NINE BOOKS OF PHYSIC AND CHIRURGERY Written by that Great and Learned Physician, Dr SENNERTUS. The first five being his Institutions of the whole Body of Physic: The other four of Fevers and Agues: With their Differences, Signs, and Cures. LONDON, Printed by J. M. for Lodowick Lloyd, at the Castle in Cornhill, 1658. THE INSTITUTIONS OR FUNDAMENTALS Of the whole Art, both of PHYSIC AND CHIRURGERY, Divided into five Books. Plainly discovering all that is to be known in both; as the Subject and end of Physic; the Nature of all Diseases, their Causes, Signs, Differences, Events and Cures. ALSO The Grounds of Chemistry, and the way of making all sorts of Salves, and preparing of Medicines according to Art; nothing of the like nature in English before. Written first in Latin by that Great and Learned Phycitian D. Sennertus, Doctor and Professor of Physic. Made English by N. D. B. P. late of Trinity College in Cambridge. London, Printed for Lodowick Lloyd, and are to be sold at his Shop next door to the Sign of the Castle in Cornhill. 1656. To the Lovers of the Study of Physic, especially those who desires to attain to the true knowledge thereof. OF all the Arts and Sciences that the Sons of Men so much covet after, there is none so pleasant and profitable as Physic; Physic doth not only teach thee to preserve thyself from the assaults of those manifold Enemies which Nature is liable unto, but it teaches thee to restore Health when lost, and to heal thyself though wounded by thy greatest adversary; besides in the Anatomical part it entertains thy fancy with the wonderful work of Nature where the unsearchable wisdom of the Creator is as legible, as in those things we count more sublime and Celestial; which if considered, Physicians cannot be so Atheistical as the world reports them to be. I undertook not this work out of design to prejudice the College, by making that English, which they would have remain in Latin; nor to advantage myself by any private gain, but to benefit those who are unskilled in the Latin, but lovers of the Study. I say for the benefit of such, have I put this into English. Although by my Profession I am otherwise obliged: it's something unsuitable to my spirit to have that Monopolised into the hands of a few, which should be in common to all: such is the practice of Physic, yet would I not have those to Administer, who are ignorant of the Institutions of Physic, as too many have done of late, to their own and others detriment: He that can but well digest this Book, his understanding will sufficiently be enriched in the very inside of the whole body of Physic, and will need no other foundation to go upon, being the best that ever the Doctors met with for their own informations. I shall not need to acquaint thee with the Author's Method, that thou wilt find by the Contents of Chapters before the Book, nor of the Author's worth, for that thou wilt sufficiently understand by his works, which speaks aloud in their Master's praise, whose fame and worth is well known to the Commonwealth of Learning throughout the world. If thou meetest with any Errata 's in thy reading, thou art desired to correct them, the Translators absence sometimes from the Press occasioned them. The Contents of the Chapters of the five following Books. BOOK. I. CHAP. I. OF the nature of Physic. pag. 1 Of the division of Physic. p 2 Of Health. p 3 Of Temperaments. p 6 Of innate heat. p 10 Of Spirits. p 12 Of the natural constitution of or ganick parts, and the common unity of parts alike, and not alike, called simular and dissimular parts. p 14 Of the faculties of the soul, and of the differences of actions in Man's Body. ibid. Of the natural faculty, and first of nutrition and augmentation. p 15 Of Generation. p 20 Of the vital faculty p 23 Of the animal faculty, and first of the external senses. p 25 Of the internal senses. p 27 Of the intellective faculty. p. 29 Of the desire and moving faculty. ibid. Book. 2. Part. I. Of Diseases. OF the nature of a disease. p 31 Of the differences of diseases. p 32 Of diseases of intemperature. p 33 Of diseases of the whole substance, or of the hidden qualities. p 34 Of organic diseases. p 35 Of diseases of confirmation. p 36 Of diseases of number. p 38 Of diseases of magnitude. ibid. Of diseases of composition. p 39 Of diseases of solution of unity. p 40. Of the accidental and common differences of diseases. ib Of the times of diseases. p 44 Book 2. Part. 2. O Of the causes of disease's. p 46 Of things which are the causes of a disease, and first of non-naturals. p 49 Of internal causes of diseases, and first of fullness of blood. p 52 Of phlegm p 53 Of choler. p 54 Of melancholy. p 55 Of the serous humour, and of wind p 56 Of humours according to the opinion of later Physicians and of Chemists. p 57 Of the generation of stones and worms p 58 Of the causes of diseases of intemperature without matter. ibid. Of the causes of distemper with matter p 59 Of the causes of Diseases of the whole substance. p 60 Of the causes of organic diseases. p 61 Of the causes of diseases of solution of unity. p. 63 Book 2. Part 3. Sect. 1. OF Symptoms. Of the difference of Symptoms. What a Symptom is. p. 65 Of the causes and differences of Symptoms in general. p 66 Of the differences in general, of actions hindered. p 68 Of the Symptoms of the natural faculty. Ibid Of the Symptoms of the vital faculty. p 71 Of the Symptoms of the external senses. p 72 Of the Symptoms of the internal senses. p 73 Of the Symptoms of the motive faculty. p 75 Of the Symptoms wherein all, or most part of the animal actions are hurt. p 77 Of the Symptoms of the changeable qualities of the body. p 78 Of the Symptoms of excressions and retensions. p 79 Book 2. Part 3. Sect. 2. Of the causes of Symptoms. OF the cause of the Symptoms of the natural faculty. p 81 Of the cause of the Symptoms of the vital faculty. and of the hindrances of respiration. p 95 Of the causes of the Symptoms of the external senses. p 97 Of the causes of the Symptoms of the internal senses. p 103 Of the causes of the Symptoms of the moving faculty. p 108 Of the causes of Symptoms wherein all, or most animal actions are hurt. p 113 Of the causes of Symptoms, which happen to qualities changed. p 116 Of the causes of Symptoms in those things which are sent forth and retained. p 118 Book 3. Part 1. Sect. 1. Of signs in general, of the difference and Heads of Signs. OF the Necessity and benefit of the method of signs: p 122 OF the differences of Signs. p 123 Of the Heads of signs. p 125 Sect. 2. OF knowing the temperature of man's body, and of his principal parts of the signs of a wholesome body. p 127 Of the signs of bodies differing from their best constitution. p 129 Of the signs of the constitution of the Brain. p 132 Of the signs of the constitution of the heart. p 136 Of the signs of the constitution of the Liver. p 138 Of the signs of the temperature of the Testicles. p 139 Of the signs of the constitution of the Stomach. p 140 Of the signs of the constitution of the Lungs. p 141 Book 3. Part 1. Sect. 1. Of Urines. OF the abuse of inspection of Urines p 142 Of the difference of Urine; and first of the substance of Urine. p 143 Of the Conteints in Urine. p 145 Of the causes of the various consistency of Urine. p 147 Of the causes of colours in Urines. p 148 Of the causes of an oily Urine, and the other differences p 150 Of the causes of smell, quantity, and such like accidents. p 151 Of the causes of Contents in Urines of those that are sick. p 152 Of the causes and changes in Urines. p 154 What is to be observed in the inspection in Urines. p 156 What may be discerned and foretold by Urine. p 157 Book 3. Part 3. Sect. 4. Of Pulses. WHat a Pulse is. p 158 Of the simple differences of Pulses. p 159 Of the compound differences of Pulses. p 160 Of an equal and unequal Pulse. p 161 Of the order and harmony amongst Pulses. p 164 Of certain things necessarily requisite to distinguish Pulses by. p 165 How to know the differences of simple Pulses. p 166 How to know the respective differences of Pulses. p 167 Of the causes of Pulses in general. p 168 Of the causes of the simple differences of Pulses. p 171 Of the causes of the respective differences of Pulses. p 172 Of the causes of varying of Pulses. p 174 What the simple differences of Pulses signify and presage. p 176 What the other differences of Pulses signify and presage. p 177 What Pulses presage health or death. p 179 Of signs to be observed from the Tongue. p 179 Book 3. Part 2. Of the Diagnostic Signs. OF the signs of causes in general. p 182 Of the Signs of causes and of humours in particular. p 184 Of the Signs of Diseases. p 187 How to know the parts affected. p 189 How to know Symptoms. p 194 Book 3. Part 3. Of the Prognostic Signs. OF the several kinds of prognostic signs. p 195 Of those kinds of signs by which the times of diseases may be known. p 196 Of the signs of times of diseases in particular. p 198 Of the signs by which we may foretell the events of a disease. p 199 How to presage of life and death, from the error and faults of actions. p 2●2 Of the signs of life and death, which are taken from excretions and retentions. p 207 Of the signs of health and of death, which are taken from the mutations of the qualities of the body. p 212 Of knowing the times, longitude, brevity and event of a Disease. p 214 How many mutations there are of Diseases, and the manners, and what a Crisis is. p 215 Of the causes, differences, manner and time of judgement. p 216 Of critical days. p 218 Of the causes of critical days. p 219 Of the signs of Crisis in general. p 221 Of the signs of differences in Crisis. p 222 The signs of Crisis to come, by excretion and imposthumation. Ibid Through what places there will be excretion, and where there will be imposthumation. p 223 Of the time of the Crisis. p 225 Book 4 Part 1. Sect. 1. WHat things appertain to the Doctrine of the preservation of health; and how many kinds there are of necessary causes for the preservation and defence thereof. p 227 Of Air. p 228 Of Meat. p 231 Meats from Plants. p 232 Meats from living creatures. p 239 Of ●rink. p 261 Of the passion of the mind, and of the exercise and rest of the body, p 266 Of sleeping and waking. p 267 Of hathes. Ibid Of Ex●retions and Retentions, and of Venery. p 268 Book 4. Part 2 OF those things which are to be observed by all, for the preservation of health. p 270 Of the cure of little ones not yet born; and of the diet of women with child. p 272 Of the diet of Infants, and thence forwards, until twenty one years of age. p 274 Of the diet of middle age. p 275 Of the diet of old men, p 280 Of the diet of such as are out of temper, and of Neuters. p 282 Book 5. Part 1. Sect. 1. Of the Materials for cure of Medicines. What a Medicine is. p 285 Of the faculties of medicines in general. p 286 Of the first faculties of the medicines. p 289 Of medicines proper to every part, or of corroborating medicines. p 293 Of extenuating and preparing of humours. p 297 Of Emollients, relaxing, rarefying, etc. p 298 Of medicines easing pain and causing rest. p 301 Of drawing and repelling medicines. p 302 Of ripening things, and such as generate quitture; also of such as generate flesh and brawny flesh; of such as dry and cleanse green wounds, and cause cicatrising; and of such as generate Seed and Milk. p 303 Of such things as make the skin red; of such as cause blisters, and of such as cause scabs or pustules; of burning things of Corrosives, Putrifactives, and of such things, as take away hair, and extinguish milk and seed. p 305 Of medicines purging through the paunch. p 307 Cholagogues, or the milder purger of Choler, p 308 Stronger purgers of choler. p 310 The milder purgers of phlegm. p 311 The stronger purgers of phlegm. Ibid The milder purgers of melancholy and black humours. p 313 The stronger purgers of melancholy and adust humours. Ibid Hydragogues, and such as evacuate Aqueous humours. p 314 Of Medicines that cause vomits. p 315 Of Medicines causing Urine. p 316 Of Medicines causing sweat. p 317 Of Diaphoreticks, and medicines discussing wind Ibid Of provoking courses, expelling the secundine, and a dead child. p 318 Of Medicines that break the stone. p 319 Of Errbines, Sternutatories, and Apophlegmatismes. Ibid Of things causing spittle, p 320 Of Medicines killing and expelling worms. Ibid Of Drugs good against poison. 321 Of the manner of finding out the virtue of Medicines. ib. Book 5. Part 1. Sect. 2. Of Chirurgery. OF Chirurgery in general. p 323 Of putting together, and binding in general. p 325 Of swalling Ibid Of Cerots or Bolsters. p 326 Of Splents. p 327 Of Binder's. p Ibid Of fit placing of a member that is bound. Ibid Of Coaptation of bro●en bones. p 328 Of restoring of bones that are out of joint. p 330 Of the putting together of the soft and fleshy parts. p 331 Of correcting of bones that are repressed or set awry p 333 Of disjunction in general, and of dissection of soft parts. p 334 Of Section of bones. p 337 Of burning. p 339 Of drawing of things out of the body, which were sent into the body from without. p 340 Of drawing out of things generated in the body according to nature, but retained in the body beyond the limits of nature. p 343 Of taking away the corrupt parts of the body. p 344 Of freeing and taking away things generated in the body contrary t● nature. p 345 Of restitution of parts that are lost, or of the Chirurgery of imperfect parts. p 346 Book 5. Part 2. Sect. 1. OF the method of healing; and of Indications in general. p 348 Of Indicants. p 350 Of the concord and discord of Indicants. p 353 Of Indicants. p 354 What m●r●ist●ue causes indicate and peculiarly of purging a juice in the body which causes ill digestion. p 360 Of the time fit for the purging of a disease. p 363 Of the preparation and concoction of humours. p 365 Of the quantity of purgation. p 371 Of the pl●●e by w●●ch purgation ought to be made p 372 Of the ●●ue administration of purges. p 374 Whether it be lawful to sleep, having taken a purge. Ibid Whether it is be●● after purging to use cleansing and abstergent me●●oines. p 375 Of evacuation by ●rine. Ibid Of evacuation by sweat. p 376 Of particular evacuations. p 378 Of the abating abundance a blood with Leaches, Cuppinglasses, Scarrifications, etc. p 379 Of opening a Vein. p 382 Of revulsion. p ●85 Of derivation. p 3●8 Of repulsion. ibid. Of intercepting. p 389 Of discussing. p 390 Of softening and ripening of matter. p 391 Book 5. Part. 2. Of showing how to Cure. OF diseases of Intemperature. p 392 Of curing diseases of the whole substance. p 394 The cure ●f diseases of confirmation. p 395 Of the cure of diseases of number. p 397 Of curing of diseases of magnitude. p 398 Of curing diseases in s●ituation and connexion. p 3●9 Of the cure of solution of continuity. p 400 Of the cure of oppressing and urging Symptoms. p 402 Book 5 Part. 2 Sect. 3. Of the Vital Indication. WHat doth indicate Diet in those that are sick. p 404 What things belong to Diet. p 4●5 How many sorts there are of Diet, and which agrees to which ●●seases. p 406 Of the right administration of a dict of sick persons. p 407 Book 5 Part. 3 Sect. 1. OF preparing and compounding of Drugs in general, of necessity and profit of preparing and compounding of simple Medicines. p 409 What things are necessary for the Artificial preparatîon and composition of Medicines. p 411 Of the weights of Medicines. p 412 Of Physical measures. p 414 Of Dozes of Medicines. p 416 Of the Dozes of Purges. p 417 Book. 5. Part. 3. Sect. 2. OF operations necessary for the preparation and composition of Medicines. Of the parts of Pharmacopaea. p 419 Of the kinds of heat. p 420 Of the first rank, or form of operations of breaking, sleeking, or making plain, shaving and filing: p 421 Of the second rank and form of operations: p 424 Of the third manner of operations. p 428 Sect. 3. OF the forms of Medicines. p 429 Of the division of medicines. ibid. Of Decoctions. p 433 Purging decoctions. p 436 Of infusions and other purging potions. p 437 Of medicinal wines, drinks of Honey and water sodden together, of wines mingled with honey, of Oxymel, of medicinal vinegar, decoction, or barleywater; also of clarified juices. p 439 Of distilled water, and spirits. p 443 Of oils. p 444 Of Syrups and Julops. p 445 Of Emulsions and Ahes, mixtures bringing, or causing milk, and of strengthening things. p 448 Of tinctures, and extracts, and liquid dissolutions. p 450 Of conserveses, preserves, and medicinal jûices p 451 Of Electuaries. p 453 Of Eclegmays and Lohoches. p 455 Of Bowls. p 457 Of Powders and Trags, or Comfits. p 458 Of Salts. p 459 Of Crosses. p ibid. Of flowers and sublimates. p 460 Of precipitates. ibid. Of Glasses, Regons', of certain chemical powders p 461 Of Comfits, little round cakes and morsels, and such like. ibid. Of Troches. p 464 Of Pills. p 465 Of Suppositors. p 468 Of Clystors. p 470 Of Injections into the womb, and of Pessaries p 472 Of those things which are injected into the Yard and Bladder. p 473 Of the washing of the mouth, and Gargarisms. ibid. Of medicines that draw away phlegm. p 474 Of medicines that rub and cleanse the teeth. p 475 Of medicines put into the nose, and to prouke sneezing. p 477 Of sweet smells, perfumes, and odcrifierous Balsams. p 478 Of those things which are put into the ears. p 479 Of liquid medicines for the eyes. ibid. Of oils and balsams. p 480 Of linements and ointments. p 481 Of Cerots and Emplasters. p 482 Of Cataplasms. p 485 Of medicines to take away hair, Salves made of Mustard, and medicines causing weals, or pustles in the body, Vesitatories, or medicines that cause blisters. p 486 Of Epithems (which are something moister than Plasters) Medicines made of Vinegar and Roses, and of medicines applied to the Temples to stop fluxes of Rheum) from falling to the eyes. p 427 Of medicines applied plaister-ways to mitigae pain, and of little bags. p 489 Of Embrocations, Lotions, and Baths. p 490 Of Sopes' p 491 Of Cauteries. p 492 THE FIRST GROUND OR FUNDAMENTALS Of the whole Art of PHYSIC, AND CHIRURGERY. BOOK I. CHAP. I. Of the Nature of Physic. THE word Medicina, The name of Physic. since it is derived 〈◊〉 Medendo, that is, helping such as are sick; doth properly belong indeed to the Therapeutical part only; which part being the most necessary, was first invented and garnished, and in this sense the word was formerly taken. The Definition of Physic. Yet afterwards when that part was added, which shown the preservation of present health; the same ancient Appellation was still retained, and is now attributed to the whole Art. Physic is an Art (as far as it is possible) of preserving man's present health, and restoring it when it is lost. Physic is most properly set down amongst the Arts, The Genus of Physic. because it propounds to itself, not knowledge only, but effecting somewhat; namely, gaining of health. For the distinction betwixt Disciplines are taken from their next end: neither doth Physic observe the other principles that are requisite in a Science. The Subject of Physic is man's Body, The Subject of Physic. as it is endued with health, and obnoxious to diseases. And this Subject hath one excellency peculiar to itself, beyond the Subjects of all other Arts; in that they do nothing, only they perform obedience, and undergo the operation of the Artificer; but this hath a certain inbred power striving for health of its own accord. The End of Physic is Health; The End of Physic. and that is the true and last aim of it, the first mover, and that for which it is; but the scope or means, and that to which it aims is to heal, as J. C. Scaliger in his first Book of Plants teacheth; for although the Physician do not always obtain his chief end, since it is impossible to cure all that are sick, yet the physician hath performed his Office, if he have omitted none of those things that are in the power of Nature and Art. For out of those two the Excellency and Dignity of Physic is manifested; The Excellency of Physic. for it is employed about man's Body, of all natural Bodies the most noble. The end it aims at is health; than which (amongst all things that may be called good by Mortals) nothing is better; and that which alone is sought by itself. Whereas all the rest of the Arts aim at nothing themselves; but perform all things because of some outward end. CHAP. II. Of the Division of Physic. SEEing that the end of Physic, The division and parts of Physic. is to preserve present health, and to restore it when it is lost; it is properly divided into the Preserving and Curing part; yet there are also higher things pertaining to these parts which are necessary to be known by the Physician, and they are to be added. For since a Physician cannot heal unless he know the Subject whereon he ought to work, and since all Arts begin from the knowledge of their end: first he should acquire the knowledge of man's body, wherein he ought to work, and wherein health doth consist, 'tis necessary he should understand; and since that a disease is repugnant to health, he ought to know the nature, differences, causes and effects of a disease; and by what rules to find these in every individual. And so Physic is conveniently divided into five parts, the Physiological, Pathological, Semeiotical, Hygieinal, and Therapeutical. physiology handles the subject and end of Physic; Physiologie and so treats of man's body, and shows the constitution thereof, and all its parts, their uses and actions, and the faculties of the mind. pathology teacheth the nature of diseases and Symptoms, pathology their differences and causes, and explains all things whatsoever, by which man's body recedes from a natural constitution. The Semeiotick part shows the Signs, Of signs of sickness and health. whereby we may know whether a man be sick or well, and by which we may discover diseases and causes that lie hid in man's body, and the events of diseases. The Hygieinal part shows, by what rules present health may be preserved, Of preservation of health. and how a man may beware beforehand (as much as is possible) lest he should fall into a disease. The Therapeutical part teacheth, by what means health is to be recovered; and how diseases with their causes and symptoms may be repelled and taken away. Of curing diseases. If there be any other besides these which are counted parts of Physic, they are not principal, but lesser, into which these are subdivided, such are the Diatetical, Chirurgical, and Pharmaceutical parts, and such like. CHAP. III. Of Health. FIrst, as for the Physiological part, indeed very many dispose of it, and place it otherwise, What physiology handles. Of things called Naturals. and in that comprehend things called Naturals, without which our bodies cannot subsist whole, and they account them seven, Elements, Temperaments, Humours, Spirits, Parts, Faculties, Actions; but since the handling of them as they are such, is properly the work of a Physician; they are considered by a Physician in this place, as they conduce to the knowledge of the subject, which is man's body; to the explication of the end, which is health: to which also we are willing to order the handling of them. And indeed, to it belongs, principally the description and knowledge of all the parts of man's body; which since it is more copious then to be contained in a Compendium, that is to be sought in Anatomical books; but especially by seeing bodies dissected: afterwards followeth the explication of the end of Physic which is health. But since that all men do then think themselves wel●, The definition of health. when they can rightly perform the natural and necessary actions of life, Health is defined fitly to be a power of man's body to perform those actions which are according to nature, depending on the natural constitution of all the parts: for health doth not consist in the action itself, since that those who sleep, or are quiet in what manner whatsoever, and cease from certain actions, are sound, and as Galen hath it in the 2 cap. of the differences of diseases; not to operate, is to be well, but to be able to operate: nor is he only well who performs his natural actions; but also he that doth them not, so that he be able to do them: And so the formal reason of health is, a potency of body to perform natural actions; but because Galen in the place , makes health to be a natural constitution of all the parts of the body, and in the first Chapter of the Differences of Symptoms, a framing made according to nature fit for operation, or a natural constitution of all the parts of the body, having power to undergo those things which are according to nature; therefore it comes to pass, that that position or constitution is rather subject to the actions of a Physician, then to the power of acting. The subject of health is a living body, The Subject of health. or the parts of a living body, as to that, to which alone the power of acting belongs; but those which live not, and have no power to perform natural actions, those are neither said to be sick nor well. But the cause of health, The efficient cause of health. or that whereby a body and its parts are said to be sound, is a natural constitution of them: But seeing there is a twofold constitution of a body, and of all its parts, the one Essential, which consists of matter, and substantial form; the other accidental, which follows the former, and is such a disposation of qualities and other accidents in the several parts of the body, by which the essential form may exercise all its actions, and according to its diversity, it acteth variously: Health doth not consist in the essential but accidental constitution; for the mind cannot be hindered or hurt, but remains always the same and unchanged; so that it have instruments constituted in the same manner. The Essential constitution also, so long as a man lives, is immutable, and at length is changed by death; but the accidental constitution of the body is subject to many alterations, whence the same soul in the same body acts one way and another way. And because the parts of the body are several, the natural constitution of them also is not the same. The definition of similar and dissimilar parts. The parts of the body are twofold, similar, and dissimilar. Similar parts are such whose particles have the same form, and are alike to the whole, and to one another; and indeed, some are truly and exactly such, wherein no difference can be found, neither by accurate sense, nor by reason: such are a Bone, a. Gristle, simple flesh, a very small vein, Fat: Others are so only to the sense, which although at the first sight they seem such; yet if they are viewed more diligently, they are perceived to be composed of more, as flesh of muscles, substance of Veins, Nerves, Arteries. Dissimilar, are such as are compounded of more, Of a Dissimilar. Whether a similar part be opposite to an organic. which are also called for the most part organic. For although, if we may speak properly, an Organic is not opposite to similar, but a dissimilar or compound, and similar may be organic also, as you may see in bones, which have their organic constitution: Yet because singular parts, for the most part, do not perform a whole and entire action, which Galen requires in an organic part strictly so taken, hence it comes to pass the Physicians, for the most part, oppose an organic to a similar. But the constitution of similar parts, The constitution of similar parts milar parts even as of those which consist of Elements, and other mixed bodies, consists in the lawful mixture of the four primary qualities. But besides that temperature of primary qualities, Occult qualities. other qualities also are in them which are more occult, arising from their forms, which parts all of them possess, as is manifest by their sympathy and antipathy with other natural bodies, and by several actions, and kinds and manners of actions, which are beyond the force of Elements. The natural constitution of organic parts, The constitution of dissimilar parts. consists in a composition fit to perform actions; namely in number, magnitude, conformation, composition or situation. There is a common unity in them both, as well similar as dissimilar and organic: for not only the whole body, but every part thereof, whether similar or organic, aught to be whole and entire. And if our bodies obtain these three things, it is sound, if either be wanting, it becomes sick. Yet, there is a certain latitude of health, The latitude of health. nor do all men acquire the same perfection of performing actions; but in regard of age, sex, and other circumstances, some do perform all or certain actions better than others, yet all of them nevertheless are sound; but Physicians call all those that deviate from perfect health, Whether there be a Neutral disposition. and yet are not sick, Neuters; and place a neutral constitution, as it were, in the middle betwixt the sick and well. For although, if we rightly weigh the matter, there is no such thing as middle disposition, differing from health and a disease, and every man is either sick or well; yet Physicians consider Neuters, not as the mean betwixt sick and well; but as differing from perfect health peculiarly, and distinguish Neuters from those that are sound, not as differing in kind, but in respect of more or less. CHAP. IU. Of Temperaments. BUT that the nature of health may be the more manifest, something shall be spoken particularly of this threefold constitution of a body which is necessary to health; What a Temperament is. and first, for what belongs to the constitution of similar parts, as they are such, that is a Temperament, which is a quality arisen from the mutual action and passion of primary qualities, and resulting out of them separated and joined together. But not the form itself of a mixed substance; since it is subject to the senses, acquired by change (or motion) subject to alteration, and hath its rise from the primary qualities; Nor is it only a harmony (although there be a certain proportion of qualities in a Temperament) since it is the immediate instrument of actions, which doth not belong to a bare proportion which is an accident. But from the Temperament, A Temperament of a mixed body twofold. things are said to be temperate or intemperate; and indeed, any thing is said to be temperate two ways, either simply and absolutely, and in its own kind, or in relation to some other; for if there be that proportion of qualities, that they wholly concur in equal strength, such a Temperament is said to be simply and absolutely such, and such a Temperament is commonly called a Temperament ad pondus, To weight. or according to weight, (as if it were weighed in a balance) and is of an Arithmetical proportion; But if there be a certain inequality of qualities in relation to their strength, To Justice. it is called a Temperament to Justice, and this is called a Geometrical proportion; although, if you strictly regard the proportion of the qualities amongst themselves, it is then an Intemperament, not a Temperament. Now this Temperament (as we call it) wherein there is not an equality of primary qualities, takes its denomination from that quality, which doth exceed the rest, whether it be one or two. And the action which proceeds from the Temperament, is ascribed to the quality that doth predominate; although the rest are no ways to be excluded from having a share in the action. Of these Temperaments some are simple, Temper te to Justice twosold. Simple. others compound; Simple, is when one quality only exceeds its contrary, and therest are equal, whereof there are four kinds, according to the number of the primary qualities; Hot, wherein heat doth rule over cold the moisture and drought being equal; Cold, where cold overcommeth the heat, but the moisture and dryness are equal; Moist, wherein moisture exceeds dryness, the heat and cold being equal; Dryness, wherein drought dries up moisture, the heat and cold as before being equal. But when two qualities exceed their contraries there ariseth a compound Temperament: Compound. The latitude of Temperament. whereof there are likewise four kinds according to the combinations, (as far as possibly they may combine) of the four primary qualities: to wit, Hot and Moist, Hot and Dry, Cold and Moist, Cold and Dry. In every one of these there is a great latitude, and in the simple Temperament some have more, some less of heat or cold by much than other. In compound Temperaments some one, sometimes both qualities, exceed the rest in an extraordinary, yet different manner. Any thing is said to be Hot, Cold, Moist, or Dry, How many ways any thing is said to be hot, moist cold, and dry. not only simply regard being had to the universal nature of mixed bodies, wherein if you consider a middle sort of body exceeding in neither, and in respect of this you account all others that differ from it Intemperate, and from the quality excelling is called, Hot, Cold, Moist or Dry; but besides this, there is made a comparison to three: First, the comparison is made to the next Genus, or kind in nature, as if in the whole sort of living Creatures, you appoint one living Creature to be temperate, all others in respect of that, are called intemperate; Secondly, a comparison is made with a middle sort of the same kind, so a Boy is said to be hot, an old man cold; Thirdly, respect is had to every individual, that so this compared to that as being Hotter, is Cold, but compared to a colder is hot. Man, for whose sake these things of Temperaments are spoken, In man there is a twofold Temperament. since his body is not simply mixed but organic and living, there is required in him a double Temperament, one of the body, as it is absolutely and simply mixed; The other as it is living. This is lost by death, and is often changed by old age; but that remaineth sometimes in the dead carcase after death; yet at length by putrefaction and corruption of that which is mixed 'tis dissolved. In that also, according to Heat, Cold, Drowth and Moisture, there is a great diversity of parts. But the matter which is proper to living Creatures in all, is Heat and Moisture. Again the Temperament of a living man is twofold, Temperament, Innate, Influent. the one Innate, the other Influent. Innate, is that which is imbibed in the living parts of man, & by reason of the Innate heat is inherent in him from his first being. Influent, is that which floweth from the principal parts, and is communicated to the whole body. And that it is not the same with Innate, is manifest from those that fall into a Swoon; when the body becomes extreme cold, and yet the Innate Temperament is not changed. These three Temperaments though they may be considered severally: Yet they concur to constitute one Temperament of a sound man. And, therefore although without all doubt, amongst all other living Creatures man is of the most temperate, so that other living Creatures, as also medicines compared to him, are said to be Hotter, Colder, Moister, or Dryer; Yet simply and absolutely he is not temperate; The Temperament of a man, of what sort it is. for commonsense tells us, that Heat in man is predominate over the other qualities; for the Temperature of a man to perform his actions best is Hot and Moist, and our lives consist of Heat and Moisture: on the contrary, coldness and dryness lead us to death, and by how much sooner a man is cooled and dried, by so much sooner he grows old and dies. Yet, The differences of the Temperaments of man. that heat and that moisture have their degrees. For if the heat exceed the cold and the moisture the drought moderately, that Temper is best and is accounted Temperate. All others differing from this are called either Hot and Moist, Hot and Dry, Cold and Moist, or Cold and Dry; although all in general are Hot and Moist. These differences of Temperaments are commonly explained by the names of Sanguine, Sanguine, Choleric, Phlegmatic, Melancholy. Choleric, Phlegmatic and Melancholy Temperaments. These differences and appellations may be admitted of, if they are not taken from the diversity of excrementitious humours, in various bodies; but from the variety of blood, which is the nutriment of the body. For those whose Blood is temperate, Occult qualities. or moderately hot and moist, are called Sanguines: Those who have hotter and drier blood, and their bodies from thence become hotter and drier, are called Choleric Persons: Those who have colder and moister, and their bodies from thence grows colder and moister, are called phlegmatics: Those who have cold and dry blood, and their bodies from thence become cold and dry, are Melancholians. But we must not rest at the Primary qualities; for there are others more noble and more abstruse, the causes of many actions, and of Sympathy, and Antipathy, with other alterations that must be granted; although in this humane imbecility, for the most part, they are unknown to us. The Astrologers, The opinions of the Astrologers. that they may some way express the various Constitutions of Bodies, according to the occult diversities of Stars, call some Solar bodies, born under the influence of the Sun; so Jovial under Jupiter; others Marshal, Venereal, Mercurial, Saturninal, as being born under one of those; and also admit of mixed constitutions born under several Planets; nor indeed absurdly altogether, since there is a great agreement and consent betwixt Superior and Inferior bodies. But since there are divers parts of a body, and each part hath its peculiar Temperature, not only proceeding from the mixture of Elements; but some are hotter, some have less heat in them; nevertheless they agree together, to make the Temperament of the whole, which is hot and moist; and so heat with cold, moisture with dry things are equalled. So that from thence there proceedeth a certain Harmony, and the Temperament of the whole, is moderately hot and moist. But to constitute that Temperament of the whole, The Temperament of the whole wherein it depends. the noble parts of the body perform more than the rest, and most especially the Heart, the Fountain and Treasury of the native heat, and vital spirits. From whence all the parts of the body receive the influent spirits and heat. Next to it the Liver, which furnisheth the whole body with aliment, namely blood; afterwards the Stones; then the Brain, the shop of Animal spirits; last the Stomach, the place for the first Concoction. Concerning the Temperament of several parts, The Temperament of the parts of the body. The Hot Parts. the most Temperate is the skin; especially that in the Palm of the hand, to which as to the mean, the other parts being compared, tend to heat, cold, drought or moisture. The Hot parts are the Heart, of all the parts the hottest, the Fountain of native heat, and Closet of vital spirits. Also the Liver, flesh of the Muscles, Spleen, Reins, Lungs, Veins and Arteries, Fat also and fatness. The Cold, are Bones, Gristles, Ligaments, Tendons, Nerves, Cold. Membranes, Spinal Marrow, the Brain. The Moist parts are Fat, the marrow of the bones, the Brain, Moist. the marrow of the back, the Duggs, the Stones, the Lungs, the Spleen, Reins, flesh of Muscles, the Tongue, Heart and softer Nerves. The Dry, are Bones, Gristles, Ligaments, Tendons, Membranes, Dry. Arteries, Veins, hard Nerves. There is a certain difference of Temperaments in man's body by reason of Sex and Age: As for what belongeth to Sex, The Temperament of Sex. Females are colder than Males, as having contracted a colder nature from their principles of generation, lest that the blood necessary for future generation by a stronger heat should be consumed. The Temperament is also changed according to age; to wit, The Temperament of ages. the age which is principally ordained for certain internal changes by heat and moisture. Authors for the most part divide man's life into three ages, Childhood, Manly-age, and Old-age; or Youthful, Age of perfection, Declination; or if you please, into the first, middle, and last age; to which differences other ages, spoken of by Authors, may be referred. The first age therefore is our Infancy, which remaineth till the seventh year; the second our Childhood, which for the most part continueth to the fourteenth year of our age: then our youthful age from the fourteenth to the five and twentieth, when our growth for the most part in stature ceaseth. And sometime Hypocrates in his first Book of Aphorisms and fourteenth chap. accounts these ages before mentioned, ages of growth. From thence to the five and thirtieth is our manly of flourishing age; from thence to the forty eighth year is our prime or most principal age, then gins old age; which hath its degrees also, for each age hath its Temperament, Infants and Boys are hot and moist; youthful age is most Temperate, and obtains the most convenient temper for humane actions; the flourishing manly age, or prime Viril age is hot and dry; lastly old age by reason of the wasting of the Radical moisture, and defect of the promigenial Innate heat is cold and dry; and by how much the older, by so much the colder and drier. CHAP. V Of Innate Heat. THat those things may the better be understood which we spoke concerning Temperaments, Innate heat. we will say something of primigenial heat; for these things are the chief Instruments of the Vegetative soul. By the innate heat we do not understand that heat which belongeth to the mixed body, as mixed; but that heat which is proper to living Creatures; the which with the radical moisture is the next and immediate subject and domicil of the Soul, diffused through all the parts of the body. Nor by heat and moisture do we understand the bare quality, but the quality, with the Subject; to wit, a body hot and moist; the matter namely or Subject wherein heat is, and the quality from whose predominancy the Subject hath its name; to wit, the most pure, subtle, and hottest portion of the similar parts, and especially of the Spermatick parts. This heat is otherwise called both by Physicians and Philosophers, by the name of the within seated spirit, or the native spirit; and it is more conveniently called, the within seated spirit, than the innate heat. For although in all the substance be hot; The Innate heat. yet heat is not sensibly perceived in all bodies, but only in living Creatures, and the more perfect of them, which by touching are perceived to be hot. This Innate heat consists of three things, Whereof the Innate heat consists. which make up its ●ssence, Radical moisture, the within seated spirit, and heat; hence fernelius defines it to be the Primigenial humidity spread ●rough all the body, by the innate heat and spirit. And these ●ree, Heat, Spirit, and Moisture are linked together by the nearest conjunction in the world; for since that heat ought to be (as it were) Governor and Ruler of our lives, it is only of an aëricus or spi●●ual nature, and so by itself movable and separable, or apt to be dispersed, it could not subsist alone, but that life might be prolonged, 〈◊〉 ought to subsist in a more stable, moist and durable body, more permanent; namely, not a thin and watery body, but a fat and oily body which is inserted within the fibers of the similar parts, and is called the radical moisture. Concerning the nature and original of the innate spirit and heat, Of the original and nature of the Innate heat. there is a great controversy amongst Physicians and Philosophers, and 'tis disputable, whether it be Elementary, or of another nature; And although in such an obscure thing, since very learned men disagree, it be very hard to determine any thing, yet I think theirs to be the more probable opinion, who consent with Aristotle in his second Book of Generation of living Creatures, and third Chapter; That Innate heat is not Elementary, nor hath its original from fire or other Elements; nor yet is it of a Heavenly nature, but proportionable to the stability of Stars. For every specifical form requires its peculiar domicil and proper subject, and the more noble form requires the more noble habitation, and a more Divine power then Elementary, requires a more noble manfion than a body that is composed of Elements. Moreover, more noble actions, The subsect of the Innate heat. and Sympathy and Antipathy are in it, which purely from Elements cannot proceed; & again this Innate heat and inborn Spirit, in many Plants is preserved in winter time, and in the midst of frosts safe and secure; Moreover this Innate heat, and radical moisture is founded in the parts which are fashioned in the first generation of an embryo; but the greatest plenty of it is in the heart, which from thence is called by Galen, the fire-fewel of the Innate heat. This inborn heat, is the chiefest instrument of the soul, The use of the Innate heat. by which it perfects, undergoes all the actions of life and whatsoever healthy thing in us, and profitable in generation, in nutriment, or in expulsion of a disease, is performed by that. From this benefit and excellency of Innate heat, The Innate soul is not a soul. some have taken it and the Soul for the same thing, and have called it the Essence of the vital faculty; the faculty governing us, the substance of the soul, and the Author of all our actions; but since the Innate heat is neither the soul, nor the chief cause of our actions, it is only the chief instrument in performing the actions of the soul, in operation, which is not corporal. This Innate heat doth not remain always the same, The changing of the innate heat but is changed in the course of our age. For at our first coming into th● world, it is most, and age increasing, the radical moisture wasted by degrees, and drieth up. So that in the end the radical moisture being clearly gone, the heat also wanting wherewithal to support itself, goes out, and a natural death followeth. CHAP. VI Of Spirits. BUT although every part of the body have this heat innate in it yet that alone sufficeth not to undergo all actions, Influent Spirits. but requires heat and spirits flowing from elsewhere; by which it may be stirred up and cherished; for by itself it hath no power to perform all actions, but soon languisheth, and so is scattered and vanisheth, except it be daily stirred up, nourished, and strengthened by the spirits of the principal parts, especially the heart. Although the name of Spirit may admit of various significations yet in this place it is taken for the purest, What the influent spirit is. finest, thinnest, hottest, most movable body, proceeding from the most purest and subtlest part of the blood; and although the name of Spirit be attributed to the Innate heat, yet it especially belongs to those that are most fluent and movable. The Use of Spirits. These Spirits are the bond by which the body and soul are united, and the chief instrument of performing our actions, and being wrought in the principal parts of the body are conveyed through their channels into the whole body, and are joined with the Innate heat, that they may help the powers and faculties to perform their actions. Spirits are not the Vehicle of the faculties. But that is false which some teach, That the Spirit is the Vehicle of the faculties, and that the faculties and power of performing, are carried by these Spirits from the principal parts; for the faculties of the soul are unseparable proprieties, and the soul is fitted with its faculty in all its parts, nor doth it take them from any other parts, but there useth them, where it hath fit instruments. These Spirits are of three sorts, Spirit's how many forts. Natural, Vital, Animal. The Natural are generated in the Liver, and are said to flow from thence into all the parts of the body; but although the name of Spirit may in some measure be attributed to the most thin and subtle parts of the blood, which oftentimes comes forth out of the Veins with the blood: yet there is not a little difference betwixt them and the other Spirits, properly so called; The natural Spirit. and so properly doth not deserve the ●●me of Spirits, as the rest do, since they are not the proper instruments of our actions, nor the bond of the soul, which uniteth it ●●th the body, and is not generated in any peculiar cavity as the ●●ital Spirits are. It's use. The use of the Natural Spirits are to strengthen ●●e Innate Spirit in all its parts, that it may supply the Vital Spirits ●●th matter, and may serve for the more convenient distribution of blood through the Veins. The Vital Spirit is generated in the heart, The Vital Spirits whence generated. of the thinnest and purest blood, or the natural Spirit, commonly so called, and aêr, by h●●p of respiration drawn, & by the dilatatian of the Arteries in the left Ventricle of the heart, and being there freed from all fuliginous vapours is distributed through the Arteries into all the parts of the body; but the Blood out of which this Spirit is generated, for the most part is conveyed through the arterious vein, from the right Ventricle of the heart into the Lungs, and from thence with aër drawn by breathing in is carried through the arterious vein into the left Ventricle of the heart. Their Uses Now this Spirit with its innate heat in the heart, is not only the chief instrument of the actions of the heart, but is distributed through the Arteries into the whole body, and stirreth up, cherisheth, increaseth, and strengtheneth the innate heat in all the parts, and doth, as it were, give action and perfection thereunto, whence it is called by some, the Influent heat; besides which it affords matter fit for the generation of the animal spirits. Thirdly, The Animal Spirit. there are Animal spirits really different from the Vi●●l, for they are generated in a peculiar place, namely the Brain, and ●om thence through peculiar Channels, to wit Nerves, are dispersed over the whole body; nor can the Vital Spirit perform what the Animal can, since it is a living part, o'erspread with a Vital Spirit. Nevertheless being touched may be deprived of sense and motion ●●rough the defect of the Vital Spirit. They are generated of the ●urest part of that blood, Where and whence generated. which is contained in the comers or ca●ities of the brain, which comes from the mixed vein and artery, ●nd is o'erspread with the vital and natural Spirit, the purest part ●eing poured out through little branches and small furrows in the obstance of the brain; for in this, and not in the Ventricles of the brain, the purest and most subtle part of the blood is changed into animal spirits. It's Uses. The Animal Spirit serves for the use of living creature's; namely to perform internal and external senses; as al●●, it serves for motion in Animals, and its presence occasioneth ●he faculty of the soul, actually to perform the operations of the internal and external senses, and it perfecteth animal motion, and ●an occasion local motion. CHAP. VII. Of the natural constitution of Organic parts, and the common Unity of parts alike, and not alike, called similar and dissimilar parts. THe natural Constitution of the Organic parts, The natural constitution of the Organic parts. consist ●● the due composition, and a convenient knitting of the 〈◊〉 milar parts into one form, fit and profitable for action for making up whereof these things ensuing are necessary. First, Their Number. a certain number of the parts compounding, whic● in some are less, others more, according as the instrument are more or less compounded, till at length there is made up a perfect instrument, which can perform perfect actions. Secondly, Magnirude. a due magnitude of the parts compounding, being neither bigger nor lesser than they ought. Thirdly, Conformation. due framing: which comprehends first a convenient figure; secondly, cavities and pores, that in case a part be no● solid, but porous, it may contain the just number and magnitude of those pores; thirdly, a certain disposition of the secundary qualities, namely, that some parts may have a sharp superficies, some parts light, others heavy, some soft, others hard, some coloured others not; light colour, or dark colour, according as the nature and use of the part requireth: Site and connexion. Fourthly, situation and connexion, that every part may be in its own place, and may agree with others. Lastly, it is requisite that there be a common unity, a● well of parts alike, as disalike, which is a coherence and growing together of divers bodies into one; Unity. which if it be wanting and taken away, the natural action is hindered. CHAP. VIII. Of the faculties of the Soul, and of the differences of actions i● man's body. AFter that we have showed wherein health consists, The actions and differences of the faculties of the mind. and what i● requisite for the performing of actions, now we are to explains what are the differences of the faculties of the mind, and of actions in a body. Physicians (whom we here follow) divide Actions (for thei● purpose) into Natural, Vital, and Animal, according to the three principal members, the Liver, Heart, and Brain, by which all Actions in the body are governed. For Physician's purposes are not the same with Philosophers, to inquire or search the kind● or differences of Souls of living creatures, which appears by the di●●inct manners of life, which is in Plants, in brute beasts, living ●treatures, and man, but only ought to find out in man the differences of actions, whose actions it is their business to preserve, and if offended to restore; and moreover a Physician doth not so much consider the faculties themselves, which hurt not, as the Organs and instruments, and then distinguish actions according to the differences of them. CHAP. IX. Of the Natural faculty; and first of Nutrition, and Augmentation. THat we may begin with the natural faculty, The principal natural faculties. I mean the Natural faculty so called peculiarly by Physicians, (for as it is taken generally it is opposed to preternatural, and so the Vital and Ani●mal faculties may be called Natural;) The Natural faculty by the Philosophers, is called a growing or flourishing power. All its actions tend to the preservation of its kind, or else of the Individuals of its species. Now to the preservation of its individuals belongs Nutrition, and Augmentation, to the preservation of its kind Generation belongs. The nourishing faculty whose action is called Nutrition, Nutrition, or alteration. is that which turneth aliment into the substance of the body living, and restores what is taken away, and performs this work during all one's life time. The faculty increasing whose action is called Augmentation is, Augmentation. that which extendeth the body to its due and just bigness, whose office is most performed in our growing age, and is extended till it compleateth and perfecteth its due magnitude. The generating faculty whose action is called Generation is, Generation. that by which man by his kind continues to perpetuity, which by Individuals cannot be done. And these three faculties being as it were the Princes, The servile faculties, Attraction, Retention, Concoction, Expulsion. have others as it were their servants added to them; The Attractive, the Retentive, the Alterative or Digestive, the Expulsive. The Attractive draweth profitable nourishment to the parts; The Retentive, reteins it so long there till it be digested. The Digestive altereth aliment, changeth it, & renders it fitting for that which is living. The Expulsive faculty rejects that as excrementitious, which is dull and unfit to be converted into the substance of the body. The Attractive, Retentive, and Expulsive faculties perform their actions principally by the benefit of the fibers. Attraction is made by the right fibers placed along the length of a member; Retention by the obliqne or flaunting fibers; Expulsion by those that pass overthwart; but Digestion or Concoction are performed by the Heat of the member. But in the other parts of the body, the same faculties want not the help of the fibers, but perform their operations only by the help of the Innate heat which is in each part. But although aliment in nourishing be in a capacity to be like to the body yet actually it is unlike at the first; and therefore is changed by little and little until it be rendered like to that into whose substance it is to be turned, which is performed by several Concoctions. Concoction is either private, One Concoction is public, another private. and is appointed only for nourishment and use of the part where it is made; or public, which is made for the common use of the whole body. That is made in the several parts: this in the Stomach, Liver, and Spleen. Hence there is commonly accounted three Concoctions necessary for nourishment of the body: The first is that which is made in the Stomach, the second in the Liver, from which that of the Spleen is not to be excluded; the third in the several parts of the body. There are other actions which pass through the Fabric of the whole body, such as that of the Vital spirits in the Heart, the Animal in the Brain, and that of milk in the Duggs, the generation of seed in the Stones, unless you will refer this to the Generative faculty; not by reason of the part wherein it is generated, but by reason of the end for which it was instituted (namely) public use. The first Concoction is made in the Stomach, The first Concoction is made in the Stomach. which first prepares Nutriment for the whole body: To which for this reason, not only the power of Concoction, but also a double Appetite is given; Natural, by which it desires nourishment necessary for itself; Animal, by which it requires nutriment for the whole body. The Natural Appetite doth not sensibly want nutriment; Appetite twofold. Natural. Animal. but as the other part by a natural instinct requires and draws nutriment. But the Animal Appetite hath an exquisite sense joined to this desire, living in the upper Orifice of the Stomach, by which it can perceive not only its own wants, but the wants of all the body besides. For after the whole body is emptied, it draws out of the Veins, and the Veins which require to be filled again, suck upward again from the Stomach, and their sucking is again received in the Orifice of the Stomach, The first preparation of meat. in the mouth. whence ariseth the Animal Appetite, which is twofold, Hunger and Thirst. But before Food descend into the Stomach, it is first prepared in the mouth, where it is chewed into pieces by the teeth, moistened by the spittle and by the heat of the mouth, and of the tunicle which is common both to the Ventricle and the mouth, it is altered by attraction. The meat chewed and so altered in the mouth by the motion of the tongue, is sent down through the gullet into the stomach, which by the help of the obliqne fibers is there retained and imbrace●, until by the Digestive faculty and proper heat of the stomach and the adjacent heat it be changed into one form and masse, not unlike to the scum of Ptisan, and is called Chyle. Meat being taken, The Chyle. that ani●nal appetite ceaseth, or hunger and thirst ceaseth, to wit the twitching and plucking for want of Aliment ceaseth; but the natural appetite is not satisfied, except perfectly nourished and refreshed with the blood of its own body. The Chyle generated in the stomach is sent down through its lower orifice into the first guts, by which, with their digestive force which they have by reason of their community with the stomach, is here somewhat wrought and perfected. But seeing that all nourishment is proper for nourishing certain parts of the body; Nature in this concoction separates nourishment, The excrement of the first concoction twofold: thick. whence their ariseth a double sort of Excrements, the one thin, the other thick. The thick which is called the ordure of the paunch, whilst the Guts contract themselves up by the circular or transverse fibers, and the Muscles coming in the Guts by the paunch, the paunch is pressed and the siege is thrust out, and voided through it. The other thin and watery which is not forthwith sent out through the paunch, but continues mixed with the chyle, Watery. that it may the more easily pass through the narrow Veins of the Mesentery, of the Port and of the Liver, afterward it is separated by the veins and expelled by Urine. The Chyle being separated in the Guts from the thicker dregs, is drawn by the Meseraick Veins, and is somewhat altered by them, The second concoction in the Liver. and first it receives the rudiments of blood, and hence it is carried to the branches of the gate Vein, and Liver; and there by the innate heat and power of the Liver is turned into blood, which action is Sanguification, or turning into blood. The Liver reteins a part of this so gotten blood, that it may by it be nourished, the rest through the hollow Vein, in which some part of it is hitherto retained and perfected, it distributes it through the whole body. That the purer blood may be generated in the Liver, the Spleen draweth to itself from the trunk of the Meseraick Veins, The use of the Spleen. before the Chyle be carried to the Liver by an inbred faculty through the splenick branch of the gate Vein, the more earthy and thicker part of the Chyle, and generates blood, though not so good blood, yet fit and proper for its own nourishment, and for the nourishment o● the more ignoble parts of the lower Ventricle, that thereby the pun● and better part of the Chyle may be drawn through the branch 〈◊〉 the right side of the gate Vein, called the Mesentery to the Liver and there purer blood might be generated; and so in one work the Spleen serveth to cleanse the blood from dregs and generate worse sort of blood; For the Spleen is not appointed only for th● drawing and evacuating the Melancholy blood from the Liver. Th● beginning of the Splenick branch, which ariseth not out of th● Liver but the gate Vein; The Symptoms of Diseases in the Splee● do show the constitution of it to be near that of the Liver, and the● is a connexion of the Spleen with the stomach by Vessels. But the which cannot be turned into blood by the Spleen, by convenient passages is evacuated, and the thick and dreggish matter for th● most part is sent through the paunch, either with the excrements o● without them through the Haemerod Veins, and trunk of the gat● Vein; yet sometimes 'tis evacuated by Urine. The acqueous matte● most commonly is drawn through the Splenick arterics to the Vein● and purged out there; yet sometimes that also is expelled by th● paunch, by sweats, by the stomach. In Sanguification in the Liver, two excrements are generated Yellow Choler and Urine. The excrements of the second concoction. Yellow choler. The Yellow Choler is gathered into the bladder of the Gall, and from thence the most part is sent into the Guts, and the sharpness of it stirs up the expulsive faculty to do its office, to stir the dregs of the paunch, and is cast out with the ordure. But the serous matter and the aqueous humour is drawn by the Veins, through the emulgent vessels, and is transmitted through the Ureters to the bladder; Urine. by which afterwards it is cast out, and is called Urine. The Urine therefore consists, first of aqueous and potulent matte● sent with the Chyle to the Liver, but unprofitable to nourish the body, Urine consists of three things. afterwards of a clammy or salted excrement of blood, and thirdly of natural contents in sound bodies, but in bodies diseased of many other things which are mingled with the Urine. And so Urine is properly called an excrement of the second concoction, to wit, wherein the serous part of Urine is separated from blood, and mixed with potulent matter, affords Urine. Blood thus separated and cleansed from its excrements, The parts of the mass of blood. nevertheless is said to contain in itself many humours; Nor is that mass of blood so elabourated and wrought in the Liver, and contained in the Hollow Vein plainly Homogeneal or of the same kind, but some parts in it are Temperate, others colder, others hotter, others dryer, others moister; The most Temperate in its kind is called blood, the hotter and drier part by reason of its consanguinity with choler is called Choleric blood, the colder and moister is called Pituitous blood, the colder and drier is called Melancholy blood. Yet all these parts of blood are contained under the form or essence of blood, and are profitable for the nourishment of the body. Nor do the humours in a sound body constitute a mass of excrementitious blood, neither in the Veins of a man most healthy are these humour's Choler, Phlegm, Melancholy, accounted excrements. Hence ariseth the decision of the question, whether our bodies be nourished by blood only, or by the four humours; For when Aristotle Tays that animals that have blood in them are nourished by blood only, he intended the whole mass of blood; but Physicians when they say that our bodies are nourished, not only by blood but by other humours, by blood they understand the most temperate part of blood, or one part of the mass of blood, and this they would have, that not only that part, but the rest of the mass, to be profitable for the nourishment of the body. But that our bodies are nourished by excrementitious humours, no man in his wits ever said. The third concoction. The blood being perfected in the Liver, is distributed through the branches of the Hollow Vein over the whole body, to nourish it and all its parts: That change by which it is assimilated to other parts, is called the third concoction, which is performed by the innate heat, in each part. Four secondary humours. In this concoction the blood before it assimilates the parts, receives some external dispositions, and is changed into four humours called secondary humours. The first is called Innominate, or without a name, The first In nominate. when the blood passeth through the capillar Veins, and admits of a sensible mutation by reason of the heat of the external parts, and in the Spermatick parts turns white, in the fleshy parts remains red. 2 The second is Dew, The second Dew. namely that blood which passeth without the orifice of the Veins. 3 The third is called Glue, The third Glue. The fourth is cambium or exchange. The excrements of the third concoction twofold; thick, thin. because while it is still more concocted it becomes clammy and thick. 4 The fourth is called dry Exchange which turneth into the substance of the part, and exchangeth and changeth its nature with it. This third concoction hath also its excrements; one thick, to wit filthiness in the skin, which is collected in the garments, also in the brain, eyes, and ears; the other thin, which is dissolved by insensible transpiration, sometimes also it is evacuated by sweat. For although all things are rightly performed in the body, and the nourishment be well concocted, and moreover nothing external and violent befall the body, as Baths, Heat, Violent exercises, no sweat pass through the skin in the night; yet because even in the most healthy all things are not ever exactly performed, and many deviate from their best condition as to health, and moreover many errors are committed in diet; Nature useth to expel such superfluities by sweats. Another office of the natural function is Augmentation or increasing, Augmentation. by which man's body, out of nourishment taken and assimilated to the parts, is extended in all its dimensions, and acquires magnitude convenient to perform actions. Nutrition and Augmentation how they differ. Although this function ariseth from the same soul with nutrition, and is perfected with the same Instrument, Innate Heat; hath the same matter out of which it proceeds, blood; the same subject, a living body; yet it ariseth from another efficient determinate cause, to wit, from the increasing faculty; it differs in form, which in nutrition is a coagulation of aliment, but in augmentation there is a motion of Extension of the whole & of every part thereof; 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 always grow, but to the certain time of his age; which comes not to pass by reason of the soul, which always reteins its force and strength, but by reason of the body, especially of the bones, which in process of tims are so hardened, 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 endure 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 female in herself 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 retained 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 necessary 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 itself; 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 smatter in each; for the forms of each alike do manifest themselves in the offspring, Blood. although the power and force be greater in the male than 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 itself is not offensive, nor is it expelled because it is hurtful, but because it aboundeth in quantity; but when it becomes pernicious, 'tis 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 shows itself 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 domicile 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, than 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 plastic heat, or that Spirit proportionable to the Element of the Stars, for the seeds being received into the womb are mingled together, retained, cherished, and the power which lies 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 gins a sending forth of the instruments of the body to be made, & then is it called a Conception, which commonly is said to continue till 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 form, by which the seed is shut in, and the Spirit and heat thereof is covered, and as it were entrenched. 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 core 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 shown. 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 infant's nurse, two Arteries branches arisen from the Iliak Vein, by which the Infant breathes (although later Authors, who teach us that the vital Spirits by which the Child breaths proceed not from the Mother, but from the Childs own heart, do assign another use to the said Iliak branches; to wit, that the Vital Spirits should be carried from the heart of the Child to the exterior parts thereof, namely the Secondines) and the Urine-passage which is carried from the bottom of the bladder unto the Navel. The time from the conception to the bringing forth, Physicians divide into two parts; the first is called the time of formation, from the conception till the time when first the Child gins to move; the second the time of adorning, which is the time from its motion till its coming forth. Of adorning. Hypocrates in his book of the Nativity of a Child, makes the time of Females formation to be two and forty days, but males thirty days, which is to be conceived from their more imperfect formation; but afterwards nature more elaborately frames the parts, which are not framed in males till three months, nor in females till the fourth month. When all the members are framed and rendered more firm, the Infant gins to spring and kick, in males in the third, in females in ●e fourth month as 'tis commonly reported, so that the time of ●rmation being doubled is the time of quickening, The time of motion. the time of mo●●on being trebled is the time of bringing forth. Yet one quickening 〈◊〉 more obscure, another more manifest, which about the middle of time of a Woman's going with Child, as all Women commonly persuade themselves, is first perceived. The time that Women go with Child although it be uncertain and various; yet for the most part, The time of birth. it is nine months' end or the beginning of the tenth month, that a natural birth happens: for the most part such Children as live come into the World at that time, and that time for humane birth is most natural. But before half a years time experience tells us, that a Child can hardly be brought forth and live; and if it so happen that before the scaventh month be ended, a Child be borne and live, it is a great rarity and very strange. But in the seaventh month because the perfection is finished of all the parts, the Child may live, and especially, which, as Hypocrates in his book of beginnings says, is of two hundred and ten days, that is, about the end of the seaventh month brought forth. But Hypocrates says that a Child borne in the eighth month cannot live. Yet others say, that some that are borne in the eighth month may live. After the tenth month, the Child being great wants nourishment and room to be in, although we read some are delivered after the tenth month, yet that is seldom. The time of legitimate birth. For a legitimate birth (according to the Law of Nature) is then when there is not room enough for the Child to live and move in, nor aliment enough to satisfy him, for then 'tis time to shake off his shackles those tunicles, and endeavour to make away for its own birth, and the Mother finds pains, and the womb strives to put out that bag, and by its expulsive faculty sends forth the young, which thing the Voluntary endeavour of the mother much helpeth, which is done by her contracting her Spirits, and depression of her Midriff and squeesing the muscles of the paunch. CHAP. XI. Of the Vital Faculty. THE Vital faculty which Physicians call the second faculty, although some would refer it to the Animal, The Vital faculty differs from the other faculries. some to the Natural faculty, and others think it to be mixed of them both; Yet since it differs not only from those actions, which are performed by the natural and Animal faculties, but also goes forth by its own organs, nor doth it move hither and thither by the assistance of the Animal Spirits, but by its own proper Spirits, which from thence are called Vital Spirits, it is deservedly to be esteemed a peculiar faculty, di●●inct from the Vegetable and Animal faculties. There are three sorts of Vital faculties, Its actions are three. and so many motions of the heart wherein they relied. The first is the generation of the Vital Spirit and heat; The second is the Pulse; The third is the Irascible faculty. The first to wit, Generation of Vital Spirits. A Pulse. It's definition. Of Dilating. Of Contracting. is the generation of the Vital Spirits, and influent heat; The second, without the which the first cannot perform its office is the Pulse, namely the motion of the heart and of the Arteries, consisting in dilating and contracting, that so the Vital Spirits may be generated and distributed, and the natural heat may be preserved in its natural harmony: By Dilatation the heart is filled, and attracts to its self air, with blood from the right Ventricle, by the Venous Artery (which goes from thence to the heart) and attracts from the lungs air and blood by help of the Arterial Vein into the left Ventricle of the heart; for the generation and refreshing, and restauration of the Vital Spirits and heat. By the Systole or Contraction of the Heart, it distributeth the Vital Spirits and Arterious blood through and by the help of the great Artery into the whole body, and sends the fuliginous excrements to the Lungs by the Arterial Vein. In like manner the Dilatation of the Artery through its little Orifices, terminating in the skin, attracts to itself ambient air to form and cool its heat; the Orifices that are terminated near the Heart, draw from it the hottest and thinnest blood, full of Vital Spirit; But as the mouths of the Arteries with the Orifices of the Veins, do draw the purest and finest Spirits to fostet and cherish their heat, but by Contraction they expel fuliginous excrements, which action is called a steaming through or transpiration, which is made through the hidden Pores of the skin, and by the Latins is called Transpiratio. In the third place the Irascible faculty belongeth to the Vital faculty, The Irascible faculty. from whence, Anger, Joy, Fear, Sadness, and terror, and other passions of the mind arise. And that its residence is in the Heart is most evident, because the motion of the Heart and the Pulse of the Arteries are most evidently changed in the passions of the mind. Respiration is also added to the Vital faculty as principally necessary to further its action, Breathing. and hath the same end and purpose, as the Pulse hath, and is instituted for the benefit of the Heart. It is performed principally by the Lungs, and the Lungs are as it were the fan or bedows of the Heart, and are the primary Instruments of breathing, and are endued with a peculiar power of moving themselves, even as the Heart is, differing only from the Animal faculty. Nor are the Lungs moved only by the motion of the breast, but by their proper force and power. The motion foe the Lungs. And although the motion of the Lungs and Breasts are made together; yet neither are the cause of the others motion, but they therefore move together, because they conspire to bring one end to pass: for the Lungs are stretched that air may come into them, as into a pair of bellows drawn wid●, and are so much dilated and extended, as the dilating of the Breast will give way to; and on the other side the Breast is dilated more or less, as there is more or less air to be drawn in As the Pulse consists of two motions Dilatation and Contraction, A twofold motion of respiration. Inspiration, Expiration. so Respiration is performed by a double motion, Inspiration, and xspiration. By inspiration, the Lungs and Breast being ex●ended the air by the mouth and nostrils is drawn in: by expiration the Lungs and Breast being contracted, the hotter air and fuliginous vapours are sent forth at the mouth and nostrils. CHAP. XII. Of the Animal Faculty, and first of the external senses. THE Third sort of faculties and actions in man, The Animal faculty. Physicians call Animal faculties, which either are resident in the brain, or derived from it, and takes necessary helps or the performance of its actions from adjacent parts. They distinguish the Aminal faculties, into the sensitive, motive, and Princes, and under the sensitive only the external senses are comprehended; under the Princes, the internal and rational power is involved: we will handle them in this order; first we will treat of the external senses, afterwards of the internal and rational faculties, at last of the appetite and moving faculty. The external senses are five. The external senses are those by which we perceive and judge sensible external objects, without the precedence of any other faculty. But that a perception may be made four things ought to concur, first the mind perceiving, secondly the instrument which is double; first the Spirit, secondly the member, wherein the sense is; thirdly the object or perceptible things, fourthly the medium interceding betwixt the instrument and the object. The external senses are five, Seeing, Hearing, Smelling, Tasting, The five external senses. Seeing. Touching or Feeling. The Sight is an external sense, discerning and knowing by the benefit of the Eye, the several kinds of visible things; whose adequate Instrument is the Eye; the Eye consists of divers Tunicles, the adnate or conjunctive, the Horny, the Grapy, in the middle whereof is a round hole, which is called the Pupil, and is the inlet and window as it were of visible Species; then the Tunicle in manner of a Net, the Pannicle without a name, the Cobweblike and the Vitreous Membranes; three humours, the watery, Crystalline, and Vitreous; a nerve optic and muscles. The object of sight is whatever is visible, to wit, colours, which are visible in potentia, in that they are capable of being seen, but in action to be visible light is required. The medium is any transparent and diaphanous body. Hearing is an external sense, Hearing. perceiving by the benefit of the ear any sound that is audible; the adequate instrument, or that without which a sound cannot be heard is the Ear, but especially as Galen teacheth in his first Book and third Chapter, of the causes of Symptoms, the term and exrremities of the Auditory Pores, where the end being dilated, the Auditory Nerves receive part of the sound. The Object is whatever is audible, or sound: the medium which it is conveyed through, is water and air. Smelling is an external sense discovering smells by the benefit of the Nose, Smelling. or mammillary processes. It's adequate instrument are the Nostrils, but principally the mammillary processes; Its object odours, the medium by which odours are conveyed, is air, and water. Taste is an external sense, Tasting. perceiving savours by help of the tongue; It's proper Instrument is the Tongue, a thin flesh soft and spongy, like to no other part of the body; the Object is savours, the medium a spongy skin, or porous cover of the Tongue, and spitly moisture. Touch lastly is an external sense, Feeling. discovering by the benefit of a membrane all Tangible bodies. But though the skin be the chiefest instrument of the sense of feeling, and covereth the whole body, that it may descry external objects and injuries happening to the body, and the skin in the hand be the chiefest rule to try all tangibles: yet there is no adequate Instrument of touch; since it is more largely diffused, and other parts are likewise endued with that sense. But the adequate organ that is of touch is a membrane; For wheresoever a membrane is there may be a touch, and wheresoever a membrane is not, there cannot be a touch, and the skin itself obtains that whereby it is sensible, as it participates of the fibers and little membranes of the Nerves. CHAP. XIII. Of the Internal Senses. THE Internal Senses are those, The Internal Senses are three. that are conversant about sensibles revealed by the external senses; and they are three, according to the diversity of their functions and operations, which are administered by them; The Common sense, the Fantasy and the Memory. The common sense is an internal sense, The common sense. perceiving all external objects by the help of the external senses, discerning them asunder, judging of their absense, and bringing sensible Species to the Fantasy. The Fantasy is an Internal sense, The Fantasy. which considereth more diligently, and longer retaineth the sensible Species received from the commonsense, and those Species that are form by itself. The Memory is that which receiveth and retaineth the sensible Species, which are known by the Fantasy, The Memory. and when occasion requireth exhibits and brings them forth again. But there are two acts of the memory, the one is called by the name of the faculty of the memory, the other is Reminiscence. The memory is a prompt apprehension or repetition of any thing heretofore known and perceived, as it was perceived and repeated and that readily. Reminiscence. Reminiscence is that which out of the remembrance of one or more things spoken of, by regression comes to remember that, which before could not come readily into the mind. The principle and immediate Instrument of all the internal senses, and of all principal actions is the brain, which other things show, but this especially; That if that be hurt these actions are hurt, and because that in curing these, the remedies must be applied to the brain. Now all these action are performed in the substance of the brain, nor are those faculties distinguished by their seats or places in the brain, neither are their distinct operations performed in distinct places of the brain. For there is not sufficient reason given why the common sense should be seated in the former part of the brain: for although it be the Centre where all the external senses meet and concur; yet the Nerves that are subservient to the external senses, take not their beginning from the fore most part of the brain. So no evident reason can appear to persuade why the Memory should be separated from the Fantasy, and by consequence from the reasonable faculty; and why the Fantasy in the former, the Rational in the middle, and the Memory in the hinder part of the brain should be placed; for the Imagination and Memory are conversant about the same things though after a different manner; But although oftentimes one of these faculties being offended the others remain unprejudiced, as oftentimes the Memory is lost, the imagination, and rational faculties not hurt, and on the other side the apprehension and ratiocination offended, and the Memory sound and perfect; yet that cometh not so much to pass through the diversaty of organs, parts of the brain from whence those actions arise, as by the change of their proper dispositions, and of those things which are required to perform those actions. The affections of those senses hitherto explained are sleep and watchfulness. The affections of the senses are two. Sleep. Sleep is a cessation of the natural and commonsense, & of the external senses ordained for the health of living Creatures, by detaining of the Animal Spirits in the brain, & hindering them from flowing to the Instruments of sense and motion. The causes that bring it to pass that the Animal Spirits flying into the brain, are there detained, and are as it were smitten and cease, are several, whereof some perform it by taking them away, as watching, labour and other things in the like nature; or by rendering them less movable and, benumbed, or as others conceive by penning in, and stopping their way as vapours ascending after taking of meat and drink, or as it were pleasingly and contentedly stopping, inviting from motion to rest, which sweet melodies, murmuring streams, gentle rocking and the like occasion; The end of sleep is the refreshing and strengthening of the Spirits and external senses, by taking away their motions and operations, and from hence comes a recovery of their strength and vigour. Watchfulness is opposed to sleep, Watching. and it is nothing else but the efficacy or force of sense, or solution rather of the senses, proceeding from the hindrance of the free flowing of the Animal Spirits into all the members of the body. Man waketh or is stirred up out of his sleep after a twofold manner; Either of his own accord, when concoction is performed, the vapours that hindered the Spirits coming forth are discussed and separated, or sharp vapours are carried to the brain and trouble the Amimal Spirits, that they cannot freely flow into the instruments of the senses; or by an external cause, when from a more violent external cause, as Clamour, or touch, the sensitive faculty being stirred up converts its self to perceive. Nor do the organs of the senses wholly want Animal Spirits in sleep, but some stil● remain in them, sufficient to discern more vehement objects. CHAP. XIV. Of the Intellective Faculty. AT length we come to the understanding or rational faculty, whereby a man is elevated above other living Creatures, and is near to, and as it were like unto his maker. The understanding abstracts things from their matter, and without considerations of matter, without quantity, without figure, knoweth things, undersands things freed from their matter; it is almost capable of infiniteness, it reflects back upon its self, and knoweth itself, and understandeth that it doth understand, and because of that it hath an unatiable desire of the knowledge of eternity and blessedness. It performs its functions without all corporeal instruments; yet it hath ●eed of the Fantasy as its object to understand, and the Imagination supplies the mind with intelligible matter; And therefore although it have not its seat in the brain, as in its organ by itself; yet because it worketh by the help of the Fantasy, and it behoveth the understanding to watch the Imagination, by accident and by the consequence its seat is appointed, where the imagination is, namely the brain. The reasonable soul comprehends two faculties, The Understanding. The Will. the Intellect whereby we apprehend things, and the Will whereby we are carried to choose things which we understand under the notion of good; And things, as they are beings, we know them; and as they are good, we desire them. CHAP. XV. Of the desire and moving faculty. BEsides the knowing faculty, Appetite twofold, sensitive; rational. there is given to man an appetite and force of moving; The Object of man's appetite is good, whether it be really so, or seemingly so. The appetite is twofold, sensitive and rational: sensitive is that which desires that which seems good to the senses, rational is that which desires that good, that seems so to reason, and the motions of the sensitive faculty are often resisted by the motions of the rational faculty, and there ariseth strife & discord betwixt the sensitive & rational faculty. Out of the appetite, as its actions, arise the affections and passions of the mind, as we call them. Voluntary Animal motion follows the desire, Voluntary motion. for after that an external object is brought by the external senses, and common sense to the Fantasy, it is known as profitable, and acceptable, or as hurtful, displeasing. Love, or hatred followeth this knowledge, or th● desire of what is pleasing, and flight of what is displeasing. Motion presently follows the desire in brute beasts, but in man there is t●● Judgement of the intellective faculty, which values what is truly go● and what hurtful. The motive faculty. Then the motive faculty follows that motion which is commanded by the rational or sensitive faculty, as the o● or the other over-ruleth, by the contraction of the muscles the ad● quate Instruments of motion, which draw the tendons, these t● bones, and they being moved, the members and whole body is ca● tied from place to place, either to accept of what is grateful, or to resist and fly from what is hurtful. But although a muscle be the adequate instrument of motion yet the chiefest part of it consists of fibers or small strings, The Instrument of motion. which being contracted, the muscle is contracted and motion performed Although their be four different motions of the muscles, while● they are contracted, or extended, or moved transverse, or