be that kind of Plurisie which we called peculiarly the Pleurisie of the girding Membrane In which if there be great Inflammation there must be pain increased from the pressing the breast and it wil extend it self outwarly because the Inflammation cannot be conteined in the thin Membrane or Periostia but must reach to the muscles joyned thereunto and so may be felt outwardly because the Breast is not so thick as we have known in the Inflammation of the Peritonaeum And in this kind If the Inflamation suppurate the Imposthume wil rather be outwaad then inward and there open But if it break inwardly the matter gets into the cavity of the Breast rather then into the Lungs because it cannot be carried so quickly unto them and pierce through them But as these Arguments prove that this may be so so it is probable that if the girding Membrane be ininflamed together with the Lungs and from them that that Inflammation in the Membrane wil be discussed rather then suppurated because the great quantity of Blood in the Lungs at that time cannot easily be in so thin a Membrane or if it could be it would rather be carried outward as we shewed and fil those muscles and there come to suppuration And hence it is that after a true Pleurisie though the girding Membrane be also inflamed and nothing appear outward yet an Empyema seldome followeth And this is like to be also when the dividing or intercepting Membrane is inflamed with the Lungs in which as being a different disease especially when the Inflammation reacheth to the Capsula of the Heart and Diaphragma there are grevious symptomes that seize upon the mind and endanger the life These Inflammations both in a Peripneumony and true Pleurisie being in any part of the Lungs or elswhere come from Blood with which the Lungs abounding by reason of the many great vessels and being hotter by reason of the Arteries and the nearness of the Heart it is easily inflamed And the Inflammations of the Lungs are more usual then of any other part This Inflammation comes from Blood as others when it is got into the substance of the Lungs out of its vessels which are the Arterial Veins and Venal Arterie and not into the branches of the rough Arterie for otherwise there would be a spitting of Blood this Blood therefore fils the Lungs and lifts them up causeth Heaviness and Compression and streightness of the Breast and inflames the Heart more that before commonly had a Feaver And by the Cough which it causeth when it is sent into the branches of the rough Arterie it makes the Spittle sometimes mattery and after bloody at length this Blood being ripened and concocted or suppurated is coughed up til it be all spent The substance of the Lungs being unhurt for if they be ulcerated a Phthisis would follow As we have seen often Blood alone and other humors turnd into Matter the substance of the part not being suppurated or ulcerated both in the eyes and other parts and in other Excretions made from the Lungs by other means Also it may chance that from Inflammation of the Lungs the Blood may fall upon the near side upon the girding Membrane and inflame it but not usualy because the Vessels are smal and few and the vein to which the fault is laid called Azygos is only on the right side and the Pleurisie is often on the left As from the Inflammation of the Lungs in a true Pleurisie when the sides are attracted and the girding Membrane pulled aside there may be a pricking Hence it is that Pleurisies are more usual then the peripneumonyes because the inside only of the Lungs are not so often inflamed as it is in a peripneumony but the Inflammation reacheth outward to the side adjacent in which the pricking is greater when they ly upon the sound side and the Lungs hang down being Inflamed and with their weight draw the girding Membrane then there is more pain then when they ly on the sick side and the pain is greater if the Membrane be Inflamed Upon which if so much Blood fall from other causes and inflame it the Lungs being sound there wil be another Pleurisie differing from the true as we shewed in which there is no such Spittle All these accidents in the divers kinds of pleurisies are also in a peripneumony which sometimes begins of it self and sometimes followes a pleurisie when the Matter is gathered inwardly and because the Heart is then more inflamed they cause a more sharp Feaver by which the Blood being heated also in the superior parts of the Body there is a redness in the Face and Cheeks This is counted the peculiar signe of this disease and it may be more observed to be in Peripneumony then Pleurisie and because this disease is more usual in old people if their Cheeks be red it is looked upon as a strange thing According to the variety of the Blood these inflammations of the Lungs are divers for if it be pure such as is in the veinous Artery it wil be a simple Phlegmon in which Spittle is mixed with pure Blood If the Blood be too thin or hot as in the arterial Vein there wil be a phlegmon with Erysepelas in which the Feaver is greater as it is if the Blood cause an Inflammation which is mixed with pure Choler and then the Spittle is bloody and yellowish Because this is usual it caused some to write that Peripneumony comes from an Erysipelas of the Lungs Also if melancholy be mixed with the Blood causing the phlegmon there is blackness with the bloody Spittle And if Choller joyned with Blood be the cause of this Inflammation then there is a Pleurisie or tertian Feaver as I have often observed Oftentimes also without these Diseases there is a discolouring of the Spittle and it is not bloody but yellowish greenish blackish from cholerick humors when the Blood is any otherwayes impure and mixed with vitious humors it causeth an impure phlegmon But if a phlegmon comes from a crude and waterish Blood it wil be an OEdema with gentler accidents and the Spittle less discoloured as in the Peripneumony called therefore crude Also from this diversity of Blood If the Inflammation be in the girding Membrane the Symptomes wil be greater or less Because no phlegmon comes from any other humor seperated from the Blood we cannot make the Defluxion of Flegm or other humor upon the Lungs or the gathering of it there to be the cause of a true Pleurisie or Peripneumony as some doe and call it flegmatick for if these humors are in the lungs they wil cause other Diseases that hinder breathing as we shewed in defect of breathing and if they fall upon the Muscles of the breast or upon the girding Membrane they will cause a false Pleurisie as I shewed The cause of this flux of Blood that causeth a phlegmon is often a Synoch Feaver which from the Blood inflamed in the Veins sendeth a
with a plentiful Diarrhaea The Method of Cure for both is The Cure of a true Pleurisis and Peripneumony to divert the Blood that flows to this noble part so to prepare that which is flown to the Lungs and inflames them that it may be coughed and spet forth because except Nature do it of her self it is in vain to purge it by Urin or Stool Also still abate the pain in the Pleurisie which is very pricking and in both cases inlarge the Breast and hold up the strength alwaies having an eye to to the Fever as we shewed in Fevers therefore abstain from hot things and use temperate things that incline rather to cold all which are done as followeth The Defluxion of Blood to the part is diverted best by Blood-letting and the heat of the Fever abated therefore neglect it not though the Patient be very young for we observe that in other cases and bleedings by cuts and falls they can loose much blood without danger and in this Disease they wil find much ease by it nor let it be omitted in women with Child or old People nor when the Disease comes from impure and cholerick blood nor when the pain goes down to the Hypochondria But for these causes do it moderately rather than omit it Blood-letting must be suddenly while the matter is flowing the first day at what time of day or night soever it be or if it hath been neglected do it the next or the third day taking much at a time or six ounces at a time often if the first bleeding do not abate the Disease bleed then thrice a day or two or three daies together after the third or fourth day except you fear the increase of the Discase or a Relapse from a new Flux of Blood for which cause after many daies if there be strength you may bleed again you must not bleed rashly You must open a Vein in the Arm because the Veins are larger and neerer the part either the middle Vein or that which most appeareth which is alwaies best And what vein soever in the Arm is opened whether it be on the right or left side the blood comes from the hollow Vein from whose upper part above the heart the veins of the Arm come and therfore by consequence blood is drawn from the right side of the Heart into which the hollow Vein is joyned before it ascendeth and so also blood is drawn from the Lungs by the veiny Artery by which the blood flows from the right side of the Heart to the Lungs Except because the hollow vein is more on the right side and sends blood into the right side of the Heart and only sends out the vein without equal or not paired to the right side only you desire to open the Vein in the right Arm for a directer way of bleeding which some think to be necessary in a Peripneumony and Pleurisie Yet in a Pleurisie it is thought better to open a vein on that side that is pained than on the contrary side as the Arabians do who first open the contrary Arm for Revulsion and then for Derivation not only from the right order and direct flowing of the Vessels on that side because the same may be good in a Pleurisie as wel as a Peripneumony the Lungs being as I shewed affected in both but because in a Pleurisie the veins on that side where the pain is are more swollen with blood Therefore if the pain be on the right side open the Vein in the right Arm if on the left open the vein in the left Arm by reason of the Defluxion of blood caused through pain And if the Vein in the Arm appear not open that in the Hand on the same side by which if the blood come freely there will be a greater Revulsion and if not a less Also it is good to bleed in the Foot or by the Fingers after bleeding in the Arm especially in Women who have this disease from stopping of the terms Cupping-glasses to the Shoulders Emunctuaries and Groyns make Revulsion and the more if there be Scarification these help the other bleeding or supply when the other cannot be Also Frictions and Ligatures of the outward parts cause Diversion or a Decoction to wash and rub the Hands and Feet but it must be such as doth not heat Some adventure to use a Caustick to the sids but it is neither safe nor profitable nor Cupping-glalsses to the Breast Clysters are given to loosen the Belly before bleeding if it be bound they are to be cooling and gentle such as are mentioned in Fevers and other internal Inflammations and Quninsie And some advise clensing Clysters at the end of the Disease if the matter tend from the Breast to the Guts lest it should hurt them which they think to be possible Loosners are better than purgers for it is not convenient in Inflammations of the Breast to give purgers both because the matter cannot be purged by stool from thence as also because they heat the body and cause a Diarrhaea which useth easily to come with much hurt to the patient These Laxatives must be good for the Breast whereof Manna is the chief Next syrup of Violets three ounces or Cassia or simple Diaprunes two ounces alone or with pectoral Decoction Or thus Take sweet prunes Raisons stoned each an ounce Violets a pugil boyl and dissolve Cassia half an ounce Manna an ounce make a potion After the seventh day the Ancients used stronger purges the humor being first prepared but these are best in a false pleurisie as I shewed or if the true pleurisie ceaseth they are good against accidents that remain otherwise they hurt more We give to drink things that cause easie Coughing and Spitting because the Humor being fastned to the Lungs and not to the Membranes girding them can-cannot be sent a better way This is done by Lenitives to the parts and such as first thicken the Matter to stop the Flux of Blood if it be thin and to make it more fit to be spit forth and then by Concocters Clensers and Cutters if it be too thick and slimy Or by things to ripen and cause matter to be spet forth lest it lying long there the Lungs be corrupted by it and a phthisis caused Or if Nature endeavors to throw it out by stool or Urin which is rare and perhaps a meer Fansie by such things as help Nature therein These are done as followeth Lohochs to be swallowed by degrees and so communicate their Vertue better to the Lungs are the best As the usual tablets of Diatragacanth frigid and Dia penidies without the species held in the Mouth Or a Lohoch made of them with syrup of Jujubes or Violets to be licked Or this Take the species of Diatragacanth frigid two drams Penidies a dram with the Syrup aforsaid make a Lohoch adding half an ounce of the Diacodium if the Cough be great others add Conesrve of Violets but it is
in the Palpitation thereof or Oyl of Jesemin or Oyntment of water Lillies or Citrine Oyntment Or Take Oyl of water Lillies two ounces juyce of Citrons and Vinegar of Roses of each half an ounce boyl them to a Consistence add of all the Saunders Roses and Sorrel seed of each one scruple Coral one dram Pearl half a dram Camphire half a scruple with Wax make an Oyntment Or apply this Emplaister Take Treacle one dram and an half the Cerot of Sanders half a dram the species of Diamoscbu and Diambra of each half a scruple A Cordial Bag. Take of all the Saunders each one dram dryed Citron peels the four cordial flowers of Scabious and Leaves of Balm each half a dram Ivory or the Bone of a Stags heart two scruples Species Diamoschum one dram make a little Bag sprinkle it with Wine and Rose-water or Fume it therewith apply it to the heart It is good to raise them to sprinkle Water and Rose-water and Vinegar and Wine upon the Face Also to bind the Limbs and rub them very hard Also to stop the Nose and pul it and open the mouth and rub the Tongue They are soonest raised with great Noise and Neesing And to place them with the Head down and the body high Let them be quiet after the Fit for weak people faint upon the least motion CHAP. XI Of the Depravation of Vital Motion The Kinds IF the Vital Motion be Depraved which may be seen as I shewed in the Voluntary and Involuntary Functions of the parts Heart and Arteries we do not observe it as in the defect for none can live too much and the body and its parts cannot be too strong And if any parts that move voluntarily move too much or wrong that belongs to the depraved voluntary motion of which we have spoken We observe Depravation of Vital Motion in the pulse of the Heart and Arteries when it is oftener or more vehement than it ought to be by nature or proceeds otherwise disorderly Oftentimes the pulse of the Heart and Arteries is more frequent than is fit The quick beating of the Heart and Arteries whether great or smal both in sound and sick the breathing being also quick and if this pulse be great also it is with pain in the Breast Neck Head Ears It is to be felt in those parts and by Physitians at the Wrists Vehement and immoderate pulsation or beating of the Heart and Arteries Heart-beating is a symptom often by it self or in cathectick Maids before they have their Terms or such as have the Hypochondriack Melancholy This is called palpitation or trembling of the Heart because the motion is unequal And being alwaies strong it is perceived plainly in the left side of the Breast often in the Neck somtimes under the Ribs especially on the left side it is very troublesom and weakneth him much if it continue Sometimes it forceth the Ribs and as Fernelius saith puts them out of their place Aneurisma Sometimes it so dilateth the Artery and drives it out that it causeth the Tumor called Aneurisma which is great and beating This Symptom somtimes remitteth and comes again sooner or later and it continueth longer or shorter time as we said I observed a grievous and wonderful palpitation of the Heart in the yeer 1627. in a noble Virgin of Narbo in France who was alwaies held in her fit by two strong men that bare down the left side of her Breast with her hands til it ceased otherwise shee complained that her Breast and Ribs would break An Inordinate and uneven Pulse causeth trouble An uneven Pulse but that which beats low is considered not as a Symptom but only a sign shewing the Disease and the strength And therefore Physitians feel it The Causes It is most certain that the Heart and Arteries cause this depraved palpitation by their motion because no other parts do beat When these beat moderately sound people ought not to perceive it least the noise should be a hinderance as it is when they beat vehemently especially where the Arteries are great and many and free not sunk into the Muscles as in the left side not only by reason of the left Ventricle of the Heart and the Ear that moveth it self there but by the great Artery that comes from the left side of the Heart and descendeth by the left side of the Vertebrae Also in both fides of the Throat which the great Artery ascending goerh through being divided and there produceth the sleeping Arteries and those of the Arms Also under the Ribs especially or the left side because the great Artery descending thither lieth chiefly on the left side As also because it produceth great Arteries which accompany the branches of the Gate-vein on the right side especially those that go to the natural bowels and the Spleen For which causes when the Arteries beat much the putefaction is perceived on that side and is troublesome In other places where the Arteries are less or hidden though they beat stronger yet are they not perceived except it be by the pain of the part adjoyning which is troubled at the least touch of an Artery As in pains of the Head by reason of the great Ventricles of the brain beating and in Inslammations Or when a little Artery beating too violently in a strait place and hurts a Nerve as in the Ears wherein we may hear the pulsation But in naked parts without flesh you may touch a pulse and judg whether it be natural or depraved especially in the Wrist The truest causes of the great beating of the Heart and Arteries is the dissipation of vital spirits and the repletion and dilatation of the Arteries among which there are others less probable If the influent vital spirits be suddenly or too much dissipated so that the innate spirits cannot enjoy them sufficiently because it is necessary that new be alwaies sent from the Heart to the whole body which must be done by the pulsation of the Heart and Arteries It is therefore no wonder if their motion be enlarged and more quick and if the cause be great more vehement with great breathing which as is said brings matter to make vital spirits And this may come also from the spirits stirred with the blood the Heart and Arteries being inflamed When the spirits are suddenly tossed hither and thither The too great stirring of the spirits is the cause of quick great pulsation of the Arteries and dispersed and not equally communicated to the body the Heart and Arteries beat quick for new and the respiration is greater or otherwise strength would fail This comes from the motion of the body and mind as we shewed in quick respiration which comes from thence Hence is it that the pulsation increaseth by the passions of the mind as anger Joy Terror Fear Shame the spirits being moved which Erasistratus knew when from the sudden motion of the pulse from the beholding of the Nurse that
