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A59999 A short compendium of chirurgery containing its grounds & principles : more particularly treating of imposthumes, wounds, ulcers, fractures & dislocations : also a discourse of the generation and birth of man, very necessary to be understood by all midwives and child-bearing women : with the several methods of curing the French pox, the cure of baldness, inflammation of the eyes, and toothach, and an account of blood-letting, cup-setting, and blooding with leeches / by J.S., M.D. J. S. (John Shirley), M.D.; Shirley, John, 1648-1679. 1678 (1678) Wing S3496; ESTC R38236 39,001 140

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mal non ha morte chél pensar a morire E chi morir pur duce quanto piu tosto more Tanto piu tosto al suo morir sinvola A Faculty is a certain disposition of the Body whereby it can do something though it may be it doth it not so that it is only a power of acting It s division is needless since it is but one power though it produceth several actions according to the Vacuity of its Organs A Function is described the exercise of a Faculty and is only distinguisted in Natural and Animal Pulse being referred by the Moderns to sanguification whereof we have spoken in the Theorem of Blood and Respiring to motion of which will be said hereafter The Natural Function is divided in 1. Nutrition 2. Growth 3. Generation To the first whereof the Antients made four others to be subservient for as Dykes saith of the Soul Here she attracts and there she doth retain Here she decocts and doth the food prepare There she distributes it to every Vein And here expels what she may fitly spare Yet the Moderns do exclude from thence all similary attraction and retention Deglution being performed by Detrusion only the several parts of the Mouth the Tongue the OEsophague c. contributing thereunto Retention being also effected by the Oblique Fibres of the Stomack but Hunger is produced by the sourish Vapors of the acid in the Stomack which do gently Vellicate its upper Orifice and the apparent cause of Thirst is the want of moisture To Concoction three others are subordinate 1. Chylification 2. Sanguification 3. Assimilation The two first whereof together with Expulsion are explained in the describing of Humours so that only Assimilation and Growth are here to be expounded which take thus When the Arteries begin to swell as aforesaid the particles of the Blood which in them are convey'd to the roots of certain filaments issuing from the ends of the smallest Arteries whereby they compose the Bones Flesh Skin c. according to the various manner of their application and contexture or directed by the same Plastick virtue whereby the said parts were formed which they nourish something distending them and intruding themselves in their vacancies where they remain when the Arteries return to their former state And Growth is likewise effected The pores of the matter of Chi●drens Bodies being easily extended whereby some particles of the Blood a little greater than those whose places they fill may enter and subsist therein which cannot be longer done when their Limbs are grown more solid Generation is a Function whereby a man produceth another like to himself whereunto the Antients did subordain two others 1. Alteration 2. Conformation Which the Moderns do rather attribute to the Plastick virtue of the Seed though denyed by Rhegius and other Cartesians who affirm That the particles of the Seed moved by its own heat and that of the Uterus because of their various figures are necessarily turned into the Brood of an animal whereunto they since attribute the whole formation of the Foetus without the Function of any intellectual faculty directing it The Animal function is divided in 1. Principal 2. Moving 3. Sensitive Whereof the first comprehends these three viz. 1. Imagination whereby all Objects Species offered to the external senses are perceived and discerned 2. Reasoning whereby a man discourseth and understands 3. Memory whereby the Species of things perceived conceived and understood are preserved whereof will be further spoken in the period of Sensation Motion is thus performed The most vivid and quickest particles of the Blood such as we may conceive the Vital Spirits do ascend from the left Ventricle of the Heart through the Caroties and Cervical Arteries into the Cavities of the Brain where they are turned into a subtile flame or wind usually called the Animal Spirits which being driven by grosser particles do not enter in the Pineal Glandule Steno having shewed us how unapt it is thereunto but in some yet unknown more convenient place of the Head whence they sally out into the Cavities of the Brain and the pores of its substance to be thence conveyed into the Nerves where they have a power which the learned Willis calleth Elastick to change the figure of the Muscles and so move the whole Body To this manner of moving Respiration is also to be referred for the Muscles of the Thorax drawing it up the Lungs to avoid vacuity are extended whereby their small cavities are opened and receive the inspired Air which is again excluded in expiration when the Lungs following the restriction of the Abdomen their said