nutrition is a coagulation of aliment but in augmentation there is a motion of Extension of the whole of every part therof it differs also in regard of the end which in Nutrition is only a restoration of that which is taken away but in Augmentation an acquiring or a getting of a greatet magnitude to exercise perfectly all the necessary actions of our life and lastly in time for Nutrition dureth the whole time of our lives Augmentation to a certain time in our life For man as other living creatures doth not alwayes grow but to the certain time of his age which comes not to passe by reason of the soul which alwayes reteins its force and strength but by reason of the body especially of the bones which in processe of tims are so hardned that they are not apt to any farther extension of growth CHAP. X. Of Generation BUT since man although he be nourished cannot live perpetually and in individuals as other living Creatures also cannot indure to perpetuity The generative power the generative power is granted and given by the Creator of all things that mankind might be preserved and the third kind of Natural actions is Generation which by ejaculation of seed begets his like For although this faculty and Action be common to plants yet in man and other more perfect Creatures it requires greater preparation and distinction of sex as male and semale concur in Generation and it is necessary that both of them do some way help and conduce to Generation and the male not in himself but in another The distinction of Sexes The instruments of generation but the foemale in her self doth generate For the male ejaculates his prolifique sperm into the female womb which mingled with hers is cherished by the same it is also nourished and reteined until it hath the shape of a perfect man For which purpose the Creator hath made necessary Instruments for both Sexes for the male Testicles Vessels preparing and conducting sperm and a yard necessaâ—y to ejaculate it into the part most fit to receive it for the Females Stones seminary vessels and the womb There are two principles which concur to the Generation of a Child the seed of the male and female and the menstruous blood The Principles of generation Seed The seed is a body hot and moist full of that divine Spirit of the first Principles or Elements and proportionable to the Quintessence or Element whereof Stars were made fit for the propagation of the Soul and generation of a living Creature like it self and is getherated in the Stones whither the purest part of the blood Spirits and heat is sent through the Veins Arteries and Nerves from the remote parts of the body and is changed into a white frothy or slimy matter The male and female seed both confer seeing the same Instruments are appointed by nature for generating and semitting of sperm and the same cause efficient and the same â—matter in each for the forms of each alike do manifest themselves in the off-spring Blood although the power and force be greater in the male then the female But the menstruous blood is only the material principle wherefore it is ordered by the Creator that at the time when semales are apt and fit for procreation which for the most part is from the fourteenth till the five and fortieth year of their age that blood which the other parts wants not each month is sent to the womb to supply what may be wanting for a little one or if the female be not great may be by it evacuated Menstruous blood This menstruous blood of it self is not offensive nor is it expelled because it is hurtful but because it aboundeth in quantity but when it becomes pernicious 't is by reason of its remaining too long in the body by its comixture with other humours The forming of the young is caused by the Soul The formation of the young which is in the seed and there shews it self in two actions in putting life into the conception and forming of all the parts and the Soul as Scaliger writeth out of Themistius is its own architect which builds a convenient domicill for its own habitation But it receiveth this power from the Creator whose Instruments and hands as it were the Souls are and he hath given this energy to them at the Creation of them then which nothing can be more wonderful to be thought on The Generative faculty hath two others whereby it performs its Office The Alterative and Formative The Alterative The Formative The Alterative is that which changeth the generative matter into the substance of the young and all its parts the formative is that which Forms all the members and gives them their quantity figure number place and the rest The Instrument which the Soul and formative power useth is the formative or plastick heat or that Spirit proportionable to the Element of the Stars for the seeds being received into the womb are mingled together reteined cherished and the power which lyes hidden in the seed is stirred up by the innate heat of the womb and then a Conception is said to be made Conception and then begins a sending forth of the instruments of the body to be made then is it called a Conception which commonly is said to continue til the seventh day But first of all The order of frameing Firs the membrances whereof are framed two Chorion Amnios The Secondine The Spermatick parts are described together Theumbilisall vessels The Veins belonging to the Navel Two Artcries Urachus The time of formation the membranes about the Child are formed by which the seed is shut in and the Spirit and heat thereof is covered and as it were intrenched They are two in number the first is called Chorion and covers the whole Child and is fastened to the vessels belonging to the Navel by their intervening the whole cleaveth to the womb the other coare doth immediately cover the Child and is called Amnios These two coats in the birth seem to be one as it were and come forth after the Child and are therefore called the Afferbirth But the solid and Spermatick parts shall be explained in the first place and afterwards according to their nobleness and as necessity requires the rest shall be perfectly shewn The Infant in the womb doth not take that nourishment which it receiveth by the mouth but from the Mother for the receiving whereof there are appointed by nature four vessels belonging to the Navel namely a Vein which is a branch which comes from the Gate-vein which is as it were the infants nurse two Arteries branches arisen from the Iliak Vein by which the Infant breaths although later Authors who teach us that the vital Spirits by which the Child breaths proceed not from the Mother but from the Child 's own heart do assign another use to the said Iliak branches to wit that
and rest Exercise for idlenesse and too much rest fills the body with Excrements dulls the native heat and renders the body slow and feeble on the other side too much exercise dissipates the Spirits consumes the body and by consequence cooles the whole body hinders concoction the veins and vessels often break stirs up untimely humours heats them and causeth fevers and especially if the body be full of vitious humours they being stirred are carried through the whole body and stir up fevers and other distempers and symptomes Fifthly Passions of the mind the affections of the mind make great alterations in the body in anger the Blood and Spirits become extream hot and are hurried to the external parts from the internal whence they inflame the whole body and often kindle Fevers and raise other Symptomes Too much joy may so dissipate the Spirits that it is observed one may die therewith in fear and trembling the Spirits and heat desert the exteriour parts and fly to the heart and suffocate the heart sorrow by degrees dissolveth the Spirits cooleth the Body dryes spoils concoction causes watchings and begets melancholly diseases Lastly Excretions and retentions those things that are reteined in and sent out of our bodies are the causes of Diseases for if the profitable humors be untimely sent out it debilitates the body and consumes it but if the excrements are retained diseases are bred that are like unto them CHAP. III. Of the internal causes of Diseases and first of fulnesse of Blood INternal things which are the causes of diseases Internal things the causes of diseases either are generated in the body according to nature or are found in the bedy contrary to nature those which are generated according to nature are those three of Hypocrates conteining conteined and doing violence or as others would have it solid humid and spirituous those are called preternatural humours which are found in the body contrary to nature as stones gravel wormes and all things that are generated in the body differing from natural whereunto belongeth those things that are sent into the body and there stick and remain as darts bullets of lead and such like But these things are made to be the causes of diseases How many wayes either as they are in their whole kind contrary to nature or as they offend in qùantity quality motion or place The fault of humours in Specie is divided into Plethorick and Cacochimick The fault of humors twofold Plethorie for humours are either apt to nourish the bedy or not fit plenty of the one â—s called Plethorick of the other Cacochimick for Plethory is when blood and humours profitable for the nourishment of the body abound Plethorie towfold To the vessels To the strength and are beyond mediocrity This plenitude is twofold either as to the vessels when blood so abounds as that the vessels wherein it is contained are stretched beyond their ordinary bigness the other as to the strength when there is more blood then the strength can bear to which Horatius Augenius adds this mixt of them both to wit when there is so great plenty of blood as stretcheth and extendeth the veins and so great pains that the strength cannot bear it Chacochimy is an excesse of other humours besides blood Chachochimy namely when natural excrementious humours offend in plenty or preternatural excrementious humours abound and whilest either these or those putrifie and bring in a strange nature The seat of Plethory and Chacochimy Both pure and spurious Pure Plethory Pure Chacochimy Spurious The causes of Plethory The seat of Plethory is only in the veins but Chacochimy is not onely in the veins but also out of them and in the whole body or some parts especially the bowels But sometimes Plethory and Chacochimy are mixed whence both are divided into spurious and legitimate pure Plethory is when there is too great plenty of pure blood and humours without any vitious ones Pure Chacochimy is when there is too great plenty of ill humours and no good blood with them but when good juyce aboundeth and ill humours are mixed therewith it is called a spurious Plethory or Chacochimy according as blood and ill humours do more or lesse abound There are many causes of Plethory as plenty of Dyet supplies matter to cause it nourishment of good juyce and great plenty of such nourishment the Efficient causes are Constitution of the Body and principally of the Heart and Liver hot and moist and youthful age which may be occasioned in the Spring time and a temperate constitution of the Air idlenesse moderate sleep a life without care and paines suppression of accustomary evacuations of blood Chacochimy according to the variety of excrementitious humours is manifold The kinds of Chacochimy for sometimes phlegm sometimes choller sometimes melancholly and adust melancholly and sometimes serous humours abound of which humorsthere are again various differences CHAP. IV. Of Phlegm THere are divers kinds of Phlegm which are commonly divided into natural and preternatural The kinds of Phlegm Natural Phlegm Natural is a cold and moist juyce or blood not perfectly concocted but if we rightly observe the matter this humour is not properly to be reckoned amongst the excrementitious humours because the blood is crude and may be turned into the aliment of the parts Of the preternatural Phlegm there are four kinds unsavory The kinds of preternatural Plegm Unsavory sharp vitreous salt Unsavory Phlegm peculiarly and principally may be called a Crude Humour which for want of concoction hath not acquired that perfection which it ought in the stomach and therefore can no where in mans body be turned into good substance Acride Phlegm is also crude and called so from the taste it relishes of to them that void it Acride and proceeds from the defect of heat These two kinds proceed from the same causes which according to greater or lesser power they have of introducing coldness and crudity so sometimes this sometimes that kind is generated such are cold meates hard to be digested too great plenty of meat and drink and taken at unseasonable times a cold constitution of the stomach and the adjacent intrails which way soever occasioned Salt Phlegm Salt so called from the savour and is occasioned by the mixture of a serous humidity and a salt with Phlegm whence it is not simply cold but mixed with heat and drinesse and as there is more or lesse of the salt humour mixed so is it more or lesse hot Lastly Vitreous Phlegm is vitreous so called by Praxagorus because in substance and colour it somewhat doth resemble melted glasse this is exceeding cold clammy and thick CHAP. V. Of Choller CHoller is threefold The kinds of Choller Alimentary Natural and Contrary to Nature but the first is not an Excrement but the hotter and dryer part of the Masse of Blood of a different nature from that which is in
the bladder of the Gall. Excrementious Choller is twofold Natural and Contrary to Nature Natural is yellow Yellow Choller and is generated by Nature and that onely is properly called Choller it is an Excrement of the second concoction and generated in the Liver and collected into the Bladder of the Gall it is generated out of the hotter and dryer parts of nutriment Preternatural is that which is not generated in our bodies according to the law of Nature Preternatural whereof for the most part we account four kinds Vitelline Leekeblade colour Verdegrease colour and Woad colour or a blewish green The Vitelline is so called from the yolk of an Egge Vitelline it is yellow hotter and thicker it is generated of yellow and burnt Choller whence it is sometimes called rosted Choller And there is another kind of Vitelline Choller but not so properly so called which is neither so hot nor so yellow which is compounded of Phlegm and yellow Choller Leekgreen Choller so called Leekgreen because it represents their greennesse which is often voided with the Excrements of children by the panch and is often generated in the stomach by corrupt nutriment and sometimes also in the Veins and about the Liver out of the Vitelline from the great heat of the Liver and 't is of a venemous nature and it is hot and very biting the likest to Verdegrease The Aeruginous which comes neer to the colour of rusty greenish Brasse is generated out of corrupt aliment Aeruginous when the heat is more vehement in the Stomach in the Liver and Veins from the inflamation of the Liver and the too great heat of the Veins Lastly Woad colour Blewish green or a blewish green Choller is more deep in sense then the Leek colour and is caused by more adust Aeruginous Choller Aliment hot and dry Causes of Choller affords matter fit for all the kinds of Choller and especially sweet and fat things A constitution hot and dry hath regard to the Efficient cause and those things that adde to it are youth full age Ait that is hot and dry watching anger too much exercise of the body CHAP. VI. Of Melancholly THe third is the Melancholly humour Melancholly which commonly is distinguished into Alimentary and Excrementitious but Alimentary is nothing else then the colder and dryer part of the Masse of Blood The Excrementious is twofold Natural and Preternatural Twofold Natural Natural is that thick and feculent Excrement which in sanguification which is made in the Spleen as is abovesaid is collected and separated for the generation whereof much meat conduceth 'T is of a terrestrious and thick juyce of every sort especially being hardned with salt and fuliginous vapours old Cheese Cabbage all sorts of pulse as Pease c. a cold and dry constitution of air cares fear sorrow The black Melancholly which is generated contrary to nature Preternatural although it be sometimes also called by the name of melancholly yet Physitians for the most part call that Excrement which is naturally generated black Juyce not black Melancholly but that which proceeds from adustion is called black Melancholly and that Excrement is naturally cold and dry but this Preternatural hot and dry the worst of all humours But adust Melancholly is commonly accounted threefold Its kinds One is that which is occasioned by adust blood and is counted the least the second is that which is generated of Melancholly humours if they are burnt The third is that which proceeds from adust colour which is of all the worst Hence it is manifest that although all which can generate Melancholly humours or yellow Choller conduce to the generation of black Choller yet the generation of black Choller principally depends upon the too great heat burning the humours CHAP. VII Of the Serous Humour and of Wind. AMongst the humours that are the causes of diseases Serous what we are not to slight Serous Humours and Wind by Serous Humours we sometimes understand all thin humours and watery sometimes peculiarly we mean not those onely which are watery but have a saltnesse joyned therewith which Galen calls A salt serous moisture the greatest part of this serous humour turns to Urine and is ejected by it yet some part thereof is mingled with the Blood to clarifie it and make it more easie to be distributed and lastly through the Pores of the skin or insensible transpiration or sweat is emitted Of this serous humour there is found but small quantity in the Veins in sound bodies yet sometimes for some causes Preternatural there is found greater quantity The matter that breeds it are Meats that contein much Whey in and watery juyce in them It s cause much Drink Obstructions and Distempers of the Bowels by reason whereof this serous matteris not rightly separated it is deteined and gathered together because the reins do not draw enough and by reason of the weaknesse of the expulsive faculty and the suppression of its passages by Sweat and Urine Of humours oftentimes are generated Vapours and Wind Wind. which are the causes of many evils windy meats afford matter for wind so doth much drink especially when yellow and black Choller is spread over the stomach Also wind is generated from debility of heat which rusheth out of the abundance of matter that it cannot overcome it all and that is such either simply and in its own nature or in respect of the matter from the plenty whereof although it be otherwise strong enough it breaks out CHAP. VIII Of humours according to the opinion of latter Physitians and of Chymists ALthough some Chymists plainly reject these things that have hitherto been said The opinion of Chymists about humours according to the opinion of the Galenists and having rejected them they have in their stead and place put the names of Salt Sulpher and Mercury yet they have no reason for it for as Galen in his first Book of Places affected and second Chapter writeth That that which put we are diseased and which taken away we are freed 'T is taken for granted by all to be the cause of a disease but we see the humours being present we are diseased and being taken away we are freed therefore humours are the causes of diseases Yet this we grant that humours are not confined to the first qualities but that they have in them secondary qualities such are bitter acide salt sharp which may offend and hurt the body no lesse then the primary as Hypocrates of ancient Physick teacheth which he calleth the Powers and Efficacies also the force and strength of humours Whence Galen also and other Physitians call them Salt Nitrous Aluminent Humors which plainly manifest themselves in many diseases as the Gout Scurvy Cankers and others Venemous humours And so such humours are not to be rejected but to be explained by the principles of Chymists and such things as have affinity with themselves
and hence venenate humours bred of poyson and poysonous matter do not seem so properly to be referred to Choller Phlegm Melancholly although in colour it seems to have some affinity with some of these yet their nature is far different and therefore are to be described by their Powers Hyppocratically The Melancholly humour explained Lastly of the Melancholly and black humour It is to be noted that by it selfe it is thick earthy feculent or salt and for the most part 't is so much moystened by many serous and watery humours that it becomes like unto Lee which consist of watery adust and salt parts and therefore it is called by some Water CHAP. IX Of the generation of Stones and Worms BEsides Wormes there are other things found and generated in the body Stones which are the causes of diseases as stones and worms that Stones for the most part are generated in all bodies experience and the observations of Physitians do manifest They are generated of feculent matter earthy slimy muddy and of moisture apt to putrifie which when the passages are straiter and narrower in the body sticks and of its own accord tends to coagulation and concretion Wormes also may be generated in most parts of the body Worms out of corrupt and putred matter containing in it Seed or some proportionable principle to Seed namely some vital principle CHAP. X. Of the causes of Diseases of Intemperature without Matter HItherto we have explained the causes of Diseases general The eauses of hot distemoen now we will handle them severally And First for Diseases of Intemperature Galen accounts five sorts of Diseases of distemperature by heat Motion of the body and mind Exercise which causes heat by too much stirring of the humours and spirits Putrefaction which is the cause of heat because in putrefaction the internal heat Putrefaction is called forth by the external and being outward is more sensibly hot Hot things touching our body The proximity of a hot thing and impressing their qualities on our bodies Costivenesse of body and Retention of the hot steeme which should passe through our Pores Lastly mixture with some hot thing or hot things taken into our bodies as Air Meat Drink hot Medicines Galen in his fourth Book of the Causes of Diseases of Distemperature by cold Costiveness reckons these The presence of cold things the quantity and quality of meats and drinks condenseing rarifying Mixtures of a hot thing Causes of a cold distemper idleness and immoderate exercise all which and if there be any other may conveniently be reduced into four ranks For whatsoever brings a cold distemper to the body do it either by altering and by its proper force cooling the body such are cold things whether outwardly applyed to the body or taken inwardly or suffocating the innate heat such are those things that prohibit the ventilation and blowing of the fuliginous vapours or extinguish the heat by their too great aboundance Dissipation or dissipate the same by overmuch exercise of the body or mind a hot constitution of Air and such like or through want of food which poverty may occasion or by letting too much blood Hence it is manifest that the causes of hot Distempers when they are in excesse become the causes of cold Distempers Drawing away food Moist by dissipating extinguishing or suffocating the innate heat The causes of overmoist Distempers may be reduced unto two the proximity to moist things or those things that hinder transpitation and so retain the cold steem of the body Dry distemper is occasioned by the contrary causes to wit Dry by alteration of drying things and want of aliment Compound distempers are from compound causes Of compound distempers and if the causes of simple distempers are joyned together there ariseth a compound distemper yet complication of causes is not always necessary for production of compound distempers since there are many causes which have in them double qualities which therefore if they have equal strength and force cause a compound distemper so that the body be so disposed as it be fit to receive the actions of them both alike CHAP. XI Of the causes of distemper with matter SInce every humour hath its peculiar Temperature The causes of distemper with matter and communicates it and impresseth the part which it adheres to The blood which is hot and moist heats and moistens yellow Choller which is hot and dry heats and dryes Phlegm which is cold and moist causeth a cold and moist distemper Melancholly which is cold and dry causeth a cold and dry distemper The matter which is the cause of distemper in the affected A collection of matter either is collected by degrees or else falls on it on a suddain 'T is collected either through the error of the Aliment or default of the part through the fault of the part it is collected when either the faculty of concoction is weak and doth not rightly elaborate the Aliment and from thence causes excrements which either the expulsive faculty can expel or the weaknesse of expulsion is such that it cannot expel that too great quantity or some disease of conformation and straitnesse of the passages suffers not the Excrements to be cost forth But by default of the Aliment the matter is collected when that is not good but such by reason whereof great store of excrements are generated or slimy and viscious humours are produced that the expulsive faculty cannot expel them A flux is either when humours are drawn to a part A flux made by drawing or sent to a part Attraction is principally through heat and pain not because they draw but because they afford occasion for humours to flow to the part to which you may adde for the supply of vacuity But humours flow to the parts affected Transmismission though they are not drawn for two reasons first because the humours collected in the vessels by their own violence begin to flow into some part according to its situation and its respect to the vessels Secondly because the parts which have strong expulsive power tire or decay in their strength or quality or being burthened with plenty of humours unlade themselves and lend that which is troublesome to another part either the whole body sends forth vencmous humours or else some parts Yet that there be made a flux there is required not onely the part flowing but the part receiving which is either weak or apt and disposed to receive fluxions CHAP. XII Of the causes of Diseases of the whole substance DIseases of the whole Body Causes of diseases of the whole substance or of Occult qualities which are in the similar parts besides diseases of intemperature are all produced from causes of the whole substance or acting in a hidden manner such are all venomous malignant things and such as act in a hidden manner Of such causes some are produced in the Body