was beloved he discovered a Disease to be from the mind that is Love This Palpitation of the Heart is sooner in weak people and such as are disposed to it Stirring of the Spirits causeth palpitation of Heart in them that are subject thereto the least exercise wil cause it in some One confessed to me that he had it presently in the act of Venery and was so troubled therewith that except he gave over he should be stifled as it fel out afterwards This pulsation also is greater when the spirits are dissipated from other causes as at the point of Death when they are vanished though there be great weakness by which nature labors to assist them in the greatest danger by this motion and recollection of Spirits When the Spirits grow hot with the blood Over-heating of the Spirits is the cause of quick and great pulsation there is great motion of the Heart and Arteries not so much because the spirits are hot and unquiet but because they then are sooner spent that what is suddenly lost may be suddenly repaired Whether it come from the external causes as the Fire or Fume or from internal and the rather if the Heart grow hot and continue so as in a Feaver Or if the heat come from motion of the body or exercise in heat Or when the mind is so affected that not only the Spirits are troubled but set on fire thereby as in anger Or when all these concur As we knew a Noble man that playing at Tennis was so hot and angry and so moved in the Pulsation and Respiration that he could not recollect himself nor could the motion cease but he died suddenly When the Arteries are too full of blood and too much dilated thereby in regard they ought not to be filled as the Veins are that there may be room for the Vital spirits the Pulsation which before was not perceived when moderate is felt by the Patient and that vehement Diastole about the Heart and great Arteries mentioned in the Palpitation of the Heart is raised Especially when the blood floweth to the left Ventricle of the Heart and to its Ear which may be much enlarged to the great Artery whereby they are too full and extended And it ceaseth when it flows from those parts and doth not more lift them up and dilate them Or it molesteth continually if an Artery be so dilated as Fernelius observed Yea that the great Tumor called Aneurisma doth follow And if this Aneurisma be within in any part of the great Artery or in the breast Throat under the Ribs or in the Ear of the Heart which wil be very much stretched it causeth a perpetual Pulsation as an external Aneurism and is the cause of that Palpitation of Heart which lasteth so long and kils so many as some have observed in Anatomy It is plain that this Palpitation comes from plenty of Arterial blood Plenty and heat of Arterial blood that fils the Arteries causeth palpitation of Heart because the Arteries have nothing else in them And Galen seems to grant it when he saies all such are cured or eased by bleeding And this pulsation is greater by how much the blood and the spirits mixed therewith which fill the Arteries are the hotter Fernelius witnesseth that he saw such blood in the Arteries burnt like black choller And we prove that that cholerick hot blood is gathered in the Mesaraick Arteries and and sent to the great Arteries by these Arguments Because as such juyce as is frequently bred in the mesaraick Veins from meat and drink doth inflame pollute the blood being carried from the branches of the Gate-vein to the hollow vein so doth it get into the mesaraick Arteries which are joyned to those Veins and so into the greater Arteries and so to the Heart and so filleth them and doth what is mentioned And the rather because these mesaraick Arteries are branches of the great Artery but the meseraick Veins come not from the hollow Vein nor are joyned to it but by the substance of the hinder Hence is this Disease so usual in Virgins from the stoppage of their Courses which begets an evil habit and in those that have Hypochondriack Melancholy In which as the fulness and foulness of the Venal and Arterial blood causeth Cachexy and Melancholy so do they cause palpitation of the Heart and Arteries Some say this may be from Wind filling the Arteries which we cannot allow because none hath observed that the Veins can be filled therewith Nor do we grant that vapors gathered about the Midriff Spleen or Womb and so sent into the Arteries and Heart or a thick vapor shut into the Heart that came from another place as some have written can so fill it that they may cause this Pulsation As for other causes of palpitation of which they write especially wind or water in the Pericardium we count them not the true cause of Palpitation but of some fluctuation when the body is moved as may appear by the noise in the breast as we shal shew in preternatural Swoons in the body Other Diseases of the Heart besides these mentioned may cause it to move inordinately and quicker as heat that moves the Spirits and disperseth them and too great Repletion by the blood of the Arteries Such are those that so offend the Heart it moveth violently to cast them off rather by a natural sensation than by feeling which the Heart wanteth A Venemous quality from within or without A malign quality stirs up the Heart to palpitation doth cause palpitation or any malignity in the arterial blood which fils the Arteries causeth the same by stretching them and by troubling the Heart I understood that one who died of a continual Trembling of the Heart had a Bone or Gristle found in his Heart The Cure That Palpitation which comes from vehement motion of mind or body The Cure when it comes from vehement motion or Heat ceaseth when they cease as we shewed in Short-breathing which is joyned therewith But when many causes concur it is dangerous as we shewed When it comes from plenty of blood it is dangerous and lasting Cure of Palpitation of heart and troublesom by continual motion but wasting of the Spirits many have dyed hereof others have long been troubled therewith many have been cured by removing the cause And because the Cause is commonly about the Meseraick Vessels which are distributed in the natural parts and there is the plethory and filth it is cured as Cachexy Cachochymie and Hypochondriack Melancholly which are usualy joyned therewith By preventing too great increase of Blood Humors and Wind and such humors as chiefly abound by purging of Choler and strengthening the natural parts and mixing Cordials with all things And in regard it is hard to evacuate the conjunct cause in the Artesies and Heart we must strengthen them with Cordials Thus. Letting of blood except some thing hinder is good according to Galen
either the third or fourth day as in double Tertians and triple quartans A double Tertian Triple Quartan Double Quartan but if it be a double quartan the fit is two daies and the intermission one If a Tertian meet with a quartan the fit is three daies together and the intermission one day if it return the same day it is not a new sort but when quotidians come sooner one may come when another departeth And if the later feaver that it fal in with the former in the time of the fit then the fit is longer and may continue eight or ten hours but it is two fits of two Agues the one begins with a new chilness at the end of the other Some return the fifth or sixth day A Quintan or Sextan Feaver but they are but quartans which staied longer away than usually There are divers accidents of intermitting feavers which are troublesome as cold heat thirst Head-ach and change of Excrements Intermitting feavers not only begin but return with a cold fit first as the continual do with yawning shivering and coldness of Hands feet Nose and Ears first then shaking the Germans therefore call it Kaltwee or Frierer from the cold This is greater or less An Ague in High-dutch called Kaltwee or Frierer according as the Ague is Somtimes the body is very cold and the chilness come sooner in a Tertian slower in a quartan the Body shaketh the teeth gnash Both begin somtimes with less cold but then they last longer somtimes the cold is felt inwardly and outwardly also somtimes more within or without And when every part feels cold with heat it is called Epiala But we suppose that this is because intermitting feavers meet in the same day and the cold of one begins before the heat of the other is past Or when intermitting feavers meet with continual as we shewed Semitertians for in the continual there is alwaies heat and when the intermitting comes it begins with cold The heat which follows the cold and shaking or mixeth with it in most vehement Tertians presently kindled dispersed through the body sharp quickly at the highth and quickly declining In others it is gentler nor so general in the whol body but like the burning of green wood as in tertians that have lasted long It is also vehement in quartans but not equal over the body but with mixture of cold and as it were pain of the joynts and bones Thirst is the greatest Symptom in tertians and quartans they call for drink as for life And somtimes in the cold fit especially when the cold is outward and the heat inward they desire drink Somtimes there is Head-ach at first but it ceaseth before the end The change of Functions is seen chiefly in these They somtimes dote in the time of the fit they are unruly and tost when the heat is at the highth And they cannot sleep somtimes Somtimes they sleep too much as in Children They draw much breath the Puls at the first is smal afterwards quick and often and great and more or less uneven There is weakness except the strength be renewed in the time of intermission There is in some a swounding from whence it is denominated A swounding feaver is a sort of intermitting Feaver At the end of the cold fit there are often bitter Vomitings Also after every fit there is plenty of vaporing and hot sweat by which they decrease and by which they are judged Somtimes they void much Urin often and have somtimes the Haemorrhoids or Courses There is alteration of Excrements to be seen by the Urin which is of a yellow or flame color and substance and in Tertians ptesently or in quartans at a little distance they turn white and waterish at first Also a black Urin is not alwaies bad in a quartane if the matter of the disease be thereby purged The stools are cholerick and yellow somtimes black The Causes The first Cause of all Feavers is a Disease A hot distemper is the cause of all Feavers which is an hot distemper or preternatural heat making all the body hotter than it should be The heat which disturbeth the Patient is a symptom First we shal consider the place then the essence of this heat whether it be a Disease or a Symptom The place affected is not one but all parts of the body In all Feavers the whol body is the seat of the hot distemper not only the fleshy parts which are sooner inflamed but the Membranes and bony parts take this preternatural heat The heart grows first hot and then all other parts more or less begin to burn by consent as they are by nature hotter or colder But this is not a Feaver except the heart be also inflamed though the whol body burn with the blood spirits and other principal parts as the Brain Liver and the like Nor can the heat of the heart cause a Feaver if it be little or if it be short though vehement such as comes by Anger or Motion except it be fixed The essence of this preternatural heat in Feavers 〈◊〉 not the same in all and the difference thereof makes different Feavers For this heat is either adventitious and mutable which is called a fiery heat and that is either pure and single which inflameth only the body and causeth pure or not putrid Feavers Or impure and mixed with putrefaction infecting the body and making putrid or impure Feavers Or it is malignant and putrid together or alone and infecteth causing malignant putrid pestilent and venemous feavers Or this heat is fixed and constant or a change of the temper of body into a more hot hence come those called Hecticks How these come whether of pure heat or filthy shal be shewed in these three causes A pure simple heat when it only is a little increased A pure heat is the cause of pure or not putrid Feavers first in the Spirits and Blood Veins and Arteries and so sent to the Heart and fixed to the matter that nourisheth it and so communicated to all parts causeth pure simple and continual feavers when the heat being once kindled goeth not out till it be quenced These are either solitary or without any other disease in their course or accompanied with another disease that went afore or cometh after The cause of this variety is when the cause of the disease is either in the vessels or out of them If Blood is kindled or inflamed in the vessels that is Heat of blood and spirits coming to the heart is thecause of pure continual Feavers Heat remaining in the vessels causeth solitary Feavers in the Veins and Arteries and so the heart set on fire and a feaver produced and it continue to the end without moving into other parts then the feavers are called Solitary or accompanied or symptomatical as they come from or not from the disease If no Disease cause these Feavers but the blood is inflamed in the Vessels then they