Cavities are again straightned The Sensitive Function is the exercise of the five external Senses which comparatively to certain Beasts are comprised in these two Verses Nos Aper Auditu praecellit Aranea Tactu Vultur Odoratu Lynx Visu Simia Gustu That is The Bore excels in Hearing and the Spider By sence of Touch is a subtil divider The Vul●ers Smell th' Apes Taste and Lynxes Sight Excells the Man by far that solid Wight Their respective Instruments are 1. The Eyes of Seeing in the Retin● 2. The Ears of Hearing in the Auditory Nerve 3. The Nose of Smelling not through the Os Cribriforme which is not pierced as the Antients conceived but by the Apophysces Mammillares or the extremities of the Nerves 4. The Tongue of ●asting by the Papillary eminencies noted by Bellinus whence Savours are conducted to the Filaments of the 4 and 7 pair of the Nerves that end there 5. The Skin of Touching by the Pyramidal papils observed by Malpigius and esteemed the extremities of the Nerves of the sixth pair ending in it Sensation is performed as followeth When the small Filaments of the Sinews are in the least moved by the Objects of the senses they draw to them the parts of the Brain from whence they take Origin whereby they open some pores of the inward superficy of it through which the animal Spirits being derived into the Nerves and Muscles do excite those motions which we perceive our senses being thus or so affected which is to be understood of all Sensation and if the said spirits having the Impression of some Id●a conceived or also discerned in some fit place of the Brain as Cartesius esteemed the Pin●al Gland●le do often pass through the same pores of the Brains texture they do dilate them so that the Objects being absent they may be represented to the Soul whence Memory doth depend But if opening one or more of them some others are dilated Reminiscency is effected and if the traces of the Ideas are conveyed by the smal Ar●eries to the heart and diffuse their beams throughout the mass of Blood it may thence proceed that the Foster is sometimes noted with certain markes Sleep is a Cessation of Motion and of the External Senses and is produced when the Braines substance is not sufficiently ●istended by the Spirits aforesaid or when it is over●whelmed with
and hurtful and is either of the whole body chiefly performed by Phlebotomy Sweat and Purgation or of the several parts by their respective Conduits as the Brains by the Eyes Nose and Eares the Lungs by the Wind-pipe c. In all Evacuation three things are to be observ'd and considered The Quantity Quality and manner of Excretion V. g. The Empieme being opened the excluded matter ought to be answerable in quantity to that which is included The most laudable is white even and as little stinking as may be And lastly all must be purged out at one time least the Patient suffer too great an Effusion of Spirits The Passions of the Soul or Perturbations of the Mind are very prevalent to alter the Bodies Constitution for as the Banished Poet saith Unda locusque nocent causa valentior istis Anxietas animi quae mihi semper adest The Sea and place do hurt but yet I find A greater Cause the torment of my mind We wil therefore brie●ly expound their Effects A moderate Ioy dilates the heart and distributes abundance of Spirits to the Face and other parts it helps Concoction and renders our habitude more chearful and pleasant Anger or Wrath performs the like effusion but much more rapid and swift● It kindleth sometimes the Humours so much that it makes them apt to receive a sharp volatile Salt which is thought the cause of putrid Feavers and produceth also other Symptoms yet it may be profitably used to quicken the natural heat and render it more active when it is almost prostrated Sorrow and Fear draw heat and blood suddenly to the Heart whence the forces do presently fall and sometimes death immediately follows the Vital Faculty being over whelmed with Blood and Spirits This I conceive sufficient since all other Passions of the mind may be referred to these three or four Those things are termed against nature which may procure the destroying and ruine of the Body They are the cause of Diseases Disease it self and its Accidents or Symptoms The Cause of a Disease is Whatsoever doth any way contribute to the being or increase of it Which though Physitians give them many distinctions may nevertheless all be referred to the efficient especially divided in 1. External 2. Internal For Alas How many things may extinguish our light The humours within us maintain an equal fight and least it be too long Death hath a Pike a Ball a Sword a Knife a Stone and an Arrow to cut our feeble thred c. The External Cause cometh from without the Internal hath its seat in the Body and is either 1. Antecedent that yeilds aptitude to a sickness Or 2. Conjoyn'd which immediately and of it self perfects it They are also co-ingendred with the Patient or have accesse to him after his Birth A Disease is A disposition against Nature immediately and of it self hurting the actions The same is Simple or Complicated The first is when there is no plurality or composition of Diseases The second When it is followed of many Symptoms or when the Cause is so connexed with it