inflammations of the Midriff the Eungs the Liver the Gutflion Loathing and Vomiting have their rise from the same causes differing according to Major and Minor Causes of loathing and vomiting either in the stomach it selfe ill affected and weak or from something contrary to nature tearing the stomach The stomach is ill affected by a cold and moist distemper or by conformation thereof or by a certain native straitnesse thereof by reason of drynesse and leannesse swelling an Ulcer whereunto belongs frequent vomiting which indeed it selfe disposeth the stomach to more frequent vomiting as also the shutting of the inferiour Orifice of the Ventricle by some tumour as an obstruction also of the Guts and mesentary and inverted motion of the fibres of the Guts The diseases called the Chollick and Stone by the communion of the Membranes and lastly wounds and hurts of the Braine and its Membranes But the matter which Irrirates the stomach to expel either loading it with its plenty or twitching it with its sharpnesse or moilifying the superior Orifice or by stimulating it with a malignant quality it doth it whether it be meat and drink or medicines poysons worms blood quitture choller effused into the stomach which happens to those which have a vitious implantation of the Pores or the Vessel that carries the Choller into the bottom of the stomach The evident external causes are too much exercise of the body and the sight of loathsome things The cause of Choller is offensive Moist Choller and sharp matter irritating the expulsive faculty of the stomach by its plenty and its quality to expulsion and stimulating it to evacuate upwards and downwards Such is Choller collected about the Liver Pancreas and parts adjacent also sharp adust humours salt nitrous and other peccant humours bred of corrupt food as Mushrooms Garden-fruits and such like strong purging Medicines and Poysons do the same and stir up this matter As for the difference betwixt the other Choller and this Dry Choller which we have newly explained that is dry this is moist the cause is a flatuous and sharp spirit stirred up by yellow black and adust Choller spread over the stomach Belching is occasioned by thick and fuming vapours breaking out upward and stimulating the stomach to expulsion Belching Concerning a loosenesse Alientary and Celiack affects the causes of a Lyentary and Coeliack affects are for the most part the same differing onely in magnitude And in this also that a Coeliack is rather a Disease of the Guts then of the Stomach although its name seems to signifie otherwise For in a Lyentary as hath been said the meat is cast forth crude In a Coeliack the Chyle is ejected contrary to nature and therefore the cause of a Lyentary is the hurting of the retentive faculty of the Ventricle and Intestines by reason whereof the meat before it be perfectly concocted descends into the Guts and is cast out And indeed in a Lyentary the retentive faculty of the stomach is principally hurt Nor can it be that meat unconcocted can be cast forth out of the Panch unless it be sent too soon into the Guts by reason of some fault of the retentive faculty of the stomach but the Coeliack is occasioned rather by some hurt of the retentive faculty of the Intestines because Chyle generated in the stomach ought to remain some time in the Guts that it might there be in some manner elaborated and be conveniently drawn by the meseraik veines and the ordure should be throughly elaborated If the retentive faculty of the Intestines be hurt all these things cannot be performed but the Chyle untimely and in some as measure crude is cast out of the Panch but the retentive faculty of the Stomach and Guts is hurt either of its selfe or by accident of it selfe through a cold and moist distemper and that either alone or joyned with a phlegmatick humour as also by cicatrising after a disentary and the immoderate use of fat things and such as cause Lubricity By accident it is hurt when the expultrix being stirr'd up exceedingly drives the meat presently downward by reason of the ulcerous disposition of the Stomach and Guts caused by biting and sharp humours sometimes also by a hidden quality or from hurtful and poisonous meats or ill disposition of air A Diarhaea proceeds from the expultrix of the Guts stirr'd up by plenty of humours A Diarhaea crudity or pravity whether they proceed from corruption in the stomach and guts or flow from the wholebody or any part to the guts from what cause soever they are generated and collected The more remote causâ—s of Diarhae a are imbecility of concoction and distribution through the distemper of the stomach and parts adjacent ill diet untemperate air omitting exercises of the body or taking a strong purge The cause of a Dysentery improperly so called or of voiding of blood without exulceration of the Guts are the opening of the mouths of the Mesentary Veines A Dysentary either by too great plenty of this blood or by crudity by reason of the concoction of the Liver or being retained too long in the Liver Veines and by a burning with a preternatural heat But as for Dysentery properly called the causes are sharp and biting humours whether they flow from the whole or from some part to the Guts or are generated in them and are peculiarly troublesome to them of which kind also are sharp gnawing drugs â—speciplly violent purges sharp quitture and poysons A Tenesmus or desire to go to stoole and cannot void any thing but blood A Tenesm comes for the most part from the same cause yet principally salt phlegm and a sharp humour clammy thick closely sticking to the skin of the Gut called Rectum The Belly on the contrary is suppressed either because the expulsive faculty of the Intestines is hurt Suppression of the helly or because the Muscles of the belly do not help to expel or because the ordure doth not stimulate or because the Guts are not alwayes sensible of pricking and stirring up the expulsive faculty doth not expel either because it is hurt or frustrated by some external error or fault in the object 'T is hurt either because it is weakened by a cold and dry distemper or it is hindered by the strength and driness of the retentive faculty or by the narrownesse of the Guts which proceed first from astringent and drying things Secondly from their inflammation or a Tumor bred in them Thirdly from growing together especially of the Fundament Fourthly from the going out and turning of them which happens in a Rupture Fifthly from obstruction by reason of the hardnesse of the siedge Worms Stones viscous Phlegm Sixthly from the Muscles refrigerated and straitned shutting the Gut Rectum The belly is supprest through default of the object when the Ordure is too thick viscid and hard the Muscles of the Panch do not help to expel either because they are
it go from him That happens by a certain imbecility of the Sphincter of the Bladder Yet there concurs a more deep sleep and a certain negligence of the superiour faculty as also custome It is not easie to explain from what cause a Diabetes doth proceed To this obscure matter I say Diabetes It seems probable that the immediate cause is the hurting of the retentive faculty of the Reines by too great plenty of Urine which when the Reines cannot endure they suffer it to flow into the bladder This plenty of Urine seems to be occasioned by the heat of the bowels liver and spleen and the veins drawing drink very powerfully and melting of the humours in the veins to which for the most part there happens imbecility and relaxation of those parts which carry the watry humour from the Stomack to the Liver and Spleen by reason whereof the drink is suddenly carried to the Reins The causes of those Symptomes which are deservedly joyned to these The cause of defect of milk and belong to the generation of milk seed and courses of women milk either is wanting or corrupt it is wanting either when it is generated in too small quantity or through some distemper of the Paps or some disease or straitnesse of passages by reason whereof they cannot draw and elaborate suffitient quantity of blood Vitious and corrupt milk is generated either through the pravity of the matter Vitious and fault of the blood or by some distemper of the bâ—ests Lastly Coagulated Milk grows thick and coagulates whilest either it is burnt by too much heat or if it abound in quantity and is retained 100 long in the brests or if any vitious humour be mingled the ewith which hath a power to coagulate A Gonorliaea Gonorhaea or emission of Sperm against ones will happens without erection of the Yaâ—d and desire of Venery 't is occasioned either by the hurting of the retentive faculty or some exrernal error the faculty is weakned through distemper principally moist rendring the spermatick vessels more loose whether it proceed from too great a flux of flegmatick humours or too much coition or other causes But from external hurt or fault of the seed whether it be too cold watry thin or crude sometimes also a Gonorhaea happens by convulsion as in such as have the falling sicknesse The cause of Nocturnal pollution is too great plenty of seed Of nocturnal polution heat and sharpnesse stimulating the expulsiye faculty and therefore this infirmity principally happens to those whose Reins and parts adjacent are very hot and to those who have sharp humour flowing to the spermatick vessels and then especialiy when nature in venereal dreams is irritated to ejaculate seed or their loyns are become hot by lying on their backs But the cause of a Venereal Gonorhaea is poysonous seed A Vencreal Gouorhaeâ— corrupt sharp and foul stirring up and stimalating the expulsive faculty The cause of suppression of Courses The cause of suppressions of Courses is the narrownesse of the veines belonging to the Womb and the foulnesse of the Blood as for the straitnefle of the veins they are most frequently the cause of suppression of Menstrues by reason of thick blood and dull humours sometimes they grow together with the vessels after abortion or compression of the same by some Tumours of the parts neer the cunto or from condensation contraction and driness of the â—â—â—tance of the Womb but by default of the blond the Courses are supprest whilest that is thick viscid and unapt to move The same cause Causes of diminishing of Courses The dropling of Courses but more gently occasâ—oneth small evacuation of Couâ—ses viz. They eithâ— flow in lesse quantity or else more slowly The comming down of Courses when they come out drep by drop and with pain is occasioned through default of the blood when there is too much and is thick viscid biting and sharp and flowing down to the Womb with too great violence some way obstructs the passages and extends them and stirs up pain or else through default of the passages or veins about the Womb and in the Womb when they are become narrower then they ought Too much slowing of the monthly Terms Of too much flowing aâ—iseth when the vessels are opened either by an Anastomasis when the mouths of the veins are opened or a Diairâ—sis when they are divided or when the blood being hotter thinner more moveable sharp and troublesome to narure stimulates the expulsive faculty to expel Now for the Causes of encreasing vitiated Terms Causes of encreasing vittated 't is manifest what things shew the causes of diminution thereof from what is spoken of want of nourishment But the cause of too much encrease is too great plenty of blood from too plentiful use of meat and drink full of nourishment an idle life much sleep too frequent use of baths of fair water and manly strength which converts the blood into the substance of the parts And these are the causes of the Symptomes of the natural faculty so far The causes of generation hurt as they belong to the preservation of individuals Now follows the causes of Generation hurt and that either tâ—ken away or depraved there is no generation made and bartennesle happens either in respect of the Man or of the Woman In regard of the Man In respect of the man it is hurt either through default of the seed or by vitious ejaculation of the same unfruitful seed or not sufficient is generated or the faculty is hurt through some distemper of the Stones especially cold and moist whence unripened thin and lesse spirituous is generated or else some hot whence too sharp seed proceeds or through default of matter whilest the blood and spirits necessary for the generation of seed or by old age or some disease drying the body or its principal parts or by fasting are defective or when the vessels which are necessary for generating and carrying of the seed be wanting or when the nutriment turns into fat or when the blood is vitious The emission of the seed into the Womans Womb is vitiated by the Yard either shorter whether by nature or by a disease or crowded through the shortnesse of the ligament The action is hurt by default of the Woman In respect of the Woman either when no seed or unfruitful seed is generated and emitted for the reasons lately mentioned Secondly if she do not draw and receive the mans seed by reason of her cold and moist distemper of the Womb or by reason of a Tumor Ulcer or Straitnesse of the neck of the Womb. Thirdly if she cannot retain the seed received because of the moist distemper of the Womb an Ulcer opening of the mouth of the Womb a flux of Courses and other humours Fourthly if the Seed be not well tempered by the womb or being some other way affected is not rightly cherished Fifthly if the
blood necessary for the forming of the young be deficient or very little Generation is depraved when the young are very weak or when monsters are generated which comes to passe through the foul Seed of the Father or theâ— imagination of the Mother Lastly Abortion the causes of abortion are either too great bignesse of fruit or defect of necessary nourishment or humours which are contained in the Membranes which when they are broken are poured into the Womb putrifie and become sharp and stimulate the expultrix or by a breaking and loosening of the vessels by which the Child adheres to the Womb. CHAP. II. Of the Causes of the Symptomes of the vital faculty and of the hindrance of respiration THe Symptomes which happen about the vital faculty Causes of the Palpitation of the heart or as hath been said Palpitation of heart swooning and sudden deprivation of the senses the causes of the Palpitation of the heart are first things troublesome to the heart meeting with it which it desires to remove from it namely vapours either in plenty or quality either manifest or occult or both troubling the heart putrid humours sharp hot abundantly rushing into the heart or pressing it also tumours and fleshy excrescencies and callous flesh bred about the heart or Worms molesting it in the Chest thereof moreover some moderate defect of the vital Spirits through want too great evacuations passions of the mind vehement griefe too much exercise which the heart strives by more vehement pulsation to restore and strengthen Thirdly preternatural heat encreased not onely consumes and scatters the Spirits but also enflames them which that nature may restore temperate and coole it appointeth this motion of the heart The causes of Sypothymy are defect and want of vital Spirits Of Sypothymy which either are not generated whether by defect of matter namely of air and blood or the debility of the generative faculty and from disease of the heart or being generated or taken away and destroyed whilest either they are suffocated or dispersed or corrupted by some occult or malignant qualities These causes if they are very grievous produce swooning The changes of Pulses shall be spoken of in their due place Respiration is hurt first when the moving faculty is hurt The cause of Respiration hurt Faculty of Luâ—gs hurt Of the Brest and that either of the Lungs or Brests the faculty of the Lungs is hurt either by its selfe when its temperament is destroyed and the innate heat is deficient as in such as are dying or it is hindered and hurt by accident when the brest by what means soever becomes straiter and the Lungs have not space wherein to dilate themselves The faculty of the Brest is said to be hindered by its self or by accident by its selfe when the animal spirits necessary to motion is wanting or because it decayes as in such as are dying or its influx is not made as in an Apoplexy or it is not received through default of the Nerves carrying the animal Spirits to the Muscles of the Brest and Midriff but 't is hurt by accident when by reason of the pain of the side or parts adjacent or matter and blood contained in the Brest or Wind or Tumours or something in the Panch the Brests and Midriff cannot freely be moved or when the Bowels in the Panch hanging about the Midriffe are obstructed exceedingly and swell so that by their weight between breathing the Midriff suffers not them to move freely Secondly Of Instruments Respiration is hindered by reason of the Organs when there is any Organick Disease or solution of continuity in the Lungs Midriff Muscles of the Brest and Panch the Wind-pipe Thirdly In regard of use when the custome of breathing is changed namely when it is too violent through the fiety heat kindled in the Lungs and Heart Lastly Of Air. Respiration is hindered by reason of the sharpness which we draw in in breathing if it be not fit for cooling and fanning of the heat The difference of an Astma and an Orthopnae The causes of an Astma and shortnesse of breath which are peculiar diseases of shortness of breath is this when a man constantly breaths with great difficulty without a Fever such as do those who after a violent â—ace and exercise stop The immediate cause is straitness of the mouths of the Lungs or the use encreased by reason of the narrowness of the Pipe of the Lungs but that straitness is caused by stoppages or pressure of the Lungs or of the Wind-pipe of the Lungs and both obstruction and compression are caused fiâ—st by thick and viscid humours but sometimes by thin and serous humours but in great plenty Moreover a Crude Tumour or by some swelling or gravel sticking in the â—ungs which cause obstructions when they stick in the Pipe of the Lungs but compression when they are in the substance of the Lungs or its Veins and Arteries This matter sometimes is gathered by little and little through its weaknesse sometimes it flows from elsewhere and most commonly it is thought to flow from the head by the vulgar but to me it seems more probable to flow through the Arterious Veins from the Liver into the Lungs whilest crude humours are generated therein or abound in a venemous kind which even that shews that in an Astma the cough is not alwayes present which neverthelesse perpetually accompanies a Catarrh and because these that are troubled with an Astma have always an ill habit of body and the signs of debility of the Liver A Crude Tumor may consist not onely in the Wind-pipes but without it which when it happens and consisteth about the smooth Arteries yet it presses the rough Arteries and respiration is thereby hurt and the Heart is drawn into consent and an uneven pulse is produced CHAP. III. Of the causes of the Symptomes of the external senses SInce order requires that we speak of the causes of the Symptomes of the Animal faculty first of all the the sight is hurt divers ways by reason of diseases of parts constituting the eyes and the default of the optique and spirits The Tunicle called Cornea which comes in the fiâ—st place since it is transparent and void of colour that it may permit the passing through of visible species if it lose its transparency Faults of the Cornea or be affectd with a stange colour it hinders the sight it loseth its diaphanity if it be thicker and become more dense or be moistned or pustules or little skins cover it It grows thicker and more dense by drying and that either the whole which disease is called Caligo or else some part is become white which is called an Albugo Caligo Albugo which spot if it be perfectly white and darkning so that it permit no passage for visible species and cover the whole Pupil it causeth blindness but if it be not perfectly white nor hinders all the passage
latter is occasioned two wayes either when the vital spirits are generated vitious and impure in the heart which when the matter of the animal spirit is such in the braine 't is necessary that there be generated in such black animal spirits in the braine or because although the vital spirit be good and pure neverthelesle the constitution of the brain is vitious which changeth the pure vital spirit into a black animal spirit The cause of mad Love is sorrow and conti nual solitation Of mad Love to which anger is often joined arising through the desire of a fair thing whether it be really so or seem so to be for although the amorous herb Philtra may stir up desire to lust yet that desire is not terminated in any definite person nor can the mind of a man be compelled to love that which he is unwilling to love and that Philtra doth not cause love but madnesse also as experience often teacheth The cause of madness is a hot and fiery disposition of the animal spirits Madnssâ—e such hot and fiery spirits proceed from a hot distemper of the braine or hot vapours mingled therewith which black Choller will set foreward sometimes in the veins of the head only other times in the whole body especially in those that are great with child and when it resides about the womb whether they are generated of fervent blood or adust colour or dryed Melancholy The disease which causeth men to think that they are turned into Wolves is called Lycanthropie Lycanthropie if it proceed from a natural cause and not from the Devil It ariseth from the depravation of the imagination and ratiocination and the blood of living creatures being drunk may be very powerful to cause the same yet for the most part it becomes from poyson communicated to us by the biting of any mad living creature or by the froth of their mouths thrown upon us by spittle by receiving their breath with our mouths by eating the flesh of ravenous animals whence Wolf-madness also Dog-madness and Badger-madness do arise as Hydrophobie which is when one is distractedly timerous of waters which neverthelesse may be occasioned without the biting of any mad animal by poyson in mans body but principally is occasioned by terror of the observations of Physitians do witness and then the disease is not to be referred to madness because those Symptomes which are proper to those that are bitten with mad creatures do not appear in these but onely the diâ—eased are adverse to all liquid things and neither can swallow liquid things but also at the sight and noise of them they fall in danger of swooning and death which nature is peculiar to this poyson nor can any other cause be rendered from manifest qualities But the disease of Tarantators Of Tarantulas and a company of S. Viti occasioned by the venemous biting of a Tarantula and the Chorea of S. Viti so called hath its rise from a venemous and malignant humour somewhat like to the venom of a Taâ—antula begotten in mans body and indeed is the cause of the Symptomes of the rest of the poysons in general but because they dance in this manner that is proper to this poyson onely neither can there be rendered any manifest cause thereof but here it is necessary to fly to that sanctuary of ignorance and to say that this poyson is destroyed in an occuâ—â— manner by the force of musick and this little creature is harmoneous and delights in musick CHAP. V. Of the causes of the Symptomes of the mooving faculty IN the first place the cause of a Palsie Cause of the Palsie or deprivation of motion in one part or more is the defect of animal spirits in the Organs appointed for motion the spirits are deficient when they are not sent out by the Nerves from the braine as happens in an Apoplexy sometimes also this disease is called a Palsie for although they are emitted yet through the ill disposition of the part they cannot exercise motion and sense therein they are not admitted through default of the Nerves and spinal Marrow namely when they endure some cold distemper and moist especially yet sometimes hot and dry or are dull or are cut or knockt or beaten or are made narrower or by obstruction or compression by reason of some humor or tumor or tubercle whether they are in the Nerves themselves as after wounds of the Nerves and contusions of the same scars do arise or in the parts neer thereunto by some contusion by a stroak or a fall by a sudden relaxation made of the Vertabres or being bound Besides a Palsie there are other impotencies of motion Cause of taking away motion the cause whereof besides that of the Nerves even now explained in a Palsie is the fault of the part instituted for motion a vitious disposition and disease namely if the bones in the joynts which are framed for them cannot move oâ— cannot rightly be removed out of their place through ill conformation fracture relaxation if the ligaments which come about the joints and continue in motion in a natural state are broken cut asunder eroded attenuated or become softer or on the contrary are dryed hardned and filled witk a hard and knoty substance if the Muscles and their Tendones are cooled too much and their native heat be as it were dulled or moistned by some humour contrary to nature or on the other side if they are dryed and hardned if any tumor knot bunch hard flesh ariseth in them if they are wounded if the Tendones are so stretched out by violent motion that they become longer then they were or wont to be or as it were broken with bonds or if a painful tumor be in a Muscle The cause of Lazinesse is the reception of trouble in the Muscles and parts appointed for animal motion Of Laziness but since this slownesse is two-fold voluntary and against our wills the one comes without much exercise and labour from vitious humours burning the parts appointed for motion the other which is also called Excicrative comes after too much labour and motion the parts serving for motion being dried and the spirits consumed The cause of trembling is the imbecility of the motive faculty Of Trembling which cannot keep the member in that part wherein it is placed The faculty is become weak through the faintnesse of the strength and some defect of animal spirits whether they are not generated by reason of some distemper of the brain or defect of the vital spirits either scattered or consumed both which may be occasioned by too large evacuations long fasting watchings long and tedious sicknesse too much Venery or through diseases of the Nerves as distemper especially cold contracted by what meanes soever or want or losse of sense is occasioned by stupifactives or by straitnesse but lesse then in a Palsie The cause of Convulsion is the irritation of the expulsive faculty Of