remai● straight, as Galen says in his first Book of the motion of muscles an● eighth Chapter, or as others explain it, contraction, conservation o● contraction or tonic motion, relaxation, and perseveration of relaxation: yet contraction only, to which tonic motion belongs, is the proper action of the muscles; but extension which is a passion rather than an action, is not the immediate cause of motion; for whilst a muscle contracted by its opposite muscle is extended, it suffers, it doth not act. THE SECOND BOOK. PART I. OF DISEASES. CHAP. I. Of the nature of a Disease. WHereas we have hither treated of those things that are incident to the body according to Nature, Thingspr●ter-natural how many. and so have discoursed about health; now I will speak of those things that are preternatural or contrary to Nature, (for I do not intent to make any distinction betwixt these) They are in number three, a Disease, the cause of a Disease, and Symptoms: in the handling whereof the Pathological part of Physic is delivered. And first for what belongs to a disease; Although as the name of health is generally attributed to all things that happen to a man according to nature, so the name of a disease is given to all things that befall a man contrary to nature, and those are said to be morbific: yet if we may speak properly, these three, a Disease, the cause of a Disease, and Symptoms, as they differ in the thing, so they may be discerned by their names also. But whereas a disease is conrrary to nature; The formal reason of a disease. but health is that power of acting which is to be performed according to nature: a disease is an impotency of performing natural actions; and as those who are apt to do those things which are according to nature, are said to be sound; so those are deservedly said to be sick, who are unapt to perform those actions. Moreover the Subject of a disease, as also of health, The Subject of a disease. is only the living parts of a body, as being those to which alone a power of undergoing natural actions is given; But all those things which are not in the number of the living, as humours and other things, which are not able to perform natural actions in a man, cannot be the subject of a disease. The cause of a Disease or of impotency to perform actions, is an ill constitution of the parts, The causes of a disease. The definition of a disease. The galenical definition of a disease. as the cause of health is a right disposition of the same. Hence a Disease is defined to be an impotency of the living parts of man to perform natural actions, arising from their constitution contrary to nature. Although according to Galen also to be sick, is not to be able to operate, and so this definition is not contrary to the sense of Galen: yet that out of the definition of diseases, differences, and profitable observations may the better be drawn, Galen retains the same terms of the definition, but places them otherwise, and in the second Chapter of the differences of Diseases, defining a Disease saith; That a constitution of a vicious function contrary to nature is the cause thereof, and in his first Chapter of the differences of Symptoms calls it a disposition contrary to nature, by which action is hurt. Namely as health is a certain quality, or harmony in the qualities in magnitude, number, figure, and other things neceslary for the constitution of each part, by reason whereof the body is disposed, and made fit to perform natural actions. So a Disease is such a quality by reason of which the same body is rendered unfit to perform the same actions. Diathesis what it is. For the word Diathesis taken generally signifies every quality according to which a man is well and ill disposed, whether it be easily or difficultly taken away. And therefore as certain later Physicians will have it, A Disease is not only a privation. a Disease is not simply the want of health, and nothing positive, but such a want as proceedeth from a disposition contrary to that disposition, on which health depends, which is wholly something positive, and when a part is wounded or diminished, a quality and disposition is brought into it contrary to that which was present there before in time of health: as a hand that is wounded, is otherwise difposed then that which is well, and that which hath four fingers, otherwise then that which hath five. In brief; a Disease consisteth not only in privation of a good constitution, but in a contrary and vicious constitution. CHAP. II. Of the differences of Diseases. THE differences of Diseases are twofold; The Essential differences of diseases. Essential or Proper, which are taken from the essence itself of a disease, and so agree to one kind that they cannot be common to another; or accidental, which are taken from those things which follow the essence of a disease, and from other circumstances. But because as 'tis said before, there is one natural constitution of the similar parts, as they are such and another of the organic, and a common Unity in them both: the regression from that natural constitution of every one affords several kinds of Diseases. First therefore, Diseases of the similar parts. the proper Diseases of the similar parts are Diseases of Intemperature, when that due proportion of the primary qualities is not observed, but when one doth excel the other three, or two overrule the other two, contrary to nature. Moreover there are found in similar parts Diseases of hidden qualities, or of the whole substance, as they call them; when there is not only in the constitution of the similar parts, a due congruity of the primary qualities, but a certain disposition also of the occult qualities is requisite. Secondly, Diseases of Organic parts. there are so many signs of Organic Diseases as we have said, are requisite for the composition, and constitution of an Organ; namely four, Diseases of Confirmation, of Number, Magnitude and Composition. Lastly, the third kind of Diseases, Common to both. which are common to them both; They call solution of Unity, or continuity. CHAP. III. Of Diseases of Intemperature. Disease's of Intemperature, as is said, Diseases of Distemper. are when that due proportion of primary qualities is not observed, which ought to be, but either one overcomes the other three, or two the other two. Whence one distemper is said to be simple, another compound. Simple is that wherein one quality exceedeth, and this according to the number of the four qualities is quadruple, hot, cold, moist, dry. Compound is that wherein two qualities exceed, and this according to the quadruple mixture of the primary qualities is , hot and moist, hot and dry, cold and moist, and cold and dry. And so in the whole there are eight Diseases of Intemperature. But these distempers are again distinguished divers ways, Distemper without and with matter. which distinctions nevertheless produce not new kinds but differences, which are found in many differing in kind. For first, one distemper is with matter, another without matter. Intemperature with matter is when it hath a humour joined with it, and is cherished by it; Distemper without matter, is that which is cherished by no preternatural humour, as when heat is sent into any part from the fire or heat of the Sun. Moreover one distemper is equal, another unequal: Equal intemperature. equal is that which is a little and equal in all living parts, and affects them all alike, Unequal. and equally: Unequal, is that which is more intense in one part, and more remisle in another, and affects one more, another less. For since that the members of our body are constituted of many particles, it may come to pass, that all may not be equally affected by the altering cause, but some more, others less, whence an unequal distemper ariseth. But if the action thereof proceed so far, until that all are altered and affected equally, that is an equal distemper; Whence an unequal distemper is joined with pain and trouble, as being that wherein the part is as yet to be altered; but in an equal distemper no pain, nor molestation is perceived, as being that wherein the part is already altered, and the Intemperature becomes as it were familiar and domestic. CHAP. IU. Of Diseases of the whole substance or of hidden qualities. IT is a controversy amongst Physicians, whether there are any other. Whether there are any Diseases besides those of Intemperature. Diseases in the similar parts, besides those of Intemperature. Truly the ancient Physicians make no mention of them; but the Modern do and principally Fernelius in Lib. 1. Pathol. Cap. 2. and Lib. 2. of the Hidden causes of things, Cap 9 and afterwards he largely endeavours to prove that there is yet another kind of Disease besides Intemperature in the similar parts, and that is twofold: the one is of the whole substance; the other in the matter, which may be seen in the forequoted places. But 'tis not our purpose largely to reckon up the opinions of others, for this Epitome will not permit it. But that we may briefly propound our opinion, There are Diseases of hidden qua. lities. The reoson. we determine that there is another kind of Disease in the similar parts, besides Diseases of Intemperature, being so persuaded for these reasons; first, because every agent which acteth, desires to make the patiented like itself. But there are agents from the whole substance or such things, whose actions can be reduced into no manifest quality, and which are beyond the power of Elements, as elsewhere is proved: It necessarily follows that those agents from the whole substance, whilst they bring in Diseases, and act in our bodies, do not change the primary, but Occult qualities, and introduce Diseases agreeable, and correspondent to their nature. Also because contraries may be cured and resisted by their contraries: But the whole substance, or things acting in Occult qualities cure many Diseases; It necessarily follows that their are such Diseases to which such Medicines are opposed: and unless there should be certain Occult Diseases, in vain are Medicines invented which act in the whole substance. Thirdly, since there are actions hindered or hurt which neither can be referred to any Disease commonly known, nor to any external error, as may appear in the plague and other Venomous Diseases, hence we may well conclude that there are other Diseases of Intemperature, from whence these kind of mischiefs happen. But which and what those Diseases are is likewise controverted. We setting aside the opinions of others determine, Which are Diseases of the whole substance. those Diseases of the whole substance, or of hidden quality, to be those which consist in a certain occult, and malignant disposition of the similar parts, and to be no other than such whose mischiefs cannot be referred to the primary, qualities, and such as the agent cause excites, which is endued with a malignant, venomous and occult quality, and which are cured not by primary qualities, but by those things which are said to act in the whole substance. But Diseases of matter which Fernelius brings there, Whether there be ary Diseases of matter. are no new Diseases of similar parts, but either Organic Diseases, as softness and hardness in parts, wherein they ought not to be such, or Symptoms, or causes of Diseases. CHAP. V Of Organic Diseases. THE second kind of Diseases, are of the Organic parts, Organic Diseases. which in general are called Evil composition; namely when the natural constitution of the parts, as they are Organic is vitiated, which although it may agree also to the similar repears, yet it happeneth to them not as they are such, The difference of Organic Diseases. but as they are Organic. Again the differences hereof are so many, as there are qualities belonging the natural constitution of an Organic part; Nemely, first a definite number of the parts constituting, than a convenient magnitude of the same; Thirdly a due framing, or conformation; which comprehends a decent figure, cavity, or solidity, and smoothness and roughness, and such like qualities. Lastly, 〈◊〉 is also necessary that every part may enjoy its own natural place, and be joined with those which it ought. Therefore from all and every of these things, which belong to the constitution of an Organic part, since a regression may be made to the state that is contrary to nature, there ariseth so many kinds of Organic Diseases also, namely Diseases of Number, ●●●nitude, conformation and composition; But if you would divide Diseases of conformation into those three or more, which belong unto them: namely Diseases of figuration, of cavities, and of superficies, and secundary qualities, there will arise six kinds of Organic Diseases; which moreover, if you are pleased to divide Diseases 〈◊〉 composition into those of situation and of connexion, there wi●● arise seven kinds of Organic Diseases. CHAP. VI Of Diseases of Conformation. A Digression from the natural conformation causeth Disease of conformation, How many Diseases of Conformation. but seeing that three things are require● to the natnral conformation of an Organic part, a convenient figure, hollowness of passages, smoothness and roughness of the superficies, there are also three kinds of Diseases of conformation constituted in figure, cavity, and superficies: But because other qualities are required also in some Organic parts, besides smoothness, and roughness; namely that some may be soft, others hard some thin, and full of pores, others thick, some coloured; other void of colour, some dark, others perspicuous, and the change 〈◊〉 these qualities breed Diseases, because when these qualities a●● changed, the Actions of those parts are hindered. A Disease in regard of figure is when the natural figure of a part is so vitiated, Diseases in figure. that by reason of it the action of the part is hurt; namely when those, which are strait are made crooked, or otherways disposed contrary to nature; those are affected with such Diseases which we call crook legged, when the legs bend inward, crook-legged outward; such as are disfigured with the small pox, splay-footed; to these belong crook backed, and flat-nosed persons. Moreover Diseases of conformation are when the passage, How many Diseases ●f Jassages. through which matter passeth from one place to another, such as are the throat, wind pipe, Veins, Arteries, Nerves, Ureters, Guts, Pores o● the Skin, Cavities, and Receptacles, such as are the stomach, bladder, womb, when they are affected. As for Diseases of the passages, they consist either in number, or multitude, or differ from the natural condition in magnitude; Excess and Defect in multitude, in magnitude. The difference of opening of Vessels. and again both of them either in excess or in defect. Excess in multitude of passages, is when there are more pores, o● ways then there ought to be according to nature. Defect in number is, when they are Fewer than they ought. Excess in magnitude is when any way or passage is dilated more than it ought; Defect in magnitude is when 'tis become straiter than is fit. To excess belong those infirmities which are called Anastomasis, Diapedeses, and Diairesis. Anastomasis is when the mouths of the vessels are opened and dilated too much. Anastom Diaped. Diairesis. Diapedeses is when the Tunicles of the vessels are become so thin, that the humours may as it were sweat through them; Diairesis is when from some cause that happens by Erosion or by breaking, some passage is opened which ought not. That Diairesis, which is made from some incident cause, or by breaking, is called (in Greek) Rexis, that which happens by Erosion is called Diabrosis. Defect on the other side according to the variety of causes that occasion it, is , Obstruction, Constipation, Coalescence, The differences of narrowness of Vessels. Obstruction Constipation. Compression, Descension. All which in general are called straitness of passage. Obstruction, which the Greeks call Emphraxis, is when some passage is stopped either by plenty of humours, or thickness of them, or clotted blood, or Gravel, or such like. Constipation which the Greeks call Stenochoria, is when a passage is stopped by some tumour in it, Compressure which the Greeks call Thlipsis is when a part is pressed together by some external matter. Coalescence is when (after an Ulter) the sides of the passage grow together. Coalescence Subsidence in the Greek Sunizesis, is, Conjunction and Constriction. when the parts of the vessels consent as it were in pressure and squeezing of themselves together, to which no constriction is added, when from some external causes, or by reason of cold the passages are contracted. Diseases of cavity are either in multitude, or magnitude: Diseases of Cavity. in multitude it seldom happens unless from ones nativity, there happen more or less passages in the body then there ought. In Magnitude passages offend either in excess or defect: excess of magnitude is too great dilatation of the receptacle, or cavity; defect in magnitude is when they are too straight, which is either from our first original, or afterwards, from repletion, compression, subsidence or constriction. Thirdly, Diseases of the superficies, Diseases of Superficies. are ruggedness and smoothness, for when according to nature, some parts are rougher, and others smother; if those which should be more rough become smother, or those that should be smother become more rugged, and so any action be thereby hindered from thence, ariseth Diseases of the superficies. Softness and hardness, as we said before, Softness and Hardness. Rarity, Density. may be referred to these Diseases, as when the bones which ought to be hard are become soft, or the tendons are so hardened, that they cannot be contracted. Also Rarity and Density, when a part which ought to be full of pores lose them, and become thick. Hitherto belongeth colour in the eye, Colour in the face. for although colour be not necessary for the conformation of other parts, yet that the eye may become the fit instrument for sight, it is necessary that it be so fashioned, that it may be fit to receive (for such there are) visible species▪ Therefore it is requisite that the horny coat, and the watery, crystal, and glassy humours of the eye be not only clear and transparent, Darkness. but without colour. If the eye lose this natural constitution, and that those parts which ought to be perspicuous and void of colour, are darkened or coloured, the sight is hindered, and visible species either are not received, or are received in a colour differing from their own. CHAP. VII. Of Diseases in Number. THE second sort of Diseases of Composition or Organic Diseases are Diseases in number; Of Diseases in number. for when there is a certain number of the parts compounding to make up the natural composition of every organ, how often soever that is not observed a Disease in number doth arise. A Disease in number is twofold, The difference of a Disease of number. Abounding. either in defect, when that is wanting which should be present, or in excess, when that is present which should be wanting. That which aboundeth is either to nature, as the sixth finger, or preternatural, as stones, and Worms are according to Galen; which nevertheless is disputable. Nor indeed are such things, since they are substances, as such Diseases; but as some conclude causes, by which an aptness and a certain disposition against nature is brought into the part, whether it be in respect of number, or passages, about which authors disagree. Deficiency in number, Wanting. is when there is a Disease by which either a whole part perisheth, or is wasted: those which are wholly wanting are clearly according to nature, nor can it be a defect against nature; such a Disease may they be said to have who want their number of fingers, or of teeth. CHAP. VIII. Of Diseases of Magnitude. THirdly, Diseases of magnitude. amongst Organic Diseases, are Diseases of Magnitude, when the natural bigness of the part is so altered, that for that reason it cannot perform its natural action. Diseases of Magnitude are twofold, either when there is an increase or a Diminution of Magnitude, according as the whole or part be increased or diminished. To the increasing of magnitude belong all tumours, and growth of parts contrary to nature; to diminition belongs leanness and wasting of parts. But because Diseases in Magnitude, and in Number, are sometimes complicate, therefore they are thus to be distinguished; If a whole part be wanting or abound, it is properly called a Disease in number. But if only some particles of a part be wanting, or that it be bigger than it ought, it is called a Disease in magnitude. Secondly, if with a portion of any organ many particles are taken away, a Disease is deficient in number, and diminished in Magnitude. CHAP. IX. Of Diseases of Composition. THE last kind of Organic Diseases are Synthetical, Diseases of Composition. commonly called Diseases of Composition; but although Avicen doth account all Organic Diseases, Diseases of composition, yet in this place we do not, we only take them for a peculiar kind of Organic Diseases. Since that two things are to be considered in Diseases of composition, situation and connexion; Twofold. Diseases of composition are of two kinds, the one is when the parts do change their situation, Diseases in site. In Connexion. which is called a Disease of place: The other is when they are not knit together as they ought, but they are separated which ought to be joined together, and the contrary, as when the eyebrows grow together, which are called Diseases of connexion or vicinity, others call them Diseases of consent, society, colle, iate. The most common Disease in place, is a losing of a joint, Luxation. the Greeks call it Exarthrosis, when the joints or heads of the bones go out of their hollow places or cavities. Yet other parts besides the bones go out of their places, which happeneth in ruptures, when the paunch or guts fall down into the Cod, or when by great wounds the guts come forth: also in the falling out of the womb, or of an eye. Another kind of Disease of composition is, when the parts are separated, that aught to be joined together; which happeneth if the bonds by whose intervene they are linked together are loosened, made longer or broken, which happeneth sometimes in the womb and other parts of the body; or it happens if those are joined together, that should be parted a sunder; as when one is tongue-tied, or the eyelids grow together, or two fingers grow together, or the fundament be closed. CHAP. X. Of Diseases of Solution of Unity. THE third kind of Disease is common to similar and Organic parts, Diseases of Solution of continuity. and is called Solution of Unity, when the parts which ought to be one, and continued, lose their continuity and are divided. There are many differences of Diseases of Unity, principally taken from the part affected, Their differences. and the causes dissolving Unity. Those things which dissolve Unity, some of them cut and prick, others erode, others bow and break, others beat in pieces. But the parts which are dissolved are either soft or hard; if a soft part be dissolved by a thing that cutteth, A wound. it is called by the Greeks Trauma, by the Latins Vulnus, i. e. a wound. But if a soft part be dissolved by a sharp instrument pricking, A puncture. Contusion. it is called a Puncture. But if a soft part be offended by a blunt weapon and a hard one, and be straitened within itself, it is called a Confusion, the Greek Thlasis and Thlasma. If a soft part be broken by any thing that bendeth it, Rupture. 'tis called a Rupture, and in the nervous parts peculiarly, it is called a Spasme. But if there be solution of continuity in a hard part or bone from any other cause then Erosion, Fracture. namely from cutting or contusion, it is called a fracture, Caries. in Greek Agma and Catagma; but if by Erosion it is called Caries, in Greek Teredon, i. e. rottenness in bones. If continuity be dissolved in soft parts by Erosion, An Ulcer. it is called Elkos in Greek, in Latin Ulcus (Anglice an Ulcer.) Lastly, An Apospasme. if there be solution of Unity of compound parts, and those which naturally are different from each other in kind are nourished and grow together, they are called Apospasmes, as when the skin from a membrane, the membranes from the muscles, and a muscle from a muscle are separated. CHAP. XI. Of the Accidental and common differences of Diseases. HItherto we have spoken of the effential differences of Diseases: The accidental differences of Diseases. there remains the accidental differences, which are taken from those things which follow the essence of a Disease, or from the subject, and causes, and other circumstances, and are also common to many. First, a body sometimes is sick of one disease, One disease. sometimes of another: and that is said to be one disease which only seizeth on one part, and offends its actions, or when one disease afflicts the whole body; but there are many diseases, Many diseases. which in a different manner affect many and different parts of the body. A disease which occupieth one part of a body, is either simple, A disease simple; compound. or compound. Simple, is when no other disease is joined with it. Compound, is when it is coupled with one, or more other diseases, in the same part, whether they are of the same nature, or of some other; but diseases which are knit together, not with other diseases, but with some grievous symptoms, are not properly called complicate diseases; Fernelius calleth them diseases of fellowship, Diseases of fellowship. Solitary. even as he calleth those that are neither joined with any other disease, nor with any grievous symptom Solitary diseases. As for diseases that are not joined together in one part, there are many, they are divided by Fernelius into separated, and implicit; connexed and consequent. Separated are such as consist in divers parts, Separated. which neither have common use, nor action, neither do they communicate the affect by turns from one part to another: as, the Podagra, or Gout in the foot, the Ophthalmie, or Inflamed Eye. Those are called implicit diseases which afflict divers parts which have one common use, and action, In plicite. as if divers parts of the breasts are afflicted. Moreover, he calleth them connexed and consequent diseases, Connexed. when one disease is the cause of another, which principally cometh to pass when one part communicates its effects to another. Secondly, from the manner of generation and subsistence, Making. some are called diseases Making, others Made. Diseases Making are such, Made. that although they are produced out of their cause, and now are; yet they cannot subsist without their efficient cause, but their cause retreating, they also withdraw from their subject. Made diseases may continue, though their efficient cause be taken away. Thirdly, in respect of the subject, Universal. Particular. one disease is called Universal, which afflicts the whole, another particular, which affects any part of the body, another external which occupieth the outward parts of the body; another internal which possesseth the inward parts thereof. Some diseases also are congruous, such as are agreeable to the Temperament and constitution of the body; Others are Incongruous, and disagreeable to the Temperament, and constitution thereof. Of Age. Fourthly, in respect of age, some are diseases of Infants, others of children, Sex. others of boys, others of youths, others of young men, others of middle aged men, and others of old men: as also in Relation to sex, some of Males, others of Females. Fifthly, By the being of a thing. By consent. diseases some are by Idiopathy, or Essence, others by sympathy, or consent. A disease by essence is that which hath its beginning, from a cause begotten in that place wherein the disease is stirred up. By sympathy, or consent is that which is stirred up by matter severed from the part, where the disease is. Sixthly, Legitimate. Spurious. some diseases are legitimate, others Spurious, Legitimate are such as proceed from one simple and only cause; Spurious are such as proceed from mixed humours. Seventhly, some diseases are inherent to man from his first beginning, others happen to him after he is begotten. Those which come from our first beginning, Hereditary are twofold; first, hereditary whose causes, and dispositions are derived from the seed and menstruous blood of the parents to their children; and cause a disease, in them which they were troubled with; secondly, from ill conformity some evil may happen to the child, Congenite. from its first beginning, although the parents beware not troubled therewith; and therefore all diseases communicated to man from his generation are not Hereditary. They seek a knot in a bulrush, who think such recess from the natural state and condition, Whether a Congenite deformity he a disease. ought not to be called a Disease, but a salt; and they conceive that not every defect, and regression from the natural state; but those only they think, aught to be called diseases of defect, which are defects of perfections which they once had. But a Disease is not only a privation of perfection once had, but to be had, which agreeth to every one of the Species: and as a man is said to be sound, which hath that perfection in all the parts of the body, which ought to be in mankind; so he may be said to be born sick, to whom any of those perfections are wanting. Eighthly, Contagious. Not contagious. Common. some diseases are Infectious which transfuse their seed, and pullution into other bodies, and affect them with the same disease. Not Infectious, are such as cannot infect others with their venom. Ninethly, some diseases are spread, as when many diseases of divers kinds invade. Some are common, wherewith many are affected at the same time, with the same disease. These again are divided into Endemiall, and Epidemical. Endemiall Endemiall are (as it were) native, and genuine diseases, which often frequent one place, and afflict the inhabitants of one region by reason of their common and domestic cause: such is the Scurvy to the inhabitants of the Baltic Seas. Epidemical, are such as infect many from one cause, Epidemical. Diseases of the severll times of the year. but not genuine to that people at the same time. Tenthly, in respect of the time of the year, some are Vernal, some Estivall; some Autumnal, and others Hibernall, namely, such as are agreeable to this or that season of the year. In respect of the time of the day, some are called Diurnal, others Nocturnal. In the Eleventh place, some diseases are called great, Great. others small. A great disease is said to be such, either by its self, or by accident. A disease is said to be great by itself three ways; first, How manifold. in regard of dignity, when it hurteth the organs, and instruments, that are most necessary for the preservation of life, and in this sense, Diseases of Intemperature, amongst Diseases are of greatest dignity; Next those Diseases of solution of continuity; next to them diseases of composition: 2. By itself a disease is said to be great, in respect of its going back from its natural state, for by how much the more it recedes from that, by so much is it the more venement: 3. It is said to be great in respect of ill Manners, as when an ill quality is joined with it. By accident it is said to be great, in respect of the best part which it possesseth, in which regard a disease which otherwise was small, is said to be great, as a wound in the heart, or in the brain, which in musculous flesh, were not dangerous. 2. When it hurts the faculty that governs our body. In the twelfth place from the manner, a disease is benign, Benign. or malign: Benign is when besides its own nature, no grievous symptom is joined. Malign, Malign. is when it hath worse symptoms joined with it, than the nature of the disease affords of itself, from some occult qualities. Thirteenthly, in respect of duration, some diseases are short, Short. Long. some long, which soon terminate, or continue long, before they come to amend. Fourteen, some are acute, others not acute, Acute. Not acute. and all acute diseases are short, but all short diseases are not acute. That a disease may be said to be acute, 'tis requisite that it may not only be terminated in a short time, but may have some grievous symptoms joined with it, Which acute. that may speedily not without danger end it in health or death; For an acute disease is that which swiftly with violence, and danger comes to its height. Acute diseases are again distinguished into very acute, How manifold. simply acute, and such as degenerate from acute. The very acute terminate by the seventh day; the simply acute end by the twentieth day; such as degenerate from acute are extended beyond the twentieth, even to the fourtieth day; But all those diseases that are extended beyond the fourtieth day, are Diurnal, and chronical. Fifteenthly, Salutary. Deadly. in regard of the end, some diseases are salutary, which terminate with the health of the sick, others mortal, which destroy the sick; and both either absolutely, or secundum quid. Simply and absolutely, those are Salutary that terminate with the perfect health of the sick; Mortal, are such as kill the sick; on the other side, salutary and deadly may be such, secundum quid, when they terminate in health; but not sound and perfect health. Sixteenthly, Continual. some diseases are continual, which continually afflict, and intermit not, in the whole term of their duration. Intermitting, Intermissive. Ordinate. Inordinate. are such as have certain periods, and do sometimes intermit, or cease between while. Seventeenthly, some are ordinate, which afflict at certain times, which the Greeks call at Periods, as Tertian, Quartan Fevers: Inordinate, are such as observe no certain periods. CHAP. XII. Of the Times of Diseases. SUch as age is said to be in living creatures, time is said to be in diseases. The times of discases. For as animals are first generated, thence increased, and come to their perfection and state, and then waste, and lastly die, so diseases have their beginnings, increase, vigour, afterwards they decline, are lessened, and at length vanish. The times of diseases are twofold, Universal. Universal, and Particular. Universal times are said to be such wherein the course of the whole disease is included; for since there are diseases which have certain Intervals, Particular. and again new fits, or certain extentions, and remissions; Particular times are limited by the end of the fit. The Universal times are four. Universal times how many. Beginning. Increase The beginning, The augmentation, The state, and Declination. The beginning is that time, when the morbifique matter of the disease is yet crude, and no signs of concoction appear. The augmentation is when the symptoms become grievous, and the signs of concoction begin to appear in such diseases, as tend to recovery of the sick, or contrary signs in those that are mortal. The state is when the greatest contention is betwixt Height. a disease, and nature, and when all the symptoms are most vehement. The Declination is, when a disease beginneth to abate, Declination. being conquered by nature. But all diseases have not these four times, but such as tend to health only; in deadly diseases, the sick (nature being overcome) may die either in the beginning, increase, or state, for such come not to the declination, for no man ever died in the declination of a disease. In the same manner Particular times may be limited, Particular times. and every course hath its fit, which course Remissness, or an Interval follows. A fit hath its beginning, increase, state, and declination, which Particular times may happen during the Universal times. The end of the first part of the second Book. THE SECOND BOOK. PART. II. Of the Causes of DISEASES. CHAP. I. Of the Causes of Diseases. SEeing that nothing can perfectly be known unless the causes thereof are known whither can diseases be avoided unless the causes are shunned; neither can the same be taken away, unless the causes if they are present, be first taken away: We will now treat of the causes of Diseases. Although by the Philosophers there are rightly constituted four kinds of causes, The sorts of causes. the Material, Formal, Final, and Efficient; yet here we are to speak only of the Efficient causes of diseases; for the form, such as accidents have, is already explained. Diseases have not matter unless it be the subject wherein they are inherent; The Physician treats of efficient cause. The causes of diseases are fourfold. The proximate. The remote the end also is not since they arise from the want of perfection, and therefore Physicians when they handle the cause of diseases understand the efficient cause only. But Efficient causes of Diseases are considered either in respect had to a disease and a body, or absolutely, and as they are things which can take upon them the nature of mortifique causes. If causes as they are referred to a disease, or its effects, they are considered thus; first, one cause is proximate and immediate, another remote. The proximate is that cause betwixt which and the disease nothing intercedes. The remote is that betwixt which and the disease there comes another nearer cause. The proximate (since nothing can come to pass without a cause) is in all diseases; but the 〈◊〉 is not so. Secondly, since that of those causes which conduce to the generation of a disease, and indeed such as some matter doth exeite, Containing. some are nearer, others more remote, and oftentimes there is a long rank of them: Physicians call some causes containing, others antecedent, others primitive. A cause containing, which is also named consummative, Containing. is that which proximately adheres to a disease in a body, and cherisheth it, and which being put the disease is, being taken away, the disease is taken away: so a stone is the cause containing of obstruction of the bladder. A humour in a turnour is the cause of increasing of Magnitude, but a cause containing and immediate, is not absolutely the same, for as much as all diseases have a proximate cause, since nothing can be done without a cause, but they have not all the cause containing; namely, these oak of a sword is the proximate cause of a wound, but not the cause containing. And those diseases only have a cause containing, which are joined with matter, and are cherished by it as tumors, obstructions, putrid Fevers. Yet you are here to be admonished that these things which are here spoken of a cause containing, as also of the differences of other causes, are all spoken of in respect of a disease, defined by Galen, per dispositionem, or casually as they say; for in respect or this, not all but some diseases only have a cause containing. But if a disease be defined formally and through impotency, all diseases whatsoever have a cause containing, namely some vicious disposition of body. The antedent. The antecedent causes are certain dispositions lying hid in the body which go before a disease, and out of which a disease may arise. For although that be most properly called a cause which doth now act; yet Physicians call those things causes which as yet produce not any disease, so that they may produce them. Antecedent causes are defined not by the act, but by the power of effecting, so some vicious humour which lieth lurking in the body, produceth not a disease as yet; yet it may gonerate one, The primitive. How causes differ. The manifest evident. The manifest external. that is called the antecedent cause thereof. The primitive causes which anciently they called Prophasis, are such as move the antecedent in a body, and give occasion that they may become proximate causes; such are watch, cares, ange, too much exercise, and motion, and such like. But primitive causes and evident are not the same, for every Pro●atarcktick is evident or manifest, but every evident and manifest is not a Primitive, as a sword is the evident cause of a wound, but not the primary; for an evident or manifest cause is whatsoever produceth a disease in a manifest manner, whether it be immediate or remote, but the primitive can never be the proximate, but always requires preceding preparation of the body, and a nearer cause in the body which it may move. Nor is the primitive cause the same with the external; for external is only in respect of the body, and every thing which is without the body, after what manner soever, it produceth a disease, it is called an external cause, but Primitive is spoken in respect to other causes, and is that which stirreth up and moveth the hidden causes of the body, either within the body or out of the body; whence Sleep, Watch, Passions of the mind, and other causes which are in the body, are named primitive, not external. Thirdly, Evident causes. Occult. some causes are evident, others hidden, and obscure: evident and manifest are such as are obvious to the senses, neither is there need of any other signs to know them by. Occult and hidden are such as lurk in the body, and require signs to be known by. Fourthly, Internal. Externall. some causes are internal, others external; internal are such as are within the body, external are such as are without the body. Fifthly, Perseus By accident. some causes are by themselves, others by accident. Causes by themselves are such as produce dieases by their own proper force and violence, and not by the assistance of other causes; so fire heateth, water cooleth. A cause by accident is when it performs aught by the intervening of another cause, and not by its own force; so cold water by accident is the cause of heat, whilst by its binding, and closing the pores of the skin, the hot exhalations are detained within, which otherwise would evaporate by insensible transpiration. Also some causes are common, Common. Proper. Positive. as Air, Meat and drink, when many use them in one place; others are proper which are peculiar to certain men. Lastly, some causes are positive, others privative; positive are such as by their presence produce an effect like themselves, Privative. after which sort water cooleth. Privative are such as by their absence produce an effect like themselves; so heat returning to the internal parts, and leaving the external, is the cause of refrigeration of the outward parts. CHAP. II. Of things which are the Causes of a Disease, and first of Non-naturals. MOreover the efficient causes of Diseases considered absolutely, or as they are such; all things are the causes of Diseases, which can hurt the natural constitution, and turn it into a preternatural: and such things are either without the body, or within it. Things that are without our bodies, are either necessary, External Causes. and to be suffered by all, and none can avoid them; or not necessary, but may be avoided. Of the first sort are those things called non-naturals, and are in number six, Air, Meat and Drink, Necessary. Unnecessary. Non-natural things. Sleeping and Waking, Exercise and Rest, Repletion and Inanination, and the Passions of the Mind; whereof the four latter are rather to be called evident then external. Things befalling us not necessary, are those that wound us, knock us, or in such like manner hurt our bodies, which befall us by chance, which are not included within a certain number. But both those, as well necessary as unnecessary, Four ranks of things non-natural. Those which are taken. Which are carried. may be reduced to four heads; those things which are taken in, those which are carried; those that are put out and retained; and lastly, those that befall us externally. Under the notion of those things which are taken, are comprehended Air by breathing, Meat and Drink, and Medicine inwardly taken. By those things that are carried about, we comprehend all the motions of the body and mind, of what kind soever; such as the perturbations of the mind, anger, grief, joy, sleep, waking, rubbing the body, navigation, the course of our lives, and such like. By Excretion and Retention is understood whatever is thrown out of the body; such are the Ordure, Urine, Which are retained and rejected. all sorts of Humours, Seed, Menstruis; for these as those that are emitted, altar the constitution of the body, belong to those which are called Excretions; and the same when they are detained, are referred to Retentions. Moreover those things that externally happen to us, Those which happen outwardly. comprehend them that encompass us, as the Air, Baths, and those things that are applied to our bodies; as Garments and Cover, Oils, Unctions, and such like. Lastly, those things that by force and impulsion befall us, as Wounds, Contusions, and such like; but since there is no certain number of them, we will only speak of non-naturals, as they are the causes of Diseases. First from the air is made a great alteration, Air. as being that wherein we continually live, and without which we cannot live a moment; for it altars us in a twofold manner; namely, as we draw it in by breathing, and as it encompasseth us, and by the Pores penetrates us, and communicates that distemper which it hath to our bodies; The effect of hot Air. for the hot Air heats our bodies, dissolv● humours, melts, attenuates, increaseth choler, and whets, inflames the spirits, so begets hot Diseases; for by calling forth and dissipating the natural heat, it weakens the concoction. The cold Air, Of Cold. Of moist. on the contrary, cooleth, condenseth, closeth the Pores, thickens the humours. The moist moistens the body, hapeth up superfluous humours, drives out the natural heat, generates crude distillations, especially joined with cold. But if joined with heat, Of dry. it is the greatest cause of putrefaction. Dry Air dries our bodies, and being joined with heat, burns them. First the constitution of the Air depends upon the season of the year, The constitution of the Seasons of the year. Of Wind and of Situation. Pestilent Air. whereof the Spring is temperate, the Summer hot and dry, Autumn cold and dry, Winter cold and moist; and hence several Diseases happen at the several seasons of the year; of which Hypocrates in the third of his Aphorisms, 4, 5, 6.7, 8, 9.10, 11, 12, 13, 14, 15, 16, 20, 21, 22, 23. The winds also conduce to the alteration of Air; so do Countries and Situations, of which Hypocrates 3. Aphorism, 15, 17. And in his Book of Air, Water, and Places; and it doth not only affect our bodies with primary qualities, but impresseth in us a malignant and pestilent disposition (if it be infected therewith) and can communicate to us those effects which it hath, and so excite malignant and epidemical Diseases in us; of which is spoken in the doctrine of malignant and pestilent Fevers. Secondly, Meat and Drink. It offends in quantity. Meat and Drink, if either it be taken in too great measure, or be unwholesome, or if any fault be committed in the taking of it, may be the occasion of many diseases. Diet then offendeth in quantity, manner of taking it, and quality; for if too great a quantity of meat stuff the stomach, it cannot be well concocted, but sendeth abundance of vapours to the brain, which offend it, and is the cause of divers fluxes of Rheums; and when the error of the first concoction is not corrected in the second, that Crudity is the occasion of many Diseases which arise afterwards in the whole body; and as an immoderate quantity of meat and drink, is the occasion of many Diseases. So the want of them is hurtful; for thereby the good humours of the body are wasted, and the body dried, 1. Aphor. 14. In an impure body it stirs up ill humours, Manner of using. whence divers parts are ill affected; for it is hurtful to eat meat whilst any is unconcocted in the stomach: variety of meats is also hurtful. As for the qualities of meats, Quality. those which have in them certain qualities, by which they can alter our bodies, are called medicamental, and they are changed into humours of a like qualities with them, and in a sound body cause a like distemper; and in a sick body may introduce an unlike and contrary distemper; to wit, if they are contrary to the preternatural distemper, but if they agree with it, they increase it. Meats differ not only in the first qualities, but also in others, nay in the whole substance; some thick, others thin; some much, others little; some cause good Asiment, some bad; of which Galen in his books of the faculties of the Aliments, and in his book of good and evil Juice treateth; and we shall speak more in our fourth Book. Thirdly, sleeping and waking moderately preserve health, Sleeping and waking. immoderately destroy it, 2. Aphor. 3. For too much sleep hindereth the natural evacuations and excrements, and dulls the heat of the body, and so is the occasion of cold diseases, and principally of Distillations. On the other side, too much waking dissipates the Spirits, dries the body, and whilst the humours are kindled and become adust, they are of themselves the causes of hot distempers; and whilst they dissipate the Spirits, the native heat is weakened, and the radical moisture is consumed, and by accident are the causes of cold diseases. Fourthly, there is the same reason of exercise and rest; Exercise for idleness 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 cools 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 vicious humours, they being stirred are carried through the whole body, and stir up fevers and other distempers and symptoms. Fifthly, Passions of the mind, the affections of the mind make great alterations in the body; in anger the Blood and Spirits become extreme hot, and are hurried to the external parts from the internal, whence they inflame the whole body, and often kindle Fevers, and raise other Symptoms. 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 exterior parts, and fly to the heart, and suffocate the heart; sorrow by degrees dissolveth the Spirits, cooleth the Body, dries, spoils concoction, causes watch, and begets melancholy diseases. Lastly, Excretions and retentions. those things that are retained in, and sent out of our bodies, are the causes of Diseases; for if the profitable humours 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 fullness 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, containing, contained, 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, worms, 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 ways. 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 Plethoric and Cacochimick; The fault of humours twofold. Plethorie. for humours are either apt to nourish the bedy, or not fit: plenty of the one ●s called Plethoric, 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 than the strength can bear; to which Horatius Augenius adds this mixed 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 excess of other humours besides blood, Chachochimy. namely, when natural excrementious humours offend in plenty, or preternatural excrementious humours abound, and whilst either these or those putrify, 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 only 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 vicious ones. Pure Chacochimy is, when there is too great plenty of ill humours, and no good blood with them; but when good juice aboundeth, and ill humours are mixed therewith, it is called a spurious Plethory, or Chacochimy, according as blood and ill humours do more or less abound. There are many causes of Plethory, as plenty of Diet supplies matter to cause it; nourishment of good juice, 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, idleness, moderate sleep, a life without care and pains, suppression of accustomary evacuations of blood, Chacochimy according to the variety of excrementitious humours is manifold; The kinds of Chacochimy. for sometimes phlegm, sometimes choler, sometimes melancholy, and adust melancholy, and sometimes serous humours abound; of which humorsthere are again various differences. CHAP. IU. 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 juice, 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, unsavoury, The kinds of preternatural Phlegm. Unsavoury. sharp, vitreous, salt. Unsavoury 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 not where in man's 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 meats, 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 entrails 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 dryness; and as there is more or less of the salt humour mixed, so is it more or less hot. Lastly, Vitreous. Phlegm is vitreous, so called by Praxagorus, because in substance and colour it somewhat doth resemble melted glass; this is exceeding cold, clammy, and thick. CHAP. V Of Choler. Choler is threefold, The kinds of Choler. Alimentary, Natural, and Contrary to Nature; but the first is not an Excrement, but the hotter and drier part of the Mass of Blood, of a different nature, from that which is in the bladder of the Gall. Excrementious Choler is twofold, Natural, and Contrary to Nature. Natural is yellow, Yellow Choler. and is generated by Nature; and that only is properly called Choler: 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 drier 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 bluish green. The Vitelline is so called from the yolk of an Egg; Vitelline. it is yellow, hotter and thicker; it is generated of yellow and Choler, whence it is sometimes called roasted Choler: And there is another kind of Vitelline Choler, but not so properly so called, which is neither so hot nor so yellow, which is compounded of Phlegm and yellow Choler. Leekgreen Choler, so called, Leekgreen because it represents their greenness, which is often voided with the Excrements of children by the paunch, 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 'tis of a venomous nature, and it is hot and very biting, the likest to Verdegrease. The Aeruginous which comes near to the colour of rusty greenish Brass, is generated out of corrupt aliment, Aeruginous. when the heat is more vehement in the Stomach, in the Liver and Veins from the inflammation of the Liver, and the too great heat of the Veins. Lastly, Woad colour, Bluish green. or a bluish green Choler is more deep in sense then the Leek colour, and is caused by more adust Aeruginous Choler. Aliment hot and dry, Causes of Choler. affords matter fit for all the kinds of Choler, and especially sweet and fat things. A constitution hot and dry, hath regard to the Efficient cause, and those things that add to it are youth full age, Ait that is hot and dry, watching, anger, too much exercise of the body. CHAP. VI Of Melancholy. THe third is the Melancholy humour, Melancholy. which commonly is distinguished into Alimentary and Excrementitious; but Alimentary is nothing else then the colder and drier part of the Mass 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, 'Tis of a terrestrious and thick juice of every sort, especially being hardened with salt and fuliginous vapours, old Cheese, Cabbage, all sorts of pulse, as Pease, etc. a cold and dry constitution of air, cares, fear, sorrow. The black Melancholy which is generated contrary to nature, Preternatural. although it be sometimes also called by the name of melancholy; yet Physicians for the most part call that Excrement which is naturally generated, black Juice, not black Melancholy; but that which proceeds from adustion is called black Melancholy; and that Excrement is naturally cold and dry; but this Preternatural hot and dry, the worst of all humours. But adust Melancholy 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 Melancholy 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 Melancholy humours, or yellow Choler, conduce to the generation of black Choler: yet the generation of black Choler, 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 only which are watery, but have a saltness joined 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 clarify it, and make it more easy 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 contain much Whey in, and watery juice in them, It's cause. much Drink, Obstructions and Distempers of the Bowels, by reason whereof this serous matteriss not rightly separated, it is detained and gathered together, because the reins do not draw enough, and by reason of the weakness 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 Choler 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 Physicians, and of Chemists. ALthough some Chemists plainly reject these things that have hitherto been said, The opinion of Chemists 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, Sulphur, 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; 'Tis 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 less than the primary, as Hypocrates of ancient Physic teacheth, which he calleth the Powers and Efficacies; also the force and strength of humours. Whence Galen also, and other Physicians, call them Salt, Nitrous, Aluminent Humours, which plainly manifest themselves in many diseases, as the Gout, Scurvy, Cankers and others. Venomous humours. And so such humours are not to be rejected, but to be explained by the principles of Chemists; and such things as have affinity with themselves: and hence venenate humours bred of poison and poisonous matter, do not seem so properly to be referred to Choler, Phlegm, Melancholy; 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 Melancholy humour explained. Lastly, of the Melancholy and black humour. It is to be noted, that by itself it is thick, earthy, feculent, or salt, and for the most part 'tis so much moistened 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 Worms 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 Physicians do manifest. They are generated of feculent matter, earthy, slimy, muddy, and of moisture apt to putrify; which when the passages are straighter and narrower in the body, sticks, and of its own accord tends to coagulation and concretion. Worm's also may be generated in most parts of the body, Worms. out of corrupt and putrid 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 distemoens. 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. costiveness of body, and Retention of the hot steam which should pass 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 applied 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 abundance, 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 excess, 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 joined 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 Choler which is hot and dry, heats and dries; Phlegm which is cold and moist, causeth a cold and moist distemper; Melancholy 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 sudden; 'Tis 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 weakness of expulsion is such, that it cannot expel; that too great quantity, or some disease of conformation, and straightness 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 add, 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, tyre, or decay in their strength, or quality, or being burdened 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 only 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. Disease's 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, some happen to it from without. Those which are in the body are humours and excrements, Internal. if they contain in them malignant and venomous qualities; as putrified Blood, Seed, and other corrupt humours. As for external causes, External. First venomous and malignant Air. Secondly, Virulent and contagious Diseases. Thirdly, Poison drunk, or after what manner soever taken into the Body. Fourthly, Poisons which come by the smitings, or bitings of venomous creatures, or some other way communicated to the body externally. Venom is either generated in the Air, or else the Air receives it from some other thing; Aire. It receives it from some other thing by malignant exhalations and vapours, from , Marish grounds, dead Carcases, and other such like exhalations. Poison is generated in the Air, by reason of its hot and moist constitution, or the occult influences of stars. Contagion is a Granary, or if you please, Contagion an Affect contrary to nature, which is communicated to another body, from a body affected likewise contrary to nature. This Infection is twofold, either by touch, when the body which is infected toucheth that body which is next to it; or at distance, when a body far distant from another, by that which it emits, it infects the distant body. Poisons taken into the body, are either Plants, Poisons taken. Poisons from without. or living Creatures, or Minerals, or poisonous Metals. Poisons which happen externally to the body, are the biting of venomous Creatures, Strokes, Exhalations, or venomous Unguents and Powders. CHAP. XII. Of the causes of Organic Diseases. NOw for the causes of Organic Diseases, and first the figure of Conformation is vitiated either by itself, or by accident. By itself it is vitiated first in the womb, The causes of the figure vitiated, through some error of the formative faculty. Secondly, out of the womb through violent motion, either of those things that happen externally, or those which are with us, or in us, or by the errors of our Midwives, Nurses, or Chirurgeons. Thirdly, by too great repletion and increase, and on the contrary, by Inanition, or Defect of Aliment, and lesning the due magnitude, or in default in number. By accident the figure is hurt, when any parts grow not, as they ought, but another way, through loosening of Nerves, Convulsion, Inflammation, or swelling, a Scyrrhus or hard bunch on the Liver, the cutting of a Nerve or Tendon, or by some hard skin growing in them. Moreover to what belongs to Diseases in the Channels of the Body. Diseases in the Channel, are either in excess or defect; Diseases of the passages. in excess the passages are too much dilated by something, filling them contrary to nature, and stretching them sometimes too much; But straitness of the passages is either from our first formation when our stomaches are narrower than they ought, or by repletion, or when in an Empyema, an Impostumation or Ulcer is generated in the breast, and there broken, and flows, and makes it narrower; or whilst a stone groweth in some hollow part; or by compressure, when from what cause soever a hollow member lying under its Cavity is pressed too close, or by the closing of its outsides, or by constriction, when by too much use of binding things the stomach is contracted. Diseases of the passages since they are in excess or in defect; The causes of Diseases of passages Anastomasis. Diaresis. An Anastomasis is caused first by the too great quantity, or the quality of humours initating the expulsive faculty, or the mouth, of the vessels opening themselves; moreover sometimes by Medicines, and other things which have power to relax and loosen the mouths of the vessels. A Division is made by some gnawing or cutting cause, such may be sharp humours, or fretting Medicines, either stretching them too much, as too great store of humours, Diapedeses. or else breaking them, as violent motion, clamours, heavy burdens, knocking. An opening the Tunicles of the vessels is by moistening and rarefying things. The causes of defect and straightness of passages. Obstruction. Constipation. Coalescence. Compression. The causes of the defect of passages, or of narrowness of them are five; Obstruction, Constipation, Cealescence, Compressure, Subsidence. The cause of obstruction is, first, that which is contained in a passage, and is not generated, for such are thick or viscide humours, clots of blood, quitture, hard dung, stones, worms, and too great abouncance of humours. The cause of Constipation is hard flesh; as when there is a Tumour, the flesh grows in the passage; Coalescence is caused when after a wound the walls of the passages grow together. Compression is made by things externally happening, which have power by weight and violence, or otherwise, to press the passages, and have strength to force them inward, as divers tumors and bones out of joint, are amongst the internal causes; amongst the external, Bones, Confusion's, Strokes, and such like; Subsidence. Subsidence is when the outsides of the passages, by too much moisture are made loser than they ought: to which some add Constriction, by cooling and astringent things. The causes of Diseases on the outside, The causes of Diseases in the Superficies. or extremities of the body, are such as make it rough or smooth; rugged things make it rough, so does gnawing things, and such as dry overmuch, as sharp humours, and medicines endued with such qualities, sharp vapours, Wind, Smoke; sharp Meats, things endued with contrary qualities make the body smooth. Moistening things make the body soft, contrary to nature; drying things make it harder, the mixture of black humours, and such as give a tincture, spoils the clearness of complexion. The cause of Diseases of defect, Causes of Diseases in number. in number are either from a man's birth; namely defect of matter, or imbecility of the faculty, drawing matter, being not able to retain and elaborate the same, or error of formation: Or else after one is born, by outting, burning, gnawing, putrefying, and too much cooling; either natural things abound contrary to nature, and that from our beginning, the cause whereof is either too great plenty of profitable matter, and the strength and error of the formative faculty; or after our birth, as is a Membrane, a Tubercle, the cause whereof is plenty of good matter, and by it occasion is given of breeding an Ulcer; or somewhat contrary to nature aboundeth, as Warts, Stones, and such like; the cause whereof is peccant matter. Magnitude is increased contrary to nature, Of Magnitude increased. either according to some dimensions only, or according to all. First, it is increased by things contrary to nature; as by wind, as in a Timpany, and a windy Tumour; or by water, as in a Dropsy; or by the falling of one part into another, as when one is bursten. Augmentation is made according to all the dimensions, by the spreading of humours over all the substance of the body, which comes to pass either by reason of profitable humours, which happens to fat people, and in the increase of certain parts; or from an unprofitable and Excrementitious, which happens in divers kinds of tumors. Magnitude is lessened by weakness of virtue, Diminished. and want of sustenance, or by cutting, burning, gnawing, putrefaction, refrigeration. Lastly, parts change their places by reason of the looseness, Of changing place. or solution of unity of those parts wherein they are contained, or contraction of ligaments, or when they are violently put out of their places. The vicinity and connexion for the most part is hurt by the same means; namely, Of Connexion. if the parts by whose intervening they are knit together, are loosened, broken, or wounded. CHAP. XIIII. Of the causes of Diseases of Solution of Unity. THe causes of Diseases of Solution of Unity, Causes of Diseases of Solution of Unity. Of cutting although they are very many, yet all may be reduced into five ranks; for all things that dissolve the continuity of any part, either cut, or gnaw, or knock, or bend and break, or burn: those that cut are all sharp bodies, which whether edglings, or wound with the point, as all kinds of weapons and darts, thorns, the biting of living Creatures, and such like. All sharp things erode, as humours, Eroding. and all sharp, eroding, putrifying, burning medicines. Those that are heavy, and great, and blunt, knock, as stones, woods, Knocking and breaking. Eating. dashing the body against hard things; which if they happen to a part that can give way to it, they bruise it; if they happen to a hard part which cannot yield, they break it; they knock and break those things that fill the part, as plenty of humours, and store of wind, or they powerfully dry or violently dilate the part, as dancing, and all loud singing, and heavy burden oppressing, to which belong immoderate cold. Lastly, hot Irons burnt, Burning. and other metals, and hot and fiery things. The end of the Second Part of the Second Book. Book. II. PART. III. OF SYMPTOMS. SECT. I. Of the Differences of Symptoms. CHAP. I. What a Symptom is. THE name of Symptom, The word Symptom. although sometimes it be taken generally for every thing which befalls the body contrary to nature; so that both Diseases, and causes of Diseases are comprehended under the notion of Symptoms. Yet Physicians take not this name so generally; But by Symptom understand something different from a Disease, and a cause of a Disease,; and so a Symptom is an affect, or accident contrary to nature in those things which are necessary to perform natural actions, without the constitution of the parts, some other thing contrary to nature following: It's definition. or 'tis an accident different from natural, and changing the natural constitution of the body, which to perform natural actions, is no necessary; whether the action itself be hindered, or some accident contrary to nature in the humours and excrements, or even in the living parts, so that it hinder not their actions; for a Symptom may consist even in the living parts. For example heat caused by a Bath, or exercise, so that there be not any effect which can hinder action. CHAP. II. Of the causes and differences of Symptoms in general. SO that in respect of the causes, It's division. a Symptom is properly divided into a Symptom of a Disease, a Symptom of a Cause, and a Symptom of a Symptom; for they labour in vain who endeavour to draw all Symptoms from Diseases. A Symptom of a Disease is that which immediately follows a Disease, A Symptom of a Disease. A Symptom of a Cause. no other affect contrary to nature coming between, as when an ill concoction follows a distemper of the stomach, which is called in Greek Cylosis. A Symptom of a cause is when the action is hurt, although the faculty, and its organ be well; the faculty being hindered by an external fault, as when the Liver, though sound, cannot sanguify, by reason of vicious chyle; Whether hurt by external means be Symptoms they trouble themselves exceedingly here, who endeavour to deduce every Symptom from a Disease, and actions hindered, which happen without a Disease, no way worthy the name of a Symptom, but think them worthy to be called certain natural differences, or imbecilities, since that they are accounted to perform nothing beyond their own strength: but they plainly err in the matter, for that any work: may be perfected, not only the agent, and that rightly disposed, but also the patiented which receives the operation of the agent, is required: For as in voluntary actions; as for example, in gesture, or lifting of a weight, the business is in the free will of man, but that some work may be performed in the body; as for example, Sanguification, Nourishment. It is necessary that the patiented be joined and coupled with the agent, but since the action of him that moves, and the patiented movable is but one motion, and differ only in reason, as Aristotle teacheth, in the second Book of his natural Philosophy, Chap. 3. Title 23. Diservedly therefore in natural actions, when that is not performed which ought to be, especially in natural concoctions, all that which either is hurt, or frustrated, is deservedly called a Symptom, whether it be done by reason of the agent, or of the patiented; for although, in respect of the agent, it be impotent. Yet some fault doth happen by reason of the patiented; and therefore it is the office of a Physician if he will govern a man's body aright, to govern as well the patiented, as agent in such actions. A Symptom of a Symptom is that which follows another preceding Symptom, A Symptom of a Symptom. A division of Symptoms. no other affect contrary to nature coming between. Moreover there is a common division of Symptoms into an action hurt, errors of excretion, and retention, and qualities changed, namely such as do not hinder the actions of our bodies. Actions hurt are of two kinds, Manner of actions hurt. the one is so called when the faculty is hurt; The other by reason of some external fault, as is said. When the faculty is hurt, the action is said to be hurt; How many ways are actions hart when the faculty is hurt. since the agent is not right, or since the instrument (for the faculties of the mind cannot be hurt) is affected contrary to nature. That the natural constitution of the part, which is the next instrument of the faculty is vitiated, which being spoilt, the mind cannot perform its actions. Again, some divide the faculty hurt into the faculty hurt alone by its self, and into certain actions hindered. The faculty hurt by itself they say is, when the next instrument which it useth, in performing whereof that action is ill affected: as for example, when the Bladder doth not expel Urine, by reason that the Fibers which are used in expelling, are ill disposed. Again, to the good constitution of the instrument is required not only as abovesaid, constitution of the part, as it is mixed, temperateness, and innate heat, but spirits, and influent heat, which being deficient, the faculty cannot rightly perform its actions, as most plainly appears in the senses. But they then say the faculty is hindered, when the next instrument of the faculty is well, yet the faculty is hindered in its action, by some Organic Disease; as when the expulsive faculty in the Bla●der will not send forth Urine, though it be well, by reason of obstructions of the Ureters, occasioned by the Stone. On the other side, if the agent and instrument are in all respects sound, and they be well constituted; Through some external error. yet nevertheless for some other cause, which is without the constitution of the part, the faculty is frustrated in acting, and is hindered that it cannot perform its action. The action is said to be hindered by some external error. To external error first belongs the patiented or object, betwixt which and the agent, there ought to be a proportion; for if the patiented be not fit to receive the operation of the agent, a perfect action is not brought forth. Hitherto belong all these things by which actions are performed, or without which they cannot be performed, as time, place, and order in some, and moreover the use and necessity of actions. The other two kinds of Symptoms, The cause of excretions, and retentions, and of qualities changed. to wit, the fault of excretion and retention, and the qualities changed by hurting of the natural actions, depends on them, and the humours proceeding from them; for from evil concoction proceeds ill excrements: and hence also the qualities of the body are changed; for such as the humours are in the body, such colours, smells, tastes, and such like qualities the body sends forth. CHAP. III. Of the differences in general of actions hindered. MOreover of actions hindered, The differences of actions. Abolished. Diminished. Depraved. there are accounted commonly three differences; namely, actions abolished, diminished and depraved; an action is said to be Abolished when it ceaseth: to be lessened when nature acts weakly, and imperfectly, and performs its actions either in longer time than is fit, or else never acquires that perfection which it ought, or if there be any other manner whereby it may deviate from its perfection; but an action is said to be depraved as often as it is performed otherwise then it ought to be, and erroneously. But not undeservedly aught we to add to these; Increased. Action increased, which is performed more strongly and violently, then ought to be in its kind; such are too much watch, strong breathe, and pulsations, much hunger and thirst, and other such like, which exceed mediocrity. CHAP. IU. Of the Symptoms of the Natural faculty. BUt that we may handle the kinds of Symptoms severally, The differences of Symptoms of natural faculty. first the Symptoms of the natural faculty respect nutrition, augmentation, or generation; which again have their servants, attraction, retention, concoction, and evacuation, and indeed every action is abolished, or weakened, or made worse, or increased. Whence arise great variety of the Symptoms of the natural faculty, First, Nutrition taken away. for what belongs to the action abolished, which they call the third; nutrition is taken away to our senses, or rather it is diminished in an A trophy, when it will not nourish well, Depraved. and in leanness either of the whole body, or some parts thereof, but the nutriment is depraved in a Cachexy, or ill habit of the body, Itch, Scabs, Leprosy, and such like affects thereof. Symptoms of concoction of the Stomach. The appetite increased and depraved. Thirst. Symptoms of swallowing. Symptoms of retention. Those Symptoms which happen in the first & public concoction, which is in the Stomach, are first appetite, and truly first when the appetite is dejected,; when a man desires not meat, whereunto belongs also daily abstinence from meat. Secondly, appetite is lessened. Thirdly, increased, as in a Boulomia, or insatiable desire to meat. Fourthly, Depraved, as in a Malalachia. As the desire of Meat, so desire of Drink is either increased, diminished, depraved, or abolished. Secondly, the Symptoms of swallowing are, when it is taken away, as when a man can swallow nothing; or 'tis lessened, when one swalloweth with difficulty; or depraved, when we swallow with panting, trembling, twitching. Thirdly, the fault of the retentive faculty, is when the Stomach cannot retain meat as it ought, or cannot retain it at all, or not long enough, when occasion requires; or offends in all these: the Stomach doth not rightly retain meat, when it embraceth it, with panting, or with twitching, or with trembling, or shaking. If meat be not retained, or not long enough retarned, it turneth into corruption, or is distributed with unconcocted meat, or ejected by ordure, as in a Lyentary. If the embracing of the meat be weak, swimmings, or flatulencies are occasioned. Fourthly, the errors of concoction in the Stomach, The errors of concoction. Symptoms of expulsion. The Hiccock. Loathing. or the errors of the Chyle are Crudity, slow, or dull concoction, or corruption of the meat. Lastly, the Symptoms of expulsion are Hiccock, mutation in the uppermost parts of the Stomach, whereby it strives to put and cast out that which is offensive, and sticks in the orifice thereof. Disposition to vomit, or loathing, or abhorring of meats is a depraved mutation in the Stomach, when it is straightened in the lower part of it, and dilated in the upper, and stirs to cast forth upwards what offends it, but cannot cast it forth. Vomiting is a depraved motion in the Stomach, Vomiting. whereby the things which are contained in the Ventricle of the Stomach are cast out at the mouth of it. Choler is a depraved motion in the Stomach, Choler. whereby the peccant matter is evacuated by both Orifices. Belching is an excression of Wind from the Stomach out of the Mouth, Belching. with noise. To the expulsion which is made by this concoction; those vicious Symptoms belong which happen to the guts. Alientary. Alientary, which is a flux of the paunch contrary to nature, whereby meat and drink is cast out unchanged. A Caeliack affect, A Caeliak affect. A Diarhaea. which also is a Flux of the Belly, is, when Crude and unconcocted Chyle is ejected. A Diarhaea, is a plentiful and often emission of excrementiticus humours by the paunch. A Dysentary is an avoiding of the excrements of the Belly contrary to nature, A Dysentary. wherein the biting matter is cast forth with blood, twitching and pinching of the Guts. A Tenesme, A Tenesmus. which is an immoderate and continual desire, yet in vain, of going to stool, where nothing is ejected from the body, but a little slimy matter and blood. The contrary fault is the suppression of the paunch when it is dull, A slow paunch and shut. An Illiak. and putteth forth nothing in a long time. To these belong the Illiak, which is, when the dung, which ought to be ejected by the paunch, that being closed, 'tis cast out of the mouth with the meat. For the other public concoction, Symptoms of Sanguification. which is made in the Liver, Sanguification is either abolished, when for the most part there is no change of the Chyle, and in stead of good blood, serous, and Petuitous is generated, or else it is diminished, when half raw blood is elaborated; or it is depraved, when hot and adust blood is generated. The Symptoms which belong to the evacuation of the excrements of the second concoction, Symptoms about making Water. Iscury. Dusury. A Strangury. Incontinency of Urin. Diabetes. Bad milk. are an Iscury, or suppression of Urine, or stopping of Water, or a Dusury, or difficulty in making Water, a Strangury, or dropping of Urine, when it comes away drop by drop, and that there is a continual irritation to expel Urine. Incontinence of Urine, is when it goeth from us against our wills; Diabetes, or plentiful making Water, is when whatsoever is drunk cometh away by Urine, not changed at all, or altered very little. Hitherto belong the Symptoms which belong to the generation of milk, when too much, or none, or not enough is generated, or it proves scurvy, and is coagulated and curdled. Hitherto we refer the Symptoms, Gonorhaea. Flux of Months. which belong to the other concoctions, as the running of the Reins, suppressions of Courses, diminishing, dropping, flowing in too great plenty, the Flux of the Womb. Increasing is hindered, when either the whole body, Symptoms of increasing. or some part is not increased enough, and ceaseth to increase before it comes to its just magnitude, or it increaseth too much, and grows to too great a bigness. Lastly, there are some hurts of the generative faculty, Symptoms of generation. for generation is either taken away when no Children are generated, or diminished when few and weak ones are begotten, or depraved when Monsters, or a Cripple, or any way an imperfect thing is begotten: and because to the generation of mankind, there is required male and female joined; hitherto belongs impotency in men, extinction of lust in women, barrenness and other Symptoms of this kind. CHAP. V Of the Symptoms of the vital faculty. FOr the Symptoms of the vital faculty there is a palpitation of the heart (a Lypothymy, Palpitation of heart or an absence of Spirits for a short time) or an Aphyxy, or no Pulse. Palpitation of the heart is when there is a depraved motion of it, swifter than it ought to be, when the heart leaps and strives to fly from that which troubles it. A Lypothymy, A Lypothymy. or want of vital spirits is when the Pulse beats swift on a sudden, and then ceaseth to beat at all, or is suddenly taken away with a small, slow and weak Pulse, to which some add an Eclusie, or absense of the vital soul. A Syncope again is a motion depraved, A swooning. Absence of Pulse. when the Pulse is much lesser, slower, and weaker than a Lypothymy. An Asphuxy is a total absence, as it were, of the Pulse, and the highest degree of swooning, and nearest to death: of the other preternatural differences of Pulses we will speak in another place. Respiration, which is caused by the heart, Respiration hurt. Taken away. Depraved. Shortbreathing. Shorter. Shortest. either is wholly taken away, Which Symptom the Greeks call Apnoia, or is depraved, which they call Dyspnoia; besides these, the respiration is either too great, or too small; too often, or too seldom; too swift, or too slow; equal, or unequal. And lasty, of swift and slow breathe, there are some differences, according to more and less; for the first degree is a Dusopme, the second is an Asthma, the third is an Orthopnie, when the sick are forced to fit upright to breath. Of the Symptoms of the external senses. FOr as much as belongs to the external senses, Symptoms of sight: first of the sight, that either is wholly lost, as in blindness, & the Disease called Amagrosis, or it is diminished in the disease, which is called Ambluopia and dimness of sight, or Muopia which is to see as Mice do; that is, to discern objects which are near us, and seeming less to us than they are. Depravation of sight. Nutolopea is when any one sees well by day, but very bad in the evening and not by night, or the sight is depraved. When these things which are white seem red, or yellow, those things which are straight, crooked, those things which are whole, seem half, and perforated, those things which are single, double; when Cobwebs appear before the eyes, and Flies, and Gnats, when shinings and glistning appear, which the Greeks call Marmarugase. The hearing is either taken away, Symptoms of hearing. which disease is called Deafness, when the diseased can neither hear a great nor small sound, or it is diminished when loud sounds are heard, but with difficulty, small sounds not at all; which disease is called hardness of hearing; the Greek name Barucoia, Ducecoia, Hypocophosis; or it is depraved when there is a hiding in the ears, which disease the Greeks call Ecos and Sorigmos, i. c. a hiding, a whistling, a hissing. The smell is hurt when it is abolished, Symptoms of smelling diminished, or depraved; when things seem to stink, have in them no ill smell. Moreover the taste is either plainly taken away, or else diminished or depraved, Of tasting. when a thing seems to taste otherwise then it doth. The touch is either wholly lost and can feel nothing, or is diminished, Of feeling which is called Numbness, or 'tis depraved, as in pain, or itching, hitherto also belongs want of sense in the teeth. CHAP. VII. Of the Symptoms of the Internal senses. THe Symptoms of the Internal senses are watch and sleepings, when either of them are contrary to nature; Symptoms of the common sense. Too much watching. Too much sleep. as likewise dreams; the error in watch are when men either sleep not at all for a long time, or if they do, they sleep too little. Sleep is opposite to watching, if it be too much, which comes to pass when it is natural, but not absolutely such; but longer either from the repletion of the head by vapours, and exhalations, as in drunkenness, or by the consuming of the heat and spirits through too much labour. But preternatural sleep is such as doth proceed from a morbifique cause, which is a Cataphora, or a Co●na, that is, a diminution of the action of the common sense, which, as it were, a wreathing, neither suffers the Animal Spirits to be diffused into the external senses; nor being entertained by them, doth know, and judge aright of other objects. A Coma is twofold, Coma twofold. Somnolent Vigilant. somnolent and vigilant; somnolent is that which is oftentimes called an absolute Coma; with which disease those that are affected, the eyes being shut, do sleep sound and too much: but a vigil is when the sick have a propensity to sleep, yet nevertheless they cannot; but only shutting their eyes and winking, they are possessed with too great a desire of sleep. In sleep there oftentimes happens dreams, wherein the action of the fantasy doth concur; Dreams. for dreams are nothing else but the deliriums of the brains of sleepers, although dreams happen to those which are well, yet contrary to custom, they often remain longer, and during the whole night, or are terrible, and trouble the mind exceedingly, and bring great anxiety in sleep, and wearisomeness when one is awake. To these kind of Symptoms belongs an ecstasy, An Ecstasy. and that natural, which is nothing else but a heavy sleep, with heavy dreams, and hence sometimes cometh a delirium therewith. As also the affects of Sleep-walkers, who whilst they sleep, Sleep-walkers. arise out of their beds, walk, and perform certain works, as w●king people do, at that time when they ought to rest; yet if the imagination be together offended, these Symptoms may be referred to that rank wherein many internal senses are hurt. As for what belongs to the offending of the rest of the Internal senses, Whether the Phantafie, and reasonable faculty be always hurt together. sometimes one of them is offended, sometimes many together; for the most part the Fantasy and Ratiocination are offended together, yet not always; for although the understanding be busied about Phantasms, yet the understanding acting, illustrates the Phantasms, and frees them from their supposed matter, and runs from one thing to another, and is busied about the Ideas retained by the memory, by which the error of the Fantasy may often be known, sometimes also the memory is together offended; yet sometimes remains safe from the errors of the fantasy, and the reasonable faculty. But those actions are either abolished, The Memory abolished and diminished. or diminished, or depraved; nevertheless the memory whose office it is not to judge, but only to receive representations, may be so much debilitated and abolished, namely when it does not receive, and retain those things which it ought, or it receives nothing, and retains nothing, and so a man forgets all things: it cannot be depraved, but if sometimes it receives and retains false objects that is not to be ascribed to it, but to that faculty which discovers absurd and false representations, the memory seems then to be depraved to some, when it doth not render things in that order which it received them, but errs in order; but this seems to happen only by reason of the weakness of the memory. The principal actions are abolished and diminished in the imbecility and dulness of the mind, The Fantasy, and rational faculty diminished and abolished. Folly. Foolishness. Madness. slowness of the Wit, stupidity, when a man hath a certain knowledge of the chief things, and draws some conclusions from them, but with great labour. The greatest fault, and the greatest hurt of the Fantasy, and Ratiocination, yet without delirium, is fatuity. But when a man is so destitute of all ingenuity, and the fantasy and Ratiocination are so hurt that they can neither know the first principles, and can beget no conceits, it is called foolishness, and madness; especially if the action depraved concur, and a man judgeth not only a little but false. But the imagination and reasonable faculty is depraved in deliriums, A Delirium. whereof there are several kinds; for a deliri 'em is either with a Fever, or without a Fever; with or without a Fever, Melancholy. is either simple, viz. A moderate delirium, and without madness stirred up by hot vapours in a Fever, or by watching, or drinking too much Wine, which the Greeks call Paraphrosune, or Paraphrora. A Frenzy is with a Fever, which is a continued delirium, arising from the inflammation of the Brain and its Membranes. But a delirium without a Fever is Melancholy, and madness; Melancholy is a Delirium without a Fever, with sorrow and sadness, as it is commonly defined; or a failing of the Fantasy and reasonable Faculty about one certain thing: and indeed the Fantasy is principally offended, but the reasonable Faculty not always nor in all, but the memory for the most part is safe. To melancholy Deliriums also is referred Mad Love, wherein concur various passions, Mad love. now they conceive joy with hope of obtaining the thing beloved; where they do many things, and speak beyond decency, and now sorrow and anger when they despair of obtaining the thing beloved. Madness is a delirium without a Fever, with Fury, Fear, Madness. Audacity, Anger, Quarrels, and Ferosity. To madness are referred Wolf-madnesse, Dog-madnesse, Badger-madnesse, fear of Water, viz. a Disease wherein if one be bitten with a Dog, a Wolf, a Badger, or any other ravenous Animal, he becomes altogether averse to all liquid and potulent drinks, although as for other things, they do not shun them; also those that are bitten by a Tarantula, leap and dance, and a Corea or company of S. Viti, which is a kind of delirium and madness, with which those that are affected strive to dance night and day. CHAP. VIII. Of the Symptoms of the motive Faculty. ANimal motion is either abolished, diminished, Symptoms about motion. Palsy. or depraved; motion is abolished, not only in the Palsy, which is impotency of motion, wherein the next instruments of motion are relaxed, and ceased from their action, and are not contracted, but cannot be moved by reason of putting out of joint, fractures of bones, wounds of the muscles, Lassitude. dryness and induration of the parts serving for motion. It is diminished in the green sickness, or in laziness when the motion is become weak. It is depraved in trembling, which the Greeks call Tremos, Trembling wherein the part cannot move freely, but is now elevated, and anon depressed: for although in respect of the motive faculty, trembling is only imbecility of the motive faculty; yet because the motive faculty doth not wholly fail, but the member which contrary to the dictate of the will is depressed by its own weight, it endeavours in some measure to elevate itself; here is made a depraved motion, where in the smallest intervals of time the member is lifted up, and depressed in a continual course. As also in the Convulsion, Kind's of Convulsion fits. which is a preternatural contraction of a Muscle, towards its beginning, contrary to the will; and a violent stretching out of the part, into which a Tendon is inserted. A Convulsion is either Universal or Particular, Universal is threefold, Emprosthotonos, i. e. when the Neck and the rest of the Body is bowed forward, so that the diseased cannot set himself upright. Opisthotonos, when the body is bend backward. Tetanoes, when the body is so stiff that it cannot bend any way. A particular Convulsion in regard of several particular parts, hath divers names, Aspasmos Cynicus, a Convulsion of the Muscles of the Mouth. Trismos, a Convulsion of the Muscles of the Jaws, with grating and grinding of the Teeth. Strabismes, a Convulsion of the Muscles of the Eye. To these belong Convulsive Motions, Convulsive motions. wherein is made a Contraction of the Muscle towards his beginning, but continues not in one difference of Location; but it happens with various concussions and agitations of the Member, as in an Epilepsy. Sometimes also a Palsy and a Spasme are complicate, A Palsy. Cramp. Complicate Voice hurt. so that by changes and turns they afflict, and so the part is sometimes contracted, and sometimes dilated. Hitherto is to be referred the error of the voice, which either is abolished, as in Aphonia, or dumbness, or diminished, as in an inward and obscure, or small and low voice, or it is depraved, being broken in a shrill, sharp, hoarse, or trembling voice. The speech also is hurt, Hurt of speech. which is either taken away, as in those which are called mute, or else it is difficult, as in those who pronounce certain Letters, especially R, with great difficulty; or it is depraved, as in those who in speaking now stop, and anon precipitate their speech, which evil, the Greeks call Traulates and Psellotes, the English, Stammering. Amongst these errors of Motion, those Symptoms are to be reckoned wherein the natural expulsive Motion, being stimulated by a preternatural cause, ariseth up to expel; it cannot perform motion without the help of the animal virtue, and Organ, such as are a cough, sneezing, yawning, quaking, stretching. A Cough is a depraved motion, A Cough. and vehement efflation occasioned from the sudden constriction of the Lungs, and Breast, whereby that may be expelled, which was troublesome, and be sent forth by the instruments of breathing. Sneezing is a motion of the Muscles, primarily of the Brain, Sneezing. secondarily of the Breast, and inferior Muscles, whereby that may be expelled, which is troublesome to the Brain. Yawning, or Gaping, Yawning. is that motion whereby nature endeavours to expel the flatuous vapours by breathing them out of the mouth. Stretching is a distension of the members in the whole Body, Stretching discussing the vapours in them. Shaking fits, that is a concussion of the skin of the whole body, Horror. to shake off some troublesome thing. Cold fits, that is a shaking of the whole body, Cold fits. to put off that which offends it. CHAP. IX. Of the Symptoms wherein all, or most part of the animal actions are hurt. BUt sometimes it happens that either all, or most of the animal functions are offended together: amongst these Symptoms, a Vertigo is the first, the Greek Dinos and Iliggos, A Vertigo. 