that it may be lookt upon as a particular Sickness Diseases are of a threefold species 1. Intempery 2. Evil Conformation 3. Solution of Continuity The first is an Indisposition of the Similary parts caused by the excess of a single Humour or the Exuberance of more The last whereof is called naked or conjoyned with a Vice of the same Humours and is termed equal as being ●qually spread throughout the whole Body or inequal as affecting only some particular part of it There are four sorts of evil Conformation Namely in 1. Figure 2. Magnitude 3. Number 4. Scituation Solution of Continuity is a common Disease of the Similary and Organical parts which hath several Names according to the places where it is incident For in the Flesh it is called Helcos in the Bones Cathagma in the Nerves Spasma The Symptoms of a Disease are the Effects and Productions of it To wit 1. A hurt action that is 1. Abolished 2. Diminished Or 3. Depraved 2. A Vice in the Bodyes Habitude 3. Vitiated Excretions Of the aforesaid Precepts are collected two Intentions 1. What is to be done 2. And if it may be done But the third belongs to Art viz. How it must be done The Practice whereof is better declared in the Words annexed and the following Chapters that do briefly comprehend what doth belong to a Chirurgeon The Indications are of three first and principal Species viz. 1. The first is drawn from the natural things which do Indicate their conservation by the use of things like to themselves and of this kind are the Indications drawn from 1. The strength and forces of the Patient which to preserve the proper Cure is often to be delayed for without them the Chirurgeon can effect but little 2. His Temper viz. 1. Sanguine 2. Cholerick 3. Phlegmatick 4. Melancholy 3. The Habitude of his Body 1. Soft and delicate 2. Lean or Fat. 3. Tall or Short Least he lose that Symetry which Nahath allotted him 4. The Condition and Nature of the part affected Wherein we consider 1. It s Substance whether if Similary it be 1. Hot. 2. Cold. 3. Moist 4. Dry. If Organical 1. Principal 2. Or Ignoble If it be 1. Of a quick Sense 2. Or Stupid and Dull And lastly it s 1. Form 2. Figure 3. Magnitude 4. Number 5. Connexion 6. Action or Use. 5. The Age for many Diseases cannot be Cured in Old Age. 6. The Sex for Women are easier purged than Men. 7. The Season of the Year for Hot meat is convenient in Winter Cold in Summer Moist in Autumn and Dry in the Spring 8. The time of the Disease for what is convenient in the beginning is not so in the progress state or end II. The second is drawn from the things not Natural Which do indicate their Alteration as if Air does conspire with Nature against the Disease it ought to be kept otherwise it must be altered III. The third is taken from the things against Nature which indicate their Ablation and are 1. The Cause of a Disease 2. The Disease it self 3. The Symptoms Which do often indicate contrary things but then this is the Rule When there is Complication the first Remedies ought to take away 1. The most Dangerous 2. The Cause 3. That without which nothing can be done As 1. Loss of Blood 2. Fluxion 3. Intempery A SHORT Compendium OF The PRACTICAL Part OF CHIRURGERY CHAP. II. Of Impostumes HAving thus far treated of such Theorems and Institutions as are wholly necessary to be known of all Well wishers to Chirurgery let us now say something of the Practical part thereof since it is almost impossible to treat perfectly of the Theorical unless the same do give some urgent occasion of it and in this it resembles the three Parts of Curative Physick that can hardly be separated from one another for as a French Poet doth intricately say Quand
aaren sender Inarings meening Shy hun den til blod forvender Ocs giffuer det igieu naar saften ny yder At samme ferske blod til alle Lemmer flyder Ued aarr gangr krum c. That is Thou Stomack gallant Cook thy meat so well dost dress That of it in a trice thou canst a juic● express Full of craft which is then sent by the middle Vein To th' Liver that it may the dye of blood obtain Whence it is given out when th' other sap is wanting And is seen through our Limbs a free passage attempting By crooked Channel-Veins c. This was the Antients meaning but the Moderns have found that the aliments being well chewed in the Mouth are by the Oesophagus transported into the stomack where by the virtue of some acid liquors proceeding from the reliques of the former Concoction and the Vapours of the Pancreatical juice together with the sub●il descending from the Maxillar Glandules they are fermented agitated and calified almost in the same manner as mettals are dissolved by Aqua fortis In the mean time the aliments helped by the warmth of the neighbouring parts do often contract a spontaneous heat as we see sometimes hay too freshly brought in whereby they are digested which being done the stomack straightning it self and opening its lower orifice called the Pilorus they are thrust down to the Duodenum where by an effervescency arising from the mixture of Choler descending thither by the biliary conduit together with the pancreatical juice and Phlegm sticking to the Bowels they are segregated and their grossest parts precipitated down to be expelled at the seat whilst