellow and black as for what belongs to the internal causes the Vrine is made black when either the melancholy humour is evacuated with it which happens in those which cumulate melancholy humours in the Spleen or black choller is mixed with the Urine or when the heat and spirits are extinguished in the veins the blood is corrupted and becomes black CHAP. VI. Of the causes of an oyly Vrine and of other differences O Leaginous Urines either have only fat swimming in the superficies Of oyly Vrines or represent Oyl in substance and colour the first difference proceeds from a melting of the fat and is rather to be referred to the differences in the Contents but that Vrine which seems like Oyl in substance and colour and yet is nor truly fat hath its beginning from the mixture of excrementitious humours especially of pale and black Choller as also of Flegm from whence proceeds a crudity with a certain greenness like Oyl Black Vrine always thick but when the difference in substance and colour are joined a black Urine cannot be thin but if the black humor makes it black it is necessary that there is so great plenty thereof mixt with the Vrine that the Vrine must become thick A light red Vrine is thin from the small portion of blood mingled therewith A light red thin but if it be made of a pale red 't is by choller which cannot happen unless there be so great
Naturall rest in the beginning make the pulses lesser Sleep weaker slower and thinner afterwards greater and more vehement and the slownesse and thinnesse by little and little is increased moreover if the sleep be too long they returne againe to pravity and debility and retaine their sloath and thinnesse when a man is stirred up or awakned the Pulses begin to be greater more vehement swifter more frequent equally indeed if a man be awakned by degrees but unequally and troubled if he be suddenly awakned yet a little afterwards the pulse againe becomes moderate long watchings cause little and weake pulses yet swift and frequent at length the faculty being weakned they become dull and thin Exercise and motion moderate cause great pulses Exercise vchement swift frequent but overmuch exercise cause little faint swift frequent when the use may be increased and the faculty debilitated at length they are little slow and thin Moderate use of baths make great pulses swift frequent Baths and vehement but if they exceed measure little faint swifter and more frequent Passions of the mind As for the passions of the mind anger causeth great pulses swift frequent vehement joy makes great pulses thin and slow moderately vehement but if it be overmuch it renders them unequall and inordinate In sadnesse they are little languishing slow thin feare soone makes the swift pulse vehement Inordinate unequall but they are of as long continuance as those are in sadnesse Immoderate evacuations Evacuations because they debilltate the faculty bring forth pulses like to those caused by a weake faculty But as for those things which happen contrary to nature Preternaturall things how they alter the pulse although they are various yet they change the pulse because either they change the use or affect the instruments or faculty in the first place when the faculty is affected many changes are made of the pulses for whether the faculty be diffolved and weakned by those things which dissolve the Spirits and sollid parts such as are soule diseases great distempers vehement and diurnall greifs fastings too great Evacuations or whether they are burthened or oppressed by plenty of humours or by diseases of instruments inflamations or other tumours the pulses are made lesse in the first place and swift frequent feeble afterwards the least most slow most frequent most faint and at length the faculty being almost prostrated intermittent deficient declining vermiculant formicant all which running through the various kind of affects contrary to nature and principally out of the doctrine of feavers are made more manifest CHAP. XIII What the simple differences of Pulses signifie and presage ALthough from the causes of pulses Great pulses what they signify it easily appeares what every pulse signifies and portends yet that we may add something of each in particular a great pulse although principally its familiar use be in increasing a strong faculty and a soft instrument in those which are sick it signifies a hot disease and a great pulse unlesse it be hindered followes all feavers and it cannot be much dilated with the Artery unlesse the power be strong or at least not weake a great pulse in all feavers is good signe A small pulse argues either debility of the faculty or remisnesse of the use or hardnesse of the instruments and indeed if a small pulse shall be also faint t is a token that its weakness proceeds from a weake faculty if small and hard from the Artery if neither debility nor hardnesse be perceived in the pulse it is an argument that it comes from the diminution of the use whence little pulses with a weake faculty foretell death the rest of pulses that are small for the most part presage long and difficult diseases A swift pulse signifies that the use is increased and the vigour stronge A swift or certainly not very weake whence in those that are sound a swife pulse signifies heate stirred up by motion exercises baths and such like causes which if it be also great the strength is not yet debilitated but in those which are sick a swift pulse signifies a hot disease and is proper to those which are feaverish and if magnitude be joyned therewith itshewes that the use is increased with strength of nature but if frequency be adjoyned without magnitude it shews that the powers are weakned if hardnesse of the instrument the use being increased hinders dilatation that hardnesse is to be perceived by the touch A slow pulse shews Slow the contrary to wit little heate and the use diminished and then it is onely thin and the vigour not firme enough and withall it is feeble A frequent pulse signifies the use to be increased Frequent or the faculty weakned or the instrument hard if it proceed only from the use increased it is not faint nor hard and magnitude frequently goes before and then extraordinary great heat is discovered in those that are sick if it proceed from debility or hardness of the artery that is discerned by the pulse Thin pulses are made either through a strong faculty Thin and a soft instrument or from the use diminished in sound bodies it signifies a cold constitution but in sidk a cold disease and coldness of the heart and that which is contained therein and therefore 't is accounted an ill signe A strong and vehement pulse shews a strong faculty Vehement and if its vehemency exceed the bounds of nature it signifies also great irritation A faint pulse on the contrary Faint signifies powers to be dejected and that either by dissipation of spirits and resolution and then it is also smal and if use hinder not slow or by oppression occasioned by plenty of humours and then the pulse also is inordinate and unequal A soft pulse shews softness of the arterie Soft and moreover in a sound body signifies immoderate drinking or dyet over moistning or a bath or idleness but in a sick a moist habit of the body On the contrary hard pulses Hard. shew the hardness of the arterie and indeed either by extending in convulsions Tumours or by repletion of vessels with humours and wind or by drying as in burning Feavers Hecticks consuming Feavers Quartans and other drying causes CHAP. IV. What the other differences of Pulses signifie presage NOw for the other differences of pulses and first Equality and inequality of that of equality and inequality equality although it shew a fixed disposition of matter yet it signifies firmness of nature and therefore affords the better hope but all inequalities are worse and either signifie obstructions of vessels or compressions or aboundance of humours hindring the force and indeed a single inequality is more dangerous then systematick or mixed whence intermitting pulses in one pulse are more dangerous then intermitting in many if both of them proceed from debility of the faculty Uneven pulses Vnalike stirred up Myouri Dicroti therefore being stirred
generation of flegme if they have preceded Flegme of which above Lib 2. part 2. ch 4. Moreover those which abound with flegme are dul flow lazy and unapt for motion more stupid in their senses dullet of apprehension propense to sleep and sleep more soundly they dream of waters and raine snow haile ice and of drowning their manners are unbeseeming they are not easily angry the pulse is little dul thin and soft they are not troubled with thirst their desire is weaker they are affected with cold diseases moist and durable they send forth many flegmatick excrements and abound with spittle their urine is white pale sometimes thin sometimes thick and troubled their dejected ordure is crude pituitous the whole body is thick white soft and more cold to the touch heating and drying things cutting and atenuating and evacuating flegme advantage them they easily indure fasting On the other side all cooling and moistning things and thickning and those which retaine and increase Flegme offend them if the Flegme be sour all those signes are the more vehement but salt Flegme is known from the preceding causes of which is spoken before thirst is present a salt taste those things which are cast out are crude but withall biting Moderate salt things delight them too much drying and heating things hurt them Choler is known to abound if the causes Of Choller and dispositions of the body have gone before which conduce to the generation of Choler proposed before lib 2. part 2. chap 9 as if a man be not drowsie but watchful if he dreame of fire thunder and lightning and contentions and is ful of activity in motion and rash or precipitate in consultation is easily angry the pulse vehement swift frequent hard if his concoction be depraved and turned into a nitrous crudity if the appetite of meat be less then the appetite of drink hot and dry diseases afflict him and those which have a swift motion and symptomes arising from choler if the urine be yellow and splendid the excrements coloured with cholour the habit of the body is dry and leane and carries with it lively heat the colour of the body is yellow cold and moist things and such as purge choller as also acid things delight them hot and dry things as also fasting hurts them Melancholy is known to abound from the causes and dispositions going before Melancholy propounded aboue lib 2. part 2. chap 6. For what belongs to the consequences those which abound with a melancholy humour are silent full of thoughts stable and pertinacious and slow to anger who nevertheless are not easily pacified their sleep is turbulent perplext with horrid and terrible dreams they are sad and fearful without any manifest cause they have a little pulse dul thin and indifferent hard their colour is yellow dun or duskie almost black they desire meat and Venery moderately they are void of thirst and abound with spittle they make much Urine and if none of the melancholy be evacuated therewith it is thin and white or if some of it flow with it it is thick and black and they sweat plentifully in their sleep the Hemorhoids either flow or are suppressed much wind is in the body and they are apt to four belchings the habit of the body is lean sharp and hard the colour yellow the spleen sometimes swels and grows hard within them tubercles appear in the veins and they are affected with other melancholy diseases Black choler is a signe of yellow choler and melancholy mixed together Black Choler and the indications of melancholy appear but joyned with manifest signes of heat whence madness a canker a Leaprosie and such like diseases arise Aboundance of serous Humours are collected Of the serous humor not only from the antecedent causes whereof we have spoken before but also from a somewhat moist and pale body and the Urine is crude and aqueous Moreover Winde winds discover themselves by those signes which are reckned above in the lib 2 part 2 chap 7 moreover fluctuations rumblings tumblings in the guts and Hypochondrias are perceived and switching pains without gravity wandring such as suddenly arise suddenly vanish also a humming and buzzing in the ears pantings of some parts of the body belching breaking wind backward or in the paunch are discovered and the Urines are frothy Malignant and pestilent humors Poysons how they may be known is spoken amongst fevers but the signes that poison is drank are if any biting happen in the stomack or guts to any sound man after eating and drinking and if the belly or stomack be moved to expel and their colour within six hours turn yellow and spottie if the extream parts of the body grow cold and swounding palpitation of the heart and swelling happens but if one be hurt by the biting of any living creature or with a prick or sting or froth and the offended part should mortifie become putred should be inflamed and swel and the paine be great and those symptomes before mentioned appear it is a token that the living creature was venemous CHAP. III. Of the Signes of Diseases SOme signes of diseases indicate the kind of diseases Causes what diseases they shew others the magnitude others the manner and they are taken from those three fountains the causes those things which necessarily inhere and the effects of the causes and what force each hath is spoken of in lib 2. part 2 Disposition of the body and therefore if any causes are present or hath gone before it is a signe of a disease which that cause is apt to produce but amongst the causes the dispositions or inclinations of the body are to be weighed which are apt to produce this or that kinde of disease for every body either fals into a disease like its own constitution sooner then contrary to it and that disposition depends on the age sex course of life and manner of dyet Neither are those things to be past over which help and hinder for if hot things are advantagious cold things are mischeivous and a cold disease is understood the contrary comes to pass if the disease be hot the same reason is of other tempers also Out of those things essentially inhering Essentially inhering or in the proper essence diseases are easily known in the external parts and are obvious to the senses but diseases of the internal parts although they may be known by those things which essentially inhere yet not immediatly but others coming between so a tumour of the bowels is known by the skin mediating which is lifted up by the subjacent parts and it self is become swolne As for what belongs to the effects and symptomes Effects and symptomes an action that is hurt if it be not by some external error it signifies that a disease is present in that part whence the action is hindred and indeed an action abolished and diminished signifies a cold distemper
that a greater this a lesser but depraved actions signifie for the most part a hot distemper and since an alteration cannot be made suddenly nor doth the distemper suddenly cease when the alteration is introduced if the action be suddenly taken away and suddenly restored it doth not indicate a disease of intemperature Excretion and retentions but an organnick but if the actions are presently taken away and remain absent long either obstructions occasioned by thick matter or a cold intemperature is signified the excrements too much coloured signifies a hot disease as also doth dry ordure but clammy thick and white dreggs shew a cold distemper Qualities changed qualities also changed indicate diseases softness signifies a moist distemper a pale colour of the body signifies a cold distemper but a red colour a hot As for the magnitude of a disease Signes of a great disease if a great cause and that which hath great force of acting hath gone before in what kind of disease soever without doubt 't wil generate a great disease the proper nature of a disease wil easily betray it self for by how much the more the pathognomick signes or the signes that discover a disease shal be greater or lesser by so much it shews a greater or lesser disease hither to belongs also the worthiness of the part affected for by how much the part affected is more noble or can draw more noble parts into consent by so much the disease is counted the greater moreover the symptomes by how much the more and greater they shal be to which this happens that if the disease do not give way to exquisite and great remedies by so much the greater the disease shal be it is deservedly accounted great A malignant disease is likewise known by malignant venemous causes preceding Of a Malignant Moreover 't is the nature of certain diseases that in the same manner is they are known they indicate malignity such are the Morbus Gallicus Leaprosie and such like Thirdly malignity discovers it self by the effects for when no dangerous or vehement symptome is present which might trouble the sick nevertheless is unquiet and weak and the disease after smal remisness is swiftly and vehemently exasperated by sweats and other excrements and the sick perceives no manner of ease especially if frigidity of the extream parts or watchings should happen if in the beginning of sleep sleep seemetroublesome if the sick without a cause be afraid waxeth exceeding hot drops blood and the other ill signes be present which are spoken of amongst malignant feavers it argues amalignant disease Acute diseases are known from hence Of Acute diseases that they are suddenly moved and immediatly after the beginning afford grievous symptomes CHAP. IIII. How to know the parts affected The fountains of the signes whereby the parts affected are known Signes of places affected Galen in his first Book of the places affected Chap the 5th accounts five the actions hurt excrerions scituation proper accidents and propriety of paine which notwithstnding are comprehended under those foundations before proposed Amongst the causes the first are those things which are taken in whereof some have power of hurting this Causes others of offending that part moreover to those things which are carried about us belong arts and course of life from whence it happens that sometimes this sometimes that part is more hurt as sleeping and watchings which principally offend the braine anger which principally hurts the heart as also other passions of the mind Thirdly those things which are retained they more offend that part wherein they are detained 4ly Those things which happen and befal us externally they also shew the part affected if any one use mercuriall vunctions it is probable that the nervous parts are hurt that evil which commonly overspreads signifies that part to be hurt which is manifest doth labour in other sick persons By things essentially inhearing here are understood both the proprieties of the parts and the diseases themselves inhearing for although diseases are not of the essence of a part as it is a part yet as it is an effect centrary to nature diseases themselves seem to be in a part essentially inherent diseases therefore indicate parts affected a tumour appearing any where signfies either that part is affected or the part which is placed above it and the scituation and figure of the Tumour and the motions hurt will shew it in its kinde a falling of the guts into the codds signifies a rupture of the peritoneum or rim of the belly gibbosity signifies hurt of the spine or marrow the propriety of parts shews places affected as they are proper to those parts so if we see stones come forth with Urine without doubt we conjecture the veines or bladder to be affected As for the effect Effects actions hurt first an action hurt shews that member by which it is offended unless it be hurt by some external error so ratiocination being hurt imagination memory they signifie the brain to be affected as likewise by sleep watchfulness exercise of the whole body The visive faculty is hurt by an affect of the eye the hearing of the ear the smelling of the nose the taste spoiled is a token of a disease of the tongue if the urine be suppressed the cause is to be sought in the reines uriters bladder or urinary passages if yellow choller be not purged from the blood blood it is a token that the bladder of the gall is distempered Paine Hitherto belongs paines which shews that some sensible part is affected yet a differing paine may be a signe of divers parts a pricking paine is proper to inflamations of membranes a striking paine is caused by parts sensible which are inflamed containing arteries a burthensome paine agrees to the whole substance of the bowels lungs liver spleen reines inward deep and profound paines as it were breaking the part signifies the membrances of the bones to be affected a broad paine spreading it self every way about is a token that the membrances are affected streightness shews somewhat belonging to the extending of the nerves The vital actions being hurt shews that the heart labours Lastly natural actions hurt in what part soever shew a signe of that part which is affected but more manifestly in publick parts more obscurely in private parts Excretions Secondly in excrements which also afford signes more things are to be considered namely the kinds qualities manner of casting them out quantity order the kinds of excrements are two-fold for either something is cast out of the substance of some part signifies that part to be affected as if a little skin orflake or little peece of flesh should be cast out of the mouth it shews the lungs the wind-pipe the Epiglotis the gullet or ventricle to be corroded and if it be cast out by a cough it is a signe that it comes from the brest but if it be cast out by vomit it
2. On the other side ill dejections and those which portend destruction derogate from the good in substance colour smell time wherein they appear nor are they voided with ease As to their substance and quantity dry excrement and rolled up in clods are signes of fiery heat and if besides they shall be black they declare a burning disease to be in the middle of the body and for that reason are evill On the contrary liquid excretion is not evill if it have other good notes but the watry ordure is worse and proceeds from greater crudity and moreover in cholerick diseases with ill Urines t is deadly but in more milde it signifies the disease will continue long A glutinous white light fat and foetid ordure and little are condemned 2. Prog. 21 22. Cleare dejections also in acute diseases are condemned 2. Prorrh 15. and froathy and cholerick ejections in acute cholerick diseases are accounted evill ibid. Apho. 18. As to the colour excrements which differ from the naturall colour are white red bloody watry green yellow black full of mixt colours unlesse they are emitted critically they portend danger Yet in all these ejections in judging of them regard is to be had of the meat and to take heed you observe whether that quality hath its rise from dyet that hath been taken for they become white either by the obstructing of the passages through which choler descends to the guts or through the motion of the choler to some superiour and more noble part Red are also of themselves dangerous yet if they are extruded after the victory of nature they rather shew hope of present health then portend any thing of evill Black Excrements since they proceed either from blood or melancholy humours or from black choler that blacknesse which comes from concrete blood or a melancholy humour is not alwaies evill but pure black choler can never be sent out of the body without destruction of the sick Green and aeruginous ordure which proceeds from aeruginous choler tending to black is an argument of a pernicious disease if it be cast out from any principall part and the bowels be affected with an Erysipelous if the Excrements are yellow they signifie vehement cold in the internall parts and as it were a certain mortification Ejections also of divers colours are evill 2. Prog. 23. Faetid Excrements are evill also and the worst of all and few are preserved whose excrements in acute feavers are foetid yellow fat black and blew or lead colour Those vomitings are good which truly purge the causes of diseases Of vomitings or which are made critically and when concocted matter appears on the criticall daies and are suitable to the nature of the disease and take away or abate the same but on the contrary all those are evill which happen in the beginning when the matter is not yet concocted and which take not away the morbifique matter and the disease and they are so much the worse if other pernitious signes be present such as are sincere Vomits leek coloured lead coloured black stinking and foetid from the guts Ileon and very little Sweats are good which happen after decoction is made Os sweats and on a criticall day and coldnesse and stifnesse proceeding flowes out hot and plentifully from the whole body and lessen and abate the disease on the other side those are evill which happen whilest the matter is crude which are too much or too little and those which are cold or flow not from the whole body and neither diminish nor take away the disease The Hemorodes of the nose are good which happen in the state of a disease From the Hemerodes of the nose with signes of concoction nor is that alwaies to be condemned which happens in the augmentation and also in the beginning seeing the blood wants no other preparation neither do the other humours Good Hemerodes ought to be large but yet not over much but to be made with ease and the symptomes of the Feaver to be abated and to happen in a criticall day and in those diseases wherin bleeding is proper to their nature and condition and moreover the blood ought to flow from a part opposite to the part affected on the contrary those are ill Hemerodes which happen in the beginning unlesse other good signes are present and if they appear with dangerous signes and those which are too large or too little Dropping of blood from the Nose is evill if it be caused by pervernesse of matter multitude imbecility of force or all these especially in the beginning or on the fourth day if the blood be black sincere and without mixture But it be a token of a future Crisis t is no ill signe which happens when the signes of concoction have been before and the disease is not dangerous Spittle is of great use in shewing of diseases of the breast From spittle and that is good which is concocted white and equall and is spit out conveniently and easily in a short space of time without great pain and a great cough on the contrary t is evill if it be crude yellow worse if it be green worst of all if black especially if it be without mixture if it appears more dull and is spit out with great difficulty t is also evill when the spittle is bloody for it proceedeth from erosion or from breaking of Vessels Lastly decretory Imposthumations are good Vlcers if they happen with signes of concoction and other good signes and break on a judicatory day they are good by nature which are removed from the bowels and more noble parts which persevere are suppurated and help the sick On the contrary those are evill which break forth without signes of concoction the matter as yet being crude and on a day that is not criticall if they are too great or too little or happen to be in the fingers or toes if they are lead colour or too red inclining to black and those which decrease and vanish without any reason and without any precedent evacuation those which are not well suppurated which are corrupted and they bring either that part where they are or the whole body into danger CHAP. II. Of the signes of health and of death which are taken from the mutations of the qualities of the body MOreover to the mutation of the qualities of the body What may be fore-told by the habit of the body and first concerning the whole body t is a good signe if it be rendred not much unlike to a sound body in habit and colour T is no good signe for the most part in a great Disease when nothing is changed 2. Apho. 28. T is also an ill signe when bodies are extenuated in the declination of a Disease and although they take food are not thereby refreshed For in acute Diseases t is an ill signe when the body is puft up and swelled unlesse criticall humours are then remitted The colour of the