into the Joynts and then they are red and swollen except the tumor lie very low So that such as are inclined to the Gout being easily taken with this Feaver Nature being used to disburden her self into the outward parts joynts or skin are subject to these Diseases Also albeit these feavers go before Defluxions or Catarrhs and promote them yet because they do it not by affording matter to them but by moving the flux with their heat they are not differing from solitary feavers though they may also be joyned with other diseases Nature doth often discharge blood into the superficies of the body Inflamed blood in a Feaver sent to the superficies of the body is the cause of Synoch with a Botch Erysipelas smal Pox Measles or Carbuncle the Skin especially Glandules and internal Membranes in these Synochs and cause there Redness Heat Tumors or Pustles sooner or later and as the blood is Pure Thin Thick Yellow Black or Waterish or impute yet not putrid as we shall shew the Tumor and Heat and Pain are different This Difference is chiesly in respect of Tumors and Pustles These Feavers often produce Tumors or Redness called Carbuncles These are so usual to some Natures by reason of the Heat Thinness and Waterishness of the blood or Impurity that they have them upon the least occasion at certain times if the blood be but a little inflamed nor do they spare old or gouty people They are diary as we shewed and a Tumor follows them seldom the same day but two or three daies after either in the Glandules of the great Veins in the Groyns Arm-pits and Chine if blood go along with them And these are with pain and sometimes with inflammation The blood often falling into the lowest parts of the Legs there is often an itching and then a burning in the Ankles and after a redness with Yellow or Black as the blood is in thickness if it be an Erysipelas Somtimes it swels and is inflamed if it be an Erysipelas with a Flegmon when better blood flows thither and if the blood bewaterish the whol Leg swels with an oedematous Erysipelas These have a Bubo or swelling in the Groyn going before them the feaver commonly abates at their coming forth so that former Writers were deceived that thought the feavers began with them and were symptoms to them which are the contrary for the feavers appeared before there was sign of inflammations And if the Glandules only swel there is no great heat and it cannot be from a feaver The smal Pox though it be usual in malignant feavers are somtimes in pure feavers And the Measles in Infants by reason of the fulness of blood or disposition to be inflamed they come forth the third or fourth day but in a pure feaver they are not infectious and depart themselves Nature labors also to do the same in Synochs not putrid if the blood be black which it desires to expel by a Carbuncle not pestilential either alone or with a Bubo And many fear they have the Plague through ignorance A Heat mixed with Foulness first raised from putrid humors or parts of the body A putrid heat causeth putrid Feavers and so carried to the Heart and inflaming it and sent from thence to all the parts of the body causeth putrid feavers which continue or return while the putrid vapors or humor go to the Heart which they wil do because they are bred in the Veins and Arteries by which they may be directly carried therunto For these go to the heart with great Orifices conveighing humors and spirits into it and they cannot be carried another way For if a stinking Vapor couldpass the the cavity of the Breast another way into the Heart to inflame it we should alwaies have a Feaver from the vapors sent from the Excrements which though thin and hot so that they may be let flie and burned to flame yet cannot reach the upper parts to infect them unless it be by making a stinking breath As we shall shew And although a poyson or venemous quality can reach the heart wheresoever it is bred or by any passage yet these vapors bred in a thick putrid matter constrained to a certain place but by the manifest passages aforesaid By which means as a simple heat sent to the heart in the spirits and blood causeth a pure simple Feaver so doth a putrid vapour or matter by the same way cause a putrid Feaver which is divers according to the divers places in which the matter is bred which matter also is not alwayes of the same Nature The stinking Matter is either bred in the veins or arteries or out of the vessels in the humor of some part or substance thereof The Humors that cause putrid Feavers either putrifie in the vessels that is the veins and arteries either continued to the heart or in them that are not joyned by continuity to the heart but can send a vapour by vessels that are continued And this is cause why among putrid Feavers some are continual others intermitting The vessels continued to the Heart are the Veins and Arteries except the Mesaraicks Foulness of blood in the vessels continued to the Heart is the cause of putrid continual Feavers If any humor putrifie in these being largest and dispersed through the whol body because the way is open to the Heart the vapor and part of the humor go to the Heart and sets it on fire causing continual feavers because the cause is included in the vessels These if they kill not by the vehemency of the cause and the Disease or melt the body with heat go slowly off and and continue til the heat of the Feaver hath consumed the mattter by Vapors and Nature hath made Concoction of it and discharged it by a perfect Crisis The humor putrifying in the vessels is blood which being too hot and moist easily putrifieth as we may observe by it out of the vessels But all wil not putrifie but from a great fault but a little only some remaining good though by reason of the Disease and fasting the Patient gets no new and this is separated from the bad into other places And if it were mixed and grew hot yet it did not stink but the filth being separated it returns to its former purity As we observe in letting blood it flows somtimes pure somtimes impure and somtimes confused or mixed Moreover though blood hath divers parts yet one cannot be corrupted alone but all is made thinner thicker or fatter rather than cruder which cannot make perfect blood as I shewed for the blood in the Veins is made of them not distinct but confused or mixed though they seem divided in cold blood and there is no part of blood but is made of them This is manifest by the Urin and Sweat when the serum is putrified Hence are divers sorts of putrid feavers not because divers parts thereof called humors as Blood Flegm Choller or Melancholly are
corrupted but from the place in which the humors putrifie and the diversity of the blood so corrupted There are distinct Feavers in respect of the place wherein the humor corrupteth first in the respect of the veins and arteries The corrupt Blood that causeth putrid Feavers is constantly in the branches of the hollow Vein and in the greatest of them in which more may be contained and from which the Heart may be sooner reached which cannot be done in the least branches Therefore in the trunk of the hollow Vein which passeth upwards and downwards from the Heart by the Back-bone or in the great branches that come from it into Throat and Groyns this corruption of blood being contained and alwaies disturbing the heart it causeth divers putrid feavers as the filth is nearer or further the Heart Any corruption near the Heart which sends it self Corruption of blood in the hollow Vein near the Heart is the cause of putrid Synoch causon Leipyria or vapors to it maketh a Synoch feaver which increaseth or decreaseth or stands at a stay according to the corruption And in a causon or bruning feaver because its heat is near the Heart there is no manifest change because the heat is equal especially when the heat is at the height and cannot be raised but by death Yet the Patient may find about the Breast Midriff Back where the corruption lodgeth a burning which troubleth the Heart and parts adjacent And this is the cause why in a Leipyria which is a sort of causon that the inward parts do burn When the corruption is in the branches of the hollow Vein distant from the Heart Blood corrupted in the hollow Vein remote from the heart is the cause of a Synoch exasperated because it causeth not so much heating it begets Feavers with fits which have different heat For when the Vapors whose matter is forced of are hindered by the long passages and cannot come in order and the same measure to the Heart it comes to pass when it is increased it comes with more violence and encreaseth both the heat and fits without horror as at the first because the feaver was before These fits go away when the Vapors are discussed but not the feaver for heat once kindled although the cause abate cannot thereby be extinguished as we shewed concerning simple heat from an external cause which cause being removed the Feaver ceaseth not till the Heart return to its former temper And this is the true cause of fits which come somtimes twice in a day when the stinking vapor is much and not far off and the other day once because the day before some part was discussed and keep or change their course in respect of the cause which acteth Also when the cause is far of or is less the fits come every third day at first and so continue for a time seldom the fourth or every other day For which causes these putrid continual Feavers are called ordinate or inordinate quotidians Tertians or quarrans But in those whose cause lurketh in the Veins remote from the Heart there is a heaviness or pain or burning in the part where the matter lodgeth in the Neck Loynes or Joynts There is alwaies a pain of the heart also not that the matter lodgeth there but from the hot Vapors Also in all these putrid Feavers whether the matter be near or far from the Heart A Portion of putrid blood which causeth a putrid Feaver sent from the hollow Vein into other parts causeth continual Feavers accompanied with other Diseases a part of it may be forced by nature out of the Veins as in pure Feavers by which she is disburdned into some internal or external parts producing Tumors Pustles or Spots which are not signes of Inflamation but Putrefaction As in Children the smal Pox and Meazles break forth as Fernelius saith plentifully in a Feaver like a putrid Synoch but they are not infections but in Malignant Feavers It is a question whether blood can thus corrupt in the Arteries to cause Feavers Corruption of blood in the great Artery causeth a burning Feaver For it being hot and spritful may easily burne and conveigh a a simple pure Feaver to the Heart but it can scarse alone or seperated from the blood of the hollow Vein which is very pure be corrupted though with it it may or be infected by neighboring humors especially because vapors that come from putrid blood are carried that way to the Heart both in putrid and intermitting Feavers But if corruption should be in the Arteries from the causes aforesaid the feaver will be most violent as in a causon when corruption is in the trunk of the great Artery near the Heart These feavers also differ in respect of the blood in respect of its temper or distemper before it caused them Temperate blood which offendeth only in quantity and which is not naturally inclined to putrefaction if it corrupt Corruption of temperate blood in the Vessels is the cause of a putrid Synoch causeth a putrid Synoch which is either made so from a Simple Synoch wherein the blood was first inflamed and then corrupted or from the external causes at the first Therefore some call the beginning of them putrid Ephemera which come from outward Causes But we because this putrid heat ends not in one or somtimes many dayes as a simple doth cannot call the ephemeral but putrid Synochus because in them the heat is milder then in other continual putrid Feavers and more equal from the temper of the blood having no fits from the equality of the blood and because being near the heart in the great vessels it is first afflicted with the external causes and so the heart beats with an even Pulse As we shewed If the blood be distempered Corruption of hot blood in the Vessels causeth a burning Feaver before it corrupt it must be hotter then ordinary for if it be too cold or crude it rather causeth Cachexy or ill habit of Body then Feavers And if it be so Corruption of hot blood in the hollow Veins and Arteries near the Heart causeth a melting Feaver before the feaver come whether it be too thin or too thick or corrupted it causeth Inflamation and the more when it is in the Arteries or any place near the Heart hence come burning feavers continuing in the same state so violently burning that except they kill the substance of the Heart is melted away therewith and dryed so that the whol body consumeth as we shewed in a melting feaver Praeternatural Heat or fault in the blood is the antecedent Cause of Corruption of it in the Veins If the blood beinflamed with heat we shewed that it caused diary feavers within a sanguine and full Body as we shewed in a simple Synoch except the heat abate of it self or by cooling medicines cause a suppuration either in the blood or in the parts So that the mass of blood being corrupted by long
heat there is not a simple heat but a compounded feaver with putrefaction And this is the cause why a Synoch not ending the second or third day becomes putrid This is known by the signs of an Ephemera and simple Synoch the one whereof is that the heat began externally And this is the reason why fulness of blood which many say is the cause of putrid feavers causeth a change of simple feavers into putrid Foul or evil blood which hath the seeds of corruption in it or is disposed thereunto if it be gone so far by its plenty or corruption that nature cannot order it that is amend or purge it causeth by putrefaction divers putrid feavers differing according to the place wherein or the matter of which the putrefaction is These are foreseen before they come by a constitution not perfectly sound nor sick by reason of some secret fault in the blood in which there is a laziness haviness and pain of the Head troublesom dreams stretching of the sides or Hypochondria Heart pain Nauseousness loathing of Meat change and stink of usual Excrements or not usual as sweat spitting vomiting belching This fault of blood comes either from things taken in or from Excrements retained or from outward things Things taken as meat and drink which are the matter of which blood is caused if they be of evil juyce or corrupt cause this fault in the blood Meats of evil juyce though after they are eaten they are somwhat changed by concoction and turned into blood yet in regard the former condition remains if they be often taken produce these putrid feavers which are popular or common when the meats ordinary eaten by most people from necessity are such as Herbs and Fruits or Corn eaten in too much plenty when unsound as in time of dearth these infect the blood and cause Epidemical Feavers in Cities and Armies Also if the food be naturally good and be putrified before it be taken it infects the blood As when they are too old or corrupt by too much moisture whether Flesh Fish or Cheese by stink and Putrefaction being long taken infect the Blood and cause Feavers And common Feavers come by corrupt Water Bread or Flesh at Sea or from Corn that is mowed up wet Those most easily corrupt being eaten which have much Excrementitious moisture as summer fruits the eating of these in summer abundantly causeth Feavers in Autumn or the Spring following Things that nourish as Mâ—â—k and Eggs or sweer things soon corrupt in hot Stomacks and turn to Choler which causeth other Diseases rather then Feavers So do hard Meats and slimy when the Stomack Liver or Spleen are afflicted for want of concoction cause crude blood and obstructions rather than Feavers Except there be other accidents The retention of the Vapors and Excrements of blood usually sent forth by insensible Transpiration or sweat infects the blood and causeth Feavers This may be from divers causes from idlness and sluggishness of nature in expelling of Excrements obstruction of the Skin and pores thereof and want of Aire Not that the blood is inflamed and then corrupted for want of Air through the pores to cool it as we shewed in the causes of a Diary Feaver Nor that it can come from a sudden cold taken in while the body is hot But because the skin being made thick the Excrements usually purged by the pores cannot come forth And because the body cannot be refreshed with Air to consume the moist Excrements under the skin As we may observe by things kept in close places where fresh Air comes not they grow mouldy and musty so by the long retention of these moist Excrements for want of Air the blood may be infected and Feavers follow When the Air is infected with evil Vapors from stinking Carkases and taken constantly into the body it infects the Spirits Blood and Heart and causeth putrid Feavers and they are somtimes popular when many live in it and are disposed for it Or contagious when the putrefaction comes from the breath or sweat of sick men This is from a malignant or venemous quality rather then a simple corruption The vessels not continued to the heart of veins and arteries are only the meseraicks Corruption of blood in the meseraicks is the cause of intermitting putrid Fevers branches of the gate-vein which comes from the liver dispersed through the bowels in the lower belly and no where else never coming forth to the skin but in the Fundament where they are called Haemorrhoids For the Arteries which accompany these as also those that accompany the branches of the hollow Vein coming all from the great Artery are continued to the Heart thereby Therefore if a humor corrupt in the meseraicks though their passage be intercepted by the substance of the Liver in which all their branches are yet because the branches of the hollow Vein are also in the same substance of the Liver and are joyned to the mouths of of the branches of the Gate-vein and because there is a constant passage of the Blood in the Liver by them And also because the Arteries coming to the Heart are joyned to the Meseraicks in the Spleen Stomach and Guts By this communion and vicinity it happens that as oft as evil vapors rising from the Meseraicks do fill the branches of the hollow Vein and great Artery they pass that way to the Heart and cause putrid Feavers by their stink but these are not continual but intermitting And because the putrid Matter is not far from the Heart in continual Feavers they may a little intermit but not wholly cease For the Heart once on fire before it be wholly quenched and a new vapor in the Veins that come unto it must have fits at certain times As we shewed Also this is from other Causes a filthy vapor in the Meseraicks which causeth a Feaver which doth not constantly touch the Heart with the same force by reason of the distance this is not alwayes unequal but wholly ceaseth by reason of the stoppage of passages to the Heart And so long intermitteth while the putrid Matter confined to its fire swells and sends forth a vapor to the Heart with some of it self For it being abundant and of an evil quality provoketh Nature to send it into the branches of the hollow Vein and great Artery and so into the Heart where it causeth Feavers to continue so long till all the fuel be burnt up or sweat out After which manner a Feaver wholly ceaseth till a new fit cometh by a new motion and heat of the Matter sooner or later and not in the same form As shall be shewed Now let us consider what humor it is that putrifieth in the Meseraicks what is the conjunct cause of intermitting Feavers and the antecedent Cause of Corruption The humor contained in the Meseraicks is Blood yet not so pure as that in the Liver purged from the waterish and cholerick Excrements and fit for nourishment although some part
