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A86032 A treatise of the rickets being a diseas common to children. Wherin (among many other things) is shewed, 1. The essence 2. The causes 3. The signs 4. The remedies of the diseas. Published in Latin by Francis Glisson, George Bate, and Ahasuerus Regemorter; doctors in physick, and fellows of the Colledg of Physitians at London. Translated into English by Phil. Armin.; De rachitide, sive, Morbo puerili. English. Glisson, Francis, 1597-1677.; Bate, George, 1608-1669.; Regemorter, Assuerus, 1614-1650. 1651 (1651) Wing G860; Thomason E1267_1; ESTC R210557 205,329 373

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concerning the Animal faculty and otherwise expounding the matter do substitute a somwhat different description we thought good to offer both to the Readers consideration According to the former and vulgarly received opinion and description of the Animal faculty the animal constitution is that affection of the Body which consisteth in the generation and due motion of the Animal Spirits Now by the due motion of the Animal Spirits they understand the excursion of them from the Brain thorow the Nerves like lightning and again their recourse back to the Brain whereby they declare unto it what is perceived by the Organs of the outward Senses Others as we have said do otherwise explicate this matter They grant indeed that the Animal constitution doth include the generation and destribution of the Animal Spirits but they say that that swift motion of the Flux and Reflux of the Animal Spirits like lightning is inconceivable in the Nerves and if it be not unprofitable yet certainly it is very little necessary to establish the animal faculty But instead of this they substitute in time of waking a certain contractive motion of a moving endeavor of the very substance of the Brain of the Spinal Marrow of the Nerves arising from thence and of the parts into which they are destributed And this motion or endeavor produceth say they a certain Tensity in the aforesaid parts by whose force all the alterations imprinted in those parts by any objects are communicated to the Brain For as in a Harp when the strings are stretched to a just pitch if they be stricken in the most gentle manner at either end that motion in a moment at least a Physical one runneth to the other end so they likewise affirm that any Nerve being moved which is duly stretched without the Skull that motion is extended to the Brain it self by reason of the continuity and Tensity of the said parts and there fixeth a certain impression conformable to the caus thereof But in time of sleep they suppose the Brain the Spinal marrow and some of the Nerves to be somwhat loosned And indeed they say perpetually and simply that the foremost connexions of the Spinal Marrow with the Brain remain loos continually during sleep but they grant that the hindermost connexions with the Cerebethi are somwhat extended as in Night-walkers and so by that means they do in some sort discern outward objects but they judg not of them by common sense but as it were reflected from the memory to the Fantasie Neither do they suppose it necessary that all the inferior parts of the Spinal Marrow and therfore the Nerves from thence proceeding should be perpetually loosned during sleep seeing that most Birds sleep standing upon their feet seing that respiration in time of sleep doth presuppose the Tensity of some Nerves and lastly seing where sleep first steals in the uppermost Nerves are wholly loosned before the neathermost As for Dreams they conceive that they proceed from a various and chanceable agitation and commixture of divers impressions treasured up in the memory which are now again freshly perceived by reason of a retained Tensity in som parts of the Brain But when in deep and profound sleeps no dreams are represented then they say that the whol Brain is loosned Now whether the former opinion or this latter be most agreeable to truth for the present we do not much care Neither do we here undertake to determine this Controversie seing that the Animal faculty doth exercise his function both waies from the same causes and that the secondary vice doth happen by this affect in the Animal Constitution almost after the same manner For first as for the generation of the Animal Spirits whether the former or the latter opinion be true it wil be all one becaus we find no fault in the Brain unless perhaps some other Diseas be conjoyned wherin each opinion supposeth the Animal Spirits to be generated For we have shewed above that the Head ought not to be numbred among the first affected Parts and that the internal and proper actions therof are not viciated in this Diseas Then secondly As for the destribution of the Animal Spirits whether it be perfected backwards and forwards by that rapid and sudden motion like lightning or by a motion only made forwards and that too gentle and slow commonly the same fault occurreth in this Diseas For first Seing that that supposed rapid motion of the Animal Spirits is caused by their passage into the first affected Parts namely through the Spinal Martow without the Skul through the Nerves from thence proceeding and through the parts into which those Nervs are destributed and seing that all these parts in this affect do labor with a cold distemper with a paucity and dulness of inherent Spirits the due swiftness of that motion must needs be somwhat retarded For a cold distemper as also a benummedness and penury of Spirits are repugnant to any motion excepting a constrictive some may say