disease will be judicatory on the fourteenth and therefore the signes of concoction are to be sought in the following quartarnaries for if the signes of concoction appear about the twentieth day there is hopes on the first quartinary after the twentieth day that the disease may be judged of but if no mutation hitherto appeares it may be extended to the fourth week and those diseases which retaine all the signes of crudity to the foure and twentieth day cannot be decreed before the fourtieth day and those which are extended beyond the fourtieth are not ended with a Crisis but with slow concoctions Sometimes not only the day but also the houre of the end of a disease may be foretold The houre of the event of a disease how to be known namely if we consider particular fits for if we think any one will dye on any day t is probable he will dye in the worst time of his fit or in a particular declination when the strength in the height of a discase is dejected by the cruelty and vehemency of Symptomes CHAP. IX How many mutations there are of diseases and the manners and what a crisis is THe third thing which ought to before known by Physitians is the manner of event and end of diseases Changes of diseases how many they are terminated six severall wayes as well to health as to death for either the disease is suddenly fully dissolved and the sick recovers immediatly his firme health or there is a sudden change to better and the sick is transferred from a worse state into a better after which at length also he recovers to be well or there is a conversion of the disease by little and little to health or contrary the sick suddenly dies or the disease is suddenly become more dangerous which change at length ends him That mutation which is made by degrees tending to death is called a Marasme or Wasting that mutation of a disease which is made by little and little and tends to health is called a loosing but that sudden and hasty change which is made in Feavers especially acute and tend to health Crisis or death is called a Crisis but that change cannot be made unlesse vitious humours which oppresse nature are moved which indeed cannot happen without great perturbations of the body and vehement symptomes a Catalogue whereof Galen recites in his 1. of criticall daies Cap. 1. CHAP. X. Of the causes differences manner and time of Judgment SInce that in Judgments many things happen The cause of a crisis Conturbatâ—on conturbation evacuation and sudden mutation tending to safety or death that conturbation which is a heap of those judicatory symptomes which proceed from agitation and molestation of humours which the body affords and this comes to passe either from an externall cause as influence of Stars or an internall irritating and provoking as well nature as the matter The cause of evacuation is the expulsive faculty Evacuation which either is stird up by the plenty or the quality of matter yet critically expels that which doth molest There are four differences of Crises Differences of Crisis according as nature is sometimes stronger sometimes weaker and sometimes oppressed more by vâ—tious matter sometimes lesse for either the sick forthwith recover their former health or suddenly dye or undergo some change tending to safety or death Good Evill yet immediatly they neither recover nor dye From whence afterwards other differences will arise for some Crises are good some evill those are good which tend to the recovery of the sick those are evill which discover the death of the sick Again some are perfect and very good Persect Impersect which free the sick perfectly and wholly from the disease and leave none of the morbifique matter but the imperfect leave some of the morbifique matter behind Again some are faithfull and secure Secure Not secure which so take away the disease that there is no feare of a relapse unfaithfull is that which leaves a doubt of falling into it again Moreover t is called a safe Crisis which happens without danger of Symptomes A safe Dangerous but a dangerous which is joyned with perilous Symptomes Some Crises are with good signes Eusemes and have their indications from the daies going before them and are called good signes but that which happens without signes and is Asemos as it were unseperated is said to be an ill signe But all these differences depend on three things The differences of Crisis whereon they depend the strength of nature the nature of a disease and the condition of the matter which ought to be expelled and that a good and perfect Crisis be made t is requisite that nature be strong and Heaven favourable the disease not dangerous and the matter benigne and facill in all other Crises one or more of these are wanting All Crises are made two waies either by excretion Crisis how many waies made By excretion by translation or emitting or else by removing the matter By excretion a Crisis is made when peccant humours are expelled by vomit Seidgs sweat plenty of Urine Hemerodes of the Nose flowing of the months and Hemerodes A Crisis is made by translation when the matter is not expelled out of the body but is removed into another place and that either into internall parts or externall the former Crisis is the better because the matter for the most part is throughly cast out from the center of the body by so much also a Crisis is the better that is made by translation by how much the matter is transferred to a more ignoble and remote place so much the worse by how much the place is more noble and nigher to the seat of the former disease An Imposthumation also or Ulcer ought to be out of the region of the part affected and to have the other notes of a good Imposthumation an abscesse also ought not to vanish suddenly but to remain untill either it be turned into quitture or till it be dissipated by degrees But the best Crisis never happens unlesse it be towards the end of the height when the concoction is perfected A good crisis when it happens for that which happens in the augmentation before the state is imperfect and is so much the worse by how much t is longer distant from the end of the state sometimes also evacuation which is made in the beginning of diseases and is symptomaticall is not to be accounted evill especially if those humours are evacuated from whence the disease had its originall and the strength of nature can endure it CHAP. XI Of Criticall daies WHereas the Crises are made more frequently and better on certain determinate daies then other daies Criticall daies those dales therefore are called criticall but other daies wherein a Crisis seldome happens or such a one as is not good does happen are called not criticall Criticall daies are of
three kinds some are those which are simply and according to preheminency called criticall wherein Judgments are made better and more frequently all which are bounded within the circuit of a septinary number and are these the 7.14.20.27.34.40 for daies are not taken whole but shorter Moreover there are some which are called indicant and contemplable from whence the Crisis to come is shewn and they are the middles or quarternaries of every seventh morning as 4.11.17.24 Others are such as come between Intervening which the Greeks call Parempiptontes others call them provocatory wherein from some accident contrary to nature or by the violence of a fit or by reason of some externall cause nature is provoked to hasten to untimely expulsion such are the 3.5.9.13.19 and according to some 15.18 Vacant or not criticall daies are those wherein no crisis happens Vacant or very seldome and unperfect and evill such are the 6.8.10.12.16.18 to which some add 22 23.25.29 30.32 33.35.38.39 which daies are also called medicinall because the Physitian on those daies may safely administer purging Medicines After the 40. day diseases languish and by a slow concoction and by Imposthumations rather then Crisis are terminated after these some diseases are judged by months others by years and especially in climactericall years when changes are made even of diseases which have been contracted from their Mothers Womb. From this doctrine neverthelesse of Hippocrates and Galen which Galen reduceth as it were in brief in the 1. of decretory diseases cap. 5. the ancients now long since have departed Asclepiades Archigenes Celsus and others which accounted the third criticall year not the twentieth but the one and twentieth the fourth not the twenty seventh but the twenty eighth The Astrologers also do not simply observe daies and numbers The opinion of Astrologers but referring all the reason of criticall daies to the motion of the Moon note those daies wherein the Moon comes to every quadrangle or fourth corner and comes to the diameter in respect of place wherein she was found when the disease began as now in the causes of criticall daies shall be shewn CHAP. XII Of the causes of Criticall daies THat we may omit the opinions of others The cause of criticall daies of the causes of criticall daies no offence to any other judgments we appoint criticall daies to depend on the Moon and the condition and disposition of peccant humours and the expulsive faculty for what mutations soever the Moon in her conjunctions oppositions and quadrangles makes in these inferior bodies is very well known and therefore that power which is attributed to quaternaries and septinaries do all depend on the motion of the Moon yet neverthelesse that this or that Crisis may be made betwixt those the motion of the Moon alone is not sufficient since not alwaies the seventh or fourteenth day is not alwaies criticall and somtimes a good and an ill Crisis is made on the same day and therfore the condition and disposition of peccant humours are to be joyned and lastly the expulsive faculty is to be added which being stimulated by the motion of the Moon and disposition of humours is the next and immediate cause of a Crisis First seeing the order of criticall daies cannot proceed only from the faculty of the body nor from morbifique matter The Moâ—n but a coelestiall cause is to be joyned therwith and the Moon in every quarternary and septinary and according as it takes up one and another place of the Zodiack in its motions and by reason of the light from the Sun varying shews to us various lights or representations it may make great alterations in sublunary things t is not therfore without a cause determined that great mutations arise in diseases in those places which have regard to the place wherin the Moon was in the beginning of the disease with a quadrate or opposite ray and when she is come so far as that she hath a new shape and manifest mutation of light for the motion of the Moon and her progresse to the quadrate and opposite signes and the changings of the shape of the Moon are to be joyned whatsoever they are yet the crises are stronger when the Septinaries exactly fall into the quadrates of the Moone But in the computing of the criticall dayes A periodicall month in criticall dayes to be observed the month of wandring or travelling is to be observed as being naturall and according to which many changes are made in this inferior orbe which for the most part is made in twenty seven dayes and eight hours which if they are divided into foure weekes the first will be ended in six dayes and twenty hours the second in thrirteen dayes and sixteen hours the third in twenty dayes and twelve hours Therefore on what day soever any one fall sick at the first onset of the disease a conjunction as it were is made of the Moone and the disease hence when the Moone hath measured three fignes or past over ninty degrees and comes to the first quadrate the first criticall day is made when she hath past through six signes or an 180. degrees she comes to the opposite signe and the second criticall day begins when from the opposite signeshe passeth to the second quadrate the third crisis begins if the disease be prolonged till then lastly when she returns again to the place where she was at the beginning of the disease the fourth crisis begins and she shews as she did at first Prognosticall diseases The same reason is of indicatory dayes for when the Moone hath passed over two signes or 60. degrees from the signe wherein she was when any one began to fall sick and is said to come to a sextile the first indicatory is begun when she hath past over foure signes or a 120 degrees and becomes triangular the second indicatory is made and when from the opposite signe againe she comes to be triangular then is the third indicatory lastly when she hath gone from the second quadrate to the second sextile the fourth indicatory is But here the dayes are not to be numbered according to the diurnall indifferent motion of the Moone Which motion of the Moone is to be observed in critiball dayes which is thirteen degrees ten minutes 35 sec but according to the true motion of the Moone for the Moone is sometimes swift sometimes slow in motion nor doth she passe through alike number of degrees each day whence it comes to passe that she arrives sometimes sooner sometimes later to the quadrate and opposite signe and hence without all doubt it comes to passe that most admirable Physitians vary in defining of criticall dayes and Hippocrates as also Galen account the twentieth and seven and twentieth Archâ—genes as also Diacles count the one and twentieth and eight and twentieth for criticall dayes neither are allwayes distinct aspects to be observed but often times plarick are sufficient Secondly besides the
motion of the Moon The disposition and motion of humours The nature of a body â—the disposition and motion of humours are to be considered and which is the cause that the crisis happens sometimes sooner sometimes later Lastly the nature of the body is to be adjoyned which being assisted by the motion of the Moone and stirred up by the humours begins a combate with the morbifique matter and expels the same and makes a crisis CHAP XIII Of the signes of crisis in generall BUt crises are made as it is also said before only in acute In what diseases crists are made and violent diseases arising from hot thin and acrid matter which may tire out nature but if sometimes in durable or chronick diseases also criticall evacuations as it were are made it is necessary that ther be certain periods of time before the disease become vehement and become of the same nature with acutes Moreover that the crisis may be made t is requisite that there be strength of nature according as ought to be thirdly to the foreknowledge of a crisis certain perturbations in the body conduce which use to arise before a crisis Signes of crisis and signes which Galen in the third of crisis Cep second at large describes and he breifly comprehends in the same book Cap. the tenth when he writes that when a crisis is to come there is some new alteration either about respiration or concerning the mind or the sight or hearing or about some of those which we call breifly by one name criticall accidents or signes CHAP. XIIII Of the signes of differences in Crisis A Good crisis is thus known The best signe of crisis First because critick signes have precedes Second because the signes of concoction have gon before especially in urins and other excrements Third because it is shewn on the judicatory day Fourth because it happens on the judicatory day Fifth because convenient excretion is made according to the nature of the disease Sixth because the sick after the Crisis is almost freed from the feaver the Symptomes abate and the face is of a better colour But these Crises that differ from the best are known thus Of the declining from the best because the signes of exquisite concoction have not gone before nor have they happened in the state nor a little before but in the augmentation they are not made on a criticall day the evacuation doth not plainly answer to the nature of the disease the sick doth not well endure that evacuation the Pulses are not better the sick is not eased of his disease and in the night which followeth the crisis he is not more lightsome yet amongst the other evacuations which are went to happen before an absolute concoction the best of them is the Hemerhodes An evill crisis is known by the signes which are contrary to the best crisis Evill namely because such a crisis first doth not expect the time of concoction secondly in the judicatory day it was judicated by ilâ— signes or it suddenly grew upon him without preceding signes thirdly it is not made on a decretorie day but for the most part on the sixth or eigth day fourthly the evacuation doth not answer to the nature of the disease and the excretion of it selfe is evill fifthly the sick is not eased the pulse is become worse the strength decayes and the sick doth totally fall into a worse condition CHAP. XV. The signes of a crisis to come by excretion and Imposthumation BUt whether a crisis be to be made by emission of morbifique matter Sgnes of a crisis to come by excretion or by transposition of it into another place or by imposthumation the kindes of diseases and the motion time of the yeare nature and age of the sick do shew for if the disease be very acute ariseing from thin and acrid matter and the crisis be to come after the first periods if nature be strong the pulse high the passages open and nature accustomed to sweate or some other evacuation if it be Summer time t is a signe that there will be a crisis by excrements By an vlcer or imposthumation But on the contrary if the disease be not so acute and the matter be thick nature weaker especially if the urines come forth thin and crude for a long space if their be debility of the externall parts and propensity of nature to thrust out humours to these places if the time of the year be cold t is a token that there will be a crisis occasioned by imposthumation And indeed excretions are good when they are evacuated as they ought and such as ought Signes of good or evill ex cretions and in such manner as they ought and when and as much as is expedient namely when the humour which offendeth is evacuated and concocted in due quantiry in a criticall day in a right manner together and through places sending them out together evill evacuations are contrary Good imposthumations are those which are made when the matter is concocted have laudable substance Imposthumations good or evill namely a figure swelling externally and sharpned do equally ripen and are not hard round about and are of a good colour red yellow or white indifferent bignesse when they continue and go not away untill they are suppurated and are soon ripened on the contrary ill imposthumations swell not enough without and are not pointed they suppurate not all alike they are hard about and cloven into two their colour inclining to red yellow or black they are greater then is convenient and they vanish before they are suppurated or are ripened very slowly CHAP XVI Through what places there will be excretion and where there will be impostumation THrough what place there will be excretion the inclination of the humour teacheth and about those parts to which the humour to be expelled is moved or through which it is moved a certain change is perceived When a Crifis is to come by the Hemerodes of the Nose Signes of Hemerodes of the nose the Hypocondries are wont first to be extended without pain then when the blood finds the way to the superior parts it causeth difficulty of respiration but not long continuing afterwards followes the paine of the head and neck and the pulse becomes more vehement and at times the Arteries are discerned to beat and pant and the face and eyes become redder and the eyes shed involuntary teares and shinings or glistrings are observed in them or dimnesse ariseth the imagination is also hurt and a Delirium happens and certain red apparitions seem to be before the eyes and moreover the Hemerodes being now nigh the sick begin to scratch their Nose with their fingers and these signes are the more certain if the age of the sick and nature and the time of the year and the present constitution of the aire consent If by reason of sweat which happens very often Of a critick sweat
parts of Physick the Hygeeinall and Therapeuticall or the preservative and restorative yet first of all we will place before hand certaine common Axioms and Maximes to be observed in the method of them both 1. Nature doth nothing rashly 2. Too much of any thing is an enemy to Nature Common Maximes 2. Apho 51. 3. Nature is the Physitian of Diseases but the Physitian the Servant of Nature and ought to imitate her she acting aright 4. Custome is a second Nature and those things which are accustomed along time although they are worse they are wont to be lesse troublesome then those things which are not accustomed or which men are not used unto Now concerning the Doctrineof the preservation of Health The Doctrine of the desence of health it may conveniently be comprehended in two parts the first is the knowledge of those things which are as it were the materialls of health or the knowledge which is required of wholsome causes and of things called Non-naturall Secondly a method necessary for preservation of health which teacheth how or in what manner those non-naturall things are to be used to preserve health First for the causes which are necessary for the maintaining of health they are comprehended under the notion of things called non-naturall and are conveniently reduced into foure ranks into those things which are taken those things which are carried those which befall the body without and those things which are emitted and retained First therefore we are to speak here of Aire Meat and Drink Passions of the Mind motion and exercise of body and rest sleep and watchings Venery Bathes Excretions and retentions CHAP. II. Of Aire THe Aire affects our bodies two waies Aire either as it incompasseth us extrinsically and insinuates it self through the pores of the skin or as it is attracted by inspiration both waies it alters our bodies and impresseth its force on them but that Aire is the best which is temperate The best Aire as to the primary qualities and is pure and infected with no pollutions but is serene moved or stird with the winds breathing sweatly with pleasant gales and which is sometimes moistned with wholsome showres Corrupt On the contrary that Aire is vitious which is infected with exhalations and vitious vapours breaking forth on every side or is incompassed with Marish grounds where are standing waters or after what manner soever it be impure and such as cannot be purified by the blowing of winds Situation of places change the constitution of aire that which is troubled or too hot too cold too dry or too moist But the constitution of the Aire may be polluted through divers causes first the constitution of the Aire depends on the scituation and nature of places for some Regions are hotter then others others colder for by how much the more any Regions receives the direct beames of the Sun and by how much the longer the Sun remains above their Horizon by so much the Country is the more hot for the contrary reasons t is so much the colder Yet this cause only doth not suffice The earth and nature of the place neither is the same constitution of aire in all the inhabitants under the same paralell secondly the mould and proper nature of the earth conduceth to the constitution of the temperature of the aire where in is to be observed what the nature of the ground is fat dirty filthy gravelly stony sandy whither the place be high or low what scituation there is of mountains and vallies what winds it often admits and from what climates whether the the sea or any lakes be neere it whether it brings forth mettalls from whence malignant aire may be exhaled The mountains also change the constitution of aire Scituation of Mountaines according as the blowings of certain windes drive away and admit it and if the mountains drive away the North-wind but admit the South it comes to passe that the places are hotter and moister but on the contrary if by scituation of the Mountains the blowing of the South be hindred and the North admitted the place is colder and dryer The winds bring forth great mutations Winds also the Orientall winds are more temperate as also the Occidentall but these are moister the Notherne are cold and dry and have power to bind and dry our bodyes the Southerne are hot and moist therefore as the Region or scituation is more or lesse disposed to this or that wind so it obtains this or that constitution of Aire Regions and Countryes exposed to the Orientall Sun are more wholesome then those which are exposed to the Septentrionall and hot winds as also then those which are exposed to the West The vicinity of the Sea also and lakes conduce much to the peculiar nature of Aire The vicinity of the Sea and of lakes unlesse interjected Mountains prohibit for from moist places of this nature many exhalations are drawn up which mingles themselves with Aire and moisten it and indeed the humidity will be increased if the Sea or a lake be scituated on the South but if towards North the frigidity increase if a lake of the Sea be Orientall and the rising Sun not far off it drawes aboundance of moist exhalations to those places but if the Sun be more remote the Vapours with the beams of the Sun wax hot and bring drynesse to that place but lesse moisture comes from lakes and waters scituated to the West Metallick pits for the most part sends forth filthy malignant Vapours Metallick Mines and communicates them to the neighbouring places Dens do the same and Caves exhaling venemous Aire Woods that are too thick take away the light of the Sun and Moone and hinder the motion and agitation of the Aire Thirdly the seasons of the yeare change the Aire which indeed Astronomers constitute equall according to the motion of the Sun Times of the year and Zodiack being divided into foure parts but Physitians principally regard these times according to the temper of the Aire and call that the Spring when the constitution of the Aire is more temperate when we neither grow stiffe with cold nor sweat with heat but the Summer when the same is hot and dry Winter when it is cold and moist neither do they appoint these seasons to be equall in all Regions Hence the Spring as being the most temperate The spring or as Hippocrates calls it hot and moist that is when calidity moderatly overcomes frigidity and humidity moderatly exceeds drynesse it is the most wholesome time of the yeare and although diseases are generated in the Spring time yet the Spring of its selfe doth not produce them but the vitious humours which are gathered together in the Winter time are driven out by the heat of the Spring The Summer Summer because t is hot and dry makes bodies hotter and dryer rarifies dissolves and renders them weaker it attenuates humours and kindles them