sends it out moist or by taking of meats that loosen the belly or by defluctions from the Head to the Guts or by the effusion of Choller and other thin humours to the Guts But the ordure is become hard by too much heat which consumes almost all the humidity whether it be that internal heat of the Liver or of other parts neer thereunto or of the whole body either natural or preter-natural moreover from the drinesse of the Guts or of the whole body Thirdly if there be too much Urine or if there be a continued sweat Fourthly by thickning and astringent meats Fifthly by long stay in the Guts by reason whereof the moisture is sucked out Sixthly through want of aliment in the parts Of sharp Faetid and too much attraction of the members The dung is sharp through the mixture of sharp homours use of sower meats 'T is become faetid through the use of stinking meats and ill concoction especially by the mixture of divers sorts of meats as also by the humidity and heat of the body which disposeth it to putrifaction Ordure is cast forth with a noise through the mixture of much wind violently breaking forth It becomes white White when choller is not mingled therewith as in the yellow Jaundice through the use of meats that are whitening being mixt with plenty of flegm also Yellow It becomes yellow through much much mixture of yellow Choller It becomes green through aeruginous choller It grows black by reason of a black humor by the use of Cassia and such like Red. Black Frothy It becomes red by the mixture of blood or adust yellow choller It becomes frothy by reason of slimy flegm and a defluxion of windy matter from the head and mixture of wind The causes of the the changed qualities of Urine shall be explained in the following bâ—ok Hot sweats proceed from hot humors either whilest the humors wax hot Causes of sweat preter 〈◊〉 or especially when the matter is overcome is attenuated and concocted cold are caused through plenty of cold matter which cannot be so easily overcome as heat or by the resolution of spirits and extinction of the native heat or through the malignancy of the matter â—he sweat smels by reason of too great plenty of stinking filth they are yellow in the yellow Jaundice by the mixture of yellow choller Green by mixture of leek-coloured choller red and bloody by the watrishness and thinness of the blood loosenesse of the skin and weaknesse of the retentive faculty yet there are administred Wines which being drunk in some discolour their sweat They are salt for the most part which consist of a salt and serous excrement Bitter by the mixture of Choller sharp by the mixture of sharp humours The menstruous blood offendeth in quality whilest it is white Of vitious Courses yellow black or has any ill colour moreover whilest it smells foul and is too watry which comes to passe whilest the like humors are gathered together in the body or about the womb and goes out through it with the menstruous blood The spittle is too thick if it be contained too long in the Mouth Of the spittle changed and its thinner parts consumed or if thick matter distil from the head or be mingled with it or if it be thickned by heat which happens in Fevers It becomes frothy through the mixture of spirit and much air Spittle borrows its tastes from salt bitter sower humours especially cleaving to the Stomach It receives its colour from humours in the bowels and the vapours going out of them 'T is become white from flegm Yellow from Choller Red from Blood Black from Melancholy or thick dryed Blood Green from aeruginous Choller it acquires a foul smell from inward putrifaction especially from an Ulcer of the Lungs At length the excressions erre in quantity Causes of excrements changed the excrements of the belly are cast forth in greater quantity then is convenient First by reason of moist food especially if after the use thereof store of drink be taken Secondly by reason of meats containing little alimentary juice but much excrementitious Thirdly through the ill distribution of Chyle Fourthly by conflux of Excrements from the other parts to the Guts But fewer then is convenient are ejected for contrary reasons namely if the meat be hard and principally if little drink be taken after it if the meat be of good juice and nourishment and be taken in small quantity if the Chyle be greedily snatched from the Meseraik Veines and if Choller which is as it were the Goad to stimulate and expel dregs come not much into the Guts The quantity of Urine ought to answer likewise to the quantity of drink but that also is sometimes made in greater or lesse quantity the causes whereof shall be shewed in the following Book The causes of plenty of sweat are rarity of body Cause of store of sweat strength of the expulsive faculty aboundancy and tenuity of Excrements and therefore in the Crysis of a disease great sweats arise whilest all the excrementitious matter together and at once is put forth Little sweat is occasioned by contrary causes namely by the smalnesse or thicknesse of Excrements straitnesse of passages weaknesse of expulsion by the vehemency of the matter which destroyes heat Lastly why Courses sometimes flow more plentifully Of Courses sometimes more sparingly then is convenient above in the Third Part Second Section and First Chapter where we have spoken of suppression diminution and flowing of Months The end of all the Second Book Book III. PART I. SECT I. OF SIGNES In General Of the Difference and Heads of Signs CHAP. I. Of the necessity and benefit of the Method of Signs SInce we have hitherto explained what health is Necessity of the Semiotick Method and wherein it consists and what is the difference of things contrary to nature we now rightly come to the Method of healing and preserving health and are to teach by what means health may be preserved and diseases taken away The benefit of it but neverthelesse since arts are conversant about individuals and a Physitian doth not cure in general man but Peter and Paul c. The Method and way is first to be explained whereby the present constitution of every man both sick and well may be known which now lies hid in individuals they may be found out by the signs of a disease and what may be known and hoped for of the event and end of diseases and the Method of signs are to go before Moreover there is that benefit of this Method that whilest the sick see those things that may happen to them being known to the Physitian they may trust the more to him and obey him for the Physitian when he foresees those things which shall happen to the sick may have time to prevent them and avoid the reproaches of the vulgar whilest he foretells those things which
to be so exact and happening by some occasion from the external air or the heat vanishing of its own accord the vitious matter is separated from the other humors But if Vrine be made thick Troubled which grows clear and afterwards become thin that happens because the natural heat begins to perform and concoct the matter and to stir it and mingle it which notwithstanding since it is not exactly mingled the heat afterwards ceasing the Heterogeneal parts are separated of their own accord and the thicker reside in the bottome The same comes to pass if the Vrine be thin but some matter may be mingled therewith in its passage but since it is not exactly mingled with it but only confused afterward of its own accord it settles in the bottom Lastly Troubled which remains so if the Vrine be made thick and remain so it signifies great confusion of humors is made in the Veins by the heat stirring the humors but not rightly concocting them nor is there good concoction made which the excrements elaborate to make after their manner and indeed if such a Vrine appear in the beginning of such a disease wherein no concoction seems hitherto to be made by the natural heat it is a token that 't is caused by the fiery heat contrary to nature agitating and troubling the humors in the veins but if the Vrine in the beginning is not made thick but clear and afterwards becomes turbulent it is a sign that the disease grows worse and that the heat acting upon the matter contrary to nature is encreased yet always this and also other signs must have regard to the rest of the conditions of the Vrine and hence it is to be collected whether such signs be made by the strength of nature working upon the vitious humors or by the encrease of the preter-natural heat and putrifaction or debility of strength CHAP. V. Of the causes of colours in Vrines COncerning the causes of colours in Vrine The causes of a golden colour in Vrine a golden colour which agrees to the Vrines of sound men proceeds according to the vulgar opinion from some portion of yellow choller or rather from a serous and salt excrement yet that also something tinctured with choller which is mixt with the Vrine A white Water is made Of a whit either because nothing is mingled with it which may colour it which is properly called aqueous or because some white body is mixed therewith The first cause of aqueous Vrine is Crudity and weakness of the native heat by reason whereof this excrement is left Of an aqueous as it were imperfect Secondly obstructions of the passages through which the matter useth to flow to the Vrine Thirdly if choller and therewith that salt humor be carried to another place as happens for the most part in acute Fevers and Phrensies with them Fourthly much drink Fifthly heat of the Reins and Liver which plentifully draw drink to them but do not concoct it Sixthly Gravel in the Reins or Bladder too much of that which is salt and thick adheres but the aqueous flows out Vrines of another kind are made by the mixture of some white substance whether it be flegm or quitture or seed Of milky and these Vrines we call milky yet for the most part they are made thick and afterwards become clear and the matter setling in the bottome of what kind it is may be easily discerned A Vrine is somewhat pale Of palish Of pale when pale choller in a sufficient quantity or a little of yellow is mingled with the Urine but if much pale choller or yellow in an indifferent quantity be mingled with the Vrine a pale colour ariseth If yellow be mixed in greater quantity Of yellow the Vrine becomes yellow yet some times other causes besides internal external may give a tincture to the Vrine as Rhubarb Saffron the leaves of Senna and such like A ruddy colour in Vrine is caused by choller and blood Of blood red and indeed if the Vrine be coloured with blood it doth not look clear and is properly called Vrine dyed with blood and has a colour like water wherein the flesh of animals newly slain have been washed and is made either in some open vessel for what cause soever or by the weakness of the Liver and Reins by reason whereof they cannot contain blood and assimulate it to themselves or because nature at set times evacuates the blood abounding in the whole body with Vrine but the blood which is mingled with the Vrine is either thin and the Vrine is made red or reddish or thick which if much be mingled the Vrine is made exceeding red but if little either simply red or of a pale red but that Vrine which is coloured by store of choller the choller colouring it and and making it redder it shineth and is as it were like flame sometimes also it is made red and thick by plentiful mixture of adust choller like wine of a blackish or deep red Wine like Vrine is made by the mixture of ceruleous choller Of Vine colour Of grape colour or representing the colour of Woad as also by the mixture of plenty of red choller Grapy by the mixture of yellow choller exceedingly dryed and as it were changed into a Violet colour and degenerating towards black A green Vrine is caused by plenty of Aeruginous Of green and Leck-like colour Yellow and black Vrine are sometimes caused by the mixture of external things Of yellow and black as for what belongs to the internal causes the Vrine is made black when either the melancholy humour is evacuated with it which happens in those which cumulate melancholy humours in the Spleen or black choller is mixed with the Urine or when the heat and spirits are extinguished in the veins the blood is corrupted and becomes black CHAP. VI. Of the causes of an oyly Vrine and of other differences O Leaginous Urines either have only fat swimming in the superficies Of oyly Vrines or represent Oyl in substance and colour the first difference proceeds from a melting of the fat and is rather to be referred to the differences in the Contents but that Vrine which seems like Oyl in substance and colour and yet is nor truly fat hath its beginning from the mixture of excrementitious humours especially of pale and black Choller as also of Flegm from whence proceeds a crudity with a certain greenness like Oyl Black Vrine always thick but when the difference in substance and colour are joined a black Urine cannot be thin but if the black humor makes it black it is necessary that there is so great plenty thereof mixt with the Vrine that the Vrine must become thick A light red Vrine is thin from the small portion of blood mingled therewith A light red thin but if it be made of a pale red 't is by choller which cannot happen unless there be so great
ulcer lyeth hid in the Reins Bladder or otherwise through which the Vrine passeth or when from the superiour parts as the Brests or Lungs nature evacutates matter through the Vrinary passages Small pustles of flesh called Caruncles in the Vrine of exulcerated Reins are aprts of the substance Of Caruncles Of slimy Ecrements Slimy thick and tough flegm like the snot of the nose if it be made with the Urine and be voided with pain for the most part it is a token of the Stone in the Bladder but that which is made without pain Fernelius saith doth proceed from a crude ulcer of the Reins or parts thereabout or from an imposthume and truely for the most part such matter being present in the bladder as it is the beginning so it is a sign of the Stone of the Bladder and moreover being sent out it coagulates into a lapidious hardness but sometimes flegm which is cast forth in great plenty is the off-spring of crude matter and ill digestion in the parts beyond the Reins Worms if they appear in the Urine proceed from corrupt and sordid matter Of worms as in other parts Small strings and little bodies like hairs Of fibres and hairs and cobwebs if they are put forth with the Urine have their original from a thick humour either in the veins or in the reins or dryed in the ureters and reduced into this form by the longitude of the vessel Bubbles and froth are generated from wind included in viscous matter Of bubbles and froth which when it cannot exhale extends the matter into a tumor and those bubbles may be of divers colours according to the nature of the humour in which the inclosed wind stirs them up A Crown shews what kind of humors are contained in the greater vessels Of a crown and according to the diversity of humors hath divers colours and is seated in the upper part of the Urine and in that circle many things are obvious to our eyes which cannot be discerned in the rest of the humors because the light in the superficies of the liquor is otherwise divided and received then in the middle Lastly Of fat if fat swim upon the top of the Vrine it proceeds from melting of the grease but this proceeds from heat therefore if the fat continually swim in Urine like cobwebs it shews consumption and melting of the body yet Fernelius writes that he would advise you of Oyl taken inwardly least any small bodies of Oyl swim in the Urine by that means CHAP. X. Of the causes of changes in Vrines BUt Urines vary also in those that are sound Causes of changing of Vrines in regard of temperaments sex age time of the year sleep watching exercises passions of the mind and such like which are called the causes of variations of Urines As for the temperaments Vrine of those that are hot and cold hot temperaments have higher coloured Urines and thinner and less sediment or in stead of a sediment a cloud or Nubecula but colder have Urines paler coloured and few Contents also unless raw juice which proceeds from weaker concoction be mingled with the Urine In respect of age Of Boyes Youths Old men Of middle age Boyes have white Urines thicker with a plentiful sediment youths thinner with few Contents but higher coloured old men have white Urines but thin and without Contents unless many excrements meet together which if they are mingled with the Urines it happens that the Urine is made thick and full of Contents those that are of a middle age have indifferet Urines In regard of the Sex the Urines of men are far higher Of men or deeper coloured then the Urines of women thinner and have fewer Contents but the Urines of women are paler and by reason of crude humors thicker with more plentiful sediment yet nevertheless the Urines of men and women do not so vary that they can be known by certain signs whether it be a mans or womans water Of women great for reasons may be given also in men which produce such Urines as otherwise are familiar to women although as in such as are great with child there may be some change of Urine when the Menstruous blood is retained in them and from thence no small change is made in the body yet that change doth not afford a certain sign whether a woman be great when the same causes of change may be shewen in other women which are not great but in some which are more lively there is little change of Urine As for the time of the year Change of Vrine according to the time of the year the Urines of every kind in the middle of the spring are moderate as also in the middle of autumn but by how much the more the year goes on towards Summer by so much the more the colour of Vrine is encreased and the thickness and Contents are diminuished in the Summer also the Vrines are higher coloured thinner and have less sediments in autumn the colour of Vrines and tenuity are lessened the Urines in the Winter come neerest the best state In hot Regions According to the Region and degrees of Heaven To exercise and rest and under the hotter degrees of Heaven Urines are made deeper coloured thinner and of little sediment In colder Climates they are neerer to the best state Those which exercise and labour moderately make well concocted Urines and in colour substance and contents moderate but those that exercise and labour immoderately in those first the colour is encreased and the thickness and contents diminuished but if the exercise continue long the colour and tenuity is lessened when the streng this weakned but those that live idly make Vrines not much coloured and moreover thick and with many sediments In immoderate watchings first the colour is encreased According to sleeping and waking but if they continue long 't is abated sleep if it be moderate causeth Vrine to be good in all but if it be immoderate it encreaseth the colour of the Vrine but abateth the contents and substance but if it be protracted longer it becomes crude The passions of the mind since some encrease the heat Passions of the mind some diminish it according to the calidity and frigidity which they bring upon the body they alter the Vrines Lastly Meat Drink and Medicines Meats Drinks and Medicines change the Vrine and Meat taken moderately causeth a moderate sediment more plentifully a more plentiful thin causeth none Meats also Drinks and Medicines have a power of changing colour and smel lof Vrines CHAP. XI VVhat is to be observed in the Inspection of Vrines SInce all these things are spoken of Vrines for that end that from thence diseases the causes of diseases maybe known and the events foretold that this may be rightly done we are to admonish you what things are to be observed in the Inspection of Vrine First the time in
from whence cholerick and sharpe humours are collected Autumne Autumne because that in the same Morning and Evening the cold prevailes about mid day heate its constitution is mixed with cold and heat and by reason of this inequality of Aire it is very obnoxious to diseases and the blood at this time of the year is diminished and mellancholly abounds bodyes are thickned and pores shut In Winter as being cold and moist Winter phlegme is cheifly increased and bodyes are rendred obnoxious to distillations All which neverthelesse are so to be received if you compare one houre with another or the times of the yeare observe their naturall constitution 3. Apho. 8. but if the seasons of the year are unstable divers diseases according to the various constitutions of the year arise of which in the selfe same Apho. 6.11.12.13 Out of all which it is manifest that those scituations of places are more wholesome wherein the constitution of the Aire is temperate the Spring temperate The most wholesome scituation of places the heat of Summer sufficient to ripen fruits and graines Autumne colder Winter cold yet not offending our bodies with two much frigidity where ther is also a fruitfull soile men indued with a comely habit of body well coloured in the face laudable in their manners ingenious and rejoycing in their prosperous health CHAP. III. Of meate AS for what belongs to meate and drink Aliment what t is wherewith the substance of our bodyes is renewed and increased it is aliment which can increase the substance of our body and it is either properly so called because it nourisheth our bodyes only or Medicinall because it also doth alter our bodyes But aliments are taken from two kinds of things Food whence to be taken either from plants growing out of the earth or from living creatures and those things which are taken from living creatures are either the parts of animalls or those things which proceed from them as eggs milke and those which are made from these as butter cheese hony and such like Differences of aliments The difference of food is great for some meats are of a good others of an ill nourishment and juice some are easily others with difficulty concocted some are easily corrupted in the stomach others not The best meate That is the best food which is easily concocted nourisheth much affords much aliment is not easily corrupted nor indued with any ill quality and leaves few excrements Vnwholesome but that food is unwholesome out of which an ill juice is generated and which easily putrifies That food is accounted firme which brings forth much nourishment but wants great strength of heate for concoction Firme but that is infirm which is easily concocted and nourisheth but affords but little nourishment and such as is soone dispersed Meates from plants THe most ancient Fruits or Graines and most familiar kind of aliment are plants and those things which grow out of the earth amongst which in the first place are all sorts of Corne and grain which the Greeks call by the name of fitou and in the first place truly Corne is hot and moist and beyond all the rest affords much nourishment and that firme and most wholesome out of which although divers kinds of food are made yet the best amongst them is bread but that leavened which agrees to every age and is conveniently taken with all meats A sort of Barly which they commonly call spelt Spelt is the next in nature to Corne and is the middle as it were betwixt wheate and Barly and it nourisheth more then Barly but t is weaker then Wheate out of this spelt is made a kind of frumenty or Barly broath Frument Bye of which Pliny 18. Booke 11. Chap. Rye of which bread is made for the most part in Germany and other parts is hotter then Barly yet not so hot as Wheate and the bread which is made of it hath more aliment then Barly bread and that stronger yet it is something more hard of concoction then Wheaten bread The bread which is made of Barly is colder and yeelds not so firme nourishment Barley Partisan of Barley of Barly also is made ptisan which being taken after what manner soever affords good nourishment both to those that are sick and those that are well and is no way or clammy or viscide but easily passeth through and cleanseth the passages yet the aliment which it affords is a little thinner Rice is hot and dry Rice or rather temperate it nourisheth much especially being boiled with milke it increaseth seed it doth not easily putrify stops the Loosenesse it is hardly concocted and yeelds nourishment somewhat thicker and the frequent use of it may easily occasion obstructions Millet Millet and the graine like it called in Latine Panicum i. e. Indian Oates are almost of the same nature and are cold and dry and stop fluxes of the belly neither do they afford much nourishment nor very profitable yet millet is the better Oates are hot and afford nourishment of a better account Pottages and Broathes are made of them which may be given to those that are sick or well which stops Loosenesse of the belly The Corne called Saracenicum Saracenicum of which Pottages are wont to be made yeelds nourishment profitable for men that are given to dayly labour and it is hard of concoction it begets wind and offends the eyes Beanes are cold and dry and flatulent Beanes hard of concoction and crude and yeeld excrementicious nourishment yet not visced but have some cleansing power they make the senses dul and noises seeme troublesome Pease are cold and dry and flatulent Pease especially the greene yet they yeeld better nourishment then Beanes but not so plentifull Parsenips are hot and dry Parsnips and have greater force of cleansing then Beanes and therfore more usefull in Physick then dyer Lastly Lentils are the worst food cold and dry thick Lentills of evill and vitious juice and hard of concoction they fill the head with thick Vapours they hurt the eyes they ingender thick blood and are cheifly hurtfull to melancholy persons After graines instead of food Pot-herbes are given Pot-herbs and the leaves of the Herbes Branches Roots and the fruits of them as also of Trees which neverthelesse yeeld not so good and profitable aliment as Corne but many or them are too Medicinall yet all of them are better boyled then raw Lettice that is sowen is esteemed the best of all Pot-herbs Lettice and affords more nourishment then other Pot-herbs yet t is cold and moist and Medicinall and moreover in a hot constitution of Aire t is conveniently given to young men and those which abound with choler and those which have hot stomaches it provokes sleep allayes the heat of the reines yet too much use thereof diminisheth the naturall heate Cabbage is accounted by most to be cold and