of thick blood in the Mesaracauseth an intermitting quartan or sextan exquisite or Nothus as the mater is pure or impure because it is longer corrupting it requires a longer time to get to the Heart to make a fever therefore the fit is not til the fourth day and it is called a Quartan This comes sooner or later is exquisite or bastard hath a shorter or longer course for the same cause that a Tertian from which in heat and other accidents it is much different only by reason of thickness of the humor it is longer and worse to be abated And if the matter grow so tough that it corrupteth not under five or six daies to send up vapors that cause a feaver then these feavers which are rare are called quintans or sextans These vary according to the place as the matter is in one or divers places If in the same it putrifie the feaver is a simple-tertian or quartan exquisite or Nothus in respect of the matter If in divers places it wil be either in the Mesaraicks only or also in the branches of the hollow vein If Choller corrupt in the Meseraicks only not in one but two or three places about the Liver The cause of a double tertian or triple quartan or confused is when thin blood putrifieth in one place and thick in another place of the Mesaraicks Spleen Mesentery or Caul the feaver is double or treble and one ceasing another follows the the next day or the same Hence it is that Quotidians are not as some talk from flegm though they cannot prove it for they are double tertians or treble quartans which have every day a fit or more for I observed in a double bastard tertian two fits in a day and three in twenty four hours And to these may the double quartanes which come two daies and intermit one be referd and as these are when Choller of the same nature corrupts in divers places And when the Choller is divers in divers places as thick in one thin in another there are Tertians mixed confusedly with Quartans divers daies These are known by their symptoms If blood corrupt not only in the Mesaraicks but Branches of the hollow Vein Asemi tertian is caused by corrnption of blood in the Mesaraicks and vessels continued to the Heart at the same time then there is a continual with an intermitting feaver called a semi tertian where in respect of the diversity of the matter tertians or quartans single or double bastard or legitimate are joyned with a continual feaver that either hath no fits or upon certain daies Hence it is that the feaver is alwaies either with sharpness from the continual or fits from the tertian The antecedent cause of this corruption in the humors of the Meseraicks which causeth fevers is either efficient or adjuvant The efficient is meat and drink by which hot sharp chollerick or burnt juvce is bred in the stomach or first passages This being long gathered nor wel separated from the blood but in the Mesaraicks or another place or divers when it corrupteth it causeth feavers agreeable to its humor shorter or longer or otherwise differing This juyce comes from food that hath such in it self or gets it by corruption These have sharp chollerick juyce Onions Garlick Leeks Rotten Cheese and like naturally By corruption these turn into such juyce especially in hot stomachs Sweet things which easily turn into choler and fat Raw fruits by eating whereof in Autumn come Dysenteries or bloody fluxes from choller and also quartans Also other moist meats as Eggs and Milk which nourish much by corruption turn into sharpest choller of which this filth proceeding if it be not purged it is carried into the Veins and gets feavers though the vulgar impute them to other causes The cause adjuvant is the disposition of body in respect of constitution or season They who are hot and chollerick are soonest taken and they of middle age and Infants by intemperance and have the matter from the Womb like black chollerick blood and bring these feavers into the world with them Somtimes they suck them from their Nurse as March 27. 1640. I had a Son born in the seventh month when the Mother had the third fit of a bastard tertian which had at first the feaver at the same time with the Mother and two sits after it had sucked and in the third with some light Couvulsions it departed being not fourteen daies old Sometimes old men have them but they are seldom The hottest time of the yeer and when the diet is worst is the time to get Agues in Autum tertians and quartans are usual by reason of the Summer Diet in Spring and Summer Tertians are frequent Putrefaction out of the Veins and Arteries causeth feavers Corruption out of the Vessels is the cause of gentle symptomatical Feavers when it sends evil vapors or corruption to the Heart and afflicteth it with a stinking heat hence come symptomatical feavers which follow a disease caused by this cortuption These are gentle and unequal because the matter out of the vessels cannot send to the Heart so much as when it is in the vessels nor keep that order these are quicker or slower to the tast as the matter is either in a Natural or Pretertatural humor or a Natural or preternatural body or part thereof When a few humors contained out of the vessels corrupt without the putrefaction of the parts containining they cause putied feavers Corruption of some humors out of the vessels causeth gentle symptomatical Feavers Some say all humors whether hot or moist being corrupted out of the vessels wil cause it but this we shal examin These are hot viz. natural blood falling out of the Veins and divers cholerick excrements These are moist the waterish and flegmatick humor If blood flow from the veins into any part and cause inflammation it causeth only a pure symptomatical fever and not a putrid though it corrupt except the part corrupt also But if blood coming from veins open or broken congeal and by continuance corrupt especially in great quantity and in a place neer the Heart as in the breast and Lungs then putrid but gentle Fevers follow these Affects or Diseases but seldom when it is in the stomach or Guts because it cannot stay long there or in the Reins or Bladder because the Urine washeth it away If either that Choler which comes from the Mesaraicks into the Gall or Spleen to be purged as they say or that which breeds in the stomach of things eaten either corrupt in its own place or in another some think it begets putrid Fevers if yellow Tertians if black quartans exquisite or Nothus as it is pure or mixed But we not observing any such black Choler in the substance of the Spleen and perceiving no Gall or Bladder to receive it as there is for the yellow Choler in the Liver and knowing that the use of the Spleen is more excellent
a Drink to cool a hot Liver and the blood and spirits It is good to sweat often in due season for thereby the blood is purged from excrements especially such as are thin This must be done by Exercise Stuphes or Fomentations and by things taken into the Stomach Let the Diet be moderate in quantity And beware of all things which easily inflame the Blood and Spirits The Cure is directed partly to the Fever partly to the Disease that accompanieth it As for the Fever because Nature from the beginning doth of her own accord send forth the Vapors which rise from the Inflammation of the blood by transpiration or sweat we must do the same in helping her that so some part of the cause being taken away little or none may be carried to the emunctuaries or pores or other places internal which are worst Wherefore since Nature in this Fever goeth about first to expel by sweat which she doth later in a Synoch let us at the first give things that cause sweat but not very strong least the body hot before be worse inflamed thereby or that help and make them sweat more freely Let the Patient be quiet and covered and not exposed to the cold Air which hath been so dangerous to some that many fear to apply a cold wet cloth outwardly or to an Erysipelas Some advise plenty of Barley water to be drunk and to boyl Lentiles therein to send forth the matter and to sweat as in the small Pox. And if Nape and Citron seed be added the Decoction wil cause more sweat Also the Decoction of Sorrel roots with burnt Harts-horn and Lentiles husked and Nape seed with a little Cinnamon provokes sweat And divers distilled waters but here we make choyce of the most temperate in regard of the Fever as that of the three colored Violet highly comended also of Fumitory Carduus Marygolds Chervil and such as are usually given in other Fevers which begin in the same manner To these Waters we add Rob or syrup of Elder or of Danewort or syrup of Ambrosia or Treacle Also we refresh in the sweat or after it especially with a little Bread tosted and dipt in Water and white Wine with a little Cinnamon and Sugar and if you do so at first they wil sweat the better Blood-letting is not so requisite here as in solitary Fevers except there be fear of greater internal inflammation and a Plethory for the sending of blood into the Emunctuaries and the extremities is not so much to be feared that it should be stopt by letting blood The Belly must be loosned if bound as in a solitary Synoch and purged a little if there be ill humors with Cassia or Manna And the Alterers must be given in and applied outwardly if the heat be great as in a solitary And the Accidents corrected as there said As for the Botches or Buboes they somtimes vanish of themselves without any application except in the Neck where they are kept from the Air with a cloth or a Fur. When they are ill ordered they burn to an Imposthume as we shewed As for Erysipel as that departs presently after the Fever but if it be hot and painful asswage it as shal be shewed When it is ill cured it turns to an Ulcer and somtimes into a Gangrene And therefore commonly they say that if any Ulcer or Tumor or scurf come after it was caused from the evil curing or wetting of the Erysipelas If a Synoch be joyned to a hot Disease or Inflammation The Cure of Fevers coming from external Inflammations and their Accidents and there is an outward Inflammation with a tumor Contusion Wound or Gun-shot that causeth a Fever if it be small little is given but such as may be mixed with the medicines against the Tumors as bleeding which is good for Revulsion And loosning of the Belly and other altering Medicines used in other Feavers When there is internal Inflammations of the Lungs The Cure of Feavers that produce internal Inflamations or in a Pleurisie or Peripneumony or in the Liver Spleen or other parts we direct our Medicines to the Inflamation rather then to the Fever which requires no such hast as the Inflamation and goes away with the Disease except as I shewed in the causes it springs again Yet we so order the Inflamation that we increase not the Feaver And the Medicines are best which are contrary to both Blood-letting is excellent in both for it is the chief remedy in a Synoch and it hinders Inflamation by drawing the blood from the Noble part Therefore it must not be neglected but let out freely and somtimes repeated It is good also against both Fever and Inflammation to keep the Belly open with gentle Laxatives or Clysters Strong Purges are Enemies to both because they take away more of the cause but inflame the body and stir up the blood to flow to the Inflammations and abate the strength which is here precious And they are to be feared least they bring a Diarrhaea which is here dangerous and deadly Therefore imitate not the Empericks in giving them Things that are given cold though they are contrary both to the Fever and the Inflammation yet they must be given warily with regard to the part where the Inflammation is lest they hurt one when they profit the other Although much cold water is good against a Synoch yet it would hurt internal inflammations by a sudden repercussion Therefore we give it prepared for that part and in Diseases of the Breast we give Pectorals and in Diseases of the Liver openers of Obstructions mixed therewith And therefore sharp waters though they may do good in Fevers and many internal inflammations yet we give them not in diseases of the breast especially if they bind and are very sour This rule is to be observed not only in ordinary Drink but in Juleps Syrups and Conserves Remedies applied outwardly must be profitable for both they must not increase Inflammation as Epithems though they are in all Fevers profitably applied to the Heart yet in Inflammations of the Lungs they wil do hurt The Diet which is thin for a Fever is good in an Inflammation also while the matter slows that while the hungry parts catch away blood for nourishment it may less come to the part affected But we have shewed at large in our Practice how to order internal Inflammations with a Fever whether it went afore or followed them Fevers with Meazles or Small Pox which are Synochs or putrid The Cure of Synochs putrid malignant or pestilential which produce Meazles or small Pox. malignant or pestilenlial are judged and cured according to their divers causes and the age of the Patient These are less dangerous when they come not from a malignant cause and then they keep the same course with Synochs Solitary Putrid or not Putrid But if there be a malignant cause not pestilential these Fevers alone hil not Infants because Nature sends
no other in the Heart for it is sufficient by touching the Arteries to know the vital strength especially in regard the motion of the pulse is answerable to that of the Heart Also the Defect of the Heart is known by the breathing In the pangs of Death there is extream weakness Extream weakness in the hour of death which is more or less longer or shorter In which although the conflict between life and death or Convulsions the Members are moved yet the strength is gone And the pulse intermitteth and ceaseth like the flame of a Candles end that somtimes blazeth with a little refreshment from the grease but goeth out again when that is wanting And the motion of the Heart and Breathing are much stirred up in the Agony before they cease so that the whol breast is shaken and the Nostrils moved the body sweats and farteth which caused the Poets to say the Soul went out And death being at hand the heat leaves the external remote parts as Hands Feet Nose by degrees and the rest while the breast is warm a while til all the breath ceaseth the mouth and Eyes remaining open and the body turned like a clay colour we are certain the Soul hath left the body Sometimes while the man liveth the strength is taken away for a time Syncope or Swooning and all the Functions of the whol body suddenly Pulse and Motion ceasing so that it cannot be felt at least In the Disease called Deliquium Lipothymy or Lipopsychy in Greek if it be great 't is called Syncope And then all breath is gone so that you cannot perceive it by a Feather applied to the Nose or the like which may be stopped in this case only during the Fit while the motion of the heart is staied and hath no need of Breathing without Death But while the the Heart moveth it cannot want Breath because it procureth vital spirits In this Syncope they fall suddenly only with a noise in the Ears or hissing the strength being lost as in an Apoplexy if the Syncope be great but they differ in this that in the Apoplexy the Heart and Arteries beat and they breath though with difficulty and obscurity There is also a cold sweat called Snycoptical or Diaphoretick not from the digested substance of solid things but from the conflict of nature and the dissipation of the Spirits which is so great that not only thin humors but also the Dung and Urin break forth And because then heat vanisheth from the outward parts there is a cold sweat remaining and a paleness all over in those places that should be red by nature shewing it self first in the Lipps Somtimes there is a particular weakness when the internal or external Organs are deprived Particular weakness and it is called the weakness of that part not every weakness that comes from a Disease but as shal be shewed in the causes that which comes from the loss of the flourishing vertue Such as is sometimes in the Stomach Liver Brain Eyes Joynts or Members which shal be spoken of in those accidents which are produced thereby The Causes The Cause of all failing of strength The cause of all want of strength is in the vital spirit in man when it is not nourished with another spirit or moisture or consumed fainting and weakness of particular parts dependeth upon the inbred and inhaerent spirit of the similary parts which makes the spiritual substance of parts as they call it and giveth living vertue or life and strength and heat which is natural This natural spirit