'tis such a mischief, and depravation of the imagination, sometimes of the common sense, that all things seem to run round in a circle, and for the most part, the motion is so hurt, that a man falls down. Sometimes the external senses are affected likewise, which if it happen at the same time, the eyes are obscured by a fuliginous mist; the Greeks call it Scotoma, and Scotodinos, i. e. a shady disease. Sometimes the hearing is somewhat depraved, or some certain swimming ariseth, or some other senses are affected. Moreover an Incubus, or a riding of the Mare, An Incubus. or an hindrance of breathing, and interruption of speech, and hindrance of motion, as it were, an oppression of the body, with a false dream of a weight lying upon the breast. A Lethargy, which is a perpetual desire of sleeping, A Lethargy. with a giddiness of the head, with forgetfulness of all things, or it is a continual Delirium, with a weak Fever, heaviness to sleep, and destruction of memory. A Carus, which is a profound, or dead sleep, A Carus. wherein the sick hear not, and being pricked, scarce perceive it, or a deep sleep with diminution, or taking away of sense, motion, and imagination, the breathing being gone. A Catoch, A Catoch. or Catolepsis is a Diminution of the principal functions, or external senses, especially of feeling, and voluntary motion by abolition; or 'tis a sudden apprehending, whereby those which are affected being stiff, remain in the same place and gesture of body as they were in when they were taken, and opening, and not moving their eyes, they neither see nor hear, nor perceive; the breath and pulse only remaining safe. An Epilepsy is an ablation of the principal actions, An Epilepsy. An imperfect Epilepsy. and of sense and voluntary motion, with a preternatural Convulsion, or Convulsive motion of the whole body. To the Epilepsy also are referred certain Diseases, as it were, small Epelepsies, wherein the sick are not velified in the whole body, neither do they fall down, but some parts only are twitched, as either the head is shaken, or the eyes are drawn, or the hands and feet are snatched this way and that way, or the hands are held shut, or the diseased is turned round, or runs up and down, and in the mean time speaks nothing, hears nothing, perceives nothing. Lastly, An Apoplexy. an Apoplexy, which is an abolition of all animal actions, to wit, of motion and sense, in which the whole body, with the hurt of the principal faculty of the mind, respiration after a sort being safe. CHAP. X. Of the Symptom of the changeable qualities of the Body. THe second kind of Symptoms are those which consist in a simple affect of the body, The difference of qualities changed. or the qualities of the body changed; namely, when some natural quality of the body is changed, by reason of which change, there follows no hurt of the actions; their differences are to be sought out of the number of the external senses. The visible qualities changed are colours contrary to nature, Colours changed. either in the whole body, as in the yellow Jaundice, or in a Cachochimy, or ill habit of the body, or in some part, as in the Face, Tongue, an inflammation, black Teeth, yellow Nails, and such like. Smells contrary to nature are changed, Smells changed. when a man breathes forth an ill smell, either out of the whole body, or from some part, as the Mouth, Nose, hollow of the Armpits, or sols of the Feet. Tastes or Savours are changed when the spittle, Taste changed. or any thing else which swims in the Mouth is spit out, and gives a sharp, salt, bitter, or other taste; but since these qualities are not the parts of the Body, but Excrements; they may be more fitly referred to the third kind of Symptoms. To the fourth belong Tactil qualities only, Change of Tactil qualities. as they are contrary to nature, and troublesome, but do not hinder actions, as Heat, Cold, Softness, Hardness. Hoarseness. To Hearing may be referred, sounds, warbling, crackling, grinding of Teeth, and such like, which are perceived by hearing. Lastly, hitherto are to be referred common sensible things, as Figure, Magnitude; if they are preternatural, and all those things which are spoken of in the Hypocratical Face, and are described in his First Book of Prognostics. CHAP. XI. Of the Symptoms of Excretions and Retentions. THe third sort of Symptoms comprehend the errors of those things which we ought to be cast out of the body, Errors of Emission and Retention. or use to be retained in it, contrary to nature; in which kind of Symptoms regard is not to be had to the excression itself, or action of casting forth, whose faults are the Symptoms of actions hurt, but only to the matter which is cast out, which as it recedes from the natural state, constitutes this or that sort of Symptoms. Retentions and Excretions offend either in the whole substance, or in quality, or in quantity. First, Excression and Retention offend in substance. in the whole substance they offend, which ought never to be found in the whole body, in the stead of an Excrement; such are Stones, and divers sorts of Worms, little Hairs, and such like. Secondly, those which in their whole substance are not contrary to nature, but are cast forth in this or that manner, or place, contrary to nature; such are the Courses out of the Nose, Eyes, or Teats, the Ordure by the Mouth. Thirdly, those things which are plainly natural, yet ought rather to be retained then evacuated, as too much profusion of blood by the Mouth, Panch, Nose, Bladder, Pores of the Skin, which happens in a bloody swear. To these belongs particular ejections out of the Lungs, and other parts. In quality they offend many ways, in heat and cold, moisture and dryness; In colour, smell, and taste, in quantity, excretions offend, when either more or less than ought to be are cast forth, which often happen in the dregs of the Panch, Urine, and Courses. The end of the third Part and first Section; of the second Book. Book. II. PART. III. SECT. II. OF THE CAUSES OF SYMPTOMS. CHAP. I. Of the causes of the Symptoms of the natural faculty. Since we have reckoned all the differences of Symptoms, The cause of want of nourishment. order now requires that we may show their Causes in the same order we have set down them; and as for the Symptoms of the Natural Faculty, amongst them the first is Atrophy, or want of nourishment; and that is either in the whole, or in some part. In the whole. Atrophy in the whole is occasioned through the debility of the faculty, or default of the nourishment; the vertne is weakened through a dry distemper, and sometimes hot, which principally proceeds from the Heart, labouring with the like distemper, as in Hekticks, and other Fevers; yet sometimes from the defect of other parts which may communicate their affects also with the Heart, diseases may perform the same. Atrophy is occasioned through defect of Aliment, when either it is not communicated in sufficient quantity, or when it is affected with some ill quality: 'Tis wanting when too small a quantity is received, or although sufficient quantity be taken, yet 'tis not concocted through the weakness of the bowels; or being concocted, 'tis not distributed by reason of the narrowness of the Veins about the Liver; or it is dispersed, or not conglutinated, by reason of distempers of the parts, especially hot and dry. Atrophy is made through the pravity of nutriment, when ill blood by reason of the distemper of the bowels is generated, especially hot and dry, and not so profitable. In part. Atrophy is in some part whilst its force is weak, through cold distemper and defect of native heat, or through want of nourishment, by reason of the straightness of the passages, by which it should be communicated to the part, or occasioned by what cause soever. The immediate cause of depravation of nutrition, The cause of ill habit of Body. and of ill habit, is vicious and raw nourishment in the bowels, appointed for public concoctions, arising from the vicious disposition there; to which sometimes a cold and moist dsstemper, and habit of the body is added. The Scabs, Of the scab, leprosy. etc. the Leprosy and other known cutanious diseases have their original from ill nourishment, but not crude, but sharp, salt nitrous, or having some other pravity which since it is various, various diseases from thence do arise. But amongst the Symptoms which happen to the concoction which is made in the stomach. The cause of the appetite taken away and diminished. The first is when the appetite is hurt, and the reason of abolishing or diminishing of the appetite is, because either little or no juice is made, or else is not perceived; juice is not made, or very little is made, when many crude and watery humours compress the mouth of the stomach, or the chyle hither to sticks in the stomach, or because aliment abounds in the body, which may be when it is not evacuated, by reason of the thickness of the skin, or idleness, or weak heat, or because it is not attracted, through some distemper of the Veins, or straightness of the Meseraick veins, and of the hollow Vein of the Liver, or because concoction and distributiis hindered in the stomach. The sucking is not perceived either through the error of the sensitive faculty, when the animal spirits which should flow are desicient, or when the action is converted another way, as in such as are out of their wits, or when the nerves of the conjugation are defective, or when the mouth of the stomach is ill with some distemper, as swelling, or ulcer, or by the dulness of the stomach occasioned by some stupefactive Medicines, The cause of daily abstinence. Hitherto belongs the daily abstinence of those men who abstained not only some days and months, but years also from all meats; of which wonderful Symptom, although it be not easy to render a reason, yet it is probable that all such had not need of restoring, and that because nothing is taken away, or not in a long time wasted, because of the humours which preserves our bodies, is so disposed, and proportioned to the heat of the same, that it could not be destroyed by it. On the contrary, The cause of the appetite increased. the cause of the increase of the appetite is too much sucking, which comes to pass either from some humour sticking in the stomach; such is Melancholy, which by its sharpness and austereness binds the stomach, or through want of nourishment, which happens by reason of Worms, which consumes the Chyle, or by too much labour and exercise, watch, long fastings, evacuations of blood, vomiting, or from some old distemper, binding the stomach. But the appetite is depraved by a vicious humour peculiarly corrupted and fixed to the Tunicles of the stomach, which is either generated in the stomach by ill food, or else flows from some other part, especially the Womb, into the stomach. Thirst is abolished, or diminished, either from cold, sweat, The cause of diminishing of thirst. unsavoury, petuitous, aqueous, many humours generated in the stomach, want of meat and drink, or flowing from some other parts, continually moistening the stomach, or because the stomach doth not perceive its want of drink, as it often comes to pass in Frenzies and burning Fevers. Again the Thirst is increased through want, Of increased. and dryness of humours, which proceed from those things which have drying faculties, and such as consume the primogenial humidity of the stomach; such are all drying and heating things, as hot humours, sharp and salt, a hot and dry distemper in the mouth of the stomach, proceeding either from the whole, which is in Fevers, or in some part near to the stomach, which either sends hot and dry vapours and humours to the stomach; or by reason of the communion of the Tunicles and Membranes which cover the stomach, the orifice of the stomach, the Windpipe, and the neighbouring parts, communicating a hot and d●y distemper to the Office of the stomach: external causes which are evident perform the same as those which have a power of heating, drying, and consuming the humidity in the O●ifice of the Ventricle. Vicious thirst is caused by some vicious humour in its whole kind contrary to nature, Vicious thirst. sticking in the mouth of the stomach, The swal owing is hurt either when the faculty is offended, Of swallowing hurt. or through some external error; and indeed the faculty either natural, or animal may be hurt: the natural is hurt whilst either the attractive faculty cannot draw meat through the straight fibres of the internal Pannicle into the parts; or the expulsive through the Transuerse fibers inserted into the external Tunicle, cannot thrust food which is drawn into the mouth of the stomach, farther down into the stomach; which is caused through the relaxation of the fibers of the Orifice of the stomach, by reason of a cold and moist distemper, when the matter flows from the head to the chaps; or by reason of their dryness occasioned by some Tumour, Ulcer, or Excoriation. The animal faculty is hindered when the Muscle which is before the gullet, either is inflamed, which use to be in the Quinsy; or 'tis contracted either by Convulsion, or Palsy; it is hindered also by reason of the straitness of the entrance into the stomach, which proceeds from divers causes, as tumors in the Throat, Relaxation of the Vertebraes of the Neck, and Back: external things being swallowed, as when Fish-bones, Pins, and other things stick in the mouth of the stomach, as also Worms. The swallowing is hindered by some external error when any thing, hard, dry, sharp, rough, viscid, or ungrateful is swallowed. The retention of meat swallowed is hindered, when it is abolished, The causes of Retention of meat hurt. diminished, or depraved. Retention taken away and diminished proceed from the same causes, the one from the greater, the other from the lesser: and this comes to pass if the Retentrix be weak. The Obliqne fibres loosened by a cold and moist distempers, or if any Tumour, as an Inflammation or Ulcer be present. The cause of windiness in the stomach, is windy meats, and a stomach not cold enough, but the cause of floating with a noise, is when the stomach is freed from that which might be turned into wind, yet still remaining full of drink, or extremely cooled. But the retentive faculty is depraved when the stomach doth not ●ightly enfold the meat, Of Palpitation. and indeed a Palpitation with floating and noise happens through the weakness of retention and thick winds penned into the stomach, Of Convulsion. which arise either from the causes or crudity, or from flatulent meat, or yellow, or black choler spread over the stomach; But a constriction, and a certain sighing, or Hiccock happens, when after emptiness and defect of aliment, the stomach too violently contracts itself, having newly received meat. Trembling is caused by the imbecility of the retentive faculty from a cold distemper, and the wait of the meat oppressing: Of trembling. Of Shaking. The cause of abolishing and diminishof concoction in the stomach. Faculty hurt. External error. and a certain Quavering when the Ventricle is molested by any biting thing, especially choler. For as much, as what belongs to the concoction hurt, is either abolished or diminished in the stomach, they both proceed from the same causes, they only differ according to Major and Minor, and the concoction is hindered, either primarily and by itself, when it cannot do its office without the hurt of the rest of the faculties. Or secondarily, and by accident, when it is vitiated by the retentive or expulsive faculty. For unless meat can be retained so long as it ought. The concoction cannot be rightly performed. The concoction is hurt by its self, either when the faculty is hindered, or by some external error, the faculty being hurt is hindered through some distemper of the stomach, from what cause soever ariseth, or other diseases of the stomach, tumors, ulcers, and such like which hinder concoction; the concoction is hindered through external errors; first, by reason of Excrements, which if they abound in the stomach and offend with cold, they are the cause of abolition, and diminition thereof. Secondly, by meats which offend either in quantity, or else divers and various kinds are taken, or in quality, if the meats are cold, or hard, and clammy, and hard to be concocted. Thirdly, by reason of the time of taking food; namely, if meat raw betaken before it is boiled. Fourthly, after the taking of meat, if a man watch the whole night, or sleep very little, or exercise himself violently, or suffer the passions of the mind. The corruption of meat is twofold, the one nitrous, Depraved. the other acide; the nitrous hath its beginning from a hot distemper of the stomach, the choleric excrements being collected in the ventricle by hot aliments which are obnoxious to corruptions; such as are sharp, oily, pinguious things, Milk, Mushrooms, garden Fruit, and such like; but crudity produceth acidity, through the cold distempers abounding with cold aliments; cold, pituitous, and melancholy humours in the stomach. We have said the Symptoms of the expulsive faculty of the stomach, are Hiccock, Loathing, Vomiting, Choler, Belching. The immediate cause of Hiccock is something troublesome to the superior part of the stomach, Hiccock. especially to the Orifice thereof, which it endeavours by that motion to put away and expel, but the causes which trouble the stomach on this manner, are either in the Stomach itself, or in the parts which can draw the Ventricle by consent. The cause of Hiccock in the Stomach itself, is matter either oppessing by its plenty, or offending in quality, as sharp meats, and biting, and such like humours, sharp medicines, malignant and foul vapours, either generated in the stomach, or sent thither from elsewhere, Worms, an immoderate cold distemper, and those things which outwardly press the stomach, which may happen by the pressing and bending the extremities of the ribs to the stomach. But Hiccock by consent happens when the nerves of the sixth conjugation suffer together, in an inflammation and percussion of the brain; as also inflammations of the Midriff, the Eungs, the Liver, the Gutflion. Loathing and Vomiting have their rise from the same causes differing according to Major and Minor, Causes of loathing and vomiting. either in the stomach itself 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 straightness thereof, by reason of dryness and leanness, swelling an Ulcer, whereunto belongs frequent vomiting, which indeed itself disposeth the stomach to more frequent vomiting: as also the shutting of the inferior 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 Colic and Stone, by the communion of the Membranes; and lastly, wounds and hurts of the Brain and its Membranes. But the matter which Irrirates the stomach to expel, either loading it with its plenty, or twitching it with its sharpness, or moilifying the superior Orifice, or by stimulating it with a malignant quality it doth it; whether it be meat and drink, or medicines, poisons, worms, blood, quitture; choler effused into the stomach, which happens to those which have a vicious implantation of the Pores or the Vessel that carries the Choler 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 Choler is offensive, Moist Choler. 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 Choler 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 Poisons do the same, and stir up this matter. As for the difference betwixt the other Choler and this, Dry Choler. 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 Choler spread over the stomach. Belching is occasioned by thick and fuming vapours breaking out upward, and stimulating the stomach to expulsion. Belching. Concerning a looseness, Alientary and Celiack affects. the causes of a Lyentary and Coeliack affects are for the most part the same, differing only 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 signify 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, aught to remain some time in the Guts; that it might there be in some manner elaborated, and be conveniently drawn by the meseraik veins, 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 self, or by accident: of itself through a cold and moist distemper, and that either alone, or joined with a phlegmatic 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 stirred 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 stirred 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 caus●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 Veins, 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 Veins, 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, ●speciplly violent purges, sharp quitture and poisons, A Tenesmus, or desire to go to stool 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 always 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. 'Tis hurt either because it is weakened by a cold and dry distemper, or it is hindered by the strength and dryness of the retentive faculty, or by the narrowness of the Guts which proceed, first from astringent and drying things. Secondly from their inflammation, or a Tumour 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 hardness of the siege, Worms, Stones, viscous Phlegm. Sixthly, from the Muscles refrigerated and straitened, shutting the Gut Rectum. The belly is suppressed through default of the object when the Ordure is too thick, viscid and hard, the Muscles of the Panch do not help to expel, either because they are weak, or because they, or the parts under them endure pain; the Ordure doth not stimulate when either there is but little, or when there is no mordication, or it hath no sharpness, or by reason of eating of cold meats, or because yellow Choler is not mingled therewith. The Guts are not sensible of stimulation, either because their preception is dull, or because through long retention they are accustomed to, and become familiar with the Ordure, or because they are stopped with phlegm. The iliack passion hath its original from the inverted motion of the fibres of the Intestines, Illiack. which proceed from some inflammation, or obstruction, from hard dung, or from a Rupture, or from Exulceration, or a Canker, or from a high flowing of humours. Moreover for what belongs to elaboration of blood, Sanguification hurt. that is hindered either primarily, and by its self, or secondarily, and by accident; Primarily it is offended either when the faculty is hindered, or by some external accident; when the faculty is offended, 'tis done by reason of some diseases of the Liver, distemper (by reason of which alone, without any other manifest disease of the Liver; those which are troubled with its imbecility are called Hepaticks) obstructions, tumours, ulcers. But it is hurt by some external error, when either the Chyle is not rightly elaborated in the stomach, or when it is throughly elaborated, some peccant matter is mingled therewith. Secondarily, or by accident it is hurt, either when the attractive faculty is hindered, by reason of diseases of the Liver, or obstruction of the Mesentary, or because the retentive faculty in like manner is hindered through some disease of the Liver, and especially through its moist distemper, opening and gnawing of the ressels, and thinness of Chyle, or by the expulsive faculty; principally by cold distemper, and obstructions of the gibbous parts of the Liver, by reason whereof the blood cannot be distributed. But as for the Symptoms which happen in making of Urine, The cause of an Iscury, and of little Uria the first is an Iscury, or suppression of Urine, and making of less Urine: 'tis properly to called when the Urine is in the Bladder, and is not ejected, or very little is cast ou●; which Symptoms arise from the same causes, differing only according to Major and Minor; but the Urine is suppressed, or little is made, because the xepulsive faculty is either hurt and weakened, or hindered. It is hurt whilst either the sensitive faculty o● the Bladder being hurt, doth not perceive the pricking of the Urine; namely, when the proper Nerves of the Bladder are affected either by some stroke, sliding, loosening of the Vertebraes in that part, wounds of the spinal Marrow and Tumours, as also stupefactive Medicines being applied thereto, or it may happen when the expulsive faculty is hurt, and the transverse fibres of the Bladder appointed for expulsion, or affected with some cold moist distemper: or are extended over much, that they lose their tune or note; so that afterwards they cannot be contracted, which comes to pass when the Urine is too long retained, or the Muscles which help and assist the Bladder to expel Urine, are affected so that they cannot be contracted. But the expulsive faculty is hindered whilst the Neck of the Bladder and Urinary Passages are not open, and is either stopped by a little Flesh or Callous Substance in the passages, or is obstructed by Gravel, clotted Blood, Quitture, or thick humours; or it is compressed by a Tumour in compassing the Neck of the Muscle of the Bladder, or of the neighbouring parts, or it is shut by contracting of the Muscle of the Neck, or it is pressed and wreathed by the falling of the Bladder out of its place. Urine also is not made when too great plenty thereof is long retained, too much dilating the fibres of the Bladder, so that afterwards they cannot contract themselves, nor cannot squeeze out, nor expel Urine, which comes to pass either when the Urine (mens business being urgent) of its own accord is retained long; or when the pricking of the Urine, as is said before, is not perceived. Lastly, Urine is not cast out through its accustomed passage, if by some Wound, Ulcer, Fistula of the Bladder and Urinary passages, the Urine which ought to pass through them, goes out by a way opened elsewhere. There is another Iscury less properly so called, or suppression of Urine, when little or no Urine is sent, and comes into the Bladder, which happens when the attractive faculty of the Reins is hurt through distemper, especially cold, or is hindered by obstruction and straightness of the emulgent vessels, or when the Urine is carried to another place, and is cast out of the Panch, or by Sweats, or is collected in the Panch, and stays in the first passages, as in a Dropsy, But a Dusury properly so called, Difficulty of making Urine. or difficulty of making Urine, is when the time of making water, and the quantity, is a little altered, yet in the very making water, the Urine doth not pass out freely, but is made with great striving, pain, and burning, which comes to pass by some fault of the Urinary passage; namely, whilst it is affected with some Ulcer, and is eroded, or the Urine itself being sharp doth it, or the passage was formerly ulcerated. The cause of a Strangury is either some sharp thing which stimulates nature continually to expel, Of a Strangury. but because nature is sensible of pain, it hinders free emission, the Urine is made drop by drop, and dribbling, which is caused by crude Urine unconcocted, or having a sharp humour mixed with it, by Gravel sticking in the neck of the Bladder, or some fault of the Urinary passage: whereunto belongs Intemperature of the Bladder, and inflammations of the same, and of the parts near thereunto: hot humours, also exulceration of the neck of the Bladder and Urinary passage. Involuntary pissing, Of Involuntary pissing. which happens both to those that are sleeping and waking, is caused for the most part when the contractive power of the Muscle Sphincter of the bladder is taken away, which is occasioned by a Palsy, proceeding either from a cold and moist distemper of the same, or by hurting of the Nerves which come to this Muscle, by compression in loosening the turning joints of the back near the Hucklebone by a stroke, a fall, or some tumour, or obstruction, or by hurting of the same Muscle, or certain fibres, in cutting the stone of the bladder; yet sometimes Urine is made against our wills, when the Muscles of the Panch are exceedingly drawn together, so that the Urine by reason of their constriction and compression of the belly is, as it were forced out of the bladder, as also sometimes it happens to those that are great with Child in their last months. For the same reason they cannot contain their Urine. But if a man contain his Urine waking, Of pissing in one's sleep. and in his sleep let 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 superior faculty, as also custom. It is not easy 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 Reins, by too great plenty of Urine; which when the Reins 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 watery humour from the Stomach to the Liver, and Spleen; by reason whereof the drink is suddenly carried to the Reins. The causes of those Symptoms which are deservedly joined 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 straightness of passages, by reason whereof they cannot draw and elaborate suffitient quantity of blood. Vicious and corrupt milk is generated either through the pravity of the matter, Vicious. and fault of the blood, or by some distemper of the breasts. Lastly, Coagulated. Milk grows thick, and coagulates whilst either it is burnt by too much heat, or if it abound in quantity, and is retained 100 long in the breasts, or if any vicious 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 Ya●d; and desire of Venery; 'tis occasioned either by the hurting of the retentive faculty, or some exrernal error; the faculty is weakened through distemper, principally moist, rendering the spermatick vessels more lose: whether it proceed from too great a flux of phlegmatic humours, or too much coition, or other causes. But from external hurt, or fault of the seed, whether it be too cold, watery, thin, or crude, sometimes also a Gonorhaea happens by convulsion, as in such as have the falling sickness. The cause of Nocturnal pollution is too great plenty of seed, Of nocturnal pollution. heat and sharpness, 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 loins are become hot, by lying on their backs. But the cause of a Venereal Gonorhaea is poisonous seed, A Vencreal Gouorhae●. 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 narrowness of the veins belonging to the Womb, and the foulness 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 tumors of the parts near the cunto, or from condensation, contraction, and dryness of the ●●●tance of the Womb, but by default of the blood, the Courses are suppressed whilst that is thick, viscid and unapt to move. The same cause, Causes of diminishing of Courses. The dropling of Courses. but more gently occas●oneth small evacuation of Cou●ses, viz. They either flow in less quantity, or else more slowly. The coming 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 than they ought. Too much slowing of the monthly Terms, Of too much flowing. ariseth when the vessels are opened, either by an Anastomasis, when the mouths of the veins are opened, or a Diair●sis, when they are divided, or when the blood being hotter, thinner, more movable, sharp, and troublesome to narure, stimulates the expulsive faculty to expel. Now for the Causes of increasing vitiated Terms; Causes of increasing vittated. 'tis manifest what things show the causes of diminution thereof, from what is spoken of want of nourishment. But the cause of too much increase 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 Symptoms 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 t●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 vicious 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 less spirituous is generated, or else some hot, whence too sharp seed proceeds; or through default of matter, whilst 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 vicious. The emission of the seed into the Woman's Womb is vitiated by the Yard, either shorter, whether by nature or by a disease, or crowded through the shortness 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 man's seed, by reason of her cold and moist distemper of the Womb; or by reason of a Tumour, Ulcer, or Straitness 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 pass through the foul Seed of the Father, or the● imagination of the Mother. Lastly, Abortion. the causes of abortion, are either too great bigness 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, putrify, 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 Symptoms of the vital faculty, and of the hindrance of respiration. THe Symptoms 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 tumors, 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 grief, too much exercise, which the heart strives by more vehement pulsation, to restore and strengthen. Thirdly, preternatural heat increased, not only consumes and scatters the Spirits, but also inflames them, which that nature may restore temperate and cool; 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, whilst 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 Lungs hurt. Of the Breast. and that either of the Lungs, or Breasts; the faculty of the Lungs is hurt either by its self, 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 breast by what means soever becomes straighter, and the Lungs have not space wherein to dilate themselves. The faculty of the Breast is said to be hindered by its self, or by accident; by its self when the animal spirits necessary to motion is wanting, or because it decays, 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 Breast and Midriff; but 'tis hurt by accident, when by reason of the pain of the side, or parts adjacent, or matter and blood contained in the Breast, or Wind, or tumors, or something in the Panch, the Breasts, and Midriff cannot freely be moved; or when the Bowels in the Panch hanging about the Midriff 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 Organic Disease, or solution of continuity in the Lungs, Midriff, Muscles of the Breast and Panch, the Windpipe. Thirdly, In regard of use. when the custom 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 shortness of breath. which are peculiar diseases of shortness of breath, is this, when a man constantly breathes with great difficulty, without a Fever, such as do, those who after a violent ●ace and exercise stop, The immediate cause is straitness of the mouths of the Lungs, or the use increased, 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 Windpipe of the Lungs; and both obstruction and compression are caused fi●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 ●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 weakness, 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, whilst crude humours are generated therein, or abound in a venomous kind, which even that shows that in an Astma the cough is not always present, which nevertheless 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 Tumour may consist not only 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 Symptoms of the external senses. SInce order requires that we speak of the causes of the Symptoms 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 optic and spirits. The Tunicle called Cornea, which comes in the fi●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 strange colour it hinders the sight: it loseth its diaphanity if it be thicker, and become more dense, or be moistened, 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 darkening, 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 for visible species; it causeth only debility of sight, or brings forth some depravation, and deception: If it doth not cover the whole Pupil, so that things seem as if they were divided; the same comes to pass by reason of cicatrizing left after wounds, and ulcers. By its moisture it loseth its transparency in an inflammation of the eye: Moreover by pustules bred therein; and the nail of the eye which the Greeks call Pterugion, or a Tunicle. But if the Cornea be affected with any strange colour which very seldom happens, the sight is depraved, and represents visible species in other colours, not their own. Secondly the Aqueous humour offendeth either in quantity, or manner of substance, or colour. Defects of the Aqueous humour. It offends in quantity if it be wanting, or lessoned by a wound or ulcer, when the Cornea being cut, or eroded by a sharp humour it flies out, or by quotidian diseases, or extreme old age, and as it is waming more, or less: it causeth blindness, or diminution, or depravation of ●ght. Sometimes it offends in substance, when it is become thick or impure, or any thing is mingled with it of a different substance; if it only become thick, the sight is made duller, and those things which are obvious to the sight are seen, as it were, through a cloud; and if they are remote, they could not be discerned; but if they are near, they are not exactly seen. But if the mucous and thick matter be mingled therewith, A perfect Cataract. and be so thickened, that it loseth all transparency, and fills up the hollowness of the Pupil, it causeth blindness, and that disease is called vulgarly a Suffusion, or a Cataract; but if the whole aqueous humour be not obscure and dark, but only some part thereof obscure and dark, if through that part which is dark, visible species are not received, but only through that which is perspicuous at once not more, but fewer things are discerned; but if in the centre and middle of the Pupil only a particle of such a thick and dark humour be present, and all the parts round about of the aqueous humour be transparent, whatsoever is beheld seems not to be whole, but perforated and hollow in the middle; but if the little dark bodies are not continuous, but divided and many of them stick in the aqueous humour, Gnats, Flies, Cobwebs, and such like, seem to appear in the air; but i● the extremities are obscured with such a humour, the object is not discerned whole: when you look foreright. The same also may happen in a disease which is called Hypopuon, Hypopuon. when there is purulent matter collected under the Cornea There is also another Suffufion, A spurious Cataract. which is called Notha, or a bastard Cataract, which is when vapours are carried to the eyes from the rest of the body, through the A teries and Veins, the aqueous humour being safe, which happens to those which are drunk, and in burning Fevers. Lastly, if the aqueous humour be affected with some strange colour, there ariseth the same depravation of sight, as when the Cornea is discoloured, and all those things which are brought before the eyes, represent that colour, wherewith that humour is died. The Pupil which is as it were the window of the eye, Diseases of the Pupil. four ways recedes from its natural state. 1. Whilst either it is dilated, or contracted, or closed, or is removed into another part, or broken, or obstructed. The Pupil is dilated by the extending of the Unca, when it is stretched, or through dry distempers, or by a Tumour, or by wind included, or some spirit or humour, for those which have a broad Pupil; in the night time, Contracted and in an obscure place see best; but in the day time, and a light place see worst; but it is become narrower, when by its moisture it is loosened, and falls as it were into its self: moreover when the aqueous humour is wanting. 3. When some thick matter sticks in the aqueous humour, for those who have a narrow Pupil discern more clearly in the day, not so well in the night: Dislocated and broken the Pupil is dislocated and broken, which when it happens, and changes its place, those things are seen better, which are set on the sides of the eye; then those that are set opposite to it, and those which are opposite seem not to be so, until the sight shall be moved thither where it may be opposed to the visible things, A strabismos. which affect is called a Strabismos, in English squinteyed. The Crystal humour recedes from its natural state, Diseases of the Crystal humour. either according to the manner of its substance, and quality, or according to its situation. As for the manner and quality of the substance; If it be somewhat more solid, thicker, more obscure, so that it wants greater illumination night-blindness ariseth; but if in some part, Nyctalonia. or altogether, it loseth its clearness, there follows debility of sight, or blindness. If it contracts a grey colour, it is called Glaucoma, Glaucoma. with which disease those that are affected seem to see through a cloud, as it were, and through smoke, but if the same humour change its place and decline downward, or ascend upward, all things seem double, if towards the sides, things seem more to the right hand, or the left, than they are; It is recedes towards the middle, or centre, things nigh are ●ightly, sar off are not distinctly seen: if it should go back beyond the middle and centre towards the Nerve Optic, things remote would seem lesser, and those which would discern them truly, must needs put them close to their eyes, which disease is called Mouse-sight and Purblind; Myopia. Lusciositas but if the contrary happen towards the fore part of the Pupil those who have the Crystalline so placed, things nigh seem less, and things a far off bigger, which happens to old men, and especially to those who were employed all their life times in reading, and other businesses where their eyes were continually busied. If the vitreous humour either change its place by some contusion, Diseases of the vitreous humour. and some part of it is carried before the Crystal humour, and puts the Crystal besides its place, ochanges its clearness and perspicuity, or is become thicker, divers diseases of the eye do happen. But if the whole eye, Diseases of the whole eye. or most of its parts are not rightly placed, the sight is diversely hurt, and is either plainly abolished, and blindness follows, or it is weakened, or depraved; namely, when the whole eye wants nourishment, or changes its situation in coming out too forward, by what means soever occasioned, as also in a Strabismos, or Convulsion of the Muscles of the Eye, or it is not moved as in a Palsy, or more humours are fallen out of the eye, by reason of its wide wounds, inflammations, and ulcers. The sight is hurt by default of the Optic Spirits (where we also conclude the errors of the Optic Ne●ves) if they are deficient in the brain, Diseases of the visive spirits and of the Optic Nerve. being hurt through cold distemper, compression, obstruction, and then for the most part, the other senses both internal and external are affected, or at least that part of the brain is affected from whence the Optic Nerves have their original, and then the sight only is taken away, or by default of the Nerve Optic itself, which is its narrowness, or by rapture which proceeds from obstruction of the Optic Nerves, compression, percussion, a stroke by chance, contorsion, or by any violent motion whatsoever. Lastly the cause of Splendour and Glittering of the Eyes is reflection of the Rays of the internal light, Causes of glittering eyes. by reason of the Object, a more thick body or vapours, or thick humours, if they are mingled with the Crystalline, or vitrious, humours, or cover them. The hearing is hindered through default of the Organ of hearing, Causes of deafness. or of the spirits; and first of all if the external ears are wanting, sounds, and articulate voices seem like the warbling, or purling of Waters, or singing of Grasshoppers. Secondly, if the auditory passage either wholly, or in part br hindered, either from an external cause, as a little Stone, a Kernel, Water; or an internal cause, as a Tubercle, an Ulcer, and such like; and so either deafness is occasioned, or hearing diminished, or depraved. Thirdly, if the Membrane which they call the Drum is too thick, or moistened too much, or is loosened, whether it be from the first birth, or afterwards from internal, or external causes the hearing is hurt. Also if it be too much dried by any grievous diseases, or old age, deafness doth arise; But if it be broken either by internal force, as by the violent putting in of an ear-picker, or by an extreme shrill sound, or is eroded by an Ulcer, deafness is occasioned. Fourthly, if the other parts of the ear be not rightly constituted, and the air implanted be impure, or deficient, or the Nerve being dilated is cooled, or is made thicker, or affected with a Tumour, or those three little bones either are not well framed by nature, or are moved by some violence out of their places, or the internal passages are filled with vapours and humours flowing contrary to Nature, or the Arteries passing under the ears are filled with too much spirit, and heat, and too much agitated; or lastly, the auditory Nerve either is not rightly framed from our first beginning, or is obstructed and compressed by a humour, according to the diversity of the disease, the hearing is sometimes abolished, sometimes diminished, or depraved. Lastly, the hearing is hurt through default of the Spirits either through the straitness of the passages of the brain, as in an Apoplexy, or through its perturbation, as in an Epilepsy. or through cold distemper, by reason whereof difficulty of hearing is occasioned. The smelling is hurt through default of the Organs, Causes of smelling hurt. or Spirits, or some external error; the faults of the Organs are the narrowness of the Adequate senses, and external Nostrils, whether from compression, or constipation, or obstruction of the Scive-like bone, and its Membrane, as happens in such as are great, or by the distemper of the chief Organ of smelling, the mammillary precess; but especially moist distemper, or obstruction of the same, from matter flowing, which happens in Catarrhs, and according to the variety of these diseases, the smelling is sometimes abolished, sometimes diminished; the smelling is offended by reason of the animal spirits, if either they are deficient, which are in those which are ready to die, or are hindered from flowing, as in an Apoplexy, an Epilepsy, and such like diseases of the brain. Lastly, the smelling is depraved through some external errors, whilst a vapour, or some filthy and stinking matter sticks in the ways through which the smell passes, for here it is infected by the foul smell thereof, to that things having no ill smell, seem to the sense of smelling to stink. The taste also is hurt through default of spirits, 'Cause of taste hurt. or by some disease of the Organs, or some external error: The taste is hurt by reason of spirits when they are deficient, which useth to happen to such as are dying; or the taste cannot flow to the Organ, either through straitness of that part of the brain, from whence the Nerves appointed for the taste arise, or from obstruction, compression, or wounds of the said Nerves. The taste is hurt through default of the tongue, as of an instrument, whilst it is troubled with cold and moist distemper, or cold and moist matter is poured on it, or whilst it is dried, or is troubled with Pustuls, or an Ulcer, and according to the magnitude of diseases, the taste is either wholly abolished, or diminished. Lastly, the taste is depraved by external error, or from external causes; as from something taken into the mouth, whose savour is not easily taken away, or from an internal cause, as a humour, or a vapour wherewith the tongue is imbued, being communicated from the stomach, the Lungs, the Brain, and other parts to the tongue. Lastly, 'Cause of fieling hurt. for what belongs to the causes of hindering the touch, insensibility and dulness happens through defect and diminition of the animal spirits of the Organ touching; this come to pass either because the animal spirits are not generated through imbecility of the native heat, which happen to them in years, or defect of matter, by reason of great evacuation, or whilst they are resolved, or scattered, or cooled, or stupefied by a Narcottique Medicine, or when they cannot flow to it, through the narrowness of the Nerves, obstruction, constipulation, compression, solution of continuity of the same. The proximate cause of pain is solution of Unity in a membranous part, 'Cause of pain. whether it be occasioned by some primary quality, or secondary, whereof this stirreth up solution of continuity not so manifest, but rather contemplable, by reason; but that is manifest, which therefore is properly called solution of Unity. Lastly, Itching. itching is stirred up from thi●, salt, and sharp Exerements, collected in the skin, moving man to scratch. CHAP. IU. Of the causes of the Symptoms of the internal senses. OVer much watching is occasioned by too much effusion of the animal spirits, Causes of too much watching. to the Organs of the senses: through defect of restraint of the first sense, and too much irritation of the common sense, the bond of the first sense, or sweet exhalations are defective, either because they are not generated in the body, which comes to pass by long fasting, or the use of meats, which do not produce such exhalations, or because they are consumed, scattered, and called away from the brain, which comes to pass in a hot and dry distemper, either of the whole body, or of the brain, and when hot humours and vapours are elevated in the brain, which often happens in Fevers and Delitiums. The same causes also, for the most part have a power of stirring up the common sense, and besides those, principally grief, which in what part of the body soever it is, when it violently affects the sense of touching; it also stirs up the common sense, which once moved irritates also the rest of the senses, and so it is necessary that over much watchfulness must ensue. 'Cause of too much sleep. The causes of too much sleep, and first the cau●es of non-natural, are all those things that hinder the spirits from being sent forth to the external parts, Non-natural. in due manner and season; such are those which dissipate and consu●ne the heat of the spirits beyond measure, or they are called back too much into the internal parts, or hinder the spirits that they cannot go out to the remote parts, as too much exercise, pains taking, too much watching, baths, and such like, which fill the brain with halituous vapours. Moreover the causes of a preternatural and diseased sleep so called, are also against nature; namely, Preternatural. those things which detain the spirits against nature, so that they cannot freely pass to the Organs of the senses. The cause of a Coma, Coma and Cataphora. or a dead sleep is a plentiful vapour, whether cold and moist, or hot and moist, either generated in the brain, or sent thither out of the whole body, or part of it; but principally stupifactive, rendering the animal spirits heavy and drowsy. When there is too greedy desire of sleep, Coma vigil. the same stupifactive vapour is the cause, but because hot and sharp vapours are mingled with it, and many various and absurd imaginations are brought to the fancy, the sleep is troubled and interrupted. The causes of immoderate dreams are impure vapours, Of immoderate dreams. black and melancholy, arising from food and humours, causing exhalations of the same nature, and stirring up the animal spirits, or a distemper of the brain, stirring the vapours ascending from the inferior parts and spirits in the brain. A natural ecstasy hath for the most part the same causes, Of an extasic. for those which are troubled therewith, have in their deep sleep various shapes and images represented to their fantafie, about which, the imagination being too much busied and fixed, the rest of the senses ceasing: when they awake they account those dreams by reason of the too much intentiveness of the fantasy for truths; and think and say to themselves that those things did really happen. The cause of such as walk in their sleep, Sleep walkers. is a stronger imagination from an internal object, represented by a dream, the fantasy being violently affected, stimulates the desire, and thence the motive faculty, to perform something; the senses for the most part being bound, and the rational faculty obscured, but the imagination doth depend either on some vehement diurnal disease, which hath gone before, or on the disposition of the spirits, which the vapours thicken, which are not only mingled with the spirits, but also have force of binding all the spirits, and set before you many clear dreams. The memory, Abolishing and diminishing of the mentory & fantasy. as the imagination, is either abolished, or diminished, principally through the fault of the instrument, which is the brain: through its too cool a distemper thereof, whereunto belongs, not only innate heat, but default of spirits: the default of innate heat is either native, and contracted from our birth, or happening afterwards from our birth. Heat is deficient to those who have too great heads, or a brain weak, and cold by nature, and mixed with too much moisture, or a head too little, and therefore little brains, or a figure, too concise, the figure also itself of the head, may hinder these actions. After a man's birth the native heat is deficient through old age, and what other causes soever, which may destroy and debilitate the innate heat, and may cause foul spirits, whether they be internal, and diseases and vicious humours, or external, as cold meat, moist, thick, corrupt and impure air, overmuch watching, strokes and wounds of the head. Besides the defect and cold distemper of the native heat, the memory also is weakened, yea and taken away, sometimes by too much moisture of the brain; the same also is hurt sometimes by external error, namely through the fault of objects, whilst in certain diseases it is confounded, and distracted, by almost innumerable objects, which may likewise happen to such as are well; who whilst they are busied in telling any story, by reason of some object happening by chance, they are so called aside, that they cannot make an end of their story. But the reasonable faculty is not diminished nor abolished of its self, nor by reason of its instrument, but because the fantasy is hurt, and sometimes the memory, and sometimes both. The depravation of the imagination and ratiocinatination happens in divers kinds of Deliriums, and all have their rise from some default of the animal spirits, which being ill disposed, represent objects so disposed to the fantasy, and whereas for the most part, the imagination, and ratiocination are both affected in a Delirium; and the imagination useth a corporeal Organ with its Spirits, but the rati●●ination useth none, but only beholdeth phantasms. In every Delirium, the next cause of the hurt of the imagination, is the viciousness of the animal spirits, but the depravation of the rational faculty is caused by the phantasms. The imagination and understanding hurt, called Paraphrosune hath its beginning from hot vapours, which in burning F●ve s and inflammations of the interior parts are elevated to the brain, and disturb the animal spirits, yet moderately, which thing also may happen if any one should take in his meat or drink that which may trouble the spirits. On this manner cometh sottishness, and such as is caused by Wine, the weed Darnel, Hops, and such like. A Frenzy is caused by a hot Tumour of the Brain and its Membranes from whence the hot vapours being advanced continually trouble and stir the spirits in the brain. A Frenzy. The cause of offending the imagination in Melancholy, Of Melancholy. is dark animal spirits, but the causes of depraving of the rational faculty, are dusky phantasms, but the animal spirits are become dark and black two ways; first when the spirits themselves are pure in their own nature; but some strange foul and blackish matter is mingled with them. Secondly, when the spirits themselves are darkish in their own nature, and generate such; the former is caused three ways; the first is when the matter dark and impure clouding the spirits is contained in the vessels in the head. Secondly, when the matter is communicated to the brain from the whole body, and principally from the greater veins. Thirdly, when it is transmitted principally from the Hypocondries, which is thence named Hypocondriacal Melancholy: the latter is occasioned two ways, either when the vital spirits are generated vicious and impure in the heart, which when the matter of the animal spirit is such in the brain, 'tis necessary that there be generated in such black animal spirits in the brain, or because although the vital spirit be good and pure; neverthelesle the constitution of the brain is vicious, 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 madness also, as experience often teacheth. The cause of madness is a hot and fiery disposition of the animal spirits; Madnss●e. such hot and fiery spirits proceed from a hot distemper of the brain, or hot vapours mingled therewith, which black Choler will set forward, 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 dried Melancholy. The disease which causeth men to think that they are turned into Wolves, is called lycanthropy, lycanthropy. 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 poison 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 timorous of waters, which nevertheless may be occasioned without the biting of any mad animal by poison in man's body, but principally is occasioned by terror of the observations of Physicians do witness, and then the disease is not to be referred to madness, because those Symptoms which are proper to those that are bitten with mad creatures, do not appear in these, but only the diseased 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 poison, 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 venomous biting of a Tarantula, and the Chorea of S. Viti. so called, hath its rise from a venomous and malignant humour somewhat like to the venom of a Tarantula, begotten in man's body, and indeed is the cause of the Symptoms of the rest of the poisons in general, but because they dance in this manner, that is proper to this poison only, 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 poison is destroyed in an occu●● manner by the force of music, and this little creature is harmoneous, and delights in music. CHAP. V Of the causes of the Symptoms of the moving faculty. IN the first place the cause of a Palsy, 'Cause of the Palsy. 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 brain, as happens in an Apoplexy, sometimes also this disease is called a Palsy; 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 knocked, or beaten, or are made narrower, or by obstruction, or compression, by reason of some humour, or tumour, 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 near thereunto by some contusion, by a stroke or a fall, by a sudden relaxation made of the Vertabres, or being bound. Besides a Palsy there are other impotencies of motion, 'Cause of taking away motion. the cause whereof, besides that of the Nerves, even now explained in a Palsy is the fault of the part instituted for motion, a vicious disposition and disease, namely, if the bones in the joints which are framed for them cannot move, o● 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 dried, hardened, 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 moistened by some humour contrary to nature; or on the other side if they are dried and hardened, if any tumour, 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 than they were, or wont to be, or as it were broken with bonds, or if a painful tumour be in a Muscle. The cause of Laziness is the reception of trouble in the Muscles, and parts appointed for animal motion, Of Laziness. but since this slowness is twofold, voluntary, and against our wills, the one comes without much exercise, and labour from vicious 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 faintness 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, watch, long and tedious sickness, too much Venery, or through diseases of the Nerves, as distemper, especially cold contracted by what means soever, or want, or loss of sense is occasioned by stupifactives, or by straightness, but less than in a Palsy. The cause of Convulsion is the irritation of the expulsive faculty, Of Convulsion. of the Fibres and nervous parts in the Muscles, by reason of something troublesome, which draws the part joined to it into consent, and stirs it up to this motion, whereby the Fibres being contracted, the Muscle is drawn back to its original. Emprosthotonos, Emprosthotonoes. Opisthotonos. is made in the Muscles, which bends the body of such as are affected, forwards. Opisthotonos by the Muscles affected, bends the body backward. Tetanoes is from an equal contraction of the Muscles. T●tanos Spasmus Cynious. The Spasmus Cynichus, or troublesome Cramp ariseth from a convulsion of the Muscles of the Mouth; Trismos from contraction of the Muscles of the Jaws. Also the cause of convulsive motions is a humour, Of grinding Teeth. Of convulsive motions. or a vapour, an enemy to the whole generation of Nerves, irritating the expulsive faculty in them, and stimulating them to expulsion, yet is not fixed, but hath various motions through all nervous parts, and so the member is agitated in various motions, and for the most part it happens that the brain is affected, and matter is se●● from thence into all the Nerves. When the Cramp and Palsy are complicate, Of the complication of the Crump and Palsy. Privation of speech. the ●●mour is of a mixed nature, which hath force partly o● loosening Nerves, partly of vellicating and twitching them. Privation of speech happens through default either 〈◊〉 the Spirits and Nerves which carry them, or of the par● which are necessary for the bringing forth of a word. The spirits are deficient in an Apoplexy, Epilepsy, an●● dumbness, properly so called. Men are become du●● through the fault of the Nerves when either the Nerve●● of third pair are affected, from whence the tongue also receives its Nerve; which defect if it be native, for the most part the hearing is abolished, by reason of the communion of the Nerves of the tongue and the ear, that fellowship is hurt, or when the Nerves of the sixth and seventh conjugations, and those going back, and voc● Nerves are either cut, or stretched, or cooled, or intercepted, or hurt by what means soever. The voice is hurt through organic diseases thereof, if either the Membranes of the Larinx, or top of the Windpipe are filled with some humour, and grow soft, or some chink thereof be shut, by what means soever, or if the tongue be cut about, or maimed, or the Muscles which move the Larinx, Tongue, or Throat are hurt, or relaxed, or knock●, or wounded, or any other way affected contrary to nature or lastly through desault of the windpipe, if that be cut, exulcerated, or closed. The same causes are if they are less, Of the voice and speech diminished. diminution of voice and speech is occasioned, yet more frequently the cause remains in the tongue, namely, if the ligament be too long from one birth, so that it extends to the extremity of the tongue, or if after a child's birth it be wounded, exulcerated, swoolen, or be affected with a Palsy on the other side. The cause of depravation of voice and speech, Of stammering. and first of stuttering, and stammering is principally a moist distemper of the instruments of voice and speaking, and sometimes a dry; also an ill framing of the Tongue and its Muscles, a Tumour borne under it, as also the fault of a swelling at the entrance into the Throat, and want of the fore teeth. Hoarseness ariseth from over much humidity of the outsides or the instruments for speech, Of hoarseness. whether that matter flow from the head, or be cast out of the breast, from looseness and inflammation of the Columella, or a fleshy substance in the entrance into the throat, as also from external and evident causes, first from air violently straining the voice daily, which causeth inequality of the Windpipe. All the causes of the Cough are those which hinder the instruments of breathing, whether they be internal, Of a cough. or external causes, either by Idiopathy, or by Symptothy stir up the Cough by Idiopathy, an unequal distemper, principally cold causeth the Cough, which is the greatest enemy to the breast, sometimes also distempers hot and dry; moreover the roughness of the Windpipe which happens either through distemper, or through biting humours flowing from the head, or by Medicines, or sharp drinks, or obstruction by a humour, thick, or thin, a pimple, gravel, worms, a little hard swelling, clod of blood. By Sympathy the Cough is raised, if the other parts which can draw the Organs of respiration into consent be affected, namely the Midriff, Liver, Spleen, Stomach, which by reason of the common Tunicle, they have vellicate the instruments of breathing, or send vapours to them, or press the Midriff, by reason of some Tumour, ot obstruction. But the external causes are cold air, dry, cold water, too much desire of drink, cold medicines applied to the breast, dust, smoke, sharp vapours, sour aliment, sharp things, and whatsoever contrary to the order of nature slide into the windpipe, straying, or wand'ring in the gullet, if it intercept the way, or stop it, or exasperate the Artery, or any way molest the Windpipe. Those things cause sneezing whatsoever doth stimulate the Nostril's, Of sneezing. and the fore part of the Brain to excretion, whether generated in the body, as humours flowing from the Brain, or those things which affect the Nostrils by communion with the interior skins by Sympathy, which comes to pass when worms stick in the Guts, or whether they happen from without, as whatsoever sharp things are drawn by the nose, smells also and sharp vapours, the splendour of the Sun, and over much light. Gaping, Of yawning. or Yawning is when malicious vapours stick in the Muscles appointed for chewing, and moving the lower chop, which nature endeavours by this motion to cast off, but some time's imagination is the cause thereof. Stretching ariseth from such vapours as may be emitted through the Pores, Of stretching. which nevertheless are not sharp, but being store of them they cause trouble, in the spaces of the Muscles of the whole body stirring up the expultive faculty to expel, which the nature may discuss, it useth such a motion of the Muscles by constriction of them. Lastly, Shaking fits and trembling. Horror and Trembling, which are Symptoms near alike, as also are vehemency, and greatness of motion; and so is the difference of the cause, they are stirred up by something that offend in the circumference of the body suddenly vellicates the sensitive parts, and stimulates them to expulsion, which it strives to perform by a natural concussion. But the causes which bring forth that twitching, are either external and evident, as whatsoever befalls the body, or vellicates the sensitive parts, or cause the sharp humours contained in the circumference of the body to be stirred and moved as a spark of sire cast on, scalding water thrown upon, a biting medicine applied to an Ulcer; piercing cold, and such like for internal, as humours, or sharp vapours, either generated in the parts themselves, or drawn, or sent from elsewhere. CHAP. VI Of the causes of Symptoms wherein all or most animal actions are hurt. THe cause of a Vertigo is inordinate and circular motion of the animal spirits in the brain; Of a vertigo. but the causes which perform this circular motion in the brain are internal, or external; internal is an inordinate motion of a flatulent spirit, moving the animal spirits circularly, and exhibiting a false representation of the moving of external things, and of its own body; but this flatulent spirit takes the occasion of its motion, either from its self, seeing that every spirit by nature is movable and fluid, especially if it be hotter, and more fervent than ordinary, or moved by somewhat else, whereas hereafter shall be shown, which the straitness of the vessels, or of the Pores of the brain occasioneth; for if both the flatulent spirits, and animal spirits are moved in passages that are obstructed, they return back and move circularly, they are generated either in the brain, whence a Vertigo by Idiopathy ariseth, or are sent from elsewhere upward, either from the whole body, as in some Fevers, or from some part, as the Stomach, Spleen, Womb, whence it is called a Vertigo by Sympathy, the external and manifest causes are whatsoever humours can suddenly turn into and dissolve into vapours, or stir up an inordinate and circular motion, with winds, and spirits; such as when the constitution of the air is suddenly altered, immoderate and untimely exercise, emptiness, baths, anger, turning round of the body, the beholding of bodies swiftly turning round, or otherwise moving with violence, looking down from a high place, shaking of the head, a fall and such like. The cause of an Incubus, or riding of the Mare, Of an Incubus. is a thick vapour ascending from the lower parts of the body and obstructing the hinder parts near the Spinal marrow, and hindering the passages of the spirits to the muscles of the breast, whence respiration is hindered, which when a man perceives in his sleep, considering various causes, he feigneth and adviseth with himself, and even from this or that, he imagineth himself to be oppressed and suffocated in his dream. This vapour is, elevated from thick phlegm, or a Melancholy humour residing in the Hypocondries, or proceeds from surfeiting, or swelling by lying supine, or flat on the back: in children also a vapour of the same nature is occasioned by worms. A Lethargy commonly proceeds from a phlegmatic humour thickening in the brain; Of a Lethargy. and so the matter of its self is cold, yet by accident it happens to be hot, but it is impossible that out or phlegm only putrified, both a fever and a deep sleep should arise; for this humour is neither apt of its self to admit of putrefaction, especially in the head, neither if it should admit of it, can it utter so much as will diffuse the heat over the whole body, and kindle a Fever, and heart the Heart especially if it putrify without the substance of the Brain, or its vessels in its bosoms and turn; but it is more agreeable to reason that this drowsiness either is not a primary disease of the brain, but occasioned from stupifactive and pituitous vapours rendering the animal spirits dull, and are the Symptoms of a Fever, which are called companions; namely, of a continued Quotidian of a bastard Tertian, and Semitertian, or if it be a primary disease of the Brain, it doth not seem to have its beginning only from putrified phlegm, but rather from a petuitous inflammation of the Brain, or from an inflammation arising from the blood mixed with phlegm. In both these Lethargies there is present great heaviness, and hurt of memory, by reason of stupifactive, and pituitous vapours, but a delirium, by reason of vapours risen out of the putrid humours troubling the animal spirits. The cause of a Carus is either the straightness of the Brain by compression, Of a Carus. or obstruction near the bottom thereof from cold humours, or a moistening, cooling, and repletion of the Brain from a c●ld and pituitous humour, and an alteration of the spirits by the same, or a stupefactive power, rendering the animal spirits unfit for the actions of the senses and motions; wherewith not ●nly stupefactive medicines are endued, but also some poisons, humours in certain Fevers, Smokes, and Vapours of Coals, new Wine, and new strong Beer, etc. A Catoche hath its beginning from a cold and dry vapour, A Caroche. endued with a peculiar force of fixing the animal spirits rushing into the brain, and in some sort stopping the spirits, rendering them immovable, and, as it were, congealing them, which for the most part is stirred up by a Melancholy humour; such also is the force in a Thunderbolt, and it is sometimes taken from the vapours ascending out of the earth in an Earthquake, and breaking out of their cells, but the spirits serving for imagination, and ratiocination are rather fixed and stopped then those which lately were dispersed into the members of the body, which is apparent from hence, that although those that are Cataleptick move no member, yet if they are moved by another the power of moving exerciseth its self, and being struck they fall down, and moreover spreading their eyelids they keep their eyes open. The immediate cause of an Apoplexy is a flowing of the animal spirits into the organs of the body, Of an Apoplexy. hindering sense and motion; but the influx of the animal spirits is hindered either by the passages through which they should flow into the organs of sense and motion, or the narrowness of the beginning of the Nerves, or through the unaptness of the animal spirits themselves, or by too great a quantity, or perturbation of the same. The straightness of the passages of the animal spirits is made when the beginning of the Nerves in the bottom of the brain is so shut, that the passage and way for the animal spirits and motion into the organs of all the external senses are intercepted; a few only resisting, which flow from the Cerebellum, which scarce suffice for the motion of the breast which striveth exceedingly for respiration. The beginning of the Nerves cause this straightness, first the phlegmatic humour poured into these places performs it by obstruction, or compression, which the Ancients took for the principal, nay some for the only cause of an Apoplexy. Secondly, blood poured out of its vessels by a stroke, or any other cause whatsoever into the basis of the Brain, and pressing the beginning of the Nerves. Thirdly, placing of phlegm when the vessels of the Brain, their being plenty of blood, are filled and stretched that the substance of the Brain is compressed, and the Pores and passages being made narrower, a free ingress for the animal spirits into the Nerve is hindered. Fourthly, a blow, or fall violently pressing the Brain itself, and so the beginning of the Nerves, rendering the animal spirits slow, as it were degenerated from their nature, and are made altogether unfit to perform animal actions, bring forth vapours which contain in them a stupefactive power; moreover the effusion of animal spirits by deep wounds, and troubling of them by a stroke, and by a great fall and commotion of the Brain may take away all sense and motion from a man, but that Apoplexy which ariseth from a pituitous and stupefactive power is the chief, and is understood for the most part when mention is made of a perfect Apoplexy, to wit, which is occasioned by its sefe, when the other Apoplexies by reason of the differences of causes, either are occasioned by some external and violent cause, as by a stroke, by a fall, or they follow other diseases. An Epilepsy is occasioned from a vaporous and thin matter, Of an Epilepsy. whether by its acrimony, or venomous and malignant quality vellicating and molesting the Brain and all the Nerves, and together afflicting the animal spirits, darkening and troubling of them: and there are to help this matter forward not only certain humours corrupted in a peculiar manner, and fit for an Epileptical disposition, but also parts of the body corrupted in like manner, as Worms, Afterbirth, and such like. An imperfect Epilepsy hath the same cause with the perfect Epilesie, but mote gentle and less store of humours, which otherwise could not vellicate all the Nerves, yet may trouble them all, but cannot trouble and darken the animal spirits in the Brain. CHAP. VII. Of the causes of Symptoms which happen to qualities changed. ANd these are the causes of the actions hurt, Causes of colour changed. or of the first kind of Symptoms which consist in the actions hurt: the second kind, or colour of the whole body, or of its parts changed, contrary to nature are humours of the body, such are the colours of the whole body, or its parts, as are the humours in them, so in the yellow Jaundice, by reason of yellow choler effused into the body, the whole body is coloured with the yellow choler in a Dropsy by stegm it waxeth pale. The teeth grow black either through default of aliment, Causes of change of the colour of teeth. or when any slimy matter flowing from the Stomach, Brain, or elsewhere, or also from meat left behind sticks to the teeth; and putrifying corrupts and make them black. The Nails change their colour through peccant matter nourishing them. Of Nails. Fifthly, Of stinking smells. smells and exhalations are breathed out of the whole body, when hot and moist bodies produce plenty of crude humours, which when they cannot be overcome by heat, become putrid, and send forth a stink from the whole body. A stink is sent out of the mouth, Of stinking breath. when either many crudities are heaped together in the Stomach, which are corrupted, and send forth putrid and stinking exhalations by the palate, or when filthy vapours exhale, from the putrefaction in the Lungs, or when such matter cleaves to the Teeth, Gums, or palate, and infects the air which is breathed out with its stink. The smell of the Armpits which they call Goats smell, Stink of the Armpits. proceeds from excrementitious humours, which are sent from the heart, and internal parts in such abundance to these places and emunctories, that all of them cannot easily be discussed, but corrupt, and send forth filthy smells. The faetid smell of the Groin comes from the same cause, namely, Of the Groin. too great plenty of excrements which are sent out from the Liver and Veins to those emunctories. The foul smell of the Nostrils is caused by excrementitious humours there collected and putrifying by a Polipus, a Canker, or an Ulcer in the Nostrils. Of the Nostrils. The ears stink by an Imposthume and Ulcer in the internal Ear, or by vicious humours sent out of the Brain. Of the Ears. Lastly, Of the Feet. the Feet send forth an ill smell, when the moist excrements in them, which are of a hot and moist constitution, and given to surfeit, are collected and putrify in the Feet, being drawn thither by their motion, especially when they are covered with such garments, that they cannot freely expire vapours. The c●uses of tactil qualities changed, Of tactil qualities changed. appears by those things which are spoken of the Causes of Diseases when sometimes they are referred to the rank of Diseases, sometimes to the number of Symptoms; namely, as sometimes the actions are hindered by them, sometimes they hinder not the actions, but only 'cause trouble to the touch. CHAP. VIII. Of the causes of Symptoms in those things that are sent forth and retained. AS for what belongs to excretion, and those things which in their whole kind are contrary to nature, Causes of excrements contrary to nature. and may be generated in the body, as stones, worms, since the same belongs to the causes of Diseases they are spoken of before in the second Part, and the ninth Chapter; but artificial things, as instruments of Iron, Knives, and such like cannot be generated in man's body, but by the enchantments of the Devil are insinuated into the body, or are fitted to parts without, through which they cannot come back, and are there shown, as it were, going back. If those things which are wont to be cast forth naturally are cast out another way, ●●eressions through unaccustomed passages. which comes to pass because the accustomed ways either are grown together, or obstructed, or some way or other shut, for then nature by reason of plenty of matter, which it was wont to evacuate through the usual ways, they being shut, it wearied seeks new ways, either more open, or otherwise, to which some pricking humour leads it, or which it chooseth of its own accord. Thirdly, the effusion of blood contrary to nature through what place soever happens because the Veins and Arteries are opened contrary to nature, Of bleeding contrary to nature. for those reasons which before in the Second part and thirteenth Chapter are explained; and particularly sweeting of Blood happens through the thinness of the Blood, rarity and laxity of the skin, and debility of the retentive faculty. Small parcels are cast out of the body, when from any internal part which was wont to be evacuated that way, or in that way by an Ulcer, Putrefaction, and eroded by a sharp humour, and separated from the body. As for the causes of excretions offending in quality hot ordure is cast out, if choler and hot humours are mingled. If the Liver and Guts are too hot, if hot meats are used. The siege is cold by the extinguishing of the native heat, the use of cold meats and the mixture of cold humours. Moist Excrements are cast out either through crudity, when the meat is not concocted, or by obstruction of the Meseraik Veins, Causes of excretions peccant in quality. Hot. Cold. Moist. Hard. by reason whereof the Chyle cannot pass to the Liver, and therefore being mingled with the ordure 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 Choler, 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 near thereunto, or of the whole body, either natural, or preternatural; moreover from the dryness of the Guts, or of the whole body. Thirdly, if there be too much Urine, or if there be a continued sweat. Fourthly, by thickening 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. . and too much attraction of the members. The dung is sharp through the mixture of sharp humours, & use of sour meats; 'Tis become 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 putrefaction. Ordure is cast forth with a noise through the mixture of much wind violently breaking forth. It becomes white, White. when choler is not mingled therewith, as in the yellow Jaundice, through the use of meats that are whitening, being mixed with plenty of phlegm also. Yellow. It becomes yellow through much much mixture of yellow Choler. It becomes green through aeruginous choler. It grows black by reason of a black humour, by the use of Cassia, and such like. Red. Black. Frothy. It becomes red by the mixture of blood, or adust yellow choler. It becomes frothy by reason of slimy phlegm 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 b●ok. Hot sweats proceed from hot humours either whilst the humours 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 ●he sweat smells by reason of too great plenty of stinking filth, they are yellow in the yellow Jaundice by the mixture of yellow choler. Green by mixture of leek-coloured choler, red and bloody by the watrishness and thinness of the blood, looseness of the skin, and weakness of the retentive faculty, yet there are administered 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 Choler, sharp by the mixture of sharp humours. The menstruous blood offendeth in quality whilst it is white, Of vicious Courses yellow, black, or has any ill colour; moreover whilst it smells foul, and is too watery, which comes to pass whilst the like humours 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 thickened by heat, which happens in Fevers. It becomes frothy through the mixture of spirit, and much air. Spittle borrows its tastes from salt, bitter, sour, humours, especially cleaving to the Stomach. It receives its colour from humours in the bowels, and the vapours going out of them. 