dry Cabbage yet in the juice thereof a certain bitternesse and acrimony is perceived which hath a force to stir the paunch t is hard of concoction affords little nourishment and that thick and Melencholy from whence fuliginous Vapours fly into the head and produce turbulent sleep and weaken the sight its malignity is corrected if it be boyled with sat meates the staulks are worse then the broad leaves and are to be eaten only by those which are used to much labour Spinnage cools and moistens Spinage affords little nourishment yet not so evill as Orach or Blitum which is a kind of Beet it generates cold and serous humours in the stomach unlesse it be corrected with pepper and oyle or butter it is not laudable and it begets wind Beets Beets Blitum Orach and Mallowes can scareely be used with profit or benefit for aliment only but are more beneficially taken when there is need to loosen refrigerate and moisten the belly and Be et indeed is hot and dry and takes away obstructions of the Liver and Spleen and hath a different substance the juice is detergent wherefore it loosneth the belly but the substance stops the same Blitum Blitum Orach Mallows Orach and Mallowes loosen the belly only by humectation they nourish little they yeeld a watry juice and have of themselves no pleasing savour unlesse they are dressed with Butter or Oyle and other Sawces Asparagus Asparagus Young Hops to which the young branches or tender sprigs of Hops are next like unto neither heat nor manifestly cool they are gratefull to the tast and cause appetite yet afford little nourishment and therefore do afford not so good nourishment they have a detergent faculty and provoke Urine they cleanse the Reines and open obstructions of the Liver and of the other Intralls Garden Cresses Mustard-seed or Water Cresses and Mustard-seed may be used instead of Sawces but not as nourishment they are hot and dry and of a biting tast they attenuate crude meats as also crude and thick humours Onions afford little nourishment Onions they are acrid and have a heating cutting and extenuating faculty and inflame the blood and together with the discussed thinner parts they leave behind them a thick juice they irritate Venus they are all hurtfull to the head eyes teeth and gumms they cause turbulent Dreams In raw Garlick there is almost no nourishment Garlick in boyled very little and that bad but there is manifest heat and drinesse in it and a power of extenuating thick and viscide humours and of cutting them and taking away cold and t is the best remedy to convert the pravity of waters as also against the Plague Leeks and venemous aire Leeks have almost the same power Raddish The Roots called Raddishes which we use being dipped in Salt affords little nourishment but are rather instead of medicinall knacks they heat beyond the second degree and have a tart tast they cut phlegme attenuate provoke Urine and expell sand from the Veines Wild Raddishes have the same force Wild Radish but are more powerfull which are fit for sawce but not of aliment Turnips Rape-roots round are slowly concocted Rape and fill the belly with wind especially when they are raw but boyled they are easier digested and afford aliment enough and therfore not so hurtfull but are hot and moist Long Turnips are almost of the same nature Tuâ—nips but of a better tast and yeeld lesse thick and flatulent juice and afford strong nourishment they stimulate Venus Parsley is hot and dry provokes Urine and courses Parsley opens obstructions purges the Reines and bowels yet it afford little nourishment Garden Parsnips yeild little hot and dry Parsnips and not very good nourishment they cause lust provoke Urine and bring down courses Red Beets which are pickled with Vinegar Red Beets the seed of Carawayes and the roots of wild Raddishes are used rather instead of Sawces then as food since they nourish very little The fruit of Plants are various Melons Melons are pleasant to the tast and send forth an Aromatick smell but they are of a watry moist substance not without coldnesse whereby they quench thirst and causes Urine they cleanse the Reines but they are easily corrupted and being corrupted become as it were of a venemous nature and stir up choler or generate Feavers whereby many great men are killed and therfore they ought to be eaten at the first course that they may the easier descend through the Paunch and after the eating of them some food of good juice is to be taken and good Wine is to be drank that the corruption of them may be hindred Cucumbers are also cold but not so moist Cucumbers and the juice not so hurtfull nor are they so easily corrupted in the stomach they are most conveniently taken before they are ripe being pickled in Vinegar or Brine and Pepper and they are least offensive to those which have hot stomachs Artechocks Artechocks heat and dry to the second degree they are hard of concoction and afford not very good nourishment they are windy and stimulate Venus unlesse this be rather to be attributed to the seasoning or dressing of them Strawberies Strawberies are cold and moist they are profitable to those that are troubled with choler in the stomach they coole the liver they restraine the heate of the blood and cholerick humours they allay thirst and therefore are beneficiall in hot constitutions of bodyes they have thin juice purge the reines cause urine but are easily corrupted in the stomach and therefore ought to be eate the first Now followes the fruits of Trees Peares and frutices first of peares there are divers kinds nor are they all of the same faculty the austere and sharpe are astringent and cooling and hurtfull to the stomach and Guts sweete are more temperate yet almost all are of a cold and moist nature only some are hot and moist and moreover more apt to corruption they are not unpleasing to the stomach in the first place being taken they stop a loosenesse but being taken after other meate they loosen the belly and shut the mouth of the stomach they are better boyled then raw There are divers sorts of Apples which discover themselves by their taste Apples the sower are colder then the sweete and of a thinner and lesse flatulent substance the austere and sharpe are yet colder and of a thick substance and descend more slowly through the paunch and stay it yet their violence is corrected by boyling and sower austere and sharpe Apples are to be used rather instead of medicines then aliment they all afford ill juice but those are most hurtfull which are watry and for the most part have no taste the best are sweete ones with an aromatick taste and smell and such as afford an indifferent quantity of aliment and that not evill they strengthen the heart
be yet remaining that is to be taken away by degrees and by helping and the principall parts are to be strengthned but if nothing of the vitious matter be present the body is carefully to be refreshed with moist aliment and that which is easie to be concocted namely the yolkes of eggs broathes with Bread Chickens Hens Capons Fish lastly Goates flesh Mutton Veale sleepe helps concoction unctions strengthen the stomach before meate are appointed frications also moderate walking Baths of fresh warme waâ—â—r lastly strengthening things are to be used and such as may resist the reliques of the causes of imbecility and of sickly disposition but those things which may call back the distemper which trouble sick these are to be avoided THE FIFTH BOOK PART 1. Of the Materialls for Cure SECT I. Of Medicines CHAP. I. What a Medicine is THere remains the last part of Physick which is the Therapeuticall which restores men that are fallen into diseases to their former health and expells those diseases from mens bodyes which torment them but that the Physitian may obtaine this end it is necessary that he be instructed in two things first a Method whereby he may find those things that are helpfull by Indications secondly Instruments or Materialls for cure whereby he may performe that which he found out by Indications The matter fit for cure is properly reduced to three heads Instruments of Physick dyet manuall operation and making up of Medicines First you are to be admonished that you are to distinguish cures from the materialls used in curing for cure is that whereby instruction is given from the Indicant to performe or act something and is alwayes one as to heate or make hot but the Matter of helpe is that whereby that is performed by the Physitian which the Indicant commands which may be manifold as whilst you are to heat it may be done with Pepper Ginger Wormewood c. But since that of Dieteticall matter is spoken sufficiently in the former book it remaines that wee speake of Medicines Medicine what is it and Manual operation and first as for Medicines by amedicine wee understand every thing that is a different thing from nature which may alter our bodies and reduce them to a naturall state from a preternaturall In which respect it differs from aliment and Poyson for Aliment as it is aliment is onely that which increaseth the substance or it renewes and increaseth our bodies a Medicince alters but doth not repaire but if any thing can together nourish and alter our bodies t is alimentall Medicine or medicinall aliment but poysons neither nourish nor alter our bodies but are destroyers of our bodies and have power to corrupt them CHAP. II. Of the faculties of Medicines in generall MEdicines are two-fold Medicines how manyfold Simple Compound some are simple other compound a simple is that which is such by nature onely and hath nothing mixt with it by art compound are when more naturall things are mingled by art into the forme of one medicine Simple Medicines are taken from Plants Simple how many fold Plants Animalls Mineralls and Plants are either taken whole or their parts Roots Woods Piths Barkes Leaves and Branches Flowers Seeds Fruits Juices Gumms Rosins Oiles and Liquors as Wine Animals also are used whole Living Creatures or their parts as Harts-Horn Marrow Flesh or those things that are generated in them as Milke Eggs or their workes as Hony Wax or their excrements as Gall Urine Under Mineralls are comprehended not onely those things which are properly called Mineralls Mineralls Vitriall Antimony Sulphure and Mettalls and the excrements but also divers kinds of earths as Uermillion Irish Slat Bole-Arminack as also all Stones and Gemms also divers kinds of Salts and concreted juices in the earth of which Naptha is one also bathing-waters in which ranke Manna may be put if there be no other place fit for it The faculties are various of so many different things The difference of Medicines Actuall and from hence the divisions of Medicines are various for first some Medicines are said to bee such in action others in power to be such things as are said to be such in action which in them containe that which they are said to be the act being as it were present and absolved and so the operation is in a readinesse and can affect our bodies at the first touch with that quality wherewith they are endued so Water and Ice are cold in action because after what manner soever they are applyed to a body they can presently coole the same but those things are such in potentia Potentiall whose force is not perceived at the first touch but lyeth hid and as it were asleep nor doth it discover it selfe by action untill it be some way changed by our heat and be burnt and reduced into action so Pepper and Wine although to the touch they are cold yet neverthelesse they heate But although the force of Medicines are various Facultiei of Medicines manifest yet they may conveniently be divided into manifest and occult those are called manifest which affect our senses or which excite qualities in the patient which are discerned by our senses and whereof a manifest cause may be rendred But occult are such which doe not produce qualities in a Patient obvious to sence Occult but performe something by a hidden propriety to wit they purge a certaine humor they strengthen a certaine member they resist poyson or being hung or carried externally worke upon the body the manifest causes whereof cannot be explained and no other reason can be given then that such a power or force is in them by a peculiar propriety of nature although there are some who reject hidden qualities yet I. C. Scaliger rightly thinks that t is a high peice of impudence to reduce all things to manifest qualities in the 218. of his exercises Sect. 8. and those which endeavour this bring foolish and ridiculous reasons or deny those things which are confirmed by experience and these faculties and actions are different from those in their whole kinde as also from others which are spoken of before in the 2. Booke 2. Part. Cap. 12. both from hence in the first place because the strength of these qualities are far greater then theirs of the primary qualities and their efficacy is great oftentimes in the smallest body But both of them The first the second the manifest and occult faculties and actions of Medicines are various of manifest qualities some are primary others secondary others of a third kind The third kind of qualities the first have power of heating cooling moistning and drying the second to soften to harden condense rarify resolve attenuate thicken to draw to repel the third to provoke Urine to cause and stay courses to move vomit generate flesh and to breake stones although the power of breaking stones may more fittly be attributed to the propriety of
haire Liver-wort Ceterash Ground-pine common Germander Bind-weed Hore-hound Calamints Penny-royall Scurvygrasse Brooklime Water-Cresses Anniseed Fennell seed seed of Ammi of Agnus Castus red Parsnibs Lupines bitter Almonds Capers Kernells of Peaches and Apricocks Cinnamon Cubebs Sorrell Ammoniack the juice of Lymons To these are opposed Iucrassating Incrassating things which make the thinner and more liquid juices thicker such are cold or temperate without sharpnesse of a thick and terrene substance whereby whilst they mingle themselves with thinner humours they make them become of a thicker consistence as Bolearmenack Poppy Sorrell Rice Lentills Quinces wild Pares Amylums t is a food made of Corne without grinding Chalybeate milke the juice of Pomgranets Emplasticks Playster-like things and those which have a clammy and Plaister-like force are such as adhere close to the passages of the body and Plaister up the pores as it were fills them and stops them and they are certaine dry and earthy things yet without mordication and acrimony and if they are bedaubed over the passages of the body they are hardly taken away but some are also mixt with an aqueous and acrious humour yet are tenacious as sweet oyle such are Amylum Pompholix which is the soile that runs off Brasse Cerusse Chalke Bole armenack Irish slat Parget Litharge burnt lead the Rootes of Marsh Mallowes Lillies seed of Fenegreek all mucilages and bran of wheate Kernells of Pine nuts bruised in water Gume Arabeck Sarcocolla Tragacanth fresh Grease and Marrowes fresh butter new cheese whites of an egg wax To these are opposed detergent things Detergent things and such as open obstructions and such as open obstructions whereof these cleanse filth in the superficies of the body or skin but those are of a more subtil substance penetrate into the pores also and open obstructions and moreover have a drying faculty with tenuity of substance whether they be hot or cold for there are both hot and cold abstergent things such as are all salt things bitter things nitrous things as Hore-hound Century the lesse smallage Wormewood Southernwood Hyssop Cresses the bread of Lupines and of a kind of Pulse called Orabus Agrimony Beets Germander Tansey Bitter Almonds Roots of Birthwort Orice Gentian Solomons Seale Barley Bran Iuice of Lymons Nettle-seed Rootes of Tamariske Bark of Capers Spleen-wort Squils Nitre Hony Sugar all Lixuviums or Lee Whey the Galls of living Creatures Verdy-grease CHAP II. Of Medicines easing paine and causing rest Lastly in this forme are Anodunes Narcotticks Anodunes and Hypnoticks those are properly Anodunes which doe not take away the cause of a disease or dull sence of paine but such as mitigate the paine the cause stil remaining and they are temperate and gentle and endued with mild heat and are soft to the touch and bring forth a pleasant and sweet pleasantnesse and those performe that which are endued with a luke-warme and gentle heate and are most like to our bodies in temperature and for the most part are soft and fat and loosen and mollifie the part that it may be the lesse apt to be sensible of paine such are Camomil Melilot Dil Elder Mallowes Marsh-mallowes Seeds of Fenegreek Flax wheat Barley sweet Oyle of middle age Oyle of sweet Almonds and other things prepared with those above fresh Butter Hens grease Goose-grease Whites of Eggs the pulpe of White-bread warme Milke and Hoggs grease Narcoticks or stupefactives and Hypnoticks Stupefactives which also cause sleep but neither take away the cause of paine but stupifie the part and benumes it least it should perceive that which is painefull but this power depends on a hidden quality such like are Lettice Water-lillies Poppey Nightshade Henbane Mandrake and Opium CHAP. VIII Of drawing and Repelling Medicines IN the second forme Things drawing are drawing Medicines which attract the humours and Spirits out of the body into the superficies but that attraction is made by heate concurring with tenuity of substance and some are hot and dry in the second degree which draw moderatly others in the third degree which draw more others in the fourth which draw most of all and with their heate raise a tumour in the skin with rednesse and lastly raise blisters from whence medicines to take away haire Synapismes Rubifying medicines are prepared such are the Rootes of both kinds of birthwort selandine sow-Breed little Dragon Gentian wild Pellitory or sneezing-wort Crowfoot mustard-seed Cresses Garlick Onions Leaven an Indian fruit like a Birds heart and the juice like blood Gum Amoniack Galbanum sagapenum Opoponax dry Pitch Propolisâ— or that in a Hony-combe like wax Goose dung Pidgeons dung Hen dunge and Cantharides Repelling Medicines Repelling are opposed to attracting and prohibit the Flux of humours or represseth and casteth back that humour which hath newly flown in and moves therein and is not as yet settled they performe this either because they are cold or astringent or because they have both a cold and astringent faculty astringents are two-fold some are cold others not and indeed they doe most powerfully bind which are both cold and astringent those things which repell only by frigidity and are aqueous or humid are cold water life for ever Purslan Ducks-meate Endive Lettice Night-shade Coltrops of water Venus Nauell Fleawort the white of an egg cold things astringent are Plantine narrow leaved Solomons seale Mouseare Daizes Horsetaile the leaves of service or sherve Tree Oake Mirtle Medler Tree the Flowers of Rosemary Pomgranates Mirtle-berries Oake Apples swallow Peares Barberries Mirtles the Barks of Pomgranates the Rootes of wild Damsons the Rootes of Barberries the Rootes of Cinqfoile Snake-weed or small Bistort Tormentill the juice of Pomgranates Acacia Hypocistis or sap of the Rootes of Cystus of Mulberries not ripe sorrell Irish slat Bolearmenack sanguis Draconis Tutty hot astringents are spike Aloes Frankencense Mirrh Cypresse Wormewood Cyprus Nuts the Barks of Frankencense sweet Garden Flag Allom CHAP. IX Of Ripening things and such as generate quitture also of such as generate flesh and Brawny flesh of such as dry and cleanse green wounds and cause Cicatrizing and of such as generate seed and milke IN the third forme are ripening and concocting things Ripening and concocting of quitture and moving purulent matter so called because without them the generation of matter cannot be easily performed by nature to wit such which by the similitude they have with our bodyes defend and increase the substance of the native heat for they are temperately hot and together moist and emplastick which shutting the pores or passages keep in and retaine the spirits and heat such are sweet Oyles Oyle mixed with water Butter Hogs grease Calves grease the seed and Bran of Wheate Wheaten Bread the seed of Fenugreek Flax Leaves and Rootes of Marsh Mallowes Mallowes Beares breech the Rootes of white Lillies boyled Onions dry Figs Fat 's liquid Pitch or Tarr liquid storax Turpentine whereof some if they seem either too dry or too moist