Heart and fibrous neither is it easily concocted but if it be well concocted it yeilds neither ill juice nor a little and that stable and firme The Liver it self is hard to be concocted Liver and yeilds thick nourishment which is slowly distributed it is of good juice and firm but there is great variety in this part not only according to the kinds and ages of living Creatures but also by reason of their food and full nourishment for Animals which are not grown to their full state and which use better and fuller feeding have also a greater Liver more delicate and fuller of juice The Spleen affords little nourishment Spleen and that melancholy t is hardly concocted and slowly distributed The substance of the Lungs is light and thin Lungs and nourisheth lesse yet it is easier concocted nor doth it afford ill nutriment The Reines afford not very good but thick aliment Reines and the Reines of younger Quadrupeds or Calves are of better juice and are easier concocted The Tongue excels the other parts in pleasantnesse of tast and goodnesse of aliment Tongue it is also easily concocted The brain yeilds pitutious and thick juice Brain and is not easily concocted nor distributed and causeth loathing The Stomach and Guts of Animals are of a harder substance and of a colder and dryer nature Stomach they are harder of concoction and not to be concocted except it be by a strong stomach and that they be well boyled they yeild little blood and that cold and not very good Flesh that is full of Muscles Musculous flesh which is frequently taken instead of food differs principally according to the kinds of living Creatures Swines flesh nourisheth very plentifully Swines flesh and yeilds firme nutriment and therefore is most profitable for those that are in their flourishing age sound strong and which are exercised with much labour yet because too much humidity abounds in it it yeilds a thick and slow juice and many excrements it agrees not with all men especially with those that are sick wherefore many other sorts of meat are preferred before it Brawn or the flesh of tame Bores Brawn so that it be of younger Bores is the best because it hath not so much excrementitious moisture A Lamb before t is a year old hath moist flesh Lamb. slimy and viscid but when t is a yeare old t is very good nourishment consisting of good and plentifull juice and indifferent lasting and easie of concoction but in those which are exercised with hard working t is easie discussed and aliment that is not solid is made thereof But because Lambs that are of a longer growth Weather Mutton become Sheep and the flesh is then become ungratefull and not of so good juice their stones are cut out and they are made Weathers the younger whereof are the best meat and t is easily concocted and generates good blood and therefore agrees both with those that are well and those that are sick But Mutton of Ewes is evill Ewe Mutton both by default of the temperaâ—and by frequenting of copulation and of bringing forth young t is hardly concocted evill and dull and viscid juice is bred thereof Veale is temperate render and affords good juice Veale of a pleasant tast yet it yeilds somewhat a thicker juice then Lamb or Mutton Beef is thick flesh hard of concoction Bâ—ese and doth not easily passe through the Veines it doth not participate of viscidity and sliminesse the frequent use thereof causeth dry and melancholly humours in the body especially Cow-beef or that of an Oxe which with age and much working hath contracted drinesse and hardnesse of flesh or is hardned with salt and smoak Goates flesh affords good nourishment Gotes-flesh and may easily be preferred before the rest of Sylvestrous Animalls in goodnesse of aliment facility of concoction pleasantnesse of tast and paucity of excrements yet they are something drier Venison is hard of concoction Venison and generates melancholy juice especially if the Venison be grown to ripenesse of years and doth obstruct the bowels Hares flesh is accounted a great dainty Hares-flesh yet by Physitians t is numbred amongst those aliments which yeild a melancholy juice and therefore are not so good for those who have dry bodies yet if they are well concocted they are thought to occasion a good colour in the face if they are well boyled the juice is not evill There are many kinds of Birds amongst the which neverthelesse nay amongst flesh the Hens are accounted the chief Hens for they are temperate easie of concoction of good juice and contain few excrements and thence they procreate good blood and yeild most profitable food for those which are not much exercised with labour yet there is a certain difference amongst this kind of Fowl the best is the flesh of a Capon the next is that of Chickins yet their flesh is moister Hens are dryer the flesh of Cocks is harder and dryer the Hens flesh affords nourishment not firme enough for those who are day-labourers A Turky-cock also yeilds much and laudable nourishment Turkie-cocks nor is it inferiour to Capons neither in tast or goodnesse of juice it is profitable food for those which are in health The flesh of Patridge is temperate Patridges something inclining to drinesse t is easie of concoction it affords excellent juice and much nourishment and few excrements and is very good food for those that are in health and those that are troubled with the French Pox. A Phesant and a Quail Phesants Quails Pigeons which are the best nourishment and most excellent food for such as are in health There is no small variety of Doves the better sort are those that are of the Mountains and Woods yet the flesh of all of them affords a thick Melancholy and excrementious juice and is not easily concocted and t is hurtfull in putred Feavers The flesh of tame Geese doth abound more with excrements then that of wild Geese yet the flesh of them both is hard of concoction and yeild no good juice but vitious and excrementitious and such as is easily putrifyed but if one have a strong stomach and it be well concocted it affords plenty of nourishment but the liver of Geese that are well fatted are temperate meate most pleasant easey of concoction of good juice and much nourishment A Thrush is easily concocted A Thrush yeelds good juice not excrementitious and affords nourishment firme enough A Lark also generates excellent juice A Lark and is easily concocted and by a peculiar faculty it is reported not only to preserve one from the cholick but also to cure it The flesh of Black-birds both for pleasantnesse and facility of concoction Blackbirds and goodnesse of juice is somewhat inferior to that of the Thrush A Quaile is hot and moist hard of concoction A Quaile of ill
water The Fountaine is the best which hath these notes of good water Fountain that which spreds towards the East and runs towards the rising of the Sun and thrickles through sand and gravell that carries no mud with it that is hotter in Winter and colder in Summer River water for the most part is Fountaine water River and ariseth from many Fountains flowing together and therefore is of a mixt nature and receives also a mixt nature from the earth through which it flowes and somtimes also they are mingled with Snow melted in the Mountaines and great Showres of water collected together yet its crudity is corrected by the beames of the Sun whilst it runs through many parts of the Earth before the use of it it should stand and setle in water-tubs that whatsoever it carries with it that is impure may settle in the bottome Rain water which falls in the Summer time with thunder is the thinnest Raine and lightest but since many Vapours are lift up by the heate and mingled with the Showres these waters are not very pure whence they are obnoxious to putrifaction Well waters Well waters since they are not raised above the Earth and are lifted up on high only by the benefit of Art they are thick and heavy whence they continue long in the bowels and offend them Lakes and marish waters are the worst Lake waters they easily become purred they are thick and crude and often times malignant and Pestilent from whence the stomack is offended by them the bowels obstructed and humours corrupted and often times putred and malignant feavers and Pestilentiall do thence arise Waters of Snow and Ice are condemned Of Snow and Ice for they are thick and hurt the stomach and stirr up greivous diseases of the joynts nerves and bowels But the malignancy of waters are corrected by boyling Boyling of waters whereby not only the crudity and frigidity is amended but also the terrene and vitious parts are separated which afterwards when the heate vanisheth settles in the bottome Wine hath a heating Wine and drying power which even the Spirit which is drawn out of it teacheth yet because it easily nourisheth and increaseth moisture and blood fit to nourish the body t is said to be moist namely Wine is a medicinall aliment hot and dry some in the first some in the second and some in the third degree for this reason the use of it is forbidden boyes and by reason of this drying faculty many use to mixe water therewith yet there is not a little difference in heating and drying not only according to age but also according to the nature of the Wine it selfe for some is very little suffering because in mixture it will indure but little water but other Wine is called winy Wine because it may indure more water to be mixt with it But Wines differ according to taste smell colour Differences of Wines Savour and manner of subsistance as for what belongs to the taste sweet Wines properly so called nourish best and are not only most gratefull to the palate but to the bowells but because they are thicker they easily produce obstructions in the Liver and Spleen inflame the Hipocondries and are easily turned into choler they are profitable for the Lungs Chops and Throate nor do they so hurt the head nor offend the nerves Austere or harsh wines have the weaker heat tarry longer in the belly nor doe they easily passe through the veines and penetrate through the passages of the urine whence they are good for a loosenesse of the belly but hurtfull in diseases of the brest and Lungs for they detaine spittle the best wines are the middle sort which are neither very sweet nor sowre A fragrant smell is a token of the best Wine Smell because it can increase Spirits restore decayed strength and recreate and suddenly refresh those that are languishing even by its smell and can exhilerate the mind and strengthen the whole body and all its faculties and principally t is good for old men only that it fills the head and hurts the nerves but Wines that have no smell are base and neither received so greedily by the stomach nor are they so easily concocted nor do they afford matter nor so fit aliment to engender Spirits nor do they add so much strength to the heart nor do they so much refresh the body but those which have a strange smell whencesoever contracted are all nought White or pale Wines heate lesse Colour then full and yellow Wines and are weaker especially if besides their whitenesse they are of a thin substance all black wines are of thicker substance and for the most part sweete and nourish very much yet they beget thick blood and not so laudable they cause obstructions and continue long in the bowels and fill the head with many Vapours between the white and red there are middle colours yellow reddish yellow a pale red and perfect red a pale red are necrest to the white and if the substance be thin are the best such as are Rhenish Wines the most apt to strengthen the heart and to renew strength Greek Wines also strengthen the heart and are beneficiall to to those that are troubled with cholick paines and with the flatus of the stomach red Wines for the most part have not so great a force of heating they generate good blood and do not load the head but if they are of a thicker substance they are not so good for the Liver and Spleen by reason of the obstructions which they occasion between the white and red is a Wine of a mixt colour which also doth not heat so much nor offend the head As for the manner of subsistence The manner of subsistance tenuity is in the first place in that which is watry hence that which is of a pale red and yellow crassitude is in that which is black red sweet and sowre and thin wines easily penetrate and soon refresh the strength they open passages move sweates and urine yet they nourish more sparingly but the thick nourish more and are longer detained in the parts and heat and dry them more and often times bring forth obstructions Wines also differ according to age Differences of Wines according to age new Wine is thick and flatuous begets the cholick impeads excretion of urine yet it loosens the belly and unlesse it doth so t is the more hurtfull new Wine and that which it as sweet as Wine new prest is not easily distributed into the body but old Wine does work too much upon the nerves and offend the head That which is middle aged is more commodious for all uses in which thing neverthelesse there is a great difference according to the nature of the Wine for some will indure age others sooner loose their strength and consume away and loose all their Spirits In places towards the Septrentrionall Strong drinke wherein there is
ignoble part not having any great vessells since without great danger it cannot be performed Seaventhly Paracentesis to Seperation or Section belongs Paracentesis by which word every pricking in generall was denoted by the Ancients and t is performed in divers parts and that either with a needle or with the point of a knife this operation is famous and Ancient in the paunch to evacuate water of those that have dropsies which retaines the name of the generall name the manner and reason of performing whereof in the Institutions and in the 3. Booke of Practise part the 6 th sec the 2 d. Chap. 3. is delivered in water of the head the same pricking is sometimes used in the skin of the head and in the cods filled with water Hereunto belongs the cure of a Cataract by pricking which is so to be performed as Celsus also describes in his 7. Couching of a Cataract Book and 7. Chap. As also the cutting of the wind-pipe Laryngotome which is called Laryngotome which when it is necessary is to be performed with a launce the other parts being removed under the Larynx betwixt the third and fourth ring of the Wind-pipe the manner of operation is propounded in the Institutions As also the cutting of the brest in an Empyema An incision of the brest or an Ulcer or imposthume in the cavity of the brest which is performed on one side of the brest betwixt the fift and sixt rib and how it also is to be performed is explained in the Institutions Moreover a Seton Applying of a Seton or using of a Seton Needle by which operation the neck is prickt and the wound kept open that peccant humours may be evacuated by it of which operation you may also read in the Institutions To prickings we have annexed leaches Leaches or the application of leaches which being chosen prepared and cleansed are applyed with a rag or a reed by their biting they open the veines and draw out blood and indeed from the subcutaneous parts only and capillary veines if they are applyed only to the skin but if they are applyed to any great vessell they draw blood from the innermost parts of the whole body and therefore they are applyed according as there is need of this or that evacuation and are applyed to children when we dare not use the launce to open veines To the veines of their armes when they are affected with any greivous disease that requires evacuacion of blood CHAP VIII Of Section of Bones BUt that cutting which is performed in hard parts or bones is fourefold according to the various manner of seperation and variety of instruments namely shaving filing perforation and sawing First shaving is a plaining and a making smooth of the inequality of bones with an incision knife shaving them Shaving or a detraction and taking away of the filth clinging fast to the bones and it is performed with files in magnitude and figure according to the severall natures of diseases and of bones either straight such as are hammers which they use in driving or bent in the end such as they use in drawing sometimes they use both a file and a Hammer wrapt in a clout Secondly filing Filing or wearing away of bones with a file it usefull in the teeth when they hang out contrary to nature The third is perforation whereby we cut the part out of the middle of a bone Perforating either with a Trepan or with a file or together with a Trepan and a file the perforation which is made by a Trepan the Greekes call Trupesis a wimble they call Trupanon Kinds of Trepans or Wimbles and Trupane but a Trepan is either straight and sharpe and in a hollowed circle which is called a wimble in particular or it is hollow which is called Modiclus Trepan is like to common wimbles which Carpenters use and t is twofold the one is that which answers plainly to the wimbles of Carpenters the other which neere the point at such a distance as the thicknesse of the skull is of hath a knot without or a circle fitted which whilst the Trepan is within the skull hinders it that it cannot goe deeper then is fit which kind of Trepan because it cannot goe deeper the Greekes call Trupanon or Abaptiston Modiolus the Greeks call Cointhion and Coinichis and Prion Caractos t is a hollow Instrument of Iron round and long like a Pillar at the bottome of the mouth like a saw or full of teeth and straight Trepans which are called Periteria are opposed to it which are turned about with a handle which if it have a naile or pin in the middle t is called male and if it have not is called female but the perforation or boaring is performed principally when the skull is broke or when some matter or blood is contained within the skull the manner of which operation may be seen in the Institutions sometimes also in rotten bones when the rottennesse goes deep Lastly by sawing Sawing or cutting with a saw bones are divided when any dead part the flesh being first cut away with a knife to the bone and the bone is laid open or when some broken bone hangs our and cannot be put back into it place or when any chinke is to be filled up or when the table of the skull is to be taken away CHAP. IX Of Burning THe last kind of seperation remaines Burning which is burning which is to be used when diseases cannot be taken away by medicines nor cutting burning is performed two wayes Burning twofold either by those things which actually have in them fire and a fiery quality as Iron or other fiery Instruments made of Gold Silver Brasse which are called actuall Cauteries or with burning medicines which are called potentiall Cauteries There are some differences of actuall Cauteries especially An actuall Cautery in respect of matter and figure and differing also some other wayes as for matter Metallick Instruments prepared of Iron Brasse Silver Gold are in use this day Iron burnes potently Brasse and Gold not so violently the figures of Cauteries are various which are described every where sometimes they are fiered more sometimes lesse sometimes impressed deeper sometimes superficially only the manner of burning is to be seen in the Institutions Another manner of burning is that which is performed by potentiall Cauteries Potentiall what Caustick medicines are and Escaroticks is spoken above part the 1. sect the 1. Chap the 10 th and in what manner Cauteries are to be prepared shall be shewne in the end of this Book Fontanells Issues and Issues are made by actuall and potentiall Cauteries namely little Ulcers prepared to evacuate draw back and drive humours through them but in what parts and how these Fontanells are to be made shall be shewn in the Institutions To this third operation may be referred that Cupping glasses whereby something is drawn in the body or
they may together infringe and debilitate the venome In Administring of which there is no need of all those rules or observations which are necessary to be observed in provoking sweates in other diseases but presently in the beginning of a disease those Sudorifique resisters of poyson are to be given neither is too much debilitating of strength to be feared CHAP. XV. Of particular Evacuations AS for particular Evacuations Particular evacuation of the braine Errhines if any vitious humours are collected in the braine it may be evacuated two wayes by the Nose and the Palate By the Nose first Errhines call out phlegme which is spread about the braine and filmes that cover it and stirs up its faculty that it may strive to cast out super fluous humours Moreover sternutatories Sneezing which are stronger and irritate the braine and by the force thereof humours which lye deeper may be cast forth of both of these this in generall is to be noted that such remedies are not to be used unlesse universalls have preceded and that the whole body be purged but or the matter and forme of Errhines and those things that cause sneezing see before part the 1. Sect. 1. Chap. 18. and hereafter part the 3 d. Sect. 3. Chap 30. But those things which evacuate by the Palate Apophlegmatismes are called Apophlegmatismes and purge the more inward cavities and ventricles of the braine they are not conveniently given to those the inward part of whose mouth throate gullet or Larynx is exulcerated and such as are obnoxious at other times to distillations to the Chops and breast Those which purge the Lungs are called expectorating things Purging the breast and because humours cannot cast out from the lungs through the Wind pipe without a cough they are called Becchica of which kind for the most part are Arteriacks i.e. medicines for Rhemes all of them especially those which cleanse cut or any way prepare the matter for expulsion but that humours may the more easily be evacuated by cough their consistence ought to be indifferent neither too thin nor too thick but only so thick that they may be carried upward by Aire not so viscide as to stick in the mouth of the Lungs and therefore if the humours are viscide they are to be moistned and cleansed with sowre things but if too thin to be somewhat thickned The stomach is evacuated by vomit or by the paunch Things purging stymach Liver Reines Wombe the guts with glisters and medicines purging the belly the cavities of the liver through the belly the gibbous parts by urine the reines and urinary passages by urine the wombe by the cources Of which t is now spoken in universall evacuation CHAP. XVI Of the abating abundance of blood with Leaches Cupping-glasses Scarrifications c. THe other fault amongst morbifique causes is quantity and the common Indication which is taken from hence that that which aboundeth may be deminuished What shews the fault concerning quantity What offends in quantity and that which is diminuished may be increased but since nothing can be said to abound unlesse that at other times it be naturally present but in the body blood only and such excrements are contained which proceed from nature blood and naturall excrements in this second manner may be the causes of diseases as also milke and seed and moreover the spirits and solid parts of the body all which if they are deficient in quantity ought to be increased but if they exceed are to be deminuished naturall excrements are seldome desicient in quantity but they often exceed but since the same reason is of evacuating naturall excrements which there is of the humours in their kind preternaturall here only we will speak of taking away of blood when it abounds Therefore if Plethory be present and the blood abound Plethory what it shews the blood is to be diminuished and that which aboundeth to be taken away and too great plenty of blood indicates diminution of the same But concerning the manner how we abate the blood The manner of abating blood some performe it more strongly others more weakly frications Sweates Bathes Exercise Fastings performe it more weakely Leaches opening of the Hemethodes provocation of courses Cupping-glasles and Scarrifications performe it more strongly but the most generous and powerfull remedie here is opening of a veine Frications sweates Bathes and Exercises they diminuish the blood one way because they stir up the heate in the body which dissolves and dissipates the substance of our bodyes But fasting doth not evacuate by its selfe Fasting but by reason that it takes away humours and diminuisheth the body because it puts nothing in the stead of that which is consumed by heate and denyes necessary aliment to the body but because fasting evacuates the whole body equally t is then requisite when the humour abounding doth abound not in one part but in the whole body yet shorter fasting first evacuates humours out of the stomach and about the stomach but because fasting evacuates by degrees it is not profitable nor sufficient for an indication when plenitude is suddenly to be abated But t is endured when the strength is powerfull to which all other things which prohibit fasting are to be referred as temperature of body hot and dry hot and moist a thin habit of body griping or biting in the Orifice of the stomach vomiting flux of the belly Leaches by opening the mouths of veines Leaches and sucking blood evacuate blood by themselves and sensibly yet by little and little in which respect they may diminuish the plenitude of the whole body and helpe diseases of many parts to which they are applyed and evacuate sometimes a greater sometimes a lesser quantity of blood as they are applyed to a greater or lesser veine in the application therefore of them you are to observe whether they are placed for the evacuation of the whole body or for a disease of some private part for if they are applyed for the evacuation of the whole they are to be put to the great and prominent veines in the Legs and Armes or Hemerhodes yet in women that are with child they must be applyed only to the Armes but in regard of peculiar diseases they are to be applyed to divers parts as this or that part is affected The Hemerhodes if they use to flow at other times Hemerhodes the opening of them may be instead of breathing a veine but otherwise the Physitian in opening of them shall labour with little profit unlesse happily they are opened by leaches putting to them but since the Hemerhodes are twofold externall and internall the externall are opened to abate a Plethory as also for diseases of the Reines Wombe Back Hips and other diseases arising from the hollow veine with profit as in diseases which proceed from the Hypocondries the Liver Spleen Mesentery the internall may be conveniently opened but the externall are opened with frications