'Tis become white from phlegm; Yellow from Choler; Red from Blood; Black from Melancholy, or thick dried Blood; Green from aeruginous Choler; it acquires a foul smell from inward putrefaction, especially from an Ulcer of the Lungs, At length the excressions err in quantity, Causes of excrements changed the excrements of the belly are cast forth in greater quantity than 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 than 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 Veins; and if Choler, (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 less quantity, the causes whereof shall be showed 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 Crisis of a disease great sweats arise, whilst all the excrementitious matter together, and at once is put forth. Little sweat is occasioned by contrary causes; namely, by the smallness, or thickness of Excrements, straightness of passages, weakness of expulsion, by the vehemency of the matter which destroys 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 SIGNS 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 nevertheless since arts are conversant about individuals, and a Physician doth not cure in general man, but Peter and Paul, etc. 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 whilst the sick, see those things that may happen to them, being known to the Physician, they may trust the more to him, and obey him; for the Physician when he foresees those things which shall happen to the sick may have time to prevent them, and avoid the reproaches of the vulgar, whilst he foretells those things which shall come to passs, and that they may not rail against the best Medicines, being given to those that are desperately sick By the name of Signs we do understand all those things which signify any thing, A Sign what ' 'tis. or all evident things which lay open a hidden matter, or as the Author of Physical definitions speaks, A sign is a manifestation of somewhat hidden, or every thing that shows any of those things which are in the Method of healing, and can demonstrate them, and make them manifest. CHAP. II. Of the differences of Signs. OF Signs of this kind there are certain differences; Differences of signs wholesome and unwholesome. first according to varieties of Bodies, some Signs are counted wholesome, which show soundness and health; others unwholesome, which show unsoundness, others are neutral, which show a disposition to neither. Secondly, certain Signs are called Diagnosticks and Deloticks demonstrating, and demonstrative, Diagnostic. which demonstrate those things which show the present constitution of the body, whether it be according to nature, or contrary to nature; certain are Prognostics, Prognostic. which foreshow what shall come to pass; Anamnestick. certain are Anamnesticks which call to memory the state of the body which is newly passed. Thirdly, Proper. Common. some signs are proper, others common, proper are such as agree to one disease only, Common are such as are found in many diseases. Galen, in the first of the differences of Fevers appoints three kinds of proper Signs, and the one he calls unfeparable, another proper in its kind, a third proper and inseparable; also he calls those unseparable, which cannot be separated from the effect which they show, and agrees to every such effect, but not only proper, are such as agree to those alone, but not to all, Proper and inseparable are such as agree to such an effect alone, and to all. Out of this division there ariseth other differences of Signs, they are called by the Greeks Pathognomonick, Synedruors, Epiginomens', Epephanomens'; in English ●●separable, sociable, concomitant, subservient, and such as appear afterwards. Pathognomonicks are such as follow the disease also and necessary inhere in it, Pathognomonicks. and therefore prefently in the beginning of a disease is present and cannot be separated from it, and agrees to every such disease, and always where they are, they show the disease that must necessarily be there present, yet it seldom happens that there is one Pathognomonick sign, but for the most part the Pathognomonick signs are constituted of more joined together, which if they are taken severally are not Pathognomonicks. Synedruons, Synedruons. that is sociable ones, are such as are not inseparable from a disease, nor do they necessarily cohere to the essence of a disease, nor are always present, but besides the Pathognomonicks, sometimes they appear presently at the beginning, sometimes they follow afterwards, and sometimes they are not present at any time of the disease; and therefore they do not show the disease itself, or its kind, but signify some condition thereof. Epiphanomenaes' and Epiginomenaes' are such as neither show the kind of a disease, Epiphanomenaes' and Epiginomenaes'. nor the condition thereof, but show only its mutation, and they are threefold; some signs are of concoction, and crudity, others signify health and death, others are Critic, or decretory which foretell the termination of a disease. CHAP III. Of the heads of Signs. OF the heads of Signs, although there are many, Fountains of signs. 1 Essentially inhering. yet they seem to be reduced to there; the first are taken from the nature and essence its self of the thing, or as Galen speaks from things essentially enhering in the substance; whether it be a disease, or a cause of a disease, or a Symptom; namely, when a thing in its own nature is so manifest to the senses that there needs no other signs. Secondly, signs are sought from diseases, that is, From the effects. from all things which follow health; a disease and the causes of diseases, accidents and Symptoms, whether they be actions, or excrements, and retentions, or qualities of the body. Thirdly, from causes whether they be external, From the cause. or internal, by themselves, or by accident, or what other soever. Whereunto belongs ability and disposition of body, and from hence 'tis easy, or difficult to fall into this, or that disease, for this shows alike temper, that a contrary, such as help also, and such as hinder; as those which increase a disease are an argument that the disease hath an agreement with the thing, which increases it, but that which delights, and profits is a token that there is in nature something contrary to the disease. To these heads of signs some add such as are alike and disalike, understanding by those things, Things alike and unlike either a body which is compared to another body, or a part, which is compared with another part, or with itself, yet others think that similitude and dissimilitude is not a peculiar head of signs, but rather a reason of fitly comparing other signs among themselves, but the comparison may be right the manners properly, and nature of the sick should be known, wand'ring diseases commonly belong to these; when if many happen to be sick of one common infirmity, and he which is sick gins to be so as the rest were, it is to be suspected that he hath the same disease. Sect. 2. Of knowing the Temperature of Man's Body, and of his Principal Parts. CHAP. I. Of the Signs of a wholesome Body. AFter we have spoken of the Signs in general, we come now to handle the several kinds; and because bodies are twofold, Sound, and Sick, and there is a certain difference and latitude of a sound body, which embraces neither of these; first we are to speak in what manner the various constitutions of a sound Body, and of its parts are to be known; and going back from thence, even from a natural state may be understood how a diseased, and 'tis not difficult to discern a sound from a sick: and all those that are to be accounted for sound, who can perform all those actions which belong to a man. Yet how such counterfeit diseases are to be found out. Galen teaches in a peculiar Book; but since there is a great latitude of health, first of all the signs are to be proposed of the best constitution of body, which is, as it were, a rule for the rest, and to which, as to the statue of Polycletus, the natures of men of all of Ages, Sexes, Countries, and Conditions are to be compared. The signs of such a Constitution, as also of others differing from it, Galen in his art of Healing, and fifth Chapter draws from two heads; first from those which essentially inhere, and which according to the nature of the essence are in them. Secondly, from those which necessarily follow those in their operations and accidents. First, Signs of a sound body. therefore it is necessary that a sound body may obtain the most convenient temperature and constitution of the simular parts, fittest for all actions. Secondly, a convenient number it ought to have of organic parts, and likewise magnitude, figure, situation, connexion with others, and all things in all respects, which are required to the constitution of a part, as it is organic. Thirdly, all the parts in order ought to be united and joined, but in respect of actions, a man that is very sound doth very well perform all the actions convenient for a man, natural, vital, and animal; So that there is no defect in them, and observes moderation in them all, and is very little subject to diseases, and withstands all the causes of diseases, violent excepted: the excrements observe their natural substance, quality, quantity, time, and convenient part on't; which to be ejected, the qualities which follow the best constitution of a Body, are a rosy colour of the face, nay and of the whole body, calidity, frigidity, softness and hardness, smoothnesss and roughness; a sound body well constituted observes mediocrity, the body is neither bald, nor too rough, but the hairs themselves keep mediocrity, and in youthful age tend to yellowness, in manly to blackness; the habit of the body is the middle betwixt too corpulent, and too slender, good flesh, and good stature, out of all which the handsomeness of the body proceeds; yet all these most evidently appear in the middle and flourishing age. CHAP. II. Of the Signs of Bodies differing from the best constitution. BUt Bodies which differ from the best constitutions, either are sick, which are discerned from sound Bodies, by the hurting of the actions; and the sign which distinguishes betwixt a sound and sick body, is sensible hurt of the actions; Or they are hitherto sound, which have not their actions hitherto sensibly hurt, whereof there is a great latitude, and some in the temperature of the simular parts, some in the composition of the organic parts,, some of them both deviating from the best constitution. And first those bodies which are too hot, Signs of a hot body. yet moderate in dryness and humidity, such discover themselves to the touch, hair abounds in the whole body, and is yellow and thick. They are thinner, as to matter of fat: they are swift and strong for motion, prone to anger, the colour of the face is redder than of a temperate body, they are easily hurt by hot causes. If dryness be joined to the heat, Of a ho● and dry. which they call choleric, the body shall be hot, hard, thin, and lean, hairy, and the hairs are black, cu●led, the Puise of the Arteries are great, and the Veins great, they are angry persons, which are endued with such a temperature, obstinate levers of brawlings, they desire few things, they are fit for the generation of Males. If moisture be joined to the heat, Of hot and moist. which temperament they call Sanguine, the bodies shall be hot, and soft, abounding with much blood, fleshy, endued with large Veins, and those which are so in their youth, often have the Hemorrhoides of the Nose; and if the humidity somewhat abound, they are apt from their youth to discases of putrefaction. If the body be too cold, Of a cold. such a body is perceived by the touch, 'tis white, at, slow, soft and baid, 'tis easily hurt by cold things, it hath a narrow breast, and without hair, and narrow veins scarcely appearing, the hairs are thin and of small increase for the most part, they are fearful that are of that temperament. If moisture be joined to the cold, Of a cold and moist. not much, nor that coldness great, the body shall be white in colour, fat, thick, soft, red hair, inclining to paleness; but if the frigidity with the humidity be more intense, the body shall be thick, coloured yellow, exceeding bald, the hair smooth, the veins lying hid, such temperaments are dull and slow of apprehension, and for the most part altogether idle, no ways ready, simple, and not prone to anger. If frigidity is joined to dryness, Of a cold dry. such a body is discerned by the touch, those shall be lean, bald, pale, which are of such a constitution they are slow in going on, dejected in countenance with their eyes fixed. And for what belongs to Melancholians in particular, Of Melancholians. not only whom the vulgar, but whom Aristotle in the thirtieth Section, and first Problem accounts ingenious; wherein the said Aristotle writes that much and cold choler is black; these are foolish, and idle, wherein there is much and hot choler, those are quicksighted, and ingenious, apt to love, propense to anger and lust, and some greater babblers: but those whose heat is more remiss, more temperate, and as it were reduced to mediocrity, those are much more prudent, and although they less exceed in some matters; yet in others they are far better than the others, some in the study of Literature, others in Arts, others in Commonwealths; namely, those Melancholians are ingenious, who by nature abound with good and plenty of blood, wherewith some part thicker and drier is mingled, which adds, as it were, strength to the blood, and when attenuated, and, as it were, poured, it is spiritual. And whereas the differences of bodies are constituted according to Astrologers, Saturnines and according to the number of Planets. Those that are born under Saturn have a dry skin, black hair, and are delighted with those black things; they have little eyes, small pulse, a slow and dull gate, they are fearful, sad, love solitude, they are busybodies, covetous, slow of endeavouring, silent, laborious, they have terrible and obscure dreams. Those under Jupiter are fair, Jovials. and have rosy countenances, with a pleasant and venerable aspect, they have black eyes, are of a fit stature, and handsome composure of all the parts, their habit of body is good, flesh, blood and spirits, pure and in great plenty; hence they are mild, joyful, ingenious, bountiful, moderate lovers of friends, just, and all their manners composed with comeliness, and their gate is moderate. Those under Mars abound with choler, Martial. have a lean body, rather than a fat, have red faces and shadowed, burning and threatening eyes, a broad breast, an upright neck, they are propense to anger, contentious, bold, and often precipitate, contemners of danger, seditious, Those under Sol are of a yellowish, Solares. or a Saffron colour tending to red, they have yellow hair, golden, and curled, black eyes, swelling, full faces, moderate garbs, and have hotter blood and spirits; hence they are courteous, wise, open hearted, honest, strong, magnificent, and aspiring to high things, and sometimes proud. Those under Venus are fair, Venereus. coming nigh to the feminine beauty, and softness, delicate colour is red, or of white, inclining to red, their eyes shining, sparkling, and casting lascivious looks, the brows and lips thin, they are quiet, joyful, pleasant in conversation, delighted with jests, company, singing, delighted with Music, lascivious and principally love neatness, and ornaments of the body, Those under Mercury are rather little in body then great, in face somewhat pale, they have little eyes, Mercurians. and those buried within their orbs, thin lips and nose, and youthful face in manly years, very thin beard, quick voice, light spirits, whence they are wise, subtle, studious of sects, and subtle things; prevalent in memory, eloquent, but unconstant, and sometimes also crafty, deceitful, witty liars. Those under the Moon are great in body, fat, thick, Lunar. white, unstable, and sometimes delighted with one thing, and sometimes with another. CHAP. III. Of the signs of the constitution of the brain. NOw follows that which belongs to the constitution or parts, and first of the Brain; although a just constitution of the Brain be necessary to perform animal actions proper to the Brain, yet to perform them, a right composition and conformation of the head, and of the brain depending thereon, do much avail; wherefore following Galen in the art of Physic, we will propound in the first place certain signs of the constitution of the brain, drawn from the figure and magnitude of the head. A little head if the body be great is an ill sign, A little head. for the brain also in such a head is little, because it will generate but few animal spirits, or if it doth generate animal spirits enough, yet they cannot be moved well enough in so narrow a ●oom, but either being penned in they stick, or being stirred up they move too violent, whence the animal actions are the weaker; and those that have such a body are unstable, and do many things inconsiderately; the brain also in a little head for the most part is intemperate and dry, and it argues unaptness, and debility of hear, and of matter in their formation, and especially a little head is naught, if it also have an ill shape. A great head if it be well shaped, A great head. and have the joining parts, as, to wit, the neck, the spin of the back, and all the Nerves correspondent, it signifies the brain is well constituted, and is a token that the formative virtue is powerful, which can rightly inform and elaborate plentiful matter; but if that be wanting, it signifies only plenty of matter: but weak power, which is unfit for such matter, and therefore is no token of a good constitution of the head, and such for the most part are dull and unapt. The natural and best figure of the head is most like to a sphere, The best figure of the hea●. gently pressed on each side, so that that compression may be lengthened from the ears towards the forepart, and those which have that excel in wit, judgement, and memory, are strong in body, but those which differ from that best figure are generally accounted Phoxa, that is, vicious; figure, namely, to wit, wherein the anterior part, or posterior, or both of them are deficient in their excellency, so that either behind, or before, or upward, such heads seem ugly; but if some excellency be deficient, and the rest well raised up, or grows narrow at top, Galen calls it ambitious formation of growing sharp. and those which have this figure of the head, are the most unwise, impudent, fraudulent, and most basely corrupted with other vices, that there be a rising up of the hinder part of the head, and the other bones answer to it, is a good sign, for much good matter is present, if it have a handsome figure also, not else: but if in a thin, too long, and a weak neck, the hinder part only riseth up in greatness, or is deformed; 'tis an ill sign, and signifies only plenty of unprofitable matter, and weakness of the formative faculty. The former part of the head, the hinder part not being altogether deficient in rising up, if it be more lifted up is a good figure, and all the senses are well; and therefore 'tis no ill sign, but on the contrary, if that magnitude be joined with a deformed figure, and the senses are weak, it signifies imbecility of the formative faculty; those whose foreheads are low, have weak senses, and are stupid, yet they often have good memories, and strength of body; on the other side, those whose hinder parts of the head are not raised enough up, have all their senses whole, but are destitute of memory and strength of body; but those that lack raising up before and behind, and the head riseth much in the middle, are called Oxucephaloi, sharp pointed, those are unfit for all animal actions, and weak through the narrowness of the brain; if the head grow great near the ears on each side, it is a token of unfit matter, and of a weak motive faculty. But for what belongs to the constitution of the brain, Signs of ● temperate brain. they manifestly show themselves by their animal actions, and those things that follow them; namely, a temperate brain, doth perform all animal actions well; unless there be any fault in the organs of the external senses, it easily resists external hurts, and injuries. Its excrements are moderate in all, and are cast out at convenient places, especially the Palate, their sleep is moderate, their hair in Infants are yellowish, in Boys more yellow, in young Men yellow; in figure indifferent betwixt curled and straight, nor doth it soon fall off, nor they become bald. Those which have a hot brain are changeable in their opinions, Of a hot. swift in motion, ripe in their wits, they use little sleep, and not very sound, the excrements of their heads are few and concocted, so that no error be committed in their diet, they are easily offended by hot things, their face is redder, and veins apparent in their eyes, their hair soon grows, and soon falls away, 'tis strong, thick, and curled, and for the most part tends to blackness. These which have a cold brain, Of a cold. their senses are slower and weaker, and their apprehension, memory, and wit dull, and the motion of their body, not so lively and quick; They are moderately inclined to sleep, they abound with excrements of the brain, although they are not full of brains; from without they are easily offended by cold things, which easily occur, especially by the north wind: those parts which are near their heads are neither so warm to those that touch them, nor so red to those that behold them, and the veins which are in their eyes are not so discernible, their hair is straight and reddish at middle age, bred more slowly, yet they are lasting; first they are thin, but age coming on they are more burley. Those which have a dry brain have sharp senses, Of a dry. piercing and subtle, they are very watchful, and have very few excrements, strong hair, and often curled, which do so soon grow, and soon fall away, and are hurt by drying things. Those which have moist brains their senses are duller and more turbulent, Of a moist. they are accustomed to much and profound sleep, they have store of excrements, thin hair, soft, whitish, and durable; and they are seldom or never bald, they are comforted by dry things, and offended by moi●t. Those who have a hot and dry brain, Of a hot and dry. are ingenious, and industrious in taking in hand, and performing of business, the force of apprehension is most exquisite in them, and they are fit for motion, yet more active for the most part, then behoves them to be, they are also most vigilant and sleep very little, and have few excrements of the brain; to those that touch them, their head appears hot, their face until they come to full ripeness of years is red, afterwards the heat decaying more pale, they are offended with air, and other hot and dry things. Those which have a hot and moist brain, Of a hot moist. if either quality a little exceed, the excrements of their heads are many, the colour of the head is white, mingled with red, the veins in the eyes great, the hair straight and yellowish, and do not easily fall away; they are easily hurt by heating things, and are pained in the head, and many excrements are collected to the other especially, if they are moist, but if both qualities abound, the senses are not so sharp, they cannot watch long, yet their sleep is not pleasing and continued, they have divers dreams, and strange ones, their heads are obnoxious to many diseases; since it collects more excrements than it can discuss, they are easily hurt by heating, and moistening things, and principally by the South Wind; but if one quality overcome the other, there shall be more evident signs of the one, and more obscure of the other, which is to be taken notice of in the other temperaments also. Those which have a cold and dry brain are too ripe witted, but in process of time, Of a cold and dry. sharpness of the wit and senses abateth, and they grow old and die before their time; especially if a distemper of the Heart and Liver concur with that of the Brain; the same are unhealthy, and are easily offended by external causes, by cold air, and error in their diet; the head to the touch is cold, nor have they good complexions, unless they have the better colour, from the hot distemper of the Heart and Liver, the Veins of the Eyes do not appear, their hair grows slow, and is thin and reddish, and if the dryness overcome the cold they are well, Lastly, whosoever have cold and moist brains, Of a cold and moist. are slow and dull of apprehension, and their senses not so sharp; they collect many excrements, they sleep much and sound, they are easily offended with the coldness and moisture of the air, and are apt to cold distillations; they have long and soft hair, and whitish from their childhood, they are never bald. CHAP. IU. Of the signs of the constitution of the heart. IF the heat be temperate, Signs of a temperate heart. mediocrity is observed in its motion, the Pulse of the Arteries and respiration, and those who have such a heart, they are endued with good manners, not effeminate, nor mad headed, or angry, but humane, not covetous, nor prodigal, but liberal, not dissemblers, nor proud, but candid, without haughtiness of mind, benign, temperate, not precipitate, nor meddlers; nor busybodies, but mature in counsels, not envious, but desirous of others good. Those who have a hot heart, Of a hot. their whole body is hot, the motion of the heart, the pulse, respiration, through urgent use, exceeds all mediocrity in magnitude, celerity, and frequency, they are courageous, and swift, and unweary of undertaking enterprises, and bold in undergoing dangers: they are rough, and full of brisilely hairs in their breast, and the breast in comparison of the head is great. The signs of a cold heart, Of a cold. are contrary to those which are of a hot, the whole body is less hot, unless the liver be hotter, the motion of the heart, puise, and respiration when custom doth not so require it, is not so great, and sometimes small and slow, if there be a greater recess to frigidity; and such a heart argues slowness to anger, fear, distrust, slothfulness, and linger; whence such are effeminare, contemners of glory and honour, their breasts are without hairs, and in comparison of their heads little. Whose heart soever is dry, Of a dry. their pulse is hard, they are not prompt to anger, but being stined up to anger are implacable and mad, and they can dissemble their anger, they are obstinate, and covetous, the whole body for the most part is too dry, unless the moisture of the liver correct it. Moreover be whose heart is too moist, Of a moist. his pulse is soft, they are apt to an●e, but easily pleased, the habit of the body is drier, except the dryness of the liver resist it. The signs of a hot and dry heart are a hard pulse, Of a hot and dry. great swift, frequent, great respiration, swift and frequent, those who have such a heart are fit to take in hand and perform actions, courageous and bold, apt to anger, and unplacable, envious, proud, and if there be excess of heat, and drought, are mad, cruel, unmerciful, and sparing none; the same are hairy, especially in the Breasts and Hypocondries, the whole body is hot and dry, unless the constitution of the Liver hinder it, the Breast broad and wide. The signs of a hot and moist heart, are soft pulses, Of a hot and moist. great, swift, and frequent, and the respiration answers to the pulse, so that the breast answers to the heat of the heart, and those who have such a constitution of the heart, are industrious, and prompt to actions, and not wild, they are apt to be angry, yet it is not sharp and durable, but placable, and this temperature, so that humidity do not too much exceed, most fit to prolong life, but if the humidity doth much overcome the heat, putrefaction is easily caused, and putted fevers are generated. Those who are cold and moist in the heart, Of a cold and moist. bring forth a soft pulse, little, slow, thin, those which have such a temperament, are not bold, but fearful, and distrustful, effeminate, slow, and not apt to anger, and if they are stirred up to anger, it is not violent, but easily appeased, they are also gentle, shamefaced, desperate in adversity, and altogether endued with a soft and effeminate mind, their breasts are bare, and the whole body, and the breast answers to simple constitutions in amplitude. Moreover in those who have a cold and dry heart, there is found in the pulse hardness, smallness, thinness, Of a cold and dry. and slowness, and such is their breathing, if their breasts be ample, they are no ways propense to anger, but being stirred up, and as it were forced to anger, retain it very long, they are also covetous, and of all others most naked in the breast. Yet here you are to be admonished, Whether men's manners are according to their temperature. that those things which are spoken of signs, of the moral actions by Physicians, are not of acquired manners, and such as are completed by education, discipline, and custom, but are to be understood of the native and congenite manners, which Galen calls Hormas,; and when Physicians tell us that manners follow the constitution of the body, that is to be taken of the native and ingenite manners, not such as are acquired. CHAP. V Of the signs of the constitution of the Liver. IF the Liver be temperate, Signs of a temperate Liver. the habit of the whole body is in the middle, betwixt being too fat, and too lean, the colour of the body is rosy, and for the most part, the rest of the signs appear, which are found in a temperate body, the Urine is excellent. If the Liver be too hot, Of a hot. yellow Choler abounds, and in middle age black, or choleric, and adust blood, the Veins are broad, and ample, the whole body more hot, the Belly and Hypocondries rough and hairy; and those which have such a constitution of Liver, are carried away by pleasures, especially by meat and drink, they are offended with hot meats and drinks, and hot air; but cold air and cold meat and drink help them; their Panch is dry, they are thirsty, unless the coldness and moisture of the stomach hinder it, and they are very obnoxious to haet diseases. In a cold Liver all things are contrary, the veins are straight, Of a cold. the blood colder; and hence the whole body colder, except the heat of the Heart hinder it, the belly smooth. The signs of a dry Liver, Of a dry. are little blood, and thick hard veins, and the habit of the whole body thin or lean. The signs of a moist Liver, Of a moist. are abundance of blood, and that thin and waterish, and the whole body more moist. The signs of a hot and dry are amplitude and hardness of veins, Of a hot and dry. and hotter blood, thicker, and drier; the Hypocondris are exceeding rough, and the whole body hotter and drier. But if the Liver be hot and moist, Hot and moist. more store of blood is generated, and that of an indifferent consistence, the veins are great and broad, and soft, and the habit of the whole body moister and softer, the Hypocondries hairy enough, and if either quality do much exceed, those who have such a constitution fall into many diseases, which proceed from putrefaction. If the Liver be more cold and moist, Cold and moist. crude and pituitous blood is generated, the veins are narrow, and the whole body, if the heart hinder it not, is colder and moister, and the Hypocondries are void of hair. Moreover the signs of a cold and dry Liver are little blood, and so the nutrition not so happy, Cold and dry. less store of hair, and the whole body is colder and drier, unless perchance the heart do correct the frigidity of the Liver. CHAP. VI Of the signs of the temperature of the Testicles. THose whose Testicles are in good temper are fruitful; those whose Stones are too hot, are lecherous, Signs of temperate Testicles. Hot. and apt for Venus betimes, and fruitful also, and beget boys, and they also have hair in their privy parts betimes, and have beards also very young. Those who have cold Stones are not apt for Venus, Cold. nor fruitful; and if they do generate, they rather procreate Females than Males, and their genital parts are more bald, and have less hair, and they slowly, or never put forth a beard. Those who have moist abound with much seed, Moist. but watery, and have broad beards. Those who have dry ones, generate little seed, Dry. and that indifferent thick, and are apt to have little beards. Those who have hot and dry Testicles generate thick seed, and are fruitful, and are timely stirred up to Venus, Hot and dry. and yet are easily hurt by Venue, they beget Males, unless the sluggish nature of the woman hinder it; hair comes betimes in the genitals, and plentifully, and in all the parts near, upwards in the parts nigh the Navel, downwards to the middle of the Thighs. Those who have heat and moisture, Hot and moist. do more abound with seed, they affect Venus moderately, and can easily brook it, if the constitution of the rest of the body agree, nay sometimes they are offended by retaining of the seed, they generate as well Males as Females, and are no so rough about the Genitals. Those whose Testicles are cold and moist begin to use Venus late, Cold and moist. neither are they prone to Venus, and they are also unfruitful, or if they generate fruitful seed, 'tis more fit to procreate Females than Males, and the seed is thin and watery. Lastly, Cold and dry. those that have cold and dry Stones, Generate thick seed, and but little, and are more hurt after Coition then cold and moist ones. CHAP. VII. Of the signs of the constitution of the stomach. A Temperate Stomach shows itself moderate in all things, Signs of a temperate Stomach. it desires so much as it can concoct, and concoct it well, and neither corrupts soft meats, which are easy to be digested, no● leaves hard meats unconcocted, and crude, nor is it easily hurt by meat that overwhelms it. But a hot Stomach concocts better than it desires, Of a hot. it digesteth meat hard and difficult to be concocted, happily, burr on the other side, it corrupts soft meats, and such as are easy to be digested, and brings forth a nitrous crudity; 'tis delighted with hot meats and drink, and that so powerfully, that it is not hurt by the moderate use of cold things, but is preserved from the farthest decay, which will be preserved by heat; Thirst is greater than the desire of meat. A colder Stomach more greedily desires than it can concoct, Cold. and principally cold meats, and such as are hard to be digested, are not easily well concocted by it, but easily grow sour in it, and a little after eating pleantifully, a sense of heaviness is perceived about the Stomach, and floating, and loathing, and sometimes vomit. A moist Stomach doth not easily thirst, Scoist. it is not easily hurt by much drinking, 'tisdelighted with moist food, and easily brooks hunger. A drier Stomach is more thirsty, Dry yet unless the thirst arise from some part near thereunto; it is hurt by too much drink, it desires dry meat. From these signs of the simple constitutions of the Stomach, may easily be collected, the signs of the mixed construtions. CHAP. VIII. Of the signs of the constitution of the Lungs. THose who have hot Lungs do much dilate their breasts in breathing, they are thirsty, Signs of hot Lungs. and the thirst is not allayed unless it be in long time, and with cold things. Cold Lungs are much hurt by breathing in of cold air, Of cold. the respiration in those who have cold Lungs is little hot, that is less cold, and is a friend to breathing; also in cold Lungs many excrements are gathered together, which are sometimes cast out by coughing, sometimes by spitting only. Dry Lungs-collect not many excrements, Dry. and therefore hath no need to cast up any by cough or spittle. Moist Lungs on the contrary gather many excrements and therefore between while in speaking, Moist. 'tis necessary to spit often. The woice also is shown by the constitution of the Lungs and Windpipe, Signs by the voice. a great voice and vehemency of efflation shows a wide Windpipe, and heat of the Lungs; a small voice shows the contrary; the Windpipe rightly constituted, causeth a smooth even voice; a sharp voice but joined with clearness, signifies dryness of the Windpipe, a sharp voice with hoarseness, and obscurity proceeds from a plentiful humour moistening the Arteries, and rather belongs to a preternatural constitution than a natural; a sharp voice shows narrowness of the throat, and consequently coldness of the Wind pipe; on the contrary a great voice shows wideness of the top of the Windpipe, and therefore signifies heat strong from their infancy. Book. III. PART. I. SECT. I. OF URINES. CHAP. I. Of the abuse of inspection of Vrines. AFter we have spoken of those things which are to be known about the constitution of a sound body, The vulgar opinion of Inspection of Urine. now we are to speak of the knowledge of things contrary to nature; but because amongst signs Urine, and Pulse do arise from the fountain, we will speak of them in the first place: and first for what belongs to Urine, although a false opinion is deeply seated in the minds of many, that by the inspection of Urine alone, and wholly, the state and condition of the sick, and what ill he suffers, either within or without, from what cause soever may be known, and whether the sick be a man, or woman, whether a woman be great with child or not: yet such like are beyond the power of the Art of Physic, by the Urine to divine. In the mean time the Inspection of Urine is profitable, but as Hypocrates also 1. Aphor. 12. teacheth that Urine may teach many things of the condition of a disease; but that there may be a right judgement of Urine, the differences and causes of the differences are to be known. CHAP. II. Of the differences of Urine, and first of the substance of Urine. FIrst in Urine too things are to be considered, The substance of Urine. in regard of the substance thereof, the liquor, and that which is contained in the liquor. In the liquor again two things, the Consistence and the Choler. First for the Consistence, some are thick, Consistence of Urine. Thin Urine. some are thin, others indifferent. That Urine is thin, which for the most part consists of watery and potulent matter, but of serous and salt matter, that which is separated in the Veins and Liver; or of another humour, which hath little or no mixture with it. On the contrary, Thick. a thick Urine is that which contains much mixture of serous and salt humidity, or also of other humours. Indifferent. The middle is that which hath so much of that serous excrement, and aqueous humidity mixed with it, as for the most part is wont to be in a natural constitution of the body. Moreover some Urines are clear, others troubled, Troubled and thick Urine no the same. Troubled. or foul; those are troubled, through which the sight cannot pass; but 'tis not the same thing for Urine to be thick and troubled, when as other liquors; so Urines also are accounted thick, which neverthelesle are clear, and perspicuous; but a clear Urine is either made clear and so remains, or else 'tis made clear, and afterwards is troubled, which is properly called troubled Urine; but troubled Urine, properly so called, is that which is made so, and either remains such, which Urine commonly is called subjugal, which is like the contents of the Urine, or is made foul, or troubled, and afterwards become clear, and becomes so afterwards, as is spoken. Moreover in respect of the colour, there are accounted several differences, but the principal colours, according to which the Urines differ are six. First white; secondly, pale; thirdly, flame colour; fourthly, yellow; fifthly red; sixthly, black. First to the white Urines belong the aqueous, White Urine. which bore the colour of pure water, than those which represent thin wine, or fair water, into which is cast a little Ochre, or Choler, as also snowy Urine, which represents the whiteness of snow, as also milky and light grey, or such as represents the colour of clear horn. The second is pale like the colour of Ochre, Pale. or subpallid, which is seen in water tinckted with Ochre, but some call these Urines spicious, or the colour of ears of corn, Straw colour. Flame colour. and subspicious, and compare this colour to the colour which is seen in chaff that is old, or in straw. The third colour is flame colour, such as is that of a Citron, and in fire burning clear, which if it be more remiss, 'tis called subfulgent; Actuarius calls these golden Urines, and subaureous, because they are like gold. Fourthly, Yellow. the next and nearest to this fulgent is yellow, yet so differing from it, that this inclines more to white, Brighter yellow. that is more shining and splendid, or near to the colour and splendour of the Stars; that which is not so deep but clearer, then yellow is called subflavous; Actuarius calls these colours croceous, or saffron colours, or subcroceous, such as are in waters wherein saffron, or whilde saffron flowers are mixed. The fifth colour, or red, whereof Galen makes three sorts, Red. and places red in the middle, extreme red, the highest, and reddish the lowest, and those he places in Bole-Almonack, and Vermilion, and red, in Cherries and Apples; others make four differences, and first they place the colour that is a mixed red, such as is the hair of those who are said to be red haired, which again is distinguished into red, and reddish; the second is Rosy; the third purpurious; the forth sanguineous. To these Actuarius joins a vine coloured Urine, Vine colour. which represents the colour of a red Urine inclinable to black, to this be adds the colour of dry grapes, like new Wine (out of doubt of red Wine) boiled to the third part, Blakish. or which is pressed out of dried Grapes, or of Cherries, inclining to a black colour. Moreover there is a black Urine, Black Urine. under which some-Physitians comprehend more colours, green, yellow, black, and such like; although there be innumerable differences of green plants, yet two here are the chief, Leek-colour, which is seen in the blades of Leeks; Eruginous and Eruginous which is like Verdy-grease, and yellow, which represents the colour of red Lead, and therefore called plumbeous. To these differences they refer Oleagenous Urine, Oily Urine which represents the colour and consistence of Oil. Now these differences which are taken from the substance and colour are complicate, and constitute, The smell of Vrines. compound differences, amongst which the chief are seven, Urine thin and white, thin, pale, thin flame colour, or fulgent, thick white, thick red, thick black Moreover besides these there are other differences less principal, which are taken from other qualities and circumstances; first from the smell, for some Urines smell little, others very little, and have that odour which is natural to Urine, others stink exceedingly, and others smell pleasant. From the sound, for some Urines whilst they are poured out make no noise, others make a noise. From the quantity, for some Urines are made in an indifferent quantity, others more sparingly, others more plentifully. From the manner, for some are made without difficulty and pain, others with pain, some drop by drop, and others altogether. CHAP. III. Of the Contents in Urine. A Content in a Urine is every corpulent and visible thing which is mingled with the liquor of the Urine; some Contents are essential, Contents what, how many fold. others accidental; the essential are those which appear for the most part in all the Urines of sound persons, and most of sick, but the accidental are those which neither always nor most frequently are discerned in Urines. Essential in respect of scite or place, in which they abide there are three; the sediment, the suspension, and the clouds, the altitude of the whole Urine is to be divided, as it were, into three parts, into the bottom of the Urinal, and the highest region of the Urine, and the medium betwixt these two extremes. The subsidence or sediment of Urine, The sediment of Urine. The suspension of Urine. The nubecula. is that in Urine which descends towards the bottom, and settles in the bottom. Suspension, or subliment is that which is contained in the middle, and is, as it were, suspended. The clouds and little clouds is that which hangs in the higher part of the Urine like a cloud, yet suspension in Urine is sometimes taken by Hypocrates by the names of a cloud, as in the second of his Prognostics, in the 29. Title is manifest. Yet these Contents do not always exactly keep their natural place, for the sediment sometimes plainly sticks in the bottom, and sometimes ascends higher, and tends to suspension, and sometimes suspension also ascends a little higher from the middle sometimes descends lower; so also Clouds plainly overspread the extremities, sometimes incline towards the middle. In these three Contents, The difference of Contents. other differences moreover are to be considered from the substance; a Content is said to be thick, or thin, equal, or unequal, plain and smooth, or rugged; equal is when all the parts of the Content are of the same thinness or thickness; unequal is when one part is thick and another thin; plain and smooth is that which observes continuity of parts divulsed, or rugged, is when there is no continuity for the colour, A Content is either white, red, or black, or tinctured with a colour near to one of these. In respect of quantity 'tis either little, much, or indifferent, out of which complicated divers other differences again do arise. Concerning the accidental differences which are contained in the Urine contrary to nature, Accidental differences. some settle in the bottom, others in the middle, others in the superficies, some stick to the fides of the Urinal, others are confusedly mixed with the Urine. Of the first kind are farenacious sediments, Farenacious sediment like leaves, like Pulse. which represent thick bran●, little flakes which are like leaves, grainem, which represent a kind of pulse, or corn, besides these sometimes in a Urine, there are clots of blood, small sands, stones, little rags of flesh, quitture, worms. In the middle of the Urine there sometimes swims little bodies like Atoms, threads, or rags, and hairs, Hairs in Urine. and sometimes small sands, cleave to the sides of the Urinal, representing the substance of Tartar. But in the superficies there appears principally four things preternatural, bubbles and those various, froth, Bubbles. Froth. A crown. a crown according to the common opinion; when notwithstanding 'tis nothing else then a shadow, or light, passing through the circumference of the Urinal, received within the compass of the Urine, and so is not properly called a Content, and Fat, yet besides these sometimes fine Sand swimming in the superficies of the Urine CHAP. IU. Of the causes of the various consistence of Vrines. AFter we have mentioned the differences of Urine, Causes of Urine of an indifferent consistence. Thin. next we must find the causes of all those differences; and first the cause of a Urine of an indifferent consistence is a serous excrement of blood, mingled with an indifferent quantity of water which happens when the faculty concocting is well. The cause of a thin Urine which hath little of that serous excrement mixed with it, is debility of concoction, especially in the Liver and Veins, which coldness of the Stomach may occasion, but principally store of drink, also a cold distemper of the Reins. Thirdly, obstruction, and straitness of the vessels through which thick humours cannot flow with the Urine. Fourthly, the changing and converting of the matter in another part. Thick Urine is made by the mixture of any thick matter which happens when crude humours, Thick. which are cumulated in the Veins, are expelled by nature this way, or when any obstruction is opened out of the Spleen, Liver, Reins, and other parts, or an imposthumation is broken, or ulcer, the thick matter is mingled with the Urine, or if there be store of serous and salt humours. If the Urine be made clear and remain so, Clear. and be of good consistence, it is a token that such clearness proceeds from the natural heat rightly elaborating the matter, for nature elaborates not only aliment, but excrements also, as much as it can, Thin and clear. and impresses convenient qualities in them; but if Vein be thin and clear, also 'tis a token of crudity; neither hath nature then begun concoction of humours, and if Vrines have any other colour, than such waterish, they obtain it from choleric humours mixed therewith. But if the Urine be made clear, Troubled. and afterwards be troubled, and that be in a sound body, it is a sign that he declines from his best health, and is prone to some disease, especially a Fever, and it signifies the humours in the Veins to be indigested, which nature now hath endeavoured, yet hitherto hath not perfectly concocted: but if the same happen to those that are sick, it signifies that some concoction is now to be made, and something of the peccant matter to be mingled with the watty substance; but that mixture not to be so exact; and happening by some occasion from the external air, or the heat vanishing of its own accord; the vicious matter is separated from the other humours. But if Urine be made thick, Troubled, which grows clear. and afterwards become thin, that happens because the natural heat gins 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 bottom. The same comes to pass if the Urine 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 Urine be made thick and remain so, it signifies great confusion of humours is made in the Veins by the heat stirring the humours, 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 Urine 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 'tis caused by the fiery heat contrary to nature agitating and troubling the humours in the veins; but if the Urine 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 increased, yet always this and also other signs must have regard to the rest of the conditions of the Urine, and hence it is to be collected, whether such signs be made by the strength of nature working upon the vicious humours, or by the increase of the preternatural heat, and putrefaction, or debility of strength. CHAP. V Of the causes of colours in Vrines. COncerning the causes of colours in Urine, The causes of a golden colour in Urine. a golden colour, which agrees to the Vrines of sound men proceeds according to the vulgar opinion from some portion of yellow choler, or rather from a serous and salt excrement, yet that also something tinctured with choler, which is mixed with the Urine. 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 Urine 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 Urine. Thirdly, if choler, and therewith that salt humour be carried to another place, as happens for the most part in acute Fevers, and Frenzies 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 phlegm, 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 settling in the bottom of what kind it is, may be easily discerned. A Urine is somewhat pale, Of palish. Of pale. when pale choler in a sufficient quantity, or a little of yellow is mingled with the Urine, but if much pale choler, or yellow in an indifferent quantity be mingled with the Urine a pale colour ariseth. If yellow be mixed in greater quantity, Of yellow. the Urine becomes yellow, yet some times other causes besides internal, external may give a tincture to the Urine, as Rhubarb, Saffron, the leaves of Senna, and such like. A ruddy colour in Urine is caused by choler and blood, Of blood red. and indeed if the Urine be coloured with blood it doth not look clear, and is properly called Urine died 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 assimilate it to themselves, or because nature at set times evacuates the blood abounding in the whole body with Urine; but the blood which is mingled with the Urine, is either thin, and the Urine is made red or reddish, or thick, which if much be mingled, the Urine is made exceeding red, but if little either simply red, or of a pale red, but that Urine which is coloured by store of choler, the choler 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 choler, like wine of a blackish, or deep red. Wine like Urine is made by the mixture of ceruleous choler, Of Vine colour. Of grape colour. or representing the colour of Woad, as also by the mixture of plenty of red choler: Grapy by the mixture of yellow choler exceedingly dried, and as it were changed into a Violet colour and degenerating towards black. A green Urine is caused by plenty of Aeruginous, Of green. and Leck-like colour. Yellow and black Urine are sometimes caused by the mixture of external things; Of yellow and black. as for what belongs to the internal causes, the Urine 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 choler 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 oily Urine, and of other differences. O Leaginous Urines either have only fat swimming in the superficies, Of oily Vrines. or represent Oil 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 Urine which seems like Oil in substance and colour, and yet is nor truly fat, hath its beginning from the mixture of excrementitious humours, especially of pale and black Choler, as also of Phlegm, from whence proceeds a crudity with a certain greenness like Oil; Black Urine always thick. but when the difference in substance and colour are joined, a black Urine cannot be thin, but if the black humour makes it black, it is necessary that there is so great plenty thereof mixed with the Urine, that the Urine must become thick. A light red Urine is thin from the small portion of blood mingled therewith, A light, red, thin. but if it be made of a pale red, 'tis by choler which cannot happen unless there be so great plenty thereof, as may render the Urine thick. A pale and thin Urine is made when a small portion of choler is mingled with an aqueous Urine, A pale and thin. A pale, red, thick. but a pale red and thick, when choler is mixed in greater plenty, but if any choler be mingled with a thick white Urine, the Urine is died pale. CHAP. VII. Of the causes of smell, quantity, and such like accidents. THe Urine which obtains the natural and usual smell, 'Cause of the smell of Urine. signifies that the natural heat is right, and concoction is well performed; but if the Urine smell not, or less than the Vrines of those that are well use to do, it is a token that the native heat is weak, and almost no concoction performed, Of no smell. nor is the serous and excrementitious humour mingled therewith. Sweet Urine, Of smelling well. or that which smells well doth not proceed from any internal natural causes, but if any such be found it hath acquired that smell from meats, or medicines taken inwardly. Stinking Vrines are caused first from meat and drink, Of . and certain medicines taken, also from crudity and corruption of meats, erosion, and especially from putrefaction, Fourthly, from daily retention of Urine in the Bladder. Urine naturally aught to answer to the drink, Of store of Urine. but it is made more plentiful than is fit: First, if meats are administered which are full of aqueous humidity. Secondly, if the aqueous and serous excrements, which use to be discussed by motion, or evacuated other ways be retained in the body. Thirdly, if nature from the other parts, or the whole body expels the vicious humours through the passages of Urine, which useth to happen in Critic, and Symptomatick evacuations, as in a Diabetes, or incontinence of Urine, Fourthly, if Dyuretick medicine be taken. On the contrary, little Urine is caused by contrary causes, Of little Urine. namely, not only by reason of small quantity of drink taken, but of dry meats, moreover if the aqueous matter be consumed which useth to be in burning fevers, as also by motion and too much exercise. Thirdly, if the Urine be converted to other parts. Fourthly, by reason of the straitness of the passages, by which the Urine ought to be expelled. CHAP. VIII. Of the causes of Contents in Vrines of those that are sound. THe matter of a Content, The matter of a sediment in sound men. or Sediment in the Vrines of such as are sound (for in Vrines of those that are exactly well, there is scarce any Content save only a sediment) is some part of aliment which escaped concoction; for since it neither can be changed into perfect blood, nor into the nutriment of any part, after the third concoction it is sent to the Reins and cast cut through the Bladder, and there is scarce found a Urine of a sound man, The causes of diversity of Contents wherein the natural sediment doth not appear; because scarce any body is so exactly sound which doth not generate some such excrement; and no nourishment is to be found which cannot afford matter for such an excrement. Whence according to the diversity of meats, and natures thereof there ariseth diversity of Contents: For although the Contents settle in the bottom, and in those that are exactly sound; yet in those which do not enjoy most perfect health, The cause of the quality of the sediment. or do not eat the best meats, it doth not enjoy its natural place; but in some, and those which eat grosser food more than is convenient, it doth settle in the bottom; in others it ascends higher than is fit, by reason of the heat which cannot subdue it. A Sediment is naturally white and takes this colour from the veins and parts which are wont to impress a white colour on those things which they change: Equal and continued is not divided by reason of heat rightly concocting and rendering this excrement equal, and obtains the figure of a Pyramid, which although all parts seem to the senses to be equally thick; yet in truth some are thicker, which settle underneath, others thinner which consist in the superior part. A great sediment is through plenty of crude juice which affords matter for a sediment; Quantity. whence boys through much eating, and those that live in idleness, and those whose accustomed evacuations are suppressed, and females also have a more plentiful sediment; but men because they are hotter, and have not so many crude humours, have less sediment: the same happens in Summer through fasting, too great evacuations, and other causes consuming the humours, also obstructions, and much and thin drinks, which are distributed and cast forth before it can receive any mixture, or digestion with meat. CHAP. IX. Of the causes of Contents in Vrines of those that are sick. AGain in sick people the sediment consists of the more crude part of the aliment which cannot turn into nourishment ●f the parts; The cause of a sediment in the Urines of the sick. with which notwithstanding other vicious humours also are mingled, nay sometimes vicious humours only may afford matter for a sediment, but by how much the more the Contents of those that are sick are like to those that are well, by so much they are the better, and show great concoction, but by how much the more they recede from those either in colour, or other qualities, by so much they are the worse, and indeed the differences of colours of Contents are borrowed from the humour whereof they consist; but as for what belongs to the diversity of substance, that proceeds from the variety os burning heat and various disposition of matter: a farenacious sediment, as Galen teacheth, is made from thick dried blood, Causes of a fernacious sediment. Frothy. Bran-lik. Pulse-like or flesh unequally consumed by a fiery heat, but rough or scaly, when the solid parts are unequally consumed, and scaly particles are cast forth with the Urine, and branlike sediment proceeds from a flamy and consuming heat of a Fever, and a sore in the bladder or veins: a sediment that represents pulse proceeds from melting, as Actuarius teacheth, when a Fever comes to the flesh and melts it, but it is not thought credible by the late Physicians, that by the melting or flesh any thing so thick can be mixed with the Urine; and moreover those sediments they account do proceed from a scabby, and exulcerated bladder, or from a crude and melancholy humour. Small Sand and Gravel proceed from thick and feculent matter which sometimes contains in itself a principle of coagulation, and a light occasion being offered, Of sand and gravel. it concreates of its own accord. Clods of blood are discerned when either from an ulcer, Of Clods of blood. or otherwise from a hurt, broken or open vessel in a part through which the Vein passeth, blood is cast out. Quitture appears in the Urine when an imposthume, Of quitture in Urine. or ulcer lieth hid in the Reins, Bladder, or otherwise through which the Urine passeth; or when from the superior parts, as the Breasts, or Lungs, nature evacutates matter through the urinary passages. Small pustles of flesh called Caruncles in the Urine of exulcerated Reins, are aprts of the substance. Of Caruncles. Of slimy Ecrements. Slimy, thick, and tough phlegm 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 truly 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 phlegm which is cast forth in great plenty, is the offspring 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 dried 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 tumour, and those bubbles may be of divers colours according to the nature of the humour in which the enclosed wind stirs them up. A Crown shows what kind of humours are contained in the greater vessels, Of a crown and according to the diversity of humours 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 humours, 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 Urine it proceeds from melting of the grease, but this proceeds from heat, therefore if the fat continually swim in Urine like cobwebs, it shows consumption and melting of the body; yet Fernelius writes that he would advise you of Oil taken inwardly, lest any small bodies of Oil 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, Urine 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 Boys. Youths. Old men. Of middle age. Boys 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 than the Urines of women, thinner, and have fewer Contents, but the Urines of women are paler, and by reason of crude humours, 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 man's or woman's 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 shown 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 Urine 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 Urine is increased, 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 nearest 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 nearer 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 increased, and the thickness and contents diminuished; but if the exercise continue long, the colour and tenuity is lessened, when the streng this weakened, but those that live idly make Vrines not much coloured, and moreover thick and with many sediments. In immoderate watch, first the colour is increased, According to sleeping and waking. but if they continue long 'tis abated: sleep if it be moderate causeth Urine to be good in all, but if it be immoderate, it increaseth the colour of the Urine, but abateth the contents and substance, but if it be protracted longer, it becomes crude. The passions of the mind, since some increase the heat, Passions of the mind. some diminish it, according to the calidity and frigidity which they bring upon the body, they altar the Vrines. Lastly, Meat, Drink, and Medicines. Meats, Drinks, and Medicines change the Urine, 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 smell lof Vrines. CHAP. XI. What 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 Urine. First the time in making water is to be observed, those Vrines which are made presently after eating and drinking, When Urine is to be received. signify nothing certainly, especially if much drink be taken, since the decoction is not performed, Urine is rather to be looked upon after a perfect concoction, and about the morning. In Fevers regard is to be had of the fits, because in time of the Paroxysm the morbifique matter is expelled another way. Secondly, it is to be weighed whether any meat, drink, or medicine, be taken which may change the Urine. Thirdly, The whole Urine to be taken. It should first settle. In what place should be kept. Inspection of troubled Vrines. the whole Urine made at once is to be be taken, not to be mingled with waters made at several times. Fourthly, judgement is not to be given of Urine before it hath settled, and the Contents enjoy their proper place. Fifthly, you must beware lest the Urine by cold air, or winds especially in an open vessel, being exposed thereunto, should be changed, or corrupted, yet it may be changed no less by too much heat then by too much cold. Sixthly if the Urines are troubled they are to be settled by the heat of fire, or rather warm water, that they may return to their former state; yet it is convenient to look upon troubled Urines before they become clear again, since often times in troubled Vrines the substance of the Urine is more manifest than in clear, and often times Vrines which be not troubled seem to be alike, when troubled they differ exceedingly; and in troubled Vrines oftentimes that matter of the Urine shows itself, which scarce any one could believe had been contained in it when 'twas clear. Seventhly the Urinal in Inspection ought to be quiet, and not to be stirred, only after Inspection it may be lawful to stir the contents. Eighthly, the Glass wherein the Urine is to be viewed aught to be clear, perspicuous and void of all colour. Ninthly, the Urine is to be cast neither in a place too shady nor too light, yet the colours in a small shade, so not too dark, may be discerned best, but the Contents in a lighter place. CHAP. XII. What may be discerned and foretold by a Urine. ALL diseases and affects cannot be discerned by Urine only, since there are diseases of many parts which altar not the Urine, What can be known by Urine. but without dispute the Urine may show that disposition which is in the Liver and Vrines; since the Urine is an Excrement of the Veins, of the Reins also and passages through which the Urine flows, and the diseases of the Bladder and Yard without controversy the Urine may show; for if any thing be contained in the ways through which the Urine passeth contrary to nature; 'tis easily mingled with the Urine: moreover the diseases of those parts which send matter to the Veins, may be dscerned by the Urine. Whence if any peculiar part be affected, and the Urine changed also; if in the part affected there be also made any peculiar change, it is a token that such matter is transmitted from that part to the Reins and Bladder. On the contrary, also when the matter which is contained in the Veins is carried sometimes to other part s, and causeth various Symptoms; the diseases of those parts may also be known by the Vrines, especially if other Symptoms agree with those of the Urine. Lastly, when Fevers and venomous diseases may be joined with the diseases of many parts, although the Vrines then do not first indicate that very disease of the private part; yet 'tis not unprofitable then to consider the Vrines, and to observe the signs from thence of life and death. And thus what may be known, and foretold of every Urine is manifest, from those things which are spoken of the causes of all the differences which happen unto Urine. Book. III. PART. I. SECT. iv OF PULSES. CHAP. I. What a Pulse is. A Pulse which the Greeks call Sphugmos and Sphuxis, A Pulse what. is a motion of the Heart and Arteries proceeding from the vital faculty, consisting of dilatation and contraction, and is appointed for the preservation of the Harmony of the native heat. Instruments of a Pulse. Instruments of the Pulse are the Heart and Arteries, and the Heart is the Fountain, Chimney, and Elaboratory of heat and vital Spirits; but the Arteires are the Channels through which this vivifying heat is derived from the heart, as from a Fountain, and dispersed through the whole body, which work that they may rightly perform, power is given to them by nature whereby they can dilate and contract themselves by perpetual motion, Efficient cause. by which means Arteries Blood with the vital Spirits, is diffused through the whole body, the vapours are expelled, and cold air is drawn in; neither is the motion of the Heart and Arteries made only by the fervent heat of the Blood and Spirits; nor is this motion to be accounted accidental, Vital faculty. and, as it were, violent, but the heart by a peculiar faculty which it hath in its self, which they call Vital and Pulsisique is moved; neither are the Heart and Arteries dilated, because they are filled, but they are filled because dilated. Neither is this faculty denied to the Arteries, although in its own manner, it depends on the heart, The use of the Heart and Arteries, The use of the motion of the heart and arteries. and the end of their motion is the preservation of the native heat, the generation of vital spirits, and the distribution of them through the whole body; but the native heat is preserved (as being hotter) whilst 'tis cooled and fanned, and the matter fit for the generating of spirits is drawn, but the fuligenous vapours are expelled. The motion of the Heart and Pulse performs these duties by that double motion, out of the which as of parts it is composed, namely by Sistole and Diastole, or dilatation and contraction. But because these two motions are opposite, and a thing cannot be moved against its opposite unless first it be quiet. It is necessary that these two motions admit of two cessations between; the one is that which follows the Systole, the other the Diastole. And indeed attraction is made by dilatation; for the cooling and fanning of the heat, and the generation of spirits. But contraction is made for expulsion; for the heart when it is dilated attracts blood, the matter of vital spirits and arterious blood, and air from the Lungs through the arterious veins; But the Arteries draw some of the thinner blood from the Veins, especially they draw air through their small orifices, opening to the Pores of the Skin: by contraction the Heart expels fuliginous vapours, and together emits arterious Blood and Spirits into the Arteries, but the Arteries expel fuligenous excrements, and together communicate some Spirits and arterial blood to all the parts. CHAP. 2. Of the simple differences of Pulses. THe differences of Pulses are either absolute, or relative; The differences of Pulses. Absolute. Respective. absolute differences are when a Pulse hath any difference absolute, and in its own nature, when we consider it without comparing it with any other. Respective are those which arise from comparing of the Pulses amongst themselves. Absolute again are twofold, simple and compound. But seeing to the Pulse, as also to every local motion, Simple. five things are required. 1. The thing moving. 2. The space through which the motion is made. 3. Time. 4. The rest between the two opposite motions. 5. The instrument: according to these also the simple differences of Pulses are constituted, and every simple difference regards one of these, and so there are ten simple Pulses, a great and small in respect of space, swift and slow in respect of time, thick and thin in respect of rest between, vehement and weak in respect of moving, hard and soft in respect of the instrument. And if amongst the opposite motions we account a mediocrity, or moderate in every kind, there will arise 15. simple Pulses And if there may be added to these other differences, either they are not comprehensible by the touch, or they are unprofitable. A great Pulse is that which exceeds the space, A great and a small Pulse. which by nature is granted for the motion of the Artery. A little Pulse is that which doth not wholly keep that space. A moderate Pulse is that which doth observe its definite space for its motion; but whereas in space, longitude, latitude, profunditude may be considered, some divide a great and small Pulse into other differences, to wit, long and short, high and deep, narrow and broad, to which if a moderate Pulse be added, then there will be made five kinds, all which kinds if they are joined together, amongst themselves make twenty seven differences, which comprehend eighty one Pulses; of which Galen in the first of the differences of Pulses, Cap. 5. A swift Pulse is when an Artery runs through his space in a short time, A swift and slow. a slow when in a long time moderate, when in an indifferent time. A thick, Frequent and thin. or frequent Pulse is performed, little rest interposing between. A thin when long; an indifferent is performed in the middle of those extremes; but that a frequent and thin Pulse may be rightly perceived, The Pulses are to be divided into the stroke, and the interval; the stroke is the motion of the Artery resisting the touch; but the interval is the time interposed betwixt two strokes, whereby the Artery is contracted and dilated, which by how much the shorter or longer it is by so much the Pulse is said to be more frequent or thin. A vehement pulse is that which strikes the hand of him that feels it, Vehement weak. and resists it: and as it were reverberates. Weak is that which gently strikes the hand. Moderate is the middle betwixt these two. A hard Pulse is when the Artery is hard, Hard. Soft. and resisteth the touch. A soft is when the Artery is soft and fainty, and gives way to the touch. CHAP. III. Of the compound differences of Pulses. OUt of these differences of simple Pulses, compound differences are easily to be found, which although they are very many, yet these are the chief. Great. Swift. Frequent. Vehement. Soft. Great. Swift. Moderate. Moderate. Moderate. Great. Moderate. Moderate. Moderate. Moderate. Moderate. Swift. Frequent. Vehement. Hard. Moderate. Swift. Thin. Weak. Soft. Moderate. Moderate. Frequent. Vehement. Soft. Moderate. Moderate. Moderate. Vehement. Hard. Moderate. Moderate. Moderate. Moderate. Moderate. Moderate. Moderate. Moderate. Weak. Soft. Moderate. Moderate. Thin. Weak. Soft. Moderate. Slow. Thin. Weak. Soft. Little. Swift. Frequent. Vehement. Hard. Little. Moderate. Moderate. Moderate. Moderate. Little. Slow. Moderate. Moderate. Moderate. Little. Slow. Thin. Weak. Hard. CHAP. IU. Of an equal and unequal Pulse. REspectively or Relatively, Respective differences of pulses, equality and inequality. for either respect is had to the equality and inequality, or to order, or to proportion or number; equality and inequality of the Pulse is nothing else but a congruity or difference of one thing in pulses when compared with another. Equality and inequality is either simply and absolutely such; or Secundum quid, How manifold equal. Absolutely equal. Absolutely unequal. and which is at least in a certain kind such. Absolutely and simply, a Pulse is said to be equal which neither changed in magnitude nor in swiftness, nor in frequency nor in vehemency, nor in swiftness, and if equality be observed in neither of these, it is called a Pulse absolutely and simply unequal; but if a Pulse keeps not equality in all these, neither is made unequal in all these; it is said according to something, and in some respect to be unequal, the denomination is to be taken from that wherein it observes not equality. Moreover these unequalities again are divided into systematical or collective, Systematique inequality. An unequal pulse equally. unequal. which is observed in more strokes, and singular, which is in one stroke; collective, again is double, unequality equally, and unequality unequally; unequal Pulses are equally when the first is so to the second, as the second is to the third, the third to the fourth, and so forward, unequal; unequal unequally are those which are not alike in their change, neither is the first so to the second as the second is to the third. We call an unequal Pulse equally Myouron, Myoures. from the similitude of the tail of a Mouse, which as the tail of a Mouse from some thickness by little and little and equally tends to sharpness, so these Pulses in magnitude are lessened by degrees and equally, and the following stroke is always less than the former, which some call maimed Pulses. These again are either deficient Myourn which perpetually are lessoned till at length they plainly cease to strike any more; or such as at length cease to be lessened, Deficient Myouroi. and do not plainly give off and rest; and both of them again are various, for some keep that pravity to which they are come others do not persevere therein; but return again to magnitude, Maimed reciprocal. which the Greeks' call maimed Pulses running again, reciprocal shortened, or running Pulses, and these again either return to their former magnitude, or to lesser, or to a greater. Unequally, unequal Pulses also are various according to all the simple differences of Pulses, but the chief, and those which the Ancients gave names unto, are the intermittent, deficient, the intercedent, or intercurrent. The name of intermittent is attributed to that inequality which is in pravity and rarity, Intermitting. or only rarity, namely when the artery is so hindered in cessation, that one pulsation seems to have two or three, between two which seem to be deficient, and after one or more strokes, Intercurrent. the intermittent gins to beat again. Intercurrent, or such as go between, are opposite to intermittent, and amongst them after certain strokes, one or more strokes intervene, which causeth inequality of frequency. A deficient Pulse is when an artery after it hath made unequal strokes, Deficient. plainly seems to be defective in motion and to cease; which if it return to its former motion, it is called a reciprocal deficiency, Reciprocal defictent. and this is the difference between an intermitting and deficient Pulse, that a deficient reciprocal after a long space between, whereby the man seems to be destitute of a Pulse, returns, but an intermitting at the highest returns after intermission of five Pulses. A singular inequality is either in one part of an artery, A singular nequallity. or under one finger, or more, or all; inequality under one finger is, when in dilatation and contraction a certain diversity in celerity is observed, so that one part of one motion is swifter, another part is found slower, and this inequality Authors divide into three parts, namely an intermitting Pulse, an uneven Pulse, and a hasty Pulse, or striking double. Intermitting in one Pulse is when the dilatation of the artery before it can come to its term and external rest, Intermitting in one Pulse. is interrupted in the middle of its motion, and is refreshed in its rest, yet so that it cannot remain in rest but performs motion, and comes to its accustomed term and Externall rest. Of this kind some Authors make many differences, Caprisons. amongst which the chief is an uneven Pulse, when in the Diostile as it were in the middle of its rest 'tis interrupted, yet so that after rest the faculty ariseth higher and perfects motion, whence in an uneven Pulse in one dilatation there is as were a double stroke, and indeed the latter swister then the former. uneven. An even hasty Pulse is when the motion is continual and interrupted by no rest, stirred up. but the part of the distending one is slower, another swifter, as if the motion of distension gins slowly and afterwards ends swiftly, or the contrary. Dicrotus. Dicrotus or a double striking Pulse is when the Artery gins to be moved, but before it perfects its motion it goes back and a small contraction being made it riseth again to perfect its motion, and strikes the second time, so that a double Pulsation seems to be made, which nevertheless consists of one distension or dilatation. In equality in one Pulse, but under more parts of the Artery happens, when in one dilatation the Pulse strikes two, three, or four fingers, but those unequally, so that in one finger the Pulse is otherwise perceived then in another, and that in a twofold manner, for either the motion is interrupted, so that some fingers perceive motion, others not, or it is a continued motion, when the Artery is otherwise moved under other fingers; Myourus on Pulse. and indeed those which are made unequal in magnitude in one Pulse are called Myourus, namely when the Pulse under the fore finger is greater, less under the second, less than that under the third, but if the Pulse under the middle fingers be greater, under both extreme fingers less, they are called prominent Pulses or Myouroy, changing about unto every part. Out of these simple differences of inequality other compound do arise, Prominent. for either a systematical inequality is complicat with a simple, or a systematical with a systematical, or a singular with a singular; out of which compound differences the chief are first, a rugged or uneven, second full of surges, third when it bears as if a worm did creep under ones finger, four that feels as if it were a Pismire, five a serrate Pulse, six a hectic, seven a trembling. In an uneven Pulse whereof we have spoken before in equality is twofold in swiftness and violence, Caprisons. for one part of the motion is swifter the other, more vehement than the former. In a Pulse full of waves there are two inequalities, A surging pulse. in magnitude and frequeney, namely when the Artery is moved, the motion not interrupted, but unequal, so that magnitude may appear first under the fore finger, afterunder the second, then under the third, hence under the fourth; according to the manner of the waves. The Pulses like the moving of a Worm or Pismire, Virmicall. differ from a surging Pulse only in magnitude, for there is the same inequality in that Vermicular as in the waving, but the Artery is less and slower lifted up, and it renders the Artery as it were into the form of a creeping worm. This Vermicular Pulse being less and slower, Formicant. but very frequent is a Formicant motion, so called from the creeping of a Pismire, which indeed makes quick steps, but goes less way in longer time. A Serrat Pulse is when one part of the Artery is more lifted up and strikes the fingers more, A serrate. the other is less lifted up, and strikes the fingers less. A Hectic Pulse is so called from the similitude of a Hectick-Feaver, A hectic it always persists in the same in equality what ever the inequality be. Lastly a trembling or fainting Pulse hath inequality in many Pulses, A trembling. in magnitude, frequency, and vehemency, in the same manner, as you may observe in the panting of the heart, CHAP V Of the order and Harmony amongst Pulses. THe second difference of relative Pulses is constituted in respect of order, ●nordinate pulse. and it agrees at least to unequal Pulses, for equal Pulses are always ordinate, but that is an ordinate Pulse, which although it be unequal, yet it keeps some order in striking, but an Inordinate is that, which is unequal and keeps no order in striking; Inordinate. as if it should happen that an Artery should make four equal Pulses, and the fift differs from equality; and again an Artery makes four equal Pulses, but the sift differs again from equality, it is called an Ordinate Pulse, but if the first and second be equal, but the third less, the fourth fifth and sixth again equal, the seaventh unequal, it is an Inordinate Pulse. Inordinate Pulses again either are absolutely so or not, absolute inordinate are, if whilst more circuits are considered, those that follow no way answer to the first; not absolute Inordinate are, if the latter circuits, although amongst themselves they are not alike, answer to the first. The last differences of relative Pulses is constituted in respect of proportion or harmony now concord is nothing else but a proportion of the time of dilatation to the time of contraction. Harmony is either equal or unequal; Rhythmus. in pulses. equal according to the opinion of Ancient Physitiansis when the time of contraction is equal to the time of distension; unequal is when the time of Diastole is greater or less than the time of Sistole, and a Pulse according to the opinion of the Ancients is harmonious, which observes a proper meeter, Good order. no order. to the age, temperament, and sex: Incongruous is that which differs from the proper Harmony of age, temperament and sex; but since a dilatation can scarcely be fully known, Galen doth not constitute a Harmony by comparing of the time of contraction with the time of dilatation, but rather by comparing of the quality of motion, as of swiftnessc and slowness, so that to him a meeter or Harmony is nothing else but proportion of dilations amongst themselves, and a congruous Pulse is that, wherein the Sistole and Diastole are equally swift; but an irregular is that, wherein the celerity of dilatation and contraction is unequal, the inequality of which irregularities or discords may again be divided into nine differences, according to the variety of dilatation and contraction in celerity and tardity. CHAP VI Of certain things necessarily requisite to distinguish Pulses by. BUt that a Pulse may be rightly perceived certain things are required in the Physician, certain in the sich; Those things that are requisite in a Physician that he may know pulses. in the Physician first there is required that he have an exquisite sense of feeling, and a soft hand, especially in the Pulse of the outmost joint of the fingers, not very hot, nor too cold, but temperate; secondly that presently after his commig in he may not touch the Artery, lest perhaps the sick being troubled by the coming of the Physician, the Pulse be changed, but let him wait a little while, until he understands that the sick is quiet, thirdly let him touch the Artery of the wrist of either Arme. For the fingers rightly are to be applied to the Artery, namely the first four or three fingers, are to be put to the Artery that the more differences of Pulses may be apprehended; moreover since there is a threefold application of the hand to the Artery, compression, when the fingers do as it were press the Artery, softly when the hand is gently applied to the Artery, the medium when in an indifferent manner or with some small pressure it is put to the Artery; pressing is most convenient for the knowledge of contraction, if it may be, and for vehement pulses, but in languishing pulses it takes away the greatest part of the Pulse●by handling fearfully and softly, the vehement Pulses are not enough perceived; thirdly the medium is betwixt these two, and neither lightness of feeling is observed in vehement, nor compression in languishing. In the sick is required first what time the Physician touch the Pulse, In the sick that he be free from all passions and preturbations of the mind, lest those mutations, which happen through the passion of the mind to the Pulses should hinder the Physician. Also neither is the Pulse to be tried presently after motion of the body; lastly the hand of the sick aught to be placed right and free from all voluntary motion, and the sick may not bend his fingers much or distend them, but keep them in their middle and natural form, and the sick also may not lift up his hand with his strength, lest he tremble and causeth the Pulse to vary. CHAP. VII How to know the differences of simple Pulses. FOrasmuch as what belongs to the knowledge of Pulses, The knowledge of a great and small Pulse. if we observe the Artery to be dilated and extended more than naturally it ought, and by reason of its great extending doth as it were resist the fingers or make them pit in, we account it a great Pulse, but if they resist but a little we account it but a small Pulse. If it be considered that the Artery is moved by violence from term to term, Of a swift and flow. nimbler and swifter than in a temperate or sound man, that is called a swift pulse, but if the space is completed by the Artery by a slower stroke, 'tis called a slow Pulse. If the interval between each stroke be longer then in a temperate or sound man, that is a thin Pulse, if shorter, Of a frequent thin. a frequent Pulse. If the Pulse strive against, Of a vehement and weak. and as it were opposes itself to the application of the hand that presses it, 'tis a vehement Pulse, and if not, 'tis a weak Pulse. A hard Pulse, if the Artery be gently touched, Of a hard and soft. doth not resist the finger, as a vehement one; but if it be pressed harder, it doth not so strongly resist as a vehement Pulse, hardness also is never joined with magnitude, nor vehemency with smallness. CHAP. VIII. How to know the Respective differences of Pulses. WHen we know the simple differences of Pulses, by that means we may know the compound, therefore the Physician should first of all diligently exercise himself about the knowledge of simple differences: it is very difficult and almost impossible to find out the inequality of Pulses in one Pulsation and under one finger, but yet if it may be known, it is known only in the greatest and most vehement Pulses, which resist compression; afterwards slacking, and sometimes the middle betwixt both is to be used, sometimes one, sometimes two, now three, than four fingers are to be applied, so that if happily that inequality be not perceived under one or more fingers, yet it may be found under some or other. But if the inequality of one stroke be to be tried under several fingers, you ought to apply four fingers to the Arteries, To know the order and perturbation of order, Order how it may be known. 