or heat being inbred in every substance of parts as in the Heart which though it abound with other yet hath this in it as necessary for life hath need to be continually nourished and renewed by the vital spirit made in the left ventricle of the Heart and communicated to all the parts by the Arteries as to the substance of the Heart by the coronary Arteries called the influent spirit that it might be the matter that sustains the innate spirit and because it easily disperseth it ought to be in great plenty through the body And hence is it that the heart being the shop where that spirit is made alwaies stands in need of Air and Blood whereof it is made Wherefore if they be wanting or but little there is one cause why strength faileth As when for want of breath the heart wants Air then Death follows except its motion were hindered by other causes as shal be shewed in the causes of swooning Because the Heart being dilated by motion often not filled with matter for vital sptrits dieth And this cannot befall it while it moveth not because it may subsist a while with its own spirits as other parts So we shewed in a Syncope wherein they revive after a long stopping of the breath But seeing Blood mixed with Air in the Lungs affordeth fit matter for animal spirits if it be consumed by great want of nourishment or Arrophy or stopped in the Vessels so that it cometh not to the parts there must be weakness But no man living can be so without blood that the Lungs should be so empty which usualhave so much or the Vessels that are so large by which the Blood is carried with Air from the Heart should be so obstructed Only strength fails in this respect that spirits are not made or being made they are suddenly dissipated which causeth the innate spirits to subsist no longer And that either when they altogether vanish and leave the body as in the Agony of Death or they depart for a time from the Heart and return again as in swooning Or when they are fewer then are necessary as in Weakness Also strength must needs fail when there is want of substance making moisture in regard the innate spirit is nourished not only with the infinent spirit but by radical moisture which consumeth dayly And so it is the occasion of Death or Weeknesâ— as it is wanting in the Heart where it is the proper nourishment of the spirit or in any other parts But if the innate spirit caâ—â—ed the spiritual substance of the parts or called the natural heat be extinguished or weakened or any part cold Then if it be in the Heart which hath as I shewed its proper native heat or innate spirit besides the vital which it aboundeth with otherwise there had been no coronal Arteries and be spent Death follows but if it be diminished there is a general faintness of the whol body as a particular weakness of some other member if it be in them But now I shal shew what causeth the dissipation of both the innate spirit called native heat and of the Influent spirit by which it is susteined And how the humor that feeds it is consumed by natural and adventitious courses They who have more innate spirit or natural heat The constipation of radical moisture through age is the cause of weakness and radical moisture are more strong
distemper which may cause a Feaver in tender bodies or an Inflamation or Erysipelas of divers forts according to the variety of the Flux if it enflame it begets a Feaver in which the inflamed blood somtimes falling out of the vessels as hereafter we shal shew may renew the old or cause new inflammations These feavers are simple and pure not putrid and as the heat of the Disease is they increase or abate and end before it be quite over except there be a suppuration or a new pain or putrefaction These symptomatical feavers are in divers hot Diseases of the Bowels Membranes and other parts And the more vehement or long as the Disease is neerer to the Heart and the parts adjacent or great Veins or as the heat is greater or the body by nature more hot as in Infants who have a Feaver many times only by the breeding of Teeth They are milder and shorter when they are from the fountain of heat or outwardly in these there is little heat but horror and somtimes not that The Cholerick humor being most hot A cholerick disease is the cause of the symptomatical Feaver of the Ephemera or Synochus seldom causeth these kind of feavers But when it is not in its proper place where it doth no hurt nor mixed with the blood nor qualified with the Whey which so tempereth it that it cannot produce a feaver as we observe in the Jaundies but separated into sensible parts the Stomach and Guts and gets into their substance causing Erysipelas about the Belly the fever Lipyria in which the inward parts burn with intollerable heat and pain as Aetius observes about those parts and great thirst except it be cast forth by nature it fires all the parts adjacent with the blood and Spirits and causeth small feavers which follow such Diseases These we often see in the disease of Choller when it is vomited and purged and in the Dysentery and in the Colick coming from Choller and Erysipelas in the Guts as we shal shew And they cannot be great feavers because their cause is far from the Heart and lodgeth about the Meseraick Veins If Blood inflamed from the causes aforesaid Some Blood inflamed sent out of the vessels into other parts causeth a Synoch primary accompanied get out of the great vessels into any part internal or external and inflame the heart and cause a Feaver as it usually doth by its plenty heat or thinness or impurity either at the beginning of a Feaver or after by the force of Nature as in the Crisis of these Feavers we may see by their bleeding at the Nose Then it causeth a new disease in the part where it comes and a Feaver which is accompanied therewith but not symptomatical because it follows not the Disease but goes before it as I shal shew And these observe not the course of other simple Feavers but being increased or abated by the accidents of the Disease they are longer or shorter greater or less And when nature hath sent a good quantity of burning blood from the Veins thy are not so hot nor so thirsty nor ful of Head-ach as in solitary Feavers And this chiefly when the blood flows into the bowels or superficies of the body Sometimes this flux of blood in Feavers is into the Bowels capable thereof The effusion of inflamed blood into the inward pars is the cause of Synochus accompanied with Inflammation of the Bowels especially such as are most fleshy and bloody and ful of Veins joyning to the great Veins and neer to the Heart and chiefly into the Lungs which it inflameth and causeth a Peripneumonia and somtimes Pleurisie as shal be said These Inflammations go not before the Feavers because the Feavers shew themselves before there is a pricking pain or signs of Inflammation with horror and heat following and sometimes go some hours afore Nor are they caused by those inflammations but as they were first raised from Feavers and increased by a new heat in some part neer the Heart which shews that the Feaver did not there first begin and that is not putrid as others thought because the heat rais'd from the Inflammation increaseth the feaver rather by its quantity then filthy quality Nor doth it acquire or get any putrefaction from the inflammation especially when it first comes except the blood suppurate and then as Hyppocrates saith it is increased But we suppose this may be rather from the pain that is then increased and not a new putrid feaver from a putrid exhalation because it presently ceaseth Except this happen from an Ulcer that follows these inflammations as when a Pleurisie or Peripneumony turns into Phthisis the feaver being turned into a putrid symptomatical Hectick or from blood which is putrified and sent out of the Veins as I shal shew in putrid feavers These happen as in the Lungs from the situation and for to receive the flux So may inflammations which follow these feavers and increase them be from blood in a Synoch sent into the Liver or Spleen because they are boody parts and have large vessels These feavers in all the said inflammations of bowels are longer than other solitary Synochs in respect of the Disease accompanying them And they vary as the inflammations are true as Phlegmons from whence some are called Phlegmonodes Or Erysipelas wherein the feaver is more sharp called Typhodeis though this name be proper to the feaver in the Erysipelas of the Liver As the feavers from the Erysipelas of the Lungs are called Crymodes The same may come from blood sent into the brain in feavers which hath large cavities and is easily filled And then an inflammation of the Brain is joyned with the fearver which turns suddenly with doting into a Pleurisie with a pain of the Head which went before and caused blood to come thither and makes the feaver more dangerous and violent This may be also in the Stomach Guts Womb Bladder when the blood is sent thither in feavers But when another way which leads into the fleshy parts being membranous have only meseraick veins or are far from the great vessels and the Heart it comes to pass that when these parts are inflamed by pain which comes quickly to such sensible parts that the feavers rather follow the Inflammation than go before them and are as is said symptomatical As that inflammation which is in fleshy parts which are not so sensible of pain comes from the feavers and is a symptom of them These Feavers send blood from the veins into other internal parts Inflamed blood sent into the habit of the body causeth a Synoch these inflammations are red and painful as in the muscles of the Neck and Glandules and maketh inflammations in the mouth Tongue and Jaws and Quinsie And though they begin not from feavers but other causes yet when a feaver comes they increase Somtimes these feavers go before pains and swellings of the Gout when Nature by them drives blood
good Emulsion Things that resist Putrefaction are usually sharp and sweet Sharp things also cool and are very delightful Galen puts a little Vinegar in Water and juyce of Pomegranates Wine of Pomegranates or the like is also commended Also sharp Syrups mixed with Waters as of Vinegar Sorrel Lemmons Citrons Currants sour Grapes Pomegranats Apples and four Plums and sharp Cherries are good Things very sharp may be given if there be a Flux as Syrup of Barberries The Waters to make the Juleps are of Endive Lettice Succory Sorrel and Roses if you will bind Some sweet things resist putrefaction and Sugar more than Honey which easily turns into Choler but because usually they hate sweet things therefore add Syrups that are sweet and sour Also the Decoction of Currans is usual and good Somtimes we add Correctors of Crudities when they are weak the heat of which is overcome by the plenty of the Water Cinnamon is most usual being sweet either boyled or infused or Coriander seed boyled or Galangal red Saunders is good to cozen the Patients when they expect Wine especially if there be a little Pomegranate Wine to give it a scent There are divers Potions and Juleps which alter and correct the distemper of the humor and whol body to be given all along mentioned among the Prepatatives And this Decoction Take roots of Succory Asparagus each an ounce Endive Lettice Purslane Liverwort Ducks-meat each one handful Bugloss and Burrage flowers each a pugil Barley a pugil Gourd seeds half an ounce Fleabane seeds which are very cold a dram boyl them add Sugar and Vinegar boyl them to a middle consistence between a Water and a Syrup give two or three ounees alone or with others Or thus Take Endive Succory Sorrel Liverwort each a handful Barley a pugil make a Decoction strain them add Vinegar for the Poor and Syrups for the Rich. Or thus Take syrup of Sorrel two ounces the Mucilage of Fleabane seeds half an ounce give three spoonfull often Sick People refuse solid things to be eaten and had rather have Drinks for their thirst but for variety they may take sometimes dried Confections as the Tablets of Trionsantalon or the three Sanders Or these Take pouder of the three Sanders one dram Diarrhodon one scruple the Troches of Camphire half a scruple red Coral half a dram Conserve of Roses Violets Bugloss each half a dram with Sugar dissolved in Rose or Endive water make Tablets give them morning and evening and Endive water after them Soft Electuaries made of Conserves are given the day after purging to strengthen and correct the heat caused by the medicine and in the whol course of the fever Thus made Take Conserve of Roses Bugloss Violets each half a dram with Sugar or Rob of Ribes make a Bolus This is pleasanter Take Conserve of Roses and Sorrel each an ounce of candied Citrons Lettice stalks and Gourds each half an ounce with Syrup of Ribes make an Electuary give it often and thereupon a little Endive Sorrel or Bugloss water Clysters when they are bound are good to loosen and to bring the humors into the Guts and for to alter but because they cannot be given cold they are not so good as other things to cool the Stomach and whol body and quench thirst they are better to loosen than cool They are mentioned among the Looseners This is best to cool Take Lettice Purslane Violets Mallows Housleek each an handful Barley a pugil and an half Cordial flowers a pugil Guoard seeds half an ounce boyl them add Oyl of Violets three ounces Honey of Violets two ounces Diaprunis or Cassia an ounce make a Clyster Things may be given in the meat to nourish and cool or for sawce but the Pacient must rather have them in drink though the Vulgar love to be cramming them Boyl Lettice Sorrel Purslane Burrage Endive in Broath and Spinach or Arrach or Laxative herbs if need require it is pleasant and good to take Savory broath made with Sorrel Spinach and Arrach and with an Egg and a little sharp Wine or Vinegar and Water beaten and boyled a little pour it upon Sippets of Bread Or boyl these forms in Broath Take Lettice and Sorrel seed each adram Melon seed two drams Trionsantalon half a dram Coral a dram Diamargariton frigidum a dram and a half make them as big as Fetches Make sawces of Orenges Lemmons Cherries Pomegranats Ribes unripe Grapes Barberries dried Prunes a little boyled or stoned sharp Apples and Lemmons with Sugar and Rose-water Also of the juyce of Sorrel Vinegar and Sugar and pickled Purslane with the juyce of Secalis in the Spring with crums of bread Vinegar Cinnamon and a little Ginger is good sawce Outward things are to be regarded as Air. That must be very cold by nature or Art for it is actually and potentially cooling for the Lungs which being neer the heart refresheth it much It is allowed for breathing but not to be naked in as the Patients desire in the extremity of heat lest the sweat be struk in Besides the body must not be inflamed with too many cloaths especially Feathers or Furs and therefore it is good to change the Sheets and Shirts and Bed and lay a Leather upon the Pillow And to keep away the Sun and company especially at noon to keep out the Air and not let it in but when cool To sprinkle the Chamber with Water and Vinegar Flowers and cool herbs Willow leaves Vine leaves and Water Lillies To the Heart Liver and Kidnies apply coolers and to the Brain in time of Head-ach and Doting by reason of heat and to those parts which consent with the Head as the Stones The Heart must be cooled at first in a burning Fever in others in the increase after the matter is evacuated because all the parts are inflamed from thence adding alwaies things that properly refresh this noble part and can carry the vertue to it These are to be applied to the Breast or Wrists in form of Epithems or Oyntments and to other parts where the Arteries beat They are thus made In a Causon apply an Epithem presently to the Heart As Take Rose water two ounces Violet Bugloss and Lettice water each an ounce Scabious water half an ounce Vinegar of Roses or Clove Gilliflowers half an ounce juyce of Lemmons or sour Apples two drams Diamargariton frigidum a dram mix them for an Epithem apply it with Scarlet if the heat be great cold or otherwise warm Another Take Rose water two ounces Sorrel Bugloss Violet and Water Lilly water each an ounce Water of Scabious Balm Vinegar White Wine each half an ouncr juyce of Lemmons or Orenges or Apples two drams Sanders one dram Ivory and Harts-horn each half a dram red Coral and precious Stones each two scruples Pearl half a seruple Crystal half a dram Saffron half a scruple make an Epithem for the Heart and Pulses Or bind this Bag to the Wrists and Feet Take Flowers of red Roses