the leaves of a Fig course rags Leaches applyed the juice of an Onion the juice of Century or Sow-bread the Gall of a Hog or Bullock or with rags wet in these but the internall with suppositers and sharpe Glisters The courses whilst they flow exacuate also and diminish perfluour blood Courses but nature appointed that flux which if it be supprest is to be opened in which businesse this is to be observed that in provoking them the Physitian should make use of that time when at other times they use to flow for if he should endeavour it at another time he looses his labour Cuppings which Scarrification also Cupping with scarrisying but by die evacuating blood by themselves and sensibly but by degrees for which reason they are something applyed for good reasons sometimes instead of opening a veine if they are applyed with good reason they are indicated from no great fault of the blood But when they are used instead of Phlebotomie they are applyed for some great fault in the blood which indeed requires the breathing of a veine which notwithstanding weak strength will not endure but Cupping-glasses properly evacuate cutaneous blood yet because some of the blood which comes out of the skin is powred into the capillary veines from the great veines in this respect also they are said to evacuate the whole body but if that evacuation be more sparing it doth not reach the whole And when Cupping-glasses evacuate by drawing the use of them is most profitable if any revulsion be required at the same time as for the place of applycation if they are applyed in respect of the whole they should be put to the inferior parts if in respect of any part then to that part which requires this remedie yet in those that are pregnant they are not to be exhibited to the inferior parts but rather to the Armes Lastly simple scarification also without cupping Scarrification may evacuate blood which truly is used sometimes instead of opening a veine and t is appointed in the Legs especially by which meanes it may not only evacuate but also re-vell from the head and superior parts yet sometimes in the Arme and back also but in its proper use t is exhibited when there is a purpose to evacuate only out of some one part but especially when we would evacuate some acrid malignant and venemous matter least being retained it should cast the sick into danger which is used also in a Gangrene and by the ancients in a callous Ulcer CHAP XVII Of opening a veine BUt the most efficacious remedie for evacuation of blood is the breathing of a veine which neverthelesse hath other uses What indicates a breathing of a veine whereof we will here speake together for t is a question of great moment when the breathing of a veine or evacuation of blood by opening of a veine is to be appointed where first this is to be noted that the opening oâ— a veine is not some one Indicate but the matter of remedie which is profitable in many Indicates There are two generall benefits in the opening of a veine The use of opening a veine to evacuate blood and by accident whilst it draws away the blood the vehicle of heate to coole againe in evacuating it performes two things for it both takes blood out of the body and allwayes the cource and violence of humours in the veines first the way it both takes away the ill blood and only diminuisheth it offending in quantity but the latter way it can revell and draw back and derive the blood flowne into a part and the blood which is flowne in whilst it is yet moveable can draw it to the parts neere thereunto so that the opening of a veine may wholy performe five things namely to evacuate corrupt blood to diminuish blood to revell derive and refrigerate For first the vitious and putrifying blood may be evacuated by opening of a veine Putred blood evacuated by the opening of a veine as that which is contained in veines and they being opened it flowes out and indeed t is most profitably appointed in beginning of diseases since nature for the most part in feavers use to drive no small portion of the peccant matter to the extreames and those greater veines under the skin Secondly breathing a veine is an excellent remedie to diminish the blood The cutting of a vtine devinuisheth blood and revels Thirdly the opening of a veine is used for revulsion for a veine being opened the violence of the blood is turned and drawne back to the contrary part and therefore t is a very efficacious remedie to stop flowings of humours contained in the veines Fourthly the opening of a veine may derive the blood which newly flowed into the part It derives and is not yet setled there but as yet fluid a veine being opened nigh at hand it may I say drive the blood to a neighbouring part Fifthly Cooles opening of a veine cooles by accident but if distemper only be present which may be corrected by other remedies and no other fault of the blood be joyned with it which requires breathing of a veine also cooling medicines are ordered to be used but if the blood be so exceeding hot that it requires sudden refrigeration which other medicines perchance cannot performe or some other fault of the blood be joyned which by the same means opening of a veine may helpe for this cause also you may open a veine From whence it is manifest For which Indicants cutting of a veine serves that the breathing fo a veine may be profitable whilst the blood either putrifyes and is corrupted or offends in quantity or flowes to any part with violence or oppresseth a part or burnes vehemently Yet it is not allwayes necessary to open a veine when these â—inconveniences are present since we can take them away by other meanes but then only breathing a veine is conveniâ—ent when there is a great corruption of the blood and it requires sudden releasing as being that which is the best and most efficacious remedy amongst the evacuations of blood then presently blood may be evacuated In short The adequate Indicant of cutting a veine the Indicant to which by mediation of the Indicate as being the matter of helpe opening of a veine agrees it is a vehement fault of the flowing blood which is corrupted either in its substance or it offends in quantity or rusheth into some part or oppresseth some part or growes exceeding hot yet besides these principle faults the blood also sometimes as a cause without which it cannot and as adjuvant it may offend and then also it requires opening of a veine Yet we may not allwayes open a veine when these Indicants are present Things permitting opening a veine for since the opening of a veine evacuates blood together and also exhausteth somewhat of the spirits and so debilitates the strength if the strength be great it
permits opening of a veine if it be weake it prohibits it and regard is to be had here not only of the present but of the future strength for when the strength is weake either oppressed with store of humours or loosed in the latter imbecility only breathing of a veine is prohibited but in the former it is profitable All other things which are said to permit or prohibit the breathing of a veine besides strength they doe it only in this respect namely as they are the tokens or signes of strength or debility of nature as Age which flourishing admits of opening a veine Child-hood and old Age prohibit the same Seâ— the Sex as to women with child especially in the last monthes the opening of a veine is prohibited unlesse some disease inforce it and there be store of blood property of nature custome habit of body course of life constitution of Aire some Symptomes as large evacuations watchings and such like which dissipate the spirits and substance of our bodyes and loosen our strength unlesse they are taken away by opening of a veine How much blood to be evacuated The quantity of letting blood is indicated from the greatnesse of the fault depending on the blood and according as that hath greater or lesse force so blood is to be evacuated more largely or sparingly yet the strength as also things permitting are here to be weighed anâ— all those things which are the signes of strength and weaknesse and t is to be considered whether the strength will beare that evacuation which the magnitude of the disease requires But whether the quantity of blood which is indicated be to be taken away at once or severall times the greatnesse of the disease and the strength doe shew in a most violent evilâ— t is convenient to evacuate the blood at once in milder at severall times also strong bodyes will beare one large evacuation of blood but if they are weake t is better to doe it at severall times The presence of those Indicants which serve for the letting blood Time shews the time of letting blood and the absence of the prohibiting therefore the most convenient time of letting blood for the most part is the beginning of a disease yet it is not to be appointed whilst crude juice and unconcocted meates are in the first passages and in diseases wherein there are certaine intermissions and wherein the fits returne at certaine times the time when the fit is is not convenient for letting blood but the time of intermission is more commodious or if that be too short the declination of the fit or the abating of a disease As for the houre Houre if a disease that is violent provokes or urgeth in what houre of the day soever or even at midnight no preparation being made before and no delay being made you may open a veine at other times one houre or two after sleep is most convenient But where What veines to be opened or the place and veine to be opened although what veines soever be opened it may evacuate the whole body yet the larger performe this best and regard is to be had to the fountaine of blood and the rise of the evil which are principally the liver and spleen the veines therefore in the right or left cubit are to be opened according as the disease requires the internall externall or middle and especially the internall but what veines are to be opened for Revulsion and Derivation sake shall be shewne in there proper place CHAP. XVIII Of Revulsion AS for the third fault of humours Default of humours according to qualities namely when humours recede from their naturall state in respect of qualities how that is to be amended from those things which were spoken before of the preparation of humours and which shall be spoken hereafter of curing of diseases of intemperature is manifest enough But the error in motion is various In motion and humours decline from their naturall state if either they are not rightly moved that is when they are moved thither whither they ought not that is when they ought to be quiet according to the Law of nature they are moved at that time or else are not moved when they should be moved or are moved in parts or thither where they ought not to be moved the first error is called the restraining motion the second the inciting the third the helping the fourth the correcting and averting to another place First therefore humours as they offend in motion afford one indication only of stopping of motion Humours offending in motion what they indicate of staying the violence of a humour or an averting of a humour from a place to which it flowes contrary to nature unlesse happily nature unburthens it selfe conveniently by that meanes or the body puts away humours that trouble it to some ignoble part of it but we may satisfy this indication severall wayes namely if either we take away those things from the humour which are necessary for motion or whether we draw back the same by force namely if out of what is thin and fluid we make it thick if we stop the passages to it and straighten and make narrow the wayes through which it ought to flow lastly if we prohibit its comming and bind the passages which are in the part that it may not be conveniently received but when we cannot hinder these often or it is sufficient to stay a flux we call back and retract those humours by force Humours are drawn back either by reason of vacuity or heat or paine By reason of vacuity or rather evacuation humours are drawn back which power out and evacuate them out the body through other parts as the opening of a veine scarrifications leaches flowing of courses Hemmerodes purging by the Paunch vomitings urines sweats By heat and paine they are drawn back by those things which have power of inciting heat and paine or have power of performing them both as are frications ligatures lotions fomentations vesicatories causticks and such like An so How many waies the motion of humors may be hindered although there is one Indicant namely a fault of the humours in motion so there is one Indicate namely remedy hindring motion and averting the humour from the part to which it flowes yet the manners of performing these are various namely foure Revulsion Derivation Interception and repulsion Revulsion Revulsion what which the Greeks cal Antispasis is an averting of a humour flowing into some part into the contrary But humours are Revelled not those which are in the affected part for these are properly evacuated out of the part affected Revulsion ought not to be to the next or nigh thereunto but they are such as do flow to some part or are about to flow But since this is common to every Revulsion that a contrary motion may be occasioned for the flowing humour and may move it to a part not to that whither
help of an Incision Knife and Iron or with a silken string or with a Horse hair or with caustick Medicines and Septicks But the other kind Diseases in connexion when the part is not joyned with those with which it ought Indicates that that which containes should be rendred more firme and solid And therefore those parts ought to be strengthned and contained CHAP. VII Of the cure of Solution of Continuity THe first Vnity dissolved what it shewes What to be done by the Physitian and most usuall Indication of Solution of Unity is uniting or unity dissolved Indicates that the parts that are separated should be united which thing although it be the work of nature yet the Physitian is the Servant of nature in this matter For these are the principall duties of the Physitian here First he is to be carefull that nothing fall into the part affected which may impede conglutination Secondly That the extreams or lips in the dissolved unity are rightly joyned againe and are mutually applyed to each other Thirdly That the extreames so joyned may be kept together Fourthly That the Temperament of the part it self may be preserved and the help of nature is necessarily required in agglutination Fifthy That the Symptomes which may ensue be prevented and corrected But these aimes are not alwaies performed in all parts alike The cure of wounds For in wounds every extraneous thing is to be taken away out of the Wound then the lips of the Wound are to be joyned together and it is to be endeavoured that they may be kept united As before part 1. Sect. 2. cap. 5. is spoken the parts being joyned the rest of the work is to be committed to nature t is the parr of the Physitian onely to endeavour that the blood which comes out offends neither in quantity nor quality and to use Medicines that generate flesh of which Galen 3. of his Method of healing cap. 3. And lastly to citatrize the wound yet if certaine Symptomes which may hinder the cure do follow as Hemerodes paine convulsions they are to be resisted and principally care is to be taken that no inflamation ensue In the cure of Fractures Of Fraciures the Physitian propounds to himself two aimes First that the broken bones may be rightly joyned together againe and that the naturall Position and Figure may be restored to them The other that being joyned they may be kept together and retained and grow in their naturall figure But in what manner that may be performed is spoken before p. 1. S. 2. c. 3. But the generation of hard flesh and skin Generation of hard flesh whereby the bones and skin may be conglutinated and grow together is the work of nature But the Physitian ought to help nature which he doth if he beware least any inflamation or such like accident which may hurt the substance and temperature of the member should follow and the aliment is to be so disposed through drying Medicines that it may the sooner be changed into callous or hard flesh of which t is spoken before CHAP. VIII Of the cure of oppressing and urging Symptomes THe third sort of preternaturall things remaines Symptomes urging how many namely Symptomes Symptomes as they are preternatural Indicate in generall the ablation of themselves But that Indication for the most part is unprofitable For since they depend on diseases and their causes those being taken away these also are taken away But because it cannot alwaies be expected or waited untill the cause or the disease be taken away somethings necessary Indicate vvhich require a peculiar cure different both from the cure of a disease and of the cause and that they require to be done speedily Such Symptomes are those which are said to urge or ensorce All those things provoke which threaten such danger and mischief that the ablation of the disease or of the cause on which it depends cannot be expected but if it should be expected it would threaten the hazard of life or some great hurt But then the ablation of the disease is not to be expected when either it is uncurable and the Symptomes belongs to an action hurt that is neceslary not absolutely for life but for amendment or if it be cureable the cure whereof is so tedious that before it can be perfected danger and hazard of life will be like to happen by reason of the Symptome those Symptomes are commonly accounted but few principally paine watchings and immoderate Evacuations yet there are some others Paine indicates a medicine taking away or mittigating paine Cure of paine but since paine is either a sad sensation or else is not made without a sad perception by sense and two things are necessary to sensation perception of a thing Tangeable or sense in the part which it meetes with and advertency of the mind if one of these be wanting neither sense nor paine is and therefore those things which take away and hinder one of these are contrary to the paine and as for what belongs to the sense in the part we may resist paine two wayes either by opposing a contrary object to the sad sensation or by taking away the sense sithhence therefore a sweet and pleasant sensation is contrary to a sad that the sad sensation may be taken away that is to be offered to it which is endued with a mild and gentle heate and brings forth a pleasant Anodines and sweete sensation when touched which are Anodines or medicines mittigating paine properly so called as a bath of fresh water common Oyle the far of Animalls Muscillages and other things endued with a temperate and pleasing heate of which above P. 1. S. 1. Chap. 7. Moreover Narcotticks mittigate paine Stupefactives or Stupifactives which stupifie the Spirits and together provoke sleepe and so doe it that the Dolorifique subject is not perceived Secondly Intentiveness of mind is hindred if it be averted to other objects Over much watching indicates a medicine causing sleepe Cure of over much watching sleepe may be occasioned foure wayes first if all things may be removed which may excite any sense to operate Secondly if the mind be drawne away from the agitation of the externall senses and the animall spirits are pleasantly invited from motion to rest Thirdly if those things are exhibited which allay hot dry and sharpe vapours and send pleasant fancies into the braine whereby it is moistned and as it were stupifyed Fourthly if those things are exhibited which by a peculiar faculty make the animall Spirits drowzie and unapt or dull which specially are called Hypnoticks and Narcoticks Thirst since it is the desire of cold and moist Cure of Thirst and is made through the defect of cold and moist it Indicates cold and moist as its contrary Too great a flux of the belly as it is such Of the flux of the belly Flux of blood is stopt by astringent things Blood slowing Indicates