'tis necessary daily to apply the hand; but if in a long Series of Pulses there be some diversity observed but keeping order it, is called an orderly Pulse; but if no order be observed amongst divers Pulses, it is an Inordinate Pulse. The knowledge of Harmony, Rhythmus. since the whole depends upon the knowledge of contraction and dilatation, and the comparing of these motions amongst themselves: but to know the Systole in all pulses, if it be not impossible, yet it is very difficult; hence it appears that the knowledge of meeter is not easy; and for the knowledge thereof nothing is more necessary than those things which are required of, or the knowledge of swift pulses. CHAP. IX. Of the causes of Pulses in general. THe causes of pulses are divided by Physicians, Causes of pulses of generation. into causes of generation, or immediate and proximate; and causes of mutation or remote; or into primary or secundary; those they call primary which make the pulse, and which being put there is a pulse, and being taken away there is none; Of commutation. those which do not make a pulse but altar and change it are three, the faculty, or use or end; these are many, whereof some belong tonaturall things, as temperaments, sex, age, habit of body; others to things not natural, as air, meat and drink, exercise, rest, sleeping, weaking, excretions, retentions, passions of the mind; others to preternatural namely, diseases, causes of diseases, and symptoms. The causes of pulses containing, each of them have two differences, Proper and unseperarable pulses. for the faculty is either strong or weak, the use is increased or diminished, the instruments are soft or hard, hence some pulses do perpetually arise of one cause only, which Galen calls the necessary consequent, others call proper, and unseparable; and such like pulses only follow the faculty and iustruments, but not the use, and of necessity a strong pulse necessary follows a strong faculty, a weak pulse, a weak faculty; hard arteries, make a hard pulse, soft arteries make a soft pulse, some although they are made more from one cause containing then another, yet they do not arise from that only, Familiar. but 'tis necessary that others concur also, which they call familiar; the familiar pulses of a strong faculty, are great, swift, thin, weak small, slow, frequent; the use increased, great, swift, frequent; diminished, little, slow, thin; a soft artery, great, swift, thin; hard artery, little, slow, thick. Compound causes make compound differences, and sometimes two, sometimes three causes, are complicate; first, The saculty with the use changed; what pulses it makes. a strong faculty, and the use increased; the instruments obtaining a natural constitution make pulses, great, swift, frequent, and moreover urhement, a strong faculty and the use lessened brings forth pulses, moderate in magnitude, slower, thinness, yet vohement; from an infirm faculty and the use moderately increased comes a pulse moderate in magnitude and celerity, frequent, languishing; but if the force be very weak, the pulse is little, slow, very frequent, weak; from a faculty weakened and use dimished ariseth small pulses, flow, thick, fainty; and if there be very great debility, the very least intermittent and defirent pulses arise. Secondly, if the use and instrument be joined together, The use changed and instrument. the use increased with a soft instrument, makes great pulses, swift, moderate in frequency; or if there shall be great excess, frequent, and soft; the use increased, and instruments hard, bring forth lesser pulses, swifter, more frequent; if hardness abound; but if use, greater; if indifferent, there is excess of them both; if moderate in magnitude, they are swift, frequent; the use diminished with a soft instrument, causeth moderate pulses, in magnitude, slow, thin, soft; the use diminished with a hard instrument renders the pulses less, slow, hard: and the instrument exceeding in hardness inclines the pulse to smallness, rather than to slowness, contrariwise it happens when refrigeration exceeds. Thirdly, if the faculty and instrument be complicate, Faculty and influment. and the faculty be strong, the instrument soft, the pulses are manifestly made greater, somewhat duller, thinner, and softer; a strong faculty, and hatd instruments bring forth small pulses, frequent, and for the most part swifter, namely if hardness abound, but in an equal recess of them both, the pulses are moderate in all, yet harder; a weak faculty with soft instruments makes for the most part pulses in magnitude, and swiftness moderate and soft, but in an immoderate recess, they shall be little, slow, frequent. And if the faculty be very infirm, the pulses be come small, dull, and frequent; Lastly, if the faculty be infirm with the instrument hard, pulses that are little, slow, thick, and hard do arise. But sometimes all these three are complicate, Faculties, instruments and use. and indeed, first the faculty strong, the use increased, the instruments soft make great Pulses; swift, moderate, in frequency, vehement, soft. Secondly, if these should be complicate, a strong faculty, the use increased, and the instruments hard; and that hardness be little, but the use very much increased, the pulses are made greater than is fit, swifter, and more frequent; but if the hardness be not great nor the use much increased, the pulses are moderate in magnitude, and become more swift and frequent. Thirdly, if the faculty be more strong, the use diminished and the instrument soft, the pulses are moderate in magnitude, slower, thinner, vehement and soft, and if the use be much diminished, are plainly less, slow and thin. Fourthly, If the faculty be strong, the use diminished, and instruments hard, the pulses are lesser, In celerity and frequency moderate, or also if the use be great, and that there be a recess of the instrument from mediocrity, the pulses are slower and thinner, but the hardness of the instrument abounding, there is a great recess of the use from Nature, and the pulses are small, slow, and more frequent. Fifthly, If the faculty be weak, the use increased, and instruments soft, the pulses are become moderate in magnitude and celerity, yet more frequent, but if the power be exceedingly weakened, it makes a small pulse, slow and most frequent. Sixthly, If the faculty be weak, the use increased, and the instruments hard, the pulses are made little, slow, and frequent. Seventhly, If the faculty be weak, the use diminished, and the instrument soft, the pulses are lesser, moderate in frequency, or rather thin. Lastly, if the faculty be weak, the use diminished, and the instruments hard, pulses are made small, slow, frequent, but yet not always of the same smallness, slowness and frequency, but according to the excess of the causes are, lesser, slower, or more frequent. But here it is to be noted, first, that the force and power of causes are more to be valued then nuthe mber, since one more potent cause can do more in changing pulses then many weaker; secondly, the hardness of the Artery always doth resist the magnitude of the pulse, but not the celerity and frequency; thirdly, there is no more efficacious cause of small pnlses than weakness of strength and virtue. CHAP. X. Of the causes of the simple differences of Pulses. ALthough it may be easily collected from these things what the causes are of every pulse, Concomitant causes of pulses. yet because certain familiar causes concur, which may afford some benefit to the generation of pulses, namely grossness of body, leanness, an empty place about the artery, weight of the body lying next above the artery, and propriety of formation of parts, let us join those to the rest, and let us here add some to these. The causes of a great pulse containing, are strong force, The causes of a great pulse, of a little. Of a high. the use increased, the artery soft; a little pulse is made especially by the weakness of power, as also diminution of use as also diminution of use and hardness of the artery. The causes of a high pulse are, strong force, the use increased, and when an indifferent grossness of body happens, and the place is strait and narrow about the artery; Of a low. a low pulse proceeds from a languishing faculty, to which happens groseness of body, as being the concomitant cause; sometimes also, the artery is buried deeper by the natural framing of the body, whence the pulse is lower. A broad Pulse is made from a power not altogether so weak, Of a broad. Accidents as being complicate causes are joined therewith, the place wide, and the bodies next over it are heavy; Of a thin. the cause of a thin pulse is a weak faculty and a hard artery, the concomitant causes are leanness of body, and thinness and dryness of the skin. The cause of a swift pulse is the use increased, Of a swift. the virtue indifferently strong, and the instrument soft; the cause of a slow pulse is weak power, or the use diminished, Of a slow. or the joining of both these together. The cause of a frequent pulse is the use increased with debility of virtue, or hardness of the artery; Of a frequent. Thin. of a thin pulse, strength of virtue with use diminished, is the cause. Of a vehement pulse, Of a vehement, weak. strength of virtue is the cause, of a weak pulse languishing strength, proceeding from what cause soever. A soft pulse proceeds from the softness of the Artery, Soft, hard. a hard from the hardness of the same, from what cause soever it come. CHAP, XI. Of the causes of the respective differences of Pulses. NOw follows what belongs to the respective differences of pulses, The causes of inequality of pulses. Of a singular inequality and of an intermitting pulse. and first for inequality, the cause thereof is a weak faculty, and an Artery either obtruded, or pressed or too hard, or too soft. The reason of an intermitting pulse is because the use requires dilatation, and the faculty is ready and prepared that it may satisfy the use, but either 'tis loaden with plenty of humours, or it is hindered by obstructions or compressure of instruments; the same causes of inequality in motion, of swiftness and slowness are rendered, but they are lighter. The cause of Dicrotus or double striking pulse is an unequal distemper of the heart and Arteries, Of a Dicrotus. or the faculty varied by reason of an unequal distemper which striving by a contrary cause in the middle of its Journey, is compelled as it were to begin a contrary motion. Unequal pulses under many fingers do proceed either from weakness of the faculty, or plenty of humours, or softness of Arteries. Declining pulses which are called Myouroi, Of Myourey. proceed from weakness of the faculty, whose action by how much the more remote it is from the heart, by so much it is the weaker, or from the placing of the artery, part whereof is more remote from the heart, and is placed more in the outside. The cause of a congregation of many in equalities together are weakness of the faculty whither is oppressed, A Sistematicall inequality. or distracted, or irritated, and the fault of the instrument, when the artery is either compressed or obstructed, or filled; pulses are made unequallyunequall, from the faculty not weak by its self, but rather burdened, and oppressed, Myourei Reciproci. Of a deficient. and moreover from the ill disposition of the artery, and 'tis either pressed by some body that lieth on it, or some humour, or tumour, but unequal equally are made by an infirm faculty; and indeed reciprocal Myouroi do proceed from a faculty not so weak as those which are deficient. Intermitting and intercurrent pulses proceed from the same weakness of the faculty, Of the intermittent intercurrent. and the instruments compressed and obstructed, yet the faculty; labours more in an intermitting, then an intercurrent, and in it doth almost lie still. Concerning the causes of unequal compound pulses, Caprizantes. the cause of an uneven pulses is when the faculty, otherwise strong enough, but now is oppressed by too great plenty of humours, or is hindered by obstruction. The causes of surging pulses are weakness of the faculty or plenty of humours, or exceeding softness of instruments, Like waves. and the faculty is so burdened, and oppressed with its load that it staggers and becomes unconstant. From the same causes proceeds a vermicular pulse, Vermicular, formicant. only that in a vermicular the faculty is not oppressed, but is weak of its self but in a formicant, 'tis very faint, and the use striving, and softness of the instrument being joined therewith. The causes of a serrine or serrate pulse is a strong faculty and the use increased, Serrate. together with hardness of the artery; and this pulse is familiar in inflammations of the internal membrances. Trembling. A trembling pulse is made, whilst either the pulse is not perceived by reason of the trembling of the part, or it goeth out trembling, or when the heart trembles, and communicates that affect to the artery. The cause of a hectic pulse is somewhat that is fixed and stable, and sticks to the solid parts, also weakness of strength. Hectic. Rhythmorum. The harmony is not changed, unless the magnitude and celerity of the dilatation and contraction, be altered, but these are not changed except the use be changed, so all the causes of Harmony depend upon the use, for if the Diastole be swifter than the systole, there is a great heat present then, and a great necessity of refrigeration or expulsion of fuliginous excrements, but if the systole be swifter and greater than the Diastole, there is more necessity of protrusion of fuliginous vapours then of cooling. CHAP. XIII Of the causes of varying of Pulses. ANd in like manner divers differences of Pulses proceed from causes containing, Of the Temperants of a Pulse. which are secundary causes, and first natural things, those which are hot by nature have a hotter Pulse, and that comes from the use increased; those which are cold, the contrary; the Pulses of such as are dry and lean are greater and thinner by much, and somewhat more vehement, but in grosser bodies when the Artery is covered with much flesh, and cannot be freely distended, the Pulse is made somewhat smaller and more frequent. Men have a greater Pulse for the most part than women, Sex. a little duller, and thinner; women on the contrary have less Pulses, swifter and more frequent, but if a woman be hotter than a man, she will have a greater and more vehement Pulse. The Pulses of boys are great, Of age. very swift, frequent, in vehemency moderate; of youth they are very great, and vehement, in celerity and frequency moderate; Pulses of old men are the least, slowest, thinest, and weakest. As for the times of the year, Time of the year. in the Spring Pulses are greater, more vehement in celerity and frequency, moderate; in the Summer they are fainter, small, swift, frequent; in Autumn weak, in magnitude unequal in celerity and frequency; in Winter, small and moderate, slow, thin, and weak. Meat and drink immoderately taken cause great, Meat and drink how to change the pulse. swift, frequent, too vehement, unequal, and Inordinate Pulses; moderate lesser and weaker, and in the beginnings swifter and more frequent, afterwards slow and thin, the use of wine especially makes great Pulses, swift, frequent, and vehement, and mutations which proceed from wines suddenly comes, and suddenly goes. Natural rest in the beginning make the pulses lesser, Sleep. weaker, slower, and thinner, afterwards greater, and more vehement, and the slowness and thinness, by little and little is increased; moreover if the sleep be too long, they return again to pravity and debility, and retain their sloth and thinness; when a man is stirred, up or awakened, the Pulses begin to be greater, more vehement, swifter, more frequent; equally indeed if a man be awakened by degrees, but unequally and troubled if he be suddenly awakened, yet a little afterwards the pulse again becomes moderate: long watch cause little and weak pulses, yet swift, and frequent, at length the faculty being weakened, they become dull and thin. Exercise and motion moderate, cause great pulses, Exercise. uchement, swift, frequent, but overmuch exercise cause little, faint, swift, frequent, when the use may be increased, and the faculty debilitated, at length they are little, slow and thin. Moderate use of baths make great pulses, swift, frequent, Baths. and vehement, but if they exceed measure, little, faint, swifter, and more frequent. Passions of the mind. As for the passions of the mind, anger causeth great pulses, swift, frequent, vehement; joy makes great pulses, thin, and slow, moderately vehement, but if it be overmuch it renders them unequal and inordinate; In sadness they are little, languishing, slow, thin; fear soon makes the swift, pulse vehement, Inordinate, unequal, but they are of as long continuance as those are in sadness. Immoderate evacuations, Evacuations. because they debilltate the faculty bring forth pulses like to those caused by a weak faculty. But as for those things which happen contrary to nature, Preternatural things how they alter the pulse. although they are various, yet they change the pulse, because either they change the use, or affect the instruments, or faculty; in the first place when the faculty is affected, many changes are made of the pulses, for whether the faculty be diffolved, and weakened by those things which dissolve the Spirits and solid parts, such as are soul diseases, great distempers, vehement and diurnal griefs, fastings, too great Evacuations, or whether they are burdened, or oppressed by plenty of humours, or by diseases of instruments, inflammations, or other tumors, the pulses are made less in the first place, and swift, frequent, feeble, afterwards the least, most slow, most frequent, most faint, and at length the faculty being almost prostrated, intermittent, deficient, declining, vermiculant, formicant, all which running through the various kind of affects contrary to nature, and principally out of the doctrine of fevers are made more manifest. CHAP. XIII. What the simple differences of Pulses signify and presage. ALthough from the causes of pulses, Great pulses what they signify. it easily appears what every pulse signifies, and portends: yet that we may add something of each in particular, a great pulse although principally its familiar use be in increasing, a strong faculty, and a soft instrument; in those which are sick it signifies a hot disease, and a great pulse, unless it be hindered, follows all fevers, and it cannot be much dilated with the Artery, unless the power be strong, or at least not weak; a great pulse in all fevers is good sign. A small pulse argues either debility of the faculty, or remissness of the use, or hardness of the instruments; and indeed if a small pulse shall be also faint 'tis a token that its weakness proceeds from a weak faculty, if small and hard, from the Artery; if neither debility; nor hardness be perceived in the pulse; it is an argument that it comes from the diminution of the use: whence little pulses with a weak faculty foretell death; the rest of pulses that are small for the most part presage long and difficult diseases. A swift pulse signifies that the use is increased and the vigour strong, A swift. or certainly not very weak, whence in those that are sound, a swift pulse signifies heat, stirred up by motion, exercises, baths and such like causes, which if it be also great, the strength is not yet debilitated, but in those which are sick, a swift pulse signifies a hot disease, and is proper to those which are feverish, and if magnitude be joined therewith itshewes that the use is increased, with strength of nature, but if frequency be adjoined without magnitude, it shows that the powers are weakened; if hardness of the instrument, the use being increased, hinders dilatation, that hardness is to be perceived by the touch. A slow pulse shows, Slow. the contrary, to wit, little heat and the use diminished, and then it is only thin, and the vigour not firm enough, and withal it is feeble. A frequent pulse signifies the use to be increased, Frequent. or the faculty weakened, or the instrument hard; if it proceed only from the use increased, it is not faint, nor hard, and magnitude, frequently goes before, and then extraordinary great heat is discovered in those that are sick; if it proceed from debility, or hardness of the artery, that is discerned by the pulse. Thin pulses are made, either through a strong faculty, Thin. and a soft instrument, or from the use diminished; in sound bodies it signifies a cold constitution, but in sidk a cold disease, and coldness of the heart, and that which is contained therein, and therefore 'tis accounted an ill sign. A strong and vehement pulse, shows a strong faculty, Vehement. and if its vehemency exceed the bounds of nature, it signifies also great irritation. A faint pulse on the contrary, Faint. signifies powers to be dejected, and that either by dissipation of spirits and resolution, and then it is also small, and if use hinder not, slow, or by oppression, occasioned by plenty of humours, and then the pulse also is inordinate, and unequal. A soft pulse shows softness of the artery, Soft. and moreover in a sound body, signifies immoderate drinking, or diet over moistening, or a bath, or idleness, but in a sick a moist habit of the body. On the contrary hard pulses, Hard. show the hardness of the artery, and indeed either by extending in convulsions, tumors, or by repletion of vessels, with humours and wind, or by drying as in burning Fevers, Hectics, consuming Fevers, Quartans, and other drying causes. CHAP. IU. What the other differences of Pulses signify & presage. NOw for the other differences of pulses; and first, Equality, and inequality, of that of equality, and inequality, equality although it show a fixed disposition of matter, yet it signifies firmness of nature, and therefore affords the better hope, but all inequalities are worse, and either signify obstructions of vessels or compressions, or abundance of humours, hindering the force, and indeed a single inequality, is more dangerous than systematick, or mixed: whence intermitting pulses in one pulse, are more dangerous, than intermitting in many, if both of them proceed from debility of the faculty. Uneven pulses, Vnalike stirred up Myouri Dicroti. therefore being stirred up, and Myouri, and such, as striking double, are very evil, yet in an uneven pulse, that is quickened is less evil, than an intermitting; because although it signify the faculty declining, yet it shows not it to be extremely weak. A Sistematick inequality, Systematical inequality. or complication of inequalities unequally made is less dangerous than an equality equally made, because that for the most part is caused by, default of the instrument, but this happens by the imbecility of the faculty. Intermitting pulses with imbecility, Intermitting. since they proceed from the debility of the faculty, are altogether dangerous, and indeed the longer they are quiet, and the more strokes they intermit, by so much they are the more dangerous, yet old men and boys are in less danger in this pulse, then young men in whom the faculty is weak, and offended by a small occasion, but where the faculty is strong, not without a great cause. A deficient Pulse is yet more dangerous, Deficient. because it shows great imbecility. An intercurrent pulse is the most secure of all unequal pulses, Intercurrent. which indeed signifies the strength to be loaden, yet hitherto strong and whole, and promiseth victory. Deficient reciprocal pulses show great imbecility of the saculty, Reciprocal, deficient. yet with striving against the preternatural causes. Adescending or a declining pulse, Miourus vern●iou●ar formicant. & a vermicular, show the faculty to be much weakened, but the formicant pulse is a token that the faculty is yet more dejected, and if it be perceived in Fevers, and quotidian diseases, it is a certain token of death. A surging pulse signifies that the faculty is burdened, Surging. and weakened, and 'tis an ill sign if it be changed into a vermicular, yet sometimes it signifies, that the strength is great, and the arteries moistened with the humour, and moreover with decretory sweat A serrate pulse is ill token, Serrate. and signifies an internal great, and dangerous inflammation. But as for Order since it signifies a fixed, Order of pulse what it shows. a perpetual cause, the perturbation of order being troubled; if the pulse be otherwise profitable, order signifies firmness of power, but inordinate show that the faculty is oppressed by fuliginous excrements, but if the order of the pulse be together unprofitable with the inequality, it signifies the highest weakness, and is a very ill sign. Lastly, change of harmony signifies variation of the use. Rhythmes CHAP. XV. What Pulses presage health, or death. ALthough it easily appears from hence what pulses signify safety, or death, yet that we may handle them singly; What pulses show a strong faculty. great pulses, swift, vehement, double striking, surging, signify that the faculty is strong, and indeed amongst those the vehement is in the first place, afterwards the great; hence the swift, and surging. Lastly the double striking. But small pulses, languishing, intermitting, declining, Languishing. vermicular, formicant, and all pulses which descend from mediocrity, to the extrcame (in defect) except the most vehement; signify that the strength is failing, and weak: and these pulses of themselves do show that the faculty is weak, if they are equal, but if they proceed from the faculty burdened they are unequal; hence the vermicular, formicant, intermitting, and declining, are deficient evils, by how much the pulse is fainter and lesser, by so much it argues the greater debility of strength. Hence it plainly appears that the pulses which promise health, Health, are those which little decline from the pulses of sound men, and are equal, ordinate, great, vehement; but amongst the fainting ones, little, eunqual, & inordinate, those which are least, these (so that malignity be absent) are least dangerous. On the contrary seeble pulses, little, slow, and such like, Death, indicating the faculty weak, portend danger or death; if together other ill signs also do appear; also all those pulses are evil, which come to extremity, except the most vehement, and amongst those, the least, most faint, most slow, and most thin, are the worst of all, but of the unequal, those are less dangerous, wherein are many great, and vehement strokes, the dangerous are the declining, intermitting, intercurrent, vermicular, and formicant as is said before. Lastly, Manner of event. pulses conduce to the knowledge of the manner of the event, for pulses which are weaker; duller, and thinner to the Judgement, signify, that the disease will not give off, but rather by solution wear away by little and little; but unequal pulses, vehement, great, swift, and frequent inform the Judgement, that the disease will soon be at an end, and in a critical day (or day when there is a conflict of nature, and a disease, and a change expected) the pulses are inordinate, and unequal, and if they become strong from weak, and become great from little, it shows the next Crisis, or judgement, and they presage good; if in unequal pulses there are more great then little, swift, then slow, moderate, then frequent, vehement, then faint. CHAP. XVI. Of signs to be observed from the Tongue. But besides the urines, The tongue a signe of diseases. and pulses, the Physician also shall consider sweats, excrements of the paunch, spittle, the Tongue other things, but since we have spoken before of the former, and hereafter I shall speak again, here we will only add something of the tongue, which show certain signs, especially in Fevers, and as often as any change happens of its own accord, either of colour or taste in the tongue, it is certain that so often there is some change made in the body. But why the tongue should change its natural constitution, Causes of the changing the tongue, there are two principal causes, humours, exhaling out of the veins and arteries of the tongue, and principally affecting the coat of the tongue; moreover, vapours and humours ascending from the inferior parts, to which notwithstanding sometimes humours flowing from the head are added. The colour of the tongue is changed, and is become white with the spittle wherewith it is moistened, The colour of the tongue changed. and it is dried by heat, which often comes to pass in Fevers, a white colour is often changed into a yellow, mud colour, or black, whilst other humours are communicated to the tongue, and that external skin is changed by the fùliginous feverish vapours. Whence the colour of the tongue may show both the nature, and the time of the Fever, for as Hiprocrate; saith, in the beginning the tongue is white or yellow (in his Third Book of diseases) in progress of time it grows black, and if it grow black in the beginning of a disease, the disease will the sooner be over; but if in the latter end, 'twil endure the longer nay oftentimes the tunicle of the tongue, is so polluted with fuliginous vapours ascending, that sometimes it rots away; but when the Fever declines the colour of the tongue returns to its natural condition; and the humour which is spread about the Tongue, is taken away, and that which was corrupted is separated, and that change first appears in the top of the tongue: hence that other pa●t towards the chaps also by little and little becomes pure. Lastly, the root, and if any one daily do diligently observe the tongue of the sick, the declination of these may be known no less from thence then by the urine. The taste of the Tongue being changed, Savour. signifies abundance of humours; from choler the taste is bitter; from sweet phlegm sweet; from a salt, salt; from an acid humour, sour or sharp. The tongue is made rough and dry by defect of the humidity, which was consumed by the feverish heat, yet in roughness there is a greater defect of humidity then in dryness only. THE THIRD BOOK. THE SECOND PART. Of the Diagnostic Signs. CHAP. I. Of the Signs of Causes in general. BUt now that we may come to the Kind's, Antecedent Signs. and that we may explain the Anamnestick, Diagnostic, and Prognostic signs: concerning the Anamnestick signs we only admonish you of this; that the causes which have gone before are known either by the effects which are left, or they are known by some profitable, or hurtful thing, which they occasioned. As for the Diagnosticks, Diagnostic signs of a disease at hand. they are either of a disease near at hand, or present: Of the signs of diseases near at hand this is a general rule, that every mutation in actions, accidents, and excrements, after what manner soever happening contrary to custom, and without any external cause, Of a present. threatens a disease; for when all these things are right according to the natural constitution, they are signs of health; as soon as any thing in them gins to change from its natural state, it signifies a falling from health into a disease, and the same signs, if they are gathered together, and increased, indicate a disease to be now present. But since it doth not satisfy a man to know that a disease is imminent, or that it is present, but it is necessary to know what the disease is, the signs are to be propounded severally, both of Morbifique causes, and places affected of diseases, as also of symptoms: and that we may begin from the signs of causes, which lead us unto the knowledge of diseases; concerning the necessary signs of causes, and by which any thing may be known certainly; some are proper, others common, but collected together by a race or current, and are limited within their proper subject. Proper signs of humours from the tast● The proper signs are savour, colour, and motion of humours, as to taste, blood is sweet, phlegm, waterish and unsavoury, choler, bitter, salt phlegm, causeth a salt taste, phlegm and melancholy an acid, a sharp adust melancholy causeth a brackish taste. The blood is red, as also choler is red; From the colour: phlegm that is white hath a white colour, pale choler, a pale; yellow a yellow; Leek colour a green, an Aeruginous, is like Verdegrease; melancholy hath a black hue, troubled; black choler black, splendid, and when one savour, or colour agrees with two humours, we may know the humour from the taste and colour joined together, so that when acid phlegm and melancholy are joined, 'tis acid by the white colour, acid phlegm is known, by the black melancholy. Moreover the humours have their determinate motions several days; the phlegm is moved, the day between each, From the motion choler; Melancholy is moved the fourth day, if such a motion be wanting the blood offends, choler also for the most part is moved about noonday, melancholy in the evening, phlegm in the night, the swiftness also, and slowness of motion, indicate the humours of a disease, for a swift disease depends on a thin humour, hot and choleric; a slow, on a dull and thick. But because those signs lie hid in the innermost parts of the body, so that the humours cannot be known, Of the common signs. Current. a current of common signs than ought to suffice: the causes and affects, or the antecedents and consequences supply us with such signs; antecedents are supplied by two fountains, namely external, and evident causes, or things not natural, and the disposition of the body; but the consequences are all symptoms, and whatsoever help, or hurt. Non-natural things dispose the body and bowels to the generation of this or that humour, Antecedents. according as they either heat the body, or cool it, or make other changes in it, of which is spoken before, Lib: 1, Part 2. Chap: 2. Moreover, the dispositions of the body have great power in generating humours, without which those evident causes can do little in producing them. Now these dispositions may be reduced to four heads. First, there is an hereditary disposition of the body. 2ly. age: 3ly. Constitution of the body. 4ly. Intermission of some accustomed evacuations fit to generate this or that humour. The consequences are symptoms, Consequence. namely actions hurt, excretions, and retentions, and the qualities of the body changed; also diseases arising from humours. Lastly, all things helping, and hurting. CHAP. II. Of the Signs of Causes, and of Humours in particular. AS for what belongs to the signs of every humour in particular gone before, Signs of Plethory. signifies that blood doth abound, and a plethory as to the vessels is present, as is expressed before in the Lib: 2. Part 2. chap: 3. The habit of the body is fleshly and firm, overspread with an habituous vapour, the veins are fuller, and especially after exercise and heat swell; the muscles are extended, the strength of Nature is increased, with a certain proportion of blood, and if the blood fill the veins so full that they cannot be cooled, or fanned enough, it grows thick, and seeks to weigh down the inferior parts, hence the muscles of the legs being filled with blood are moved with pain, and wearisomeness ariseth. Respiration is more difficult after labour, in their behaviour they are merry and pleasant, and their discourse and memory duller, their sleep is profound, and more durable and pleasing, with flattering dreams, and of red things, and blood; the pulse is great and strong, all natural actions are excellently performed; the urine is more plentiful, and moderate in substance, and colour, and the contents therein are plentiful, the colour of the whole body, and especially of the face is red, and rosy, the reins of the eyes are red, the skin being touched is hot, yet that heat is gentle, they easily tolerate evacuations of blood, by what means soever made, sparing diet takes away the wearisomeness, and quencheth thirst, but they are offended by hot and moist things, and all things which increase heat; idleness and food, increasing blood hurts them, but a plethoric constitution is known as to its strength, by gravity of body, an unequal pulse, signs of crudity, and oftentimes by signs of putrefaction; begin Sweet phlegm abounding is known from the causes which conduce to the generation of phlegm, if they have preceded, Phlegm. of which above Lib: 2. part 2. ch: 4. Moreover, those which abound with phlegm are dull, flow, lazy, and unapt for motion, more stupid in their senses, dullet of apprehension, propense to sleep, and sleep more sound, they dream of waters, and rain, snow, hail, ice, and of drowning, their manners are unbeseeming, they are not easily angry, the pulse is little, dull, thin, and soft; they are not troubled with thirst, their desire is weaker, they are affected with cold diseases, moist, and durable; they send forth many phlegmatic excrements, and abound with spittle, their urine is white, pale, sometimes thin, sometimes thick and troubled; their dejected ordure is crude, & pituitous; the whole body is thick, white, soft, and more cold to the touch; heating and drying things, cutting and atenuating, and evacuating phlegm advantage them, they easily endure fasting. On the other side all cooling, and moistening things, and thickening, and those which retain and increase Phlegm, offend them; if the Phlegm be sour, all those signs are the more vehement, but salt Phlegm is known from the preceding causes, of which is spoken before, thirst is present, a salt taste, those things which are cast out are crude, but withal biting. Moderate salt things delight them; too much drying and heating things hurt them. Choler is known to abound if the causes, Of Choler. and dispositions of the body have gone before, which conduce to the generation of Choler, proposed before, lib: 2. part 2. chap: 9 as if a man be not drowsy, but watchful; if he dream of fire, thunder, and lightning, and contentions, and is full of activity in motion, and rash or precipitate in consultation, is easily angry, the pulse vehement, swift, frequent, hard; if his concoction be depraved, and turned into a nitrous crudity, if the appetite of meat be less than the appetite of drink, hot and dry diseases afflict him, and those which have a swift motion, and symptoms arising from choler; if the urine be yellow, and splendid; the excrements coloured with cholour, the habit of the body is dry and lean, and carries with it lively heat, the colour of the body is yellow; cold and moist things, and such as purge choler, as also acid things delight them; hot and dry things, as also fasting hurts them. Melancholy is known to abound from the causes and dispositions going before, Melancholy. propounded above lib: 2. part 2. chap: 6. For what belongs to the consequences, those which abound with a melancholy humour are silent, full of thoughts, stable, and pertinacious, and slow to anger, who nevertheless are not easily pacified; their sleep is turbulent, perplexed with horrid and terrible dreams, they are sad and fearful without any manifest cause, they have a little pulse, dull, thin, and indifferent hard, their colour is yellow, dun or dusky, almost black, they desire meat and Venery moderately, they are void of thirst, and abound with spittle, they make much Urine, and if none of the melancholy be evacuated therewith, it is thin and white, or if some of it flow with it, it is thick and black, and they sweat plentifully in their sleep, the Hemorhoids either flow, or are suppressed, much wind is in the body, and they are apt to four belchings, the habit of the body is lean, sharp, and hard, the colour yellow, the spleen sometimes swells, and grows hard within them; tubercles appear in the veins, and they are affected with other melancholy diseases. Black choler is a sign of yellow choler and melancholy mixed together, Black Choler. and the indications of melancholy appear, but joined with manifest signs of heat, whence madness, a canker, a Leprosy, and such like diseases arise. Abundance of serous Humours are collected, Of the serous humour not only from the antecedent causes, whereof we have spoken before, but also from a somewhat moist and pale body, and the Urine is crude and aqueous. Moreover, Wind. winds discover themselves by those signs which are reckoned above in the lib: 2, part 2, chap: 7, moreover fluctuations, & rumblings & tumblings in the guts, and Hypochondrias are perceived, and switching pains without gravity, & wand'ring, & such as suddenly arise, & suddenly vanish; also a humming and buzzing in the ears, pant of some parts of the body, belching, breaking wind backward, or in the paunch are discovered, and the Urines are frothy. Malignant and pestilent humours, Poisons. how they may be known is spoken amongst fevers, but the signs that poison is drank are, if any biting happen in the stomach, or guts, to any sound man, after eating and drinking, and if the belly or stomach be moved to expel, and their colour within six hours turn yellow, and spottie; if the extreme parts of the body grow cold, and swooning, palpitation of the heart, and swelling happens, but if one be hurt by the biting of any living creature, or with a prick, or sting, or froth, and the offended part should mortify, become putrid, should be inflamed and swell, and the pain be great, and those symptoms before mentioned appear, it is a token that the living creature was venomous. CHAP. III. Of the Signs of Diseases. SOme signs of diseases indicate the kind of diseases; Causes, what diseases they show. others the magnitude, others the manner, and they are taken from those three fountains, the causes, those things which necessarily inhere, and the effects of the causes, and what force each hath is spoken of in lib: 2. part 2, Disposition of the body. and therefore if any causes are present, or hath gone before, it is a sign of a disease which that cause is apt to produce, but amongst the causes, the dispositions, or inclinations of the body are to be weighed, which are apt to produce this, or that kind of disease; for every body either falls into a disease like its own constitution, sooner than contrary to it; and that disposition depends on the age, sex, course of life, and manner of diet. Neither are those things to be passed over, which help and hinder, for if hot things are advantageous, cold things are mischievous, and a cold disease is understood; the contrary comes to pass if the disease be hot: the same reason is of other tempers also. Out of those things essentially inhering, Essentially inhering. or in the proper essence, diseases are easily known in the external parts, and are obvious to the senses, but diseases of the internal parts, although they may be known by those things which essentially inhere, yet not immediately; but others coming between; so a tumour of the bowels is known by the skin mediating, which is lifted up, by the subjacent parts, and itself is become swollen. As for what belongs to the effects and symptoms, Effects and symptoms. an action that is hurt, if it be not by some external error, it signifies that a disease is present in that part whence the action is hindered, and indeed an action abolished, and diminished, signifies a cold distemper, that a greater, this a lesser; but depraved actions signify for the most part a hot distemper, and since an alteration cannot be made suddenly, nor doth the distemper suddenly cease when the alteration is introduced, if the action be suddenly taken away, and suddenly restored, it doth not indicate a disease of intemperature, Excretion and retentions. but an organnick: but if the actions are presently taken away, and remain absent long, either obstructions occasioned by thick matter, or a cold intemperature is signified; the excrements too much coloured, signifies a hot disease, as also doth dry ordure, but clammy, thick and white dregs show a cold distemper, Qualities changed. qualities also changed indicate diseases; softness signifies a moist distemper, a pale colour of the body signifies a cold distemper; but a red colour a hot. As for the magnitude of a disease, Signs of a great disease. if a great cause, and that which hath great force of acting hath gone before in what kind of disease soever, without doubt 'twil generate a great disease, the proper nature of a disease will easily betray itself, for by how much the more the pathognomick signs (or the signs that discover a disease) shall be greater, or lesser, by so much it shows a greater or lesser disease; hither to belongs also the worthiness of the part affected, for by how much the part affected is more noble, or can draw more noble parts into consent, by so much the disease is counted the greater moreover the symptoms by how much the more and greater they shall be, to which this happens, that if the disease do not give way to exquisite, and great remedies, by so much the greater the disease shall be, it is deservedly accounted great. A malignant disease is likewise known by malignant venomous causes preceding. Of a Malignant, Moreover, 'tis the nature of certain diseases, that in the same manner is they are known, they indicate malignity, such are the Morbus Gallicus, Leprosy, and such like. Thirdly, malignity discovers itself by the effects, for when no dangerous, or vehement symptom is present which might trouble, the sick nevertheless is unquiet and weak, and the disease after small remissness is swiftly, and vehemently exasperated by sweats, and other excrements, and the sick perceives no manner of ease, especially if frigidity of the extreme parts, or watch should happen, if in the beginning of sleep, sleep seemetroublesome; if the sick without a cause be afraid, waxeth exceeding hot, drops blood, and the other ill signs be present, which are spoken of amongst malignant fevers, it argues amalignant disease. Acute diseases are known from hence, Of Acute diseases. that they are suddenly moved, and immediately after the beginning afford grievous symptoms. CHAP. FOUR How to know the parts affected. The fountains of the signs whereby the parts affected are known, Signs of places affected. Galen in his first Book of the places affected, Chap: the 5th: accounts five, the actions hurt, excrerions, situation, proper accidents, and propriety of pain; which notwithstnding are comprehended under those foundations before proposed. Amongst the causes the first are those things which are taken in, whereof some have power of hurting this, Causes. others of offending that part; moreover to those things which are carried about us, belong arts, and course of life, from whence it happens, that sometimes this, sometimes that part is more hurt, as sleeping, and watch, which principally offend the brain; anger which principally hurts the heart; as also other passions of the mind. Thirdly, those things which are retained, they more offend that part wherein they are detained. 4ly. Those things which happen and befall us externally, they also show the part affected: if any one use mercurial vunctions, it is probable that the nervous parts are hurt, that evil which commonly overspreads signifies that part to be hurt, which is manifest, doth labour in other sick persons. By things essentially inhearing, here are understood both the proprieties of the parts, and the diseases themselves inhearing, for although diseases are not of the essence, of a part as it is a part; yet as it is an effect centrary to nature: diseases themselves seem to be in a part essentially; inherent diseases therefore indicate parts affected, a tumour appearing any where signfies either that part is affected, or the part which is placed above it; and the situation and figure of the Tumour, and the motions hurt will show it in its kind; a falling of the guts into the cod's signifies a rapture of the peritoneum, or rim of the belly; gibbosity signifies hurt of the spin, or marrow; the propriety of parts shows places affected as they are proper to those parts, so if we see stones come forth with Urine, without doubt we conjecture the veins or bladder to be affected. As for the effect, Effects. actions hurt. first an action hurt shows that member by which it is offended, unless it be hurt by some external error; so ratiocination being hurt, imagination, memory, they signify the brain to be affected; as likewise by sleep, watchfulness, exercise of the whole body; The visive faculty is hurt by an affect of the eye; the hearing, of the ear; the smelling of the nose; the taste spoiled is a token of a disease of the tongue; if the urine be suppressed, the cause is to be sought in the reins, ureters, bladder, or urinary passages, if yellow choler be not purged from the blood, blood, it is a token that the bladder of the gall is distempered. Pain, Hitherto belongs pains, which shows that some sensible part is affected, yet a differing pain may be a sign of divers parts; a pricking pain is proper to inflammations of membranes; a striking pain, is caused by parts sensible which are inflamed, containing arteries; a burdensome pain agrees to the whole substance of the bowels, lungs, liver, spleen, reins; inward, deep and profound pains, as it were breaking the part, signifies the membrances of the bones to be affected; a broad pain, & spreading itself every way about, is a token that the membrances are affected; straightness shows somewhat belonging to the extending of the nerves. The vital actions being hurt shows that the heart labours. Lastly, natural actions hurt in what part soever, show a sign of that part which is affected, but more manifestly in public parts, more obscurely in private parts. Excretions' Secondly, in excrements which also afford signs, more things are to be considered, namely the kinds, qualities, manner of casting them out, quantity, order; the kinds of excrements are twofold, for either something is cast out of the substance of some part, & signifies that part to be affected, as if a little skin orflake, or little piece of flesh should be cast out of the mouth, it shows the lungs, the windpipe, the Epiglotis, the gullet or ventricle, to be corroded; and if it be cast out by a cough, it is a sign that it comes from the breast, but if it be cast out by vomit, it is a sign it comes from the stomach; or that it is not the substance itself, but that which it contained in it, and is familiar to it, that is so ejected, so meat, drink, or chile cast out by reason of a wound, shows that the stomach is proforated, or that the guts are too thin, and if the stomach be hurt, the sick will belch much; if the guts, the wind goes out by the seat; urine flowing out through an Ulcer or wound, shows that the bladder, ureters, or reins are hurt; but which of these parts are affected, the situation of the wound discovers. The dregs of the belly ejected through a wound, or the smell of the dung perceived in the wound, shows that the guts, especially the thick, are hurt. So also of other parts. But seeing that the same things may often come forth from many parts; the quality of the excrement, and manner of its coming out, shows which is the part affected: if the blood be thinner, hotter, more florid, and comes out leaping, it shows that the artery is cut; but if it be thicker, and comes out without leaping, or dancing, it shows that the veins are hurt; blood that comes from the paunch, showing like that wherein meat hath been washed, shows that the liver is affected; if any come forth only by spitting it shows that the mouth, or parts next to it are affected, unless perhaps it flow from the head into the mouth; if by spittle, the chaps or larynx are affected; if by cough the windpipe, or lungs, so that it doth not raise a cough by defluxion from the head; if by vomit, the throat and stomach, so that it come not into the stomach from the liver, or spleen, or other parts adjacent. The quantity also of excrements afford signs; if much blood is cast out, it is a Token of an affect of the lungs; if little, of the wind pipe. That blood which flows from the reins is more; from the bladder less. Moreover, order in excrements is a token of the place affected; if first blood, and afterwards dregs are cast out, it signifies that the fundament, or some gut is affected within; if first dregs come forth, afterwards blood, it shows the guts are thin, or the parts above them are affected; so if quitture which is brought forth in the Urine come before, it shows there is an ulcer in the gut colon, if it follow it shows that the superior parts are ulcerated. Thirdly, Qualities changed. qualities changed also affords signs of places affected, red colour of the cheeks signifies inflammation of the lungs, the colour of the body, but principally of the face, pale or yellow shows that the bladder of the gall is not right, the flesh and skin being yellow, in dicate the bones that are under them to be corrupted, a filthy smell exhaling from the nostrils, shows that the parts within the nostrils are affected; if from the mouth, it shows that the teeth, chaps, lungs, or stomach are affected; if from a wound of the paunch, it signifies that the guts are wounded; hardness of the right Hypocondrie is a sign that the liver is affected, of the left that the spleen is affected. Lastly, certain diseases pertain to effects following, other diseases of the place affected, which are therefore called symptomatick, or familiar, and are discoverers of the primary disease. Signs of parts affected by consent. But least that we should err in knowing the place affected, by the actions hurt, and should take the part which is hurt by consent, for the primary affects; First the anatomy and functions of man's body, and the use and consent of all the parts ought to be known whence a part receives its nerves, arteries, and veins, and from what parts it can send any thing to them, and receive any thing through them, therefore if in a member sense, or motion be hindered, and the part suffer no ill, we must observe what nerves are inserted therein, what muscles move it, and whence those muscles take the nerves, and 'tis to be enquired, whether those parts have suffered any evil; so a nerve being hurt, 'tis easily communicated to the brain, the evils of the arteries to the heart, the hurts of the veins to the liver, and again, the brain being affected, sense and motion is hurt; the heart, the vital actions are hurt, nutrition is weakened through default of the liver, Moreover it is to be enquired whether a part be primarily hurt, or by consent of other parts; that is known first from ●he precedent causes. Namely if a part which is affected be hurt by no evident cause, but a part with which it hath consent, hath suffered some evil, 'tis probable that that part is affected by consent. Secondly, if any hurt coheres with the hurt of another member, that by increasing of the one the other increased, and by the decrease thereof it be diminished, and that ceasing, it caseth; it is a token that such an affect is stirred up by consent: but from that part where the disease first declined, it shows that to be the part affected by consent; but by essence that wherein the disease remained longest; thirdly an affect by consent doth not presently infect, but for the most part by intervals; fourthly if two parts are together affected, and by applying things that are helpful to the one, or hurtful, the other be helped or hurt; 'tis an argument that 'tis an affect by consent. Sign that the head is affected. But although any one from these Fountains of signs may come to the knowledge of all parts affected, yet that for example sake we may add some in particular, first Animal actions hurt, afford signs of diseases of the head and brain, whither they are diminished or depraved, yet this is to be noted of the external senses, and motion hurt; since that the brain is not the immediate Organ of those actions, but only supplies animal Spirits, 'tis to be inquired whether the cause of these actions hindered be in the brain, or in the proper Organ; the excrements also of the brain sent forth through the Emunctories indicate the brain to be affected. The signs of diseases of the heart, Of the heart. for the most part are taken from vital actions, and the qualities changed of the body: Actions hurt are respiration which the preternatural heat of the heart changeth, palpitation of the heart, the pulses much changed; for according as the heart is, so is the heat and colour in the whole body. The signs of the liver affected, Of the liver. are first when its action is hurt, which is Sanguification, a token whereof the urine and dregs of the paunch afford; moreover when the habit of the body is changed, and their is an ill colour of the the whole body, and penury of blood is in the veins; sometimes also by default of the spleen, or by reason of excrements regurgitating from elsewhere into the veins, the colour of the whole body is changed; thirdly distribution of blood is hindered, which is known by the leanness of the body and flux of the belly; fourthly a perception of gravity in the right Hypocondrie, as also a tumour encompassing the liver. When the stomach is ill disposed 'tis known by its Of the Stomach. actions hindered, such are the appetite hurt, the concoction vitiated, which is perceived, because those that are sick either are sensible of pain after meat, or the stomach is blown up with wind, or are troubled with belching, loathing, vomiting; also if the dejection be slower or swifter, without any fault of the liver, then is fit, the stomach is to be suspected. Of the breast The first sign that the breast is affected, is difficulty of breathing; the second, a cough; the third, pain; lastly those things which come out by coughing, as blood, quitture. Lastly, Of the windpipe. the signs of the affects of the Windpipe are the same, but principally they are taken from the change of the voice, sometimes also a cough is joined, more may be read of these things in the practical part. CHAP V How to know Symptoms. ALthough Symptoms for the most part are obvious to the senses, Signs of Symptoms. Of the natural faculty lying hid. yet sometimes they lie hid, and had need have signs, which are taken from causes, and effects: nutrition, if it be not rightly performed, the body is extenuated and grows lean: if augmentation be not rightly perfected, the body is less nourished; if the generative faculty be hurt, either none, or weak Children are generated; attraction and retention being hurt, are known from their effects, especially digestion is known by the excrements of its concoction; so that which is in the stomach, by the dregs of the belly; that which is in the liver and veins, by the urine; those excrements which are in the breast, by the spittle; lastly the expulsive faculty is known to be hurt, if those things are retained which ought to be expelled. The vital faculty is known to be hurt by the changed pulse of the heart and Arteries. Of the vital. Of the animal. As for the animal faculty, the Physician knows the depravation of the principal faculties from the words and deeds which are different from comeliness and congruity. In the same manner also other animal actions may be known to be hurt from their effects. THE THIRD BOOK, PART THE THIRD: Of the Prognostic SIGNS. CHAP. I. Of the several kinds of Prognostic Signs. YEt there remains the Prognostic Signs by which we may know those things which are to come, Of what things are to be foreknown in the sick. which may happen to thesick: For the Physician ought especially to know before hand three things concerning the Patient. First, what the event or the end of the disease will be. Secondly, at, or about what time the disease will have an end. Thirdly, how, or by what means. Of Prognostic signs. Of each of these before we speak in particular, we must speak in general of the Prognostic Signs: and we will premise some things of knowing the times of diseases; Namely, some signs are of crudity and concoction, others of life and death, others critical, or judicatory. The signs of concoction and crudity, are Urines, Of concection of crudity, of life and death. Critical. Excrements of the Paunch, spirting, and spauling, and catharrous matter; The signs of life and death are those which are sent forth with Urine and Excrements of the Paunch; also swears, easy and difficult respiration, easy or difficult enduring of the disease, the pulse, the face, and comely lying down, like unto what they were wont, and the contrary to these: Moreover, critical signs are such as show sudden mutation and perturbation, and some of these are both signs and causes as Vomit, Excrements of the Paunch, much Urinc, blood flowing from the Nose, the Parotides, or swelling of the Gums, or about the Chaps, settling of humours in one place, and then in another, which are called dissolving by Hypocrates, because they put away the disease; some are only signs of a Delirium, watching, stupidity, pain of the head, difficulty of perception, out of quiet, difficulty of breathing, and darkness arising, and appearing before the eyes, a noise of the ears, shinings before the eyes, unvoluntary tears, a troublesome night, without any reason, agitation of the lower lip, great stifness, the face and eyes looking red, a retraction of the Hypocondries, a loathing, but there is not the same force and reason of all these signs; the signs of concoction are never ill at what time soever they appear, nay the sooner they appear the betterr: but judicatory Signs are not accounted good, unless in the height or state of a Disease; so neither are those good which are wont to indicate those in the beginning of a Disease. Signs of concoction, some are proper to one sort of diseases, as spittle to the diseases of the breast, others are common to many kind of diseases, such as Hippocrates, 1. Aphor. 12. reckons, the Urine, excrements of the Paunch, sweats. The excrements of the belly are signs of that concoction which is perfected in the belly, but the Urine of the concoction which is made in the Liver and arterious vein. For when the Urines afford proper signs of the parts through which they pass, as of the Reins, Arteries, Bladder, Yard, we must have a care lest we are deceived in univerfall and acute diseases, by those particular and proper signs of those parts; and what is spoken of Urines may also be said of excrements of the Paunch. CHAP. II. Of those kinds of Signs by which the times of Diseases may be known. IT is exceeding profitable to know the times of diseases, Signs of the times of diseases. but especially the state, but the signs of times are taken first from the form, and Idea, secondly from the time of the year, and other such like things: Thirdly from the come (or fits) and circuits, increasing and decreasing. Fourthly, from the Symptoms of diseases, or from the Essence, and Idea, the causes, and those things that precede the disease, and by the Symptoms, and those things that accompany a Disease. As to the form of a Disease, From the Idea of a disease. by how much the motion of a Disease is swifter, by so much it is nigher to its height, and is a token that the Disease will be shorter, but by how much the flower the Disease is moved, by so much the more remote it is from the state. Secondly, Time of the year. Region. Temperant of bodies. In respect of diet. that Disease which happens in the Summer is nearer to its height, that which happens in the Winter is more remote: In hot Regions, Diseases are more acute and short, but in cold, longer; those that are hotter by nature, are subject to hotter Diseases, and so shorter; those that are colder, to more cold, and consequently more lasting; hotter, and drier Victuals, generate hot humours, and thereby shorter Diseases; colder, and moister diet generates pituitous humours, and so more lasting Diseases; great strength of nature in a Disease that is not mortal, Strength of nature. shows that the Disease is short, but weakness shows it will continue longer; but strength in a disease that is mortal, shows that it will continue longer, but weakness signifies that it will be shorter. Thirdly, From the course of fits. in the fits the hour is to be considered in which the Paroxysm returns, the time of duration, and the vehemency of Symptoms, for if the fits return sooner, and the latter be longer than the former, and more vehement, it is a token the disease is increased: on the contrary, if the latter fits return slower, and endure a shorter time, and are not so violent, it is a sign the disease abates; but sometimes Paroxysmes, inveigh equally and all of them return at the same hour, which most commonly is a sign of a long disease, but sometimes they come not equally, but at several hours, which shows that the disease will be shorter, and is nearer to the state. Moreover, if the fits come sooner, and that equally, the signs of concoction not appearing, it is the beginning, but if they anticipate more hours than before, it is in the increase; when they observe equality again a good while, it is the state; when lastly the omitting or abating of the fits happens to be various, it is the declination: If the order of the fits, so that sometimes they come too soon, sometimes too late, and sometimes equally, and at certain times. When the fits do equally invade without the signs of concoction, 'tis the beginning, but when they anticipate not, 'tis the augmentation; when they observe equality, it is the estate: And lastly when the coming late happens again, 'tis the declination; but if the order of fits be various, so that sometimes the Paroxysmes invade equally, sometimes anticipate, and sometimes come later; when the fits equally invade without signs of concoction, the beginning is; when they come too soon no more, the state is; but when they come too late, the declination is. As for the longitude and magnitude of fits, In longitude. if the time of intermission or declination be short, and they are neither plainly intolerable, nor altogether free from Symptoms, it is a sign of the increase. On the other side, if the abating or the intermission be long, easy to be endured, and free from all Symptoms absent, declination is shown. But the most certain signs of the times of diseases, are digestion and crudity, for whensoever a sign of concoction appears suddenly, it shows the disease will be short and terminate in health, but a sign of crudity shows the disease will continue long, or even prove deadly; and if grievous Symptoms grow upon the sick, so that they come with signs of concoction, they need to trouble no man, but if they happen without signs of concoction and with crudity, they portend danger. CHAP. III Of the signs of times of Diseases in particular. ANd that we may speak something peculiarly of knowing of the times of Diseases, the beginning of a disease is as long as the disease is crude; Signs of the beginning of a disease, of augmentation, of the height. An evident and manifest concoction is a most certain sign that the beginning is finished: And in the beginning the Symptoms are hitherto more mild, but in the augmentation all of them increase, and in the state, when the greatest contention is betwixt the matter and the disease, all of them are most vehement: but this comes to pass sometimes soon, sometimes late; for in very acute diseases immediately they have extreme pains, 1. Apho. 7 but in Chronic the times are extended longer. CHAP iv Of the signs by which we may foretell the event of a disease. ANd these things are spoken of Prognostics in general, now we are to speak of those three, The event of a disease fourfold. which use to be presaged, namely the event of a disease, the time of the end, and the manner: but the event of a disease is fourfold, for some diseases kill the diseased, others plainly leave them off, so that the sick return to their perfect health; others neither kill the sick, nor leave them off, but accompany them even to death's door; others are changed into other diseases, and sometimes into worse, sometimes into milder. The event of a disease is known by comparing the strength of nature with the disease, and by the longitude of a disease, When it may be known. or the state with the time to come; for if the sick pass over the state, there is no need, that he should any more fear the danger of death by that disease; because after the state no man dyeth in the declination by the power of that disease. The signs of strength and weakness of nature are sought principally from causes, and effects: Signs of strength and debility of nature. the proximate cause of the strength of nature is a natural constitution of the parts. And this, by how much the nearer it is to the natural temperature, constitution and naturalll unity, by so much it signifies the firmerstrength; by how much the more remote, by so much the weaker. For strength of nature principally depends upon a natural temperament, whereunto belongs age also and sex; for in men and youths the strength is firmer; in women, old men and boys, weaker. Remote causes are all those things, which by whose intervening the strength of a natural constitution is increased, or preserved, or diminished; such are those things, that are taken in, which are carried about, which happen externally, and that are evacuated, and retained; for if all these things have been moderate heretofore, and are moderate, it shows strength of nature; if immoderate, imbecility. Amongst the effects are first, actions, which, by how much the more they are observed according to nature, by so much the more they signify health: on the contrary, by how much the more or more noble they are, or by how much the more they are hurt, by so much the more they show the strength to be weakened: Secondly, Excrements signify nature to be powerful, when in their substance, quantity, and quality they are most like to natural, but they signify the contrary, if they are contrary. Lastly, qualities changed, by how much the nearer they shall be to the qualities of sound men, by so much they show the greater strength in the diseased; by how much they differ from them, by so much the more imbecility. The strength of a Disease is known from things essential, Signs of a strong disease. inhering causes, and effects, or consequent Symptoms. As for what belongs to a constitution contrary to nature, the difference which follows the form of a Disease, or the causes, or the subject, afford signs of the event; if the Disease be great it indicateth danger and death, if little health, and by how much the fewer and more gentle those Symptoms are that show what the disease is, by so much the less the strength of the disease is shown; but by how much the more or greater they are, by so much the more vehement is the Disease: but principally malignity ought to be suspected always; a disease also, by how much the more it resides in a noble part, or may draw in a noble part by consent, by so much the more dangerous; but that which is in an ignoble part is out of danger. The causes are such, as either bring forth a disease, or dispositions which have gone before it. or such as are helpers and supporters of a Disease. The efficients are either Internal or Externall, internal are either solid bodies, or fluid; Diseases therefore which proceed from solid matter, as from stones, gravel, especially such as is great, for the most part are incurable; Diseases which arise from humours are dangerous, if they offend in the whole substance, and are malignant, if they are very purred, if plentiful, endued with mischievous qualities, and inhere in a noble part, and are crude; those which are contrary indicate the Disease to be less dangerous: Diseases which arise from blood for the most part are wholesome, from yellow and pale choler not very dangerous, from leek coloured choler, and the colour of the Yolk of an Egg, for the most part deadly. The Aeruginous for the most part all are mortal, as those from black. A Disease also from an humour perversely thin, is more dangerous than if it be mingled with some other more mild. Diseases also which proceed from many vicious humours mixed together, are more dangerous than those that arise from a single humour, regard nevertheless being had to the nature of the peccant humour. Diseases also are more dangerous which proceed from a humour causing a tumour, then from a quiet, so that it doth not adhere quietly to a noble part. As for the external and evident causes, this is to be noted of them in general, if they trouble the body long and violently, and are withal malignant, and continue long in the body, they signify a dangerous Disease; those which are contrary tend more to health, and are less dangerous. Of the dispositions of bodies, Hypocrates 2. Apho. 34. writes thus. Those are less dangerously sick, whose disease is suitable to nature, or age, or custom, or time of the year, than they whose diseases are agreeable to none of these. Moreover, if Adjuvants, Effects and Symptoms. whether they are external or internal, or from nature, or from art, help, they signify a healthy Disease, and not a dangerous; but hurtful things, if they hurt not, show that nature is well: On the contrary, if those things which ought to help, do not help, they show that the Disease is dangerous and deadly. Thirdly, for what belongs to effects and Symptoms, by how much the Symptoms are lighter, by so much the Disease is more gentle, by how much they are greater, by so much the Disease is more violent. The plurality of Signs are not only to be handled here, Dignity of signs. but the gravity and dignity of good and evil signs are to be considered and compared amongst themselves, and with the strength of the Sick; for the dignity of signs is principally to be valued in respect of life, and always those are counted most worthy which indicate the force or imbecility of the vital faculty. CHAP. V How to presage of life and death from the error and faults of actions. AFter that we have spoken those things in general of knowing the event, we will speak something in particular of what may be foretold by Symptoms, whereof this is the sum: Those things which are most like or agreeable to nature are healthy, those which are most unlike, or different, The third Book, and part of the fourth. Animal actions hurt what they presage. are deadly, And first for actions hurt, and what belongs to the animal faculty, in what disease whatsoever, to have the right use of ones reason, and to be well in respect of those things which are taken in, is a good sign, but the contrary is an ill sign, Hypocrates 2. Apho. 33. and to do any thing contrary to custom, and to will something formerly not accustomed, or the contrary, that is, either to speak little or much, or madly, or absurdly, or obsceencly, to move the hands untowardly, to read wanton things, to uncover the body, and denudate the privy parts, not to be sensible of pain, untoward, and next to being frantic, Delirium. 2. Coac. Sect. 1. Apho. 10. But principally to continue well in understanding, is good in those diseases wherein the brain is affected, or is drawn into consent: But although to be well in mind, in diseases of other parts, be a good sign, yet it is not sufficient to signify health, for many dye that are perfect in their understandings. Although no ravening be safe, yet that which is with laughter, and good signs, and is light, and not continual, is more safe, but that which is with violence, continual and vehement, is more dangerous, but that which is with boldness and rashness, is the worst of all; yet other things which are joined therewith are to be considered; first, the Pulse, respiration, and appetite, which if they remain safe, it is a good sign, as also if sleep follow; but on the contrary, if ill signs are joined with ravening or madness, they threaten death, for deadly signs denote certain destruction. Ignorance with shaking fit is evil, The me●●ry hurt. 'tis hurtful also with oblivion, 1. Prorrh. Com. 2. Apho. 30. yet that oblivion which comes with a Delirium is less dangerous, so that the Delirium wherewith it appears be not dangerous. Sleeping and waking if they are customary, Sleeping and waking. and from a natural course, 'tis good, but sleep and watch if they are eccessive evil, 2, Apho. 3. but yet if watching happen before a Crisis, the matter being concocted, it denotes no hurt; a Coma or Disease that causes long sleep, in the beginning of a Disease, signifies the Disease to be dangerous, as also that which happens in the height of a Disease, and by so much the more dangerous is the Coma, by how much the more grievous Symptoms are joined with it. As for the mischiefs of the external Senses, if the sight, Hurt in of the external senses. Of sight. the time of judicature being instant, be hurt with the signs of concoction, it indicateth no evil, but that sight which is hurt without the signs of concoction, and after an ill Crisis, wants no danger, Cal. 4. Aphorism 49. The hindrance of hearing also, if it happen during a good Crisis, is not evil, but if without a Crisis, it is evil; and in acute Diseases for the most part it denotes the brain to be affected: And in the first place, that is mortal which is made by reason of decaying of the strength and extinguishing the faculty; those evils also which proceed from evil evacuations, 3 Prorrh. 37. The sound also and continual humming of the ears, if it happen with signs of crudity, and in a day that is not judicatory, and the strength languished, it signifies a mortal or deadly Frenzy; when it happens otherwise in the vigour of a disease, and decretory days, it indicateth the hemorrhoids of the Nose. The mell and taste being offended, Of Hearing is a certain sign rather of the peccant humour, then of the event of a disease, but yet if the sick, the faculty being extinct, should be deprived of taste, it is a deadly sign. The sudden want of the sense of feeling, Of Touching. which happers in diseases, is an ill sign, since it is a token, either of the dilating of the vicious humours so sar as to the brain, or of the extinguishing of the native heat. If inflaming pains which presently appear in the beginning, Pain. and are not too vehement, nor continual, and are taken away in a short time, or are abated, especially, after a plentiful evacuation, occasioned by nature, or art, and no dangerous sign be joined, 'tis good; but those which continue long, presage an impostumation, but those which happen, the disease increaseing, are not evil, because they denounce a Crisis. It is good also if when a concoction appears, the pains invade the remote parts from the bowels, and that principally on the critical day, but all those diseases are evil which afflict the principal parts, especially if they are joined with a continued fever, and other ill Symptoms; but diseases of the noble parts are good, if they happen after concoction, and do not vanish in a short time, and the sick are other ways the better by that means; but if they happen in the beginning, the matter being hither to crude, and the disease not abated thereby, or if shortly they vanish without any manifest cause, or beginning from a more ignoble part, and ascend to a more noble 'tis an ill token: also it is evil not to be sensible of pain in any part. The same reason for the most part is from wearisomeness, Laziness. for that lassitude which is promoted by the humours, flowing from the noble parts to the external, with signs of concoction, is a good sign, and especially if it vanish after some evacuation, but if it happen without the signs of concoction, and with other perverse Symptoms, and is not abated by evacuation, it pretends evil. As to the Symptoms of motion; Motion. if bodies are moved aright and easily, 'tis good, but not afight, or with difficulty, 'tis ill 2. prog. text. 6.7. Hitherto we may refert the decubiture, Lying down. for it is good for the sick to lie on either side with his hands neck, and legs, a little bent, his body straight, not bending towards his feet 1. prog. text. 13. for it is evil to lie supine, with the hands, and feet stretched and dejected, but it is worst of all to slide down the body to the feet, to observe no order of lying in one's bed, nor to be quiet in one place, raving and striving to fly out of the bed, to uncover his hands, foot, and nakedness, ib. textu. 14. and seq. but if a critical anxiety or trouble, 'tis not so hurtful, all the rest are evil 2. prog. 27. That convulsion is most dangerous wherein it appears that the motion is most depraved, Convulsion. and the contraction more vehement, and lasting, and which occupyeth more parts, and nearer to the brain, which renders respiration difficult, interrupted, and sighing, or from a flux of blood, or which happens from much purging, which happens in acute fevers, which succeeds a Phrenfie, as also in the iliack, passion and watch, but the convulsion which happens to Children is less dangerous, Galen 1. Epid. comm. 4.24. and that which is caused by too much motion of matter to the head or stock of nerves, or that which is occasioned through the mordication of the ventrilcle by the sharpness of the humour, or a medicine, or by straining in vomiting, and doth not last long. A Hiccock is like to a convulsion which if it come without a fever or any disease; Hiccock and be occasioned by meat or drink it portends nothing of eminent danger, but after too much purging, and with inflammations and fevers, hiccocks are always dangerous, especially if they happen to old men; unless a Crisis of vomiting afterwards be present, especially if other dangers and deadly signs joined therewith. Trembling is evil if it happen in the beginning of diseases without an evident cause, Trembling. and indicateth the diseases to be dangerous, especially if it shall be longer and more grievous, and other weighty Symptoms are joined therewith, as those which happen in an Apoplexy and Lethargy, but that trembling which happens afterwards, and is occasioned by the critic expulsion of humours, from the interior to the external parts, is a token of no evil, nor is that trembling evil which succeeds a palsy, since it is a token that nature overcomes the disease. A shaking fit which incontinued fevers happens in that hour wherein the pain useth to gripe, A partxisme. when the signs of concoction go before, 'tis a token of a future Crsis, and therefore accounted good, if some good evacuation follow; otherwise if it happen in the beginning of a disease, or with an ill and difficult crisis 'tis adjudged evil. Cold fits which happen at certain times in intermitting fevers, Cold fit. signifies no evil; nor are they ill signs in continued fevers, which happen after signs of concoction, and are tokens of critical evacuations; and after which the body grows hot again, and some critical evacuation followeth. But those which are occasioned whilst the matter is crude, by reason whereof the body cannot grow hot with evil evacuations, or when no evacuation followeth, and which happens with ill signs, are all evil. Sloth of apprehension, Torpor. specially of the body caused by cold, is perpetually evil, and without a fever or Apoplexy, it pretends manifest danger in fevers, by reason of the extinguishing of the native heat. Moreover the signs of defaults of speech are to be observed; Hurt in the voice. a shrill voice threatens danger, since it denotes exceeding dryness of the instruments of the voice; dumbness, although it be never good, nor without danger, yet it is not always deadly, namely when the judicatory evacuation follows, and when it doth not continue long; the rest that are dumb, are all for the most part mortal; and so much the worse, how many the more perilous signs are joined. Secondly, The strength of the vital faculty. the strength and weakness of the vital faculty, which are of greatest force in foreshowing safety, or death, we observed principally from the pulse and respiration. Of the pulse 'tis spoken already, only we repeat this, that the most languishing, most dull, and most thin, are the worst of all; after these the least and softest, and hardest; next the most frequent, but not swift, nor great; only amongst extremes the most vehement is the best, yet we must diligently observe always, whither the change of the pulse arise from the disease, or come from external causes. Hereunto belongs the Palpitation of the heart, swooning and falling down, as it were dead, which indicate dejection of the vital faculty, and great danger, if they happen through some disease of the heart itself. Respiration, Respiration. of it be natural, signifies neither the breast, nor heart, not midriff to be any way affected with pain, nor any adjacent parts Galen 1. prog. Apho. 25. and moreover it hath great force in signifying tokens of health, when one is sick in a fever, especially if other good signs are present Hip. ib. on the contrary preternaturally respiration, although it be not always mortal, yet 'tis always evil, but worst of all if it be joined with other ill signs; great and swift breathe signify great store of fuliginous vapours, yet the organs apt, and the faculty hitherto strong, a great and slow pulse happens only to those that are disturbed in mind; a great and frequent pulse snew pain or inflammation of the part serving for breathing; little and swift respiration shows plenty of fuliginous excrements, but with pain, or inflammation of some of the organs appointed for breathing; a little, and slow pulse shows not many vapours, with pain or inflammation of some instrument of respiration, and with other ill signs portends not a little danger; little and obscure respiration is perpetually evil, and signifies dissolution of strength; but little and thin is the worst of all, because it indicateth the greatest debility of the faculty, and if a cold breath proceed from the mouth and nostrils, it is very destructive; but the worst of all, and the nearest to death, is when it extends & is obscure, and sublime, wherein the breast is much dilated, and sometimes the Shoulders, and grisly part of the nostrils, but that which is inspired is very thick, and most frequent; but the worst respiration of all, is that which is made with ordure. Moreover for what belongs to the Symptoms of the natural faculty, Symptoms of the natural faculty what they presage. their perfection is known by their operations, of which it shall be spoken hereafter, but that we may speak here something of the desire of meat and drink; to have a good appetite to meat, and that proceeding from a natural cause, and as Hippo. 2. Apho. 33. writes, in every disease to take easily whatsoever is offered, is a good sign; on the contrary an ill appetite of meat is bad 7. Apho 6. not to thirst also in hot and burning fevers, wherein the tongue is filthy and black, perpetually signifies mischief, and a delirium, or dissolution of the desiring faculty, or of them both; but as it is an ill sign not to thirst, so 'tis a good sign to thirst in hot diseases, also to thirst immoderately and over much, is notgood, CHAP. VI Of the signs of life and death which are taken from excretions and retentions. AMongst exerements, urines principally use to be observed, Prognostic from urine. but although it is spoken of already, what they show, above, part the first See. 2. cap. 21. yet here we may briefly comprehend those things which portend to death or life, namely, that urine is best which is most like that of a sound person from this the rest differ in substance, colour, quantity, and contents. As to the substance, the goodness of the substance with a good colour, promiseth health; thin urines with a good colour promise health, yet they show a disease which requires longer time for concoction. Thin and red urins signify a crude disease 2. prog. 30. but thick, which are made so after the beginning of a disease are also good, if they were thin before, much urine if it be made on a critical day is good, which sometimes is profitably made with sharpness, and pain. Troubled urine, not settling in the bottom, because the strength of the diseased persists, argues for the most part the disease to continue long; if imbecility of the sick be present, it denotes their death, but those which grow clear are better. As for the colours of waters, a pale red, a light safron colour, and a kind of clear clay colour are good, neither is a reddish colour with a radish and light sediment to be found fault with, but on the other side bright shining urines, and white are evil; and especially if they appear such, in Frenzies, 4. Agho. 72. principally, if they are so in the beginning of a disease, and continue so long; thin, and red, signify the disease is crude, and moreover 'tis dangerous if they continue so long; black urine in acute diseases, unless they are emitted on a critical day, always denote great danger; after black, the oily are the worst, yellow, and green also are nought, and green urines if they appear so suddenly in men that are in other respects sound, with biting of the heart, 'tis a sign they have drank poison, and they are in danger of death, but in fevers they are mortal signs; especially if they appear in the beginning of the disease. As for the quanity Hippo. 3. Epid. come 3. tom 4. condemns thin urins made in great quantity; as also much urine, thick, not residing and no way helping; and all urines are made in great quantity in the beginning, are disliked; small quantities of urines in acute fevers are also nought. As to the contents, those urins are evil which have no sediment, and nothing that swimmeth in the urinal in the midst of the urine, nor a little cloud; unless the sick hath fasted long, or watched, or laboured: or because the body is exceeding full of choler; thick waters also without a sediment are dangerous, and a sediment representing, the form of thick brain, is evil, but worst of all, if it reside in a manner like scales of Fish, but if it be thin and white 'tis vicious; but that which is furfuraceous or like Bran is worst of all, Hippo. 