the urine this is to be taken away by the helpe of a Chyrurgeon and fit medicines but least that other parts should be eroded medicines are to be ejected through a silver Pipe to the tumour or else it is to be incorporated and mixt with the top and head of a wax Candle and thrust into the place affected or a little Cane with Lint and white wax put into it and bedaubed with a fit medicine being hollow that the urine may passe through it This is to be put into the urinary passages Polypus if it admits of cure Taking away a Polypus it is to be cut off with a sharpe Iron Instrument made after the manner of a Spatula being put into the Nostrills of which operation see the Institutions and the first Book of Practice Fleshy excrescencies in the Chops called Epuli a naile in the eye Epuli as also Encanthis or excrescencies in the greater corner of the Eye and the naile of the Eye unlesse they can be taken away with medicines are to be cut off as also peices of flesh here and there growing in the skin of the body Excrescencies of flesh Fungi Nodi c. and excrescencies which represent a kind of soft flesh which are like the rootes of Mushroms and grow like them and therefore are called Musheroms knots also Kings evill Kernells swellings in the Throate and swellings in the flesh or fleshy ruptures if they cannot be eradicated by Medicines must be taken away by cutting A watry rupture A watry rupture or water collected into the cods cannot alwayes be taken away by discussing medicines the cods are to be opened and the water to be let out through the wound Lastly the stone of the bladder Stone of the bladder since it is seldome diminished by medicines the bladder being cut t is to be taken out and sometimes a stone sticking in the urinary passage is to be drawn out but in what manner those cuttings and operations all of them ought to be persormed is spoken in the Institutions and may there be seen nor can the wayes of those operations be reduced into a compendium but all things which are there spoken in the operations are diligently to be observed and thus much of the fourth Chyrurgicall operation CHAP XIIII Of the restitution of parts that are lost or of the Chyrurgery of imperfect parts THere remains the last Chyrurgicall operation Chyrurgery of such as are maimed which is required in the cure of such as are imperfect and maimed namely when the extremities of the Nose or Eares or Lips are shortned and these parts maimed but although parts that are lost are counterfeited by Instruments fained made and painted out of severall matter representing the similitude of the part lost yet this is only a counterfeite and palliating cure but when it cannot be restored by a new generation of the deficient part t is to be restored by the flesh of another member being brought and united to it yet that operation is not to be tryed on every body but first it is to be observed what kind of body it is which is to be cured for in old men or in a body which hath an ill habit wherein wounds are difficult to be cured this way of cure is not to be easily attempted Casper Taliacotius in his Book of maimed Chyrurgery by inserting accuratly and largely describes the manner of this operation the sum of this operation is this he makes his transferring or bringing into the Nose and Lips from the Shoulder but to cure unperfect Eares he takes away from the Region behind the Eares namely he appoints a convenient cutting in those parts and the maimed parts being first cleansed he commits and joynes the skin of that part which is cut off with the maimed part and that they may be kept joyned together untill they grow together he binds them with swathing bands And indeed he puts that part of the Nose or Lips which is maimed into the wound made in the Shoulder with the head tyed to the Arme as it were to a prop that it is immoveable and fixt so that it can be moved no way And in this manner when it hath stuck so long untill the flesh of both parts be united and growes together he cutteth off againe from the Nose or Lip the traduct or that which was brought from another place and is here gâ—own then he makes conveniently and frames that flesh so cut off from the Arme into a forme of a Nose or Lip THE FIFTH BOOK PART II. Of the Method of healing SECT I. Of shewing how to preserve health CHAP I. Of the Method of healing and of indications in generall BUt it is not sufficient to know the Instruments for the recovery of health and those things which are profitable for the curing of a disease but t is necessary to understand how and in what manner every thing is to be used or to know the Method of healing and restoring of lost health the next thing therefore is that we may shew the Method of healing Capivaccius defines the Method of healing to be an art wherein by indications remedies are found out that the lost health of man may be restored The Method of healing for the Method of healing as also all Physick is a certaine principall effective had bit using indications as Instruments to find out remedies for the cure of diseases For the end of the Method of healing is twofold The internall or proximate namely invention of fit helps and remedies in every disease or rather an invention of indications that shew what will cure The externall is a restitution of the lost health or which is the same an extirpation of a disease But an indication which the Greeks call Endixis is sometimes taken in generall for every shewing or demonstration Indication what yet properly and in particular and as it pertaines to the Method of healing it signifyes the shewing of remedies and t is a perception of what is healthfull in the Indicant known by causes or which is the same t is a perception and comprehension of that which is helping or indicated with an apprehension of what indicates without experience or any forceable argument from the cause to effect But although Indication be the first Instrument of Dogmatick Physick whereby t is discernd from other Sects yet that doth not plainely reject experience and any forceable arguments but when diseases and the morbisique causes of nature are not sufficiently known it flyes to experience and example as to a forceable Argument Experience is the remembrance and observation which oftentimes is seen to come to passe in the same manner Experience what An Analogisme Analogisme or forceable Argument to perswad is an apprehension of what is helpefull from the like but that similitude is either amongst the affects or remedies or amongst the members As for the Indication that is really a certaine Enthymema by the force
whereof that is found out which is done for the consequence is so manifest that no man can deny it and indeed by the force of those propositions which are the foundations of Method and like Axiomes and principalls in the Method of healing and they are these Every thing which jndicates shews the conservation of its selfe or the taking of it away That which is according to nature is to be preserved and that which is contrary to nature is to be taken away Contraries are cured by their contraryes likes are preserved by their likes But there are various differences of Indications Differences of Indications the first and most generall is taken from things about which they are conversant which are according to nature and preternaturall and it is because an Indication is a perception and insinuation of the preservation of that which is according to the nature of the indicant to be performed by its likes the other is an apprehension of the taking away of that which is preternaturall to be performed by the contrary of the indicant Moreover one Indication is genericall Genericall another subalternate another specificall and determinate genericall which the common and genericall nature of the indicant supplyes and which simply teacheth how to take away the disease and the cause of a disease and to preserve strength but in what manner that may be performed it doth not shew subalternate Subalternate Specificall which the subalternate essence of the Indicant shewes and which indeed determinates the matter more yet not perfectly specificiall which is taken from the specifique nature of the Indicant and describes the whole Indicant exactly and its remedie and is also called the determinate Profitable Thirdly one Indication is profitable another unprofitable profitable is that to which some matter answers or which indicates such remedy the matter whereof may be found out and primarily Vnprofitable and by its selfe can take away the disease but unprofitable is that which shews such helpe the matter whereof which can take away the disease of the first is not to be found Fourthly of Indications some are artificiall Inartificiall others inartificiall inartificiall is that which may be known by others and to the vulgar as well as to the artist who equally knowes the disease is to be taken away and the strength to be preserved but knowes not a reason how that may be done Artificiall such as is genericall and sometimes subalternate but artificiall Indications are those which are not known to all but only to Artists and require a great deale of skill that they may be known and the Indicant and helping things are exactly described such as are specificall and determinate Curatory preservatory vitall Lastly some Indications are to restore others to preserve some are vitall according as they are taken from the restoring Indicant the preserving or vitall CHAP II. Of Indicants BUt an Indicant as it belongs to the Method of healing is some Agent permanent in mans body An Indicant What. which by its proper nature and estence shews some helpe and shews the Indicate which it requiers to be directed to its selfe that the lost health of man may be restored Whence it appeares what are the true notions of a true indicant for first it is required that it doe act What is required in a true Indicant or that it be some Agent Secondly that it be something permanent and present or adhering to it Thirdly the Indicant ought to be known to the intellect Lastly one Indicant as it is one indicates also one As for the numbers and difference of Indicants The differences of Iudicants t is taken from the end of the Method of healing which is an invention of remedies for whereas things preternaturall are to be removed and things according to nature to be kept the Indicant should be twofold called removing or curing in generall or vitall and since that things contrary to nature are three a disease the cause and the Symptomes there are properly foure Indicants so called The Indicant which is taken from a disease is called Cutratory An indicant curatory Preservatory An urgent Symptome the common name being retained of the method of healing but that which is taken from the cause besides the containing cause is called Preservatory that which is taken from the Symptome is called an urgent Symptome nor are Symptomes to be excluded from the number of Indicants since that also is preternaturall and hath peculiar indicates which of its proper nature it affords and that different from the indicates which the diseases and causes afford and remedies may be brought for Symptomes which regard neither the disease nor the cause of a disease which is manifest in paine which Anodynes shew The Indicant which is taken from things according to nature is called vitall A vitall Indicant but since things according to nature are health the causes of health and the accidents of health a vitall indicant may also be sub-divided But although some reckon more Indicants Indicants lesse properly so called yet they are not new and peculiar Indicants but belong either to the causes from whence Preservatory indication is taken or they are not true indicants but rather manifest true indicants and by accident and the intervening of another helpe to discover remedies such like are temperament habit of body age sex kind of life strength custome the peculiar nature of every one the condition of the part beset with the disease aire condition of Heaven the time of the yeare the Country the place of habitation the times of diseases and the force of the remedies Namely the temperament indicates the preservation of its selfe of which a rule That disease which differs most from the naturall state is to be cured with more vehement medicines that which differs lesse is to be cured with milder Age circumscribes the vitallindicant of this there is a rule also By how much the more a disease recedes from the nature of the age of the sick by so much the more violent remedies t is to be cured with by how much the lesse by so much the more gentle remedies There is the same reason of Sex as there is of age as for custome those things that are accustomed along time although they are worse doe lesse hurt then those which are un-accustomed whence a disease which differs much from custome is to be opposed with stronger that which recedes lesse with weaker medicines The course of life for the most part requires the same as custome Idiosuncrasia shews that choice is to be had in Medicines It is to be considered about the part affected first its excellency whence a rule Noble parts are not to be tampered with strong medicines but ignoble parts will endure them more safely moreover its conformation and figure which determinates the Indicant and the Indicate so a thinner part
it selfe quanttity or magnitude of the essence indicating denotes quantity taken in the former sense for example sake great heat shews that it must be much cooled Yet heare is to be considered whether the part be scituated deep in the body for then a stronger Medicine is to be chosen that it may come to the part affected with its full force When or the time is shewne from the time or presence of the Indicant Time for then helpe is to be Administred when that which requires it is present Order also belongs to time for that which in simple Order of doing is Time incomplicate is order and the presence of a vehement Indicant shews the order of performing but that is first to be done which is shewn by the Indicant which over rules the rest in indicating and that overcomes the rest in indicating by which the greatest danger is threatned and without the removing of which the rest cannot be taken away and therefore three things being observed we may proceed in a right order of cure if first we weigh what urgeth most and from whence there is feare of greatest danger for that is first to be opposed which strives most or from whence the greatest danger of life is threatned Secondly if we consider what regard it hath of the cause and what of the effect for the cause is to be taken away before the disease Thirdly if we confider what may be in the stead of an impediment and what before what and what with what and what after what may be cured for whatsoever may be a hindrance in the taking away of a discase or the cause of a disease are first to be removed and therefore it is to be considered whether a disease be joyned with a disease or with the cause of a disease if a disease be joyned with a disease it is to be considered whether those diseases agree or not if they no way agree but are resident in divers parts you may cure them severally or together each by their proper remedie and t is no matter to which you apply the first remedie yet regard is to be had of the parts wherein those diseases reside for those which are in noble parts or those parts which serve the noble parts or have consent with them or which performe any publike duty they are first to be taken away but if the diseases have some agreement and are some way united it is to be considered whether the cure of the one is beneficiall to the cure of the other or at least no way hinder the cure of the other or whether the cure of the one may bring any impediment or hindrance to the cure of the other or whether they partly consent and partly dissent if the cure of the one bring no impediment or bindrance to the cure of the other or also if it promotes it as if a distemper of the liver and an obstruction thereof concurr you may cure them severally or together and begin with which of them you please also when a reason thereof may be had from that which urgeth most if they are not of equall force but if they are so joyned together that the one is more dangegerous then the other you must begin with that which is the other neither of them is to be cured by its selfe but the remedies shall so be tempered that they may both be cured most dangerous qut if the one be no more dangerous then both be cured Lastly if they partly agree and partly disagree you are to begin with that the cure whereof hinders not the cure of the other and without removall whereof the other cannot be taken away if a disease be joyned to a cause the cause is first to be removed but in the removing of causes it is to be observed that they are to be taken away in that order wherein they follow one another so that you are to be begin first with that which was first in generation and last in dissolution from thence you are to goe on to the next and so to goe on forward in order untill we come to our desired end and that we may breifly comprehend all the matter the presence of the Indicant which overcomes the other Indicants and the absence of the prohibiting Indicant shews when to act and the order of performing and moreover it teacheth whether the same remedie be to be repeated often for so long and so often it is to be repeated as the Indicant remaines present and no hindring Indicant happens The place or substance of the Indicant sheweth where and the place of applying remedies and the place is to be found out in which by which and to which as they commonly use to distinguish In all alterations the place in which is principally to be taken notice of in evacuations the place from which Manner and by which if the matter be carried out of one place into another the place to which As for what belongs to the place of applycation of matter fit for remedie since a contact or touch of the matter and Indicant cannot allwayes be immediate that is to be chosen by or through which the matter of cure may come to it that there may be a touch and action and passion thereof and of the Indicant As for Mode if it regard the remedie it selfe without consideration of matter How the matter medicinall answering to the Indicate may be found out it seemes not to differ from quantity time and place but rather to be a Summetry in measure and equity to be observed in these but if it be taken for the forme of a medicine that is delivered in the doctrine of the composition of medicines The helpe or Indicate being found out that the Physitian may be carefull of the matter of cure t is very requisite which is taken from three heads Chyrurgery Ingredients and Dyet the same Indicate shews matter circumscribed and determinate with its conditions quantity time and place for that matter is proper and fit which can performe that which the determinate Indicate requires by its rules and which may have force but if there be more Indicates or matter to be sought which have more faculties or if these be wanting more shall becompounded together But because allwayes as is said regard is to be had of the strength also and it is to be weighed whether by the application of this matter there may come more good or not the nature of the whole body and of the part to which the medicine ought to be applyed is to be considered in which businesse not only manifest but also occult qualities ought to be weighed and t is to be enquired by the Physitian whether the sick have any peculiar hatred to any particular thing which therefore is in no wise to be given in the cure but in parts affected in their kind the excellency of a part is to be weighed the sense scituation conformation for
if a part be a principall one or performes a publick Office no Medicine is to be given which can much hurt it and disturbe its Office and Duty for then losse would redound to the whole body so to the mouth and chops poysons and things ungratefull to the taste and sordid are not to be exhibited nor stinking things to the Nostrills nor gnawing and biting things to the eyes nor those things to be applyed to nervous parts affected that cause paine The same rules which we have now even propounded in the right use of remedies Quantity of matter ate to be observed also in choice of matter the quantity of matter regards the measure waâ—ght thereof which was indicated by the Indicant and is propper for the performing of the Indication the quantity of the matter is found two wayes first in what quantity any medicine whatsoever is to be given and what are those bounds betwixt which if it be given it performes that which it ought and no way hurteth is manifest by experience only but in what dose whether in the highest lowest or middle the medicine be to be given to this or that sick person what the quantity is of the matter to be administred that is known from the magnitude or extent of the Indicant and if the quantity of the Indicant be great the quantity of the medicine ought to be great likewise in which matter the condition is to be weighed and the strength of the whole and of every part for if a part to be altered is more remote in place a greater quantity of the remedie altering is required namely that it may come with its full force to the part affected But the time of Administring of matter is taken not simply from the presence of the Indicant Time but is that when it can helpe but this time is known and the knowledge of the matter to be administred and the nature of the part to which it ought to be Administered for some things worke presently others after some space between the action of of some things continues long of others it ceaseth presently The part as it is open or placed deepe so it regards the action of the Agent presently the Administration of the matter is to be prohibited when it doth more hurt then good but it may doe hurt when it may preserve any thing contrary to nature which ought to be taken away or when it may take away that which ought to be preserved The place of Administration of matter is that place where the matter is to be given may helpe and performe that which t is required to do for since every action is performed by contact the Physitian ought allwayes to endeavour that the matter which he â—seth might penetrate to the place where the Indicant is and may touch the Indicant but some parts are Externall others Internall in Externall the matter is plaine for there the matter of the medicine is to be applyed where it is to worke or where the Indicant is since the Externall parts may be immediatly touched with the medicines but medicines cannot be so immediatly applyed to the Internall parts and therefore when we are willing to evacuate common wayes are to be chosen and the next through which the matter may be evacuated if we are to alter in the interior parts either manifest wayes are to be found â—ut or occult passages through which the matter that is given may penetrate and indeed as for manifest passages the widest and nearest are allwayes to be chosen But concerning the measure Manner or manner shall be shewn hereafter part the 3 d. Sect. 3 d. where various formes of medicines both simple and compound shall be proposed CHAP. V. What Morbifique causes indicate and peculiarly of purging of a juice in the body which causeth ill digestion FOrasmuch as hitherto we have explained the universall Method of healing now peculiarly we will propound the Method of taking away of Morbifique causes removing diseases and preserving strength and will begin from the causes What the differences of causes are is spoken before in the 2 d. Booke part the 1. Chap. the 3 d. for of what kind soever they are whether begotten in the body or externally or admitted into the body and become as it were internall or stirring up cherishing and increasing a disease without they all require removall But whereas causes offend either in the whole substance or quantity Causes what they shew or quality or motion or place first all things which put on the nature of a cause as in their whole kind they are contrary to nature they indicate an absolute ablation of them out of the body or as latter Physitians say an Eradication But that here we may treate only of humours What things shew in their whole nature preternatural severall wayes there are of rooting out and evacuating corrupt humours out of the body for sometimes they are purged through the paunch sometimes they are ejected by vomit sometimes discussed by sweates sometimes cast out by urine of which we will now speake in their order and first of purgation Purgation taken in the largest sense is indicated from a Cacochymie What shews when to purge or juice which causeth ill digestion and bad nourishment and a purging medicine taken in the largest signification is the matter of remedie indicated for a Cachochymie but that this doctrine of purgation may be more evident in the first place tis to be observed that Physitians in respect of purging medicines divide the body into three common Regions into the first which is without the liver and is extended from the stomach through the middle part home to the liver the second which is dilated from the middle of the liver through the greater veines to the outside of the body the third which comprehends the habit of the body with the lesser veines private parts also have their excrements and peculiat wayes to void them and hence one evacuation is called universall Vniversall evacuation another particular universall is that which evacuates humours from the common Regions of the body such is evacuation of blood after what manner soever purging by the paunch vomitting voiding of uâ—ine sweate Particular insensible transpiration particular is that which evacuates some private part as the braines lungs wombe As for universall purgation which evacuates the common Regions of the body Cacochymie consists of what Indicates it either on this side or beyond the liver Cacochymie which consists in the first Region of the body by its selfe and properly indicates those medicines which have power without any manifest agitation of evacuating superfluous humours through the paunch which stick in the first Region of the body although sometimes if the matter have an inclination upwards and the sick can easily endure a vomit by vomit also humours may be purged out of the first Region of the body so that those things which cause