that the opinion propounded in the first place doth suppose a wonderful activity and subtilty of the Animal Spirits wherby they can easily overcome this repugnance But however it may be seing that the parts react through which the Spirits have their passage and labor to communicate their coldness and dulness to them they must needs in some degree retard that activity of the Spirits lessen their subtilty and somwhat intercept that expedite transition Wherfore this opinion being supposed as true the Animal Constitution will be viciated in this affect in regard of the retundation of that motion of the Spirits And that secondarily seing that this motion is not interrupted by the primary fault of the Animal Spirits but by the fault of the first affected Parts as hath been said in like manner in the Opinion last proposed wherin the motion of the Spirits is supposed to be peaceable and gentle they must needs whilst they are somwhat slowly transmitted through the first affected parts contract some viciosity from the depraved inherent Constitution of those parts for the same Reasons which we alleaged in the Question immediatly preceding It will be therfore according to this Opinion also a Secondary vice in the destribution of the Animal Spirits Again As for the Tensity of the very substance of the Brain of the Spinal Marrow of the Nerves and the Nervous parts in time of waking which is supposed in the latter Opinion before propounded there must needs be some defect of a due Tensity in the Spinal Marrow without the Skull in the Nerves arising from thence and in the parts unto which they are destributed For first A cold and moist distemper is repugnant and advers to that due Tensitiy so also is that dulness and penury of inherent Spirits wherwith the Parts are without controversie rendred slothful and less apt to perform the Animal Actions the contrary wherof happeneth when the aforesaid parts obtain their due Tensity Secondly It is manifest by what
hath been said that the Tone of these parts is somwhat viciated in this affect by reason of their exceeding loosness slipperiness softness weakness and internal lubricity which qualities do most evidently enfeeble the just Tensity of the said Parts Although therfore that the Brain in this affect do for his part yield a due and just influx yet it is scarce possible nay it is altogether impossible that it should communicate that Tensity in a sufficient degree to to the Spinal Marrow without the Skull to the Nerves from thence proceeding c. because of the distemper benummedness and penury of the inherent Spirirs Thirdly The Symptoms in this Diseas that relate to the Animal faculty do most clearly confirm the same thing For Children afflicted with this Diseas do from the very beginning therof if they be compared with others of the same age move and exercise themselves very weakly and are less delighted in manly sports but upon the progress of the affect they are avers from any vehement motion as they stand upon their feet they reel wave and stagger seeking after somwhat to support them and can scarce go upright neither take they pleasure in any play unless sitting or lying along or when they are carried in their Nurses Arms Finally the weak Spine is scarce strong enough to bear the burden of the Head the Body being so extreamly extenuated and pined away All which things do abundantly demonstrate that the Tensity of the parts subservient to motion is less rigid in this affect than is justly requisite in time of waking If therfore that due Tensity in time of waking be a part of the Animal Constitution which we here suppose that being viciated must without all doubt necessarily constitute a Diseas in the Animal Constitution and seing that this fault hath no primary dependance upon the Brain it self but upon the inherent Constitution of the first affected parts it ought in all Reason to be reputed a Secondary fault in respect of the Animal Constitution Yet here we meet with a scruple Som may demand Why the sens as well as the faculty of motion is not vitiated in this affect The reason is plain a far greater tensity strength and vigor of the Nervs is required to exercise the motive then the sensitive faculty For almost the gentlest motion of the Nervs is sufficient for sense but not for motion So you may observe in the motion of any Joynt that the Muscles which move it are very hard and stiff but that hardness being remitted yet the sensation is easily performed Nor doth that any way hinder because that somtimes in the Palsy the sense is somwhat stupified and the motion remaineth for the Palsy is an affect very different from this for in that the primary fault resides in the very Animal Constitution therfore it may so fal out that both the sense and the motion may be equally affected Besides when perhaps one Nerve doth want the du influx of the Brain and another which is extended to the muscles of that part doth enjoy it it may be that for this cause also the sense may be abolished and yet the motion may continu although this case is not so frequent and that the motion is more usually taken away the sense remaining But we have said enough concerning this matter And thus at length we have produced those things which we have meditated of the integral Essence both primary and secondary of this Diseas and that with as much perspicuity as a matter so difficult and unsearcht into would bear In the next place we shal address our selvs to the examination of the causes of this Diseas CHAP. XV. The Causes of the Rachites And first those things which concern the Parents WE have largely