2. prog. 28. a nubecula, or little cloud, which is carried in the Urine, if it be white 'tis good, if black 'tis nought; 'tis evil also for the sick to make water and not know of it. Secondly, Of dejection of the helly. the dejections of the belly afford us signs two manner of ways; first, as they show the concoction of the stomach and guts, also as they manifest the humours flowing from other parts to the guts; As for the first kind, that ejection is best if it be gentle and constant; and sent forth at that time when it is wont to be in the best health, if quantity be according to what hath been eaten, 2. Apho. 13. The latter is good if it be critical, and with signs of concoction in the state of a disease, and happen on a critical day, and ease the sick, 1. Apho. 2. On the other side ill dejections, and those which portend destruction, derogate from the good in substance, colour, smell, time wherein they appear, nor are they voided with ease. As to their substance and quantity, dry excrement and rolled up in clods are signs of fiery heat, and if besides they shall be black, they declare a burning disease to be in the middle of the body, and for that reason are evil: On the contrary liquid excretion is not evil, if it have other good notes; but the watery ordure is worse, and proceeds from greater crudity; and moreover in choleric diseases, with ill Urines 'tis deadly, but in more mild it signifies the disease will continue long. A glutinous, white, light, fat, and foetid ordure, and little, are condemned, 2. Prog. 21, 22. Clear dejections also in acute diseases are condemned, 2. Prorrh. 15. and frothy, and choleric ejections in acute choleric diseases are accounted evil, ibid. Apho. 18. As to the colour, excrements which differ from the natural colour, are white; red, bloody, watery, green, yellow, black, full of mixed colours, unless they are emitted critically they portend danger: Yet in all these ejections in judging of them, regard is to be had of the meat, and to take heed you observe whether that quality hath its rise from diet that hath been taken; for they become white either by the obstructing of the passages through which choler descends to the guts, or through the motion of the choler to some superior and more noble part, Red are also of themselves dangerous, yet if they are extruded after the victory of nature, they rather show hope of present health, then portend any thing of evil. Black Excrements since they proceed either from blood or melancholy humours, or from black choler, that blackness which comes from concrete blood, or a melancholy humour, is not always evil: but pure black choler can never be sent out of the body without destruction of the sick. Green and aeruginous ordure which proceeds from aeruginous choler tending to black, is an argument of a pernicious disease, if it be cast out from any principal part, and the bowels be affected with an Erysipelous; if the Excrements are yellow, they signify vehement cold in the internal parts, and as it were a certain mortification: Ejections also of divers colours are evil, 2. Prog. 23. Excrements are evil also, and the worst of all, and few are preserved whose excrements in acute fevers are foetid, yellow, fat, black, and blue, or lead colour. Those vomitings are good which truly purge the causes of diseases, Of vomitings. or which are made critically, and when concocted matter appears on the critical days, and are suitable to the nature of the disease, and take away or abate the same; but on the contrary, all those are evil which happen in the beginning, when the matter is not yet concocted, and which take not away the morbifique matter, and the disease; and they are so much the worse if other pernicious signs be present, such as are sincere Vomits, leek coloured, lead coloured, black, stinking, and foetid, from the guts, Ileon, and very little. Sweats are good which happen after decoction is made, Os sweats. and on a critical day, and coldness, and stiffness, proceeding & flows out hot and plentifully from the whole body, and lessen and abate the disease: on the other side, those are evil which happen whilst the matter is crude, which are too much, or too little, and those which are cold, or flow not from the whole body, and neither diminish nor take away the disease. The Hemorodes of the nose are good which happen in the state of a disease, From the hemorrhoids of the nose. with signs of concoction, nor is that always to be condemned which happens in the augmentation, and also in the beginning, seeing the blood wants no other preparation, neither do the other humours. Good hemorrhoids ought to be large, but yet not over much, but to be made with ease, and the symptoms of the Fever to be abated, and to happen in a critical day, and in those diseases, wherein bleeding is proper to their nature and condition; and moreover the blood ought to flow from a part opposite to the part affected: on the contrary, those are ill hemorrhoids which happen in the beginning, unless other good signs are present, and if they appear with dangerous signs, and those which are too large, or too little. Dropping of blood from the Nose is evil, if it be caused by pervernesse of matter, multitude, imbecility of force, or all these, especially in the beginning, or on the fourth day, if the blood be black, sincere, and without mixture: But it be a token of a future Crisis, 'tis no ill sign, which happens when the signs of concoction have been before, and the disease is not dangerous. Spittle is of great use in showing of diseases of the breast, From spittle. and that is good which is concocted, white and equal, and is spit out conveniently, and easily in a short space of time, without great pain, and a great cough: on the contrary, 'tis evil if it be crude, yellow; worse, if it be green, worst of all if black, especially if it be without mixture, if it appears more dull, and is spit out with great difficulty, 'tis also evil; when the spittle is bloody, for it proceedeth from erosion, or from breaking of Vessels. Lastly, decretory Imposthumations are good, Ulcers. if they happen with signs of concoction, and other good signs, and break on a judicatory day; they are good by nature which are removed from the bowels and more noble parts, which persevere, are suppurated, and help the sick: On the contrary, those are evil which break forth without signs of concoction, the matter as yet being crude, and on a day that is not critical, if they are too great, or too little, or happen to be in the fingers, or toes, if they are lead colour, or too red, inclining to black, and those which decrease and vanish, without any reason, and without any precedent evacuation, those which are not well suppurated, which are corrupted, and they bring either that part where they are, or the whole body into danger. CHAP. II. Of the signs of health and of death which are taken from the mutations of the qualities of the body. MOreover to the mutation of the qualities of the body, What may be foretell by the habit of the body. and first concerning the whole body, 'tis a good sign if it be rendered not much unlike to a sound body in habit and colour. 'tis no good sign for the most part in a great Disease, when nothing is changed, 2. Apho. 28. 'tis also an ill sign when bodies are extenuated in the declination of a Disease, and although they take food are not thereby refreshed. For in acute Diseases, 'tis an ill sign when the body is puffed up and swelled, unless critical humours are then remitted. The colour of the body when changed contrary to nature, From the colour. and especially in the yellow Jaundice, is a good sign. In Fevers if it come to pass by natures driving the choleric humours critically to the out side of the body, and the skin; but that which is contrary is to be adjudged evil. Those signs which are in the face are of great force, From the face. but that face is best which is like to theirs which are in health, but if it be contrary 'tis vicious, Hip. 1. Prog. 5. but a face may be unlike to their faces that are well many ways, and by how much the more it recedeth from the face of sound people, by so much the greater evil it denotes. All which signs Hypocrates in his description of a face, Hippo. face. which differs from a face of a sound person produceth, which therefore is called an hippocratical face, 2. Prog. 6, & 7. sharp Nose, hollow Eyes, the Temples straightened, or narrow, the Ears cold and contracted, and their fibres inverted, the skin also about the Forehead hard, fixed, and dry, and the colour of the whole countenance green, or black, which change of the countenance is very deadly, especially in the beginning of a disease, unless it so happen to be from some evident cause, and mends night and day, but that face which is of a purple colour, mixed with blue, unless the hemorrhoids of the Nose, or an Imposthumation behind the Ears be to follow after, is an ill signe, and denotes a very hot disease of the brain. As the eyes are affected, so the body, By the eyes and principally the head, 6. Edip. Comm. 4. tom. 28. for if the eyes are like to theirs that are well, have a natural colour, are full, splendid, and endure the light without trouble, if they open their eye lids well, and shut them without tears, and without excrements, they are good signs. But there are divers mutations in the eyes, and as Hippo. 1. Prog 10. writes, if the eyes avoid the light, or shed tears against the will of the sick, or are perverted, or one shall be less than the other, and the white become radish, or of the colour of lead, or black Veins, or phlegm appears about the sight, or look divinely upward, or are hollow, or the colour of the whole countenance varies, all these are to be accounted evil and destructive, but worst of all if the sick see not, hear not, and if this happen in a weak body, death is nigh at hand. A sharp Nose, and a Nose that is turned, or wreathed, By the Nostril. after what manner soever, is an ill sign; if the Nose itch contrary to custom, unless it indicate a flux of blood imminent, it shows that a Delirium will follow. The Ears if they are of a wan colour, By the ears. black contracted and cold, 'tis a sign of death. The grinding of the teeth is an ill sign, By the teeth 'tis an ill sign also when any glutinous humours sticks to the teeth. When the Tongue is like theirs who are in health, By the Tongue. 'tis a very good sign, but 'tis very evil if it be green, black and exceeding dry, cleaved, or chopped, rough, and as it were burnt: But principally dry, hard, and black Tongues indicate danger, if they appear with other ill signs, & most of all if when the Tongue is rough and dry, the sick be not thirsty. The Chaps ulcerated with a Fever is hard to be cured, By the Cheps. 3. Prog 15. and if in acute diseases of the Chaps, if pains, and abjectness, and stops, without a tumour happen, they are pernicious, 1. Prorrh. 11. and if the Fever being detained, he suddenly turn his neck awry, and can scarce swallow, no tumour being present, 'tis mortiferous, 4. Apho. 35. 'tis a good sign if the Hypocondries are without pain, By the Hypocondries if they are soft and equal, on either part if they are not extenuated; yet sometimes when the Hypocondries are stretched it shows a crisis to come, but then also other critical signs are present; on the contrary 'tis an ill sign, if the Hypocondries are troubled with inflammation, or pain, or are stretched, or unequally affected, on the right, or left part; also when extenuated, By the extremities of the body. and beating, unless a Crisis be present. Lastly as to the extremities of the body, if in intermitting fevers, the extreme parts grow cold, and the internal burne, and they thirst, 'tis mortal 7. Apho. 1. but 'tis very good if all the body be equally hot, and soft; it is evil also, and for the most part deadly if all the body be heavy, and especially if the nails and fingers are black and blue, or black, if the genitals, and stones are drawn up together, also filthy smells indicate great putrefaction and danger. CHAP. VIII. Of knowing the time, longitude, brevity and event of a disease. THe length, Which diseases are ended in the first quartarnary. brevity, time, and event, of a disease are known principally by the signs of concoction and crudity, and the vehemency of a disease, by the celerity, and tardity; for if in the first day in an acute fever, the signs of concoction are present in the urine, and no danger be perceived, it argues the disease will end about the first quartarnary, third, fourth, or fifth day, if the disease be contrary to this, and presently after the beginning have the worst Symptoms, Which are extended to the second. the fifth day, or before, he will die. But if signs of concoction appear the first and second days, and the disease be neither benign nor vehement, the disease may be extended, to the second quarternary, but as long as such seavers can continue the first day, it can scarce be known, but afterwards each quartarnary are to be considered, and the signs of concoction in them are to be wieghed & compared with the vehemency of the disease, towit, if in the fourth day signs of concoction appear in the urine, 'tis a sign that the matter is apt to be concocted, and that the disease will terminate on the seventh day; on the contrary, if in such a fever, on the fourth day there appear no signs of concoction but ill signs are also increased, 'tis an argument that the sick grows worse, and may die about the seventh day; unless some error be committed, or some other cause of change be present. But if the signs of crudity, remain till the fourth or: Which to the third. seventh day, the disease shall endure beyond the third quartarnary, but if on the fourteenth day, it shall have an end, the eleventh, which is the index of the fourteenth will show it, for if then signs of concoction appear, either before the fourteenth day judgement may be given, or on the seventeenth day; but if on the eleventh day there appear not as yet sufficient signs of concoction, there is no hopes that the disease will be judicatory on the fourteenth, and therefore the signs of concoction are to be sought in the following quartarnaries, for if the signs of concoction appear about the twentieth day, there is hopes on the first quartinary, after the twentieth day, that the disease may be judged of, but if no mutation hitherto appears it may be extended to the fourth week, and those diseases which retain all the signs of crudity to the four and twentieth day, cannot be decreed, before the fourtieth day, and those which are extended beyond the fourtieth are not ended with a Crisis, but with slow concoctions. Sometimes not only the day but also the hour of the end of a disease may be foretold, The hour of the event of a disease how to be known. namely if we consider particular fits, for if we think any one will die on any day, 'tis probable he will die in the worst time of his fit, or in a particular declination, when the strength, in the height of a disease is dejected, by the cruelty and vehemency of Symptoms. CHAP. IX. How many mutations there are of diseases, and the manners, and what a crisis is. THe third thing which ought to before known by Physicians is the manner of event, and end of diseases: Changes of diseases how many. they are terminated six several ways, as well to health, as to death, for either the disease is suddenly fully dissolved, and the sick recovers immediately his firm health, or there is a sudden change to better, and the sick is transferred from a worse state into a better, after which, at length also he recovers to be well, or there is a conversion of the disease by little and little to health, or contrary the sick suddenly dies, or the disease is suddenly become more dangerous, which change at length ends him. That mutation which is made by degrees, tending to death, is called a Marasme, or Wasting; that mutation of a disease which is made by little and little, and tends to health, is called a losing, but that sudden and hasty change which is made in Fevers, especially acute and tend to health, Crisis. or death, is called a Crisis; but that change cannot be made unless vicious humours which oppress nature are moved, which indeed cannot happen without great perturbations of the body, and vehement symptoms, a Catalogue whereof Galen recites in his 1. of critical days, Cap. 1. CHAP. X. Of the causes, differences, manner, and time of Judgement. SInce that in Judgements many things happen, The cause of a crisis. Conturbation. conturbation, evacuation, and sudden mutation, tending to safety or death, that conturbation which is a heap of those judicatory symptoms, which proceed from agitation and molestation of humours which the body affords, and this comes to pass either from an external cause, as influence of Stars, or an internal, irritating and provoking as well nature as the matter. The cause of evacuation is the expulsive faculty, Evacuation. which either is stirred up by the plenty or the quality of matter, yet critically expels that which doth molest. There are four differences of Crises, Differences of Crisis. according as nature is sometimes stronger, sometimes weaker, and sometimes oppressed more by v●tious matter, sometimes less, for either the sick forthwith recover their former health, or suddenly die, or undergo some change, tending to safety or death, Good Evil. yet immediately they neither recover, nor die: From whence afterwards other differences will arise, for some Crises are good, some evil; those are good which tend to the recovery of the sick, those are evil which discover the death of the sick. Again some are perfect and very good, Persect. Impersect. which free the sick perfectly and wholly from the disease, and leave none of the morbifique matter, but the imperfect leave some of the morbifique matter behind. Again, some are faithful and secure, Secure. Not secure. which so take away the disease, that there is no fear of a relapse; unfaithful is that which leaves a doubt of falling into it again. Moreover 'tis called a safe Crisis which happens without danger of Symptoms; A safe. Dangerous. but a dangerous which is joined with perilous Symptoms. Some Crises are with good signs, Eusemes. and have their indications from the days going before them, and are called good signs; but that which happens without signs, and is, Asemos. as it were, unseperated, is said to be an ill sign. But all these differences depend on three things, The differences of Crisis whereon they depend the strength of nature, the nature of a disease, and the condition of the matter which ought to be expelled; and that a good and perfect Crisis be made, 'tis requisite that nature be strong, and Heaven favourable, the disease not dangerous, and the matter benign and facile; in all other Crises one, or more of these are wanting. All Crises are made two ways, either by excretion, Crisis, how many ways made. By excretion, by translation. or emitting, or else by removing the matter: By excretion a Crisis is made when peccant humours are expelled by vomit, Seidgs', sweat, plenty of Urine, hemorrhoids of the Nose, flowing of the months, and hemorrhoids: A Crisis is made by translation, when the matter is not expelled out of the body, but is removed into another place, and that either into internal parts, or external, the former Crisis is the better, because the matter for the most part is throughly cast out from the centre of the body; by so much also a Crisis is the better, that is made by translation, by how much the matter is transferred to a more ignoble and remote place; so much the worse, by how much the place is more noble and nigher to the seat of the former disease: An Imposthumation also, or Ulcer ought to be out of the region of the part affected, and to have the other notes of a good Imposthumation; an abscess also ought not to vanish suddenly, but to remain until either it be turned into quitture, or till it be dissipated by degrees. But the best Crisis never happens unless it be towards the end of the height, when the concoction is perfected, A good crisis, when it happens. for that which happens in the augmentation before the state, is imperfect, and is so much the worse, by how much 'tis longer distant from the end of the state; sometimes also evacuation which is made in the beginning of diseases, and is symptomatical, is not to be accounted evil, especially if those humours are evacuated, from whence the disease had its original, and the strength of nature can endure it. CHAP. XI. Of Critical days. WHereas the Crises are made more frequently and better on certain determinate days than other days, Critical days. those dales therefore are called critical; but other days wherein a Crisis seldom happens, or such a one as is not good does happen, are called not critical. Critical days are of three kinds, some are those which are simply, and according to preeminency called critical, wherein Judgements are made better and more frequently, all which are bounded within the circuit of a septinary number, and are these, the 7.14.20.27.34.40. for days are not taken whole, but shorter. Moreover, there are some which are called indicant and contemplable, from whence the Crisis to come is shown, and they are the middles, or quarternaries of every seventh morning, as 4.11.17.24. Others are such as come between, Intervening. which the Greeks call Parempiptontes, others call them provocatory, wherein from some accident contrary to nature, or by the violence of a fit, or by reason of some external cause, nature is provoked to hasten to untimely expulsion, such are the 3.5.9.13.19. and according to some 15.18. Vacant or not critical days are those wherein no crisis happens, Vacant. or very seldom, and unperfect, and evil, such are the 6.8.10.12.16.18. to which some add 22, 23.25.29, 30.32, 33.35.38.39. which days are also called medicinal, because the Physician on those days may safely administer purging Medicines. After the 40. day diseases languish, and by a slow concoction, and by Imposthumations, rather than Crisis are terminated; after these some diseases are judged by months, others by years, and especially in climacterical years, when changes are made even of diseases which have been contracted from their Mother's Womb. From this doctrine nevertheless of Hypocrates, and Galen, which Galen reduceth, as it were, in brief, in the 1. of decretory diseases, cap. 5. the ancients now long since have departed; Asclepiades, Archigenes, Celsus, and others, which accounted the third critical year not the twentieth, but the one and twentieth, the fourth, not the twenty seventh, but the twenty eighth. The Astrologers also do not simply observe days and numbers, The opinion of Astrologers. but referring all the reason of critical days to the motion of the Moon, note those days wherein the Moon comes to every quadrangle, or fourth corner, and comes to the diameter in respect of place wherein she was found when the disease began, as now in the causes of critical days shall be shown. CHAP. XII. Of the causes of Critical days. THat we may omit the opinions of others, The cause of critical days. of the causes of critical days, no offence to any other judgements, we appoint critical days to depend on the Moon, and the condition and disposition of peccant humours, and the expulsive faculty, for what mutations soever the Moon in her conjunctions, oppositions, and quadrangles makes in these inferior bodies is very well known, and therefore that power which is attributed to quaternaries, and septinaries do all depend on the motion of the Moon, yet nevertheless that this, or that Crisis may be made betwixt those, the motion of the Moon alone is not sufficient, since not always the seventh or fourteenth day is not always critical, and sometimes a good and an ill Crisis is made on the same day, and therefore the condition and disposition of peccant humours are to be joined; and lastly, the expulsive faculty is to be added, which being stimulated by the motion of the Moon and disposition of humours, is the next and immediate cause of a Crisis. First seeing the order of critical days cannot proceed only from the faculty of the body, nor from morbifique matter, The Mo●n. but a celestial cause is to be joined therewith, and the Moon in every quarternary, and septinary, and according as it takes up one and another place of the Zodiac in its motions, and by reason of the light from the Sun varying, shows to us various lights or representations, it may make great alterations in sublunary things, 'tis not therefore without a cause determined, that great mutations arise in diseases in those places which have regard to the place wherein the Moon was in the beginning of the disease, with a quadrate or opposite ray; and when she is come so far as that she hath a new shape, and manifest mutation of light; for the motion of the Moon and her progress to the quadrate, and opposite signs, and the change of the shape of the Moon are to be joined whatsoever they are; yet the crises are stronger when the Septinaries exactly fall into the quadrates of the Moon. But in the computing of the critical days, A periodical month in critical days to be observed. the month of wand'ring or travelling is to be observed as being natural and according to which many changes are made in this inferior orb, which for the most part is made in twenty seven days and eight hours, which if they are divided into four weeks, the first will be ended, in six days and twenty hours, the second in thrirteen days, and sixteen hours, the third in twenty days and twelve hours. Therefore on what day soever any one fall sick at the first onset of the disease, a conjunction as it were is made of the Moon and the disease, hence when the Moon hath measured three fignes, or passed over ninty degrees, and comes to the first quadrate, the first critical day is made; when she hath passed through six signs, or an 180. degrees she comes to the opposite sign, and the second critical day gins; when from the opposite signeshe passeth to the second quadrate, the third crisis gins, if the disease be prolonged till then, last when she returns again to the place where she was at the beginning of the disease the fourth crisis gins, and she shows as she did at first. prognostical diseases. The same reason is of indicatory days, for when the Moon hath passed over two signs or 60. degrees from the sign wherein she was when any one began to fall sick, and is said to come to a sextile, the first indicatory is begun; when she hath passed over four signs, or a 120 degrees, and becomes triangular, the second indicatory is made; and when from the opposite sign again she comes to be triangular, then is the third indicatory; lastly when she hath gone from the second quadrate to the second sextile, the fourth indicatory is. But here the days are not to be numbered according to the diurnal indifferent motion of the Moon, Which motion of the Moon is to be observed in critiball days. which is thirteen degrees, ten minutes, 35 sec. but according to the true motion of the Moon, for the Moon is sometimes swift, sometimes slow in motion, nor doth she pass through alike number of degrees each day, whence it comes to pass that she arrives sometimes sooner, sometimes later, to the quadrate and opposite sign, and hence without all doubt it comes to pass, that most admirable Physicians vary in defining of critical days, and Hypocrates as also Galen account the twentieth, and seven and twentieth: Arch●genes, as also Diacles count the one and twentieth and eight and twentieth for critical days; neither are always distinct aspects to be observed, but often times, plarick are sufficient. Secondly besides the motion of the Moon, The disposition and motion of humours. The nature of a body. ●the disposition and motion of humours are to be considered and which is the cause that the crisis happens sometimes sooner, sometimes later. Lastly the nature of the body is to be adjoined, which being assisted by the motion of the Moon, and stirred up by the humours, gins a combat with the morbifique matter, and expels the same, and makes a crisis. CHAP XIII. Of the signs of crisis in general. BUt crises are made as it is also said before, only in acute, In what diseases crists are made. and violent diseases, arising from hot, thin, and acrid matter which may tyre out nature; but if sometimes in durable or chronic diseases also, critical evacuations as it were, are made, it is necessary, that there be certain periods of time before the disease become vehement and become of the same nature with acutes: Moreover that the crisis may be made, 'tis requisite that there be strength of nature, according as aught to be: thirdly, to the foreknowledge of a crisis certain perturbations in the body conduce, which use to arise before a crisis, Signs of crisis. and signs which Galen in the third of crisis Cep. second at large describes, and, he briefly comprehends in the same book Cap. the tenth when he writes, that when a crisis is to come there is some new alteration, either about respiration, or concerning the mind, or the sight, or hearing, or about some of those which we call briefly, by one name, critical accidents or signs. CHAP. XIIII. Of the signs of differences in Crisis. A Good crisis is thus known. The best sign of crisis. First because critic signs have precedes. Second, because the signs of concoction have gone before especially in urins and other excrements. Third, because it is shown on the judicatory day. Fourth, because it happens on the judicatory day. Fifth, because convenient excretion is made according to the nature of the disease. Sixth, because the sick after the Crisis is almost freed from the fever, the Symptoms abate, and the face is of a better colour. But these Crises that differ from the best are known thus; Of the declining from the best. because the signs of exquisite concoction have not gone before, nor have they happened in the state, nor a little before, but in the augmentation, they are not made on a critical day, the evacuation doth not plainly answer to the nature of the disease, the sick doth not well endure that evacuation, the Pulses are not better, the sick is not eased of his disease, and in the night which followeth the crisis he is not more lightsome, yet amongst the other evacuations which are went to happen before an absolute concoction, the best of them is the Hemerhodes. An evil crisis is known by the signs which are contrary to the best crisis, Evil. namely because such a crisis first doth not expect the time of concoction; secondly in the judicatory day it was judicated by il● signs, or it suddenly grew upon him without preceding signs; thirdly it is not made on a decretory day, but for the most part on the sixth or vl day; fourthly the evacuation doth not answer to the nature of the disease and the excretion of itself is evil, fifthly the sick is not eased, the pulse is become worse, the strength decays, and the sick doth totally fall into a worse condition. CHAP. XV. The signs of a crisis to come by excretion and Imposthumation. BUt whether a crisis be to be made by emission of morbifique matter, Sgnes of a crisis to come by excretion. or by transposition of it into another place, or by imposthumation, the kinds of diseases, and the motion, time of the year, nature and age of the sick do show; for if the disease be very acute ariseing from thin and acrid matter, and the crisis be to come after, the first periods, if nature be strong, the pulse high, the passages open, and nature accustomed to sweat or some other evacuation, if it be Summer time, 'tis a sign that there will be a crisis by excrements. By an ulcer or imposthumation. But on the contrary if the disease be not so acute and the matter be thick, nature weaker, especially if the urines come forth thin and crude for a long space, if their be debility of the external parts, and propensity of nature to thrust out humours, to these places; if the time of the year be cold, 'tis a token that there will be a crisis occasioned by imposthumation. And indeed excretions are good when they are evacuated as they ought, and such as aught, Signs of good or evil ex. cretions. and in such manner as they ought, and when, and as much as is expedient; namely when the humour which offendeth is evacuated, and concocted in due quantiry, in a critical day, in a right manner, together, and through places sending them out together; evil evacuations are contrary. Good imposthumations are those which are made when the matter is concocted, have laudable substance, Imposthumations good or evil. namely a figure swelling externally, and sharpened, do equally ripen, and are not hard round about, and are of a good colour, red, yellow, or white, indifferent bigness, when they continue and go not away until they are suppurated, and are soon ripened; on the contrary, ill imposthumations swell not enough without, and are not pointed, they suppurate not all alike, they are hard about, and cloven into two, their colour inclining to red, yellow, or black, they are greater than is convenient, and they vanish before they are suppurated, or are ripened very slowly. CHAP XVI. Through what places there will be excretion and where there will be impostumation. THrough what place there will be excretion the inclination of the humour teacheth, and about those parts to which the humour to be expelled is moved, or through which it is moved, a certain change is perceived. When a Crifis is to come by the hemorrhoids of the Nose, Signs of hemorrhoids of the nose. the Hypocondries are wont first to be extended without pain, then when the blood finds the way to the superior parts, it causeth difficulty of respiration, but not long continuing; afterwards follows the pain of the head and neck, and the pulse becomes more vehement, and at times the Arteries are discerned to beat and pant, and the face and eyes become redder, and the eyes shed involuntary tears, and shinings, or glistring are observed in them, or dimness ariseth, the imagination is also hurt, and a Delirium happens, and certain red apparitions seem to be before the eyes; and moreover the hemorrhoids being now nigh, the sick begin to scratch their Nose with their fingers: and these signs are the more certain, if the age of the sick, and nature, and the time of the year, and the present constitution of the air consent. If by reason of sweat which happens very often, Of a critic sweat. a Crisis be to come, there happens● suppression of Urine for the most part, and a cold fit hinders it: but the signs of Hemerods' are absent, as also the signs of Vomits, and monthly courses, and when the sweat comes forth the pulse is soft, waving and flowing, the exterior parts grow hot, and red, the skin is soft, and a certain hot vapour breaks out through the skin. That there will be a Crisis by vomit, the motion of the humours to the stomach show, Vomit. from whence ariseth biting of the stomach with pain of the head, a giddiness and dark cloudy shadows or mists before the eyes, agitation of the lower lip, much and thin spittle flowing out of the mouth, loathing and disdaining, a cold i'll fit, or trembling, and frigidity of the Hypocondries, a hard and unequal pulse, and difficulty of breathing. If a Crisis be to follow by reason of excrements from the Paunch, Excretion of the ●elly. there is no proper and exact rule to know it, but only thus, because signs of a Crisis are present, but signs of a Vomit, or slux of blood, or sweat, or of courses are wanting, therefore we may conjecture there will be a Crisis of the belly, and especially if belching wind, rumbling, or breaking wind in the ●elly be present; also pain of the loins, heaviness of the knees use to happen, and the Urine is sometimes suppressed, or made more sparingly. That there will be a Crisis in the same manner, By Urine. is known by the absence of signs, which use to show the manners of other Crises, and the sick are not much tossed up and down, nor are they much out of quiet, but there is present a certain gravity of the Hypocondries, and a perception of windiness about the bladder, and afterwards the Urines begin to be increased, the dregs of the belly to be retained, and the sick when he makes water is sensible of certain pain. 'tis a sign that there will be a Crisis by the courses if signs of other evacuations be absent, By courses. but when the time when the terms are wont to flow, is present; and moreover the heat and gravity of the loins concur, when there is pain and stretching out of the Hypocondries, and other Symptoms which familiarly happen when the courses are present. By the hemorrhoids that there will be a Crisis is collected, By hemorrhoids. If this flux be not otherwise familiar to the sick, and the signs of other critical evacuations be absent, and the sick perceive some heat about the marrow of the back, or pain or extending of the loins, or some pain in the belly. If critical excretions are to come through more places, By more parts. In What place an Impostume will happen. the signs of more excretions will give you notice thereof. Lastly, if it be conjectured that nature will remove the morbifique matter into another place, that place where the Impostumation will be, is known by the inclination of the matter to those parts whether inferior or superior, although the matter be thin, it shall rather be moved to the superior than the inferior parts, and if nature be strong, it rather drives the matter towards the inferior, than the superior parts. CHAP XVII. Of the time of the Crisis. LAstly, it is to be known at what time the Crisis will be, Signs of the time of Crisis. but that foreknowledge depends upon the foreknowledge of the State, of which we have spoken before, but the chief signs are those of concoction and crudity. If therefore on the first day a manifest sign of concoction appear, and all the rest portend nothing of evil, the Crisis of the disease is to be hoped for on the fourth day; but if on the first day there doth not appear a manifest signe of concoction, other days are to be consulted on; and if a sign appear, in any of the decretory days, or the next quarternary the Crisis is to be expected. Moreover those things are to be joined with the signs of concoction; which the Ideas, magnitude, motion, and manner of a disease affordeth; for of acute diseases, some at the most are judged in four days, some are extended to the seventh, some to the fourteenth, others longer: The alteration of a disease also shows the Crisis, since it shows whether the Crisis will be on an even day, or an odd: Also the times of diseases are to be considered, for in noisome diseases the crisis appeareth not perfectly before the state, only an imperfect crisis in the augmentation; but destructive are made either in the beginning, especially if the disease be vehement and the strength weak: To these signs also is to be adjoined the consideration of the time of the year, region, age, temparature of the sick, and such like, of which Galen speaketh in the third of Crisis, cap. 4. But that a Crisis is now present, Sign that of a present Crisis. the critical signs spoken of and enumerated before, do show, namely, the night wherein the Crisis is to come, which precedes the fit, useth to be more grievous, 3. Aphor. 13. but various perturbations precede in the body, according as nature is to expel matter through this or that part: Of which before cap. 13. and Galen 3. of Crises, c. 2. But oftentimes not only the day but hour of Crises may be foretell, for if we know the day of the Crisis which is to come, we ought to consider in what hour of the day the fit useth to come, and what time of the Paroxysm the sick is most grieved, and that is principally to be observed. Instead of a conclusion also, it is to be observed what certain, perfect, and best crises may be known, and the rest to know no otherwise then by the most probable conjectures, wherefore unless we can presage somewhat certainly before hand, it is more safe to hold our peace, then rashly pronouncing to be deceived. Lastly, Signs of sttable and unstable change of disease's. concerning the Crisis, the stability and instability of the event is to be weighed, but stability of the event and certain health is to be hoped for, if nature be strong, and no Symptom remain over and above; if all the rules of a good Crisis be present, if the humours are thin and hot, which are easily evacuated, but if nature be weak, and some Symptoms abound, as loathing, and such like: all the good rules of a Crisis are not present, and the humour be colder and thicker, 'tis lawful to presage unconstant health, and such may fall into relapse. THE FOURTH BOOK, PART the I. Of things necessary for the preservation of Health. CHAP. I. What things appertain to the Doctrine of the preservation of Health, and how many kinds there are of necessary causes for the preservation and defence thereof. HItherto we have explained three parts of Physic, which, as it were, prepare the way to those things which are proper to Medicine: Now the next is, that we explain those principal parts of Physic, the Hygeeinall and Therapeuticall, or the preservative and restorative; yet first of all we will place before hand certain common Axioms and Maxims to be observed in the method of them both. 1. Nature doth nothing rashly. 2. Too much of any thing is an enemy to Nature, Common Maxims. 2. Apho. 51. 3. Nature is the Physician of Diseases, but the Physician the Servant of Nature, and aught to imitate her, she acting aright: 4. Custom is a second Nature, and those things which are accustomed along time, although they are worse, they are wont to be less troublesome, than those things which are not accustomed, or which men are not used unto. Now concerning the Doctrineof the preservation of Health, The Doctrine of the defence of health. it may conveniently be comprehended in two parts; the first is the knowledge of those things which are, as it were, the materials of health, or the knowledge which is required of wholesome causes, and of things called non-natural. Secondly, a method necessary for preservation of health, which teacheth how, or in what manner those non-natural things are to be used to preserve health. First, for the causes which are necessary for the maintaining of health, they are comprehended under the notion of things called non-natural, and are conveniently reduced into four ranks, into those things which are taken, those things which are carried, those which befall the body without, and those things which are emitted and retained: First therefore we are to speak here of Air, Meat and Drink, Passions of the Mind, motion, and exercise of body, and rest, sleep, and watch, Venery, Baths, Excretions, and retentions. CHAP. II. Of Air. THe Air affects our bodies two ways; Aire. either as it incompasseth us extrinsically, and insinuates itself through the pores of the skin, or as it is attracted by inspiration, both ways it altars our bodies, and impresseth its force on them, but that Air is the best which is temperate, The best Air. as to the primary qualities, and is pure, and infected with no pollutions, but is serene, moved or stirred with the winds, breathing sweatly with pleasant gales, and which is sometimes moistened with wholesome showers: Corrupt. On the contrary, that Air is vicious which is infected with exhalations and vicious vapours, breaking forth on every side, or is encompassed with Marish grounds, where are standing waters, or after what manner soever it be impure, and such as cannot be purified by the blowing of winds; Situation of places. change the constitution of air. that which is troubled, or too hot, too cold, too dry, or too moist. But the constitution of the Air may be polluted through divers causes; first, the constitution of the Air depends on the situation and nature of places; for some Regions are hotter than others, others colder, for by how much the more any Regions receives the direct beams of the Sun, and by how much the longer the Sun remains above their Horizon, by so much the Country is the more hot; for the contrary reasons 'tis so much the colder. Yet this cause only doth not suffice, The earth and nature of the place. neither is the same constitution of air in all the inhabitants under the same parallel; secondly, the mould and proper nature of the earth conduceth to the constitution of the temperature of the air, where in is to be observed what the nature of the ground is, fat, dirty, filthy, gravelly, stony, sandy, whither the place be high or low, what situation there is of mountains, and valleys, what winds it often admits, and from what climates, whether the the sea, or any lakes be near it, whether it brings forth metals from whence malignant air may be exhaled. The mountains also change the constitution of air, Situation of Mountains. according as the blowings of certain winds drive away, and admit it, and if the mountains drive away the Northwind, but admit the South, it comes to pass that the places are hotter and moister, but on the contrary if by situation of the Mountains, the blowing of the South be hindered, and the North admitted the place is colder and drier. The winds bring forth great mutations, Winds. also the Oriental winds are more temperate, as also the Occidental, but these are moister, the Northern are cold and dry, and have power to bind and dry our bodies, the Southern are hot and moist, therefore as the Region or situation is more or less disposed to this or that wind, so it obtains this or that constitution of Air: Regions, and Countries exposed to the Oriental Sun, are more wholesome than those which are exposed to the Septentrional, and hot winds; as also then those which are exposed to the West. The vicinity of the Sea also and lakes conduce much to the peculiar nature of Air, The vicinity of the Sea and of lakes. unless interjected Mountains prohibit, for from moist places of this nature many exhalations are drawn up, which mingles themselves with Air and moisten it, and indeed the humidity will be increased if the Sea or a lake be situated on the South, but if towards North, the frigidity increase; if a lake of the Sea be Oriental, and the rising Sun not far off, it draws abundance of moist exhalations to those places, but if the Sun be more remote, the Vapours with the beams of the Sun wax hot and bring dryness to that place, but less moisture comes from lakes, and waters situated to the West. Metallick pits for the most part sends forth filthy malignant Vapours, Metallick Mines. and communicates them to the neighbouring places; Dens do the same and Caves, exhaling venomous Air; Woods that are too thick, take away the light of the Sun and Moon, and hinder the motion and agitation of the Air. Thirdly the seasons of the year change the Air which indeed Astronomers constitute equal according to the motion of the Sun, Times of the year. and Zodiac being divided into four parts, but Physicians principally regard these times, according to the temper of the Air, and call that the Spring when the constitution of the Air is more temperate, when we neither grow stiff with cold, nor sweat with heat; but the Summer when the same is hot and dry; Winter when it is cold and moist, neither do they appoint these seasons to be equal in all Regions. Hence the Spring as being the most temperate, The spring. or as Hypocrates calls it, hot and moist, that is, when calidity moderately overcomes frigidity, and humidity moderately exceeds dryness, it is the most wholesome time of the year, and although diseases are generated in the Spring time, yet the Spring of its self doth not produce them, but the vicious humours which are gathered together in the Winter time are driven out by the heat of the Spring. The Summer, Summer. because 'tis hot and dry makes bodies hotter and drier, rarefies, dissolves, and renders them weaker, it attenuates humours, and kindles them, from whence choleric and sharp humours are collected. Autumn, Autumn. because that in the same, Morning and Evening, the cold prevails, about mid day heat, its constitution is mixed with cold and heat, and by reason of this inequality of Air, it is very obnoxious to diseases, and the blood at this time of the year is diminished, and melancholy abounds, bodies are thickened, and pores shut. In Winter as being cold and moist, Winter. phlegm is chiefly increased, and bodies are rendered obnoxious to distillations. All which nevertheless are so to be received if you compare one hour with another, or the times of the year observe their natural 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 self same Apho. 6.11.12.13. Out of all which it is manifest that those situations of places are more wholesome wherein the constitution of the Air is temperate, the Spring temperate, The most wholesome situation of places: the heat of Summer sufficient to ripen fruits, and grains, Autumn colder, Winter cold, yet not offending our bodies with two much frigidity, where there is also a fruitful soil, men endued with a comely habit of body, well coloured in the face, laudable in their manners, ingenious, and rejoicing in their prosperous health. CHAP. III. Of meat. AS for what belongs to meat and drink, Aliment what 'tis. wherewith the substance of our bodies 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 bodies only, or Medicinal, because it also doth alter our bodies. 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 animals, or those things which proceed from them, as eggs, milk, and those which are made from these, as butter, cheese, honey, 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 meat. That is the best food which is easily concocted, nourisheth much, affords much aliment, is not easily corrupted, nor endued with any ill quality, and leaves few excrements, Unwholesome. but that food is unwholesome, out of which an ill juice is generated, and which easily putrifies. That food is accounted firm which brings forth much nourishment, but wants great strength of heat for concoction, Firm. but that is infirm which is easily concocted; and nourisheth, but affords but little nourishment, and such as is soon dispersed. Meats from plants. THe most ancient, Fruits or Grains. 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 Corn and grain, which the Greeks call by the name of fitou, and in the first place truly Corn is hot and moist, and beyond all the rest affords much nourishment and that firm 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 Barley which they commonly call spelt, Spelt. is the next in nature to Corn, and is the middle as it were betwixt wheat and Barley, and it nourisheth more than Barley, but 'tis weaker than Wheat, out of this spelt is made a kind of frumenty, or Barley broth, Frument. Buy. of which Pliny 18. Book 11. Chap. Rye, of which bread is made for the most part in Germany, and other parts, is hotter than Barley, yet not so hot as Wheat, and the bread which is made of it hath more aliment than Barley bread, and that stronger, yet it is something more hard of concoction, than Wheaten bread. The bread which is made of Barley is colder, and yields not so firm nourishment, Barley. Partisan of Barley. of Barley 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 milk it increaseth seed, it doth not easily putrify, stops the Looseness, it is hardly concocted, and yields nourishment somewhat thicker, and the frequent use of it may easily occasion obstructions. Millet. Millet and the grain like it, called in Latin Panicum i. e. Indian Oats, 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: Oats are hot and afford nourishment of a better account; Pottages and Broths are made of them, which may be given to those that are sick or well, which stops Looseness of the belly. The Corn called Saracenicum, Saracenicum. of which Pottages are wont to be made, yields nourishment profitable for men that are given to daily labour, and it is hard of concoction, it begets wind, and offends the eyes. Beans are cold and dry, and flatulent, Beanes. hard of concoction and crude, and yield excrementicious nourishment, yet not visced, but have some cleansing power, they make the senses dull, and noises seem troublesome. Pease are cold, and dry, and flatulent, Pease. especially the green, yet they yield better nourishment than Beanes, but not so plentiful. Parsnips are hot, and dry, Parsnips. and have greater force of cleansing then Beans, and therefore more useful in Physic then dyet. Lastly Lentils are the worst food, cold, and dry, thick, Lentils of evil and vicious juice, and hard of concoction, they fill the head with thick Vapours, they hurt the eyes, they engender thick blood, and are chiefly hurtful to melancholy persons. After grains, instead of food, Potherbs are given, Potherbs. and the leaves of the Herbs, Branches, Roots, and the fruits of them, as also of Trees, which nevertheless, yield not so good and profitable aliment as Corn, but many or them are too Medicinal; yet all of them are better boiled then raw. Lettuce that is sown is esteemed the best of all Potherbs, Lettuce and affords more nourishment than other Potherbs, yet 'tis cold, and moist, and Medicinal, and moreover, in a hot constitution of Air, 'tis conveniently given to young men, and those which abound with choler, and those which have hot stomaches, it provokes sleep, allays the heat of the reins, yet too much use thereof diminisheth the natural heat. Cabbage is accounted by most to be cold, and dry, Cabbage yet in the juice thereof a certain bitterness and acrimony is perceived, which hath a force to stir the paunch, 'tis hard of concoction, affords little nourishment, and that thick and Melancholy; from whence fuliginous Vapours fly into the head, and produce turbulent sleep, and weaken the sight, its malignity is corrected if it be boiled with sat meats, the staulks are worse than the broad leaves, and are to be eaten only by those which are used to much labour. Spinnage cools and moistens, spinach. affords little nourishment, yet not so evil as Orach, or Blitum, which is a kind of Beet, it generates cold and serous humours in the stomach, unless it be corrected with pepper and, oil, or butter, it is not laudable, and it begets wind. Beets, Beets. Blitum, Orach, and Mallows can scareely be used with profit, or benefit for aliment only, but are more beneficially taken, when there is need to loosen, refrigerate, and moisten the belly; and Beet indeed is hot, and dry, and takes away obstructions of the Liver and Spleen, and hath a different substance, the juice is detergent, wherefore it loosneth the belly, but the substance stops the same. Blitum, Blitum, Orach, Mallows. Orach, and Mallows loosen the belly only by humectation, they nourish little, they yield a watery juice, and have of themselves no pleasing savour unless they are dressed, with Butter or Oil, and other Sauces. Asparagus, Asparagus. Young Hops. to which the young branches or tender sprigs of Hops are next like unto, neither heat, nor manifestly cool, they are grateful to the taste, and cause appetite, yet afford little nourishment, and therefore do afford not so good nourishment; they have a detergent faculty, and provoke Urine, they cleanse the Reins, and open obstructions of the Liver, and of the other entrails. Garden, Cresses. Mustardseed. or Water Cresses, and Mustardseed may be used instead of Sauces, but not as nourishment, they are hot and dry, and of a biting taste, they attenuate crude meats, as also crude and thick humours. Onions afford little nourishment, Onions. they are acrid and have a heating, cutting, and extenuating faculty, and inflame the blood, and together with the discussed thinner parts they leave behind them a thick juice, they irritate Venus, they are all hurtful to the head, eyes, teeth, and gums, they cause turbulent Dreams. In raw Garlic there is almost no nourishment, Garlic. in boiled very little, and that bad, but there is manifest heat and dryness in it, and a power of extenuating thick and viscide humours, and of cutting them, and taking away cold, and 'tis the best remedy to convert the pravity of waters, as also against the Plague, Leeks. and venomous air: Leeks have almost the same power. Radish. The Roots called Radishes which we use being dipped in Salt affords little nourishment, but are rather instead of medicinal knacks, they heat beyond the second degree, and have a tart taste, they cut phlegm, attenuate, provoke Urine, and expel sand from the Veins. Wild Radishes have the same force, Wild Radish. but are more powerful, which are fit for sauce, but not of aliment. Turnips, Raperoots round are slowly concocted, Rape. and fill the belly with wind, especially when they are raw, but boiled they are easier digested, and afford aliment enough, and therefore not so hurtful, but are hot and moist. Long Turnips are almost of the same nature, Turnips. but of a better taste, and yield less thick and flatulent juice, and afford strong nourishment, they stimulate Venus. Parsley is hot and dry, provokes Urine and courses, Parsley. opens obstructions, purges the Reins, and bowels, yet it afford little nourishment. Garden Parsnips yield little, hot and dry, Parsnips. and not very good nourishment, they cause lust, provoke Urine, and bring down courses. Red Beets which are pickled with Vinegar, Red Beets. the seed of Caraways, and the roots of wild Radishes are used rather instead of Sauces, then as food, since they nourish very little. The fruit of Plants are various; Melons. Melons are pleasant to the taste, and send forth an Aromatic smell, but they are of a watery moist substance, not without coldness, whereby they quench thirst, and causes Urine, they cleanse the Reins, but they are easily corrupted, and being corrupted, become as it were of a venomous nature, and stir up choler, or generate Fevers, whereby many great men are killed, and therefore they ought to be eaten at the first course, that they may the easier descend through the Paunch, and after the eating of them, some food of good juice is to be taken, and good Wine is to be drank, that the corruption of them may be hindered. Cucumbers, are also cold, but not so moist, Cucumbers and the juice not so hurtful, nor are they so easily corrupted in the stomach, they are most conveniently taken, before they are ripe being pickled in Vinegar, or Brine, and Pepper, and they are least offensive to those which have hot stomaches. Artechocks Artechocks heat and dry, to the second degree, they are hard of concoction, and afford not very good nourishment, they are windy, and stimulate Venus, unless this be rather to be attributed to the seasoning, or dressing of them. Strawberries, Strawberries. are cold, and moist, they are profitable to those that are troubled with choler in the stomach, they cool the liver, they restrain the heat of the blood and choleric humours, they alloy thirst, and therefore are beneficial in hot constitutions of bodies, they have thin juice, purge the reins, cause urine, but are easily corrupted in the stomach, and therefore aught to be eat, the first. Now follows the fruits of Trees, Pears. and frutices, first of pears there are divers kinds, nor are they all of the same faculty, the austere, and sharp are astringent, and cooling, and hurtful to the stomach, and Guts; sweet are more temperate, yet almost all are of a cold, and moist nature, only some are hot and moist. and moreover, more apt to corruption, they are not unpleasing to the stomach, in the first place being taken they stop a looseness, but being taken after other meat, they loosen the belly, and shut the mouth of the stomach, they are better boiled, then raw. There are divers sorts of Apples which discover themselves by their taste, Apples. the sour are colder than the sweet, and of a thinner, and less flatulent substance; the austere and sharp are yet colder, and of a thick substance, and descend more slowly through the paunch, and stay it, yet their violence is corrected by boiling; and sour, austere, and sharp Apples are to be used rather instead of medicines than aliment, they all afford ill juice, but those are most hurtful which are watery, and for the most part have no taste; the best are sweet ones, with an aromatic taste and smell, and such as afford an indifferent quantity of aliment, and that not evil, they strengthen the heart, exhilerate the mind, and are very beneficial to those which are troubled with Melancholy. Quinces are cold and dry, Quinees. and have an astringent faculty, they are harder of concoction, afford little nourishment, and that thick, they strengthen the stomach, and stop vomiting, and if they are taken after meat, they hinder Vapours so that they cannot easily ascend to the head, and they loosen the belly, but being taken before meals, they stop a looseness; being taken raw they hurt the nerves, and often cause fits of the colic Peaches are cold, and moist, and are easily corrupted, Peaches. and afford little nourishment, and therefore are to be eaten sparingly, and warily, and indeed before meals, not after other meats, neither is water, nor any cold drink, to be drunk after them, but wine; being dried they are less hurtful, and especially being boiled in Wine, their pravity, if they had any, it is taken away. Apricoks which are well known to the Persians, Apricocks. in goodness are beyond Peaches, and more pleasing to the stomach, and are not so easily corrupted. Meddlers are cold and dry, Meddlers. and are not eaten till they are rotten, they afford little nourishment and are slowly concocted, they stop the belly and all fluxes, they stay vomiting, and agrece well with a choleric stomach. Sour Sherryes have a chooling faculty, Cherries. are easily concocted, and descend through the belly, they cool the stomach, and liver, they quench thirst, and raise an appetite, and are not so easily corrupted, nor are they of so hurtful a juice, but the sweet ones are far inferior to the sharp ones in goodness, by reason of the moisture abounding, and are easily corrupted, and generated urred humours, and Worms, in putrid fevers. There are divers kinds of Plumbs, all of them cold, Plumbs. and moist, the sweet ones are not so cold by nature, yet they mitigate the acrimony of choler, and therefore agree most with colerick persons, they are easily concocted, and pass through the belly, those that are fresh, alter most powerfully, they mollify the paunch, being taken before meat, but with their moisture they scatter abroad many excrements, and that crude, neither do they generate so good juice, yet some are softerthen others, those which abound most with a crude and moist juice, they are the worst, the white, and waxed colour, or yellow, are the worst, and afford ill juice, but the best are Damask Prunes, and those which are nearest to these are green, but the dry are more fit for nourishment, and afford better aliment for those which are weaker in stomach, Plumbs are not convenient; for they loosen itstone. Mulburies' moisten, cool, quench thirst, Mulburies'. mitigare the heat of choler, they nourish little, they easily pass through the belly, but if they are retained, they easily are corrupted, and become putrid, and acquire an ill nature, wherefore they are to be eaten when the stomach is empty only, and not overspred with peccant humours; that they may on a sudden descend and pass through the paunch. Figs are hot and moist, Figs. by nature they nourish more than other fruits, they easily descend and go through the belly, they have a penetrating, and abstergent faculty, yet too much use of them begets wind; dry Figs are hotter, and dryer, yet acquire a power of cleanseing, opening, and attenuating, yet they also loosen the belly, drive humours to the external parts, being often taken and plentifully, they cause sweats, and generate blood, not very good, but such as is apt to putrify. Sweet grapes are hotter, Grapes. and for that reason cause thirst; sharp, and austere are colder; those that are fit to make Wine, are betwixt these extremes; those that are fresh gathered, afford little nourishment, and are flatulent, and if they are detained long in the stomach they are corrupted and dilate the belly, and stir up colic fits, they cause the spleen to swell, and fill the stomach and liver with crude humours, and always the fresh gathered serve rather for pleasure, then for health; the austere and sour Grapes, are colder, and strengthen and bind the belly, the sweet ones are hotter and afford more nourishment; those which have a mixed taste, obtain mixed faculties, but the sweet, which participate something of sharpness, are commended before the rest, they are pleasing to the stomach, grateful to the liver, as also they are said, by a certain propriety, to be advantageous to the whole substance, they are helpful to the breasts, and strengthen all the natural members; those which are without stones are called Corinthian, they loosen the belly more, but those which have seed strengthen the stomach. Amongst Nuts, Almonds. the best are sweet Almonds, they are temperately hot and moist, and yields store of nourishment, and of good juice and moderate, they attenuate and cleanse, for which reason they are the best food for immaciated bodies, and they replenish the entrails, and the whole body with convenient nourishment, and such as is not apt to corruption, they purge the breast, open the passages of urine, and cause sleep, but they are not so convenient for a choleric stomach, nor to be given in choleric Fevers. Walnuts are hot and dry, especially dried, Walnuts: for your green ones are moister, and are not so hot, and therefore are eaten safer, but the dry generate choler, and offend the Orifice of the stomach, and hurt the Gullet and Windpipe, and cause a cough, and generate pain in the head, commonly the use of them is commended after Fish, because with their heat and dryness they prevent the corruption of Fish. Haslenuts afford more nourishment, than Walnuts, Haslenuts. but they are colder, yet they are hot and dry, they are hardly digested, and afford a thick juice, more earthly than Walnuts. Chestnuts are hot and dry, Chestnuts. and Galen conceives they have no ill juice, as all the rest of the fruits of Trees, if they are well concocted in the stomach, yet they are harder of digestion, and are distributed more slowly, yet they afford more durable nourishment, they bind the belly, and if they are eaten in too great plenty, they cause wind. Toadstools and Muskeroms for the most part are cold, Mushrooms they yield a watery and thick nourishment; Toadstools are preferred before Mushrooms: yet all of these are not to be taken without danger, because they do not only generate ill juice, but oftentimes there is poison in them. Lastly, Oil. Oil drawn out of ripe Olives affords nourishment temperate, and for the most part agreeable to our nature, and can correct the pravity of other aliments, and amend the crudity of Herbs, it also mollifies and loosens the belly, is takes away all sharpness; it helps Ruptures, and such as are bursten, and mitigates pain. Meats from living Creatures. IN the second place many living Creatures supplies us with convenient nourishment agreeable to our nature, Aliments of living Creatures. as being nearer and more familiar to our nature, and less exceed in the qualities, and afford better juice. Either the parts of living Creatures are taken as food, or those things which are taken from them, yet are not the parts of living Creatures, and amongst the latter the first is Milk, which is of a cold and moist, or rather of a temperate and moist nature, and yields nourishment, the best by much if it be rightly concocted in the stomach, and be good in its self. There are three parts of milk, Parts of milk. the butirous, the serous, and the caseous; the butirous is of an oilily and hot substance, the serous is watery, yet having some mixture with saltness; but the caseous is cold and try, and indeed Cow's milk is the fattest and thickest, and contains more butter than the milk of other Animals, and therefore nourisheth more, and is most agreeable to us, and hath more of the caseous part then Ewes milk. Goats' milk is in the midst betwixt these. Sound Animals only generates good milk, but sick generate vicious: Dry Herbs also cause the milk to be thick, but green, and such as are full of juice makes better, wherefore the milk at the latter end of the Spring is best, for by how much the thinner it be, and more serous, by so much it is the easier concocted, and sooner passeth through the belly, Best milk. Antter. and obstructs less, but it nourisheth least; the best milk therefore is that which is of a good smell, and sweet to the taste, of a middle consistence, neither too thick, nor to thin, nor serous, nor caseous overmuch, of a white colour, which yields good aliment, and that plentifully and constantly enough, especially for lean bodies, as being that which is elaboured by so many concoctions, and is become familiar to our nature, that 'tis easily, truly concocted, as in unwholesome bodies 'tis easily corrupted, in a cold stomach it easily grows sour, in a hot, it is turned into an adust smell, and choler, and causeth pain in the head, wherefore it is hurtful to those that are sick of putrid Fevers, and to such as have pains in the head, as also to those which are troubled with diseases of the eyes, or are obnoxious to breed gravel, those that are obstructed in the Liver, and inflamed in the Hypocondries, 5. Apho. 64. but the worst corruption thereof is, when it is coagulated, which may be prevented, if any Salt, Sugar, or Honey be added to it: It is most conveniently taken on an empty stomach, nor are other meats to be eaten presently after, especially the use of Wine after milk is unwholesome. As for the parts of milk, Butter is used in our Countries instead of food, and sauce, 'tis hot and moist, and almost of the same nature with Oil, yet it nourisheth more, and is a sauce for many things, 'tis used more advantageously than Oil, 'tis pleasant to the taste, 'tis easily concocted, and nourisheth much, yet it agreeth not with those that have a moist and slippery stomach, yet 'tis far better to be taken before other meats, than after; nor is it so agreeable to hot natures, 'tis most conveniently eaten with bread. Sour milk is colder, and agreeth not with colder stomaches, Sour Milk. but with hotter, especially in the Summer, and in very hot weather. Cheese is hardly concocted, and yields thick nourishment, Cheese. and therefore stops the belly, opens the Pores, and affords matter fit for the generation of stones; but that which is old affords ill nourishment, the new yields better: the new and salt is as yet cold and moist, and of a flatulent nature, the worst is the oldest, that which is of a middle age, which is neither hard nor soft, and is moderately sweat and fat, is the best, but whatsoever it be, 'tis always to be eaten after other meats, and sparingly; but since there is great differences of Cheeses, according to the nature of living Creatures, and of place, and pasture: That of the Ewe is the best, 'tis easier concocted than others, and affords better nourishment: Cowes milk is next to this in goodness, the Goats is worst of all; yet that Cheese is better, when the buterous and caseous parts are not separated, but are made altogether into Cheese, but those Cheeses are worse which are made of the caseous part only of the milk. The serous part of the milk nourisheth least, Whey. and is instead of Medicine rather than aliment, yet 'tis most fitly used for the evacuation of serous and adust humours; it consisteth of two parts, the one salt and participating of acrimony, and is altogether hot, which is the lesser part, the other is watery, and is the greater part, for which it is called cold and moist whey Eggs, but especially of Hens, are food with us; Eggs. an Egg consists of two parts, the Yolk, and the White, those are moderately hot, and moist, and of the best nourishment; these cold and dry which afford also much nourishment, and that lasting enough, but hard of concoction: The newest Eggs are the best, and nourish most, and soon, and yield good aliment; but the stalest are the worst, and the corruption of Eggs the worst: And they do not so well agree with those whose Liver or stomaches are filled with vicious humours, and in Choleric and hot stomaches they are easily corrupted, and turned into choler; As for the dressing of them, they are best when they are soft, and to be supped, being boiled in seething water, but those which are roasted in ashes are not so good; those that are boiled till they are hard, although they afford more solid nourishment, yet they are worse, but the worst of all are those which are fried in a Frying-pan, especially in Oil. Honey is of a hot and dry nature, Honey. in the second degree yet that which is whitest is not so hot, and is more commodious for those that are sound, but all honey is medicinal aliment, convenient for old men and those of cold natures, but because it easily turns into choler, 'tis not fit for hot natures, nor for the Liver, but 'tis good for the Lungs, otherwise it hath a cleansing faculty, Sugar. and resists putrefaction. Sugar, although it be not taken from living Creatures, but is made out of Reeds, hath a great agreement with honey, yet 'tis less hot and dry then honey, and therefore 'tis profitably mingled both with hot and cold things, yet in those that are very hot, it easily turns into choler, otherwise it hath an abstersive faculty without sharpness. Aliments which are taken from the parts of Animals are many, Food from the parts of Animals. Feet. which both according to the kinds of living Creatures, and according to their parts do vary. The feet of Animals, of what kind soever, are cold and dry, they have little flesh, and scarce any blood, they yield a cold juice, dull and glutinous, by reason whereof the broth of boiled feet is congealed. The Heart is of a hard and dry nature, Heart. and fibrous, neither is it easily concocted, but if it be well concocted it yields neither ill juice, nor a little, and that stable and firm. The Liver itself is hard to be concocted, Liver. and yields 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, 'tis hardly concocted, and slowly distributed. The substance of the Lungs is light and thin, Lungs. and nourisheth less, yet it is easier concocted, nor doth it afford ill nutriment. The Reins afford not very good but thick aliment, Reins. and the Reins of younger Quadrupeds, or Calves are of better juice, and are easier concocted. The Tongue excels the other parts in pleasantness of taste and goodness of aliment, Tongue. it is also easily concocted. The brain yields 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 drier nature, Stomach. they are harder of concoction, and not to be concocted except it be by a strong stomach, and that they be well boiled, they yield 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. Swine's flesh nourisheth very plentifully, Swine's flesh. and yields firm 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 yields 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 Boars, Brawn. so that it be of younger Boars, is the best, because it hath not so much excrementitious moisture. A Lamb before 'tis a year old hath moist flesh, Lamb. slimy and viscid, but when 'tis a year old, 'tis very good nourishment, consisting of good and plentiful juice, and indifferent lasting, and easy of concoction, but in those which are exercised with hard working, 'tis easy discussed, and aliment that is not solid is made thereof. But because Lambs that are of a longer growth, Wether Mutton. become Sheep, and the flesh is then become ungrateful, and not of so good juice, their stones are cut out, and they are made Wethers, the younger whereof are the best meat, and 'tis 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 evil, Ewe Mutton. both by default of the tempera●and by frequenting of copulation, and of bringing forth young, 'tis hardly concocted, evil, and dull, and viscid juice is bred thereof. Veal is temperate, render, and affords good juice, Veal. of a pleasant taste, yet it yields somewhat a thicker juice than Lamb or Mutton. Beef is thick flesh, hard of concoction, B●ese. and doth not easily pass through the Veins, it doth not participate of viscidity and sliminess, the frequent use thereof causeth dry and melancholy humours in the body, especially Cow-beef, or that of an Ox, which with age and much working hath contracted dryness and hardness of flesh, or is hardened with salt and smoke. Goat's flesh affords good nourishment, Gotes-flesh and may easily be preferred before the rest of Sylvestrous Animals, in goodness of aliment, facility of concoction, pleasantness of taste, 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 ripeness of years, and doth obstruct the bowels. Hare's flesh is accounted a great dainty, Hares-flesh. yet by Physicians 'tis numbered amongst those aliments which yield 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 boiled, the juice is not evil. There are many kinds of Birds, amongst the which nevertheless, nay, amongst flesh, the Hens are accounted the chief, Hens. for they are temperate, easy of concoction, of good juice, and contain few excrements, and thence they procreate good blood, and yield 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 Chickens, yet their flesh is moister, Hens are drier, the flesh of Cocks is harder and drier, the Hen's flesh affords nourishment not firm enough for those who are day-labourers. A Turkeycock also yields much and laudable nourishment, Turkey-cocks. nor is it inferior to Capons, neither in taste, or goodness of juice, it is profitable food for those which are in health. The flesh of Partridge is temperate, Patridges something inclining to dryness, 'tis easy 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 Pheasant and a Quail, Pheasants. 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 'tis hurtful in putrid Fevers. 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 yield no good juice, but vicious, and excrementitious, and such as is easily putrified, 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 meat, most pleasant, easy of concoction, of good juice, and much nourishment. A Thrush is easily concocted, A Thrush. yields good juice not excrementitious, and affords nourishment firm 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 colic, but also to cure it. The flesh of Blackbirds both for pleasantness and facility of concoction, Blackbirds. and goodness of juice is somewhat inferior to that of the Thrush. A Quail is hot and moist, hard of concoction, A Quail. of ill nourishment and full of excrements, and affords matter fit for the generation of fevers. Fishes are colder and moister food, Fish. than the flesh of terrestrial Animals, and scarce afford so good juice as Corn, and fruits, and other vegetables, they easily putrify also, and if they are corrupted, they acquire a quality most averse to our natures. But there is a great variety of fishes, Salmon. a Salmon in the first place, hath tender flesh, grateful to the palate, 'tis easily concocted, affords good juice, and is the best amongst fishes; when they are pickled with salt, and hardened with smoke, they are much worse. Trout amongst fishes which are bred in fresh waters are the best, and are next in goodness to a Salmon, Trout. easy of concoction, full of much good, and thin juice, but the greater of them, have flesh not a little excrementitious, fat, and full of viscidity; those are commended before others, which have red flesh, and many red spots, and that have hard flesh and participate not of viscidity, and fat, those are easier concocted, descend sooner, Soles. and have less excrementitious juice. Amongst Sea fishes, the sole is highly commended, which hath delicate flesh, and is easy of concoction. Gudgeons. Gudgeons properly so called are the best of taste amongst the fishes, and very wholesome aliment, easy to be concocted, and such, as remain not long in the stomach, and are profitable, both for pleasure, and health, and may safely be given to those that are sick, to which other little fish are alike, as dace and minners, and such like. A pick, A Pike. especially of the smaller growth, hath hard flesh, it is concocted easily, and easily distributed; and hath not many excrements, and may also be given to those that are sick. A Perch also hath tender flesh, A Perch. and such as will easily part asunder, and no fat, and glutinosity, 'tis easy to be digested, the juice is not evil, yet it affords weaker aliment, and such as is easily discussed. A bream hath soft and moist flesh, A bream. and yields a juice very excrementicious, and is to be eaten as for the most part, all other fish are, not; 'tis not to be mixed with divers kinds of meats. A Barbell, A Barbell. whose eggs perchance gave an occasion to some to suppose, that he hears very bad, it causeth not only pains of the belly, but also vomiting, and disturbs the paunch, and stirs up choler, from the use whereof we ought to abstain, but the flesh thereof is very white, easy of concoction, and distribution; and affords aliment of good juice. The flesh of Eeles is sweet but glutinous with fat, and abounding with much moisture, Ecles. it generates ill juice, and the use thereof is not safely granted to those that are sick, nor to those that are well, especially if they be taken plentifully. A Lampry is meat of a grateful and delicate taste, A Lampry. if it be rightly prepared, and sauced, yet it puts not away quite its slimynesse, and glutinosity by this means, and for that reason they are not numbered by Physicians, amongst fishes of the best sort. A Tench is neither of a pleaseing taste, A Tench. nor easy to be concocted, nor good aliment; but yields a filthy slimy juice, and such as is easily corrupted, neither is it easily distributed, and it brings forth obstructions. A Herring hath white flesh, A Herring. apt to cleave into small pieces, and hath a good taste, not hard of concoction, it affords good juice not thick, and glutinous, 'tis pickled with salt, and hardened with the smoke, but then 'tis harder of digestion, and yields not so good juice. Amia a fish which hath no English name, but is like a Thunny, Amia. hath soft flesh, yields good juice, but not much aliment. A Sturgeon hath hard fat, and glutinous flesh, A Sturgon. which yields thick juice, yet not hurtful, and 'tis not easily concocted, yet the younger are more pleasant to the taste, and easier concocted, and yield much nourishment. A Sole, Plaice, and Turbet, are white fish, A Sole Plaice. Turbet. yield good juice, and plentiful nourishment, and such as is not easily corrupted, but being dried, they become harder, and are harder of concoction. Codfish, Stockfish. (or rather stock fish) although whilst it is fresh 'tis said to have friable flesh, and tender, of good juice, and easy of concoction, yet being dried, it becomes so hard, that it is to be knocked with Hammers, and Clubs, and to be pulled into pieces in water before it be boiled, whence it affords thick nourishment, and hard of concoction, and is to be eaten without damage only by those who have very healthy stomaches, and are given to daily labour. Oysters have a soft juice, Oysters. and therefore irritare the belly to dejection, and stimulate Venus, they nourish less, and are hard of concoction, and easily generate obstructions. Terrestrial cockles, or Snails, Snails. are accounted for dainties by many, yet the flesh of them is hard of concoction, and requires a healthy stomach and the addition of many sauces, yet they remain hard, and generate thick, and black blood, but that part which is said to be given in broth for Hectics is only in the hinder part of the snail, which Aristotle in the fourth of the History of Animals Cap. the fourth, calls Micona, that is poppey, as he pleased to call it, which hath in it a certain glutinous, and caseous substance, easily dissolved, yielding to the teeth, tender, the which is not hard of concoction, and nourisheth much. Crab fish, which have no tails, and Lobsters, Lobsters. and crawfish which have tails, and are frequent in our Countries, seem to have no great difference in their nature, all of them are hard of concoction, and are not well concocted, unless by a strong stomach, yet if they are well concocted they nourish much and beget good juice. CHAP. IU. Of drink. Drink whereby the moist substance is restored which is daily consumed, and the natural thirst allayed, The benefis of drink. the fat, and thick moisture, carried through the narrow passages, and the meat in the stomach is mingled, concocted, and poured forth, and an inflammation of that fat, which is destinated by nature to nourish our bodies, is prohibited; there are divers kinds, The kinds. Water, Wine, strong Beer, and water mingled with Hony, and certain liquors made with Apples, Pears, and such like. There is great variety of Waters, Waters. all which are cold, and moist, but the best is that which is found to be pure and fincere, by the sight, taste, and smell, and offers the savour of nothing to the taste, Differences of Waters. neither odour to the smell, which soon grows hot, and suddenly grows cold, which is light, and wherein flesh, and fruit are soon boiled: some is Fountain water other is River, some is Raine water, other lake, or Pond water, some Marish, other Snow water. The Fountain is the best which hath these notes of good water, Fountain. that which spreads towards the East, and runs towards the rising of the Sun, and thrickles through sand, and gravel, that carries no mud with it, that is hotter in Winter, and colder in Summer. River water for the most part is Fountain water, River. and ariseth from many Fountains flowing together, and therefore is of a mixed nature, and receives also a mixed nature from the earth through which it flows, and sometimes also, they are mingled with Snow melted in the Mountains, and great Showers of water collected together, yet its crudity is corrected by the beams of the Sun, whilst it runs through many parts of the Earth; before the use of it, it should stand, and settle, in water-tubs, that whatsoever it carries with it that is impure may settle in the bottom. 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 heat, and mingled with the Showers, these waters are not very pure, whence they are obnoxious to putrefaction. 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 stomach is offended by them, the bowels obstructed, and humours corrupted and often times putrid, and malignant fevers and Pestilential do thence arise, Waters of Snow, and Ice, are condemned, Of Snow and Ice. for they are thick and hurt the stomach, and stir up grievous diseases of the joints, nerves, and bowels. But the malignancy of waters are corrected, by boiling, Boiling of waters. whereby not only the crudity, and frigidity is amended, but also, the terrene, and vicious parts are separated, which afterwards when the heat vanisheth, settles in the bottom. 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, 'tis said to be moist, namely Wine is a medicinal 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 boys, and by reason of this drying faculty many use to mix 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 itself, for some is very little suffering, because in mixture it will endure but little water, but other Wine is called winy Wine, because it may endure more water to be mixed with it. But Wines differ according to taste, smell, colour, Differences of Wines Savour. and manner of subsistence: as for what belongs to the taste, sweet Wines properly so called, nourish best, and are not only most grateful to the palate, but to the bowels, 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, Chaps, and Throat, nor do they so hurt the head, nor offend the nerves. Austeres or harsh wines have the weaker heat, tarry longer in the belly, nor do they easily pass through the veins, and penetrate through the passages of the urine, whence they are good for a looseness of the belly, but hurtful in diseases of the breast and Lungs, for they detain spittle; the best wines are the middle sort which are neither very sweet, nor sour. 