a remedie that stenches blood but it is stopt two wayes either by prohibiting that the blood cannot returne to the place out of which it came or if the vessells suffer it not to flow which will be done if they are shut or closed and sometimes one of them only sufficeth and sometimes when there is a great flux of blood both are necessary That the blood may not flow back to the place out of which it came is to be brought to passe if it be not drawn back by it if it be repelled if it be drawn to another place tâ—s not drawn back if the causes by reason of which t is drawn back be taken away as heat pain troublesome thirst t is repelled by the use of the Refrigeratives and astringents t is drawne into another part by Revelling or Deriving but that the blood may not flow back is prohibited when the end is shut which is done when the way is obstructed and stopped through which it flowed We cure a swooning by refreshing the Spirits Fainting or swooning although it cannot be done presently by removing the cause for this purpose the most fâ—â— things are pure Aire excellent and O doriferous Wine and spirits distilled of it But not only actions hurt but other Symptomes also sometimes trouble if the Arme pits stink and smell ranke that inconveniency is remided by the use of sweet things if the breath stinks that imperfection is hid by the chewing of sweet smelling things THE FIFTH BOOK PART II. SECT III. Of the vitall Indication CHAP. I. What doth Indicate Dyet in those that are sick SIth hence it is spoken by what means things preternaturall are to be taken away now it remains that we speake how that which remains in a sick man according to nature may be kept or preserved but those things which are according to nature commonly come under the name of strength or force and Indication which is taken from thence is called vitall and Conservatory because it preserves those things which are hitherto in the sick according to nature and those things which can preserve the strength of our body by themselves and are according to nature are called vitall and Preservatory Indicates But since as above in the 4. Booke part 2. Chap. 1. it is said there are three vitall or Preservatory Indicants health the cause of health and sound actions as we are to endeavour that in a sound condition all these may be preserved so it is to be aimed that as much as it is possible they may be kept in such as are sick and this is to preserve strength namely to preserve the native heat in the whole and in all the parts and the right use and observation of things called non-naturalls Namely the strength shews the Aliment The strength what it shews in this respect because 't is placed in spirituous solid and fleshy parts having a just quantity and doth use them as an Instrument and the vitall Indication is busied only about keeping the substance of the spirituous solld and fleshy parts But although the strength only Indicate Aliment Things prohibiting yet it may be prohibited from others for oftentimes the giving of meate increaseth the morbifique constitution and also to regard this that 't is not to Indicate Aliment but to prohibit it for when meate is given nature is called away from concoction and evacuation of morbifique matter and therefore when the powers Indicate their preservation which is performed by exhibiting nourishment in that quantity which the substance to be preserved wanteth but the morbifique cause indicates its Evacuation and therefore commands nature to be at leasure for it selfe alone and so prohibits Aliment whereby nature would be called away and hindred from its worke you must be carefull what urgeth more In breife strength only Indicates Aliment the morbifique cause permits or probibits the rest as age custome Time of the year the state of Heaven and such like are the signes of firme strength or of weaknesse or such as may shew the force and greatnesse of the morbifique cause CHAP. II. What things belongs to Dyet ALthough Dyet consists principally of meate and drink Things prohibiting to Dyet yet other things also called non-naturalls as Aire sleep and watchings exercise and rest and accidents of the mind belong thereunto but amongst these there are some things out of which primarily and by themselves Aliment is generated such is Aire meate and drink but others are accounted amongst the matter of food in this respect not because really out of those as the matter Aliment of the body is generated but as they are the causes of Aliment by accident and helpe that those things which are the true materialls of Aliments may be more commodiously turned into Aliment such are sleep and watchings exercises and rest Repletion and Inanition and passions of the mind of which is spoken above in the 4. Book CHAP III. How many sorts there are of Dyet and which agrees to which diseases BUt Dyet is threefold Dyet threefold Thick Indifferent Thin thick thin indifferent or betwixt both thick or full Dyet is that which can preserve not only the strength which is present but also can increase it indifferent is that which preserves the strength as it finds it the thin is that which preserves the strength yet somewhat abated Of thick and full Dyet again some is simple which agrees to those that are sick and is made by a ptisan with the Barley whole another is fuller and thicker which is made with fish and Eggs another which is the fullest of all which gives way to flesh of creatures that are gelded Simply thin is threefold simply such and is made by the juice of ptisan the thick juice or creame of ptisan or ptisan strained the thinner is that wherein water and Honey is mixt the thinnest Dyet was that of Hippo. wherein nothing was put the middle sort was made with bread dipt in broath or also with the flâ—sh of fowles But regard is to be had of custome places and Countries since in some Countries full Dyet is more in use in others more sparing and according to that the matter of thin Dyet is to be moderated But what kind of Dyet agrees to what diseases the comparing of the strength which Indicates food and the morbifique causes What food is fit for what diseases which hinder the same do shew for by how much the more nature is busied in opposing the morbifique cause by so much the more sparing Dyet is convenient but by how much the lesse it is busied by so much the more plentifull Dyet may be given but by so much the lesse it is oppressed by so much the state of a disease is nigher and therefore also by how much the disease is more acute by so much the Dyet is to be more sparing so that the strength can endure with it untill the state but t is known when the strength can endure
is a hot distemper of the whole depending on the heat of the Spirits inflamed Indicationâ— And seeing the heat of the Spirits and the distemper thence introduced indicate cooling yet if the cause exciting the same be still present that also ought to be taken away These Fevers are cured by good dyet The Cure so that there is seldome any need of strong medicines the food therefore ought to be cooling and moistning the meat of good juyce and easie of concoction principally cream of Baâ—ey the rest may be mixed with lettice sorrel juice of Citron or Lemmon Vinegar The drink should be barley-water small beer or small white-wine Yet if pain in the head be present or that the Fever be occasioned by anger or from a bubo then wine is to be refrained The Ancients most frequently used Baths of warm water but at present neither the same industry is used in preparation of them neither are men in our age so accustomed and disposed to bathe In the first place diligent care is to be had of that Fever Ephemeral which ariset hfrom the clovure of the skin Cure of an Ephemer a from closure of the skin or it's thickness or crudity of the stomack since they easily turn into putred Fevers And an Ephemera which is caused by stoppage of the pores of the skin since it comes to pass rather from plenty of blood then ill habit of body in that a vein is forthwith to be opened that the blood may be diminished and cooled but the thickness of the skin if occasioned by cold or astringent things is cured by those things that rarifie and open the same by a bath of fair water luke-warm soft rubbings temperate and luke-warm oils wherewith the body should be annointed But if the thickness of the skin be occasioned by drying things use moistening dyet and the body should be annointed with temperate and moistening oils Lastly if the Ephemera proceed from crudity From crudity of the stomack since that is twofold the one called Acid which proceeds from diminution of heat the other Nitrous which is caused by preter-natural heat If from Acid crudity which seldom happens the Ephemera proceed and that crudity be less so that meat may be reduced into a better state rest and sleep are to be occasioned and before sleep meat of easie concoction in a small quantity is to be taken and the stomack to be comforted with hot oyls But if the crudity be great then the meat is to be ejected by vomit or if the sick be not apt to vomit with a lenitive he should provoke a stool before it be distributed into the veins he must then abstain from meat and the stomack both with internal and external medicines is to be comforted But if the crudity be unsavoury or nitrous 't is to be conected with cold things wherewith if the concoction be not helped the corrupt meat is either to be emitted by vomit or to be purged by gentle medicines opening the first passages only such as are good against cholar and as corroborate the stomack CHAP. VII Of an Ephemera of more dayes and of a Synocha without putrefaction THere remains another kind of Fever An Ephemera of many days called Ephemera to which that appellation doth not belong because it is extended more dayes Yet it can be referr'd to no other sort of Fever then this more conveniently therefore although Ephemera should signifie the essence of the Fever Ephemera is so called though with the addition of more dayes Such Fevers are those which no wayes differ from Ephemeral Fevers newly described unless in durability the cause of which is obstruction of cutanious vessels which when they do continue stopped Synocha without putrefaction an inflamation of the Spirits so long endureth until that cause cease Moreover to these belong a Synocha without putrefaction commonly called a Fever inflative which is generated from the fervency of Spirits and thinner blood without putrefaction The cause of this Fever is the prohibition of the hot Effluvium Cause arising from obstructions or striction of the pores of the skin in a plethorick body This continues several dayes namely to the third or fourth day neither can the plenty of vapours kindled and exhaleing which proceed from the blood be discussed in one day nor can the obstruction or astriction of the pores of the skin be opened in one day The Signs of a Synocha without putrefaction are the same with those of other Ephemeraes Diagnostick signs only more evident For the heat is somewhat greater then in the others the skin is not dry but moist as it were the Urine somewhat thicker and redder the Pulse vehement swift frequent full great and equal the face and whole body red and fresh and as it were blown up the veins swell and strut with blood the head is heavy and respiration more difficult This Fever as the other Ephemerals is void of danger Prognosticks and is dissolved by sweat or Hemeroids of the nose within the fourth day or if it be protracted longer within the seventh day so it be rightly handled For unless it be rightly order'd 't will degenerate into a Synocha with putrefaction or into a Phrensie Squincy Plurisie or some other perillous inflamation But when this Fever ariseth by the inflaming of the thinner blood and Spirits in a plethorick body occasioned by the prohibition of transpiration Cure the blood offending in quantity is to be abated the heat to be cooled and the closed pores to be opened Therefore presently a Clyster being first given or a lenitive medicine a vein is to be opened that the blood may be abated fanned and cooled and better governed by nature And in that more plentifully then in any other Fever you may bleed yet so as that the strength may bear it As for things altering Galen to cool the blood drinks cold water and commands the sick to drink as much of it as they please which may be permitted in those which are accustomed to small drinks and in whom no danger is to be feared by drinking the same whether by reason of thick juices which the drinking of cold water may hinder the dividing of or by reason of some weakenness in the bowels by which they may be offended at the drinking of water which unless seeing in our bodies we seldom need we may rather use other coolers such as are Oxymel with water water of Chicory Endive decoct of barley juice of Lemmon or Citron Oxysauharum Spirit of Vitriol and Salt and the like cooling and opening things And that the appertion may the more happily be performed you must abstain from syrrups and conserves with much sugar in them unless they are much watered If obstruction of the pores of the skin be present 't is to be opened as I said before Their diet ought to be thin and little Dyet such as hath force to cool and moisten principally
is to be procured Putrefaction is to be resisted and the putred humours are to be cooled and dryed the generation of peccant humours by ablation of their cause is to be prevented Yet nevertheless seeing that these indications are often contrary and that those medicines which are administred for the cause may make the Fever worse and the contrary We must be careful how to perform these intentions And for the most part since the Fever comes last the cause is to be taken away first since the cause hath more power then the disease and the cause of a putred Fever being taken away the Fever of necessity ceaseth Yet if the greatness of the Fever inforce 't is necessary to have regard of the Fever first and afterwards to the taking away of the cause or certainly if we may first go to the taking away of the cause we should be very careful that by those things by which we take away the cause we increase not the Fever But those things are never to be used for the cure of the Fever which increaseth its cause fince that for the most pare that is of greatest force CHAP. V. Of breathing of a vein NOw for the cure to be performed by these intentions Letting blood and first concerning Phlebotomy Galen 11. meth medendi cap. 15. gives this rule It is most wholesome he sayes in all Fevers to open a vein not only in continued but also in all others which the putrifying humour stirreth up Whether when and why to be done in a putred Fever especially when neither age nor want of strength prohibites it And he addeth this reason For nature which rules our bodies being enlighthed and unburthened of that by which as with a pack it was oppressed what remains it will overcome without difficulty and therefore not being forgetful of its proper office will both concoct what can be concocted and cast out what may be emitted Yet this precept of Galen is to be rightly understood and explained For although there are many occasions for opening a vein and Authors cannot agree about the reason why Galen commands Phlebotomy in putred Fevers Yet 't is clear he did it that by evacuation of the blood nature might be enlightened and freed from the greatest part of her burthen for when blood abounds the opening of a vein and purging of Cacochymy are the best remedies furthermore when it is a plethorick body without doubt we should open a vein In some measure the breathing of a vein doth take away the cacochymy contained in the veins and mixed with the blood since the vein being opened the vitious humours go out with the blood especially because purgation which can take away foul humours out of the veins is not so safe as the breathing of a vein to be appointed at the beginning of a Fever For although Phlebotomy cannot take away all the ill humours out of the veins yet nature is lessned some part of her burthen and therefore can concoct and master the remainder the more easily for it may be that the plenty of blood which before the sickness was no trouble to the party now being sick and weakened with a Fever may become burthensom unto him And although some good blood be emitted therewith yet that hurts not the sick but rather helps as is said As we also see by critical Hemorrhodes that nature sends out no small quantity of good blood together Yet nature for the most part useth to drive no small part of peccant humours to the extream and subcutaneous parts thence and in the first place most commonly the worst blood comes first out Whence it is manifest especially in continual Fevers in those who abound with blood or have peccant humours mixt with their blood that bleeding is proper and that at the beginning that nature may be unladed of part of her burthen but if vitious humours are not intermingled with the blood in the greater veins the breathing of a vein for evacuation thereof is not to be used Cooling and fanning the blood is performed by lerting blood but they are only to be done when bleeding will not cool it alone Rules allowing Phlebotomy We are not only to observe whether bleeding be needful but also whether the party be strong enough to suffer it when the strength of the vital faculty is principally to be required so that the strength do not languish by too great store of blood suffocating the Spirits Age Habit of body and condition of the ambient air shew the strength But how much blood is to be taken away The quantity that may be taken first by the plenty of blood then by comparing the strength of the Patient with the greatness of the disease will be manifest for greater quantity requires larger emission lesser less robustious bodies require larger breathings of veins weaker require less The strength varies according to temperament habit of body age sex season of the year the condition of the Heavens and the Region as also in regard of certain Symptomes which use to be accompanied with Fevers as of watchings pain and such like As for the time for letting blood The time 't is to be done when 't is indicated and no way prohibited which is in the beginning and by how much the more the disease hastens to increase so much the sooner blood is to be taken away The place but if the concoctions are more dull and slow Pulebotomy may be deferr'd longer Veins that are opened for evacuation are best in the middle of the arm yet if the sick be weak and that also revulsion is to be made from the head the veins in the foot are to be opened to the greatest benefit of the sick CHAP. VI. Of Purging BUt because all putred Fevers have their original from foul humours Purgation Now we are to consider by what means they may be evacuated but seeing those things which evacuate them are twofold Lenitives and Purges properly so called Lenitives are safely to be administred in the beginning of all putred Fevers because there are scarce any bodies wherein the stomack guts and Mesaraick veins contain not some of the peccant humours These evacuations are to be caused by Clysters Clysters called loosening medicines and by vomit The Clysters are made of Mallows Marsh-mallows Violets Pellitory Beares-breech Mercury common Oil or mixt with Violets brown Sugar Cassia Lenitives Elect Lenitive Diacatholicon Hiera and such like Or those lenitive medicines may be given which are at this day in use Syrrup of Roses solutive of Violets solutive Honey of Roses solutive Tamarinds Cassia Manna the lenitive Electuary simple Cream of Tartar You must use such medicines at the times of remisness and intermittings when the Fever least offendeth whether it be carly in the morning or in the evening Sometimes also in the beginning of Fevers you may administer a vomit when great store of matter is contained in the stomack and adjacent parts
sometimes peccant matter in the first passages collected in the first concoction which useth to go to some of the humours which at certain Periods are moved and hath not as yet received its limits for motion it useth then to corrupt the humours and communicate putrefaction to the vena cava which Fevers for the most part are malignant A putred Synocha hath its original for the most part from transpiration hindred and want of ventilation of the blood The cause and hot fuliginous retentions by reason of obstruction of veins as well in the skin as also in the internal parts And the blood appointed to nourish the body putrifies in these Synochaes and putrefying continually sends hot vapours to the heart For when preter-natural heat is so kindled in the veins that nature can no longer rule it it becomes putred and is corrupted Nor is there any need that the putred blood should be turned into another humour presently For blood of its own nature is apt to putrefaction and in inflamations we see it changed to quitture not into choller though nothing hinder it in the veins but that it might And especially the Ichor or thin waterish part of the blood is apt to turn to putrefaction and by reason of the Ichor the blood in the first place is corrupted which happens when the vapours which ought to transpire are retained in the veins Yet the whole blood doth not putrifie but some parts thereof which so long as they are not seperated from the good blood crudity is said to be present which afterwards by concoction are seperated from the good blood which being done Nature appoints evacuation by which the blood returns to its former purity again A Synocha is three-fold Acmastick i. e. when it remains alwayes in the same state namely Differences when so much of the humour daily putrifies as is discussed this is called also Homotonos Epacmastick or Anabaticos is when the heat continually increaseth and more of the matter is kindled then can be discussed Paraemastick is when there is more discussed then corrupted and thence the heat alwayes decresseth Furthermore it blood which putrifies be temperate absolute 't is called a sanguinious Synoch a in particular But if it be hotter which useth to be called cholerick the disease is then called Synocha bilosa The Fever is known first by this Diagnostick signs that it continues from the beginning to the end without any exasperation and mutation Moreover because the Pulse is great vehement swift frequent unequal and inordinate And in a Synocha proceeding from temperate blood the signs of Plethory are present The blood to him that toucheth seems much and full of vapours and is not so troublesome and sharp as in other Fevers and other signes are present which are observed in a Synocha that is not putred A putred Synocha is distinguished from a non-putred by certain signs The heat in a putred is sharper then in a non-putred In a putred the urine is red thick and troubled without any sediment and crude or a little concocted in the beginning the Pulse affords signes of putrefaction and all the Symptomes are greater then in a Fever that is not putred A Synochabilosa happens to those that are troubled with cholerick blood and the heat is sharper then in a Synocha proceeding from temperate blood thirst is more troublesome the urine thinner and sharper and other signes which are usual in cholerick Fevers are discerned This Fever is the most simple amongst the putred Prognosticks and easiest to be cured And being pure seldom passeth seven dayes but the spurious is extended to the fourteenth day and is terminated sooner or later as the signes of concoction appear sooner or later A white urine in a Synocha is evil The least dangerous of all is that which is called Synochos Paracmasticos next to that Acmasticos But that is most dangerous which continually increaseth and is called Epacmasticos which easily degenerates into a disease called Causus And by how much the fewer the evil Symptomes are by so much the better hopes the more they are the more danger is shewn The whole cure consists in taking away the cause Indicatious and altering the fevourish heat Blood therefore as abounding in plenty is to be lessened the pores of the skin to be opened the causes of obstructions being taken away The fevourish heat is to be tempered and allayed if there be strength as for the most part there is thin diet is to be used Therefore a vein is forthwith to be opened in the right arm a Clyster or lenitive medicine being given first if occasion require and to take away as much blood as the strength will permit Breathing of a vein and you may more boldly take away blood in this then in any other sort of Fever Blood being evacuated Medicines that the concoction may be made more facile we are to use those things which allay the heat free from obstructions and resist putrefaction namely the juice of Sorrel Lemmons Citrons and Syrrups and Conserves prepared of them Syrrup of Sorrel simple Oxymel simple Oxysauharum simple Spirit of Vitriol and the four cold seeds with cooling waters are to be administred Principally we ought to endeavour that the pores of the skin may be freed from obstruction which for the most part is the cause of this disease which thing Oxymel and wine mingled with honey and the honey dissolved will conveniently perform since they are easily carried to the outmost parts of the body and attenuate dull thick humours and simple Oxymel resists putrefaction Concoction being perfected the Ancients used to drink cold water and gave so much of it to drink as might not only extinguish the fevourish hear but that the matter concocted might be evacuated by stool vomit or sweats But in our countries sick people are not so accustomed to drink cold water and many inconveniences are to be feared by the use thereof So likewise swimming in cold water which was usual with the Ancients doth not agree with our bodies The concoction being perfected nature useth for the most part critically to evacuate the corrupted matter which if it be not done it ought to be performed by the Physician with purging medicines Dyet in this Fever ought to be thin Diet. because both that blood aboundeth and the disease is short It should be cooling and moistening and also to have power of attenuating thick humours and deterging viscid ones CHAP. XII Of a Causus or Burning Fever WHereas amongst continued Fevers there is often mention made of a Causus we are also here to say something of it But a Causus is not any difference of a Fever but rather a measure expressing the quality of fevourish heat The word Causus is sometimes taken generally and not so properly sometimes specialiter and more properly Generally for any sort of Fever whose heat is vehement in particular for a Fever which hath two Pathognomonicks great heat