Arteries about the Throat and sides of the Neck beating of the Heart and Faintness especially in the Feet and first there is a pricking pain at the Heart of which they complain much This Disease though it be incident to all yet is it most common to Virgins especially at that time when their termes should begin and it begings then and continues after many Months and sometimes years while the Terms are stopped or if they who have their terms have also this Disease they are stopped Also a lingring Feaver as we said in Feavers is joyned herewith sometimes other Diseases come upon it as of the Stomake Liver Spleen and the Urine except changed by some other Disease accompanying it is white waterish and crude And if it last long the Body will grow bigger and a Leucophlegmatia will follow as shall be declared There is another kind of Cachexy which with Palness of Body and other accidents mentioned An evill Habit is the beginning of a Dropsie hath swelling of Feet which if it continue long the belly also swells and is extended and this goes before the Dropsie Ascites and is the beginning thereof as shall be shewed in the Dropsie There is a third Kind in which the Palness of the Body is not simple Evill Nourishment or Cachochymia is a kind of Cachexy but inclines to an evill Colour as yellow green black yet is not full coloured in the Jaundies it sheweth it self with a pressing Pain at the Heart and beating of the Arteries and other Symptoms as before This they call Cacochymia or evill Nourishment from the cause This is turned into a Jaundies or some kind of Dropsie One of these Kinds is when there are not only uncomely Colours and other Symptomes Cachexy with a Dropsie or want of Nourishment but the Habit of body rather decreaseth than increaseth and the Body groweth lean and thin and therefore it is called evill habited if this continue long and the body consume it is turned to an Atrophy which is so called from the Cause as shall be shewed in the Diseases of the Body diminished The Jaundies is a Discolouration in which the skin is dyed of another Colour Jaundies this Name comes from the Bird Icterus by the look of which this Disease was thought to be cured it is otherwise called Arcuatus because the Colour of the Rain bow is in the Eyes Arcuatus and the kingly Disease either because it is usually with great Men by reason of their Intermperance or because it was cured with Meade which was in time past the Kingly Drink This Disease is divers according to the diversity of Colours sometimes it is yellow and called the yellow Jauâ—dies by the Germans Geibsucht sometimes it is more Saffron like and full coloured sometimes it shines and then it is called Aurigo from the colour of Gold some time it is greenish Aurigo sometimes black which prevails over the yellow and then it is called the black Jaundies These colours appear first in the Eyes then in the Face sometimes they are over most parts of the Body or over all sometimes the Urine is of the same Colour and they seem sometimes Saffron colour'd somtimes black so that they will discolour a linnen cloath in the mean time their Excrements which ought to be coloured are white or ash coloured and therefore do not provoke the Patient to void them This Disease sometimes begins of its self and the colour first grows bright or shining with pressing pain about the Heart this commonly goes before the Jaundies and is its forerunner and this Paine before any Yellowness appears is called in Dutch Selbsucht because it follows so easily sometimes worse diseases accompany the Jaundies with their accidents or follow as a Dropsie sometimes the Jaundies follows sa Feaver and other diseases as the Colick as it hath been declared Redness is a Discolouration very sudden in those that are angry Redness or shamfac'd or blush it â—on inues longer in those that are hot or have hot Diseases especially Feavers and this Redness appears most in the Face Pâ—leness is a Discolouration in which the skin looseth its flourishing Colour Paleness and becomes less coloured then is beseeming This is usuall in those that are very cold or sorrowfull and greived and it comes quickly to those that are affrighted and to those that faint or swone in whom the Image of Death is seen till they come to themselves Sometimes a constant Paleness is the fore-runner of a Disease and often the Companion of Diseases and continueth some time after recovery which Paleness appears in the whol body but cheifly in the Face and in those places which formerly were most red as in the Lipps and Cheeks there is Blewness also Paleness will be in the Nayls and Yard when it needs not or cannot blush or be red Blackness is a Discolouration in which the skin appears black The Blackness of Moors and it is either perfect such as some have been at their birth as the Aethiopians or it is when the skin is not white but tawny which they call black which although Naturall to some yet because uncomely in their Eyes Tawny Skin which esteem that nearest colour to white the best they count it a Discoloration and Labour to cure it Hitherto may be referred the evill Colour of a wrinkled skin in old Age for that which comes from a Disease and Leanness continueth not long A particular Discolouration is only in some parts of the Skin by reason of spots or defilements They which are from externall Causes make Impression of a strange colour or are superficiall As that blackness which is from the Sun burning in the Face and Hands and Breast in those places where they are used to be naked There is also an evill Colour from filth in unclean Persons which sticks to the skin and spoils the colour Some are dyed in the skin by externall Colours and Paints The colouring of the Skin this is usual with them that trade in such Commodities and those that touch them Hence the skin is sometimes black red yellow green c. which sometimes suddenly vanish othertimes stay longer and are more fixed and cannot easily be washed out in regard of the Cause which we shall all at large declare The skin is discoulored with divers spots which sometimes are distinguished only by their colour sometimes by their bigness and bunching forth some come with and some without Diseases They which arise of themselves without a Disease accompanying them are originall spots as Freckles Pimples Fleabites Erysipelas or Anthonyes fire blood spots Gutta Rosacea Ring-worms Morphew black and Blewness Originall Spots are such as we bring into the World as Moles Originall spots as Moles these are called Signs and Marks and are divers and are of divers Colours and Shapes as like Strawberries or Cherries some are depressed broad or little and are manifest only by the Colour and
blood through the Body for the same purpose if this abound in the blood or if the greatest part of the Blood be such because not perfectly made red and yet not so corrupted but it is fit to nourish the Body then this being joyned to the substance of the Body for to nourish it still it makes the flesh and skin of the same colour pale and white and the colour is as far from the true Complexion as the blood is being so or when mixed with evil Juyce or water from evil Concoction In Women especially Virgins when that thick Blood flows not so plentifully to the Veins of the womb nor Nature which allots the purest blood for nourishing of the Child and for monethly Evacuation doth not continue her course to carry it thither and send out the crude and evil Blood there will be an evil Habit and want of Terms as we shewed the defect or want of the Terms not being the cause of that evil Habit but the evil Habit the cause of the want of Termes But if with the evil Habit Cachexy and Cacochymy there be also evil Humors about the Spleen which are carried from hence to the meseraick Arteries there will also be as I shewed a Palpitation of the Heart and other Symptomes by reason of the Cacochyma and Diseases of other parts But if this Juyce be crude and plentiful and long before it nourish the Body so that it swell therewith the cachexy is turned into a Leucophlegmacy or white Flegm and if there be much water the Leucophlegmacy will be serous or if the water abound in a Cachexy there wil be tumor of the Feet and of the Belly and Body growing less and the Dropsie called Ascites wil follow the cachexy or evil Habit. Or if this Juyce which ought to nourish the body be so bad that it will not nourish or be very little in Quantity there will be a decay of the Body and the Cachexy will be turned into an Atrophy As we shall see in the Dropsie Ascites and Atrophy how they follow a cachexy This crudity of Blood if there be serosity or waterishness or cacochymy or suspicion of a Dropsie comes often from the Nourishment if such things be taken which produce crude Juyce or Water as we said in the Imbecillity of the Stomach as Summer fruicts that will not last which if they be taken immoderately by young People make them subject to a Cachexy especially by Virgins being weak and using Exercise This crude Blood which causeth a Cachexy and evill Juyce which causeth a cacochymy or water which causeth a Dropsie comes from the Distemper of those parts which are ordained for Sanguification or making of Blood and Chyle as from the Stomach Liver Spleen and the Vessels and Membranes thereto annexed And if the concoction be made imperfect by the Distemper Weakness or other fault of the Stomach the Chylus be crude and imperfect or foule and watery which after in the second concoction produceth the like Blood because it cannot be sufficiently boiled and the rather if the parts ordained for the second concoction are also infirme We have shewed treating of the pain of the Heart what kind of Diseases are from the Stomach and cause pain Blood that is crude unconcocted foule and watery is made by the Infirmities of the Liver Spleen and Veins because these parts are ordained for the Generation of blood The Liver is the Instrument of Sanguification And that Sanguification may be hindered by the Diseases of the Spleen many former Arguments being omitted by which we shewed that the Spleen also is the Instrument of sanguifying and that it may be hindered by the Distemper of the spleen we can prove because as appears by Anatomies when the Liver is sound and the Spleen rotten there have appeared those faults of Sanguification which have been mentioned and have caused a Dropsie so that we need not make the consent between the Liver and the Spleen to be the cause Moreover from the Distemper of the Veins seeing they help to make Blood whether principally as some think or make it better after it hath been wrought by the Liver which all confess the Blood is less concocted and more crude And this cheifly caused by the Distemper of the meseraik Veins that come from the Liver and Spleen because the first change of the Chyle and preparation of it for Blood is by them for they snatch it and retain it first the Diseases which befal the Liver Spleen or Veins by which the sanguification being diminished the blood becomes crude and thence comes the Cachexy either alone with Cacochymy or Weakness Distemper Obstruction Hardness or the like Weakness of the Liver Spleen and Veins which by consent with the Bowels unto which they are joyned suffer with them is properly that which comes from want of Natural heat if it hinder the Functions so that the blood be not sufficiently wrought and therefore too crude Thus it is the cause of a Cachexy in which the Native colour of the body is lost and it grows bigger there is a shortness of breathing by reason of the Distemper of those parts and a pressing pain of the belly the Urin by reason of crudity is waterish especially if through the plenty of Water they cannot be tinctured with Choller if this Weakness last long it turns the cachexy into a Leucophlegmacy by aboundance of crudity which if it come from other causes also will make a Leucophlegmacy serous or watery Also if from the weakness of the attractive faculty of the Liver there be aboundance of Water not sufficiently attracted by the meseraik Veins the Dropsie Ascites as we shewed in the Treatise of the Dropsie will follow but if their weakness be such that the Blood be not only crude but not enough to nourish the Body it will produce a cachexy in which the Body is rather less then bigger or if by this weakness the sanguification is lost an Atrophy will follow A cachexy is known to come from this weakness if there be no other accidents or Diseases in the Bowels it appears by the evil colour of the whole Body that they are weakned and the Patients so affected are called Hepatick or Splenetick This weakness comes from this dispersing of the Natural heat which is from inward Causes from Birth or through Age or from external causes and remaineth after divers Distempers of the Bowels or other long and acute diseases Among which are Feavers after which the Bowels being weakned by too much heat or cold Drink which is usual there follows a Cachexy which by continuance caused the Feet Belly or whol body to swell Moreover great loss of blood especially of the Menstrual causeth a cachexy not only by the loss of Spirits but because the Veins want refreshment by their emptiness and want of heat with which they were nourished not onely by reason of that crude Juyce which is then produced but because the Body being exhausted looseth
its flourishing colour And if the loss of blood were great the body would rather grow less then swell Also other Evacuations by which the Spirits are consumed do the same among which too much Venery in Man especially The Distemper of the parts and Vessels ordained for sanguification may produce a Cachexy either simple or mixed with Leucophlegmacy or the Dropsie Ascites by causing the weakness which we mentioned to continue and by hindering the Actions of the parts The first is a cold Distemper which chiefly hinders the Functions and proceeds by over much and long use of cold things from external cold to which the Body hath been exposed from which the constitution is known to be such and in regard there is no Thrist and the body appears colder with all signes of a cold cause But although the hot Distemper of these parts especially of the Liver doth not at the first nor by long continuance produce this cachexy or evil Habit Paleness or swarthy colour but it appears rather in a fresh colour as we see in the faces of Drunkards and brings no great hurt as yet but only a constant Thirst by which this hot and dry Distemper of the Bowels is discerned yet in continuance of time in some sooner some later by weakning the bowels and making them unfit for action the Sanguisication being so hindered the body is thereby discoloured and of evil Habit which is a cachexy And this is turned into a Dropsie which appears first by swelling of the Feat and shortness of Breath after by other signs because by continual heat the bowels grow hard dry and cloven as we shewed in the Dropsie Ascites whose causes are chiefly constant use of hot Wines and Meats or hot Diseases The stoppage of the Liver especially of the porta and hollow Veins may be the cause of a Cachexy or cacochymy because it gives occasion to the production of evil and cholerick Humors especially which we declared in the causes of Feavers to be mixed with the blood in the meseraick Veins by reason the exact separation of them from the blood by the second concoction is hindered if impure blood be sent into the body there is rather a foul then a white colour and it is brown swart green or yellow yet not so yellow as when the Pores that conveigh the choler are obstructed and the choler is not separated from the blood as we shall shew in the causes of the Jaundies by which means the Urine in that is not so watery as in a cachexy but it is somewhat high coloured But if this chollerick filthiness retained by the same Obstruction and sent back into the Meseraiks be not much dispersed through the body there is rather a strange Paleness then a colour in the cachexy also the Urine is more crude and waterish and by reason of the plenty of choler in the Meseraiks there is a loosness rather than binding of the Belly and the Excrements will seem rather chollerick then white contrary to the Jaundies And if from the Obstruction mentioned there follow a weakness of the Liver as it may be from thence or other causes then because the working of the Blood is less there wil be a cachexy of crude blood in which crude Juyce nourishing the Body makes it swell But if the Obstruction be so great that by reason thereof the distribution of the blood whether crude or concocted cannot be made into the hollow Vein or such foul blood is produced that it cannot sufficiently nourish the Body it will decrease as we shall shew how an Atrophy comes either when the distribution of Blood is hindered by a great Obstruction or when the blood is unfit for to nourish The cause of this Obstruction in the Liver is either thick or vicid Chyle made of the like the food when it is fastned to the passages and grows more condensed and stops the parts or as some say crude chyle by reason of heat raised through violent motion or baths used after Meat which gets too soon into the Veins and is there retained til it stop them And this may come also from dryed and burnt Blood as we have observed by looking into the Liver of beasts which hath produced such Obstructions by being hindered and burnt into the ashes in the Vessels The same Observations in Man and Beast have taught us that Obstructions of the Liver may come from a serous or watery Humor For we have found in them that formerly by urine have voided Gravel the same red Gravel to be in the Vessels of the Liver sometimes turned to a brittle stone which being dispersed through the Vessels are like white Coral or Ice-sickles And these came from the Earthiness of the Serum which fixeth it self in the small passages as we have shewed in the Treatise of the Stone in the Kidneys It is generally concluded that these Obstructions come chiefly from Flegm which if it be not bred as other Excrements in the Liver of crude chyle and blood and there laid up it comes from the Stomach and Gutts where it is usually abounding being brought thither by the meseraik Veins with the chylus and there continuing it causeth these Obstructions and the sooner if it be slimy or thin and waterish which will more easily get into the Mouths of the Meseraiks if by long continuance in the Veins it grows thick by the heat of the Liver and so become viscous or slimy Also an a Obstruction in the Spleen may cause a Cachexy and such â—s is cacochymical which declares it self by a filthy colour in which if the evil Juyce get into the Arteries there will be beating of Heart and Arteries and the reason is because when the Spleen is stopt Sanguification is hindered and evil Humors are heaped up in the branches of the Spleen and gate Vein which may from the left side thereof go to the right and so into the Liver and then be distributed with the Blood A crude or cacochymical Cachexy as from other Obstructions so it may rise from the Hardness of these parts or Scirrhus which grows in the substance thereof or other hard Tumor which turns to an Imposthume for then the passages are either partly or totally stopped And this turnes to the Dropsie Ascites if from the Distemper or Hardness the parts be not only stopped but left open And because it is usual so we shall shew the causes of the dropsie Ascites more at large hereafter And in an Atrophy how it cometh as also those hard Tumors of the Liver and Spleen what are the causes of them and in what manner they are how they come either from too much drowth of the Bowels or too thick Juyce which nourisheth them They write that besides these Tumors the spleen may swell from wind but I perceive not how wind can be there to blow it up when it is not hollow It may be when the wind is gathered into the left side and stretcheth either the stomach which is