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 'tis 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 heat less, Colour. then full and yellow Wines, and are weaker, especially if besides their whiteness they are of a thin substance, all black wines are of thicker substance, and for the most part sweet 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 beneficial to to those that are troubled with colic pains, 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 mixed colour, which also doth not heat so much, nor offend the head. As for the manner of subsistence, The manner of subsistence. tenuity is in the first place in that which is watery, hence that which is of a pale red, and yellow; crassitude is in that which is black, red, sweet and sour, and thin wines easily penetrate, and soon refresh the strength, they open passages, move sweats 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 colic, impeads excretion of urine, yet it loosens the belly, and unless it doth so, 'tis the more hurtful, new Wine, and that which it as sweet, as Wine new pressed, 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 nevertheless there is a great difference according to the nature of the Wine, for some will endure age, others sooner lose their strength, and consume away, and lose all their Spirits. In places towards the Septrentrionall, Strong drink. wherein there is not so great store of Wine, strong Beer, or Ale, is the familiar drink, and indeed profitable enough, as experience shows. But the strong drink is prepared, some of Wheat, Its differences. some of Barley, others of them both, in Polonia it is made of Oats, and preserved with Hops, the manner of preparing is very different every where, the waters also differ, wherewith they are boiled, they are kept also in some places in pitched Vessels, in others not pitched. Strong drink made of Wheat nourisheth more than that of Barley, and also heats and moistens more, Drinks made with Wheat. especially seeing the strong drink made of Wheat hath less Hops, then that which is made of Barley, but it generates more viscous juice, it causeth obstructions, it provokes urine, With Barley but it loosens the belly. Barley Beer, because of the Barley, heateth less, but because more Hops for the most part are put into it, acquires no small force of heating, it nourisheth less, Mixt. and yields a thinner juice, but is more diuretic, that which is mixed of Wheat and Barley is of a middle nature. That drink which is made of Corn, no way dried but by the heat of the Sun, hath more excrementicious humours, and often times brings forth obstructions. All new drink is more unwholesome, especially, if it be troubled, for it obstructs the passages, and breeds the stone, but that which is more cleansed is wholesomer, but principally, strong drinks have their faculties, from various waters of several natures. Hony and water mingled, Hydromell. for the most part heat and dry more than Wine, especially if Aromatic things are added, but it easily turns into choler, by reason of the Honey and therefore is not so good a drink for choleric persons. CHAP. V Of the passions of the mind, and of the exercise and rest of the body. THE perturbations of the mind, Tranquillity of mind. have great power in the preservation of health, for an Euthumie, or well settled mind, and such as is at quiet doth much conduce to the preservation of health. Joy. Next to that moderate joy is fitrest to preserve the health of body, and a natural constitution, because it recreates the heart, spirits, and the whole body, but if it be overmuch, it dissipates, Exercise of body. and diffuseth the Spirits. Motion of the body, and exercise, first brings a certain solidity, and hardness to the parts, than it increaseth health, thirdly it moves and agitates the spirits from whence the heart is made strong, and can easily resist external injuries, and is fit to undergo all actions, happy nourishment is made, and the excrementicious Vapours are discussed; on the contrary, those bodies which live idly, are soft and tender, Kind's of motion. and unfit to perform labours; under the name of motion, are comprehended labours of every kind, dancing running, playing at ball, gesture, carrying, riding, swimming, walking, a stirrer up of the people, rubbing and such like, but divers exercises have different force, and some exercise some parts more than others; in running and walking, the legs are most exercised in handling of weapons; and laying them down, the arms; in singing, speaking with a loud voice and clear reading, the face and breast; the whole body in playing with a little ball, which exercise therefore is most convenient, whereof a peculiar book of Galen is extant; there is also a certain diversity according to violence, and magnitude in motion, swift attenuates, and thickens; slow, rarefies and increaseth flesh; vehement extenuates the body, and makes it lean, yet together hard, flourishing, and firm; too much motion exhausteth and dissipates the substance of the spirits, and solid parts, and cools the whole body, it dissolves the strength of the nerves, and ligaments, it sometimes looseneth, and distendeth the membrances, and breaks the lesser veins. CHAP. VI Of Sleeping, and waking. MOderate watch stirs up the Spirits, and senses, Watch. and render them more flourishing, distribute the Spirits, and heat into all the parts of the body, they help distribution of aliment, and promote the protrusion of excrements, yet if watch are immoderate, first they consume and dissipate the Animal Spirits, and dry the whole body, especially the brain, they increase choler, they whet and inflame, and lastly the heat being dissipated, they stir up cold diseases. The strength being decayed is again kindled a fresh with moderate sleep, the spirits, Sleep. that are dissipated with diurnal labours, are restored, the heat is called back into the inner parts, from whence a concoction of Aliments, and crude humours is happily performed in the whole body, the whole body and especially the bowels are sweetly moistened, the heat increased, and the whole body becomes stronger, cares are taken away, anger is allayed, and the mind enjoys more tranquillity, immoderate evacuations besides sweat, are hindered, and sleep is especially beneficial to old men; on the contrary immoderate sleep obscures the spirits, and renders them dull, and causeth an amazedness in the understanding, and memory, it sends out the heat, being hindered with crude, and superfluous humours accumulated, sleep also, which seizeth on our bodies after what manner soever, when they are empty, dries and extenuates the body. CHAP VII. Of Baths. EVery Bath of fresh water, moisteneth, A Temperate Bath. but in heating and cooling, there is not the same faculty every where, a temperate Bath of sweet water opens the pores of the skin, and softens, and rarefies the part, and discusseth the excrements into the extreme parts, and corrects the dryness of parts, and so takes away lassitude, but if it should continue long 'twould discuss that which is dissolved, and weaken the strength. Lukewarm Baths, Luke Warm. if they incline to cold, something refrigerate the body, nor have they power of rarifying the parts and discussing excrements. Cold water of itself cools, Cold. yet by accident the pores being shut, and the heat penned in heateth, whence if through dissipation the native heat should be in danger, cold things being timely applied, have power to recollect and preserve it. Baths oftentimes do hurt, and especially to those that are not accustomed to them, and to Plethoric persons, and such as are filled with crude humours, as also to those which are obnoxious to Catarrhs, and inflammations, or an Erysipelas. The Romans often frequented Baths, and they often bathed twice a day, the preparation whereof you may see Galen 10. of the method of healing Chap. the tenth; they used unctions also before and after bathing, whereof Galen the second of simple faculties of healing Chap. the twenty fourth; and the seventh. CHAP. VIII. Of Excretions and Retentions, and of Venery. THe body may be easily kept in its natural State, Excrements of the paunch. if those things which are profitable for its nourishment, be retained, and those things which are unprofitable, and aught to be cast out, are omitted, but if those things which ought to be retained, in the body, are cast out, and those things which ought to be protruded, are retained, the health is in danger. The several concoctions have their several excrements; the excrements of the paunch, if they are not evacuated in due season, hinder concoction whilst putrid Vapours exhale from thence to the stomach, and neighbouring parts, for the same reason they offend the head, stir up colic pains, and other evils, but too sudden cleansing of the paunch oftentimes hurt nothing, whilst those things which are offensive nature doth expel from the paunch of its own accord, yet if any such thing happen too often or too lasting, it necessarily defrauds the body of nourishment, and the strength is weakened, and the guts are debilitated, and offended. Urine if it be made in due season, Urine. is commodious and profitable for the body, but if it be made sooner than it ought, and especially, if it have been retained longer than it ought, it brings no small damage, for it oppresseth the bladder, and often times so fills it, that afterwards urine cannot be expelled, and sometimes an inflammation of the bladder, nay sudden death, follows; but if the reins have not drawn whey as it were, it remains mixed with blood, and stirs up grievous Symptoms in the whole body. Seed untimely retained causeth heaviness, and dulness, Venus. of the body, and if it be corrupted stirs up grievous accidents, all which may be avoided by Venery, but let it be timely, and lawful, neither is there any need to try any thing for the preservation of health, which is contrary to divine laws, and the Creator of man is so much indulgent to him in this thing, as 'tis necessary for him to shun all things which may hinder his health; but too much Venery dissipates the natural heat, cools and debilitates the whole body, accumulates crudities, hurts the nerves, generates the running Gout, and brings the Palsy, and debility of the senses and understanding. THE FOURTH BOOK, PART II. Of the Method of the preservation of Health. CHAP. I. Of those things which are to be observed by all for the preservation of health. AFter we have explained those things which are necessary for the Preservation of health, now we must show a Method how all those things are to be used for the safety thereof; but their are some certain common precepts which are to be observed by all; some peculiar precepts to be observed according to ages, sex, and other Circumstances. The most common Precept here is this, that what ever is according to nature is to be kept, but since that in some health exactly such, in others difference from hence, which is called a neutral constitution; the former is to be exactly preserved with its likes, and nothing contrary to be admitted, whereby the body may be put out of that natural state; but a Neutral constitution requires some change, yet that aught to be small, and by degrees, if the course of life will admit thereof. Yet that most general rule is to be observed by all, The most general rule to descend health. namely that mediocrity is to be ever accounted safest according to that of Hippo. 2. Apho. 52. to much of every thing is good for nothing, or all excess is hurtful to nature. As also that 2. Apho. 50, those things that we are long accustomed unto although they are worse, yet are they less troublesome to us, than those things that we are not accustomed to. Moreover, we are to endeavour, that the natural constitution of our bodies, consisting in a good moderation of cold and heat, occult qualities, due conformation of the Organic parts, and unity may be preserved by those things which are fitly borne to preserve it, namely by their likes, in case the body be throughly well constituted, or somewhat with contraries, if the body decline from the best state. But all things are to be avoided which may destroy it. Likewise causes of health sometimes require things plainly alike, sometimes a little contrary, Most health full air. and therefore the Physician shall appoint the right use of those things which necessarily happen to the body, namely air that is temperate is the best for those that are temperate, and hurtful to no constitution of body. Moreover let the purest be chosen, cold air when the fire is kindled is changed, hot air is tempered by water that is cold, being poured out of one vessel into another, or sprinkled on the floor, or by moistened in water and hung in the bedchamber, or Roses strewed in the house, or the leaves of Vines, Willows, Water Lilies and other cooling Herbs; moisture in excess may be corrected by the kindling of fires, and burning of suffumigations of ●●●t things; dryness is corrected with the moystning of waters & sprinklings or strowings of moistening Herbs. As for Meat, meats of little juice are offensive to all, Meat and drink. and profitable to none, nay even the daily use of thick, viscide, tenacious, cold, hard, flat, and acrid meats are to be avoided by all, since they cannot be well concocted, nor afford good nourishment: yet some regard is here to be had of the appetite according to that of Hypocrates, 2. Apho. 38. a litter worse meat and drink that is more pleasant, is to be preferred before that which is better and ungrateful, as also of custom according to that 2. Aphor. 50 those things that we are long accustomed unto, although they are evil, are wont to trouble us less than those things which we are not used unto. Moreover meats are to be taken only in that quantity whereby our strength may be refreshed not oppressed, that which hath been spoken of meat is also to be understood of drink. Of the passions of the mind, Passions of the mind. this in general may be spoken, that overmuch of all them are to be avoided, and quietness of mind and moderate joy is to be cherished. The excrements of the belly twice a day or at least once ought to be ejected, Excrements. urine likewise aught to be expelled as often as their is need. We are to take heed likewise of that of Celsus, lest in our best health we take things adverse thereunto, and therefore we ought not rashly to trouble or molest our bodies with purges or other medicines, but 'tis better to exercise our bodies moderately every day, least excrements should be gathered together, and if any disease seem to be coming upon us, to follow this counsel, that is by quietness and abstinence many great diseases are cured. CHAP II. Of the cure of little ones not yet borne, and of the diet of women with child, THese things being premised in general, what course of diet may best agree to every degree of health (of which before, in the first Book and third Chap.) we will now explain distinctly, and therefore we will handle good habit or the preserver of the best State, called under the general name of the Hygeinall, which governs sufficient health in all our actions. The Prophylactick is that part which guides the neutrality of those that are falling away. The Analyptick is that which brings neuters to be healthy; And first a method of preserving of the health of such as are very well is to be explained; wherein notwithstanding some things may be delivered, which may be accommodated to the other degrees of health. But in the first place it is to be noted that the foundation of our future health fully depends on the conception and seed of our parents, Seed the cause of future health. and therefore as Fernelius in his first Book of Pathology Chap. 1. writeth, If Husbandmen being to sow Corn choose the small and young seed, having found by experience, that ill fruit comes from that which is rotten, how much more diligently ought we to observe the seed in the procreation of our Children. Moreover when the Mother hath conceived a Child in the womb, Dye● of such as are great. she ought to beware of all things which might bring any detriment to the young; or rather, she ought to be careful, that she may strengthen, and preserve it safe; namely that she avoid foggy Air, that she beware of the smell of candles newly put out, of brimstone, castor and such like, and of the smell of herbs that are too fragrant, she should shun meats of ill juice, and sharp, and such as cause urine, or cause loathing, or provoke sneezing, she should not use many Aromatic things; if those that are great desire, any ill meats, they are not altogether to be denied them, but if the food, which the woman desires cannot be obtained by her; lest any inconveniencies should happen to the young, they use to give her some honey with nutmeg; or water distilled from the tender leaves of a Vine in the month of May; or of the barks of Citron, or the pills of Oranges, or of the Root of Peony, being bruised and prepared in Spanish Wine, or Malmesy. For the strengthening are exhibited, the precious Stones, Strengthening the young. called Pearls, Corals, the shave of Ivory, the barks of Citron, Cinnamon, Saffron, the wood of Aloes, Cloves, Quinces, Sugar of Roses, sweet Almonds, corrected with high Country Wine, Water, called the Balsam of Children, the confection of Gems, Diamargariti calidi, Malmsy Wine applied with Bread to the belly. The same things may hinder an abortion which is night at hand, and moreover Vnguentum Comitissae, externally applied, Hindering abortion. also those that are great should principally avoid hard labours and passions of the mind, yet to be altogether idle is not so convenient. The opening of a vein eafter the fifth month for the most part is prohibited, Whether a vein be to be opened of the woman with-child. but before the fifth month you may open a vein, in Plethoric bodies, nay some unless they are let blood, before the fifth month miscarry, of purgation Hypocrates writeth in the fifth Apho. 39 thou shalt purge those that are with child, any time within four months, and sometimes until the seventh month, but sparingly, and you are to use only lenitive medicines. CHAP III. Of the Diet of Infants, and thence forward until 21. years of Age. WHen a Child is brought forth into the World, before the teats are given him, we ought to give him some pure honey, or Coral with Sugar, or the Sugar of pennidice, with: Oil of sweet Almonds, whereby the Dregs may be drawn through the Paunch, and an Epilepsy be prevented. Afterwards let the Infant be nourished with Milk, The Infant is nourished with the mothers Milk. and that from his Mother's Breast, as having most agreement with the Infant, and it is generated of the same blood, by which before the little one was form, and nourished in the Womb, unless perhaps the Mother be sick or ill disposed; the Infant is to be nourished with Milk, until it be two years old, or certainly till the eighteenth Month, & 'tis to be accustomed in the mean time to other meats by little & little; yet such as may be easily concocted, commonly their is prepared for them Pap made of Bread, and water or Milk, yet by reason of its clamminess, it seems not to so good to many, and therefore more wholesome may be made with crumbs of Bread, or certainly with bread first dried in an Oven. Afterwards the Infant by degrees is to be accustomed to more solid meats, Diet the first three years. but the first three years, his food is to be moister, and the Infant is to be nourished with good meats, and should use Baths often, but not presently after eating and drinking; near the end of seven years' Age, the use of Baths ought to be more seldom, Infants and Boys should not drink Wine. By how much the more a boy grows in years, by so much the more both the mind and body are to be employed, yet the exercises ought not to be immoderate, lest that any member should be turned awry, or lest the body should be dried too soon with two much motion, and the growth of the body should be hindered; of sleep, by how much the more Age increaseth, so by little and little we ought to abate it. In the second and third Septinaries more solid meats are to be afforded, Dietin 7. and 3. S●ptinary. yet not over much drying: Exercise also aught to be somewhat less than the strength might tolerate, and in the third Septinary order of Diet convenient for every course of life is to be begun, for those which are given to a laborious kind of life ought to seed more plentifully in the third Septinary, and with those meats, which being taken in no great quantity, nourish much, and strengthen them for greater labours. But those which apply their minds to learning at this age ought to be careful of the animal spirits, Diet of. Scholars. and diligently to endeavour that they may be plentifully generated being pure, and clear, which may be if they live in a subtle Air, pure thin, by diet and meats that are not thick, but which may afford matter for pure and lavadble blood, and endeavour to evacuate all excrements in due time, not to accumulate crudities, nor weaken their bodies with untimely studies, nor is the use of Venery to be granted till the end of this Age. CHAP. IU. Of the Diet of middle Age, That Age which follows the third feaventh Year or from the twenty first to the fiftieth, Diet for middle age. is accounted the middle Age, and for the most part there is the same reason of Diet, unless that the former half part or the fourth septinary, and the latter half or the seaventh doth more agree with the diet of the Age, which he hath attained, then of that Age which is truly the middle. The rule of diet. variety. First for what belongs to meat, in meat is to be observed quality, quantity, time of taking, manner, and such like circumstances; as to the quality of meats, those are to be chosen, which are most temperate, quantity. and most familiar to our nature, amongst which, Bread well baked obtains the first place, hence the flesh of Animals, and those things which are taken from Animals, and always they are to be chosen which are of good juice, and to be avoided, which have ill juice, yet something is here to be granted to custom, 2. Apho. 56. and to the various constitutions of bodies, and Celsus admoni●●eth a sound man, and one which is in health to avoid no kind of meat which the people use, which is principally to be observed by those, which necessarily must live a different course of life; variety of meats please, and divers sorts of meat are eaten with greater pleasure, yet we are to beware lest meats are eatentogether of different substances, and various faculties, whereof some are thick, others thin, some easy, others hard of concoction, since from such variety corruption of meats, may easily follow, but those which have a certain similitude are rather to be chosen, that the same heat may be required, for the concoction of the same. Secondly that quantity of food is to be taken which may increase the strength, Quantity. and not hinder it, but you cannot measure that, neither by weight, nor number, but 'tis to be found in this, in that you have regard to three things; first, to the nature of aliment, secondly, to the nature of the body, and the course of life and labours, and thirdly, to the time of the year, and constitution of the air. For first, meats hard to be concocted being taken in greater plenty, hurt more, than those of easier concoction next meat brings less inconveniency if it offend only in quantity, then if it also hath an ill quality joined therewith, regard is also to be had of pleasantness as is said before. Moreover, one stomach desires more, another concocts more, in which matter the counsel of Hypocrates is more safe, the 6 Epid. Comm. 4. Text 22. The study of health is not to be glutted with meat, nor to be slow to labour: and Avicenne admonisheth us to rise from the Table, with those that are hungry; lastly those which live idly, and live a life not so laborious concoct less, those which are exercised in labour digest more. Of the time of the year, Hypocrates writeth, 1. Apho. 15. Their Bellies which are born in the Winter or Spring are very hot, and their sleep tedious; therefore at those seasons of the year they ought to eat more, forasmuch as they have more heat, whence it comes to pass, that they want more plentiful nourishment. And in the third of Diet he teacheth, that we ought to eat more in Winter, but drink more sparingly, but in Summer, the contrary. But nevertheless if any one either through ill custom, or the allurements of meats hath any way offended herein, that afterwards is to be be corrected by fasting, or more sparing diet, sleep, quiet, or vomiting, and therefore 'tis good to omit supping once a week, or else to eat very little supper. As to the time, Time. to eat often and much is neither commodious for the body nor mind, yet 'tis better to eat a little often, then much at once, but it is most wholesome that a man of middle age, well tempered, and that hath government of himself, do eat twice aday; so that he takes only so much meat, as may not oppress the stomach; in other things some thing is to be granted to Age temperatemperament, kind of life, custom and such, like but the time betwixt dinner and supper ought to be shorter then that which is betwixt supper and dinner again. But whether supper or dinner ought to be larger, Whether supper or dinner ought t● be largest. is severally understood amongst Physicians: that we may briefly conclude the matter, if any dine more sparingly, and frugally, which the Ancients for the most part did, the supper ought to be the larger, but if we observe our custom and manners, since men about noon day dine more plentifully, and cannot sufficiently concoct their meat in that short time, which is betwixr dinner and supper; 'tis altogether necessary that they should sup more sparingly, since 'tis not convenient to be twice filled with meat the same day, for than they shall have a troublesome night, and in the morning perceive crudities, and principally this to be observed by old men, because experience testifieth, that all old men are offended with large suppers. As for the order of meats, 'tis of some concernment, Order. whether we take this or that meat in the first or second place; namely, those are to be taken in the first place, which mollify the Paunch, and make it slippery, and those which are not of so good juice, are easily concocted, and descend out of the Stomach, and are easily corrupted; to these are to be added those things which may stop the belly, they are not so easily concocted, and which descend slower, and are of better juice. As for drink, quantit●y of drink. of the qualities and differences thereof we have spoken before; as to the quantity, as a little of Wine, strong Beer, and if their be any other kinds of drinks like to these, the use of them moistens the body, cherisheth the spirits, corroborates the strength, helps concoction and distribution of meats, provokes Urine, heats the habit of the body, and is a remedy against the coldness, and dryness of old age, it causeth sleep, corrects the acrimony of choler, exhilarates the mind, and makes men's manners pleasing; so the immoderate use thereof, and drunkenness is the Plague itself of health, and of a man, for by immoderate drinking, the native heat is consumed, crude and perverse humours are accumulated, the mind is troubled, and a kind of madness is begotten The most convenient time of drinking is betwixt meals Time fit to drink. for so it conduceth much to the concoction of meat, and the right distribution of the same, but if you drink upon an empty stomach, the head and the Nerves are extended; if after meat, the concoction is thereby hindered; if the meat do not easily descend, the concoction being perfected, 'tis profitable to drink something; drink also is to be avoided going to rest, but especially after exercises and Baths; sudden drinking of cold drink is unwholesome; 'tis more commodious also to divide the drink then to drink it together, lest it cause a floating in the stomach. The passions of the mind, Passions of the mind. all of them that are vehement are to be avoided, and on the contrary, moderate joy is to be cherished. Motions of the body all of them, Exercise of body. do not agree with all, yet for all sound men, deambulation may suffice, and frication and such like exercises; otherwise to thinner bodies more moderate, to stronger greater exercises are more convenient, yet regard is here to be had of custom, according to that of Hypocrates, 2. Apho. 49. those which were accustomed to daily labours, although they are weak and old, easier endure exercises then those that are unaccustomed thereunto, although they are strong and young; regard also is to be had of the time of the year, for in summer, lesser and shorter exercises, in Winter greater and stronger are to be appointed; so long also only the body is to be exercised, until a fresh colour appear in the body, and the body begin in some measure to swell, and sweat to flow out: exercise and motion is to be used when the concoction is performed in the stomach and liver, and as Hypocrates, 6. Epid. Sect. 4. Apho. the last labour ought to go before meat, wherefore the most convenient time for exercise is the morning, when the Stomach is empty, and the excrements of the Paunch and Bladder are first sent out, the same time is most fit for study; regard is also to be had of the place where exercises are, for exercise under the Sun heats the body very much, pours out humours, and are very obnoxious to those whose heads are weak or full of humours, but all exercises that are in the shade are safer. Rest is no less necessary than motion, for this is the remedy of weariness, and repairs decayed strength, and therefore exercise and rest take their interchangeable turns. Sleeping and waking. The time also is to be appointed for sleeping and waking, the most fit time for sleep is the night, appointed for man by God himself, but we ought not to sleep presently after meat, but an hour or two after supper, otherwise the head will be filled with many vapours; diurnal sleep likewise fills the head with vapours, but if any one hath contracted a sense of wearisomeness, or hath past an unquiet night without sleep, 'tis lawful to cherish sleep so long in the day time, and especially for old men, who seldom sleep the whole night, but we are to sleep so long until the meat be concocted in the Stomach and Liver, and the spirits that are taken away are restored, which space is not equally in all, less than six hours scarce sufficeth, but beyond 9 hours' sleep is scarce to be extended, for the most part the space of seven hours is sufficient. But those which are studious principally offend in their sleep, if they wake long after supper, Sleep for those that are studious. and sleep after the rising of the Sun, for they do not only pervert the order of nature, but also much hinder the concoction, whilst they impeade the instauration of spirits, which were wasted with diurnal labours, and watch, and call them from the Stomach, and fill the head with vapours. But we ought to lie down with our legs and arms a little bent, our head something elevated, on either side, Manner of lying. since lying supine hurts much, and first to lie on the right side, that the concoction of the Stomach may be helped by the Liver, not under the canopy of Heaven, nor the Beams of the Moon, and the windows are to be shut, and the nocturnal air to be kept out, the bedchamber ought to be without any smell, the bed should be soft, and fitted to drive away the frigidity of the Air, when you please, the Head also is not to be wrapped with too many . Watch after sleep should be moderate, Watch. for too much consumes the native heat, and dissipates Spirits, dries the body, brings forth crudities, dulls the senses, and offends all the actions. There is no small profit also of Baths, Baths. for the preservation of health, as is said before, part the first chap. the seventh, yet the right use of them is to be appointed, neither are we to go into a Bath before the meat be concocted in the stomach, lest crud humours should be carried into all the parts of the body. In a Bath we must abstain from all meat and drink, and we are to go out before we are weary, and to defend the whole body from cold, nor must we eat nor drink before the heat of the bath be expired. Lotions of the head open the pores of the skin and discuss Vapours, Lotions of the head. yet they are not to be used when either a Catarrh, or pain of the head offendeth, but are to be used in the morning, or an hour before Supper, and after the washing of the head it should be throughly dried with warm linen . Lastly the washing of the feet is not profitable, to hinder their sweeting, but to avert humours which would flow from the head thither. Lastly we must endeavour that presently after sleep, Excrements. the dregs of the paunch may be cast out, if the paunch answers not to desire, 'tis to be moistened with Raisins of the Sun, the broth of a Cock, a decoction of the staulkes of Borage, Mallows, Bears breech, or six or seven Prunes, boiled in the broth where Senna hath been infused, to be taken for the first course, or a little before meat, the excrements of the third concoction are to be expelled by daily exercise, the head is to be combed in the morning, the mouth to be washed with water, the ears, nose, and palate to be cleansed, the eyes and the whole face, are to be washed in cold water, and the body, especially the Arms, and the Legs are to be rubbed. And if so any error be committed in the use of these things, which may easily happen, afterwards it is to be mended the next day by its contrary, and an inequality being introduced the contrary cause is taken away. CHAP. V Of the diet of old men. THat part of Physic which rules, Diet for old men. or governs the age of old men is called, Geronomick, but because in old age the body every day is more and more dried, and the native heat is consumed, we are to endeavour that dryness may be prevented, and the native heat so much as may be preserved. Hotter and moister Air therefore is agreeable to this age, Aire. and unless it be such of itself, 'tis to be corrected by art, especially in Autumn and Winter, which Air is chiefly offensive to old men. The Aliment itself also aught to be hot and moist, Aliment. of good juice, and easy of concoction, but thick meats, hard, glutinous, and which fill the head, grow sour in the stomach, and are easily corrupted, are to be avoided, and if hurt be contracted by the use of such things, 'tis to be corrected, by the use of Diatrion, Pipereon, Diacalaminth, and such like. Of the usual quantity also every day something is to be abated, for as Hypocrates writes, 1. Apho. 10. there is little heat in old men, and therefore they need little nourishment, sigh thence their heat is extinguished with much; and therefore meat is to be given sparingly, but often, and indeed very conveniently thrice aday, viz. breakfast, dinner, and supper. The best drink for old men is Wine, Drink. from whence Wine is called old men's milk, yet 'tis not to be taken in too great plenty, and it ought to be of a hotter nature, and other things good and generous, middle aged, but thick Wines which cause obstructions, and have an astringent faculty or hinder urines, are not convenient for old men, wine mingled with honey is good for old men also. Old men should use moderate exercises before meat, Exercise. yet so that no lassitude may thence ensue, but principally moderate frication is commodious for them, especially in the morning. Old men should sleep longer, Sleep. and if they are troubled with waking, that remedied with the use of sweet Almonds, Lettuce boiled with Sugar, and dill being taken the last course, and with Somniferous lotions of the feet and hands. First of all let them avoid vehement perturbations of the mind, Perturbations of the mind. Excre. ments. and let them rather refresh their minds and bodies with honest pleasures. Lastly let old men be careful that they void their excrements well, and therefore, if the body be costive, the belly is to be moistened with convenient meats or with honey of Roses solutive, but stronger, and more Phyficall things are not to be given to old men. CHAP. VI Of the Diet of such as are out of temper and of neuters. AS for what belongs to the Diet of bodies, Bodies that are neuters how manifold. that are neutrals, there art two kinds of body's deviating from perfect health, for some are more remote from a sickly constitution, others are nearer to it, and these are twofold as before is spoken lib. the first Chap. the third, neuters falling away, which governing part of the Method of the defence of health is called Prophylactick; in neuters tending to health and waxing strong, the governing part of the Method of restoration of health is called Analyptick. But those former neuters which are as yet far from difeased, yet decline from the best health, whether from their birth, or whether they have contracted such a habit from custom and diet, it is hard to change, neither can it be done suddenly, but by degrees, and with long diligence; but if leisure doth not permit, 'tis neither commodious, nor possible, for as Galen 2. of the defence of health Chap. the third those who are busied in civil affairs, and distracted with many businesses 'tis safer for such a one not to endeavour to change his temperament. Such bodies therefore, Diet of untemperate men. if either leisure will not permit, and their minds are not bend to reduce them into a better state, they ought to be preserved so by their likes, but if you intent to reduce them to a better condition, you must use contraries by degrees; yet a hot and moist distemper, since that 'tis more agreeable to our nature, is by no means to be changed, because it introduceth no disease, but bodies which are become too dry, are always to be moistened as much as may be, during the whole term of life. Hot bodies therefore should avoid hot Air, Of such as are hot. hot and sharp meats, their drink ought to be more plentiful, but small, and strong drink rather than wine, their exercise ought to be moderate, the use of baths, of fresh waters warm, frequent; they must shun anger, too tedious meditations, and their sleep ought to be longer. If dryness be joined to the heat, let them avoid the use of hot and drying things, and therefore let them beware of a hot and dry constitution of Air, and vehement exercises, if humidity be joined and that be moderate, since that temperament is most agreeable to man, and conduceth to the prolongation of life, 'tis to be preserved as much as may be, and only to be forewarned that no more of the heat and humours may be added, and cause diseases, and stir up putrefaction, wherefore let these avoid Air that is too hot and moist, let meat be given which hath attenuating force, and let them endeavour that it may be well concocted, let their exercises be such, as may discuss excrements, yet not dry the solid parts; let all other things be moderate, and principally let them endeavour, that the excrements of the belly and the urine may freely pass from them. Those which are cold are to be nourished with hot meats, let them use exercises, which may stir up heat, Oscold. let them evacuate timely the pituitous excrements. Dry constitutions should use moist meats, Of dry. and moistening drink, and baths of fresh water, but the most unhappy constitution is cold and dry, which represents old age from the beginning, and hastens to it and therefore such are to use heating and moistening things, and to be nourished with hot and moist food, their exercises should be moderate, such as only stir up the natural heat, their sleep longer and the use of baths of fresh water frequent; Venery is very hurtful: cold and moist, if the constitution of the body be so, Moist. the frigidity is to be corrected, and the humidity preserved, to which purpose moderate exercise conduceth, and excrements if they are timely and duly evacuated. Neuters declining; which now incline to sickness, Diet of neuters declining. diseases are imminent to them, especially for two reasons, Plethory, and cacochymy, both of them therefore are to be taken away; if the falling away from health be but little, it may be done with rest and abstinence; but if it be greater, opening of a vein, and purging is to be used, which is spoken of in the following book, for this Prophylactick part is placed in the end of a cure. Only we here admonish two things, first that the Springtime is best for preservation; as Hypocrates 6. Apho. 47. teacheth, he says, to those that the breathing of a vein or purging are profitable, to them the opening of a vein, and a purgation is to be commanded, in the Spring; it is also profitable, to purge black and Melancholy humours, before Autumn. Moreover the use of aloes doth much conduce to the preservation of health, Use of the aloes. since it gently purgeth the excrements which stick in the first passages, which are oftentimes the causes of many diseases, it resists putrefaction and corruption, and seldom reacheth the Liver, but because aloes, if it comes to the Liver offends it, it is not to be used too often, and in too great plenty, lest it should penetrate to the Liver, but it purgeth only the first passages, which is performed profitably, if it be taken in a small quantity, a little before Supper. Lastly, Diet of neuters growing better. for what belongs to the diet of those newters that are inclinable to health, two things in the first place are to be observed in their diet, first that they fall not again into the disease; secondly that they may suddenly recover their former health: first when, as it is 2. Apho. 12. those things which are left in diseases after a crisis are wont to cause relapses, if ought of the peccant matter be yet remaining, that is to be taken away by degrees, and by helping, and the principal parts are to be strengthened, but if nothing of the vicious matter be present, the body is carefully to be refreshed with moist aliment, and that which is easy to be concocted, namely the yolkes of eggs, broths with Bread, Chickens, Hens, Capons, Fish; last Goat's flesh, Mutton, Veal; sleep helps concoction, unctions strengthen the stomach, before meat are appointed frications also, moderate walking, Baths of fresh warm wa●●r, lastly strengthening things are to be used, and such as may resist the relics of the causes of imbecility, and of sickly disposition, but those things which may call back the distemper, which trouble sick, these are to be avoided. THE FIFTH BOOK, PART 1. Of the Materials for Cure. SECT. I. Of Medicines. CHAP. I. What a Medicine is. THere remains the last part of Physic which is the Therapeuticall, which restores men that are fallen into diseases to their former health, and expels those diseases from men's bodies which torment them, but that the Physician may obtain this end, it is necessary that he be instructed in two things, first a Method whereby he may find those things that are helpful by Indications, secondly Instruments or Materials for cure, whereby he may perform that which he found out by Indications. The matter fit for cure is properly reduced to three heads, Instruments of Physic. diet, manual operation, and making up of Medicines. First you are to be admonished that you are to distinguish cures, from the materials used in curing, for cure is that whereby instruction is given from the Indicant to perform or act something, and is always one, as to heat or make hot, but the Matter of help is that whereby that is performed by the Physician which the Indicant commands, which may be manifold, as whilst you are to heat, it may be done with Pepper, Ginger, Wormwood. etc. But since that of dietetical matter is spoken sufficiently in the former book, it remains that we speak of Medicines, Medicine what is it. and Manual operation, and first as for Medicines, by amedicine we understand every thing that is a different thing from nature, which may alter our bodies and reduce them to a natural state from a preternatural. In which respect it differs from aliment and Poison, for Aliment, as it is aliment, is only that which increaseth the substance, or it renews and increaseth our bodies; a Medicine altars, but doth not repair, but if any thing can together nourish and alter our bodies, 'tis alimental Medicine, or medicinal aliment; but poisons neither nourish, nor alter our bodies, but are destroyers of our bodies, and have power to corrupt them. CHAP. II. Of the faculties of Medicines in general. MEdicines are twofold, Medicines how manifold. Simple Compound some are simple, other compound; a simple is that which is such by nature only, and hath nothing mixed with it by art; compound are when more natural things are mingled by art into the form of one medicine. Simple Medicines are taken from Plants, Simple how many fold. Plants. Animals, Minerals; and Plants are either taken whole or their parts, Roots, Woods, Piths, Barks, Leaves, and Branches, Flowers, Seeds, Fruits, Juices, Gums, Rosins, Oils, and Liquors, as Wine. Animals also are used whole, Living Creatures. or their parts, as Hartshorn, Marrow, Flesh, or those things that are generated in them, as Milk, Eggs, or their works, as Honey, Wax, or their excrements as Gall, Urine. Under Minerals are comprehended not only those things which are properly called Minerals, Minerals. Vitriall, Antimony, Sulphur, and Metals, and the excrements, but also divers kinds of earths, as Uermillion, Irish Slat, Bolearminack, as also all Stones and Gems, also divers kinds of Salts, and concreted juices in the earth, of which Naptha is one, also bathing-waters, in which rank Manna may be put, if there be no other place fit for it. The faculties are various, of so many different things, The difference of Medicines Actual. and from hence the divisions of Medicines are various, for first, some Medicines are said to be such in action, others in power to be such; things as are said to be such in action, which in them contain that which they are said to be, the act being as it were present, and absolved, and so the operation is in a readiness, and can affect our bodies at the first touch, with that quality wherewith they are endued: so Water, and Ice, are cold in action, because after what manner soever they are applied to a body, they can presently cool the same; but those things are such in potentia, Potential. whose force is not perceived at the first touch, but lieth hid and as it were asleep, nor doth it discover itself by action, until it be some way changed by our heat and be burnt, and reduced into action, so Pepper, and Wine, although to the touch they are cold, yet nevertheless they heat. But although the force of Medicines are various, Facultiei of Medicines manifest. yet they may conveniently be divided into manifest and occult; those are called manifest which affect our senses, or which excite qualities in the patiented which are discerned by our senses, and whereof a manifest cause may be rendered. But occult are such which do not produce qualities in a Patient, obvious to sense, Occult but perform something by a hidden propriety, to wit, they purge a certain humour, they strengthen a certain member, they resist poison, or being hung or carried externally work upon the body, the manifest causes whereof cannot be explained, and no other reason can be given, then that such a power or force is in them, by a peculiar propriety of nature, although there are some who reject hidden qualities, yet I. C. Scaliger rightly thinks that 'tis a high piece of impudence to reduce all things to manifest qualities, in the 218. of his exercises Sect. 8. and those which endeavour this, bring foolish and ridiculous reasons, or deny those things which are confirmed by experience; and these faculties and actions are different from those in their whole kind as also from others, which are spoken of before in the 2. Book 2. Part. Cap. 12. both from hence in the first place, because the strength of these qualities, are far greater than theirs of the primary qualities, and their efficacy is great oftentimes in the smallest body. But both of them, The first the second. the manifest and occult faculties and actions of Medicines are various, of manifest qualities some are primary, others secondary, others of a third kind; The third kind of qualities. the first have power of heating, cooling, moistening and drying; the second to soften, to harden, condense, rarify, resolve, attenuate, thicken, to draw, to repel; the third, to provoke Urine, to cause and stay courses, to move vomit, generate flesh, and to break stones, although the power of breaking stones may more fitly be attributed to the propriety of the whole substance, as beneath Cap. 17. shall be shown. Occult are of three kinds, for either they evacuate a certain humour by a peculiar faculty, or they have a sympathy with a curtain part, whence they are called cephalicks, or cardiacks, or they resist poison. But the faculties of all Medicines according to the changes which they make in our bodies, The kinds of faculties in Medicines. may be referred to four ranks or forms, first some belong to an inducing of a new quality, such as are those which are said to have the efficacies of the primary qualities, to wit heating, drying, cooling, and moistening, but because every thing that altars, cannot be safely applied to every part, appropriated Medicines are conveniently joined to every member which do alter. Moreover hitherto is to be referred those which are accounted amongst the number of secondary qualities, such as soften and harden, loosening, rarify and condense, styptic, and obstructing, astringent and opening, attenuating and incrassating, filling, and deterging or cleansing: lastly hereunto belongs, Anodunes, Stupefactives, and Hypnoticks or such as cause rest. In the second form are those which prevail in causing motion, attracting and repelling; to the third form those things are referred, which consist in the generation of any thing, ripening, generating quitture, breeding flesh, Glutinating, cicatrizing, and procuring milk and sperm. To the fourth form are referred those things which corrupt, corrode, putrify, such as cause dry crust, burning, and such as do corrupt seed and milk. The fift form comprehends those things which belong to the taking away of any thing, such things as make less, such as purge, such as cause Vomiting, Urine, or sweats, or provoke courses, expel the secondine, or send forth a dead child, such things as break and expel the Stone, Errhines, Sternutatories, and Apophlegmatismes, such things as purge the breasts, and such as kill and expel Worms. They may be placed in the last form which resist poison and are the drugs against poison. CHAP. III. Of the first faculties of Medicines. AS for what belongs to the first form, Altering temperate. and first for altering Medicines, some of them being compared with man's body are called temperate, which cause or bring forth no mutation in man either in coldnesie, dryness, heat, or moisture; and these are either such simply and in all the qualities, or else in two of them only; Intemperate. but the intemperate are such as have power to change the heat or moisture of our bodies. Moreover these qualities are divided by Physicians into certain degrees, Degrees of qualities. which are left to be esteemed by their effects; the first degree is when a Medicine altars our bodies obscurely and scarce senfibly; the second is, when it manifestly changeth our bodies, yet without hurting, inconveniency or trouble: the third degree is, when it doth not only manifestly alter the body, but vehemently, and not without trouble, and pain, yet without corruption: the fourth degree is that which altereth the body not without pain, and that most grieviously. To either of these degrees there are appointed certain Latitudes, which are commonly called mansions, Mansions of degrees. as they altar more intensely or remissly, or betwixt both, which they call in the beginning, middle, and end. The temperate are, Venus' hair, Asparagus, Temperate Medicines. Liquorish Sweet Oil, Pine-nuts, Jujubes, Figgs, Sebestens, Raisins, Dates, Gum Elemie, and Tragacanth, Calves and Goat's Suet, and Hogs Grease. The hot in the first degree are, Marshmallows, Borage, Hot in the first. bugloss, Beets, Cabbage, Camommil, Bindweed, Agrimony, and Fumitory, Flex, Melilot, A lease that swims in Ditches without any Root, Spikenard, Wallwort, and Coltsfoot, the flowers of borage, bugloss, Bettony, ox-eye, or Wild Camomile, Melilot Camomile, black Poplar, Arabian Staechodos, an herb with grey down like an old man's hair called Senecio in Latin: Fruits; sweet Almonds, Chestnuts, Jujubes, Ciprus-nuts, green Walnuts, Grapes, ripe Mulberries, sweet Apples, Fragrant Seeds, Coriander, Fenegreeke, Flax, Grumwell, Lupins, Sesanix rice, Roots, Marshmallows, Bares Breech, Beets, bugloss, Liquorish, Satirion, Barks, Guaicum, Tamarisk, Liquors, Juices, and Gums, Sugar, Bdellium, Laudanum, Al. 2. i. e. Others in the second degree, Gum of ivy, the tallow of Goats, Does, Hearts, fresh Butter. Hot in the second degree, Hot in the second. Wormwood, Pimpernell, green Dill, Angelica, Parsly, Mugwort, Bettony, Calamus Aromaticus, ground Pine, Faenugreek, St. Johns-woort, Ivy, Hopps, balm, Horehound, Motherwort, Sweete-ferne, Bafill, common-Burnet, Maiden-weed, Poley, Rosemary, Summer or Winter Savory, Sage, Scabious, Scordium, Staechados, Feaverfew, Flowers of Nightshade, Saffron, Gillyflowers, or Carnations, Schaenanth, Lavender, Lupins, balm, Rosmary; Fruits, as Capers, Nutmegs, Pistack-nutts, dried Figs, dried Nuts; Seeds, as Dill, Parsley, Bittervetch, Water Rocket, Pulse, or Vetches, Nettle seed. Roots, as Parsley, Caper-roots, Mayden-weed, common Burnet, Turnips, Zedoary, Rosewort; Barks, as the Barks or Wood of Cassia, Cinnamon: others in the third degree. Frankincense, Roots of Capers, Liquors, Gums and Rosins, Wine that is new, Laudanum, Aloes, and Galbanum, Myrrh, Mastic, Frankincense, dried pitch, Rosin, storax; Fats, as Lion's fat; Libards, Bears, Foxes. Hot in the third degree are Metals, Hot in the third. Flos aeris, which is that which comes from the Brass in melting, Brass, Squama aeris or the Scaling of Brass, Verdegrease, dregs of Brass, Alum, Salt, Nitre, Brimstone, Red-vitriall; Herbs or leaves, as Sowthernewood, Asarabecca, or the chaste Plant, Wake Robin, the Herb called Jerusalem, or Lady's Rose, the herb Ammios, dried Dill, Bayes, Dittany, Carnations, Germander, blue flower, Bastard Saffron, Century the greater and less, Celandine, (or Pile-wort) Calamint, Fleabane, Horsemints, Fennel, Epithymum, so called, because it grows upon Time, Juniper, Elecampane, Hyssop, Laurel, Marjerom, Marum an herb called Marjerom, Mints, Fennel flower, flowers of the wild Vine, wild Marjerom, wild Woodbine, Parsley, Sneeze-wort, Pennyroyal, Oxe-stay, Rue, Savine, Wild Time, wild Mints. Al. 2. Time, trifoile, vervain, Nettles, Fl owers of Agnus-castus, Epithymum, Violets, of the wild Vine, of the wild Woodbine. Fruits, juniper-berries, Cloves, the fruit of Balsimum, Anacardium, that is a fruit of an Indian Tree, like a Birds heart, and the juice like blood, Pepper, Al. 4. Seeds of Ammi, and Aniseed of Jerusalem, or Lady's Rose, Caraways, of Garden Cresses, bastard Saffron, according to Galen, Fern. 2. of Fennell, Cummen; Carrots, Fennell Flower, Turnips, Parfly, Hartwort, Stavesager, of a Vine. Roots; of sweet Garden Flag, others in the second degree, Asarabecca, wakerobbin, Sea Onion, or Squills, Dittany, Leopard's bane, Fennell, English Galingale, both kinds of Hellebore, Elecampane, Orrice, Parsly, Radish, Barks bf Mace, Liquors, Tears and Gums; old Wine, and sweet Asa, stinking Asa, Ammoniack, Cedar, Pitch, Opoponax, Musk. Hot in the fourth degree, Hot in the fourth. are such as belong to metals as vitriol, Arsenic, Sandaraca, which is a Gem, Chrysocolla is a kind of a mineral found like found in veins of Braffe, Silver, or Gold, which Goldsmiths use to solder Gold, and Silver with; Mysysory, is that which the Apothecaries call vitriol, Melantheria, Ink, wherewith Chirurgeons consume putrified flesh, Herbs, or Leaves; Pepper-wort, Garden, and water Cresses, some would have them to be hot in the third degree, great headed Leeks, the fullers herb Thapsia, a Milk Thistle; Fruits, as Pepper etc. Seeds as of both kinds of Cresses, Mustardseed; Roots, as Garlic, Onions, Costus, Leeks that have great heads, bastard Pelitory, or sneezing wort, Euphobium. Things cold in the first degree, Herbs, or Leaves, Cold in the first. as Orack, sour Sorrell, Mallows, Myrtles, Pelitory of the wall, Flowers, of Mallows, Roses, Violets; Fruits, as the substance of Citrons, Quinces, Pares, Plumbs; Seeds, as Barley, Millet; Rootes, of Mallows, Concreate Juices, Acacia, others in the second, Dragons' blood; Stones as a Hyacinth, a Saphir, an Emerald. Things cold in the second degree, Leaves, and Herbs, Cold in the second. a kind of beet which some call Spinack, Spanish Succory, Lettuce, Ducks-meate, Endive or Succory, Violet leaves, Sorrell, Plantine, Knotgrass, Fleawort, Nightshade; Flowers, of wild Poppies, Cichory, water Lilies; Fruits, as Gourds, Cucumbers, Oak Apples, Oranges, Pomegranates, Damask Prunes, Pippens, Peaches; Seeds, of Sorrel, Cichory, Winter Cherries, Wood of Santalls'. Things cold in the third degree, Herbs, or Leaves, Cold in the third. Purslan, Mandrake, life everlasting, Henbane, others think it hot in the fourth degree; Flowers, as of Pomgranets. Fruits; as Oranges, Mad-Apples of Mandrake; Seeds, as of Hemlock, Henbane, Poppy, Rootes of Mandrake, juice of the juice of Holly Rose. Things cold in the fourth degree; Cold in the fourth. Herbs or Leaves, Hemlock, Poppey; Fruits, Apples of Pern; Concrete Liquors, as the juice of Poppy or Meconium, also Opium, according to the vulgar opinion, which is not true, for they are hot. Moist in the first degree; Moist in the first. Herbs, bugloss, Pellitory of the wall, Mallows; Flowers, of bugloss, Mallows, Endive; Fruits, as the substance of Citron, In jubes, sweet Almonds, Seeds, of Mallows, Sesami, which is a white grain growing in India; Rootes, of Satyrion, bugloss, Lycorish, Mallows, Rape Rootes. Moist in the second degree; In the second. Herbs, as Violet Leaves, Water Lilies, Milk Thistles, a kind of Beet which hath no savour, which some call Spinach, Lettuce, Ducks-meate, Purslan; Flowers, of Water-lillies, Violets; Fruits, Gourd, Melons, Pompions, the juice whereof some place in the third degree, Peaches, Damask Prunes, ripe Grapes, Sugar. Dry in the first; Dry in the first. Herbs and Leaves, Beets, Cabbage, Camomile, Fennill, Violets, or Purple coloured Lilies, Malabathrum i. e. a certain Herb, she swims in Ditches in India without any Root appearing, Myrtles, Petty Mullein, or Longwort, Flowers of Ox eye, Camomile, Saffron, Violets, Melelot, Roses; other in the second degree, Fruits; as juniper berries, Chestnuts; Seed, as Beans, Fenegreek, Barley, Roots; of Briony, of the wild-Vine, of madder, Tamarisk, Marshmallowes, Wake-robbin; Gums; Frankincense, others in the second degree. Dry in the second degree, In the second. Herbs as, Pimpernell, Mugwort, others say in the first degree, Green Dill, Bettony, Bindweed, Calamus Odoratus, Endive, Sea Cabbage, Shepheardspowch, Horstaile, Chervills, Mints, wild Mints, Plantine, Rosemary, Spikenard, Walwort, Fumetory, Burnet, Sorrell, Vervine, Shepherd's rod; Flowers, of Peony, Scarlet, Anemone or wind Flower, ground Pine, Wood-bines, Staechadoes; Fruits, the Oily acorn, Capers, Quinces, Ciprus-nuts, Nutmegs, Pares, Pistach-nuts; Seeds, Fennell, wild Saffron, Lentils Ervum, Millet, Rice, Poppy, Nightshade; Roots, of Caper, Cichory, Radish, Wood of a Santall Tree, Tears, Gums and Rossins', as Galbanum, oppopanax, dry Pitch, Myrrh, Storax, Mastic, Hony. Dry in the third degree, in the third. belonging to metals, as flower of Brass, Brass, the dregs of Brass, Draggon-wort Salt, Solder of Gold, or Saltpetre, Brimstone, red vitriol; Herbs, and Leaves, Fearne, Yarrow, Cinqfoile, Poley Mountain, Trifoile, Wormwood, Southernwood burned, Dill burned, Parsely, Asarabecca, Ammi, Calamints, Germander, Ground pine, Epithimum, Hyssop, Juniper, Marjerom, Horehound, Origanum, Maiden beets, Wildstone, Parsly, S●eezing-wort, Rue, Savine, Willow, Water-mints, Time wild Bettony; Flowers, of Pomegranates, Epithimum, Ground pine, Wildwood-bine; Fruits, of Cloves, the Fruit of Balsamum, Oake-Apples, Pepper, Juniper-berries; Seeds, as Grains which Dyers use, I think he means Cutcheneale. Dill, Parfley, Ammi, of the herb Jerusalem, or Lady's roof, Aniseed, Carraway, Cumming, Coriander, Gith, bastard-stone Parfley, Millet of the Vine; Rootes and Barks, of sweet Garden Flag, the hollow Root of Galingale, Squills, common Cinqfoile, Trifoile, Mountain Osier, Asarabecca, Smallage, Leopards-bane, Hellebore, Cinnamon; juices, and Gums, Aloes, the juice of Sorrell, Acacia, Camphir, Musk. Dry in the fourth degree, Metalicks, Coppras, Arsenic, In the fourth. Sandaracha, Borax, or green Earth found in the Mines of Brass, Silver, or Gold, Misysory, that which the Apothecaries calls Vitroil, Milantheria or a Metallick juice; Herbs and Leaves; Wild-rue, Garlic, Cresses, Mustardseed CHAP iv Of Medicines proper to every part, or of corrobarating Medicines. BUt whereas occult qualities are often adjoined to the primary qualities, Medicines proper to every part. the same things altering are not convenient always, nor accommodated to all parts, but those things are to be chosen which have regard to every or any part in respect of the whole substance, and by reason of some occult proprieties have some singular Sympathy therewith, which Medicines therefore are called Appropriated or Corroborating Medicines, for so occult qualities concur with manifest, and conspire in acting, or performing together. cephalics Heating and drying: Bettony, Marjerom, For the head heating and drying. Sage, Hyssop, balm, Rosemary, Bay-leaves, Bay-berries, Savory, Rue, Calamint, wild Time, Spike, Lavender, Origanum, Herba Paralysis, I take it to be true love or one berry Flax, Asarabecca, Liver-wort, Squinanth, Spikes Maudlin, Fennell, Parsley, Smallage, Asparagus, bitter Almonds, Elecampane, the flower of Bettony, Raisins of the Sun, Pistack-nuts, the hot Seeds, Sweet-Garden-Flagg, etc. Wood of Cassia, Cinnamon, and the rest of the Aromaticks. Things cooling the Liver, Cooling it. Endive, Cichory, Garden Endive, Lion's Tooth, and those which belong to these, Purslan, Lettuce, Roses, Violets, Water-lillies, Sorrel, Strawberries, the greater cold Seeds, namely of Melons, Gourds, Cucumbers, and Citrons, and the lesser namely of Lettuce, Endive, Garden Endive, Purslan, Barley, Santalls', Camphire, Pomegranates, Currants, Barberies, Strawberries, Melons, Cherries, Sorrell, whey of Goat's Milk. Things heating the Spleen, Heating the Spleen. Ceterach, Spleen-wort, Epithimum, Wormwood, Fumetory, Hops, Rue, Calamint, Parsley, Speedwell, or Fluellin, wild Germander, Ground-pine, balm, Garden or Water-cresses, Scurvygrasse, horehound, Broome, Elder, Asarabbecca, the Roots of Polipody, Elecampane, Ferne, Fennel, Smallage, Vine-roots, Tamariske, Capers, Birth-wort, Madder, Bitter-almonds, Squils, Sweet-garden-flag, Ammoniack, Bdellium. Things cooling the Milt, Cooling the Spleen. Mallows, Endive, Cichory, Purslan, and for the most part the rest of the cooling Hepaticks. Things heating the Reins, Heating. the Reins. and Bladder. and Bladder, Venus' hair, Rue, Saxifrage, Betony, Lovage, Fennell, Rocket, Mugwort, Calamints, Eringo, Sparagus, Buttchers' Broom, Burnet, Liquorish, Parsley, Smallage, Nettles, Carrots, Dropwort, red Madder, red Parsnips, Grumwell, juniper-berries, flowers of Camomile. Cardomoms, Turpentine Chervill, Almonds, Pistack Nuts, the Kernels of Peaches, Cherries, Roots of Capers. Things cooling the Kidneys, Cooling the Reins. Mallows, Lettuce, Purslan, Pellitory, Barley, the four great cold Seeds, Poppy, Lettuce, Fleawort, Quinces, Pepons, Stone-berries, Violets, Flowers of Water-lillies, Camphire, Santalls', Sorrell, juice of Lemons, Melons, Currants. Things Heating the Womb, Heating the Womb. Mug-wort, Mother-wort, Bettony, Dittany and Origanum, Pennyroyal, alamints, Marjerom, Sage, Time, balm, Summer or Winter Savory, Rue, Rosemary, Bay-leaves, Flowers of Camomile, Cumminseed, Aniseed, Fennel-seed, Carrot seed, Parsley, Smallage, Roots of Birthwort, Red Madder, of Eringo, Fennel, Parsley, Asparagus Burnet, Angelica, Valerian, Master-wort, the meat and liquor of the Indian Nut, Bay-beerries, juniper-berries, Cloves, Nutmegs, Mace, Sweet garden flag, Cinnamon, Wormseed, Saffron, Galingale, Myrrh, Castor. Things cooling the Womb, Water-lillies, Violets, Roses, Cooling the Womb. Quinces, and the Syrup thereof, Purslane, Lettuce, Garden-Endine. Hot simples belonging to the joints, the Gout, and diseases of the sinews, Marjerom, one Berry Herb, Lovage, Bettony, Groundpine, Rosemary, Sage, Bay-leaves, Lavender, Staechados, Mugwort, and most of the chephalicks, Castor, earth Worms. CHAP. V Of extenuating, and preparing of humours. Out of this form of humours are sought digerent, Of cleansing and preparing. digestive, or preparing things; so called, all which, since they hinder nature in acting, take away and change the qualities, which resist the action of native heat, namely they cool too much those things that are hot, and heat too much those things that are two cold; they moisten dry things, and dry up moist things, they attenuate what is thick, and incrassate what is thin. Namely yellow choler is to be corrected with cooling, Cholers. moistening and thickening things, Phleagme is to be prepared with heating, drying and attenuating things; melancholy humours are to be corrected with things moderately heating, moistening and attenuating; black Choler is to be prepared with things that are very moistening & attenuating. And those things are to be used which are fitted to every part, according as the humour resides in this or that part, cold cephalicks prepare and digest choler in the head; cold Thoracicks, in the Breast; cold Cardiaacks in the heart, things cooling the Ventricle, in the stomach; cold Hepaticks in the Liver. Hot Cephalicks prepare Phlegm in the head; Phlegm. hot Thoracicks in the Breast, hot things appropriated to the Ventricle prepare phlegm in the stomach; hot Hepaticks in the Liver; things heating the Reins in the Reins; hot things appropriated to the Womb in the Womb. These things prepare Melancholy, Melancholy and black choler. and black Choler, Fumitory, bugloss, Borage, Spleen-wort balm, a kind of bind weed growing about flax, Venus' hair, common Germander, ground-pine, Hops, Barks of Citrons, Fennell Rosemary, juice of Apples, Ceterach, Capers, Epithymum, Violets, Butcher's Broom, the flowers, and seed of Tamariske of Basil, Ashen Keyes. CHAP. VI Of Emollients, Relaxing, Rarfying. etc. EMollients are those things which power our that which is concreate, Emollients. such are those things which neither are very hot nor exceeding dry; many hot in the second degree, and something moist, and moreover having a clammy or emplastic force, such as are the Leaves and Roots of Mallows, and Marsh Mallows, the Roots of white Lilies, Orach, English Mercury, the Seed of Mallows Sesami, (a white grain growing in India) Flax, Fenugreeke, Marsh mallows, Fat Figs, Simple Oils, the Fat of Hens, Sow's Fat, Calves, Kids, Sheep's Fat, and such like, almost all Marrows, fresh Butter, Wax, Pitch, Rosin, Bdellium, Amoniack, Storax melted, Laudanum, Galbanum. To these are opposed hardening and binding things, Things hardening. Loosening. which are cold and moist, Sengreen or life everlasting, purslan, Fleawort, Ducks-meat Nightshade. Things loosening are compared to those things which bind, which joining together humours contrary to nature, become hard, and are especially those which when certain matter, or a vapour or Wind fills the space of the parts, and extends them, rarefies them, and attenuates and discusses an unsavoury spirit and matter, such are those things that are moderately hot, moisten more largely, and are of a thinner substance, that they easily penetrate and are not hindered by thickness, as Lilies, Oil of Camomile, Flaxseed, Fenugreek, Fats, Butter, Greasy wool and such like. Condensing things, Condenseing. are of a more watery nature and contract more weakly, and moreover they close the thin and external Pores, they contract and condense, but they cannot contract the whole part on every side, and powerfully, such are cold water, Purslan, Sengreen, Fleawort, Mouse-eare, Duck's meat, Thistles, green Houseleek, the greater and the lesser. Styptic things are cold and astringent, Binding and Stopping condensing. and of a thick substance, for being applied externally, by their thickness they stop the pores, and by their frigidity and siccity they contract the part and close them into one another, of that kind are those which are otherwise called binding (or astringent) the Barks of Pomegranates, Frankincense, Mirobolanes, the Roots of tormentil, Rhubarbe Torrified, Plantine, Horse-tail, little double Daisies Blood-wort, or Wallwort, the Flowers of Pomegranates, Flowers of Roses, Sorrell; seeds; as of Plantine, Roses, Purslan, Ciprus-nuts, Myrtles, Quinces, Pares, Medlars, Mulberries not ripe, cervises, or (swallow Pares,) the fruit of a cornel or Dog Tree, Oak Apples, Kernels of Grapes, Cups of Acorns, the red juice of Wax or Honey in the Hony-Combs; also such juice of Wild Honey, Acacia, Mastic, vermilion, Spode, which is soot arising in the rising of Brass, Pearls, Coral, Bolearmenack, Irish flat, Alum, Lapis Haematites or Bloodstone, Iron. To condensing things are opposed rarifying things, Rarifying. and to astringent things, opening things; rarifying things are those which open the Pores of the Skin, and render the passages wider, that Vapours may be blown or breathed out the better; such medicines are hot, but moderately, of thin parts and not drying, as Marshmallows, English Mercury, Dill, Flowers of Camomile, of Melilot, of Elders, seed of Fenugreek, Flax, dry Figs, old Oil, Butter. Opening things are those as dilate the Orifices of the Vessels, whence they may be called in general aperient, Opening the mouths of Vessels. yet those are principally called aperient, which penetrate deeper and attenuate the thick humours, and are hot in the second degree, endued with somewhat a thicker substance, and are not easily dissipated until they have performed their operation, A hemating and to this purpose bitter things are very useful next to these are attenuating and cutting, which divide, dissolve, and make less, those attenuate the thick, these the viscide, and glutinous humours, and are moreover of a thinner substance, and hot for the most part in the third degree; also sharp, and such as appear biting and hot, to the smell, or taste, or to them both, and have a nitrous and salted savour, or they are sharp and bitter, such are the five opening Roots, Opening. so called, that is, of smallage, Fennell, Sparagus, Parsley, and Butcher's broom, Grass, Cichory, Eringo Rootes, Gentian, Ferne, wild or Garden madder, Century the greater, Asarabecca, Capers, of Tamarisk, of Ashes, Fumetary Wormwood, Agrimony, Venus' hair, Liver-wort Ceterash, Ground-pine, common Germander, Bind-weed, horehound, Calamints, Pennyroyal, Scurvygrasse, Brooklime, Water-Cresses, Aniseed, Fennell, seed, seed of Ammi, of Agnus Castus, red Parsnibs, Lupins, bitter Almonds, Capers, Kernels of Peaches and Apricocks, Cinnamon, Cubebs, Sorrell, Ammoniack, the juice of Lemons. To these are opposed, jucrassating. Incrassating things, which make the thinner, and more liquid juices thicker, such are cold or temperate, without sharpness, of a thick and terrene substance, whereby, whilst they mingle themselves with thinner humours, they make them become of a thicker consistence, as Bolearmenack, Poppy, Sorrell, Rice, Lentils, Quinces, wild Pares, Amylums, 'tis a food made of Corn without grinding, Chalybeate milk, the juice of Pomgranets. emplastics, Playster-like things. and those which have a clammy and Plaister-like force, are such as adhere close to the passages of the body, and Plaster up the pores, as it were, fills them, and stops them, and they are certain dry, and earthy things, yet without mordication, and acrimony, and if they are bedaubed over the passages of the body, they are hardly taken away, but some are also mixed with an aqueous, and acrious humour, yet are tenacious, as sweet oil, such are Amylum, Pompholix, which is the soil that runs off Brass, Ceruse, Chalk, Bowl armenack, Irish slat, Parget lethargy; burned lead, the Roots of Marsh Mallows, Lilies, seed of Fenegreek, all mucilages, and bran of wheat, Kernels of Pine nuts bruised in water, Gume Arabeck, Sarcocolla, Tragacanth, fresh Grease, and Marrows, fresh butter, new cheese, whites of an egg, wax. To these are opposed detergent things, Detergent things and such as open obstructions. and such as open obstructions, whereof these cleanse filth in the superficies of the body, or skin, but those are of a more subtle substance, & penetrate into the pores also, and open obstructions, and moreover have a drying faculty, with tenuity of substance whether they be hot, or cold, for there are both hot and cold abstergent things, such as are all salt things, bitter things, nitrous things, as horehound, Century the less, smallage, Wormwood, Southernwood, Hyssop, Cresses, the bread of Lupins, and of a kind of Pulse called Orabus, Agrimony, Beets, Germander, Tansey, Bitter Almonds, Roots of Birthwort, Orice, Gentian, Solomon's Seal, Barley, Bran, juice of Lemons, Nettle-seed, Roots of Tamariske, Bark of Capers, Spleen-wort, Squils, Nitre, Hony, Sugar, all Lixuviums, or Lee, Whey, the Galls of living Creatures, Verdy-grease. CHAP II. Of Medicines easing pain and causing rest. Lastly, in this form are Anodunes, Narcotticks, Anodunes. and Hypnoticks, those are properly Anodunes which do not take away the cause of a disease or dull sense of pain, but such as mitigate the pain, the cause still remaining, and they are temperate and gentle, and endued with mild heat, and are soft to the touch, and bring forth a pleasant and sweet pleasantness and those perform that, which are endued with a lukewarm and gentle heat, and are most like to our bodies in temperature, and for the most part are soft and fat, and loosen, and mollify the part that it may be the less apt to be sensible of pain, such are Camomile, Melilot, Dil, Elder, Mallows, Marshmallows, Seeds of Fenegreek, Flax, wheat, Barley, sweet Oil of middle age, Oil of sweet Almonds, and other things prepared, with those above, fresh Butter, Hen's grease, Goose-grease, Whites of Eggs, the pulp of White-bread, warm Milk, and Hogs grease. Narcoticks or stupefactives, and Hypnoticks, Stupefactives. which also cause sleep, but neither take away the cause of pain, but stupefy the part and benumes it, lest it should perceive that which is painful; but this power depends on a hidden quality, such like are Lettuce, Water-lillies, Poppey, Nightshade, Henbane, Mandrake and Opium. CHAP. VIII. Of drawing and Repelling Medicines. IN the second form, Things drawing. are drawing Medicines which attract the humours, and Spirits out of the body into the superficies, but that attraction is made by heat, concurring with tenuity of substance, and some are hot and dry in the second degree; which draw moderately; others in the third degree, which draw more; others in the fourth, which draw most of all, and with their heat raise a tumour in the skin, with redness, and lastly raise blisters, from whence medicines to take away hair, Synapismes, Rubifying medicines are prepared, such are the Roots of both kinds of birthwort, selandine, sow-Breed little Dragon, Gentian, wild Pellitory, or sneezing-wort, Crowfoot, mustardseed, Cresses, Garlic, Onions, Leaven, an Indian fruit like a Birds heart, and the juice like blood, Gum Amoniack, Galbanum, sagapenum, Opoponax, dry Pitch, Propolis● or that in a Honeycomb like wax, Goose dung, Pigeon's dung, Hen dung, and Cantharideses. Repelling Medicines, Repelling. are opposed to attracting, and prohibit the Flux of humours, or represseth and casteth back that humour which hath newly flown in, and moves therein, and is not as yet settled; they perform this, either because they are cold or astringent, or because they have both a cold and astringent faculty; astringents are twofold, some are cold, others not, and indeed they do most powerfully bind, which are both cold, and astringent; those things which repel only by frigidity and are aqueous, or humid, are cold water, life for ever, Purslan, Ducks-meate, Endive, Lettuce, Nightshade, Coltrops of water, Venus' Navel, Fleawort, the white of an egg; cold things astringent are, Plantine, narrow leaved Solomon's seal, Mouseare, Daizes, Horsetaile, the leaves of service, or sherve Tree, Oak, Myrtle, Medler Tree, the Flowers of Rosemary, Pomegranates, Mirtle-berries, Oak Apples, swallow Pears, Barberries, Myrtles, the Barks of Pomegranates, the Roots of wild Damsons, the Roots of Barberries, the Roots of Cinqfoile, Snake-weed, (or small Bistort) Tormentill, the juice of Pomegranates, Acacia, Hypocistis, or sap of the Roots of Cystus, of Mulberries not ripe, sorrel, Irish slat, Bolearmenack, sanguis Draconis, Tutty, hot astringents are, spike, Aloes, Frankincense, Myrrh, Cypress, Wormwood Cyprus Nuts, the Barks of Frankincense, sweet Garden Flag, Allom. CHAP. IX. Of Ripening things, and such as generate quitture; also of such as generate flesh and Brawny flesh, of such as dry and cleanse green wounds and cause Cicatrizing, and of such as generate seed and milk. IN the third form are ripening and concocting things, Ripening and concocting of quitture. and moving purulent matter, so called, because without them the generation of matter cannot be easily performed by nature, to wit, such which by the similitude they have with our bodies, defend and increase the substance of the native heat, for they are temperately hot, and together moist and emplastic, which shutting the pores or passages, keep in and retain the spirits and heat, such are sweet Oils Oil, mixed with water, Butter, Hog's grease, Calf's grease, the seed, and Bran of Wheat, Wheaten Bread, the seed of Fenugreek, Flax, Leaves and Roots of Marsh Mallows, Mallows, Bears breech, the Roots of white Lilies, boiled Onions, dry Figs, Fats, liquid Pitch, (or Tarr) liquid storax, Turpentine, whereof some if they seem, either too dry or too moist, you must observe, that scarce ever one of these is used alone but are mingled with others, so that the dryness with the one may be corrected with the humidity of the other, and the humidity of the one with the dryness of the other., Sarcotticks or such as generate flesh, are such as conduce, Generatting flesh. to the restauration of flesh, in a wound or ulcer, indeed nature, in the generating of flesh is the chief workman, yet certain Medicines do as it were help nature, whilst they remove excrements, which hinder nature in the generation of flesh, and preserve the native heat of the part, of which kind are those which moderately heat and dry, and cleanse filth, without biting according to the plenty of quirture, and according to the humidity or ficcity of the body, sometimes they ought to be gentler, sometimes stronger, such are Barley Bread, a kind of pulse, called Ervum, Fenugreek, Tragacanth, Orice, Tears of jet, Mastic, Frankincense, Scamony, Aloes, Myrrh, Honey, Walwort, Saint Johns-wort, Birth-wort, Brass Oare, Ceruse, Tutty, Pompholix, lethargy, (or white lead.) Next to these, are Glutinating Medicines, which are no way detergent, but rather astringent, and by some are called Enaima, and Traumatica, because they are used, in joining of bleeding wounds, although they are used in cleanseing Ulcers, from which nevertheless, according to more or less, Epuloticks differ from such as cicatrize, as being such dry more to the second degree; in the number of Glutinatives, and Epuloticks are, Alum, lethargy, Circocolla, Aloes, Bolearmenack, Led, Brasse-oare, Birth-wort, the Flowers of Pomegranates, Coral, Horse-tail, Plantine, Walwort, Tormentill, Cinqfoile, common Thurrow-wax, the Barks of Pomegranates, Frankincense, Burnt-brasse washed, Sanguis Draconis, Lapis calaminaris, Antimony. Hereunto belongs Traumatick Medicines, or vulnerary which by a peculiar force, so dispose the blood, that fit and laudable flesh by it may be restored, or any other substance, which is lost, and afford matter, for potions, called vulnerary, such are, great and little Cumfery, Sannicle, Cumfery, the middle Sarracenous, Agrimony, Winter-green, Fluellin, Mug-wort, Plantine, Savine, Horse-tail, Roots of Tormentill, of Gillyflowers. Carduus Benedictus, common, or water Burnet, Ladies-mantle, Periwinkle, Pimpernell, Golden-rod, Mouse-eare, century the less, Adders-tongue, Bittony Saint Johns-wort, Flowers of Roses, Tansey, Veruine, Dragon, Rupture-wort, Cinqfoiles, Scordium Crabs-eyes, Mace, Bolearmenack. To Epuloticks Poroticks all such as generate brawny flesh are ne'er alike unto, For wounds. Generating hard flesh. namely, such as dry, thicken, harden, moderately heat, and bind, some of those are given inwardly as juice of Primroses, or Cowslips, powder of the Roots of Agrimony, of the juice thereof, but especially the stone called Osteocolla, some are externally applied, as Bolearmenack, meal, Osteocolla, Aloes, Cypress Nuts, Frankincense, Tragacanth, Acacia. Lastly to this form belongs those things which generate and increase milk and seed, Generating milk. they help to generate milk which conduce to the generation of good blood, and draw blood to the paps, and have a peculiar consent with the breasts, such are Fennell, and Dill green, Lovage, Smallage, Poley Mountain, Rocket, Milke-wort, yet some are said to conduce to the generation of milk, by a propriety of substance, as powder of Crystal, Fennell, and Dill. In like manner those things for the generation of seed, Generating seed. which generate the best blood, which is the matter of seed, and what things soever, draws the blood to the vessels, appointed for generation of seed, or which fill the seed with wind, namely moderately moist, and temperately hot, such are, Leeks, Parsnips, a kind of a land Scinks, Satyrion, Rocket, Ashen Keys, Flax, Garlic, Onions, Eringo-rootes, Turnips, Asparagus, Greenginger, Galingale, sweet Almonds, Pine-nuts, Pistack-nuts, Chestnuts, Dates, Beans, Carrots, Rapes, Rice, Artechoakes, obstreae. CHAP. X. Of such things as make the skin red, of such as cause Blisters, and of such as cause scabs, or pustules, of burning things, of Corrosives, Putrifactives and of such things as take away hair, and extinguish milk and seed. TO the fourth rank, belong those things which break forth, Rube-factives, Escaroticks, and Caustics, which are all comprehended under the name of fiery Medicines, which with their exceeding heat, as the heat of water, or fire, burn our bodies, the most gentle amongst them, are Rube-factives which only by heating make the skin red, and those things which lie deeper, they draw out to the skin, Making red the skin. such are Mustardseed, Cresses-seed, Nettle-seed, the Roots of Thapsiae. The stronger are called vesicatories, Vescicatovies. because they raise Pustules, or Blisters, which for reason of the tenuity of substance, burn only the Cuticle, or the outmost skin, and draw out a humour, like scalding water, and pull the cuticle from the cutis, or thick skin, and raise it into a bladder, such are, Cantharideses, Mustardseed, Leaven, strange Clematis, Crowfoot, seed of Cresses, Thapsia, root of Showbread, bastard Pelitory, sea Onions, Garlic, Dovesfoot, Euphorbium, Pidgeons-dung, Soap. The more vehement are Escaroticks, or such as cause, Burning the skin. Pustules, or scabs, so called because they burn, not only the cuticle, but also the cutis, and they are hot in the fourth degree, and of a thick substance. Amongst these the most vehement are Caustics, Caustics. and they are endued with extraordinary heat, and thick substance, which burn not only the skin, but sometimes the flesh also, as burnt brass, Flower of Brass, quicklime, vitriol, Ashes, or dust of the dregs of Wine, little Figs, Ashes, of Ash, Savine, Pigeon's dung, Ashes of a Pine Tree, white Hellebore, Salt prepared of the lee, whereof soap is made, Arsenic, Oaker, Mercury sublimate. Besides these there are yet other Medicines which draw away flesh, Of corroding Medicines. and they are twofold, some of them are more mild and are called Cathereticks, others are stronger which are called styptics; Cathereticks, or Corrafives, are those which take away the soft flesh that is growing, and only the outmost which they touch, they take away the superficies not suddenly, but by degrees, but cannot be endured to penetrate deeper, and they are hot in the third and fourth degree, the milder whereof are, Aloes, Alum, Ashes of Oystershells, Ashes of an Oak and Figtree, the Roots of a white Vine, of black Hellebore, Lead, Antimony calcined, the stronger are quicklime, Flower of Brass, Brass, vitriol calcined, Quicksilver precipitated, sublimate vitriol, Mysysory (a stinking mettle) burned lead, Things putrifying. oil of vitriol, sulphur. styptics, or Putrifactives, soften the harder flesh, and they are the hottest, driest, sharpest, pernicious to the native heat, which seeing they destroy, and take away the radical moisture there followeth corruption of the substance of the part, and a deadly putrified disease, such are Arsenic, Orpiment male, or Female stone-Ferne; Pityocampes, they are worms in a Pine Tree, Monks-hood, sandaracha. Hereunto belongs those things that take away hair, Taking away of hair. and extirpate them, and make the part bald, and if they continue long in the skin, they exulcerate and burn it, such are strong Lee, quicklime, Aunts, or Pismires eggs, sandaracha, Orpiment and Arsenic. Moreover concerning the extinguishing and diminshing, Consuming of milk. of milk and seed, the generation of milk is hindered, if the store of blood be abated, which medicines do not perform, but spare diet, or exercise, hinders the coming of it to the breast, such are Hemlock, Lettuce, Ducks-meat, Water Lilies, Gourds, Nightshade, Purslan, Poppy but milk that is generated, is consumed, by the seed of Agnus Castus, Calamints, Cummin, Rue, sage, saffron, Bean-meale, Lupins, Basil, some whereof are thought to do it by a hidden propriety. Certain things consume the seed by a hidden propriety, Extinguishing the of seed. Rag weed, the lesser, as the greater, increaseth seed; seed of Agnus Castus, some by a manifest quality, cold things as Hemlock, Gourds, Henbane, Lettuce Water Lilies, wood-sorrel, Duck's meat, sorrel, and sour things; hot, Calamints, mints, Dill, Rue, Hemp seed, hereunto also belongs Saccharum Saturni, Camphir, which J. C. Scalliger denies. CHAP XI. Of Medicines purging through the Paunch. IN the first rank of Medicines, Purging. namely of those things which consist in the ablation of any thing, and are first called Purgers, but although all Medicines in general which free any parts of the body from excrements may be called, purging medicines, yet use hath brought it to pass that they are only called purging medicines in particular which lead or drive out excrements through the paunch or by Vomit; those which move by the belly and are wont to be known by the common name of Evacuators, are twofold; some of them are such as only purge the belly and the first passages, others there are which reach beyond the first Region of the body and emit peccant humours from the more remote parts, which are more properly called purging medicines. The former sort the Greeks call, Lenitives. Enteropticks and Hypacticks that is Lenitives, because they evacuate ordure out of the guts, and whatsoever is detained in the stomach, guts, and Orifices of the Meseraick veins, whether they do it by mollifying and humecting, or by lubrifying and making the passages slippery, which they imbue, and melt the feces with their abundant humidity, and provoke to expulsion, or whether they have a power of cleanseing and moderately stimulating, such are, Mallows, March mallows, the herb Mercury, Beets, Cabbage, Blites, Orach, Sparagus, Raisins, sweet Prunes, Sebestens, Cassia, Manna, Tamarinds, Oil of sweet Almonds, new fat Figs, sweet Apples, fat Broths, especially of a Cock or Capon, whey, especially of Goat's milk, fresh new Butter. But the purging medicines are most properly so called which send forth some particular humour out of the body, Things purging. from some particular part, but by what power they perform, that is much controverted by Physicians, but it seems probable, that purging medicines, whither taken in at the mouth, or by Clyster, or externally applied to the Navel or belly, or held in the hands or applied to the Buttocks are resolved and deduced into action by the heat of our bodies, and that the most subtle spirits, or vapours of them so resolved are dispersed through vessels into the whole body, and by a hidden force and propriety, move the humours which have affinity with them, and trouble, stir up, and as it were ferment them, and do so bring it to pass, that those humours, which before were mixed with the blood, and caused no disturbance of nature, being now stirred up and separated from them, and being by themselves, stimulate nature and irritate it to expulsion, which being irritated by the help of the expulsive faculty, expels both the purging medicine, and the vicious humour so separated by the power thereof, together from the body. But some of them are more mild which mollify the belie, More mild. yet besides this, by a propriety of substance, regard a peculiar humour, and exercise their strength beyond the first ways, to the Liver and Spleen, yet cannot evacuate from the whole, and the most remote parts, some are stronger, which evacuate beyond the liver and spleen, also greater vessels, but the strongest purges are those which evacuate humour's out of the whole body, Stronger. and from the most remote parts, and from the smallest veins; there are divers purging medicines, yet the difference of them is drawn, from the number of humours, which they attract by a specifique force. Cholagogues, or the milder purgers of choler. MAnna, Manna. which in the broth of Beef, or of a Hen, or in a decoction of Prunes, or Tamarinds being dissolved, and strained, is given, from an Ounce to three Ounces. Cassia Fistula, Cassia. is a benign, and safe medicine at all times and all ages, unless that it be too moist and windy, and therefore, not so convenient for a moist stomach and guts, and those that are flatulent, and therefore is corrected with Cinnamon, Mastic, Aniseed, Fennell-seed, Carrot-seed, half a drachm, or a whole drachm being added to it, it is exhibited conveniently in the form of a Bolus, or Electuary not long before meat, it is given from half an Ounce, to two Ounces. Tamarinds are cold and dry in the second degree, Tamarinds. and for that reason, repress the Acrimony, and heat of humours, the pulp is given from an Ounce to two Ounces, or three Ounces, and in decoction to four Ounces. The juice of Roses, syrups, Juice of Roses. and Hony prepared of it gives strength to the Liver, and bowels, but it opens the Orifices, and therefore is not to be given to such as are with child, the juice is given to two Ounces, the Syrup and Honey to three or five Ounces. The juice of Violets, Violets. and Syrup and Honey prepared thereof, mitigates heat, the juice is given to two Ounces, the syrup and Honey to four Ounces. Flowers of the Peach-Tree cause not only purging, Peach Tree flowers. but vomiting, and purge choleric and serous humours, the Syrup prepare of them is given to two Ounces, the conserve to an Ounce, a handful of them infused in Wine doth perform the same. Myrobalans, of citron colour, are cold and dry, Citron Mirobolanes. and also bind, and strengthen the bowels, but are not so safe in obstructions thereof. Their astriction is corrected, opening things being added, and sweet smelling seeds, or if they are rolled in Oil of sweet Almonds, they are given in powder to two drachms, in infusion to five drachms, or to an ounce and half. Rupbarbe besides yellow choler, purges phlegm also, Rhubarb. but not unless it stick in the nighest passages, 'tis principally good for the liver, it hath divers parts, by the more subtle it purgeth and opens, by the thicker it binds, whence it is profitable, in a Lientary, and in spitting of blood, and in ruptures, it is given in the substance, in infusion, and decoction, it ought to be very light, and the third part of Cinnamon is added, or of Camels hay or Indian spike, when you are willing only to purge, or open, 'tis best given, in infusion or decoction, but when you would bind and corrobarate 'tis best in the substance; there is also an extract prepared hereof, but such a one, which scarce purgeth stronger, than when it is taken in the substance, 'tis given in the substance 'tis given in the substance, to two drachms, in infusion to half an ounce. Turpentine moves not only the belly, Turpentine. but the bowels, and especially cleanseth the reins, 'tis given with the powder of Rhubarbe, or Liquorish, and Sugar, made into a Bolus, or with the yolk of an egg, and some convenient water therewith, wrought in a Mortar, and reduced into a milky liquor, 'tis given from half an Ounce to six drachms. Aloes is hot in the second degree, Aloes. and dry in the third, exceeding bitter, it opens the mouths of the veins, and therefore is hurtful to such as are apt to a Flux of blood, or such as are with child, and Hectics, and no way safe for those that are hot and dry, extenuated; 'tis most conveniently taken prepared, and extracted, and Rosated, as they call it, by reason of the bitterness of it; it is not easily given in drink, but in pills, most properly it is given from half a drachm, to three drachms. Fleabane, Fleawort. or Flea-wort, the seed of it, is cold and dry, in the second degree, 'tis given in infusion, rather than in the substance, from a drachm to three drachms, Stronger Purgers of Choler. SCammony is hot and dry in the third degree, Scamony. it primarily draws choler, next phlegmatics humours, and unless it be well corrected, it frets the guts by its Acrimony, causeth gripe, opens the Orifices of the vessels, and causeth a Flux of blood, it hurts the stomach, Liver, and Heart, inflames the Spirits, and stirs up fevers, and therefore we seldom use it alone; and lest that it should offend, fat things are to be added, Tragacanth, Bdellium, Oil of sweet Almonds, seed of Fleabane, Cinnamon, Spike, Galangale, Fennell seed, Quinces, Mastic, the juice of Violets, and Roses, 'tis commonly corrected, by boiling it in the substance of a Quince, and so prepared 'tis called Diagrydium, there is also prepared of it an extract, or Rosin, it is scarcely fit to be given to those that are weak although it be corrected, the dose of Dyagridium is given from five to fifteen grains, some give a scruple. Asarabecca purges choler by the Paunch, Asarabecca. yet it rather stirs up vomit, it attenuates, opens obstructions, and provokes sweats, and therefore is profitable for Hydropic and Icterick persons, and such as are troubled with the Spleen, and Quartan Agues, 'tis given in the substance from half a Drachma, to two Scruples or a Drachma, in infusion from two Drachmas to half an ounce. The milder purgers of Phlegm. MYrobolans, Mirobolanes Chebula. Emblica. Bellirick. Chebulae which principally are good for the Brain and Liver, according to some evacuate also black choler, emblick which are appointed for the heart, Spleen, and Liver, as also Bellirick are cold, in the first, and dry in the second degree, and bind, and therefore are not safely given in obstructions, nor when Phleagme tenaciously cleaves to the guts, but in fluctuations and in a looseness, and when there is need of astriction and corroborating, they are prepared according as we have showed before, of the Citron Myrobalams there is also the same Dose to be given. Agarick purges only thin, and aqueous Phlegm, Agarick. but not viscide, and principally evacuates the excrements of the Brain, and Lungs, opens obstructions of the bowels, yet is not so commodious for the stomach, and therefore the third part of Cloves, Nutmegs, Galingale, Sal gemmae, Ginger, are to be added, 'tis given in the substance to two Drachmas, in in infusion from two Drachmas to half an ounce. Mechoacan also purges Phlegm, Mecoacan. but principally serous and aqueous humours, and therefore is excellent in Dropsies; 'tis corrected with the third part of Cinnamon, Aniseed, Mastic, 'tis given from a drachma to two drachmas in the substance, in infusion to half an ounce. The stronger Purger of Phlegm. TVrbith is hot in the third, Turbith. and dry in the second degree, and draws out thick and viscide Phlegm, even from the remotest parts, 'tis hurtful to the stomach, and causeth loathing, and Vomit, and is not to be given to children, old men, nor Women with child, and when 'tis exhibited, it is to be corrected with Ginger, Mastic, Pepper, Cinnamon, Fennel, Galingale, nor must you eat fish after you have used it, the Dose is from 2. scruples, to 4. scruples, in the substance, in infusion or decoction from 2. Drachmas to 3. Drachms to 6. Drachms. The seed of wild Saffron, seed of Carthamus. purgeth Phlegm, and Water, by Vomit and Stool, and is very good for the breast, and such as have Asthmaes, but it is an enemy to the stomach, and therefore it is used with the third part of Cinnamon, Galingale, Mastic, or Aniseed, 'tis given in decoction from three Drachmas to six Drachmas. Coloquintida, Coloquintida. which is hot and dry in the third degree draws out Phlegm, from the most profound and more remote parts; Turbith cannot evacuate but is a most vehement medicine, and offends the stomach and Guts, when there is a Fever; and moreover it useth to be sod, being bound up in a skin, 'tis seldom used alone, but instead thereof Troches made thereof, which they call Alhandals, are wont to be used, 'tis corrected with Cinnamon, Tragacanth Mastic, Bdellium, and other Cordiacks, hepatics, and Stomaticks, 'tis given to 15. grains or a Scruple. Hermodactiles purge thick Phlegm especially from the joints, Hermodactiles. and therefore is good for the Gout; 'tis corrected with Cinnamon, Ginger, Mints; 'tis given in the substance from 2. scruples to a Drachma and half, in infusion, or decoction to 3. Drachmas. Euphorbium is hot and drying the fourth degree, Euphorbium. it draws away thick and tough Phlegm, but more powerfully aqueous humours, it is a violent medicine, and 'tis reckoned by some, rather among poisons, than purgers, 'tis corrected by cordials and stomaticks, Oil of sweet Almonds, Saffron, Mastic, by the sourness of a Lynion or Cytron, the highest Dose of it is 10. Grains. Opopanax heats in the third, Opopanax. and dries in the second, it draws away thick and viscide Phlegm from the more remote parts and joints, 'tis corrected with the third part of Ginger, Spike, Cinnamon, or Mastic, 'tis given from half a Drachma to a Drachma. Sagapenum is hot in the third, Sagapenum. and dry in the second degree, and purges clammy and thick humours from the Bowels, Brain, and more remote parts especially of old men hurts the stomach and Liver, it is corrected as opopanax, the Dose is from half a Drachma to a Drachma. The milder Purgers of Melancholy and black humours. INdian myrobolans are of the same nature with the rest of them, only that these purge melancholy. Indian. Mirobolanes. Polipodie evacuates adust choler, as also Phlegm; 'tis profitable in diseases of the splcene, and Hypocondries, Polipodie. the Dose is from a Drachma to three Drachmas, in infusion to an Ounce and above, Epithymum purges a dust choler, Epithymum. and Melancholy without trouble, and is profitable in Diseases proceeding from hence; yet because 'tis hot and dry in the third degree, 'tis safer to be used in Winter, then in Summer, 'tis given in the substance from two Drachmas, to three Drachmas in infusion from half an ounce to an ounce. Sena is as it were the middle betwixt the stronger and weaker, hot in the second, dry in the first, Sena. 