a continued Quartane and debilitates nature exceedingly it lasteth till the fourtieth day oftentimes and beyond it Most part of the cure is the same with that of a continued Quartane Cure and because the humour the cause of the Fever is contained in the vena cava and there mixed with the blood in the beginning those things that open the first passages being first exhibited a vein is to be opened afterwards phlegm is to be concocted and evacuated Yet you should heat and attenuate more sparingly then in intermittent Fevers but to moisten more and adde those things which may allay the heat of the putrifying humours such as are in other cases convenient against choller The humour being prepared purging is to be used and a purge should be given the next day after the fit which at first should be given the next day after the fit which at first should be gentle but if nature order no Crisis stronger may afterwards be given Diureticks and Sudorifiques may also be given after concoction but such as are not so hot and those given in intermittent Fevers and when the strength is much debilitated confortatives are to be exhibited prepared of Burrage Bugloss Balm flowers of Rosemary Gilliflowers Confection of Alkerms and such like Such Diet is to be appointed as in intermittent Quartanes Diet. yet the diet should be thinner and cool more then in intermittent Fevers since that the heat is greater and the height neerer the use of the smaller sort of wine although it may be allowed yet it must be taken more sparingly then in intermittents and if the heat be greater wholly abstain from wine CHAP. XVI Of Symptomatical Fevers BEsides these continued primary Fevers which have hitherto been explained Symptomatical Fevers there are yet other continued Fevers called Symptomatical and accidental which happen upon some other disease which hath gone before and which follows as a Symptome the disease and is taken away at the cure of the disease and so these Fevers follow other diseases which being taken away they cease Whence the Ancients also as Galen teacheth 4. Aphor. 73. said those only were fevourish which were sick without an inflammation or other distemper but those that did febricitate by reason of an inflammation of the side lungs or any other part they did not call them fevourish but Pleuretick Peripneumoniack Hepatick or other such like names But there is not only one sort of these Fevers Differences yet the principal and most usual is that which follows an inflamation of some internal part neer the heart or which hath consent with the heart when from blood powred into the inflamed part and putrifying vapours are communicated to the heart and heat it which in a Pleurisie Peripneumony and Angina happens as we are commonly taught But although it cannot be denied but that from the inflamation of these and other such like parts Symptomatical Fevers may arise and that the Fevers ensuing the inflammations in accidental wounds do prove it yet if we diligently consider it all those Fevers which are commonly called Symptomatical are not such but primary For first putrefaction is kindled in the vena cava whence a continued primary Fever is stirred up Fevers accompanied but because nature is burthened with the weight of those peccant humours she useth to force them as much as it could out of those greater vessels and from a publique and Kingly seat as it were into lesser veins and smaller parts of the body the blood with those vitious humours being diffused into those lesser parts causeth inflammation And it is manifest by this because a Fever for the most part precedes inflammation it doth not follow it and oftentimes the matter passeth from one part to another whence changes of diseases are made Hence these Fevers are properly called by Platerus Comitatae rather then Symptomatical and such Febres Gomitatae are not only those which have an inflammation of any part accompanied with them but also those to which other evils are annexed namely a Diarrhea a Dysentery Spots Measles the small Pox wandring pains the Gout of the joynts or running Gout Catarrhs For all these evils do arise when nature being oppressed with the weight of its burthen of peccant humours it protrudes some part of them out of the vessels A Fever of this kind is also accompanied which is an Erysipelas Erysipelas or Rose called by the Germans Rose for this Fever doth not proceed from an inflammation of an external part but this evil accompanies the Fever for when the thinner and hotter blood burneth in the vessels by what means soever putrifies and is corrupted and acquires a vitious quality which principally is caused by anger and fear nature being stimulated protrudes the same to some external part of the body whence this evil invadeth with a trembling and quaking and whilest the matter striving to go outwards ceaseth on the Glandules under the Arm-pits and about the groin some of the humour that is stirred up sticks there and pain and swellings are there perceived till at length it manifests it self in the leg or some other external part which may be known by the heat pain and rosie colour But we do not assent unto Platerus in that he says that all those Fevers are simple and pure continued and are without any putrefaction The Urines that we may pass by other things do manifestly shew putrefaction which hath the same tokens of crudity and concoction as in other putred Fevers and nature sometimes critically sometimes Symptomatically expells the matter offensive to it for it doth not only expel by insensible transpiration and by a moist steam which useth to be in Ephemeraes and Synochaes which are without putrefaction Some of these Fevers whether they arise from an inflammation of the parts or whether they have that as a companion Differences of Fevers are called Phlegmonides which principally proceed from blood but those which arise from Erysipelas or inflamation are called Erusipolatodes and inflame fires Phlegmonides Typhodes Lipyriae To these belong the Fever that leaves fire as it were behind it which burneth so exceedingly that all the interals are as it were burnt but the external parts grow cold and that during the whole course of the disease and this Fever ariseth from an Erisipelas or inflamation of any internal part but principally of the stomack and from blood and Spirits meeting in the part inflamed The second kind of Symptomatical Fevers which is called Lenta proceeds not from any inflamation of the bowels Febrelentae but from some obstruction and hidden putrefaction that is from matter without the vessels spread over the substance of any of the interals or at least impacted and putrifying in the capillar veins dispersed neer the substance of the interals and hath its rise from the substance of the interal decaying whence there is so great quantity as that when the matter is gotten into larger and wider vessels
in different bodies naturally yet if there be great vehemency of manifest causes even in bodies of different constitutions they may produce the same humours and diseases depending on them As for the difference of intermitting Fevers Difference they proceed from the diversity of humours for there are so many sorts of intermitting Fevers as there are of humours by which they are produced for there are according to the vulgar opinion three sorts of excrementitious humours Choler Flegme and Melancholy and so three kinds of intermitting Fevers Bilious Pituitous and Melancholy which differences we usually call a Tertian intermittent a quotidian intermittent and a quartane intermittent And in case those humours are sincere pure Fevers are generated if they are mixed spurious And that Fever which proceeds from pure Choler is called a pure Tertian but that which ariseth from yellow Choler mixt with some other humour is called a Bastard Tertian But concerning a quotidian intermittent Of a quotidian whether any be the matter is not so plain For Fernelius accounts this the rarest of all other and scarce one of them happens amongst six hundred and that those intermittent Fevers which daylie afflict for the most part he rather accounts them double Tertians But Platerus flatly denies a Quotidian Fever and wholly agreeth with Galen 8. Meth. med cap. 5. where he appoints only a twofold crudity the one nitrous the other acid and they only seem to afford matter for two sorts of Fevers Cholerick and Melancholy For although Flegme also according to preheminency and most principally be called a crude humour yet since it is exceeding cold it can scarcely putrifie and excite a Fever But whether there are more circuits of Fevers Whether there are Quintan Fevers and whether besides Tertians Quartans and if there be any such thing as Quotidians there are also other Fevers which are extended beyond the fifth circuit is doubtful Galen saw no such Nevertheless Hypocrates and other Physitians observed Fevers which returned the fifth sixth seventh eighth ninth day But what the cause of this course is is very obscure Some seek the cause of such fits out of the diverse constitution of Choler and Melancholy and Andreas Caesalpinus Art Med. lib. 2. cap. 15. refers Quintans to Choler Septanes to Melancholy and determines such flower returns of Fits to be a kind of renewing of one or more simple accessions and the Quintan to be a kind of Tertian wherein the third day is without a paroxism and a Septan to be a sort of Quartan renewing the accession of the fourth day But most derive the reason of these circuits from the various mixture of Melancholy humours with others But although it be probable that all these Fevers as keeping longer periods proceed from a Melancholy humour yet a mixture of that humour seems not necessary Because no humour can be appointed to be mixed with a Melancholy which can be a cause of a slower period then it self for those humours both Cholerick and Melancholy are not alwaies of the same sort and moreover the corruption also which they suffer is not alwaies the same so that it is no wonder that the effect also varies which proceeding from them is not alwaies the same And as in epidemical diseases somtimes rare and wonderful corruptions of humours happen so in Intermittents that some such thing may likewise happen is not altogether absurd Intermitting Fevers are easily known Diagnostick signs for they come to Apurexie and at certain times and indeed as Galen 1. ad Glaucan cap. 5.2 de crisib cap. 3. 2. de diff Febr. cap. 3. teacheth they return with shaking horror or cold For although that somtimes Fevers do occur which seem intermittent and invade without any rigour trembling or cold yet really they are not such but only slow and obscure continued ones or in case they are really intermittent they are not pure whose Idea Galen propounds but spurious But these Fevers are less dangerous then continued Prognosticks and seldome unless the strength be decayed or in regard of age or some other cause or some errour committed in diet are mortal sithence it may be convenient during the apurexie to gather strength and administer necessary medicines Concerning the cure of these Fevers in general Indications and Cure Since their cause is collected and generated in the meseraick veins there putrifies and thence is diffused over all the body and at length is discussed by insensible transpiration or sweats But the cause of the recourse of the Fever as Galen teacheth 2. de Febr. cap. the last is a twofold vitious disposition in a body the one a certain pollution or putrifaction left after the former paroxisme the other imbecility of the member or part generating excrementitious humours what therefore is to be done in each sort of Fever easily appears from hence For sithence the beginning of generation and corruption of humours producing a Fever is in the first passages Purging we are to endeavour to purge out that peccant humour before it corrupts the rest of the blood and brings weakness and a vitious disposition to the parts but we must proceed warily in those evacuations since there is not the same reason of all intermitting Fevers For when that vitious and excrementious humour the cause of a Fever in the meseraicks is mixed with blood crudity also and concoction according to their manner are necessary whereby the vitious humours may be separated from the good and rendred fit for evacuation and that often happens in a short time in Fevers full of Choler and the cholerick humour is otherwise apt enough to motion But in a Quartan the humour is more stubborn and moreover according to Galen 1. ad Glau. cap. 11. no strong medicine is easily to be admitted at the beginning And Sudorifiques are not at all or altogether to be used Sweats unless evacuations have preceded for if many vitious and excrementitious humours do hitherto abide in the first ways it may easily come to pass that by reason of hydroticks untimely exhibited they may be detruded thence to the more noble parts and may become the cause of various and grievous evils and such as may bring more danger then the Fever it self As for breathing of a vein Letting blood 't is not indicated from the primary cause of intermitting Fevers which is generated in the meseraick veins where the greatest part abideth Yet because that somtimes blood also abounds which may easily be corrupted and polluted by the vitious humours and so if it be too plentiful cannot be well governed by nature when it is weakned by a Fever and in the progress of the disease from thence some of the peccant matter passeth into the vena cava and is mixed with the blood it is somtimes needful to open a vein which nevertheless is not to be appointed presently in the beginning before the evacuation of the primary passages If the Fever be not cured by
fourteen and somtimes to twenty But these Fevers are least dangerous amongst all the putred ones 4. Prognosticks Aphor. 43. and such as are pure do not long continue but at seven fits they are accounted at the height 4. Aphor. 59. Somtimes they are terminated at the third or fourth fit but spurious tertians as they are more frequent so they continue longer for although if the matter be little and necessary medicines are timely exhibited they somtimes cease at the fifth or seventh paroxism yet for the most part they scarce end at fourteen fits and are often lengthned out to the fortieth day somtimes they continue six moneths and end with some disease of the Liver or Spleen or else are also châ—rished by them Although Tertians for the most part are not dangerous yet somtimes they become pernitious First If any errour be committed by the sick or the Physitian Secondly If the humour which Nature endeavours to expel should fall upon any principal part Thirdly If the humour be exceeding thin putred or filthy Fourthly If a thin humour have a thick one mixed with it and stir the same and enflame it Fifthly If a thick humour poured out by heat either fall down into some principal part or cause a dangerous Catarrh or Asthma or the Gout or draw the womb into consent Sixthly If the humour acquire a malignant quality But in the cure of this Fever as also in others Indications and Cure regard must be had of the Fever the cause and nature of it the Fever indicates cooling and moistning things the same Choler also as being the cause requireth which also ought to be evacuated yet if another humour be mixed with it altering preparing and evacuating medicines which that humour requires are to be mixed and because the abundance of the matter is in the meseraick veins the vitious humour is to be purged out of them and if need be prepared before it infect the good blood afterwards also it is to be altered and the disposition of the part generating peccant humours to be corrected Lastly We must endeavour that the pollution and putrifaction may be discussed by Sudorifiques First therefore the first passages are to be cleansed Purgers either by Clysters or lenitive Medicines exhibited of the Syrup of Roses solutive Manna Cassia to which also we may add Rhubarb Agarick the leaves of Senna according as the quality of the peccant humour requires Vomits also convenient may be given especially if the sick be troubled with pain in the heart loathing and a desire to vomit And since the matter consists in the meseraick veins and that nature her self at the beginning of the paroxism strives to expel it either by vomit or stool the Physician ought to be observant to it and to eject the matter if Nature endeavour to expel it by stool or vomit and because the matter for the most part in the first passages is either more abundant or hath thick humours mixed therewith there is need not only of lenitives but those medicines also which we lately mentioned nay somtimes of some of the Electuary of Fleawort or Fleabane of the juice of Roses Rosati Mesuae Yet care must be taken that we do not draw the humours out of the veins into the first passages Concerning the opening of a vein Opening a vein although Choler residing in the meseraick veins do not require it yet if there be store of blood and the peccant humour out of the first region of the body have penetrated the vena cava which may be discerned by the thickness and redness of the Urine and if the party be strong a vein may be breathed and moreover note that not at the first invading but afterwards Phlebotomy is to be used Yet regard of the Fever is to be had for if it be a pure Tertian which useth to be shorter a vein is to be opened more timely if it be required because if it be referred till after the third fit the disease comes to its height but if it be a bastard tertian you may defer it till after the third paroxism namely because more of the morbifique matter is then mixed with the blood in the vena cava but blood is to be taken away in less quantity in a pure Tertian because as in continued Fevers that is not the primary indicant and the strength cannot bear the taking away of a greater quantity blood may be taken away more safely and in greater abundance in a spurious tertian But the opening of a vein is most conveniently appointed during the intermission Afterwards those medicines are to be exhibited which both correct the qualities of the cholerick humour exceeding Preparatives whereby it is troublesome to nature and also the vitious disposition in the part generating excrementitious humours and such as are contrary to that pollution which remains after putrefaction such are cooling and moistning things which together have a power of purging the first ways and of resisting putrifaction such are Cichory Sowthistle Endive Sorrel Barley the four great and four small cold seeds the juice of Citron or Limon and medicines prepared out of these Syrup of Sorrel Acetosa simplex Oxysauharum Syrup of Cichory Endive de acitocitate citri with waters and decoctions of the same to which in spurious tertians we may adde those things which are proper for Flegme and Melancholy the roots of Fennel grass asparogus asarabecca polypodie carduus benedictus centurie the lesser wormwood scolopendrium betony the spirit of vitriol and salt is profitable cream of Tartar Tartar vitriolated But amongst those medicines there are some which by a certain peculiar force are said to oppugne Tertians Specificks amongst which notwithstanding for the most part manifest causes may be rendred for it such are Sowthistle Camomil Century the lesser Plantane Divels bit Altering medicines being given Purgers if the Fever be more pertinacious somtimes purging and vomiting are convenient which for the most part are to be administred on the intermitting day but if it be advertised that the matter during the paroxism doth encline towards the stomack or tend downwards it is lawful even when the fit is present to administer vomits or a gentle purge yet so that before the beginning of the paroxism the operation may be past in case a purge be given Amongst the vomits Asarabecca and Broom are principally commended amongst the purges Rhubarb to those that are stronger the Electuary or Fleawort or Fleabane Elect. Rosatem Mesne and of the juice of Roses may be given in spurious Tertians Agarick or Senna may be added in whom it is also necessary to repeat preparatives and purgations The body being sufficiently purged Medicines causing of urine the remainder is to be taken away by Diureticks In a pure Tertian an Emulsion of the four great cold seeds is profitable made with the whey of Goats milk or the water of Barley Strawberries Cichory In a spurious a decoction of
and such like Sweat and Urine also should be provoked with medicines made of Fennel Movers of Urine and sweat Carduus Benedictus Salsa Parilla wood of Sassafras Treacle and Mithridate and lastly the Bowels but especially the Stomack and Liver are to be strengthned CHAP. XX. Of an Intermitting Quartan THe third sort of intermitting Fevers which ariseth from a Melancholy humour putrifying in the meseraick veins A Quartan and seizeth on the fourth day also whence it is called a Quartan The proximate cause of a Quartan Fever is a melancholy humour collected in the meseraick veins about the spleen and adjacent Bowels The cause and there putrifying and that somtimes natural by its own nature cold and dry and somtimes it participates with some adustion But the more remote causes are all those things which conduce to the generation of black and melancholy humours namely meats and drinks apt to generate this humour amongst the which is vinegar of the which Hypocrates 3. vich rat in acut t. 38. writeth it attenuateth melancholy humours raiseth them and frames many visions in the mind For Vinegar is a Leader or stirrer of Melancholy The time is principally in Autumn especially if a hot Summer have preceded This Fever is known by its quartane circuit Signs and signs of melancholy abounding in the body and it invadeth with a certain unequal disturbance of the body the which a cold shaking fit followeth which at the first is little or at leastwise instead thereof there is at the first refrigeration and horrour in the progress of the disease the cold paroxism is alwaies greater and at length most vehement with pain causing the bones to knock together The heat is kindled by degrees neither is it burning but somwhat milde The pulse is thin and slow and although in the vigour of the paroxism it become swift and frequent yet in comparison of Tertians it is thin and slow The Urines at first are thin and white but in the progress of time higher coloured and thicker Sweats in the beginning are not frequent but in the progress of the disease plentiful And thus things are in a pure quartan but in a bastard one tokens of some humour mixed do appear and heat thirst watchings and other symptomes are more grievous This Fever continueth the longest of all other Prognosticks and oftentimes is not only extended to some moneths but years and if it be not gone by the next solstice or aequinectial after it was first taken it lasteth for the most part till the next after and for the most part goes away in the Spring 'T is safe and without danger if it be legitimate and without any disease of any of the bowels But that which is joyned with black choler is more dangerous as also that which is with some grievous distemper of some of the intrals and casteth the sick into a dropsie the scurvie or a consumption As concerning the cure Indications if this Fever proceed from a pure melancholy humour that since 't is cold dry thick 't is to be moistned and attenuated or if it be also adust it is in some measure to be cooled afterwards to be purged with convenient medicines The causes generating are to be removed and in case other humours are mixed regard must be had of them The Fever it self indicates cooling and moistning yet regard of the strength must be had least by the duration of the disease that be impaired as also of the stomack spleen and liver least they are offended This Fever is to be handled gentlâ— at the first Cure neither are strong medicines to be used at the beginning of cure sithence the melancholy humour may be exasperated by the use of them and out of a simple Quartan a double or treble may easily be raised Galen 1. Opening a vein ad Glauc cap. 11. yet there is least danger in Vomits The first passages of the Body therefore are first to be evacuated with clisters lenitive medicines and vomits also afterwards in case blood abound therewith a vein is to be opened and in case it issue forth black and thick the greater quantity is to be taken that by this means both the plenty of blood may be diminished and that part of the melancholy humour which is poured out into the vena cava may be evacuated but if the blood coming forth appear to be thin and yellow 't is forthwith to be stopped And indeed where there is store of blood the first passages being cleansed a vein may be opened but if this Fever begin without store of blood a vein is not to be breathed presently at the beginning but when some of the peccant humour is drawn into the veins and mingled with the blood The Basilick or median vein either may be opened most commend the opening of the Salvatella yet they have not as yet rendered any sufficient reason why that should be preferred before others The blood being evacuated the peccant matter must be prepared and concocted Preparers and likewise that disposition of the body to generate vitious humours is to be corrected And indeed in case a Quartan Fever proceed only from natural melancholy moistning things are to be first used but heating things should be more moderate but if adust humours are mixed there will be use of things moderately cooling but in the progress of the disease there will be need of cutting and attenuating medicines If the pituitous humour be mixed therewith in the beginning there will be need also of attenuating and cutting things and it may be more safe to heat a little Hence are to be administred Burrage Bugloss Violets Maidenhair Cichory Fumitory Ceterach Hearts-tongue Germander Ground-pine Carduus Benedictus the Roots of Marsh-mallows Licoras Chichory the opening roots Polipody Gentian Fern the barks of Tamarisk Capparum Roots of Walnut Trees Flowers and seed of Broom of the Vine Ash Citron juice of Apples and compounds of these and somtimes this or that may be chosen or mixed according as the nature of the peccant humour requireth The concoction and evacuation of the matter must be by intervals repealed Purging Medicines and when the matter is in some measure prepared purging medicines are to be prepared of Polipody Epithynum leaves of Senna roots of Jalop black Hellebore lapidis Lazuli and compounds of these Syrup of Apples Regis Sapor Electuary called Diacatholicon Confection of Hameck with the compound powder of Senna and Diasenna Tartarious pills or pills evacuating melancholy of lapis Lazuli Armoniack beginning with the more milde or gentle ones A Vomit also is convenient by which oftentimes pertinacious Quartans are cured So Galen of Treacle ad Pisonem cap. Vomits 15. the day before the fit after Supper he gives a vomit the next day after early the juice or dilution of Wormwood and two hours before the paroxism Treacle the gentler Vomits are of the decoction of Dill and Radish with Oxymel the stronger are