the subtilest called Chylus are transported by the milky Veins to the common receptacle where being diluted by the Lymphatick humor the Chylus is carried by the Thoracick conduits to the subclavicular branch of the Vena cava where it is mixt with the Blood descending from the Head and other superiour parts of whose Nature and Colour it begins then to partake without coming to the Liver which therefore can neither be the seat nor organ of Sanguification The Chylus thus mixt with the descending Blood being come into the trunck of the Vena cava is mingled with the Blood which ascends by the same Vein from the inferiour parts and is transmitted into the right Ventricle of the Heart where it suffers an effervescency arising from the mixture of the Lymphatick spirit and the lixivious salt of Choler communicated to the Blood out of the Gall by the Hepatick conduit whereby the fiery parts of each being freed of their hindrance do insinuate themselves in the oily parts of the blood which they rarify whereby the Valvules of the Vena cava are shut up and the Blood thus rarified craving a larger room than before the Heart is compell'd to its expulsion which it effects by the collected fibres as another muscle and the Valvules of the Arterial Vein being opened it is transported into the Lungs cooled by Respiration whereby the Heart and the said Vein is unswell'd and the Blood is conveigh'd by the usual Artery whose Valvules are then open into the left Ventricle of the Heart where it is again heated and rarified and being carried by the Aortal Artery whose Valvules then give passage into the greatest Arteries and from thence into the smaller the Heart and the said Arteries leave swelling and the Bl●od is thence received by the Anastomoses in the Veins from whence it proceeds through the vena cava into the right Ventricle of the heart repeating so a continual circulation a perpetuum mobile during our Life Blood is temperate of a mean thickness Red in colour and of a sweet taste it serves instead of fuel to the vital heat which it conveys to the several parts to whose nutrition and increase it alone contributes The Antients did divide it into Venal and Arterial though the place of their flowing be their chief difference Phlegm is of a watry nature liquid whitish and unsavoury it serveth to the ●●fervescency in the duodenum tempers the Blood and renders the Joynts slippery Choler is of a fiery nature a thin consistence a yellow colour and a bitter taste it causeth an Effervescency in the duodenum and another in the Heart as aforesaid it provokes the expelling faculty and thins all Phlegm sticking to the inward parts The Lymphatick humour is of a pure watry substance without any colour and of a subacid taste Its uses are manifold but the chief are to promote an easier slowing of the Chylus and to convey the blood through the thoracick conduit to the Heart and there contribute to its Effervescency it tempers the Blood and perhaps together with phlegm moistens the articulations of the Joynts According to the Antients Phlegm predominates from Midnight till Sun-rising Blood from that time till Noon thence Choler obtains the superiority till Sun-setting and they gave the remaining time till Midnight to Melancholy which we have said to be nothing but grosse Blood Phlegm is also more copious in Autumn Blood in the Spring Choller in Summer and Melancholy or thick blood in Winter They esteemed also Phlegm to be moved every day Choler every third day and Melancholy every fourth supposing the Quotidian Ague to be caused by Phlegm the Tertian by Choler and the Quartan by Melancholy which De Graff attributes to the various Obstructions of the lateral branches of the Pancreas In his Treatise De succo pancreatico The signs of a Bloody Complexion are a red colour in the Face a moist heat through the whole Body sleshy Muscles great Veins and a chearful Heart Cholericks are of a yellowish colour a light disposition and a lean Body they are witty and liberal but wrathful and revengeful Phlegmaticks are pale of a soft flesh sometimes fat lazy sleepy and dull Melancholick or thick blooded men have a blackish face and a sad look they are sorrowful obstinate fearful and covetous but withall very capable of doctrine The Arabs instituted four secundary Humours whereof they called the first Innominate or Implanted which they supposed to be conteined in the extremities of the little Veins where it begun to take some alteration of the several parts They called the same Daw when as it were it bedewed them Gluten when it stuck fast to them and Cambium when it was wholy converted into their substance but the nutrition and increase of the several parts is better expressed by the Moderns as will be said when we speak of Functions When the Primary humors exceed the bounds of their due qualities they are deemed against nature and they may be corrupted in the Veins or out of them Phlegm corrupted in the Veins is of a sower or salt taste and of no colour but out of the Veins it is distinguished in muscous watry plastry and glazy whereunto the Lymphatick humour the salive and the Pancreatical juice may be conveniently referred when they are vitiated Choler corrupted in the Veins is called vitellin or like the yolk