explained above both the Primary and Secondary Essence of this Disease And indeed we have sufficiently demonstrated in the same place the dependance of the secondary upon the Primary Essence It may not therfore be here expected that we should again purposely and in particular discuss the causes of the secondary Essence which we have handled before It may suffice that we have found out the causes of the secondary Essence Yet if any cause do occur which at once hath an influx as wel into the primary or secondary Essence of the Diseas we shal not refuse to take notice of it by the way as we proceed But omitting al diligent search into the several kinds of causes we purpose to contract this our discours chiefly to two heads The former containeth the Infirmities and the diseased dispositions of the Parents which perhaps have so great an influence upon the Children that they suppeditate at least a proness to this affect and infer an aptitude to fal into it if they have not actually fallen into it from their very birth The latter comprehendeth the accessary causes of this Diseas namly those which happen to children after their birth Concerning the causes of the first kind we meet with a Question at the first entrance How and whether this Diseas may be said to be hereditary That we may the more succesfully proceed in the determination of this question an hereditary Diseas must be distinguished into that properly and that improperly so called And indeed an hereditary Diseas properly so called is ever supposed to be preexistent in both or one of the Parents and from thence to be derived to the Progeny But an hereditary Diseas improperly so called is not supposed to be preexistent in the same kind either in both or one of the Parents yet the same fault must always necessarily precede perhaps altogether of a different kind at least in one of them by vertu wherof a certain disposedness is imprinted in the children wherby they are made obnoxious to fal into this improperly hereditary Diseas Moreover An hereditary Diseas properly so called is twofold either in the conformation as when a lame Person begets a lame a deaf Father a deaf Son or a blind a blind or in the similary Constitution as when a Gowty Father begets a Gowty Child It is to be noted that in the first kind ther is an hereditary fault inherent in the first affected parts of the Conformation But in the latter there is no necessity that a Diseas of the same kind with the Diseas of the Parents should be actually inherent in the Embryon from the first formation But such a disposition imprinted by one or both of the Parents is sufficient which as the life is lengthened may be actuated into the same by the concours of other intervening causes Again an hereditary Diseas improperly so called may be likewise twofold namely either in the Conformation or in the similary Constitution In the formation as when neither of the Parents is blind pore-blind lame c. yet have begotten a Son blind pore-blind or lame by the very fault of the formation For in these cases that very fault which is sensible and conspicuous in the
Tone of the Parts be in any degree vitiated The next Whether those faults of the Tone do belong to the secondary Essence of the Diseas As concerning the first It wil be unnecessary to run thorow the particular Parts of the Tone severally it will be sufficient to examine those that seem guilty of the suspected crime First Therefore we meet with an evident loosness of the Tone in this affect But this loosness differeth both from the infirm coherence and likewise from the Paralytical resolution of the Parts for the infirm coherence or weakned stifness of the part is easily made an occasion of the loosness because in such cases the Part can scarce be stretched forth but a part may at the same time be both loose and likewise sufficiently stiff as may be seen in the strings of Instruments which if you wind down the pins they become loose although in the mean time they forgo not the tenacity of their substance And in dissected bodies we have frequently observed the loose parts themselves to be sufficiently stiff yea and that sometimes in this affect Wherefore this loosness is a distinct quality from the vitiated stifness of a Part. Neither doth it less differ from that resolution of the Parts which happeneth in the Paralytical Members For the dead Palsy first consisteth in the depraved Animal Constitution But this loosness is rooted in the Natural Constitution For here is no Palsy present either in respect of motion or in respect of the sence of the Parts Neither is the Brayn in this Diseas primarily affected as we have already demonstrated Moreover that there is such an exceeding loosness of the Parts first affected in this Diseas is a thing so conspicuous that we judg it a superfluous employment to offer proof thereof For it is obvious to the very senses and therefore we have listed it among the signs of the Diseas For whether it be a Part of the Essence or not a Part if it be manifestly subjected to the Senses it acquireth the propriety of a sign in respect of the other Parts of the Essence which are removed from the Senses Secondly In this Diseas there is not only a loosness but likewise a witheredness and feebleness Now this quality comprehendeth somwhat more then the meer and simple loosness for it denoteth withal a certain emptiness of the parts wherby they sink down of themselves Now such an emptiness and such a falling down of the Parts first affected in this Diseas are so obvious to the Senses that there is no need of further proof Thirdly A a softness