our helper and the humour more aptly followes the leading of the purging medicine but if we endeavour by purges to evacutate crude humours that is such as are not as yet Elaborated and become benigne nor as yet seperated from the profitable the sick will receive more dammage then benefit from thence neither have we nature to a fist us nor are the humours apt for purgation wherefore either the purge performes not its purpose and brings out nothing or very little or if the medicine be very strong it draws out not only the unprofitable but profitable humours since they are hitherto mixt it melts and consumes the body disturbes the humours more and confounds them brings forth obstructions in the first passages the matter being stird and not sufficiently evacuated whence greivous Symptomes doe arise but if any voluntary purge shall happen and that sufficient or that any future loosness be expected there will be no need of any purging according to Hippo. 1. Apho. 20. those things which are perfectly judged and exquisitely confirmed are in no ways to be removed Sometimes you may purge in the beginning neither moved neither with purging medicines nor other endeavours but are to be let alone But although the best time for purging is after concoction yet sometimes you may purge in the beginning by the command of Hippo. 2. Apho. 29. where hee sayth in the beginning of a disease if any thing seeme fit to be moved move it but when you may purge it in the beginning of a disease It is variously disputed amongst Authors Galen shews it clearely whilst 1. Apho. 24 he saith that then onely purging is to be used when greater profit may follow by the evacuation of offending humours then the detriment is which the body receives from purging medicines or when any present danger doth more urge then crudity of humours but Hippo. shews the cause and that danger 1. Apho 22. whilst he writes That purging is not to be used in the beginning of a disease unlesse the matter raise Tumours or be angry for if hot humours acrid and biting wander up and down in the body and it be doubted least the strength should be debilitated by the agitation of the matter or least the matter being stird up should rush into some principall part with violence or into some part which may draw a principall part with violence or into some part which may draw a principall part into consent or least the native heat should be extinguished you may purge them presently in the beginning of a disease especially when they also of their owne accord are moveable and easy to be evacuated and nature wearied out by them affords its assistance towards their expulsion and indeed that should be done in the very beginning Apho. 10. Sect. 4. of Hippo. To purge in very acute diseases if the humour swell the very first day for delay in diseases of this kind is dangerous CHAP VII Of preparation and concoction of humours AT another time Concoction and preparation of humours differ Concoction of humours the work of nature concoction of humours is to be expected before purging be appointed and the Physitian shall studdy to prepare those things which further concoction and cause more commodious evacuation for we must distinguish betwixt concoction and preparation and concoction is attributed to nature preparation to Art namely nature only concocts humours and Elaborates them and draws them to that perfection and better state by putrifying which they can receive that they may the more conveniently and without prejudice or detriment to the sick be evacuated but it is not in the power of Art to concoct humours yet it may be helpfull to the native heate concocting both by cherishing and strengthning it Besides this true concoction which is the worke of nature only Preparation of humourst wofold Digestion there are yet other preparations of humours which are appointed for the more happy concoction and more profitable evacuation sake which the vulgar call concoctions also and medicines effecting them they call Concoquents or as they commonly speake Digestives These preparations are of two kinds the one is that which preceds the concoction which is performed by nature The first prepation of humours the other is that which followes it the former is that which takes away all things which are impediments to nature whereby it may the lesse begin or happily perfect concoction and commonly useth to be called concoction the quality of humours besides their quantity hinder concoction therefore what qualities soever hinder concoction are to be taken away by their contraries and hot humours are to be cooled cold to be heated dry to be moistned moist to be dryed in like manner humours that are too thick are to be attenuated those that are to thin and sharpe are too be thickned and allayed and those that are tough to be wiped away or purged Namely phlegme which is cold Phlegme how to be prepared Choler moist thick and dull requires heating drying attenuating cutting and detergent medicines Yellow choler since it is hot and dry t is to be corrected with cooling and moistning things but as it â—s thin and by its too much tenuity may molest the body it is to be thickned the other kinds of choler which are produced by too much adustion sichence they are now thicker require extenuation Moreover the melancholy humour since it is cold Melancholy dry and thick is prepared with things modernately heating and attenuating and moistning but black choler since t is a hot humour very dry and thick requires cold things much attenuating and moistning The other preparation is that which is appointed when putred humours allready concocted Another preparation of humours or others also not putred by reason of some impediment are not evacuated without difficulty unlesse that be taken away But sithence humours which ought to be evacuated ought to be moveable and the wayes through which they ought to be moved open hence it easily appeares that there are two hinderances which impead the happy purgation of humours namely thickness of humours and obstruction of passages And therefore the Physitian which would purge as Hippe commands 2. Apbo 9. must well prepare as Galen explaines it t is to extenuate the thick and dull humours and open the passagesthrough which they ought to be traduced and drawn by the force of purging medicines CHAP VIII Of the quantity of purgation THat we may purge as much as is convenient How much to purge and no lesse we are to use diligence first to know the quantity of the peccant humour that from thence the quantity of the purging medicine may be determined for the quantity of the purging medicine ought to be such that it may evacuate all the peccant humours least any part thereof remaine in the body and corrupt the other humours and afterwards cause a ralapse But whether the peccant humours ought to be evacuated together and at
be thickned and unfit to draw out But when there is need of cooling first beware that cold astringents are not given but moistning for cold things are very hurtfull to the Breast 5. Apho. 24. not onely applyed outwardly but taken inwardly In the cure of the heart Medicines are alwaies to be mixed which have a corroborating power Heart and therefore moderate astringents and odoriferous and Bezoa ticks as they are called should alwaies be mixed with the Medicines which are given to the heart But alwaies beware of vehement coolers and heaters The stomach is easily hurt as well by too much heate Stomach as by too much cold and in a hot distemper t is to be warily cooled by degrees and by little and little but in a cold you must take heed least the innate heate be too much dissipated by hot things and therefore somewhat astringent and strengthning is all wayes to be added which may hinder the dissipation of the innate heate and Spirits In curing the Liver Liver these medicines are to be chosen that have some binding and strengthning faculty with tenuity of parts such like are those that are astringent and are bitter but you must abstaine from sweet things by which the Liver as also the spleen doe easily swell The Spleeen requires and endures the strongest medicines Spleen and therefore they may safely be applyed outward yet so that the humours contained in it may not increase by sudden cooling or be hardned by drying but they are scarce safely given inwardly least the other bowells be offended by them and therefore what is wanting in vehemency is to be be made good by dayly use of them In a disease of the wombe Wombe you must abstaine from vinegar for pleasant things are more gratefull to the wombe yet such as are great must abstaine from them The Eye since it is very sensibly it doth not endure sharpe medicines The eye or such as may bind and exasperate it But in the cure of distempers not only contraries convenient are exhibited but the use of likes are altogether to be avoided Yet if the distemper be with matter Distemper with matter alteration alone doth not suffice but the cause from whence it is cherished is first to be taken away and therefore Indication in distempers of this nature is evacuation and alteration where notwithstanding by the name of a cause are not only understood causes simply so called but also diseases and affects some of which excite and cherish other diseases for these in like manner are to be taken away in the first place CHAP. II. Of curing diseases of the whole substance IN curing diseases of the whole substance the occult malignant quality is to be driven out by its contrary and a remedie against poyson and the venemous cause to be taken away and rooted out of the body and therefore poyson which is drunke or taken in at the mouth is to be cast out by vomit or presently to be drawne out through the pâ—unch but if it be drawne in with Aire or hath passed beyond the liver t is to be expelled by sweates but those which are communicated by the biting or striking of venemous animals are brought by drawing after what manner soever to the body first of all we must labour to draw back and extract and to hinder it all manner of wayes least it penetrate and creepe within the body but principally every sort of poyson is to be expelled by those remedies which experience teacheth to be most repugnant to them and with those the heart is to be strengthned yet to observe the manifest qualities also in poysons is a great part of the cure CHAP III. Of the cure of diseases of Conformation AS for the Errors of Conformation Cure of figure in diseases What they show if the bones are set awry and ill shaped in those which are growing the cure is possible but in those that are come to ripenesse of yeares and which grow no more they are incurable But t is a generall Indication which supplyes the fault of the figure a changing of the part of the viticus figure to the contrary until it acquires the figure which naturally it ought to have but this is performed two wayes by fashioning and alligation or binding How corrected by fashioning that mending of the figure is to be taken which by drawing and prossing with the hands by little and little and often is perfected by binding that correction is understood which is performed by swathings and Ferrules or Canes namely by which part of the vitious figure by swathings is drawne contrarywife and retained by splintors least it should bend back againe towards its erroneous figure The second sort of diseases of Conformation are in the hollow places which two generall indications doe helpe The cure of diseases in the channell or passages namely to open that which contrary to nature is shut and to shut that which contrary to nature is opened But amongst diseases in defect the most common is obstruction of passages Of obstruction whose common Indication is apertion of obstruction But sith thence the causes of obstruction may be various particular indications are taken from them and those being taken away the obstructions are also opened Therefore that obstruction which is made by thick and viscid humours requires attenuating cleansing and cutting medicines amongst which sometimes the weaker sometimes the stronger are used according to the nature of the humour it self and the condition of the place wherein it resides But if obstruction be made by many humours and they contrary to nature in their whole kind the cure thereof consists altogether in evacuation But if the humour be not contrary to nature in its whole kind but onely offends in quantity the Indication is Apokenosis i. e. That which abounds is to be abated according to its abundancy But although all the obstructing causes should be evacuated yet they differ as well in other things as also especially in this that each of them require their peculiar and convenient places Those which obstruct the Breast and Lungs are to be ejected by cough nor can they easily be evacuated any other way But those which are contained in the Liver or in Veines or in Arteries or in the Reines are cast out by Urine the belly or vomit The other kinds of straightness Coalescense when the causes are taken away they are likewise taken away things growing together or Coalescents since it comes to pass by the growing together of parts and sides of a passage Indicate a Medicine breaking and taking away that Siccatrizing again Constipation Indicates the cause to be taken away Pressing closing Compression which make that straightness Compression since it proceeds from externall causes resting upon the passages the Indication is common namely to take away that cause of pressing together and shutting the passage but the speciall Indications are various according to
a remedie that stenches blood but it is stopt two wayes either by prohibiting that the blood cannot returne to the place out of which it came or if the vessells suffer it not to flow which will be done if they are shut or closed and sometimes one of them only sufficeth and sometimes when there is a great flux of blood both are necessary That the blood may not flow back to the place out of which it came is to be brought to passe if it be not drawn back by it if it be repelled if it be drawn to another place tâ—s not drawn back if the causes by reason of which t is drawn back be taken away as heat pain troublesome thirst t is repelled by the use of the Refrigeratives and astringents t is drawne into another part by Revelling or Deriving but that the blood may not flow back is prohibited when the end is shut which is done when the way is obstructed and stopped through which it flowed We cure a swooning by refreshing the Spirits Fainting or swooning although it cannot be done presently by removing the cause for this purpose the most fâ—â— things are pure Aire excellent and O doriferous Wine and spirits distilled of it But not only actions hurt but other Symptomes also sometimes trouble if the Arme pits stink and smell ranke that inconveniency is remided by the use of sweet things if the breath stinks that imperfection is hid by the chewing of sweet smelling things THE FIFTH BOOK PART II. SECT III. Of the vitall Indication CHAP. I. What doth Indicate Dyet in those that are sick SIth hence it is spoken by what means things preternaturall are to be taken away now it remains that we speake how that which remains in a sick man according to nature may be kept or preserved but those things which are according to nature commonly come under the name of strength or force and Indication which is taken from thence is called vitall and Conservatory because it preserves those things which are hitherto in the sick according to nature and those things which can preserve the strength of our body by themselves and are according to nature are called vitall and Preservatory Indicates But since as above in the 4. Booke part 2. Chap. 1. it is said there are three vitall or Preservatory Indicants health the cause of health and sound actions as we are to endeavour that in a sound condition all these may be preserved so it is to be aimed that as much as it is possible they may be kept in such as are sick and this is to preserve strength namely to preserve the native heat in the whole and in all the parts and the right use and observation of things called non-naturalls Namely the strength shews the Aliment The strength what it shews in this respect because 't is placed in spirituous solid and fleshy parts having a just quantity and doth use them as an Instrument and the vitall Indication is busied only about keeping the substance of the spirituous solld and fleshy parts But although the strength only Indicate Aliment Things prohibiting yet it may be prohibited from others for oftentimes the giving of meate increaseth the morbifique constitution and also to regard this that 't is not to Indicate Aliment but to prohibit it for when meate is given nature is called away from concoction and evacuation of morbifique matter and therefore when the powers Indicate their preservation which is performed by exhibiting nourishment in that quantity which the substance to be preserved wanteth but the morbifique cause indicates its Evacuation and therefore commands nature to be at leasure for it selfe alone and so prohibits Aliment whereby nature would be called away and hindred from its worke you must be carefull what urgeth more In breife strength only Indicates Aliment the morbifique cause permits or probibits the rest as age custome Time of the year the state of Heaven and such like are the signes of firme strength or of weaknesse or such as may shew the force and greatnesse of the morbifique cause CHAP. II. What things belongs to Dyet ALthough Dyet consists principally of meate and drink Things prohibiting to Dyet yet other things also called non-naturalls as Aire sleep and watchings exercise and rest and accidents of the mind belong thereunto but amongst these there are some things out of which primarily and by themselves Aliment is generated such is Aire meate and drink but others are accounted amongst the matter of food in this respect not because really out of those as the matter Aliment of the body is generated but as they are the causes of Aliment by accident and helpe that those things which are the true materialls of Aliments may be more commodiously turned into Aliment such are sleep and watchings exercises and rest Repletion and Inanition and passions of the mind of which is spoken above in the 4. Book CHAP III. How many sorts there are of Dyet and which agrees to which diseases BUt Dyet is threefold Dyet threefold Thick Indifferent Thin thick thin indifferent or betwixt both thick or full Dyet is that which can preserve not only the strength which is present but also can increase it indifferent is that which preserves the strength as it finds it the thin is that which preserves the strength yet somewhat abated Of thick and full Dyet again some is simple which agrees to those that are sick and is made by a ptisan with the Barley whole another is fuller and thicker which is made with fish and Eggs another which is the fullest of all which gives way to flesh of creatures that are gelded Simply thin is threefold simply such and is made by the juice of ptisan the thick juice or creame of ptisan or ptisan strained the thinner is that wherein water and Honey is mixt the thinnest Dyet was that of Hippo. wherein nothing was put the middle sort was made with bread dipt in broath or also with the flâ—sh of fowles But regard is to be had of custome places and Countries since in some Countries full Dyet is more in use in others more sparing and according to that the matter of thin Dyet is to be moderated But what kind of Dyet agrees to what diseases the comparing of the strength which Indicates food and the morbifique causes What food is fit for what diseases which hinder the same do shew for by how much the more nature is busied in opposing the morbifique cause by so much the more sparing Dyet is convenient but by how much the lesse it is busied by so much the more plentifull Dyet may be given but by so much the lesse it is oppressed by so much the state of a disease is nigher and therefore also by how much the disease is more acute by so much the Dyet is to be more sparing so that the strength can endure with it untill the state but t is known when the strength can endure
and subsist untill the height but when it cannot the nature of the sick is to be considered for if the body is made bitter with choler hot and dry abounding with choler especially about the stomach he cannot endure thin Dyet or fasting for such bodyes motion is easily hinderd regard also is to be had of age for as it is in Hippo. 1. Apho. 13. old men easily endure fasting as also those of middle age young men lesse boyes least of all and amongst them especially those which have sharper and quicker wits But as for the nature of a difease Dyet in long diseases in long diseases there is need of an indifferent or full Dyet and so much the more plentifull by how much the diseases are slower but in acute dises thinner is requisite least if we should give too much meat we should cherish the discase but since there are degrees of acute diseales so much the thinner is to be given by how much the discase is the more acute Yet it is allwayes safer to give thicker Dyet then is fit Whether more error is committed in full or spare Dyet rather then thinner as for the quantity you ought rather to studdy substraction according to Hippo. 1. Apho. 5. In thin food the sick doe faint whence it comes to passe that they are hurt the more for as much as every fault here is greater then it useth to be in a little more plentifull Dyâ—â— CHAP. IV. Of the right Administration of the Dyet of sick persons IN the same manner as in medicines so in vitalls Quantity of meate a threefold these may be observed namely the highest middle and lowest which may be administred in all Dyâ—t whether thick indifferent or thin But which dose is to be given and when is collected by comparing of the strength and morbifique cause one with another for since the morbifique matter sometimes urgeth more sometimes lesse and sometimes the helpe of nature is more required in resisting the cause of a disease the same forme of Dyet may be observed sometimes a greater sometimes a lesser is to be given according as nature is sometimes busied more sometimes lesse in the combat with a disease Namely in the beginning of a disease nature contends not much as yet with the morbifique cause neither whilst it is yet imployed in concoction and Evacuation wherefore you may exhibit victualls which are convenient for the disease then the highest dose But in the Augmentation because nature begins to contend with the disease In the Augmentation and is more busied about the morbifique matter then in the beginning then some of the quantity is to be abated and Dyet is to be given in a middle dose But in the state when the combat of nature In the state and the disease is most violent and nature is most busied in concoction and evacuation of matter the victualls are to be administred in the smalest quantity and nature not to be called away from its purpose The time The time of giving food to the sick and when meate is to be given as for that in continued diseases and such as have no differences of fits Dyet is to be administred according to custome principally at that time when the sick use to eat before But in diseases which have fits when meate is to be given Hippo. shews 1. Apho. 11. It behoveth to take away meat in the sits themselves for to give it is hurtfull and when by circuit diseases returne in the Paroxismes themselves you must abstaine which neverthelesse is not simply to be taken but if a feaver be from a sharpe and biting humour kindled by the Sun anger fasting labours and the sick be thin and leane in body and in Temperament and especially in Summer time if he be hot and dry either a little before the fit or in the fit it selfe meate is to be taken otherwise he easily falls into a burning feaver or Hectick swooning or convulsion or such like and indangers the losse of his strength THE FIFTH BOOK PART III. Of the Compositions of Medicines SECT 1. Of preparing and compounding of Drugs in general CHAP. I. Of the necessity and profit of preparing and Compounding simple Medicines THere remains now the Pharmaceuticall part of Physick which prepares and compounds simple medicines for the word Pharmacopia comprehends them both namely the alteration of simple medicines by the helpe of Art without mixture of others and the mixture of simple medicines But this part of Physick is necessary Why it is necessary to compound medicâ—nes for many and great causes for first the cause may be in the medicine it selfe namely if the substance of medicines be not so proper and troablesome to the sick by preparation and composition that which is wanting may be supplyed and that which is unprofitable troublesome and hurtfull may be taken a way sometimes a medicine hath a super fluous quality which we do not then want therefore we ought to allay that by mixture of the contrary some simple qualities are easily corrupted wherefore there needs digestion distillation concoction to be used or to preserve or pickle those things with Honey Sugar Vinegar Salt The strength of some medicines is easily taken away whence we are to effect by the mixture of more viscid things that so it may not be easily dissipated moreover the causes in effect it selfe contrary to nature for if simples are not to be found which have all those faculties which are requisite in one sick person oftentimes and in the mixture of diseases contrary to nature then one medicine is to be compounded of severall simples which may performe all the Indications which kind of medicines the Greeks call Polychreston Thirdly since that simples are not allways supplyed by nature which may agree to the Temperament Sex kind of life and various constitution of the parts of every one there is need of preparation and composition Lastly for the severall formes also whereof this is more pleasing to this that to that person nay in regard of the disease also t is necessary to prepare and compound medicines Oâ— that we may breifly contract these things there is need of compounding medicines for two reasons either for the strength of the medicines sake or for its use and applycation sake for if the vertue of the medicine be weake t is to be strengthned by mixture with more vehement if any faculty be deficient t is to be mixt if a medicine be stronger then it is required something is to be added by which iâ— is to be abated or corrected If a simple have any superfluous quality or hurtfull that is to be mixt by which that hurtfull quality may be taken away But that the medicine may rightly be applyed and drawn into action t is necessary that the medicine maybe preserved least before administration it looseth its strength by mixture of some preservative for example with Suga or some other Moreover that it may