King Mithridates of which Pliny lib. 23. cap. 8. as also Theriaca Diatessaron to which the moderns have added many more as the Electuary of Saffron or of an Egg as 't is called Dioscordium Tracastory Antidotus Saxonica Antidotus Guidonis de Cauliaco Pulvis Caesaris rubeus and Gryseus Electuarium Camphoratum Kigleri and many more which the Tracts of divers Authors concerning the pestilence afford such as are profitable as well for preservation from the Plague as for the cure thereof so that it becomes us to be more solicitous about the choice of them then the store of them here And amongst so great plenty 't is more safe nevertheless to depend on those that have been approved by long use and experience then such as are newly invented what colour or pretence soever they afford themselves But because those strong and hot medicines are not proper for women with child nor children they should have medicines of Harts-horn the bone of the heart of a Stag or Deer the roots of Tormentil Pearl Bole Almenick Coral Bezor and precious stones And since that there is no small difference amongst Alexipharmacal Medicines according to the qualities they have besides their occult ones every one of them doth not agree with every age and season for in a hotter Ayr medicines that are not so hot are to be used which must also be observed in those which in regard of their age or constitution of body are hotter lest that humour should be kindled and a Fever from thence arise afterwards or if some are hotter they should be prepared with Vinegar or taken with Syrup acetos Citri Sorrel great or small Pomgranates For there is no depending upon one medicine against poyson but they are to be varied lest that nature should be accustomed to it and thereby can receive little benefit by it CHAP. VI. Of the Cure of the Pestilence IF in any disease in the world certainly in this an exact way of cure is to be used Cure since that the smallest fault being committed by any may become an irreparable damage But because the right reason of Cure depends on indications and seeing that the Plague is an occult disease and its nature consists in an occult quality which by its peculiar force is mischievous to the heart and is very contagious but that is introduced by a cause endued with the same quality Hence 't is manifest that that occult quality indicates a medicine alexipharmacal contrary to it and shews that the cause in the body whether taken by breathing in or contact or by what means soever contracted should be removed and eradicated But how that ought to be done is controverted amongst Physitians For first since that neither Phlebotomy Breathing a Vein nor Purgation are indicated by the pestilence quatenus 't is the pestilence whether they are to be used or not is controverted First Concerning the opening of a Vein since that it neither cures the disease nor takes away the venome nor the cause 't is rarely to be used and in that Pestilence which is occasioned by evil Diet 't is wholly to be omitted as also in that which ariseth from a pestilential constitution of Ayr unless there be very great store of blood which must be diminished and its heat mitigated But if the Plague come by infection and there be that plenty of blood as may cause us to fear lest that a putred Fever should happen which may become no less dangerous to the sick then the Plague it self or that it be observed that the blood flows violently to inconvenient places and that the strength is rather oppressed by its plenty then dissipated you may breath a Vein yet only bleed what the strength can well bear with and that should be in the beginning for when twelve hours or more are passed away 't is safer to omit bleeding because the strength being debilitated with the violence of the poyson it cannot well bear it Concerning the place for breathing of a Vein such a place is to be chosen as may help the motion of Nature not hinder it and may together divert the pestilent matter from a noble part Therefore if a Parotis break out behind the ears or a Bubo under the Arm-pits or a Carbuncle in the superiour parts a Vein should be opened in the Arm on the same side but if a Bubo come in the Groyn a Vein should be opened in the foot on the same side But if a Carbuncle should arise in either of the Legs seeing that useth to cause an inflammation and great pain by which the strength is weakned 't is convenient to open a Vein in the contrary leg for neither is the motion of nature hindred by this means but the matter is drawn from the superiour parts towards the inferiour and a great flux to the part affected and the increase of the inflammation is hereby prevented Moreover Purgation also is not indicated by the pestilence Purgation nor can the seeds of the Plague be eradicated by any purging medicine unless perhaps a great disturbance of nature being made which must then be joyned with danger and for as much as Nature for the most part expels the pestilent venome to the out-parts of the body this motion of Nature by Purgation is hindred and the pestilent venome is drawn into the internal parts and is more mixed with the humours and the motion of humours being stirred up most dangerous nay deadly vomits and sluxes are occasioned And therefore not in purging but in medicines that resist poyson principally and next under God the hope of health and safety is to be placed Wherefore it will be safest for any one that shall think himself to be infected with the Plague Use of Alexipharmicks having first implored the assistance of almighty God to fly to those medicines resisting venome mentioned in the fifth chapter before and to take some one experienced and approved medicine and in case it be vomited up at the first then 't is best to take of it again forthwith nay in case it be retained it will not suffice to take of it but once but the Alexipharmacal medicine should be repeated thrice in the space of four and twenty hours and so to continue for two days until that the force of the poyson shall be broken The medicine being taken the sick should forthwith compose themselves to sweat especially the second time after taking they should keep out the cold Ayr and if the strength will bear it they should continue their sweat for two hours space The sick should by no means sleep until he hath sweat twice and between the sweats should be refreshed with Conserve and Syrup of Roses Sorrel acetos Citri of Pomgranates red Gooseberries with cordial and odoriferous waters applyed to the Nostril and sprinkled about the Bed-chamber It shall be profitable also to take warm bread out of the oven and fill a hollow part of it with Treacle and apply it to the
Navel or to the Arm-pits that it may draw the venome to it The sweat being ended the body should be rubbed and dried with clean warm linnen clothes being careful that no cold ayr be admitted and the sheets and coverings of the beds should be changed After the sweat the sick should be nourished with meats that afford good juice and easie of concoction yet taken but in a small quantity When the sick hath sweat once if there be need of opening a vein let it be done in that manner as is already heretofore expressed And when the Alexipharmicks have been taken of two days by the sick and the body is Cacochymick or the Plague depend upon some internal default of humours and that great danger of a Fever be to be feared it will be convenient to administer a purge that some part of the matter putrifying and increasing the Fever may be abated so that Nature may overcome the rest more easily they should be gentle as Syrup of Roses solutive Tamarinds Rhubarb Agarick Pestilential Pills Tryphera Persica Syr. Diasercos Afterwards if it be not needful to cause sweat which nevertheless ought not to be hindred if it come on a critical day such medicines are to be continued as hinder putrifaction resist a malignant Fever and extinguish the flames in the bowels and humours And then we must be wary how we use Treacle or any of the other hot medicines without any respect of the disease nature age and other circumstances wherefore when the Fever hath set upon the body such things are not to be exhibited unless they are mixed with cold things or else cold things alone may be given such as Syrup acetos Citri of Sorrel Pomgranates red Gooseberries rubi Idaei as also Pearl Coral precious stones Bezoar But since that Nature for the most part useth to send the most venomous part of the matter to the out-parts of the body Cure of Buboes and occasions Buboes and Carbuncles If the venome perfectly or most part of it be driven out into a Bubo which may be known by the remission of the Fever and Symptomes we must expect ripening although not perfectly as in other tumors yet it must be helped by all means for if either a Bubo come not enough out or be encreased over-much and still the Fever and symptomes abate not and the sick no ways mends we must endeavour that a way may be opened for the letting out the venome Therefore either vesiccatories must be applyed or the skin must be scarrified that the poyson may freely expire and the pestilent humours fly out a young chicken also or pigeon the feathers about the rump being pull'd off should to the great advantage of the sick be applyed to it although no incision be made and that should be often repeated or a dryed Toad being moistned with wine should be applyed afterwards we must endeavour that the rest of the matter may be brought to maturity by proper medicines described every where up and down into the place opened by Incision convenient digestives should be put and if the incision be not made deep enough and the quitture be still therein detained the tumour must be opened with an Incision knife and the Ulcer mundifyed with proper medicines and it must not be healed up until all the venome be come out But Carbuncles are forthwith to be scarrified Cure of Carbuncles and that deep enough that the pestilent and corrupt humour may come forth afterwards some convenient plaister must be applyed such as may be of the soot of a chimney and others described up and down in Authors Some apply the plaister de Magnete Arsenicali 't is proper to apply a dryed Toad also being first powd'red in wine to the places adjacent lest the venome should return to the internal parts some defensitive of cooling drying and binding things must be applyed some make a circle with a Saphire stone about the Carbuncle lest the poyson should creep farther and thereby extinguish the same and if the Carbuncle be too much encreased and cause great pain a vein should be opened under the same that so the corrupt blood may be evacuated and to abate the heat a plaister of Houndstongue is to be applyed When an Escar shall be generated it must be taken away with a convenient Unguent and the Ulcer must be mundified and cured in due manner but during the whole time of the cure twice every seven days a potion of the temperate medicines that resist venome should be drunk lest any of the malignity should remain in the Body CHAP. VII Of the Nature of a Pestilent and Malignant Fever and of the difference of them from the Plague FOrasmuch as the highest degree of corruption of humours is in the Pestilence we must as it were ascend to it by the malignant and pestilent Fevers of them therefore we will now speak in what respect these three the Pestilence a pestilent and malignant Fever differ That the pestilence consists in a certain occult quality meerly adverse to mankind and that it is infectious The plague pestilent and malignant Fevers how they differ and that a Fever is not of the same essence therewith but yet commonly accompanies it is already shewed And therefore the Plague it self also when it hath a Fever joyned with it may not without cause in some measure be called a pestilential Fever yet other Fevers also are called pestilent without the plague wherein the corruption of humors hath not yet attained that high degree which may constitute the nature of venomous pestilence yet they contain in them somwhat like to that venomous and malignant pestilence and moreover either are not pernitious or contagious as the plague if they are both of them yet they are less destructive then the plague for the difference of a pestilential Fever so called in particular and of the venomous pestilence since the nature of them both is unknown betrays it self in this by the vehemency and contagiousness of it which is perceived to be less not only in sporadick Fevers but in epidemical pestilentials then in the plague it self But concerning malignant Fevers although they by a general name signifie truly pestilentials yet in particular those are called malignant wherein there is a less degree of corruption then in those that are truly pestilential and wherein the humours which kindle the Fever contain in them some occult quality tending to venenosity whence there is less destruction and infection somtimes there is none And that the matter may be handled in few words if it appear by the symptomes in any Fever that besides putrefaction there is a lso some occult and maligne quality and yet but few die thereof whether they are epidemical Fevers or sporadick or contagious or not contagious this is the first degree of corruption and such a Fever in particular is called malignant but in case many die and yet others are not infected or although there be some contagion and some
by sweats yet the thinner are dispersed and the thicker remains behind Altering preparing medicines Wherefore preparation and alteration of the humours is to be ordered by those medicines which open and if occasion require may cut those humours and may resist ebullition and putrifaction extinguish the heat of the Fever and resist malignity and may by degrees dispose nature to sweats such are Sorrel Scordium Carduus Benedictus Scorzoneca the seed of Citron Roots of Tormentil Cinquefoyl juice of Citron Pomgranates and Syrups of these Spirit of Vitriol when the humours are sufficiently prepared unless Nature expel alone they are to be evacuated by a convenient passage but then also lenitive medicines must be used and purgation scarce to be ordered before the fourteenth day If Nature tend to evacuation by urine Causing Urine it is to be helped by an emulsion of the seeds of Melons Citron or Limmon Carduus benedictus with the water of Sorrel Mayden-hair and such like But during the whole time of the sickness Topical things as well in malignant as in pestilent Fevers medicines are to be applied to the Pulses and heart such as strengthen the heart and resist malignity which are very where extant Symptomes also if any urge and debilitate the strength are to be taken away and mitigated as in their own place shall be shewed Concerning Diet Diet. the meat should be of good juice and of easie digestion and to beware that when the strength languisheth Nature be not over-burthened the meats also should be mixed with such things as resist this Fever we must abstain from wine unless swooning fits happen but 't is more convenient to use small beer a decoction also of Harts-horn may well be given with such a quantity of Spirit of Vitriol as may render it grateful to the taste to which also some Juleps of Roses and Violets may be added It allays thirst likewise opens obstructions drives away putrifaction and resisteth malignancy of Aegyptii as Prosper Alpinus in his fourth book of Medicines Aegypt chap. the fourth Pulp of Tamarinds and Barberries the fruits being dryed with the seeds of Fennel or Limmon they pour them into abundance of fair water and so prepare a Drink which they administer to the sick during the whole time of the disease in malignant and pestilent Fevers and confide much in the use of this Drink since that it is found that Tamarinds and the fruit of Barberries do exceedingly resist putrifaction in Fevers CHAP. XII Of a Malignant Fever with the Measles and Small Pox. ALthough the nature of malignity Small Pox and Measles from whence malignant Fevers are denominated be occult and therefore much cannot be spoken of the differences of these Fevers yet there is not one reason only even of the same but some variety shews it self by the effects and symptomes whence also certain differences of malignant Fevers are are appointed of which we will now speak in particular First there happen Feavers wherein pushes or eminent tubercles break forth and sometimes certain spots shew themselves the Greeks call them Exanthemata and Ecthâ—mata the Latines Papulas and Pustulas and at this day they are called the Measles and Small Pox which names although they are not used in the same manner by all yet the most at this day call variolas parvos varos little spots or Measles and they give this name to those pushes full of humours which for the most parâ— suppurate which the Germans call die Biatterne and Bocten but they call those Mobillos which are spots only in the skin or rather small tubercles in the skin which the Germans call die Masserne Variolae are pustules breaking forth in the skin and parts adjacent Definition with a continued Fever occasioned by the fervency of the blood and sent forth by the expulsive faculty but Morbilli are little red spots or tubercles coming out in the skin with a continued Fever bred by the ebullition of the blood and sent out by the expulsive faculty Of both kinds there are some differences for of Variolae some are greater some less some white others yellow or of some other colour some break out forth with and rise high and are ripened and encompassed with a red circle and come forth without any grievous symptomes and are not dangerous others are yellow come forth slowly and presently pitch again and have a livid circle about them and are dangerous To the Variolas belong those pustules also which break out of the body and are about the bigness of Lupines Differences and shining like Christal out of which a certain waterish substance issueth which some therefore call Chrystals the Germans call them Shaffsblattern oder Bindvocten which are less dangerous and without any manifest Fever for the most part they do appear Moreover to the Variolaes belong those tubercles coming out here and there in places and are free from quitture which the Germans call Steinbocten and are for the most part the least of all the kinds of Variol and freest from danger which befals children often without a Fever and are presently healed so that Infants seldome take their beds for them To the Poxes or Measles certain small red tubercles do belong which invade with heat and a cough and other symptomes of the Pox yet less dangerous then the pox the Geâ—mans call them die Rittein or die Rottein because they are red somtimes they come alone somtimes are mixed with the Pox and somtimes come after the Pox is healed which disease Halyaabas calls Rubcolam lib. 8. Theoric cap. 14. Moreover there are other breakings out which seem to be referr'd to Poxes which the Neapolitans call Rossoniam and Rossaliam as Johannes Philippus Ingrastiat of tumours speaks by others they are called Purples and Eruthemata yet some call the red spots or Patechii purples They are red and as it were fiery spots because scarce worthy to be called tumours coming out over all the body as it were certain small Eryspelaes at the beginning of the sickness or on the fourth or fifth day In the progress of the disease it spreads over all the body as if it were on fire or as if one were sick of an universal Erysipelas which colour as in the beginning so in the declination is turned into spots which again on the seventh or ninth day vanish falling away from the skin like scales of Fishes The subject of spots and pushes is the skin Subject and other parts answering to the skin in proportion for it hath been found in dead bodies that the superficies of the Intrals and on their skin without side the Pox have been setled Concerning the cause of these Cause there is difficult and great controversie amongst Physitians The Arabicks and those which follow them attribute the cause of the small Pox and Measles to the uncleanness of the blood contracted from the menstruous blood in the womb by the Infant which was there nourished with
as in Poxes and these spots in these Fevers appear principally in the back arms legs and breasts namely in places through which the most eminent veins and arteries do pass but in the face they do seldom appear because it is alwaies obvious to the external Ayr. These spots have their original from the thinner parts of the putred and corrupt humour The cause whence they suddenly come out and vanish but although they are made by the expulsive faculty driving this part of the corrupt humour to the extremities of the body yet that seldom happens critically because they come out for the most part at the beginning the matter being not as yet concocted neither is there any notable evacuation of the matter made by them nor the sick are not the better for them but for the most part by how much the more plentifully they come forth by so much the greater store of corrupt matter is indicated which notwithstanding as is said already is not sufficiently evacuated by those spots There are of those spots several differences for first Difference they differ in colour some are red arising from the more temperate blood putrified others yellow green when choler is putrified others Pomgranet colour and black when melancholy putrifieth Moreover they differ in quantity for some come out more plentifully others more sparingly some are greater others less according to the quantity and thickness of the humour and strength or weakness of nature some come out at the beginning others in the progress of the disease This Fever is known by the signs of Malignant Fevers in general already set down and when the spots joyn together Diagnostick signs they shew malignity more plainly But what event of these Fevers may be hoped for is manifest by the prognosticks of malignant Fevers in general Prognosticks Concerning the spots themselves although it be good that the peccant matter be carried to the extremities of the body yet by these spots they cannot sufficiently be evacuated therefore although if they are plentiful they shew that store of matter is present yet they shake it not of and therefore they portend danger rather then health Neither is their paucity always good and although it signifie no store of matter yet it also denotes debility of nature These spots if they lie hidden are evil signs because they shew that the matter which before was coming to the outside of the body does now tend inwards and go to the head heart or some internal part Red spots are most safe yellow and green worse and pomgranate colour and black most dangerous Although such as come out at the first appear symptomaâ—â—cal yet those that break forth the seventh day or thereabouts are critical yet unless other good signs are present put no confidence in them because they do not sufficiently evacuate the matter but if they come out slowly 't is evil for that happens either by reason of the thickness of the matter into which if the malignity fall 't is not easily overcome or else by reason of density of the skin which hindreth free transpiration Lastly concerning the cure Cure those things that are spoken about the cure of malignant Fevers are here also convenient namely the belly is to be loosned either by Clister or lenitive medicine or if the matter tend upward and the sick be inclinable to vomit a Vomit must be given Then if occasion require Bleeding a vein is to be opened before the fourth day or else afterwards to be omitted but whether the spots now coming forth do hinder the breathing of a vein is shewed in the Institutions lib. 5. part 2. sect 1. cap. 17. But since nature it self strives to protrude the matter we see to the extremities of the body and 't is profitable in all malignant diseases to drive out the matter from the greater to the lesser vessels and to free the bowels from vitious humours the endeavours of nature is here to be assisted Sweats and the matter tending to the outmost parts of the body is by it to be evacuated because that otherwise that which is malignant will admit of no concoction Therefore let the sick be kept in a place moderately hot and forthwith some Sudorifique medicine and which also may resist malignity given such as are before propounded for the plague and malignant Fevers in general and for the Measles and small Pox yet those are to be selected amongst them that may not increase the feverish heat and the Fever and the malignity are to be weighed together and of that which most requires it regard must be taken Somtimes a looseness happens in this Fever When a looseness comes what must be done which unless it be too great should not be stopped but the business should be committed to nature and in the interim only with altering medicines and such as resist malignity the morbifique cause must be resisted Afterwards to fortifie nature Pearls Coral Hartshorn juice of Pomgranates Citron Confectio de Hyacintho Alkermes and such like are to be exhibited Externally likewise medicines are to be applied to the region of the heart and to the pulses Topical medicines which draw venome from the heart and resist malignity and some use an unction ex Hydraeolo and niter to relax the skin and draw out humours Neither is it unprofitable to apply vesiccatories to the arms Vesiccatories especially if the external parts are cold and the internal burn and that pains in the head deliriums a lethargy and other symptomes in the head are present for so both the humours are called from within outwards and are likewise refelled from the head CHAP. XIV Of the English Sweat THere was a kind of Fever malignant The English sweat which began in England in the year 1486. and thence it took the name of the English Sweat and it reigned there about forty years and killed almost an infinite number of Englishmen Hence being spread through the Netherlands Germany the Low Countries Holland Zeland Brabant in Belgia Flanders Dane Norway France it continued until the year 1530. The same Fever was accompanied with Sweats and was called the Sudatory Fever for those which were troubled with this Fever abounded with Sweat without Bubo Carbuncle or puttings forth the sweat perpetually and in great abundance coming out until the dissolution of the disease which hapned within twenty four hours space Together the sick languished deficient in mind with unquietness troubled at heart pain in the head and also with palpitation of the heart and they had a pulse thick frequent swift and unequal and the palpitation of the heart accompanied those that escaped oftentimes some years somtimes till death But the cause of this disease was inherent in the most subtile parts of the blood and spirits The cause which were together affected which the shortness of the disease argues and without doubt the blood and spirits contracted this malignity from