also may be named in the Tone of the Parts first affected in this Diseas For sometimes it so falleth out that there is no coincidence between the softness and the aforesaid qualities but that it includeth or excludeth some other thing as in a suppurated Tumor there is softness but without any laxity of the Tone any emptiness or subsidence For in this present supposed case the softness chiefly dependeth upon the manner of Termination and the tenacity of the Part being vitiated But in this affect there is for the most part a coincidence with the laxity and flaccidity before mentioned So that it is needless to distinguish it more accurately then by the name only Fourthly There happeneth also another fault in the Tone of the Parts first affected in this Diseas and this is an extream inward slipperiness Some perhaps may wonder what the meaning of these words may be Internal lubricity We confess indeed that for want of words we have been constrayned to joyn this appellation For when in nature such a quality as hath a true existence hath by the oversight of Philosophers and also the neglect of Grammarians wanted a name we have taken so much liberty to our selvs as in respect of the great vicinity which it hath with the superficial lubricity of the body to give it the same Name with the distinctive Epethite of Internal In natural bodies therfore we acknowledg a twofold lubricity one External and Superficial which indeed consisteth in the smoothness and equality of the Parts of the Superficies by reason whereof the Subject of it doth easily slide by other bodies which it lighteth upon without much attrition and resistance Now contrary to this lubricity is the Superficial roughness but these two qualities have no reference to this place because they are Organical neither do they any way belong to the Tone of the Parts That other lubricity whereof we began to make mention consists in that internal profound and similary smoothness and equality of the body By reason wherof the whole substance of its Subject doth easily slide by the other introsubient bodies without much attrition and resistance And to this lubricity also there is an Internal roughness Now that there is such an internal similary slipperiness and such a roughness also opposite unto it may be shewed almost by innumerable instances For almost all mucilaginous substances are slippery and that not only in respect of the outward Superficies but also inwardly and in respect of the universal Substance and every particle thereof so that according to the definition of a similary body every particle by reason of this quality is made like unto the whol and therfore this quality is internal and similary and diffused through the whol internal substance of the Subject In like manner such an internal roughness may be observed in unripe fruits extentended thorow their whole substance and Internal flesh But when they have attained to a just ripeness then usually in the room of that roughness there succeedeth such a slipperiness as we have now described And here it must be observed that if these bodies internally slippery be besmeared or daubed upon the Superficies of bodies otherwise rough they bequeath a certain degree of lubricity to them for the time they adhere in like manner being inwardly taken as the slippery juyces and mucilages of Althea c. They do communicate a certain lubricity to the Internal passages of the Body yea and not only to the passages that relate to the inward cavities but also more or less to the very Similary substance of the parts of the Body which also the blood washeth being impregnated with that slippery juyce But this internal lubricity is manifold oyly or fat watrish spiritous saltish and perhaps earthy The oyly is chiefly conspicuous in the fat of Creatures especially such as are yong and in many expressed Oyls especially the moister and colder and also the temperate as may be observed in the Oyls of Poppy Seeds Pippin Seeds the four greater Cold Seeds Time Seed and the Oyl of sweet Almonds and the like A watrish lubricity is in some measure found in simple water it self although by reason of the fluidness it is less sensible also this lubricity may most evidently be taken notice of in the mucilages c. The Spiritous perhaps doth never happen alone but it is most frequently mixt with the
sawed thorow in a circular Figure and the little cover being removed we have observed these things 1 The Dura Mater hath been more firme and adhered to the Skul in more places then is usual in men of ripe years perhaps the same may be observed in other Children not affected with this evil although as we suppose not in so great a manner for certain it is That in new born Infants there are many and straight connexions between the Pericranian and the Dura Mater which are afterwards broken off and are scarce discernable 2 In some Bodies that we have dissected between the Dura and the Pia mater and in the very ventricles of the Brain we have found wheyish and waterish humours from whence it is manifest That this affect is complicated with the Hydrocephalus 3 We have found the Brain in others that we have opened to be firm and inculpable and not overflowed with any waterish congestions 4 Lastly We have observed in some Bodies lately opened That the Carotides have exceeded their just proportion and so also have the jugulary Veins but the Arteries and the Veins which are delated to the outward parts were of an unusual slendernesse But whether or no this be perpetual in this affect we cannot yet witnesse by an occular testimony yet we conjecture That it