a Ptisan the meat should be savoured with juyce of Lemmon Pomegranates Goose-berries Their drink should be barley-water or small beer Fernelius 5. cap. of Fevers Synoch Bilios Fernal makes mention of another sort of Synocha which is made by the kindling of the Spirits and cholerick humours without putrefaction and which ariseth from the same causes as an Ephemera if it happen in a cholerick body which opinion indeed may take place if it be meant of the thinner and subtiler part of the hotter blood which somtimes useth to be called choler but not if it be spoken of excrementitious cholar The end of the first Book BOOK II. Of Putred Fevers CHAP. I. Of Putred Fevers in General WHereas there is a two-fold sort of Fevers whose heat is inherent in the parts according to habitude whereof the one hath it's rise and is continued by the kindling of the Spirits and thinnest parts of the blood without putred humours the other hath it's original from vapours and putred humours of the former kind 't is already spoken The next business is that we handle the putred Fevers That there are putred Fevers many things shew Putred Fevers For neither is it dissonant from the nature of humours but that they may putrifie since that may happen to every mixt body and we see humours putrifie otherwise in mans body as it happens in inflamations wherein quitture is generated as Galen in the 1 of the differences of Fevers cap. 6. he compares the putridness whereby the humours putrifie in the brain with that by which Sanies is generated in the humours And that they do actually putrify sufficient reasons are given which hereafter we shall propound and the matter it self shews that humours do putrifie in the veins For both blood which cometh forth from breathed veins and those things which are evacuated by stooâ— Urine sweat sufficiently by their smell and otherwise argue putridity of humours And the way of cure proves the same for 't is not performed by things that alter but evacuate humours which is partly instituted by nature partly by the Physician For if humoral Fevers could be made without putrefaction they might also be cured by altering things only And indeed such Fevers are not only malignant as some think but the same signs appear and the same way of cure is exhibited to intermittent and continued What Putrefaction is which are void of all malignity and pestilency Aristotlc 4. Met. c. 1. defineth putrefaction to be the corruption of the proper and natural heat in every moist body by reason of external ambient heat but by Galen 11 Meth. med c. 8. without doubt not so much regarding the common and adequate subject of putrefaction as to mans body subject to medicinal consideration It is says he a change of the whole substance of the body putrifying to corruption by reason of extraneous heat the ultimate end of putrefaction is the dissolution of the parts whereof the mixt body consists and the corruption of the whole mixture That we may here pass by the tedious disputations which are extant amongst Philosophers and Physicians concerning putrefaction this is to be taken notice of How manifold it is that putrefaction in respect of the mixt body putrifying the one is according to the whole and perfect according to the whoâ— whereby mixt bodies are plainly dissolved into Elements out of which they are bred The other is in some part and imperfect whereby these which are full of moisture in some part putrify For seeing the moisture wherewith it aboundeth cannot wholly be drawn out only some parts thereof especially the thinner are And such putrefaction namely according to parts agrees to humors also namely when some particles of theirs are really corrupted and they loose their form Yet the whole humour must not necessarily loose it's form thence it continues it's name and those corrupted parts being evacuated it returns to its former nature unless the corruption have so far gone that mutation is made into another kind Which putrefaction is putrefaction indeed and not alteration only For although the whole be not corrupted yet some parts thereof are really corrupted Putrefaction in a body is caused by extraneous heat The cause of putrefaction and when the humours are no longer governed by the natural heat but are destitute thereof they are corrupted Therefore all things whatsoever which may be an occasion to hinder the innate heat so that it cannot in its due manner govern the humours may be said to be the cause of putrefaction of the humours Putrefaction of humours though oftentimes it be caused by obstruction and bowels and prohibiting of free transpiration since that as Galen 11. Meth. med c. â— writeth things hot and moist in a hot and moist place not being fanned and cooled by wine easily putrifie Yet putrefaction may be occasioned without this by the meeting with putred things and other causes which debilitate the native heat and bring in an extraneous heat First certain humours by reason of some internal defect Default of humours of heir own accord tend to putrefaction or at least are casily overcome come by small causes of putrefaction and having gotten the least occasion fall into putrefaction Such vice humours contract first from bad meats of the which they are generated whether they are such by nature or any other wayes corrupted Moreover by meats which are easily corrupted such are fruits rareripe Thirdly from the ill dressing of meats or ill concoction or when they are taken in excess or at unseasonable hours or after a preposterous manner Fourthly by the default of the parts appointed for concoction by reason whereof even the best aliment may be corrupted Lastly by reason of other causes which either impede concoction or retain execrements as also the preposterous use of the six Non-naturals Therefore by how much the more of such humours are cumulated in the body by so much the more easily they putrify For nature doth not defend excrementitious humours so carefully as those which are fit to nourish the body whence they are easily corrupted and putrify Blood also out of the veins being out of it's natural place and of a hot and moist nature easily is corrupted But although such humours turn to putrefaction of their own accord and being in a hot and moist place yet it happens sooner if any other cause be added Nay good humours also in a sound body if they are the cause in pâ—sse of putrefaction may become putted Amongst all these causes the first and chiefest is the hinderance of transpiration and ventilation Transpiration hindred whether it happen by straitnes of the pores of the skin or by obstruction of vessels passages in the more inward parts of the body For hot and moist things in a hot place unless they are ventilated easily putrify Narrowness of pores is occasioned either by constriction from cold or astringent things or driness as staying
whereof no concoction can be expected the which useth to corrupt and putrifie in the body and oftentimes that is easily vomited out which with great difficulty is purged out Vomits The Vomits are set down in the fifth Book of the Institutions part 1. Sect. 1. cap. 12. Some give at this day the roots of Asarabecca from half a drachm to a drachm The Chymists use white Vitriol Salt of Vitriol Medicines prepared of Antimony which do not open only the first passages but stir the whole body These are to be used with much caution and as Hippoc. Purging medicines 1 Aphor. 24. Not without skilful advice Concerning Purgers at what time they are to be used there is great controversie for although vitious humours at any time during the desease shew that they ought to be taken away Yet they ought not to be evacuated at any time but instead of an Oracle Galen admonisheth four of preservation of health c. 5. the Aphorisme of Hippocrates is to be had in esteem 22. Sect. 1. Such as are concocted and ripe ought to be purged and removed not crude neither in the beginnings unless the matter trouble much which seldom cometh to pass But although some interpret this Aphorism otherwise yet if it be diligently considered 't will be manifest that Hippocrates meant to speak only of putred Fevers and of no other disease and by crude humours intends those that by reason of their putresection in putred Fevers ought not to be purged being unfit by concocted he intends such as are fitting to be purged The words crudity and concoction being transsated from their proper signification of crudity and concoction to excrementitious humours Although there are certain other preparations of humours for purgation both in Fevers and out of Fevers Concoction of humors Yet the name of concoction belongs not to them and we must distinguish betwixt concoction and preparation of humours Concoction whereof Hippocrates speaketh is a reducing of the putred humours into a better condition and less obnoxious to the body and a separation of them from good blood that they may the more profitably be evacuated out of the body hence concoction belongs only to humours which are contained in the Veins and mixed with the blood but those that are in other places and not mixed with the blood may be purged at any time For these humours unless they are reduced to a certain mediocrity as they are capable of and are seperated from laudable blood the Physician in vain and with much detriment to the sick endeavours to expell them by purging For neither will the humours follow the foregoing medicine neither hath the Physician nature for his assistant since the matter is only stirr'd and troubled and various Symptomes arise either the strength is weakned by the vioâ—ence of a strong medicine or the native heat is consumed and weakened Yet flatulent humours may be purged without concoction Flatulent humours For although these are not as yet concocted yet because there is not only danger lest they should fall upon some principal part but also because being thin and already in motion they easily follow their leading medicine and the Physician hath nature to assist him which alone sometimes expells such humours at the beginning to the great advantage of the sick But by flatulent humours here we are not to understand only those which hitherto are moved to no determinate part but also those which although they rush into some part yet they are still moveable and so disposed that they 'l easily remove into another part and according to their manner are hitherto wandring but have not any fixed seat any where Concoction whereof we here speak is the work of nature only which when 't is strong gives what perfection they are capable of receiving even to the vitious humours as may be seen in the generation of quitture and this concoction is made only in putred Fevers For whilest the humours ferment in the veins like new wine and the good and bad are mixt together and cannot easily be seperated They are called crude but when the humours are appeased and cooled and the good may easily be seperated from the evil they are said to be concocted CHAP. VII Of Concoction and Seperation of humours ALthough the concoction of humours be the work of nature only Yet a Physician may help her by his medicines which may either cherish and strengthen the native heat or take away impediments which may hinder nature in concocting Digestive medicines and reduce the excess of qualities to mediocrity And medicines of the latter of these two kinds are called Digestives and Concoctives namely such as cool the hot humours heat the cold moisten the dry attenuate the thick incrassate the thin and if there are any other excesses of qualities reduceth them to mediocrity So Cholerick humours because they are hot to be allayed Concocters of cholerick humours and tempered with cold medicines and their tenuity if too much to be reduced to mediocrity and its power of inflaming to be prohibited These perform this Chichory Endive Sowthistle Garden-Endive Sorrell Burrage Bugloss Violets Barley the greater and lesser cooleing seeds the juice of Lemmon Pomegranates Goose-berries Vinegar Spirit of the salt of Vitriol and medicines prepared of these Phlegmatick humours because they are thick and dull Phlegmatick require attenuating and cutting medicines such are the opening roots Hysop Bittony Agrimony Venus-hair Vinegar also Spirit of Vitriol In a Melancholly humour Melancholy attenuating medicines are also useful but such as moisten withal Such as are Burrage Bugloss Polypody Caeterach or Spleen-wort and such like But because in all these Fevers Resisting of putrefaction corruption of humors is present those things which resist putrefaction are also necessary such are Vinegar Juice of Lemmon Citron Pomegranates Sorrel Spirit of Salt of Vitriol And those things which are spoken about concoction and crudity of humours principally take place in continued and acute Fevers which is manifest from Hippocrates who 1. Ash 24. adjoynes In acute diseases seldom and about the beginnings purging is to be used and that with diligent premeditation and 2 Aphor. 29. In the beginning of diseases if ought be to he moved move it but when it flourishes 't is best to be quiet namely if the matter swell big in acute diseases presently at the beginning 't is to be evacuated but if not a concoction is to be expected which nature alone performing very often useth to expell vitious humours which if it be not done the Physician useth to do it The same crudity and concoction is required in intermitting Fevers for since their causes are scituated in the Mesaraick veins and the Mesaraick veins contain and elaborate blood of their own accord if peccant humours be any where mingled with that blood and begin to putrefie crudity is said to be present But when those humours are so conquer'd by nature that they may
easily be seperated concoction is performed Although in intermitting Fevers in every fit some of the peccant matter be evacuated yet notwithstanding the humour which is the fuel of such Fevers is not first taken away before the concoction be performed and the bad are seperated from the good That which in quartanes useth to be long in doing For although each Paroxism some may be expelled yet as Galen 2. of the difference of Fevers cap. the last teacheth superfluities in the part wherein the fewel feeding the Fever is contained being left behind cause new fits and purgation is appointed in vain before the humour be concocted and rendred fit to be purged whereof shall be spoken amongst the intermitting Fevers Preparing of humers But besides this concoction and preparation of humours there is yet need of other things which when the humours are concocted are to be exhibited For considering purgation that it may be happily used the passages ought to be open and the humours fluid if the passages are obstructed and thick sluggish humours be present the wayes through which the humours ought to pass are to be opened and the humours to be cut and taken away CHAP. VIII Of Sudorificks and Diureticks BUt because nature for the most part expells the concocted matter by sweats Causing sweat so that almost no Fever without them ceaseth and is well cured The Physician ought to imitate nature and the body being evacuated to discuss the remainders by sweats The Sudorifiques that at this day are in use are Carduusbenedictus Scabions Fumetary Tormentill Zedoarie Harts-horn Elder Bezoar-stone Methridate and such like but no sudoriferous medicine ought to be administred if any Crisis by stool vomit or Hemerrhodes at the nose be extant lest nature should be disturbed in it's work They are most conveniently exhibited at that time when nature her self useth to remove humours which happens either before any paroxysm or at the end thereof By Urine also sometimes part of the fevourish matter is evacuated Urine provoked and therefore Diureticks after other evacuations are to be appointed and the most temperate amongst them are to be chosen which together attenuate the humours and free the passages from obstructions as Maiden-hair Sparagus Agrimony c. But those things which are cold may timely be used also since they correct the hot distemper of the humours and parts CHAP. IX Of Diet in putred Fevers LAstly concerning dyet Dyet and first of meat and drink not only regarding the use of them for the comfort and refreshment of our strength but in respect of what is to be permitted and what prohibited for when nature is most busied in concoction and evacuation of matter she ought not to be called from that work to the concoction of meat hence Hippo. 1. Aphor. 8. When the violence of the disease is great dyet is to be used most sparingly and ibid. Aphor. 11. In the Paroxism it self food is to be taken away for it affords mischief and when by circuit the Fever returns in the fits we ought to abstain In the administration of dyet in Fevers we are to observe form Form of Diet. quantity quality and time The form of dyet is threefold thick indifferent and thin Which of these are most proper for every one is to be collected by comparing the strength of the sick with the morbifique cause neither ought we to give more meat then the strength can concoct and we ought to consider whether the strength do more require food or the disease forbid it or the contrary for by how much the busier nature is in oppugning the morbifique cause by so much the less thre ought to be burthened with food She is by so much the more busied in opposing the disease by how much the paroxism is neerer at hand hence Hippocrates 1. Aphor. 8. When the disease is in it's vigour then 't is necessary to use the thinnest food and 1. Aph. 7. When the disease is peracute there are extream labourings and at height the thinnest nutriment is to be taken But when 't is not at height and that we may use more nourishing things by so much is to varied from the thinnest of all by how much the disease is remitted and abated and ibid. 10. Those who expect the vigour forthwith to come ought presently to take a little nourishment They who expect it afterwards much and should both in the vigour of it and a little before it abstain But before-hand the sick should be more plentifully nourished that he might be the better able to endure the disease But how dyet is to be moderated according to the strength Hippocrates teacheth 1 Aphor. 9. We ought to conjecture by the sick whether he can hold out to the vigour of the disease by the prescribed dyet or not or whether he will first faint and being insufficient with such food should dye before the disease depart and be overcome And 1. Aphor. 13. Old men that are not decrepid easily endure to fast according to these middle aged men young men less children least of all and amongst them especially such as are endued with the choicest and most acute wits Custom also and course of life is to be considered in prescribing of dyet The quantity of meat also is to be considered by comparing of the disease with the strength of the sick Quantity For since that we must never give more food then can be concocted at the time when nature is most busied in opposing the morbifique cause the least quantity of food is to be taken which is in the height thereof Concerning the quality of meat Quality since it is to be considered either as it is meat or as it is medicinal meat in the former respect those meats are to be chosen that are of easiest concoction full of good juyce facile to be distributed and which hath the least excrements But if it be considered as Medicinal First it ought to be contrary to the Fever and therefore it should be cold and moist 1. Aphor. 16. moreover it should be repugnant to the causes and all excess of qualities in them The time for food is most proper when 't is indicated Time when the body requires nourishment which is when the former meat is concocted and no sign is present which may prohibit the taking of it to wit no combate betwixt nature and the disease therefore during the fits we ought to abstain 1. Aphor. 11. unless the strength be much decayed and spent Care also is to be taken what drink is fittest in Fevers for although it be easier concocted then meat Drink and by it's cooling it mitigates the heat and the driness is hindred Yet we are to be careful that nature be not burthened with it and the concoction of matter hindred by it and therefore in intermitting Fevers during the Paroxism we should abstain from drink as neer as we can But in continued Fevers when heat thirst and debility
thus known Signs in that it is continued and the third day it is exasperated Yet there are present other signes and Symptomes of continued and burning Fevers But what is to be hoped concerning their event Prognosticks is manifest from things which are spoken of the Prognosticks of burning Fevers Concerning the indications for cure Cure this Fever if it be pure since it is exceeding hot and burning and the cause thereof hot and dry it requires extraordinary cooling and moistening and indeed more then any other Fever The humour it self indicates evacuation but crudity for the most part forbids it but if the Fever be spurious regard is together to be had to the humour which is mixed with choller if the Symptomes need it they are to be resisted likewise Therefore a vein is to be opened so that the strength will permit it by which means both some part of the peccant humour may be evacuated Opening a vein and the blood cooled and revell'd from the more noble parts And nature her self sometimes useth to make evacuation by the nose in the beginning of these Fevers whereby the Fever is wont to be abated but the vein should be opened in the cubit forthwith in the beginning or certainly in the augmentation and blood is to be taken in such plenty as the strength of the patient requires But you are not to appoint purgation unless the matter be turged Lenitives Yet 't is very necessary that the belly and first passages be evacuated before a vein be opened but the medicines which perform that ought to be cold and moist not hot or if they are hot they should be tempered with the mingling of cold Afterwards altering namely Alteratives cooling and moistening medicines are to be exhibited both which prepare the humour appointed by nature for concoction such as are Syrrup of Sorrel simple Oxymel simple compound Oxysauharum simple Syrrup of Sorrel Wood-sorrel the juice of Lemmon Pomegranate the accidity of Endive Cichory Violets Gooseberries the four greater cold seeds Purcelane Lettice thâ— flowers of Water-lillies Santalum Water of barley Sorrele Endive Cichory Strawberries Water-lillies Purcelane spec Diamargariti frigidi and such like to which for the resisting of putrefaction and hindring inflamation may be added Spirit of Vitriol and Salt Nitre prepared is also commended If Phlegm be mixed opening and attenuating things are to be added such as the roots of Fennel Sparagus graminis and medicines prepared of them In leek colour'd aeruginous choller John Langius l. 3. epist 1. c. 4. commends Chrystal Topical medicines are also profitable to mitigate the heat as Epithems Oyles and Unguents made of cooling things Topicks which should be applied to the heart liver or back Yet you must be careful that you close not the pores of the skin thereby and hinder transpiration and therefore before the height they are seldom used unless it be when the heat is equally distributed through the whole body and it is more commodious if they are applied hot then cold The matter being concocted that nature might be strengthned and stimulated to expulsion and that the matter might be expelled either by stool or sweat the Ancients used great quantities of cold drinks as Galen teacheth 9. meth cap. 5. and 4. de rat vict in acut 12. But if so be that after concoction nature do not institute evacuation Purgation it is to be done by the Physician with Syrrup of Roses and Violets solutive the pulp of Tamarindes Manna Rubarb Trypheta Persica such as have Scamony in them are not to be admitted yet sometimes some of Electuarii rosati Mesua de psyllio and of juice of Roses may be given For causing Urine in these Fevers an emulsion is profitable prepared of the four great cold seeds Diureticks with the whey of Goats milk or barly and strawberry water or with a decoction of the roots of Parsley Sweats also ought to be provoked with medicines proper for that purpose Sydorificks which hereafter shall be mentioned amongst malignant Fevers Diet ought to be thin but according as the height of the disease is neerer or farther off Dyet it ought to be thicker or thinner The meat and drink ought to be cooling and moistening whence a Ptisan is profitable in these Fevers the rest should be seasoned with juice of Lemmon and Pomgranates The drink should bâ— barley water or water boiled with the juice of Lemmon or Pomegranates and suggar or small beer The air should be cold and if it be not so by nature it should be prepared by art If Phlegm be mingled with choller and the Fever be a continued Tertian or burning Notha blood is to be taken away more sparingly In the preparation of humours those things are to be added which attenuate Phlegm Agarick is to be mixed with the Purgers CHAP. XIV Of a continued Quotidian A Continued Quotidian vulgarly called Latica because it hath a certain hidden and obscure heat A continued Quotidian is indeed a Fever continually lasting yet having every day exasperations arising from indigested phlegmatick humours in the vena cava The cause of this Fever is Phlegm mixed with blood in the vena cava and there putrifying Cause and therefore those fall into these Fevers which are of such an age and nature as that their bodies are moister as children and infants as also old men and such as have grosser bodies and are given to their bellies and to idleness and dwell in moist places but not young men and such as are cholerick The signs of continued periodick Fevers are also manifest in this Fever only the violence is most about the evening Signs The heat first is gentle a little afterwards more sharp and sometimes seems to abate and sometimes to increase by reason of the thickness of the phlegm which purrisieth The pulses are not so thick and frequent the urine is not so fiery and red as in other Fevers but thicker nor are the other Symptomes so vehement as in other Fevers Concerning the event 1. Prognosticks This Fever by reason of the thickness of the humour is long and hard to be cured and therefore dangerous And by how much the thicker the phlegm is by so much the more violent and durable so that it is not ended before the swetieth or sixtieth day and the beginning is scarce past before the twentieth 2. It continueth lesser time where many evacuations happen That which is pure is also longer then that which is mixed with choller and by how much the worser Symptomes are present and the strength weaker by so much the greater danger there is which if they are not health is to be hoped for 3. By reason of the duration of the Fever and weakness of the Liver the sick for the most part fall into Cachexy and Dropsie As to the cure this Fever is more dangerous in respect of the cause then of its heat Cure and therefore since it