Womb and being more then will nourish the Child hence it is that they have these crooked Veins in their Legs because their blood being stopped is carried thither that is into the Legs which Veins consent with the womb as appears by letting Blood in the Foot to provoke the Terms and after they are delivered the blood being purged by the Womb as is usual these veins fall down except they be too much dilated Also blood sent by the Veins into the extream parts by reason of its evil Juyce produceth Varices or crooked Veins and somtimes ulcers let the Blood be what it wil it produceth Varices by its violent motion therefore they are chiefly in the Feet by reason of much Exercise But hard travail and long and great throws in Child-bed are the chief cause of Blood flowing into the Feet which produceth these Swellings of the Veins Also immoderate Venery because it forceth Blood violently into the Spermatick Vessels which hath been somtimes known to come forth instead of Seed and dilateth them may be the cause of the Swelling called Cirsocele which is of the Veins in the Codds And those Swellings come the more when the part is weakned and fit by its loosness to receive a Defluxion and when the part hath more and larger Veins then others or when it is dependant and lowest as was said There is another tumor rising from Blood gathered about the womb in the Veins thereof Blood in the veins of the Womb causeth the belly to swell as if the woman were with Child and stretching them out which causeth that Swelling in women which we shewed made them look as if with Child before Conception And this comes from Blood because the Courses have long stopped and it will not be dissolved but by a Flux of Blood And it appears that this blood doth not cause this tumor by getting into the Cavity of the Womb and by filling it till it stretch because the womb is fleshy and Nervous cannot be enlarged by any Humor as a Membrane and it cannot be enlarged but by the growth of a Child or Mole as we have shewed And if it were filled with blood it could not be kept there long and would be corrupt and putrified which it doth not because alwaies it comes afterwards forth thin and though some Clodds come therewith it shews that they grew so by stoppage at the first and caused this Swelling Now from hence we conclude that this Swelling of the Womb came Because blood being a long time retained in the Veins of the Womb doth not only enlarge them externally in the outside of the Womb and make them crooked and swollen but these Veins in the substance of the Womb which at other times are small and scarce apparent being now filled and dilated by degrees do lift up the substance of the womb and make it larger and so the Swelling of it and the stretching of the veins external causeth this Swelling of the Belly which when the Courses flow and the veins grow empty is asswaged except some other Disease happen as Cachexy or beginning of a dropsie when the Belly is so swelled with wind or water as we have known it in Women with Child and then the tumor is altered and will not be gone with bleeding I have observed in two full bodied Women this gathering and stopping of Blood in the Veins of the Womb which caused a Swelling of the Belly with distension and puffing up or inflation of the Breasts as in Women with Child whom at first I judged to be with Child which was their Hope but not long after the Courses flowing plentifully they were freed both from Swelling of Breasts and Belly Blood in the Arteries causeth that beating Tumor called an Aneurism Blood getting out of the Arteries under the skin is the cause of the tumor called Aneurism which they suppose to be from the dilatation of an Artery as the other was from the Vein And it was formerly declared that this only may be in the inward Arteries and that from an internal Aneurism Pulsation of the Heart and Arteries may proceed when we spake of that Disease But since the Branches of the Arteries do not spread themselves to the skin nor are they fastned unto it as the branches of the Veins are this Swelling cannot be like that of the Veins except by chance an Artery do so swell in some part near to the skin that it appear external and cause Pulsation And if this be so it must come from the same Cause from which we told you in the Palpitation of the Heart the inrernal Aneurism did proceed But an Aneurism doth not come only from the Dilation of the Artery while it continueth sound and whole but often though not alwaies if it be external it comes from some manifest apertion of the same For then the thin Blood which comes out of the Artery gets under the skin and makes it swell and there makes a Hollowness into which the Artery disburdens its self as it is wont to do in the Brain Naturally so here preternaturally by throwing forth the Blood with the Spirits in its Diastole or Dilatation and drawing it again in the Systole or Contraction of it self and this causeth the Pulsation in this Tumor Now the opening of the Mouth of the Artery is the Cause of this Bleeding when being dilated by the Causes mentioned it doth not only swell but makes way under the skin for the Blood to get forth by opening the mouth through the Distension Or if the Artery from the force of that spirital Blood be so compelled that it is stretched forth and opened or be hurt by any external sorce so that it be broken externally it may send blood under the skin as we have declared But it is apparent that this happens not from an Artery broken or by stretching opened internal but external in that the Mouths of the Arteries which end and shut up the same have their termination in the extremities of the Body where the Arteries end and if an Artery inwardly hurt or opened should bleed the Blood would fall into the Cavities of the Body neither would it produce a Tumor such as many times is inward also when the Artery is onely stretched Moreover that an external Aneurism comes often from the effusion of this Arterial blood by the Causes aforesaid under the skin and not from the dilatation only it appears in that the Tumor is round rather than long like the Artery dilated and not wrinkled or twisted like a Varix But it appears chiefly by an incision made in the skin swollen that the blood was lodged there because it leaps out suddenly and often in such abundance that as it hath been observed it could no waies be stopped but the Patient hath bled to Death and that this Aneurism came by the breaking of the Artery appeared by the leaping and in regard the Pulsation was such and it had long continued and
in their Legs after they are delivered they commonly vanish And if either Man or Woman have them continually they regard them not till they trouble them But if they itch or pain them or turn to an Ulcer they must be cured because while they continue the Ulcer cannot be cured as we shewed in the Kind of Ulcer For the Cure first consider the Plethory and evil Habit or Juyce in the blood and this must first be cured by letting blood and purging as we shewed Then we must apply things that may repress and consume the filthy blood that stretcheth the Veins And that with Lotions or Fomentations with a Decoction made in Forge-water or Lye or Urin of Fennel roots Bugloss the great Agrimony Laurel Cole worts of Rosemary Elder and Lavender flowers Cypress nuts Sloes Lupine seeds Cole-wort seed with Salt and Allum and if you will astringe more with Vitriol Or with this Fomentation or Epithem Take burnt Chalk three ounces Bole or fat Earth one ounce and an half Acacia or dryed Sloes one ounce Sanguis Draconis six drams Myrrh half an ounce strong Vinegar one pint and an half Lye three pounds with a little Salt and Vitriol we stop the flux by Ligatures or Roulers about the part beginning from below upwards as we shewed in Oedema alone or with a Fomentation afore or we wet the Rouler in the Fomentation and strain which will be stronger thereby especially if it be made of Sloes Somtimes we cut off the great Vein which nourisheth the Ulcer when it hinders the Cure of the Ulcer if there were no Ulcer we would not do it because dangerous if but opened It is better therefore to bleed in the other Leg for Revulsion But when we will cut a Vein out that nourisheth the Ulcer first you must mark its Passage above with a Pen as it comes from the Ulcer and then open the skin by longitude and lay the Vein bare then rub the Blood down and tye the Vein above and cut it beneath in length to let out the blood then bind it next to the Ulcer and cut it that part of the Vein which is between the two Ligatures and so the way will be stopped by which the Ulcer was fed The small crooked Veins in the Codds Privities of women and Eye-brows or in other parts of the skin because they hinder not are not regarded but if you will do any thing you must revel the blood from the part and repel and discuss it as in Inflammations only your astringents must not here be so cold least the Blood congeal Cirsocele is when the spermatick vessels are swollen The Cure of the Stone vessel rupture and if it hinder not the Seed it is not regarded because it is hard to be taken without Gelding and except it grow great like a flesh Rupture it is not attempted but you must use Fomentations and the like before it comes to that Aneurisma that is a Tumor from the opening of the artery The Cure of Aneurisma when the blood thereof gets under the skin when it is old is not curable because the blood cannot be repelled by astringents or the mouth of the Artery lying deep be shut Nor may we open it because the Patient would certainly die of a Flux of Blood which cannot be stopped Therefore if at the first Repellers and Closers of the Artery mentioned in Haemorragy or Bleeding do nothing we must leave it except we will use a Ligature or Plate of Lead to keep it down As for an internal Aneurism because it hath no external Tumor of which we spake but produceth the Heart beating we have shewed how it must be ordered when we treated of Palpitation of Heart and Cachexy Tumors comming from Seed as that which is Natural of the Belly in Women with Child require nothing but good Government to prevent Abortion or Miscarriage as shall be shewed in the Treatise of unseasonable Births The tumors of a Womans Belly from a Mole The Cure of the Belly swollen with a Mole is to be mentioned in things cast off because the cause is not to be certainly known till the Mole is brought forth The Cure of particular Tumors is not here to be repeated The Cure of tumors that are from the Birth if they come from the Seed at the Birth as Sarcomata Kernels Struma's and the like because they are to be cured as those CHAP. IV. Of Defoedation or Defilement The Kinds UNder the Name of Defoedation we understand those Infections which defile the Body with many Diseases so that they are that infected with them must leave the society of sound Men. Of this there are two Kinds principally The one is old called Lues Elephantica or Leprosie the other new called the Lues Venerea or French Pox. The body is many waies defiled by them with such as are common to both as tumors pustles ulcers and falling of the Hair and others that are proper to them in particular Pains and Hindrance of Functions There are also other Infections that have been first known our age that defile the Body and are proper to some Countreys among which the Scurvey is most known usual in the North of which we shall speak here leaving other Infections to them that know them It is called Elephantiasis The Leprosie called Elephantiasis from the Likeness of the Patient to an Elephant his Ears growing thin and broad like wings they are called Lepers from the Roughness of their skin and from their Lyon like looks it is called Leontiasis and because they are Lecherous Satyriasis In this there are divers accidents which are to be searched and described because they shew how it came and they who have it are to be examined by the command of the Magistrate and separated from the sound that we may judg rightly and not mistake as usually and offend either sick or sound In regard I have been thirty years appointed and have examined above six hundered suspected of the same I will faithfully declare first the Diseases they have and then the Actions hurt and examine the things cast off that we may know how to judg of the same The outward Infirmities are chiefly in the Heads and Joynts and the Searchers do scarce examine any other part and yet give sure Judgment In the Joynts they examine the Hands and Feet Fingers and Toes and Nails and above the Knees to the Thighs above the Elbow to the Shoulder and in the Head they search the Mouth Eyes Nose inside and outside Face Ears and Hair Eye-brows and Beard and the tumors and ulcers there to judg by them alone or together There are oftentimes little tumors in the Leprous upon the Face and Joynts in the Face upon the Fore-head and Cheeks and making them look wildly which first discover the Disease and are in the Arms Backs of the Hands and in the Feet and Thighs These are moveable and without pain and are blewish red especially in the