happeneth so perpetually but it came not sooner into our minds to examine it since the beginning of our Anatomical enquiries into this subject These things being premised our next Disquisition shall be to find out the Essence of the Disease CHAP. III. Certain Suppositions are proposed for the easier finding out of the Essence of the Disease First of the Essence of Health Secondly of the Essence of a Disease Thirdly of a threefold Division of Health and Diseases The Explication of the third Division and the Vse of the same The Description of a natural Constitution and the exaltation of it The Fourth Supposition of the Combination of three Constitutions in the same parts THat we may proceed the more distinctly and clearly in the finding out of the Essense of this Disease we judged it very advantagious to premise these subsequent Suppositions I That the Essence of Health doth consist in some Constitution of the Body according to Nature But seing this is twofold in the kind one Essential and necessary respecting the tò esse simply which during life continueth immoveable and immutable under various affections and is indivisible The other Accidental having reference to the tò bene esse which in respect of the whole Animal is both moveable and mutable and hath a great latitude and can be present or absent without the dissolution of the whole Health consists not in the former but in the latter Constitution II. That the Essence of a Disease in like manner consisteth not in the Essential Constitution For so the dissolution of the whole would by and by follow But in the Accidental Constitution namely such an one as in respect of the whole can be present or absent without its dissolution We have said and not without reason that this Constitution wherein Health and Sicknesse are founded is moveable and accidental in respect of the whole for even this also in respect of some part may be essential as for example a finger being cut off a Disease ariseth in the defective number of the parts which in respect of the whole is founded upon an accidental Constitution for that finger may be present or absent without the dissolution of the whole but in respect of the lost member it is founded upon an Essential Constitution for this Disease being supposed the Essence of that finger perisheth III. That the Constitution wherein the Essence both of Health and Sickness consisteth admits a threefold manner of division or distinction in the method of Discipline The first is somewhat thick and is resolved into parts altogether Concrete namely It proceedeth Kata topous according to the division of the parts from head to heel The second is purely abstracted and searcheth out all the Elements of the moveable Constitution from whence cometh the division of Diseases into similar organical and common and then again those various subdivisions into distempers faults of figure superficies cavities and passages of magnitude number site and continuity The third is as it were a middle manner and although it hath been hitherto neglected yet we dare avouch That it may have its use and that no contemptible one in the handling of Diseases and the finding out of the causes of the Disease and it is divided into a Constitution Natural Vital and Animal The first is proper to and inherent in every part absolutely competible to it and without any dependance upon the other parts according to the Essence of it simply This remaineth a while after death till it be resolved by Putrefaction Ambustion simple Exiccation Mummification Petrification and the like violent Causes This Constitution in respect of its simple Essence doth not depend upon those Members which minister an Influx but it dependeth upon them both in respect of its Conservation and likewise of its Operation For the vital influx ceasing after death which is as it were the salt and condiment of it quickly perisheth and as long as the creature liveth this is variously affected by the influxes and thereupon the actions are either promoved or interupted The Second is the Vital Constitution which is produced by that continual influx from the heart thorow the arteries into the parts of the whole Body This also it admitteth degrees and is often subject to variations more or lesse and sometimes also seemeth to suffer a kind of eclips as in a swouning a syncope c. yet it persevereth from the beginning to the last period of life at least in its fountain and in some other parts The Third is the Animal Constitution which is derived from the Brain thorow the Nerves into the Organs of Sense and Motion This is many times totally wanting in many parts the life notwithstanding remaining yea it might for a long time together be defective in several parts or all the parts did not respiration which is absolute necessary unto life depend upon it These Constitutions therefore keep such a connexion between themselves that the second doth eternally and continually presuppose the existence of the former and the third of the second but there is not back again so absolute a dependance between them because as we have even now said the former can for some time subsist without the second and the second commonly altogether without the third And these three Constitutions may in most bodies be manifestly perceived yet we affirm not that they may be found in all The Natural indeed and the Vital are wanting to no part but the Animal is defective in the Bones though the teeth will admit some doubt gristles perhaps ligaments and some substances as of the Liver Spleen c. we assert therefore this threefold Constitution to be in all those