depends on phlegm that is to be heat attenuated cut and afterwards being concocted and prepared evacuated and regard is to be had of the strength principally of the stomack and Liver Therefore in the beginning the stomack and first ways are to be opened and evacuated by Clisters and lenitive medicines Lenitives or else the matter inherent in the stomack is to be ejected by vomit Opening a vein But although the cause of this Fever be cold yet because it is mixed with blood and putrifieth some blood may be taken away by opening of a vein in case that the urine be thick and red and that the strength will bear it and the age that nature may be eased of some part of her burthen Afterwards preparation concoction of the matter is to be endeavored with attenuating things which do not heat much Preparing and altering therefore in the beginning use Syrrup of Sorrel simple with honey of roses Oxymel simple Syrrup of Hysop Bittony with the water or decoction of Maiden-hair Sparagus Grass Fennel Hysop and medicines prepared of those plants also Spirit of Vitriol and Salt When any signs of concoction have appeared you may exhibite some gentle Purger of phlegm Purging of Agarick the leaves of Senna and such like Hence you must come to stronger preparing and purging things and so the matter which cannot be evacuated at once is to be prepared concocted and evacuated at several times And because a pure continued Quotidian seldom happens but that either choller or melancholy is intermixed we are to look to these humours also and to adde Cichory Burrage Provoke urine and Sweat Fumitory Rubarb and the leaves of Senna After the greatest part of the matter is evacuated the remainder is to be emitted by urine and sweat using such medicines as occasion the same But since that by reason of the duration of the disease the stomack and liver are especially offended Strengthening Medicines things that corroborate these parts are to be administred troches of Woâ—mwood of Rubarb of Roses with the powders of aromatici rosati and diaxyaloes The Diet ought to be attenuating Dyet cutting and clensing the meats therefore ought to be of good juice easie of concoction and affording little excrement Fish are not proper in this Fever the flesh should be seasoned with Parsley Fennel Time Hysop Savory Rosemary Cinamon In the beginning nourish somewhat more plentifully that the sick may endure to the height of the disease but when 't is neer the state abate aliment by degrees Yet if crudities be in the stomack and first passages by sparing dyet the three first days they may be abated and consumed afterwards such a dyet as we have mentioned may be observed In the beginning the sick should abstain from wine and in its stead use water and honey yet if by custom it be required give it small and mixed with water Small beer is also convenient when concoction appears wine is more safely administred whereby the concoction is assisted the stomack strengthened and the humours driven out by urine Of the Fever Epiala THe Fever called the Epiala is referred to continued putred Fevers The Fever Epiala which it self is indeed continued and quotidian yet differs from the other Quotidians in this that the sick at the same time endure heat and cold and the heat and cold together are dispersed through the smallest particles of the whole body as Galen teacheth de inaeq intemperie cap. 8. and 2. de diff Febr. c. 6. Galen in the place newly quoted draws this Fever from acid and vitrious phlegm puttrefying Cause yet in his book of an unequal distemper cap. 8. he addeth bitter choller whence he infers that since heat and cold are perceived together in one place it argues mixture of phlegm and choller in another place he determines it to arise from vitreous phlegm part whereof putrifying exciteth heat the other not putrifying causeth trembling and cold Yet Platerus refers them to intermitting Fevers and says that Epialaes are generated when intermitting Fevers happen together in one and the same day and the cold of the one beginneth before the heat of the other be ended or moreover when intermitting Fevers concur with continued and the heat of the continued always remains but the intermittent Fever coming a trembling and cold fit is occasioned The cure of this Fever differs not much from the cure of other Fevers arising from phlegm The Cure only that it requires stronger attenuating and cutting medicines because there is greater frigidity and crudity in this then in the rest also though the humour it self seem to require stronger Purgers yet the weak cannot bear them and therefore evacuation by degrees is to be appointed Of the Syncopal Fever MOreover to these Fevers belongs a Syncopal Fever commonly called a humorous Fever Syncopal Fever in which there is more of pituitous and crude humours then in other Fevers that are phlegmatick and moreover a debility of the orifice of the stomack is adjoyned whence the sick easily fall into a Syncope especially when the Fever begins This Fever is hard to be cured since the sick by reason of their extreme weakness and danger of continual soundings cannot endure necessary evacuations The Prognostick and especially if the pulse be weak small and unequal the Fever is exceeding dangerous But evacuations are most properly occasioned by frictions as Galen teacheth in his twelfth of the method of curing cap. 3. Cure Clysters and Lenitives also with medicines opening the first passages only and causing no commotion of the other humours The first passages being opened and cleansed we come to preparing and evacuating humours as in other Fevers petuitous and medicines to prevent the sounding fits are also to be administred The meats should be not much thin as to substance easie of concoction Diet. and generating as little phlegm as may be and they are to be taken often The drink should be wine which hath power to nourish heat and attenuate and doth not increase phlegm Hydromel is also good wherein Hysop hath been boiled CHAP. XV. Of a continued Quartane LAstly a continued Quartane is a Fever A continued quartan whose heat is indeed continued yet the fourth day 't is exasperated it proceeds from melancholy mixed with blood putrifying in the vena cava The cause is a melancholy humour putrefying in the vena cava The cause hence all things that can generate melancholy and crowd it into the vena cava and putresie are the causes of this Fever It is known by its continued heat the Diagnosticks raging the fourth day without trembling fear or shaking fits going before or sweats following afterwards the pulse in the beginning is small and slow afterwards great full and swifter then in an intermitting Fever wherein 't is most intended in the height This is the rarest of all Fevers â—â—ognosticks but dangerous and far more desperate then
vapours cannot be transmitted to the heart and so a Febris Lenta is stirred up which therefore is unequal and keeps no certain order This Fever is the gentlest of all and molesteth not the sick with any grievous Symptome so that the sick oftentimes thinks himself well In the mean while the strength decayes that the sick can scarce go forward and the body is no ways refreshed by aliment but wasteth by degrees whence sometimes this Fever is accounted with an Hectick and therefore when there is any suspition of this Fever in the first place we must diligently search the Hypocondries and Hypogastries to try whether any tumor be to be discerned in any of them some signs of putrefaction also will appear in the urine and discover themselves in the Pulse This Fever is more durable and goes beyond the terms of other Fevers and often endeth not in fourty days nor is it gone until the humour fastened to the interal be consumed The third sort of Symptomatical Fevers is Fevers from putrefaction of interals that which ariseth from the putrefaction of any interal from whence putred vapours through the veins inserted might be sent to the heart heat that and might stir up a continued Fever whereby the body by degrees might be extenuated and wither And this Fever is sometimes more violent sometimes more mild according as the putrefaction is more or less This often happens in putrefaction of the lungs in such as are Phthisical so 't is found that the Caul or Kell Mesentery Womb and other parts are corrupted and thence a Fever kindled In like manner from Fistulaes penetrating into the internal parts a Febris lenta being stirred up it is observed that some do consume and waste The fourth kind of Symptomatical Fevers is when either from corrupt milk From corrupt milk Putrified blood Worms which often happens in Infants or from blood putrifying somewhere without the vessels or from worms putred vapours are communicated to the heart that is heated and a Fever irritated To these may be referred that Fever which ariseth from crudity which is familiar amongst little children from their eating of sweet things which hath with it a tumor and inflammation of the Hypocondries which the Germans call Das Herngespam from the abundance of crude humours collected in the stomack and neighbouring parts which begin to putrefie and are turned into wind Diagnâ—stick signs Symptomatical Fevers properly so called are known by this that they come after diseases of private parts and the first sort of these Fevers is known from hence because it follows an inflammation of some certain part as on the contrary Fevers called Comitatae first appear and invade with rigor and trembling to which afterwards a Fever happens But those Lentae or slow Fevers are known by their slow heat wherewith notes of putrefaction in the urine and pulse appear the sick are weak scarce able to go the body wasteth by little and little and the Fever is lengthened for the most part beyond fourty days they are tormented by the use of purging But when the cause of these Fevers is hidden 't is very hardly to be distinguished and therefore the Hypocondries and other internal parts are to be observed with great diligence and we are to enquire whether any tumor or pain be to be found there But those which arise from the putrefaction of any part are more easily known nor indeed can the corruption of the part be hidden unless it be ignoble So that Fever which proceeds from corrupt milk or blood is easily known by its signs as also that which ariseth from crudity is manifest from their loathing things blowing up and swelling of the Hypocondries Although these Fevers in respect of themselves for the most part are not dangerous because they are mild The Prognostick yet in regard of their causes on which they depend we ought to doubt whether they are dangerous or not as also whether they are long or short for those which follow an inflammation of any part are short since that the inflammation it self cannot be long but the danger of them depends on the inflammation The Febres Lentae are for the most part long and often continue more then fourty days And although not by their violence yet by their duration they debilitate the strength they are cured also with difficulty because their cause pertinaciously inheres in some interal Those Fevers are very dangerous and seldom curable which come from the corruption and putrefaction of any part because the part can seldom be cured But those Fevers which proceed from corrupted mill and blood worms or crudity are often acute and dangerous and bring with them grievous Symptomes as Epilepsies Convulsions yet they last not long neither are they hard to be cured but the cause being taken away they cease The way of cure ought to be aimed at by striking at the cause whereon it depends The Cure If therefore a Symptomatical Fever depend on an inflammation of any part the cure is to be directed to the inflammation it self which being cured the Fever ceaseth And therefore most remedies which are convenient to asswage inflammations are here useful Yet in regard of the part affected the way of cure sometimes differs the part affected is diligently to be weighed Whereof it shall be spoken in the cure of particular affects The Febres Lentae since they proceed from extraordinary obstructions of the bowels require opening attenuating and deterging medicines And such are to be chosen as are appropriated to each part and such as strengthen the tone of the interals which for the most part is debilitated yet by intervalls gentle purgation may be used Neither are Diureticks to be omitted in their season Externally also if the part affected will bear it Emollients and Discutients are to be applied If the Symptomatical Fever proceed from the corruption and putrefaction of any part that cure is to be instituted which agreeth to Ulcers and Fistulaes of the internal parts If it be occasioned by corrupt milk or blood Worms or crude and corrupt meats we are to endeavour that those causes be taken away conveniently either by vomit or cleansing and evacuating medicines and together to resist putrefaction and fevourish heat In the cure of accompanied Fevers we are to look no less to the Fever then that conjunct disease or companion and the metion of nature is not to be impeded The cure of accompanied Fevers least the peccant humour retained in the body should cause more danger and therefore although it be not profitable to hinder an inflammation when 't is beginning Yet the humour that is the cause or that evil is also to be evacuated which is most conveniently done for the most part by breathing of a vein which together affords evacuation and revulsion Yet it shall be profitable also to empty the firft passages since that oftentimes the matter is gather'd together in them and since the matter for the
most part is thin and often makes toward the extremties of the body and is often full of malignity 't is conveniently expelled by sweat CHAP. XVII Of intermitting Fevers in general AFter continued Fevers intermitting are to be explained Intermitting Fevers But although the Ancients did extend the name of intermitting Fevers more largely and attributed the same to all Fevers which admit of some change of heat and are sometimes exasperated sometimes remitted and so to continued periodicks yet afterwards use brought it to pass that those Fevers only were called intermittent which sometimes cease and come to that apurexy or want of fire The proximate cause of an intermitting Fever is a putred vapour their proximate cause elevated from the putrefaction of excrementitious humours not continually as in continued Fevers but by certain intervalls sent to the heart and heating the same contrary to nature But how it comes to pass The fire place of Intermitting Fevers that the putred vapour is not continually sent to the heart but at certain times is very obscure For the explanation whereof since the knowledge of the place wherein putrefaction ariseth doth not a little conduce and whence the putred vapours are communicated to the heart which Galen calls the Furnace and Chimney in his 2. of the differences of Fevers cap. the last and in his 15. of the method of curing cap. the fourth that therefore is first to be explained But since 't is beyond the bounds of our Breviary of Institutions to reckon up the various and different opinions of Physicians concerning it we will here set down that opinion which we think truest The Chimney or Furnace and place wherein the matter the cause of intermitting Fevers is generated are the Mesaraick veins wherein the matter which sufficeth to irritate each single Paroxism is generated during the time of its interval And that many things which happen about intermitting Fevers do prove namely Loathing Vomitting Dolor of the heart Extension and pain of the Midriffe Intumescence about the Ventricle Bitterness about the mouth Belching and such like for in the beginning of intermitting Fevers pure choller is often ejected by vomit in great abundance which out of the more remote veins could not be evacuated in that manner and about the cava of the Liver Fernelius says he hath found the quantity of a pound by weight after the death of a Patient This choler being cast out the Fever is often cured which is a sign that it is the cause of the Fever and that it is collected in those first ways or passages Which Fomentations also used to the Hypocondries at the beginning of a Paroxysm shews by the mitigation of the trembling and shaking This matter is gather'd together in the Mesaraick veins a long time before it brings forth a Fever but when it begins to putrefie grow hot and be changed its heat being diffused over the whole body it exciteth a Fever which when it is dispersed the fevourish heat and Paroxism ceaseth and the Fever leaveth so long as till new matter which in like manner putrifieth in its due time is generated But although the matter which is the cause of intermitting Fevers be generated in the Mesaraick veins and first passages the cause of intermitting Fevers conteined in the vâ—na cava Yet the whole doth not reside and continue included in them but is sent to the vena cava and arteries both during the fit and out of the same Nor is it here necessary to seek for occult and blind passages through which the putred vapours should be sent to the heart during the Paroxism since there are manifest passages enough for the branches of the Gate-vein are inserted into the substance of the Liver and the mouths of these have communion with the vena cava and the arteries going from the heart are joyned in the stomack guts spleen and other parts to the Mesaraick veins Yet 't is probable that the fevourish matter may be communicated to the veins not principally and only in the Paroxism but moreover some part thereof by that passage which is from the Meseraick veins to the Liver continually may be carried to them whence both by Galen 1. de cris cap. 7. and other Physicians a Fever is called a passion of a venemous nature And that is first manifest from the urines which shew evident notes of crudity and concoction in Intermittents Hence also it comes to pass that urines during the Paroxisms are laudable and like to theirs who are well since that the peccant humor is then protruded by nature out of the veins towards the circumference of the body and so the blood in the veins is become purer which again in the intervals of fits is polluted by the vitious humour proceeding from the chimney of the Fever The same is manifest out of those things which happen at the beginning of a fit and at that time which the Greeks call Episemasian for then spontaneous lassitudes stretching compression of pulses and other things happen which indicate that the matter which is to stir the Fever begins to be moved and as it were to swell in those common vessels veins and arteries That vitious humour accumulated partly in the Mesaraick veins partly in the vena cava when in time it putrifieth nature stimulated and irritated oftentimes strives several ways first by vomit and stool afterwards by sweats and urine sensibly to evacuate the same as also through the pores of the skin and by insensible transpiration it may discuss the same being resolved into vapours and steam For since that peccant humour is not exactly mingled with the blood but confusedly nature may easily seperate the same from the good blood and may shake it off each single fit which being discussed since putred vapours cannot any more be communicated to the heart the Fever also ceaseth and apurexie ensueth But because that as long as the Fever continueth some seeds and sparks are left in the granary and chimney Causes of the return of fits and seeing that there is imbecillity in the part 't is necessary that the humour flowing to it although it be good should be defiled with that pollution and excrement which was left as it were with leaven and through the debility of the part be corrupted and so new matter of a future Paroxism be generated And these fits continue and so often return until that those seeds that putrefaction and those sparks are fully taken away from thence and the weakness of that part restored Yet it seems probable that the whole matter which is the cause of a Fever doth not putrifie together in the first Paroxism but that part which is apt to putrefaction in the other fits the rest until the whole be putrified and consumed By these things it is manifest both where the matter that is the cause of putred Fevers is generated Cause of 〈◊〉 how it causeth a fit by what ways it is evacuated and
in different bodies naturally yet if there be great vehemency of manifest causes even in bodies of different constitutions they may produce the same humours and diseases depending on them As for the difference of intermitting Fevers Difference they proceed from the diversity of humours for there are so many sorts of intermitting Fevers as there are of humours by which they are produced for there are according to the vulgar opinion three sorts of excrementitious humours Choler Flegme and Melancholy and so three kinds of intermitting Fevers Bilious Pituitous and Melancholy which differences we usually call a Tertian intermittent a quotidian intermittent and a quartane intermittent And in case those humours are sincere pure Fevers are generated if they are mixed spurious And that Fever which proceeds from pure Choler is called a pure Tertian but that which ariseth from yellow Choler mixt with some other humour is called a Bastard Tertian But concerning a quotidian intermittent Of a quotidian whether any be the matter is not so plain For Fernelius accounts this the rarest of all other and scarce one of them happens amongst six hundred and that those intermittent Fevers which daylie afflict for the most part he rather accounts them double Tertians But Platerus flatly denies a Quotidian Fever and wholly agreeth with Galen 8. Meth. med cap. 5. where he appoints only a twofold crudity the one nitrous the other acid and they only seem to afford matter for two sorts of Fevers Cholerick and Melancholy For although Flegme also according to preheminency and most principally be called a crude humour yet since it is exceeding cold it can scarcely putrifie and excite a Fever But whether there are more circuits of Fevers Whether there are Quintan Fevers and whether besides Tertians Quartans and if there be any such thing as Quotidians there are also other Fevers which are extended beyond the fifth circuit is doubtful Galen saw no such Nevertheless Hypocrates and other Physitians observed Fevers which returned the fifth sixth seventh eighth ninth day But what the cause of this course is is very obscure Some seek the cause of such fits out of the diverse constitution of Choler and Melancholy and Andreas Caesalpinus Art Med. lib. 2. cap. 15. refers Quintans to Choler Septanes to Melancholy and determines such flower returns of Fits to be a kind of renewing of one or more simple accessions and the Quintan to be a kind of Tertian wherein the third day is without a paroxism and a Septan to be a sort of Quartan renewing the accession of the fourth day But most derive the reason of these circuits from the various mixture of Melancholy humours with others But although it be probable that all these Fevers as keeping longer periods proceed from a Melancholy humour yet a mixture of that humour seems not necessary Because no humour can be appointed to be mixed with a Melancholy which can be a cause of a slower period then it self for those humours both Cholerick and Melancholy are not alwaies of the same sort and moreover the corruption also which they suffer is not alwaies the same so that it is no wonder that the effect also varies which proceeding from them is not alwaies the same And as in epidemical diseases somtimes rare and wonderful corruptions of humours happen so in Intermittents that some such thing may likewise happen is not altogether absurd Intermitting Fevers are easily known Diagnostick signs for they come to Apurexie and at certain times and indeed as Galen 1. ad Glaucan cap. 5.2 de crisib cap. 3. 2. de diff Febr. cap. 3. teacheth they return with shaking horror or cold For although that somtimes Fevers do occur which seem intermittent and invade without any rigour trembling or cold yet really they are not such but only slow and obscure continued ones or in case they are really intermittent they are not pure whose Idea Galen propounds but spurious But these Fevers are less dangerous then continued Prognosticks and seldome unless the strength be decayed or in regard of age or some other cause or some errour committed in diet are mortal sithence it may be convenient during the apurexie to gather strength and administer necessary medicines Concerning the cure of these Fevers in general Indications and Cure Since their cause is collected and generated in the meseraick veins there putrifies and thence is diffused over all the body and at length is discussed by insensible transpiration or sweats But the cause of the recourse of the Fever as Galen teacheth 2. de Febr. cap. the last is a twofold vitious disposition in a body the one a certain pollution or putrifaction left after the former paroxisme the other imbecility of the member or part generating excrementitious humours what therefore is to be done in each sort of Fever easily appears from hence For sithence the beginning of generation and corruption of humours producing a Fever is in the first passages Purging we are to endeavour to purge out that peccant humour before it corrupts the rest of the blood and brings weakness and a vitious disposition to the parts but we must proceed warily in those evacuations since there is not the same reason of all intermitting Fevers For when that vitious and excrementious humour the cause of a Fever in the meseraicks is mixed with blood crudity also and concoction according to their manner are necessary whereby the vitious humours may be separated from the good and rendred fit for evacuation and that often happens in a short time in Fevers full of Choler and the cholerick humour is otherwise apt enough to motion But in a Quartan the humour is more stubborn and moreover according to Galen 1. ad Glau. cap. 11. no strong medicine is easily to be admitted at the beginning And Sudorifiques are not at all or altogether to be used Sweats unless evacuations have preceded for if many vitious and excrementitious humours do hitherto abide in the first ways it may easily come to pass that by reason of hydroticks untimely exhibited they may be detruded thence to the more noble parts and may become the cause of various and grievous evils and such as may bring more danger then the Fever it self As for breathing of a vein Letting blood 't is not indicated from the primary cause of intermitting Fevers which is generated in the meseraick veins where the greatest part abideth Yet because that somtimes blood also abounds which may easily be corrupted and polluted by the vitious humours and so if it be too plentiful cannot be well governed by nature when it is weakned by a Fever and in the progress of the disease from thence some of the peccant matter passeth into the vena cava and is mixed with the blood it is somtimes needful to open a vein which nevertheless is not to be appointed presently in the beginning before the evacuation of the primary passages If the Fever be not cured by