especially flesh which requires more Nourishment then other parts and being soft is sooner consumed but the harder parts as Bones Grisles Membranes consume not because they are nourished with little and are more firm as we see the bones of dead Men last long This want of Nourishment is from divers Causes and first because it is not bred or it is unprofitable or it is hindered When the Bloood is not sufficient then because the Juyce nourishing the parts faileth and the fat continually decaying is not renewed by the like the body consumeth this is from want of Chyle in the first concoction when sound men have too little Food or sick men too little Appetitâ— which causeth decay as well as the Disease And this may come from other Diseases of the Stomach as want of concoction when there is little or imperfect chyle as in the Tympany those parts which are not consumed The body is extenuated from the want of a second concoction when the blood is not made this causeth an Atrophy this is from the fault of the Liver or Spleen as weakness c. When a Cachexy or Leucophlegmacy from their actions diminished or from their actions lost so that there is little or no blood also other Diseases of the Liver or Spleen breeding a Dropsie Ascites may cause an Atrophy therewith where the parts above not swollen like Feet and Belly are consumed these are described in the cause of the Dropsie The blood is unprofitable and unfit to nourish if it be foul not crude which causeth cachexy and Leucophlegmacy but impure then it breeds Leanness or Atrophy which is joyned with Cacochymy and if it be watery it gets the Atrophy with the Dropsie Ascites this is from the first concoction which is not mended in the second or in the third as we shewed When the blood is stopped from a part it hath an Atrophy The want of Nourishment from â—â—ood hindered is the cause of the Atrophy of a Part. this comes from an outward cause for the internal from want of blood would cause Leanness of the whole body The blood is hindered from distribution by the Veins stopped and pressed by the Dislocation of some Joynt as the Hip from which follows often an Atrophy of the Legs and sometimes Numness if the Nerves be pressed with the Veins Also when Members are too long bound or if the Veins are straightned by a Callus Tumor Node or Wenne about the Joynts or cut off especially if the great Veins or many be so cut off for the lesser Veins and few being cut there are others to nourish the part And if the great Arteries be cut off there will be Mortification rather then Consumption For the want of Substance making Juyce and of Natural Heat The want of substance making Juyce is the cause of Consumption or Tabes the Body consumes and that somtimes through age for as the body grows thereby being young and flourisheth thereby in middle age so in old age as that decayes the Body consumeth through the driness of the parts also which comes by their Temperament whereby they are withered The same may come from Labour Care and Diseases being vehement and persevering whereby the radical moisture and Natural Heat is consumed and weakned as in old Age so before by Labour and Cares and Diseases Men become sooner weak and lean and so continue all their lives except the Natural Heat be not so weakned but it may be repaired And then though they be very lean yet if they leave off Labour and Care and grow sound they will recover their former Vigor It happens through the change of the Constitution into a more hot and dry temper The change of the Constitution into hot and dry is the cause of Marasmus when all the parts are of a like temper that the Body doth not increase in young Men and in the aged it decreaseth and groweth dry and withered As in a Hectick Feaver coming from the heat of another Feaver which changed temper of the Heart making it too hot and dry the Body consumes of a Marasmus as we shewed in Hectick Feavers And though it is by degrees in this kind of Hectick yet is it of a sudden in Colliquation or melting and it follows a burning Feaver the extream Heat whereof did not onely turn the temper of the Heart into hot and dry but melted the substance whereby the whol body became dry and consumed As I shewed in the melting Feaver This is not only in simple Hecticks but in such as are joyned with a Distemâ—er of the Lungs The Ptysick is caused by the change of the Constitution into hot and dry and a Hectick Feaver so that the Body consumes as in a Hectick and this is called Phthisis Ptysick because the Lungs distempered are the cause of it This Consumption rising from a filth and Rottenness of the Lungs doth continually disturb the Heart adjoyning by Heat and makes it and the whol body hot and dry which causeth a Hectick Feaver as other Hecticks come from other Feavers as we shewed in Feavers The first Cause of this Rottenness of the Lungs and the Hectick that comes from thence and the Consumption that follows that is the Ulceration of the Lungs till they rot so that the Lungs are in part or all one side turned into matter and the Vessels of the Heart which are joyning to the Lungs are lost on that side and as it were cut off about the Heart and a Callus at the Root And this Corruption hath been so great that the Mediastinum that divides the Lungs and the Pericardium or Case for the Heart have been infected thereby These things being thus the matter which breeds in the Ulcer of the Lungs Matter in the Breast is the Cause of Empyema is not only spet out as it falls upon the Branches of the rough Artery but at length when the substance of the Lungs is divided by corruption it fals into the Cavity of the Breast and there being heaped up it causeth the-Disease called Empyema This appears to come from the Ulcer by Anatomy for when there is corruption of the Lungs you shall alwaies find some matter in the Breast As also in regard that matter coming from the Suppuration of the Membrane that compasseth the Breast fals seldom into the same for it will rather fal out of it as was shewed in the Pleurisie But an Impostum growing to the Membranes or to the outward Tunicle of the Lungs being broken by other Causes then Inflammation may send its matter into the Breast or matter may flow there 〈…〉 as they say may be from an Angina suppurated or Squinsie or from a Defluxion of Flegm into the Breast But in regard there is no passage from the Neck into the Breast and if they should get into the rough Artery except they were coughed up they will rather fall into the Lungs then the Cavity of the Breast this is not probable
themselves and after they come to themselves they remember none of those things they have sufferd neither do they know that they have sufferd this evil unless they be told of it or suspect it by taking some signal from the marke of some hurt left behind as a Wound or Contusion All Motion also both voluntary which wholly depends on our power and that which is performed by help of Nature as breathing and evacuating and that of the Pulses which Nature alone performs continuing in all these Species distinguisheth the Epileptical from the Apoplectick and Syncopal in whom these motions do fail the Pulse only remaining in the Apoplectick The which notwithstanding being deprived in the Convulsive doth cause that they fal and use inordinate motions But they fall not by reason of a privation of the senses but because their whol Body at once and of a suddain is convelled so that unless they be forewarned by a Vertigo which is wont somtimes to go before it or being taught by Custome of the fit at a day or hour if it be wont to come at set times they have a care of themselves being seazed with it whiles they are upright they presently fall down like to the Apoplectick and those that fall into Swonings and as t is commonly said are free neither from Water nor fire but are in the greatest jeopardy by danger of the fall and if upon this account t is less danger for those who lying in their Bed by reason of some sickness cannot fall when the Convulsions come upon them yet they are more hazarded by the cruelty of the Disease So that every Epilepsie is horrible and abominable which the ancients therefore called the sacred Disease as sent by the Gods by way of punishment and others have Superstitiously imposed the Names of the Gods on it They also so stir their Body with inordinate motions That oftentimes t is all of a fire and the pulse becomes more swift and somtimes sweats break forth Wreathing and distorting their Back Neck Head Arms Feet into divers Figures and with them beating and shaking every thing in the way as the Bed Walls Ground bruising and wounding their own Limbs gnashing with their Teeth set and bitterly biting their Tongues if they be out rowling their Eyes about which being opened and very much drawn asunder as also the bending of the Face towards the hinder parts do usually give the first sign of the fit assailing which at length in the end of the fit lying as men wearied and astonisht they keep fixt and sterne til they come to themselves again Their breathing also is very unequal whenas somtimes they hold it for a while so that from the stopping of their breath and vehement striving they somtimes cast forth their ordure and Urine and seed to especiif it abound But at other times they fetch their Breath with difficulty and noise both when an Epilepsie of the Womb hath the said strangulation its companion and cause and when Flegm falling upon the Jawes and Nostrils hinders it and they bring forth a froth at the Mouth and Nose arising from Flegm confused and stirred there with the Air which happens not to the Apolectick and Strangulated unless they die saith Hippocrates and oftentimes they make a noise with crying out But these accidents which we have related as they come on a suddain so the fit ceasing they presently remit Yet somtimes certain relicks of them do remaine and the senses being yet weakned they cannot rightly understand Reason or remember any thing or an alienation of Minde coming upon it they do all things amiss and blaspheme or they break forth into a great Laughter perhaps that which Cicero calls Sardonian and that till a new fit return which is wont to attend these foretelling signs but before and after these fits some particular convulsions somtimes either went before or remain as a distortion of the Mouth a difficulty of swallowing or a spasme of some other parts as shall be explained in its place or that Spasme which they call Flatulent which somtimes also threatens Convulsions if it be by reason of the Nerves as shall be said as also that convulsive Palpitation which also caused from an affect of the Nerves doth oftentimes along while forego an Epilepsie and remain still in the Members after it and exercise it self or other Symptomes of motions do somtimes trouble them as with Gesticulations somtimes Dancings or some other disturbance of the Limbs and tremblings of them A Stupidity with Rigidness of Body is a rare and wonderful affect A Stupidity with rigidness is a Catalepsis which is called a Catoche or Catalepsis that is a laying hold off which they cal also a Congelation whenas they are as stiff as if they were frozen in which all the internal senses and external are suddainly abolisht but only the motion of the Body is depraved whenas they keep that form which the Body had before it was seazed on with this evil whether Lying Sitting or Going and being taken like a statue they cannot change it neither of their own accord nor by compulsion and with their Eyes open whence they have called it the watchful Stupidity yet blâ—hd and altogether speechless breathing in the interim not taken away or very much hindred nor the Pulse But it happens also in some A Stupidity with hearing remaining that though they lie rigid like a stock without motion and speech yet nevertheless they perceive those things which the standers by do speak off and can afterwards relate them which they have called Ecstatick But others remaining in the same state like to dead Men although they heard nothing A Stupidity with motion remaining nor saw not now being prickt fet nothing yet if any thing were put into their Mourh they swallowed it and being lift up do stand being forced do walk and keep their Members fixt in that posture as they are bent for them In a certain Woman thus taken only the Belly and Breast were very much moved all the rest of the Body being stupid The Causes In all the foremention'd kinds of Sleep and Stupidity with Languishing Convulsion or Rigor it must needs be that the Brain is affected whenas all motion and sense proceed from that Neither here as they would have it are the Functions diversely weakend as the former middle or hinder Ventricles of the Brain are hurt nor as the Brain is affected before or behind whenas the substance of the Brain doth on every part perform its Functions but as it is more or less hurt it looseth more or fewer Functions For if the hurt be great so affecting the Brain that all the senses be abolisht then it must needs be that motion also doth cease other Functions in the interim remaining which the Brain is not the cause of as the Pulse which the Heart yeids and whenas the motion of breathing is partly Natural partly Voluntary and therefore doth proceed from the Or-Organs
of both motions both the Midrif and Lungs t is no wonder that that also if the Brain be very much hurt so that all Voluntary motion do cease as it comes to pass in the Apoplectical the Midrif or Muscles of the Breast then contributing nothing to Motion but the Lungs only after a sort moving themselves stil and whils they are dilated and filled with Air which they do by their prover Natural motion a little lifting up the Breast do a little while Persevere but very much hinderd and difficult so that unless that hurt of the Brain do speedily cease the Patient must needs be choaked breathing being wholly taken away but when voluntary motion is not wholly taken away with the senses that then respiration doth remain still more free But if the Brain be affected with a less affect compared to the former by which the senses are only opprest as in a sleepiness or gentle Stupidity then motion though it do rest a little by reason of Sleep and Consternation yet nevertheless it doth persevere or if this come to pass only by reason of the spirits of the Brain only extravagant as shall be said in a Convulsion and Catalepsis that motion doth also continue and they sooner return to themselves as shall be explained how this comes to pass in the Particular causes from which these proceed But the causes of all Consternation of Minde that happen are either some offect so hurting the Brain which gives Sense and Motion by it self or by consent that these its Functions do more or less fail as are Distemper Repletion from a flegmatick or sanguine Humor some eminent hurt a Tumor a distemper of the Brain proceeding from a Vapor or Malignant quality or a defect of the Animal spirits of the Brain of all which causes and their effects we will now treat in Particular A cold Distemper only without matter altering the Brain A cold Distemper the Cause of Stupidity a Moist of immoderate Sleep because it is wont to hurt the Functions may make it Stupid And if it be Moist too which is seldom without matter it may also cause Immoderate Sleep as somtimes by Reason of Age or the continuance of a Disease a distemper left in the Brain doth make men perpetually Prone to Sleep or as it was said in the Weakness of the Minde more dul which we have taught doth happen rather by reason of Weakness then Coldness Or induced by other causes especially from the cold external Air the North Wind blowing outwardly cooling the Head or by the Pores percing to the Brain it may cause a great Stupidity They write also that a watchful Stupidity or Catalepsis may arise from a Cold and dry distemper congealing the Spirits but whenas the Spirits cannot be congealed or if they could be then a greater Stupidity would follow we cannot at all allow of this That Convulsions are somtimes caused from Dryness which they call Inanition is a common opinion which doth not happen in this Convulsion but in a Particular one as we shall there explaine Flegm is very often the cause of Sleep and Supidity under which Name we comprehend all the Watery Cold and Moist Excrements of the Brain which immoderately heaped up within the Skul as the Brain doth ever and a non heap up such things from Flegmatick blood varried up to it and the weakness of the part if it be supprest and flow not forth through the passages appointed for it then if it perfuse the substance of the Brain with a large humor and cool it it causeth a Carus Or if by its long impulse it so moisten the same that that great bulk of the Brain becoming more soft and lax do suddainly flow abroad and sink and press the original of the Nerves at the basis of the Skul proceeding from the Brain and stop the passage of the Animal spirit it procures a grievous Apoplexy As when Flegm doth suddainly fill the Ventricles or Cavities of the Brain not by obstructing whenas the Animal Spirit is not seated in them but every where in the substance of the Brain and Nerves neither doth it pass through the Ventricles but after the same manner by oppressing the basis of the Brain it may also induce an Apoplexy the which notwithstanding if the humor descending from them do follow the course of the Nerves may end in a Palsie That all these things are thus in a Carus and Apoplexy we have learnt from the dead because this humor hath somtimes flown from their mouths in a plentiful manner And we have observed also by diligent dissection that the thick Membrane of the Brain open'd in some abundance of Humor hath presently lept forth by the Region of the Head and descended even to the Breast and the very substance of the Brain in a certain old Woman which died of an Apoplexy dissolved like to Cream after the same manner hath run all over her Face But we know that these affects proceeded from the Cause by the precedent constitution of the Body especially in old Age which is Obnoxious to this evil and from a cold constitution of the season and Air and because they have first complained of a heaviness in the Head and a weight with slaggishness darkness of the sight and also of a want of that accustomary voiding of Flegm by the Nose and Mouth and because in the dead of an Apoplexy especially oft times a great quantity of Flegm flows forth by the said passages From the same Flegmatick Humor obstructing the passages of the Brain many have written that as an Apoplexy so also an Epilepsie may be caused and therefore as in that so in this that all the senses are abolisht but do presently return again because the Brain by concussion doth speedily shake it of and then that motion with the senses doth no way cease here as is an Apoplexy because the Ventricles are not altogether but only in part obstructed or as others will have it the former only are obstructed the hindermost being unhurt so that a portion of the Spirits may nevertheless pass by to the Nerves Which though it may be condemned for many things yet let it suffice to have brought this especially to destroy this opinion viz. that if a sufficient quantity of the Animal Spirits did not descend the Functions of the Brain would rather follow to be impared in sense and motion then partly abolisht partly depraved and that if Flegm were the cause and that suddainly shaken of from the Brain did flow down it would induce that Palsie which is wont to follow an Apoplexy for the same Reason They teach that Flegm putrifying in the Brain doth Cause a Lethargie and a Feaver its companion is kindled from thence but whenas we have shewed in Feavers that from the Putrefaction of Flegm especially in the Head that a Feaver can in no wise be kindled and we find no reason how the same Flegmatick Humor being putrified by its coldness