fourteen and somtimes to twenty But these Fevers are least dangerous amongst all the putred ones 4. Prognosticks Aphor. 43. and such as are pure do not long continue but at seven fits they are accounted at the height 4. Aphor. 59. Somtimes they are terminated at the third or fourth fit but spurious tertians as they are more frequent so they continue longer for although if the matter be little and necessary medicines are timely exhibited they somtimes cease at the fifth or seventh paroxism yet for the most part they scarce end at fourteen fits and are often lengthned out to the fortieth day somtimes they continue six moneths and end with some disease of the Liver or Spleen or else are also châ—rished by them Although Tertians for the most part are not dangerous yet somtimes they become pernitious First If any errour be committed by the sick or the Physitian Secondly If the humour which Nature endeavours to expel should fall upon any principal part Thirdly If the humour be exceeding thin putred or filthy Fourthly If a thin humour have a thick one mixed with it and stir the same and enflame it Fifthly If a thick humour poured out by heat either fall down into some principal part or cause a dangerous Catarrh or Asthma or the Gout or draw the womb into consent Sixthly If the humour acquire a malignant quality But in the cure of this Fever as also in others Indications and Cure regard must be had of the Fever the cause and nature of it the Fever indicates cooling and moistning things the same Choler also as being the cause requireth which also ought to be evacuated yet if another humour be mixed with it altering preparing and evacuating medicines which that humour requires are to be mixed and because the abundance of the matter is in the meseraick veins the vitious humour is to be purged out of them and if need be prepared before it infect the good blood afterwards also it is to be altered and the disposition of the part generating peccant humours to be corrected Lastly We must endeavour that the pollution and putrifaction may be discussed by Sudorifiques First therefore the first passages are to be cleansed Purgers either by Clysters or lenitive Medicines exhibited of the Syrup of Roses solutive Manna Cassia to which also we may add Rhubarb Agarick the leaves of Senna according as the quality of the peccant humour requires Vomits also convenient may be given especially if the sick be troubled with pain in the heart loathing and a desire to vomit And since the matter consists in the meseraick veins and that nature her self at the beginning of the paroxism strives to expel it either by vomit or stool the Physician ought to be observant to it and to eject the matter if Nature endeavour to expel it by stool or vomit and because the matter for the most part in the first passages is either more abundant or hath thick humours mixed therewith there is need not only of lenitives but those medicines also which we lately mentioned nay somtimes of some of the Electuary of Fleawort or Fleabane of the juice of Roses Rosati Mesuae Yet care must be taken that we do not draw the humours out of the veins into the first passages Concerning the opening of a vein Opening a vein although Choler residing in the meseraick veins do not require it yet if there be store of blood and the peccant humour out of the first region of the body have penetrated the vena cava which may be discerned by the thickness and redness of the Urine and if the party be strong a vein may be breathed and moreover note that not at the first invading but afterwards Phlebotomy is to be used Yet regard of the Fever is to be had for if it be a pure Tertian which useth to be shorter a vein is to be opened more timely if it be required because if it be referred till after the third fit the disease comes to its height but if it be a bastard tertian you may defer it till after the third paroxism namely because more of the morbifique matter is then mixed with the blood in the vena cava but blood is to be taken away in less quantity in a pure Tertian because as in continued Fevers that is not the primary indicant and the strength cannot bear the taking away of a greater quantity blood may be taken away more safely and in greater abundance in a spurious tertian But the opening of a vein is most conveniently appointed during the intermission Afterwards those medicines are to be exhibited which both correct the qualities of the cholerick humour exceeding Preparatives whereby it is troublesome to nature and also the vitious disposition in the part generating excrementitious humours and such as are contrary to that pollution which remains after putrefaction such are cooling and moistning things which together have a power of purging the first ways and of resisting putrifaction such are Cichory Sowthistle Endive Sorrel Barley the four great and four small cold seeds the juice of Citron or Limon and medicines prepared out of these Syrup of Sorrel Acetosa simplex Oxysauharum Syrup of Cichory Endive de acitocitate citri with waters and decoctions of the same to which in spurious tertians we may adde those things which are proper for Flegme and Melancholy the roots of Fennel grass asparogus asarabecca polypodie carduus benedictus centurie the lesser wormwood scolopendrium betony the spirit of vitriol and salt is profitable cream of Tartar Tartar vitriolated But amongst those medicines there are some which by a certain peculiar force are said to oppugne Tertians Specificks amongst which notwithstanding for the most part manifest causes may be rendred for it such are Sowthistle Camomil Century the lesser Plantane Divels bit Altering medicines being given Purgers if the Fever be more pertinacious somtimes purging and vomiting are convenient which for the most part are to be administred on the intermitting day but if it be advertised that the matter during the paroxism doth encline towards the stomack or tend downwards it is lawful even when the fit is present to administer vomits or a gentle purge yet so that before the beginning of the paroxism the operation may be past in case a purge be given Amongst the vomits Asarabecca and Broom are principally commended amongst the purges Rhubarb to those that are stronger the Electuary or Fleawort or Fleabane Elect. Rosatem Mesne and of the juice of Roses may be given in spurious Tertians Agarick or Senna may be added in whom it is also necessary to repeat preparatives and purgations The body being sufficiently purged Medicines causing of urine the remainder is to be taken away by Diureticks In a pure Tertian an Emulsion of the four great cold seeds is profitable made with the whey of Goats milk or the water of Barley Strawberries Cichory In a spurious a decoction of
Navel or to the Arm-pits that it may draw the venome to it The sweat being ended the body should be rubbed and dried with clean warm linnen clothes being careful that no cold ayr be admitted and the sheets and coverings of the beds should be changed After the sweat the sick should be nourished with meats that afford good juice and easie of concoction yet taken but in a small quantity When the sick hath sweat once if there be need of opening a vein let it be done in that manner as is already heretofore expressed And when the Alexipharmicks have been taken of two days by the sick and the body is Cacochymick or the Plague depend upon some internal default of humours and that great danger of a Fever be to be feared it will be convenient to administer a purge that some part of the matter putrifying and increasing the Fever may be abated so that Nature may overcome the rest more easily they should be gentle as Syrup of Roses solutive Tamarinds Rhubarb Agarick Pestilential Pills Tryphera Persica Syr. Diasercos Afterwards if it be not needful to cause sweat which nevertheless ought not to be hindred if it come on a critical day such medicines are to be continued as hinder putrifaction resist a malignant Fever and extinguish the flames in the bowels and humours And then we must be wary how we use Treacle or any of the other hot medicines without any respect of the disease nature age and other circumstances wherefore when the Fever hath set upon the body such things are not to be exhibited unless they are mixed with cold things or else cold things alone may be given such as Syrup acetos Citri of Sorrel Pomgranates red Gooseberries rubi Idaei as also Pearl Coral precious stones Bezoar But since that Nature for the most part useth to send the most venomous part of the matter to the out-parts of the body Cure of Buboes and occasions Buboes and Carbuncles If the venome perfectly or most part of it be driven out into a Bubo which may be known by the remission of the Fever and Symptomes we must expect ripening although not perfectly as in other tumors yet it must be helped by all means for if either a Bubo come not enough out or be encreased over-much and still the Fever and symptomes abate not and the sick no ways mends we must endeavour that a way may be opened for the letting out the venome Therefore either vesiccatories must be applyed or the skin must be scarrified that the poyson may freely expire and the pestilent humours fly out a young chicken also or pigeon the feathers about the rump being pull'd off should to the great advantage of the sick be applyed to it although no incision be made and that should be often repeated or a dryed Toad being moistned with wine should be applyed afterwards we must endeavour that the rest of the matter may be brought to maturity by proper medicines described every where up and down into the place opened by Incision convenient digestives should be put and if the incision be not made deep enough and the quitture be still therein detained the tumour must be opened with an Incision knife and the Ulcer mundifyed with proper medicines and it must not be healed up until all the venome be come out But Carbuncles are forthwith to be scarrified Cure of Carbuncles and that deep enough that the pestilent and corrupt humour may come forth afterwards some convenient plaister must be applyed such as may be of the soot of a chimney and others described up and down in Authors Some apply the plaister de Magnete Arsenicali 't is proper to apply a dryed Toad also being first powd'red in wine to the places adjacent lest the venome should return to the internal parts some defensitive of cooling drying and binding things must be applyed some make a circle with a Saphire stone about the Carbuncle lest the poyson should creep farther and thereby extinguish the same and if the Carbuncle be too much encreased and cause great pain a vein should be opened under the same that so the corrupt blood may be evacuated and to abate the heat a plaister of Houndstongue is to be applyed When an Escar shall be generated it must be taken away with a convenient Unguent and the Ulcer must be mundified and cured in due manner but during the whole time of the cure twice every seven days a potion of the temperate medicines that resist venome should be drunk lest any of the malignity should remain in the Body CHAP. VII Of the Nature of a Pestilent and Malignant Fever and of the difference of them from the Plague FOrasmuch as the highest degree of corruption of humours is in the Pestilence we must as it were ascend to it by the malignant and pestilent Fevers of them therefore we will now speak in what respect these three the Pestilence a pestilent and malignant Fever differ That the pestilence consists in a certain occult quality meerly adverse to mankind and that it is infectious The plague pestilent and malignant Fevers how they differ and that a Fever is not of the same essence therewith but yet commonly accompanies it is already shewed And therefore the Plague it self also when it hath a Fever joyned with it may not without cause in some measure be called a pestilential Fever yet other Fevers also are called pestilent without the plague wherein the corruption of humors hath not yet attained that high degree which may constitute the nature of venomous pestilence yet they contain in them somwhat like to that venomous and malignant pestilence and moreover either are not pernitious or contagious as the plague if they are both of them yet they are less destructive then the plague for the difference of a pestilential Fever so called in particular and of the venomous pestilence since the nature of them both is unknown betrays it self in this by the vehemency and contagiousness of it which is perceived to be less not only in sporadick Fevers but in epidemical pestilentials then in the plague it self But concerning malignant Fevers although they by a general name signifie truly pestilentials yet in particular those are called malignant wherein there is a less degree of corruption then in those that are truly pestilential and wherein the humours which kindle the Fever contain in them some occult quality tending to venenosity whence there is less destruction and infection somtimes there is none And that the matter may be handled in few words if it appear by the symptomes in any Fever that besides putrefaction there is a lso some occult and maligne quality and yet but few die thereof whether they are epidemical Fevers or sporadick or contagious or not contagious this is the first degree of corruption and such a Fever in particular is called malignant but in case many die and yet others are not infected or although there be some contagion and some
destruction and yet neither the contagion nor destructive power have attained to the highest degree and many continue well in health 't is a pestilent Fever in particular Lastly if so be many which begin to be visited die and that most every where are infected and that the contagion be spread over remote places 't is the plague CHAP. VIII To what kind of Fevers Pestilent and Malignant ones pertain MOreover since there are three kinds of Fevers To what kind of Fevers pestilent and malignant ones belong Ephemeral Putred and Hectick and again of putred Fevers there are some differences 't is now enquired to what kind of Fevers malignant and pestilent do belong or whether malignancy and pestilency belong to all Fevers or to some certain kind only But we have already determined that there are no Ephemeraes nor Hecticks pestilent and malignant because that in all pestilent and malignant Fevers there are manifest tokens of corruption or putrefaction of humours although that malignant and pestilent humour have likewise a manifest antipathy with the spirits and may stir up a dangerous Fever But all putred pestilential Fevers are continued since the force of the venomous putrifaction is such as that it can easily diffuse it self into all the veins and arteries and may easily corrupt the humours But malignant Fevers in particular so called may also be intermittent as experience sheweth Neither is it impossible that even in the first passages of the body the putrifying humours may acquire some malignity and seeing that in such Fevers the force of the venome is not so great nothing hinders but that Nature may appoint certain excretions at appointed periods Continued pestilent and malignant Fevers are particularly addicted to no sort of them but according as putrefaction happens into this or that sickly preparation so this or that continued Fever is stirred up somtimes a Synocha somtimes a periodick whence various symptomes likewise do arise according to the sickly provision Moreover concerning the differences of malignant and pestilential Fevers The differences of pestilent and malignant Fevers since that in every such Fever there are found two things the putrifaction it self from whence the Fever ariseth and malignity in respect of these also do the Fevers differ For somtimes equally from putrefaction and malignity danger is at hand which Fevers if the putrifaction and malignity be great are exceeding dangerous but if neither the malignancy nor putrefaction be much the Fevers are not dangerous Somtimes there is more putrifaction but the malignancy is not much and then the Fever comes neerer to the nature of other putred Fevers but somtimes the putrifaction is not much but the malignant quality vehement and such Fevers seem to be milde but they are most fraudulent and dangerous Concerning the nature of Pestilency and Malignity although it be occult yet from its effects we may apprehend a certain variety whilst somtimes spots somtimes Measles somtimes wheals come forth somtimes too great sweats somtimes Catarrhs Pleurisies and other evils according to the antipathy which the venome hath with this or that particular part CHAP. IX Of the causes of a Pestilent and Malignant Fever AS for the causes of these Fevers Cause because their malignancy is less then theirs of the pestilence and through this as it were by degrees we ascend to the Pestilence those which are the causes of the Plague for the most part are the same with those of malignant and pestilent Fevers but more mild as principally ayr heaven course of diet and contagion Namely malignant Fevers in the first place do arise from a sickly provision of the body for it ariseth from meat that is bad fit for corruption and very obnoxious to putrifaction whereof Galen may be seen in his book of Meats affording good and bad juice and the humours may be so corrupted in our bodies as that they become venomous of which I have spoken in the Institutions in the second book part 2. cap. 12. Furthermore from common causes likewise namely unprofitable constitution of Ayr as also from the influence of Stars But pestilent Fevers so called in particular have the same causes but more grievous which at length if they are increased produce the pestilence whence Fevers malignant and pestilent long continuing at length turn to the plague CHAP. X. Of the Signs of Malignant and Pestilent Fevers IN the same manenr is it about the Diagnostick signs The Dianostick signs of pestilent Fevers for in a pestilential Fever peculiarly so called the same signs almost appear as in the plague only fewer or more gentle and such Fevers are not so dangerous nor so infectious as the Plague it self But as to the signs of their differences if both malignity and putrifaction be very much the strength will be much weakned and grievous nay the most dangerous symptomes appear If the putrifaction be very great the malignancy little the feverish symptomes which accompany putrifaction are vehement enough but the strength is not so much debilitated But if the putrifaction be not great but the malignant quality vehement the symptomes which accompany the Fever are gentle enough but the strength is exceedingly weakned If the humours only are affected there appear Buboes Carbuncles Imposthumes Spots Pushes and other tokens of putred Fevers if the spirits are much infected these signes are wanting neither is the heat great the strength suddenly languisheth and the sick are troubled with faintings the pulses are unequal weak and languishing and the Fever it self in one two or three days space is terminated by health or death Lastly if the heart be much infected great defect of the strength is present and the sick do not complain of any great heat As concerning Malignant Fevers Of malignant they are very difficult to be known at the first because the malignity often lies hid and shews not it self unless when it take strength wherefore all signs are diligently to be weighed and if any thing be suspected it must be seriously pondered but all the signs of a malignant Fever are greater then those of a Fever and the symptomes which appear are more vehement then those which can proceed from a Fever namely weakness of strength unquietness more anxiety then the feverish heat would occasion the pulse is freqnent little weak or if it seem to be natural other evil symptomes are present the Urine somtimes is like unto those who are in health somtimes thin and crude having in it no sediment or in case it have any 't is more like an excrement then a sediment somtimes 't is thick discoloured troubled muddy having a red and troubled sediment the heat is more milde then the nature of the disease and symptomes seem to afford the face or countenance is much changed from its lively and natural state and therefore by these signs pestilent and malignant fevers may be easily known yet there are other things happen heaviness to sleep watchings diliriums pains of the head
as in Poxes and these spots in these Fevers appear principally in the back arms legs and breasts namely in places through which the most eminent veins and arteries do pass but in the face they do seldom appear because it is alwaies obvious to the external Ayr. These spots have their original from the thinner parts of the putred and corrupt humour The cause whence they suddenly come out and vanish but although they are made by the expulsive faculty driving this part of the corrupt humour to the extremities of the body yet that seldom happens critically because they come out for the most part at the beginning the matter being not as yet concocted neither is there any notable evacuation of the matter made by them nor the sick are not the better for them but for the most part by how much the more plentifully they come forth by so much the greater store of corrupt matter is indicated which notwithstanding as is said already is not sufficiently evacuated by those spots There are of those spots several differences for first Difference they differ in colour some are red arising from the more temperate blood putrified others yellow green when choler is putrified others Pomgranet colour and black when melancholy putrifieth Moreover they differ in quantity for some come out more plentifully others more sparingly some are greater others less according to the quantity and thickness of the humour and strength or weakness of nature some come out at the beginning others in the progress of the disease This Fever is known by the signs of Malignant Fevers in general already set down and when the spots joyn together Diagnostick signs they shew malignity more plainly But what event of these Fevers may be hoped for is manifest by the prognosticks of malignant Fevers in general Prognosticks Concerning the spots themselves although it be good that the peccant matter be carried to the extremities of the body yet by these spots they cannot sufficiently be evacuated therefore although if they are plentiful they shew that store of matter is present yet they shake it not of and therefore they portend danger rather then health Neither is their paucity always good and although it signifie no store of matter yet it also denotes debility of nature These spots if they lie hidden are evil signs because they shew that the matter which before was coming to the outside of the body does now tend inwards and go to the head heart or some internal part Red spots are most safe yellow and green worse and pomgranate colour and black most dangerous Although such as come out at the first appear symptomaâ—â—cal yet those that break forth the seventh day or thereabouts are critical yet unless other good signs are present put no confidence in them because they do not sufficiently evacuate the matter but if they come out slowly 't is evil for that happens either by reason of the thickness of the matter into which if the malignity fall 't is not easily overcome or else by reason of density of the skin which hindreth free transpiration Lastly concerning the cure Cure those things that are spoken about the cure of malignant Fevers are here also convenient namely the belly is to be loosned either by Clister or lenitive medicine or if the matter tend upward and the sick be inclinable to vomit a Vomit must be given Then if occasion require Bleeding a vein is to be opened before the fourth day or else afterwards to be omitted but whether the spots now coming forth do hinder the breathing of a vein is shewed in the Institutions lib. 5. part 2. sect 1. cap. 17. But since nature it self strives to protrude the matter we see to the extremities of the body and 't is profitable in all malignant diseases to drive out the matter from the greater to the lesser vessels and to free the bowels from vitious humours the endeavours of nature is here to be assisted Sweats and the matter tending to the outmost parts of the body is by it to be evacuated because that otherwise that which is malignant will admit of no concoction Therefore let the sick be kept in a place moderately hot and forthwith some Sudorifique medicine and which also may resist malignity given such as are before propounded for the plague and malignant Fevers in general and for the Measles and small Pox yet those are to be selected amongst them that may not increase the feverish heat and the Fever and the malignity are to be weighed together and of that which most requires it regard must be taken Somtimes a looseness happens in this Fever When a looseness comes what must be done which unless it be too great should not be stopped but the business should be committed to nature and in the interim only with altering medicines and such as resist malignity the morbifique cause must be resisted Afterwards to fortifie nature Pearls Coral Hartshorn juice of Pomgranates Citron Confectio de Hyacintho Alkermes and such like are to be exhibited Externally likewise medicines are to be applied to the region of the heart and to the pulses Topical medicines which draw venome from the heart and resist malignity and some use an unction ex Hydraeolo and niter to relax the skin and draw out humours Neither is it unprofitable to apply vesiccatories to the arms Vesiccatories especially if the external parts are cold and the internal burn and that pains in the head deliriums a lethargy and other symptomes in the head are present for so both the humours are called from within outwards and are likewise refelled from the head CHAP. XIV Of the English Sweat THere was a kind of Fever malignant The English sweat which began in England in the year 1486. and thence it took the name of the English Sweat and it reigned there about forty years and killed almost an infinite number of Englishmen Hence being spread through the Netherlands Germany the Low Countries Holland Zeland Brabant in Belgia Flanders Dane Norway France it continued until the year 1530. The same Fever was accompanied with Sweats and was called the Sudatory Fever for those which were troubled with this Fever abounded with Sweat without Bubo Carbuncle or puttings forth the sweat perpetually and in great abundance coming out until the dissolution of the disease which hapned within twenty four hours space Together the sick languished deficient in mind with unquietness troubled at heart pain in the head and also with palpitation of the heart and they had a pulse thick frequent swift and unequal and the palpitation of the heart accompanied those that escaped oftentimes some years somtimes till death But the cause of this disease was inherent in the most subtile parts of the blood and spirits The cause which were together affected which the shortness of the disease argues and without doubt the blood and spirits contracted this malignity from