'tis a very useful medicine, which not only evacuates adust humours, but also choler and Phlegm; cleanseth all the bowels, and is convenient for all ages, when 'tis more dry 'tis not inconveniently corrected with the flowers of Violets and Borage, Ginger, or Cinnamon, or the fourth part of Galingale is added to it, the powder is given from a Drachma to two Drachmas, in infusion from half an ounce to an ounce. The stronger purgers of Melancholy and adust humours. LApis Armenius purges dull, thick, melancholy humours, Lapis Armenius yet more gently than Hellebore, it is corrected by washing in Cordial waters, 'tis given from half a Drachma to a Drachma, or sometimes to a Drachma and half. Lapis Lazuli hath the same virtue but is something weaker, 'tis corrected with Cordials, the Dose is the same. Lapis Lasuli. Black Hellebore is not usually to be given to children; Black Hellebore. women that are great, nor to weak bodies, and indeed it is more safely given in decoction, then in the substance, 'tis corrected with Cordials, and stomaticks; 'tis given in the substance from a scruple to two, nay to a Drachma, in infusion or decoction from a Drachma to half an ounce. Hydragogues and such as evacuate aqueous humours. THe juice of the root of Flowerdeluce is hot and dry in the third, Root of Orice. opens draws, out thin Choler and water; but for women with Child 'tis not so safe, because it provokes the months, 'tis corrected with a little Wine and Cinnamon, and Manna, or honey of Roses is added; or decoction of raisins of the Sun, 'tis given from half an Ounce to an Ounce and half, or two Ounces. Gratiola or hedge Hyssop purges by stool and vomit, Hedge Hyssop. but troubles not a little the body, 'tis corrected with Cinnamon, Aniseed, Liquorish, 'tis given in the substance to a Drachma, in decoction from half an Ounce to an Ounce. Elaterium or the juice of wild Cucumbers draws water and choler out of the Bowels, Elaterium. and happily draws forth the water of hydropic persons, but it provokes vomit also, gripes the bowels, opens the mouths of the Veins, and unless it be cautiously exhibited doth mischief; 'tis corrected with Tragacanth, Fleawort, Bdellium and Cinnamon; in the Dose you must not easily exceed six Grains. The rind and juice of the root spurge, Spurge. purgeth and gnaweth powerfully, and therefore is corrected with Bdellium, Tragacanth, Mucilage of Fleawort, Cinnamon, Spike, the Dose of the Bark of the Root is from six grains to fifteen grains, but of the milk (or juice) from three grains to eight grains. Mezereon whose force is fiery, Mezereum. exceeding sharp, exulcerating, biting, kindling Fevers, dissolving the strength of the heart, and noble parts, and purging choler violently; and Bilous serosities, 'tis corrected with Sorrel, with the juice of Pomegranates or of Quinces, of Purslan, Mucelage of the seed of Fleabane, the Dose in the substance is from six grains to ten grains, in the decoction from half a Drachma to a Drachma. Dwarf elder, Elder. Dwarf. or Dane wort and elder, the seed and middle bark, and juice of the root and leaves, draw out water, they are corrected with Cinnamon, the Dose of the berries is given to a Drachma, of the barks to two drachms, of the juice from half an ounce to six drachmas. Soldanella or sea Colewort are the best remedy to draw out water, but 'tis an enemy to the stomach, Soldanella. 'tis corrected with Cinnamon, and Ginger, the Dose is from a drachma to 2. drachmas, of the juice to half an ounce. Gummigote purgeth choler and water, Gummigote. and oftentimes causeth vomit, which is prohibited by the addition of the spirit of salt or Mace, the Dose is from five grains to eight grains. The root of jalap powerfully and with violence purgeth serous and black humours, 'tis given from a scruple to 2. scruples. jalap. Although each of these do purge single humours, yet some of them do purge other humours also secondarily, Rhubarbe, Aloes, Cassia, Agarick, Scammony, evacuate choler with Phleagme; Myrobolanes, Chebulae, Lapis Armenius, Lapis Lazuli, Phlegm and black choler. Sena, Epithymum, Polipodie, black Hellebore, purge choler, Phlegm, and Melancholy, the latter Physicians have drawn other medicines into use unknown to the Ancients, prepared of Venus Mercury and Mars. CHAP. XII. Of Medicines that cause vomits. SEcondly amongst evacuating medicines are such as cause vomitings, Things causing vomits. which indeed evacuate the stomach immediately, yet if they are too strong they draw the neighbouring Bowels and the greater veins, they perform that for the most part by a peculiar propriety, by reason of which they have an inclination upwards, yet some of them for a manifest cause, namely because they swim in the stomach and oppress it, and loosen the Orifice of the superior ventricle, such are all fat and oily substances. But some are gentle, others indifferent strong, others very strong. The gentle are simple water, or Barley water luke warm, The most gentle. especially with a little honey, and salt, drank by little and little at one draught, common oil luke warm, four ounces or six ounces, Hydromell largely taken, Hydreles to ten ounces, Figgs newly eaten, and cold water dranked after. The middle sort are the Flowers of Dill, The middle sort. as also the Seed of Orach, and of Radish, they are given from two drachmas to half an ounce, the root of Asarabecca, and Orach are given in the substance to four scruples; Bittony, the middle bark of a Walnut, to a drachma, in infusion to half an ounce, the green pill that cover the walnut shell dried in an Oven, from half a a drachm to a drachm, the juice of Radish to two ounces, the tops of green Elder, (or the berries.) The strongest are the Roots, The strongest. of Spurge, of Showbread, to a drachm; in infusion, from a drachm to two drachms; the Roots of white Hellebore, in infusion from half a drachm to a drachm, adding cardiacks, Flowers of Danewort, Barks, or Root; Flowers of broom, seed of broom, from two drachms, to half an ounce, the seed of spurge, the husks being taken of, ten in number, a water to provoke vomit made of green Walnuts and Radish Rootes, Ana, parts 2. of Vinegar part 3 d, being distilled, is given to two ounces or three ounces, white vitriol, Salt of vitriol, glass of Mars, and Flowers, crocus Metallorum, and from thence a water to cause vomiting prepared by Rulandus, Mercurius vitae etc. are in use with the chemists. CHAP XIII. Of Medicines causing Urine. OF Diuretic medicines, or such as cause Urine, some are properly so called, Diuretics. namely such as easily penetrate into the veins, and pour humours into them, they cut, and separate the thick from the thin; that they may so do, 'tis necessary that they be hot in the third degree, and of a most thin substance, of this kind are, the Roots of smallage, Fennell, Parsly, Butchers-broome, Asparagus, Valerian, Burnet, Spikenard, Asarabecca, Wormwood, Agrimony, Nettles, Ground-pine, Cheruil, Rue, Scordium, Aniseed, Fennell-seed, Hart-wort, cheruil, Gromwell, Saxifrage, Juniper-berries, sweet Almonds, Peach-stones, and water distilled out of them with Malmsey Wine, Cubebs, Garden-cresses, the wood cassia, Medicines of spirit of Salt, and of Tartar, others less properly so called, whereof some are hot but do not attain to the third degree, as Turpentine, Parsnips, Dill, Venus' hair, fresh gathered Roots of Smallage, others are moist also which supple, or loosen the passages of Urine, as Liquorish, march Mallows, the seed of Mallows, others are cold, which have an abstersive faculty moderate, attenuating, and refrigerating force, such are Pippens, Gourds, Cucumbers, the substance and seed thereof, Barley, Strawberries, whey, juice of citrons, and Lemons, others besides that they are of thin parts, they afford much aqueous humidity, as thin white Wine, the seed of Melons, Gourds, cucumbers, waters of baths. CHAP XIV. Of Medicines provoking sweats. I Droticks, Provoking sweat. or Sudoriphicks are endued with a greater tenuity of parts, than Diuretics, they are hot also and besides they penetrate into the farthest parts of the body and cut humours, they attenuate, rarify, and turn into exhalation, and what ever is in their way, they carry with them, and drive into the extremities of the body, or if some amongst them are cold, or astringent also, by a hidden quality, whereby they resist poison, they drive malignant humours to the superficies of the body. Such are Carduus Benedictus, Venus' hair, Roots of Fennell, Smallage, Parsley, Burdocke, Burnet, Angelica, Tormentill, Wormseed, China, Flowers of camomile, the wood guaicum, Sassafras, Irish slat, Hartshorn, juice of Elder, Bezoarticum, Minerald without; and with Gold, fixed steel, or Diaphoretic, and copper, and steel fixed, Diaphoretic, Mercury precipitate, also to provoke sweats, Laconic baths, of sweet water are profitable, also fomentations, as warm Bottles, and hot Tiles, Frications, Unctions and such like. CHAP. XV. Of Diaphoreticks and Medicines, discussing wind. DIaphoreticks, with the Greeks' are the same, Dissolving. with discutient and dissolving medicines with the Latins, and they drive out through the insensible passages, and secret pores, all such things are hot and dry, and have power of converting humours into Vapours, and of opening, and dilating the pores of the skin, such are camomile, Melilot, Dill, Fenugreek, Rue, seed of Flax, Lupins, Galbanum, dried Pitch, Storax, Brimstone, Sagapenum, and such like which are lately named. Next to these are they which are called, Discussing of wind. discussers of wind, which as well can discuss, and consume wind within the body as when it is moving to the extremities, such are, besides those already named, century the less, which wonderfully conduceth to the discussion of wind, upon the Hypocondries, Aniseed, Bay-leaves, pennyroyal, Fennel-seed caraway-seed, cummin, Ammi, carrot seed, Parsley, Agnus Castus, Dill, Juniper-berries, Bay-berries, Galingale, cloves, Mace, the Pills of Oranges, the genitals of a Beaver. CHAP. XVI. Of provoking courses, expelling the secundine, and a dead child. SUch as bring down menstruous, Eringing down courses. are either improperly so called, to wit, such as corroborate the expulsive faculty, or further the generation of blood, or else attenuate its thickness, and viscidity; or properly so called, which open obstructions of the womb, and draw down blood to the womb, which opening and cleanseing things most powerfully perform, and such as are not of a very thin substance, lest through their tenuity of substance, they should presently be scattered, and therefore there is most conveniently provided for this purpose, things which have some bitterness, mixed with Acrimony; such like are Sage, Pennyroyal, Dittany, or Garden-ginger, Marjerom, Rue, Calamint, Wild-Marjerom, Bittony, Spike, Asarabecca, Mugwort, Germander, Wormwood, Ground-pine, Roots of red Madder, Birth-wort, Fennell, Parsley, Flowerdeluce, Eringo, Lovage, Burnet, Saffron, Flowers of white Violets, Parsnips, Juniper-berries, of Bays, Flowers of Camomile, Cinnamon, Myrrh, native Borax. The stronger of these drive out the secundine, Expelling Secondines and a dead child. and expel a dead child, which therefore are called casters out, and drivers out, or Ejaculators, because they drive out the young; such like are, Asa faetida, castor, Myrrh, and those things which are variously applied externally, as Opopanax, Galbanum, Amoniacum, Sulphur, the smell of the hooves of an Ass, Coloquintida, Rue, wild Cucumbers, the gall of a Cow, or Calf. CHAP. XVII. Of Medicines that break the stone. SInce the common Doctrine of the generation of stones is suspected, as is said before in the second Book, page 2. Breaking the stone. C. 9 also the common opinion which strives to support it concerning the power of dissolving stones is suspected, and therefore here we deservedly fly to the propriety of the whole substance, which nevertheless is not inconveniently drawn, from a Saline or salt force, the medicines breaking the stone are Ground Ivy, Bitony, Pelitory, the Roots of Restharrow, the five Diuretics, the Roots of Radish, Saxafrage, Burrs, bitter Almonds, cherry-stones, the stones of Apricocks, the Kernels of Medlars, Grumwell, Parsnips, cinnamon, Gourds, crabs stones, Goat's blood, Lapis Judaicus, the Roots of Sparrage, Snales, Lignum Nephriticum. CHAP. XVIII. Of Errhines, Sternutatories, and Apophlegmatismes. ERrhines draw out phlegm into the Nostrils, Errhines. not from the ventricles of the brain but such as is about the membranes covering the brain; they perform that by their heat and vitrosity wherewith they are endued by their extergent and sharp faculty; such are made of Marjerom, Rue, Pimpernell, cabbage, Beets, Roots of Flowerdeluce, Fennel flower, Penneroyall, Wild Marjerom, horehound, Showbread, Wild Cucumbers, celendine, Fell-wort, the juice of double or single Pasque flower. Ptarnicks, or Sternutatories, or such as cause sneezing, Sternutarories. are those which by their Acrimony irritate the expulsive faculty of the brain, which being wearied desiring to expel the medicine, sends out together with it the excrements, which remain about its membranes, and in itself, such like are certain Errhines most curiously powdered, and likewise white Pepper, Ginger, white Hellebore, bastard Pellitory, Caster, Cloves, sneezing-wort, Euphorbium. Lastly, Apophlegmatismes, Masticatories, Apophlegmatismes. or Gargarisms are those which being put into the mouth and touching the Palate, draw excrements from the brain into the Palate and mouth, and that by their whole substance, or by their heat and Acrimony, which pour out and melt excrements, and stimulate the expulsive faculty of the brain to expel, such are made of Mastic, Raisins, Hyssop, wild Marjerom, sweet Marjerom, Penneroyall, Caster, Cubebs, the barks of the Roots of Capers, Ginger, Fennell flower, white and black Pepper, Mustardseed, Turbith, Staves-acre. CHAP. XIX Of things causing spittle. THose things which help to evacuate humours in the breast and lungs when they are therein contained, Expectorating things. aught to be cutting and attenuating and somewhat sharp, that they may render what is thick thin, and what adheres by reason of viscidity, may be cleansed, lest the thinner parts being resolved, the thick should be left behind and become unfit for expulsion, nor should they be too sharp lest they should stir up the cough, such are made of Hyssop, Venus' hair, Scabious, Raisins, Horse-hoofes, the Root of Elecampane, Birth-wort, Angelico, Flowerdeluce, Wake-robbin, Squills, Liquorish, Raisins of the Sun, Injubes, Sebestens, Almonds, Figs, Pistack-nuts, the seed of a silk worm, Garden Cresses, Water-cresses, Hartwort, Nettle-seed, Sperma ceti. CHAP. XX. Of Medicines killing and expelling worms. LAstly those things may conveniently be referred to this rank which kill worms, Killing worms. whither they do it by bitterness, or by a peculiar or occult force, such are century the lesser, Wormwood, the Herb Lung-wort, Mints, the leaves of Peach-Trees, Rue, Purslan, Sorrell, Lyons-Tooth, Cynae or Santonici an Herb like Southernwood, the stalks of Leeks, Orach, Plantain, Lupins, Roots of Grapes, Ferne, Gentian; Elecampane, bitter Almonds, Peach-stones, Aloes, Syrup of Pomegranates, Citrons, Hearts-horne prepared, Bole armenick, Myrrh, whither they are taken inwardly or externally applied to the Navel. CHAP. XXI. Of drugs good against Poison. IN the last rank of Medicines, Drugs good against Poison. we will place those things which resist Poison which are called Alexiteria or Alexipharmaca, all of these if we rightly weigh the matter, perform that which they do either with their whole substance, as they say, or else by some occult propriety: Medicines against Poison are twofold, some are general, and common, which resist all manner of Poisons, and strengthen and comfort the heart and vital Spirits, so that they cannot easily take infection, others are particular which oppose some peculiar sort of Poison. Common Antidotes against Poison are Angelica; Common Antidotes. Carduus Benedictus, Valerian, Dittany, Scabius, Divells-bit, Swallow-wort, Burnet, Tormentill, Rue, Germander, Sorrell, Wormwood, Plantine, Marigolds, Speedwell, or Fluelin, Vipers-grass, Zedoary, Gentian, Juniper-berries, Citrons, Bezoar stone, Unicornes-horne, Hartshorn, Bowl armenick, Irish-slat. Of those alexipharmics which resist particular Poisons, Proper. many are delivered by Dioscordies in his sixth book. CHAP XXII. Of the manner of finding out the virtue of Medicines. WE come to the knowledge of the faculties of these Medicines two ways, by reason, and Experience; How the virtues of Medicines may be found out: and indeed especially by experience; for the force of some Medicines, as acting in their whole substant, is found out only by experience and although reason may seem to persuade some things, yet unless it be confirmed by experience it is to be rejected; truly those indications are not plainly to be rejected which are taken from external passions of things, from the place, and Air, from colours, and smells, and remarkable signs, yet in many things they fail, unless experience be joined: nay experience alone often sufficeth, for those things which are clearly manifest to our senses, leave nothing of doubt, yet if that which is found by experience, can be confirmed by reason, Manner of experiments. that is, by much the most certain knowledge, but when reason seems to be adverse to experience, 'tis better to cleave to experience, yet experience ought not to be taken rashly, nor to be taken from one example but many observations, and those are choicely to be collected, which may be done if the medicine acting, and the body or subject suffering, be diligently considered. In medicines, especially such as are taken from Plants, the substance, quantity, quality, age, time of gathering, native place, and such like, are to be considered, and especially to be regarded, whether it have got any strange, and acquired quality, but it ought to have its own virtue whole and entire. The subject is man's body, and all medicines are said to be such, not absolutely, nor in respect of other things, but in regard of man's body, whence it comes to pass, that experience ought to be made, of the primary qualities in a temperate man; in others for the most part, especially those that are sick, and those that are affected with me simple disease, and not a compound, lest experience should be put out of its course, nor is it enough, that experience be made once, or in one body, but observation ought to be made in many that are alike in Temperament, age, sex, structure of body; it is also to be considered whether any Medicine, performs any thing primarily, and by its self, or by accident. THE FIFTH BOOK, PART. I. SECT. II. OF CHYRURGERY. CHAP I. Of Chirurgery in general. AFter we have spoken of the faculties of the medicines, it remains that now we speak of Chirurgery, and that we propound all the operations, which are made by the hand, and v instruments, in man's body, for the recovering of healths sake, we will propound the operations which often are the matter of help. Chyrurgeries what. But although the word Chirurgery, which signifies manuel operation, may be taken of all actions, which are done by the hand, yet according to Preeminency, 'tis taken for that part of Physic, in particular, which by the artificial use of the hand, cures diseases of man's body, which are contrary to nature, and so Chirurgery is employed only in the external parts of the body, and exercised in those internal parts also to which the hand, and v instruments can reach. Sith hence three things are required to perform an action, the Agent, the Subject patiented, and those things by which the action is made, in Chirurgery also, these three are to be considered, Description of a Chirurgeon. the Agent, is the Chyurgeon, which Celsus in his seventh Book, and the beginning of that Book thus describes, a Chirurgeon ought to be a young man, or a middle aged man, with a strong hand, stable and never shaking, and as ready with his left hand as with his right, sharp, quick and clear sighted, not daunted in courage, not pitiful, as he is willing to cure, whom he takes in hand, one that may not by the clamour hasten his motion more than the matter requires, nor loss then is necessary, let him cut, but let him perform all things, as if no others pain could trouble him by their crying. The subject is man's body, The subject. the knowledge exactly where of, and the figure of every part, and their situation, and concoction is required in a Chirurgeon, which often defection of bodies will bring forth. Those things by which an action is performed, are instruments; and some other things are necessary for performance of operations, as the place, light, garments, Servants, standers by. The Instruments are various, Instruments. yet the chief are, an incision knife, a Penknife, a pair of Tongues, an instrument to pluck hair from the body by the Roots, called vossella, a Probe, a broad Probe, a Seaton needle, a Needle, Thread, a Hook, a little hollow Instrument of Surgeons, boared, a Phillet, Swathing-bands, Clouts, and little rags, Lint, Sponge. The place is to be chosen, Place. which is most commodious for v operations, and wherein the sick may not be hurt, by wind, cold, heat, or any external accident. The light whether it be that of the Sun, Light. or some other, aught to be such, that the Chirurgeon may accurately discern that part, which he dresseth, lest he should offend himself or the patiented. The Servants, Servants and standers by. and standers by aught not to be displeasing and troublesome to the sick, but aught to be attentive to the commands of the Chirurgeon, silent, and which is their duty, faithful to perform his dictates. The garments of the Chirurgeon ought to be so made, Garments. that they may no way hinder him in his operation. The Chirurgeon himself ought to endeavour as much as in him lieth, to perform his operation presentsy, safely, and with delight, and as much as possible without pain. All the v operations are five, v operations how many. a putting together or conjunction of separated parts, a correcting and setting right of those things which are out of joint, or out of their place, a Solution of continuity, an Extirpation, or cutting off of Superfluities, and a Restitution of deficiencies, of which now in their order. CHAP II. Of putting together, and binding in general. POsition is that operation of Chirurgery whereby the parts, are joined together, Setting or putting together. Finding. which were separated contrary to nature. Deligation or binding is necessary to this as also for the most part to other v operations, to which belongs fasciation, or Swathing-bands, and the putting in of Tents, fitting of Splints to bind about wounds, and the action itself or putting in of a round string to cleanse the wound, aright or true placing of the part bound. Of Swaddling. A Swath is a long and broad band (or list:) Swathing. fasciation is a convenient circumduction and convolution of the swathing-band about the member to be cured, the most convenient bands are linen, which are clean, light, soft, which have neither seams, nor knots. The differences of Swathing-bands are various, Differences of it. which are taken from their figure, length, and breadth, they differ in respect of figure, because some are rolled up thick, long and equally broad, and rolled up into a round circle, others are rend, or broken, which consists only of one linen cloth, but that cut or parted, either in the middle or outsides, others are sowed together, which are Swathing-bands and Ligatures ending in divers heads, and representing several figures; Swadlings differ in longitude, because some are longer, others shorter, and so it is of latitude. There are two kinds of deligation, the one simple, Differences of deligation. the other compound or manifold, the simple is either equal or unequal, the simple that is equal, is only round, which incompasseth the affected member, in a round circle, alike every way, without declination, unto either part, but is simple equal, binding is divided into Asciam, and Simam, which only differ in respect of more and less, because Asciadeclines a little from a round, but Sima, much of several ways of swathing are many differences, taken from the similitude of the parts which are bound, or from the similitude of certain Animals or other things, of which Galen in his Book of swathing. As for what belongs to the manner, The manner. sometimes the binding, is to be begun from the part affected, other times from a sound part, nearest to the part affected, sometimes from the opposite part, moreover sometimes swathing is to begin, at the end of the swathing-band, sometimes at the middle, thirdly swathing-bands should neither press the part too hard, nor suffer it to be lose, for when 'tis too lose, it doth not sufficiently contain the part, and when it is too hard it causeth pain and inflammation. The use of swathing is twofold, one by its self, which is to draw together the disjoined parts, to contract thedilated, to direct the distorted, to contain the member framed and the adjunct parts, to resist a humour flowing; or to repress a humour which is already flown, or to force blood to extenuated parts; but that which gins in a place affected represseth from the part, that which gins from a sound or opposite, forces towards the part, the other is by accident, which is to keep on medicines applied to any part. Of Cerots or Bolsters. SPlenia, Splents made up with Linen. are Plasters so called, from the figure of the Spleen, the Ancients calls them, Plumaccoli, but now they are called Pulvilli, Plagulae, they are linen rags folded up together, which are put to the part, some according to longitude right, others obliqne, others transverse, and some doubled, foam threefold, others fourfold, sometimes single, and sometimes more, according to the use which they are put for to strengthen, the binding members, unequal in thickness, or thin and hollow parts are to be equalled, and filled up; that the whole dilagation may be equal, the parts also are to be defended from the pain of the swathings and bands, and the Sanies, and thin matter, is to be expressed and imbibed. Of Splents. SPlentors, or splents, Splents. which are wont to be fitted to broken bones, and such as are out of joint, after they are set, which were prepared by the Ancients, of wooden-slips of a cane, but now they are prepared of the wood, of Fir, or splentors of some other wood, or of the Barks of Trees, or Paistboard, and hard Leather, which may answer to the parts greivously wounded, or broken, or put out of joint, especially to the hands, sometimes to the chest of the body, so made up, of light wood, that they may answer to the figure of the member, or of white thin plates of Iron, or tough skin, or shell, Paper glued together, and fitted, so that they may contain, the parts drawn and joined together, lest that they shake or totter, and slip out again, and slide out of their places. Of Binder's. LAqueus, Swathing-bands. is a band or binder so knit together that being drawn in or pressed by weight, is shut, or closed, the use thereof is to extend broken limbs, or such as are out of joint, to continue such as are put right in their places, to bind the parts and draw them in strait, also to bind the heads of vessels out of which blood flows, the differences of them may be seen, in Oribasius de Laqueis. Of fit placing of a member that is bound. THe convenient placing of a part that is bound consists in this, that it may have that position, which may preserve its natural figure, and may be without pain, and may be convenient for the cure of a disease. A member shall be so placed if all its parts, bones, muscles, nerves, veins, and arteries, may enjoy that position whereby they neither are distended, nor pressed; if the member be set or placed softly, and equally; if the orifice in a hallow ulcer, or wound, tend downward as much as may be, that the quitture may be purged out; lastly if moderation be observed in ordering of the binding so that it be neither too strait nor too lose. But collocation is made either by putting in, or by suspending; a member is fitly restored, when 'tis underpropt with certain stays, with feathers, wool, or soft rags, that it may be quiet and leaning or resting on somewhat, it should lie always even, and soft, lest it either should be shaken by motion, or extended by reason of flux, or lest the sanies and thin matter should be retained in it: the member is suspended, either when the sick keeps his bed, or newly gins to walk, and especially the hand, and the arm are to be kept in a Swath, which Celsus calls, Mitellam. CHAP III. Of Coaptation of broken bones. Synthesis, which joins together separated parts, is either of bones, Setting how manifold. or of fleshy and soft parts, setting together bones is either a fitting those that are broken, or a restoring those which were out of joint. The putting together of broken bones, is performed by two operations, Of broken bones. whereof the one is called Catastasis, Antitasis, or extension; the other is called Diorthosis conformation, or 'tis called reposition of the bones, into their own places; extension is either equal, or unequal, equal is that wherein the member is equally extended from either side of the broken bone, but that is said to be unequal, when the member is more extended on one side; that side ought to be more extended, wherein the broken bone is contained but no man can rightly perform those operations, Extension. unless he knoweth the nature, and differences of bones and fractures, for when a muscle is drawn back to its head, and so carries with it that part of the member which is joined to it, first there is need of extending, which the Greeks' call Antitasis, which ought to be done, as near as may be, with little or no pain, and that is performed by one work, or more, and that either with the hands only, or rain as it were swathings, or instruments, according as the bone is more or less broken. Diorthosis, or conformation, Strengthening. is a restitution of a broken bone into its place, and a right fitting of the extremities of the broken bone, which is performed if after the member be so much extended, that in putting it back the bones cannot touch one another, the Chirurgeon is to take hold of the member on both sides, with both his hands, and that which is slid into the right part he should thrust into the left, and the contrary, and what ever hangs out of the bones, he should put back into their own cavities, until the extremities of the bone are rightly united, and thrust back, into their places, and the member hath recovered its natural figure. The cure of a fracture with a wound. But if the extremities of the broken bones, break through the skin, that they hang out, some convenient instrument of Iron, like a bar, is to be used, to force the broken bones into their place, but if any particle of a bone so hang out, that it cannot easily be put into its place, it is to be cut off with a sharp pair of cissars, or to be filled off with a file, that it may be shorter, neither let it any more hinder the reposition: in such a fracture which is joined with a wound, if any thing stick betwixt the broken bones, which may impede their glutination, whither particles of a bone, or any thing whatsoever, it is to be taken away without violence; when the bones are rightly placed, the extension is to be remitted by degrees, and with convenient binding and placing of the member, and so to be performed, that the bones united and rightly framed may remain so. Yet before swathing-bands are put about a broken member some medicines used to be applied, to hinder the Flux of humours and inflammation, and to farther the generation of brawny flesh, of which, read the Institutions. The deligation is to be performed, Manner of swathing or deligation. neither too strait nor too lose, with two swathing-bands, whereof the first is to begin above the fracture, and to be bound about it, twice or thrice upwards; the other, being longer by half, is to be rolled about the contrary way, and is to be put on first upon the fracture, and beginning from thence to be rolled about something downward and again is to be carried above the fracture, and lastly towards the superior sound part, but in fractures of great bones, that the deligation may be the more stable, and the bones firmly put into their places, may remain so, Bolsters or cross folded , and splentors, and Plates, are also to be used, moreover the member is rightly to be placed, gently, equally, and inclining upwards, so that the part may obtain its natural position, to which purpose, both a hollow Pipe, and Cane, or Plate, or such like, are sometimes to be applied, the deligation being well performed, is to be loosened the third day, the fracture to be cleansed, and bound up again, and this is to be continued until hard flesh be grown, and the fracture healed, but if a fracture be joined with a wound, after the extension is abated, and there is convenient conformation of the broken bones, the lips of the wound are to be drawn together, and being drawn, to be kept together, yet so that the swath-bands be not too strait bound, which ought to be flacker, and to be extended on both sides, beyond the lips of the wound, least pain should be stirred up, but in the following deligations, a hole, or vent, may be cut above the wound, both through the Plasters, and swathing bands, that it may be perfectly cured. CHAP iv Of restoring of bones that are out of joint. Synthesis which puts bones slid out of their places into them again, call this Arthrembla, this is performed three ways, either with the hands of the Chirurgeon which is convenient in tender bodies, and when the hurt is newly done, or with certain common instruments, as by the help of reins, swathing-bands, Laqueorum, scalarum, sedilium, forium bifidarum, and it is convenient for children, Women, and those whose muscles are grown stronger, and luxations have been longer, or by instruments, certain Engines, peculiar for that purpose, is performed, and are used for strong bodies, and old luxations, and altogether on those, which cannot be restored by the two former ways, of such Engines, you may see Hypocrates, of joints and fractures, and Oribasius of Engines intititled, de machinis. But after what manner soever, restitution of a boneout of joint is performed, four operations are necessary to do, it first Extension, Reposition, Deligation, and Confirmation, What things are required for the setting of bones. and Collocation, of the members so replaced. Extension, is made, either by the hands of the Chirurgeon, or his Servants, or by reins, bindings and swathings, or Instruments, and Engines, as is said. Extension being made, the bone which is slid out of its place is to be put into it again, which work the Greeks' call, Moclia, and Mocleuses, Reposition. namely a compulsion of a bone that is out of joint and extended into its own place, which being slid from or out of the end, in the same way which the joint slid, it ought to be put back to that place out of which it slid, whereof there are so many ways as there are joints. The joint being restored, the intention is to be remitted and the member afterwards, so to be strengthened that the joint cannot again go out of its place, Deligation. which for the most part is performed in the same manner as in fractures. Lastly the member is to be placed gently, and equally, and to be kept unmoved till the fourth or seventh day. Collocation. CHAP. V Of the putting together of the soft and fleshy parts. THe fleshy and soft parts, disjoined, Setting of soft parts. preternaturally are joined together, either without any division of them, or by solution of their continuity, that putting together, which is performed without any division of parts is various, and of different parts, and first of all sometimes certain parts being slid out of their places, come to be put into their natural place again, such are the guts, and paunch, which sometimes by the wounds of the paunch come out, sometimes the Rim of the belly being loosened, or broken, falls into the groin, and cod, or break out at the navel, hitherto belongs the womb, and gut Rectum, which sometimes also fall out of their places, and therefore all these are to be put into their places again, but how the restoring of each singular part ought to be performed, is spoken in our Institutions, and 3 d. Book of praxis. Moreover, Wounds, how set. for what belongs to the manner of joining together, wounded parts, without division, the lips of the wounds, since they are disjoined, are to be brought and joined together, and when they are brought, being joined are to be kept together, which may be done too ways without solution of continuity, either by swathing, or gluing, or a suture with the Glue, and indeed as for swathing that is convenient being made for Wounds according to the length of the member, Swathing. and not very deep, and when we hope by fasciation only, the lips may be joined. A future is not rashly to be appointed, and indeed if the wound be long, narrow, and strait, swathing is better, that is, deligation of three fingers breadth is enough. The manner of fasciation may be seen in the Institutions. But when in transverse and long wounds, A suture by glue. sasciation alone is not sufficient to draw and continue the lips of the wound together, there is need of a suture; but when in wounds of the face prickings cause deformities, and in other long and great wounds before the glutination of the wound the sutures are broke; render bodies also cannot endure a seam which is made with a needle, a certain lutination or suture is invented by glue, by which without any division of the wounded part, or stitching with a needle, the lips of the wound are drawn together. Provision to perform this may be seen in the Institutions. But that conjunction of wounded parts which is made by solution of continuity is performed with a suture and pipes to the suture, A suture by a needle. three Instruments are to be used, the Needle must be triangular and thread strong, lest it should be broken, not too hard, but softened with Wax, equal, or even, the Pipe ought to be Gold mixed with Copper, or Silver, with a hole in the end that the Needle may pass through the hole, and the Pipe holding it, and being put to i●, it may stay the lips of the wound, lest whilst the needle is put to it it should be stirred, neither should it be lengthened to the protraction of the thread and needle: the manner of the suture is twofold, the one is that which is performed in the same manner as Skinners or Furriers use to sow their skins, being fitted for wounded guts; the other is thus, in the middle of the wound, with a Needle drawing a double thread, the lips of the wound are tied, and a knot being made, the thread a little above the knot, is to be cut off: Moreover in the middle space on both sides another hole is to be pricked with a double thread, and a knot being made in the like manner, 'tis to be cut off, and that is to be continued till the lips of the wound be rightly sown together, and brought to mutual contract. Fibulae. There is mention also amongst the ancients of a Pipe, but what it was for the most part is unknown at this day, since it is incredible that those iron hooks should be fixed to the skin, since that would have caused intolerable pain, the opinion of Gabriel Fallopius is more probable, who teacheth that pipe to be that future newly described, which is called Intercisa, and at this day is most frequent, which is drawn with a needle drawing a double thread through both the lips of the wound, and above the wound, with three involutions, both the ends of the thread are tied together and knit into a knot. But the word Fibula signifies every Instrument that joineth things together. And thus much of the v operation which is of putting or joining together. CHAP. VI Of correcting of Bones that are repressed or set awry. THe other v operation is Diorthosis, or the putting right, a correcting of bones put awry, or writhe; The Skull if it be depressed, which often happens in Children, is to be reduced into its natural condition and place, either with Cupping-glasses, the hair being shaved with a great flame put to them, and the mouth and nostrils being shut, the Patient by expiration, together with a violent striving, by putting Cucurbita Cornea, out of which the mouth and nostrils of the sick being shut, a strong man may suck up air, or with some Plaster sticking very fast to the skin, which is to be applied, and when it cleaves very fast then to twitch it up, or with an elevating Augur, or trepan, or by performation and elevation of the Skull. The bones of the nose being broken or bruised, Of the nose are to be drawn back by the finger, or a Specillum put into the nostril, and without are to be directed and put into frame by the hand, and afterwards a tent is to be put into the hollow of the nose or nostril. A member being contracted first it is to be softened, Directing of contracted members. afterwards either gently to be bowed, or with an Instrument fit for that purpose it is tenderly and by degrees to be drawn in, or stretched out. The Legs or Arms in Infants being awry, Direction of crooked Legs or Arms. the best way of directing them is, that they may be reduced by handling and directing them gently with the hands and by degrees, and with swathings drawing them the contrary way to that which they are in, and by rolling the swathband by little and little they may be reduced into their natural and due figure, but if the swathing be not strong enough, and that the child desire to go, little boots like bagging shoes in that manner as Paraeus hath described them in his twentyeth book of Chirurgery, Chap. the eleventh, are to be fitted to his Legs; and thus much of the second operation of Chirurgery. CHAP. VII. Of disjunction in general, and of dissection of soft parts. THe third operation of Chirurgery is disjunction, The kinds of division. which divides those parts of the body which are joined and continued together, of the first of these there are two kinds, Section, and Ustion; Section, some is of soft some of hard parts; and of soft parts according as it is made by cutting or pricking, in particular it is called, Tom, or cutting, or Paracentesis, pricking; of the bones and hard parts there is perforation or boaring with a wimble, shaving, filing, sawing; lastly Ustion is common both to hard and soft parts, all which operations are now to be explained in their several kinds. In cutting soft parts, Opening of a vein. first comes the opening of a vein, which is appointed for emission of blood out of the body, in divers parts of the body, the provision and convenient preparations for that purpose may be seen in the institutions. Moreover since that sometimes the matter in tumors should be changed into quitture, Opening of imposthumes. nor doth an imposthumation, always break of its own accord, and it is to be doubted lest the purulent matter retained should offend the neighbouring parts, and bring rottenness to the bones, sometimes also there is venomous matter, and affects the way to the internal parts, or an imposthumation or Ulcer near a principle part, or joints, may stop the fundament, oftentimes an Ulcer or imposthume full of matteris to be opened with an Instrument, or by which opening aught to be so performed as that the adjacent veins, arteries and nerves may not be offended; the Sanies either is included in a bladder, or else hath no bladder; if the quitture be not included in a bladder, let that part be wounded that the tumour may come to its height, and the skin is very thin, yet as near as may be do it in a declining part; the Instruments fit for cutting are, variety of Incision knives, according to the variety of figures, and necessity of their use, the bigness of the cut is to answer to the quantity and the quality of the matter to be emitted, an incision being made, and the matter in some part evacuated, lest the wound before the whole matter be let out should close up again, tents are to be put in, nay if need be, the wound must be dilated, and the part so bound up and placed, that the quitture may conveniently flow forth, but if the purulent matter be enclosed in a bag, the tumour according to its longitude if it be less or cut athwart like, the letter X; if it be greater and the whole bag with the matter in it, 'tis to be taken out and nothing of it to be left behind. Thirdly Fistulaes' also are often to be cut, The cutting of a fistula. which is done with a fit Instrument, which therefore the Greeks call Syringotomon that is a Pipe cutter, the manner of cutting may be seen in the Institutions. Fourthly parts also are sometimes to be separated which are joined together from ones birth, after ones birth, Separation of parts that are joined together preternaturally. whereunto belongs the cutting of the tongue when it is tied, of ears when they are shut, of the fundament when it is closed, the opening of the private part of a female, the freeing of the prepucium when 'tis straightened, a separation of it from the glans, the opening of the top of the yard, or glans when 'tis closed, separation of fingers growing together, the opening of the eye lids when they grow together, all which may be performed by cutting by a skilful Chirurgeon, and how it shall be performed, shall be explained in the Institutions. Fifthly hitherto belongs scarification, Scarification. which is performed with an incision knife, or lance, and so that the skin may be opened only with gentle cuttings, or to wound it deeper, and that the more ready evacuation of blood may follow, cupping glasses for the most part with a burning flame are to be applied, which may attract the humours more potently, yet sometimes scarification is appointed without cupping glasses, such as that of Mallets which was in use amongst the Ancients, and the scarification, in use with the Egyptians this day. Sixtly, Cutting of vessels. Angeiologia so called in particular, which is a cutting of the vessels in the forehead, in the Megrim, and an inveterate Opthalmy, and when there is a perpetual weeping of the eyes, whereby a vessel, freed from the neighbouring parts, is tied with a thread on both sides, and afterwards in the middle betwixt the two threads it is to be cut transverse according as the manner of operations is delivered in the Institutions. To the cutting of vessels belong the cutting of the varices, Cutting of the varices. which was done by the Ancients, almost in the same manner as the cutting of the other vessels lastly propounded, as you may see out of Celsus the 18. Book Chap. the 13. Paulus Aegineta the 6. Book the 82. Chap. Hier. Fabricius hath another manner of v operation, Tit. of Chirurgery of the vessels called varices, namely such a one, the Instrument Volcella (which is to pluck up hair by the Root) bowed or lifted up first with a hook, he prick; the varices in many places, afterwards he puts to it a binding medicine representing the figure of a candle, according to length of it, and upon this he puts the bark of a hollow reed or Cane, To Angeiologie also may be referred that cutting of an Aneurisme, Cutting of an Ancurisme. out of Paulus Aegineta, 6. Book, 37. Chap. and 64. Chap. which may there be seen, which nevertheless is scarce to be attempted unless the Aneurisme be very small, and in an ignoble part, not having any great vessels, since without great danger it cannot be performed. Seaventhly, Paracentesis. to Separation or Section, belongs Paracentesis by which word every pricking in general was denoted by the Ancients, and 'tis 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 retains the name of the general name, the manner and reason of performing whereof in the Institutions and in the 3. Book of Practice 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 cod 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 windpipe, Laryngotome. which is called Laryngotome, which when it is necessary is to be performed with a lance, (the other parts being removed, under the Larynx betwixt the third and fourth ring of the Windpipe, the manner of operation is propounded in the Institutions. As also the cutting of the breast, in an Empyema, An incision of the breast. or an Ulcer or imposthume, in the cavity of the breast, which is performed on one side of the breast, betwixt the fift, and sixth 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 pricked, 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 leeches, Leaches. or the application of leeches, which being chosen, prepared, and cleansed, are applied with a rag, or a reed; by their biting they open the veins and draw out blood, and indeed from the subcutaneous parts only, and capillary veins, if they are applied only to the skin, but if they are applied to any great vessel, they draw blood from the innermost parts of the whole body, and therefore they are applied according as there is need of this or that evacuation, and are applied to children when we dare not use the lance to open veins. To the veins of their arms when they are affected with any grievous disease that requires evacuation of blood. CHAP VIII. Of Section of Bones. BUt that cutting which is performed in hard parts or bones is fourfold, according to the various manner of separation, 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 several natures of diseases and of bones; either strait, such as are hammers which they use in driving, or bend in the end such as they use in drawing, sometimes they use both a file, and a Hammer wrapped in a clout. Secondly filing, Filing. or wearing away of bones with a file, it useful 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 Greeks' call, Trupesis, a wimble they call Trupanon, Kind's of Trepans or Wimbles. and Trupane; but a Trepan is either strait and sharp, 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 'tis twofold, the one is that which answers plainly to the wimbles of Carpenters; the other, which near the point at such a distance as the thickness 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 go deeper than is fit, which kind of Trepan, because it cannot go deeper, the Greeks' call Trupanon, or Abaptiston; Modiolus the Greeks call, Cointhion, and Coinichis, and Prion Caractos, 'tis a hollow Instrument of Iron, round and long like a Pillar, at the bottom of the mouth like a saw, or full of teeth, and strait Trepans, which are called Periteria, are opposed to it, which are turned about with a handle, which if it have a nail (or pin) in the middle 'tis 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 rottenness 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 chink 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 separation remains, Burning. which is burning, which is to be used when diseases cannot be taken away by medicines, nor cutting; burning is performed two ways, 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, Brass, which are called actual Cauteries, or with burning medicines, which are called potential Cauteries. There are some differences of actual Cauteries, especially, An actual Cautery. in respect of matter and figure, and differing also some other ways; as for matter, Metallick Instruments prepared of Iron, Brass, Silver, Gold, are in use this day, Iron burns potently, Brass and Gold not so violently, the figures of Cauteries are various, which are described every where, sometimes they are fired more, sometimes less, 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 potential Cauteries, Potential. 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 shown in the end of this Book. fontanelles, Issues. and Issues are made by actual and potential Cauteries, namely little Ulcers, prepared to evacuate, draw back, and drive humours through them, but in what parts, and how these fontanelles are to be made shall be shown in the Institutions. To this third operation may be referred that, Cupping glasses. whereby something is drawn in the body, or out of the body, by cupping glasses, but a cupping glass is a vessel with a belly which is fastened to the body to draw, all whose strength of acting comes by reason of vacuity, but what the differences of them are, the manner of applying of them, and their use, shall be shown in the Institutions: and thus much of the third v operation. CHAP. X. Of drawing of things out of the body which were sent into the body from without THe fourth v operation is, How many ways things may be drawn out of the body. Drawing out of things thrust into the body. A Dart how many ways it may be drawn out. Exairesis, or extraction of hurtful and unprofitable things out of the body; but things which are to be taken away, are either sent from without into the body, or begotten in the body. First for what belongs to the extraction of things sent from without into the body, they are twofold; first all those things which are sent to wound the body, as darts of all sorts, and Bullets shot out of Guns; Moreover certain external things which come into the Chaps and Throat, Ears, Nostrils, and Eyes, and stick in them, But Darts are taken out two ways, either by extraction, or impulsion, that is, either that way which they came in, or that way which it aimed to go out at; 'tis drawn out by the part which it came in at, either without any lancing, or with lancing; for if the dart pierced not deep, if it hath not passed through great vessels, or nervous parts, and and meets with a bone, veins, arteries, or nerves, out of the region whither it tended, and if there be no fear of any great tearing, it may be drawn back that way, which it entered into the body, and that without cutting; but if there be danger, and that it be to be feared lest that the body should be lacerated, if the dart should be drawn out the same way that it went in at, the wound is to be dilated either by cutting, or without lancing, namely with that Instrument, which Ce●sus in his 7. Book and 15. Chap. calls Hypsiloeides, or Swans, or storks beak, or other dilating Instruments whereby the Dart may the casier be drawn back. 'tis drawn out by the hand, if it may be, when it is apparent, and is fastened only in flesh, or with a Volcella, when it sticks so deep that it cannot be taken hold of by the hands, or other Instruments which the Greeks', Boloulca, that is certain Instruments to pull out Darts, of which kind are long Tongues, Tongues with teeth, strait, a little bend inward, but the outmost part broad and round, to which the latter Surgeons have given several names from their figure, and call them Crows, Storks, Ducks, Geese bill, the figures whereof are extant, in Amb. Parey in the 10 th'. Book 18 th'. Chap. but if the point of the Dart, hath pierced into the member more than half through, and the place by which the dart is to be drawn through, be more, than it hath hitherto passed, and neither bone, Nerve, Veins, nor Arteries hinder it, 'tis more convenient, to drive the Dart thither whither it tended; dissection being made in that part, and to draw it out by making of a new wound; but yet if the Dart be too broad 'tis not expedient to draw it out through another part; lest that we add to that great wound, another great one. The reason of drawing out Musket bullets in many things is agreeable to the extraction of Darts, The way of taking out of Musket bullets. for three things are required to extraction, the first that the way may be dilated with an Instrument; secondly that the bullet be taken hold of; the Instrument takes the bullet, either as a pair of Tongues, or the point of the Instrument enters into the bullet, incompasseth it with its cavity, or it takes hold with the end that is toothed like a faw; thirdly a bullet being taken hold of with an Instrument, is drawn out by the hand of a Chirurgeon with the Instrument, of which more in the Institutions. Moreover sometimes thing shappen externally to the Chaps, Things that stick in the Chaps. Throat, Ears, and happen into the Nostrils, and Eyes, and use to stick in them, each of which require several ways of drawing forth; if a little fish bone, or the back bone of a fish stick in the Throat, and that it be in sight when the mouth is opened, 'tis to be taken out with a Volcella, and that either strait, or a little bowed towards the end, and convenient to take out the bones from the Threate, but if it should descend deeper into the Throat, or having used a Speculum of the mouth to open it wide, if it doth not appear, a vomit is to be stirred up with oil of sweet Almonds, or of Olives, or with a quill, or putting down one's finger. A Worm sticking in the Ears, A worm in the ears how to be taken out. first of all it is to be drawn out a live, and that it may be the better performed, and the worm may the easier be taken, it is to be enticed outward, by injecting sweet things into the Ears, and applying of them outwardly, but if it cannot be enticed, or drawn out alive, it is to be killed with those things that are bitter, and by a peculiar propriety and force, are destructive to worms, but being killed, 'tis drawn out by pouring in water or wine and Oil luke warm, and putting in of tents made of Cotton, wet with Honey, Turpentine, or some glutinous gum, wherewith twisting it up and down in the Ear, the worm is drawn forth, the sick leaning on that side the Ear is affected Other things which may be put, or slid into the ear are either hard, or liquid; if the things are hard, warm Oil is to be poured in that they may be dissolved, if it be possible, or certainly the passages of the Ear may become slippery; but if the thing which falls in be of that nature, that it will swell with moistening, as Pease, Beanes, etc. all moist things are to be avoided, afterwards sneezing is to be provoaked, the Nostrils, and the mouth being shut, that the spirits may be forced to go out through the Ears, and so that together to be thrust out which was slid into the Ears, but if the thing cannot be extruded in this manner, 'tis to be drawn out with a convenient Instrument, yet very warily, lest either that which is to be taken forth should be thrust deeper, or the membrane called the drum of the Ear should be broken. If that which is to be taken out be liquid, the affected should hop upon his foot on the contrary side, bending his head downward on the afflicted side, that the moisture may come forth, which if it doth not come to pass, sneezing is to be occasioned, or a little dry sponge is to be put into the Ear, so that the extremity of the Channel which goes into the Ear be first stopped and fortified with Cotton, that whilst the spirit is drawn, there be no room granted for the letting in of Air in any ways. If any thing come into the Nostrils sticks in them, there is another way of drawing of it out, then that of drawing out those things that stick in the Ears. If sand or dust stick in the Eyes, the stone found in the maw of a Swallow, Crabs Eyes, Pearls, if they are cast into the Eyes, cleanse them, but if any greater thing be fixed in the Eye, 'tis to be drawn out with a fine linen cloth, wet in pure fountain water, or with a sponge tied to a soft quill, but if it be greater, 'tis to be taken out with a little Volcella, or unless extraction in this manner doth succeed, Anodunes, or medicines taking away pain, being applied and other convenient medicines, the business is to be committed to nature. CHAP. XI. Of drawing out of things generated in the body according to nature, but retained in the body beyond the limits of nature. AFter these, amongst those things which are to be drawn out of the body, somethings are found which indeed are generated in the body according to nature, yet are detained there contrary to nature, and hitherto belongs first of all, extraction, or excision of a living or dead child out of the body, moreover the drawing out of Urine detained preternaturally. First of all, Of taking out a lived child. if the young can neither be brought out by the help of the mother, nor by any other, there is no other help remains then cutting, whereby the living child is taken out, and those which are brought forth on this manner, are called Caesares, the young is cut out when the mother is living or dead, Of a dead. but of this Cesarean bringing forth, you may see a peculiar Book of Francis Rousset, but as for the extraction of a dead child by what means that may be rightly performed Celsus teacheth in his 7. Book. 29. Chap. 23. Aetius Tetrarch Book 4. Ser. 4. Chap. and Hieron Fabricius ab Aqua P. of v operations, Amb. Parey describes fit Instruments for this operation in his 23 d. Book Chap. 26. Job. Andr. a Cruse. Next to these is the drawing out of a Mole and the same reason for the most part is in drawing out them as in the extraction of a dead child. Extraction of a Mola Lastly hitherto belongs the drawing out of Urine by v operation, Drawing out urine with a Cathera. but that operation is performed by Silver, or brazen Pipes, which they call Catheters, which that they may be fitted for every body greater or less, three of them are to be prepared for men, and too for women in a readiness, the manner of operation is in the Institutions. CHAP. XII. Of taking away the corrupt parts of the body. SOmetimes the parts of the body are so corrupted that there is no hope of curing of them, Cutting of dead flesh. which as being unprofitable and hurtful, and such as may infect the parts next to them, and pollute them, are to be taken away; whatever therefore is corrupted, is to be cut off, but the manner of cutting offis various according to the variety of the parts that are hurt, and the place where they are, and nature of the disease itself, and therefore the rightest manner of taking away such from the body is known by particular operations, yet oftentimes in fistulas and other malignant Ulcers, cutting alone is not sufficient as being that which cannot take away the smallest fibrillaes and particles, but after cutting there is need of an actual or potential Cautery that the remainders may be taken away, nay sometimes without cutting, by Cauteries only things so corrupted are taken away. Hereunto belongs the Amputation of parts corrupted with a Cancer, Amputation of a cancer. Of a Wula, yard, womb. Of bones. also a cutting off of the Uuula, corrupted either by inflammation or by Morbus Gallicus, the cutting off also of the putrid, or corrupted yard, as also of the corrupted womb. Corrupted bones are taken away by filing, shaving with an incision knife, or with a wimble, of which it is spoken before, as also with divers kinds of Tongues, whereby the corrupted bones of the fingers, and broken bones hanging out may be taken away. Hitherto belongs the plucking out of teeth, Teeth. which is performed, the Teeth being first loosened from the gums, and is done with several Instruments, whose names are taken from the figure, and similitude for the most part, which they have with the beaks of living Creatures, which Hieron Fabricius, reckons up, the figures of them are extant in Amb. Parey. the 16 th'. Book Chap. the 17 th'. and Joh. Andr. a Cruse. Lastly it sometimes happens that in man's body certain parts are corrupted with mortification & they so die that there is no hope of recovery of life, Amputation of Limbs. when there is one indication that which is corrupted is to be cut off, lest the sound also should be affected, which operation the Greeks' call Acroteriasmos, or a tearing off the dead ●lesh, but in what place and when that Amputation is to be made cannot be delivered in a compendium, see the Institutions. CHAP. XIII. Of freeing and taking away things generated in the body contrary to nature. THe last kind remains of taking away things out of the body, Things preternatural begotten in the body how manifold. namely those which are generated in the body contrary to nature, but there is no little difference amongst those things, for some of them are borne together with the parts of our body and are adhere tenaciously, as Warts, Warts great above and small below, swell and inflammations in the fundament, the top of the yard, the way to the womb, callous flesh, Corns, Knots, the King's Evil, excrescencies of flesh in the Nostrils, and Polypus, swelling in the Chaps, small tumors in the Urinary passage, Excrescencies on the eye lids, fleshy ruptures, or else they are contained in some part of the body, as water in an aqueous rapture in the paunch, stones or gravel in the reins, bladder or yard. The cutting of warts is performed either by binding, Warts. cuttings, or burning; Warts hanging down are taken away either with a silken thread, or Horse hair, or they are to be tied with some other strong thread every day harder and harder until they come off; cutting is performed with an incision knife, like a Myrtle leave, or with a lance; burning is performed with an hot Iron, or with green wood that is burnt; but how severally the tumour called Thymus in the fundament, glans or prepuce, are to be taken away is shown in the Institutions, and in the 3 d. Book of practice. Sometimes a little tumour ariseth in the Urinary passage from an Ulcer, Caruncles extirpated out the urinary passages. and is so increased sometimes that it stops the urine, this is to be taken away by the help of a Chirurgeon, and fit medicines, but least that other parts should be eroded, medicines are to be ejected through a silver Pipe, to the tumour, or else it is to be incorporated and mixed with the top and head of a wax Candle, and thrust into the place affected, or a little Cane with Lint and white wax put into it, and bedaubed with a fit medicine, being hollow that the urine may pass through it. This is to be put into the urinary passages. Polypus if it admits of cure, Taking away a Polypus. it is to be cut off with a sharp Iron Instrument made after the manner of a Spatula, being put into the Nostrils, of which operation see the Institutions, and the first Book of Practice. Fleshy excrescencies in the Chaps called, Epuli a nail in the eye. Epuli, as also Encanthis, or excrescencies in the greater corner of the Eye, and the nail of the Eye, unless they can be taken away with medicines, are to be cut off, as also pieces of flesh here and there growing in the skin of the body, Excrescencies of flesh. Fungi. Nodi etc. and excrescencies which represent a kind of soft flesh, which are like the roots of Mushrooms, and grow like them, and therefore are called Mushrooms, knots also, Kings evil, Kernels, swell in the Throat, and swell in the flesh, or fleshy ruptures if they cannot be eradicated by Medicines, must be taken away by cutting. A watery rapture, A watery rapture. or water collected into the cod cannot always be taken away by discussing medicines, the cod are to be opened, and the water to be let out through the wound. Lastly the stone of the bladder, Stone of the bladder. since it is seldom diminished by medicines, the bladder being cut, 'tis to be taken out, and sometimes a stone sticking in the urinary passage is to be drawn out, but in what manner those cuttings, and operations all of them ought to be performed, is spoken in the Institutions, and may there be seen, nor can the ways of those operations be reduced into a compendium, but all things which are there spoken in the operations are diligently to be observed, and thus much of the fourth v operation. CHAP XIIII. Of the restitution of parts that are lost, or of the Chirurgery of imperfect parts. THere remains the last v operation, Chirurgery of such as are maimed. which is required in the cure of such as are imperfect and maimed, namely when the extremities of the Nose or Ears or Lips are shortened, and these parts maimed, but although parts that are lost are counterfeited by Instruments feigned made and painted, out of several matter representing the similitude of the part lost, yet this is only a counterfeit and palliating cure, but when it cannot be restored by a new generation of the deficient part, 'tis to be restored by the flesh of another member being brought and united to it, yet that operation is not to be tried on every body, but first it is to be observed what kind of body it is which is to be cured, for in old men or in a body which hath an ill habit, wherein wounds are difficult to be cured, this way of cure is not to be easily attempted. Casper Taliacotius in his Book of maimed Chirurgery, by inserting, accuratly and largely describes the manner of this operation, the sum of this operation is this; he makes his transferring, or bringing into the Nose, and Lips, from the Shoulder; but to cure unperfect Ears he takes away from the Region behind the Ears, namely he appoints a convenient cutting in those parts, and the maimed parts being first cleansed, he commits and joins the skin of that part which is cut off with the maimed part, and that they may be kept joined together until they grow together, he binds them with swathing bands. And indeed he puts that part of the Nose or Lips which is maimed, into the wound made in the Shoulder, with the head tied to the Arm, as it were to a prop, that it is, , and fixed so that it can be moved no way. And in this manner when it hath stuck so long, until the flesh of both parts be united and grows together, he cutteth off again from the Nose or Lip, the traduct, or that which was brought from another place and is here grown, than he makes conveniently, and frames that flesh so cut off from the Arm into a form of a Nose or Lip. THE FIFTH BOOK, PART. II. Of the Method of healing. SECT. I. Of showing how to preserve health. CHAP I. Of the Method of healing and of indications in general. BUt it is not sufficient to know the Instruments for the recovery of health, and those things which are profitable for the curing of a disease, but 'tis necessary to understand how and in what manner every thing is to be used, or to know the Method of healing, and restoring of lost health, the next thing therefore is that we may show the Method of healing. Capivaccius defines the Method of healing to be an art wherein by indications remedies are found out that the lost health of man may be restored, The Method of healing. for the Method of healing (as also all Physic) is a certain principal effective had bit using indications as Instruments to find out remedies for the cure of diseases. For the end of the Method of healing is twofold. The internal, or proximate, namely invention of fit helps and remedies in every disease, or rather an invention of indications, that show what will cure. The external is a restitution of the lost health, or which is the same, an extirpation of a disease. But an indication which the Greeks call Endixis is sometimes taken in general for every showing or demonstration, Indication what. yet properly and in particular, and as it pertains to the Method of healing, it signify the showing of remedies, and 'tis a perception of what is healthful in the Indicant, known by causes, or which is the same, 'tis a perception, and comprehension of that which is helping, or indicated, with an apprehension of what indicateth without experience or any forceable argument from the cause to effect. But although Indication be the first Instrument of Dogmatic Physic whereby 'tis discerned from other Sects, yet that doth not plainly reject experience, and any forceable arguments, but when diseases and the morbisique causes of nature are not sufficiently known, it flies to experience and example as to a forceable Argument. Experience is the remembrance and observation which oftentimes is seen to come to pass in the same manner. Experience what. An Analogisme, Analogisme. or forceable Argument to persuade is an apprehension of what is helpful from the like, but that similitude is either amongst the affects or remedies, or amongst the members. As for the Indication, that is really a certain Enthymema, by the force whereof that is found out which is done, for the consequence is so manifest that no man can deny it, and indeed by the force of those propositions which are the foundations of Method, and like Axioms, and principals in the Method of healing, and they are these. Every thing which jndicates shows the conservation of its self, or the taking of it away. That which is according to nature is to be preserved, and that which is contrary to nature is to be taken away. Contraries are cured by their contraries, likes are preserved by their likes. But there are various differences of Indications, Differences of Indications. the first and most general is taken from things about which they are conversant, which are according to nature, and preternatural, and it is because an Indication is a perception, and insinuation of the preservation of that which is according to the nature, of the indicant to be performed by its likes, the other is an apprehension of the taking away of that which is preternatural, to be performed by the contrary of the indicant. Moreover one Indication is generical, Genericall another subalternate, another specifical and determinate; generical which the common and generical nature of the indicant supplies, and which simply teacheth how to take away the disease, and the cause of a disease, and to preserve strength, but in what manner that may be performed, it doth not show; subalternate, Subalternate. Specifical. which the subalternate essence of the Indicant shows, and which indeed determinates the matter more, yet not perfectly; specificiall which is taken from the specifique nature of the Indicant, and describes the whole Indicant exactly and its remedy, and is also called the determinate. Profitable. Thirdly one Indication is profitable, another unprofitable; profitable is that, to which some matter answers, or which indicateth such remedy, the matter whereof may be found out, and primarily, Unprofitable. and by its self can take away the disease; but unprofitable is that, which shows such help, the matter whereof which can take away the disease of the first is not to be found. Fourthly of Indications some are artificial, inartificial. others inartificial; inartificial is that which may be known by others and to the vulgar, as well as to the artist, who equally knows the disease is to be taken away, and the strength to be preserved, but knows not a reason how that may be done, Artificial. such as is generical, and sometimes subalternate; but artificial Indications are those which are not known to all, but only to Artists, and require a great deal of skill that they may be known, and the Indicant, and helping things are exactly described such as are specifical and determinate. Curatory, preservatory, vital. Lastly some Indications are to restore, others to preserve, some are vital, according as they are taken from the restoring Indicant, the preserving, or vital. CHAP II. Of Indicants. BUt an Indicant as it belongs to the Method of healing is some Agent permanent in man's body, An Indicant. What. which by its proper nature and estence shows some help, and shows the Indicate which it requires to be directed to its self that the lost health of man may be restored. Whence it appears what are the true notions of a true indicant, for first it is required that it do act, What is required in a true Indicant. or that it be some Agent, Secondly that it be something permanent and present, or adhering to it, Thirdly the Indicant ought to be known to the intellect, Lastly one Indicant, as it is one, indicateth also one. As for the numbers and difference of Indicants, The differences of judicants. 'tis taken from the end of the Method of healing; which is an invention of remedies, for whereas things preternatural are to be removed and things according to nature to be kept, the Indicant should be twofold; called removing or curing in general, or vital, and since that things contrary to nature are three, a disease, the cause, and the Symptoms, there are properly four Indicants so called. The Indicant which is taken from a disease is called Cutratory, An indicant curatory. Preservatory. An urgent Symptom. the common name being retained of the method of healing, but that which is taken from the cause besides the containing cause, is called Preservatory; that which is taken from the Symptom, is called an urgent Symptom, nor are Symptoms to be excluded from the number of Indicants, since that also is preternatural, and hath peculiar indicateth which of its proper nature it affords, and that different from the indicateth which the diseases and causes afford, and remedies may be brought for Symptoms which regard neither the disease, nor the cause of a disease, which is manifest in pain which Anodynes show. The Indicant which is taken from things according to nature is called vital, A vital Indicant. but since things according to nature, are health, the causes of health, and the accidents of health, a vital indicant may also be subdivided. But although some reckon more Indicants, Indicants less properly so called. yet they are not new and peculiar Indicants, but belong either to the causes, from whence Preservatory indication is taken, or they are not true indicants, but rather manifest true indicants and by accident, and the intervening of another help to discover remedies, such like are temperament, habit of body, age, sex, kind of life, strength, custom, the peculiar nature of every one, the condition of the part beset with the disease, air, condition of Heaven, the time of the year, the Country, the place of habitation, the times of diseases, and the force of the remedies. Namely the temperament indicateth the preservation of its self, of which, a rule; That disease which differs most, from the natural state, is to be cured with more vehement medicines, that which differs less, is to be cured with milder. Age circumscribes the vitallindicant, of this there is a rule also; By how much the more a disease recedes from the nature of the age of the sick, by so much the more violent remedies 'tis to be cured with; by how much the less, by so much the more gentle remedies. There is the same reason of Sex, as there is of age; as for custom, those things that are accustomed along time, although they are worse, do less hurt, than those which are un-accustomed, whence a disease which differs much from custom, is to be opposed with stronger, that which recedes less, with weaker medicines. The course of life for the most part requires the same as custom. Idiosuncrasia shows that choice is to be had in Medicines. It is to be considered about the part affected, first its excellency, whence, a rule; Noble parts are not to be tampered with strong medicines, but ignoble parts will endure them more safely; moreover, its conformation and figure which determinates the Indicant and the Indicate; so a thinner part being moistened over much requires not great dryers, but a thick and compact part requires great dryers, Thirdly situation, of which you must know, that parts which are deep in the body, are to be cured with stronger medicines, but those that are in the Superficies with weaker: Fourthly, the place, of which is to be noted, that if many ways lie open for the giving of medicines, the next are to be chosen. Aire according to a several respect, sometimes signifies a Curatory Indicant, sometimes a vital. Of the season of a disease Hypocrates his Axiom is, In diseases beginning, if any thing seem proper to be removed, move it; but in diseases that are quiet, 'tis better to be quiet. Lastly, medicines sometimes show a greater, sometimes a lesser regress from the natural state. CHAP III. Of the concord, and discord of Indicants. BUt those Indicants, according as they sometimes agree amongst themselves, and sometimes disagree, they are allotted new names, and are called Indicaats, Consentients, contrary Indicants, Prohibents, Permittents, Repugnants, Correpugnants. Coindicants or consentients are those, Coindicants. which conduce to the finding out the same remedy, and more of them indicate the same thing, yet others would not have Coindicants to be Indicants, which require the same help, but to be that only which in the foregoing chapter we have said to be called not so properly Indicants, namely such as indicate mediately, and by the intervening of another, but the rest which are properly called Indicants, and require the same help, which is required by another Indicate, are called by a peculiar name Consentients. Prohibents which you may call contrary Indicants, Repugnants. and Repugnants, they are those which differ from other Indicants and require, and indicate another thing which is adverse to that, which was indicated from another primary Indicant and indeed so that the indication thereof be to be preferred before the other, and that which was indicated from the other is to be omitted. Those are called Correpugnants, Correpugnants. Permittents. which resist together with others, and prohibit something. Lastly, Permittents are those which although they indicate contrary to that which was indicated by another, yet, they are overcome by another, as being more powerful, so that they are compelled to suffer that which the other persuades. From whence it is manifest that a Physician ought to consider not only what one Indicant persuades, but also what another requires, for if all the Indicants agree, and conspire as it were in one, that is boldly to be performed which is commanded by them, but if there be some disagreement amongst them, 'tis diligently to be weighed which of them persuades most powerfully, and those things which descent amongst themselves are to be valued by their strength, dignity, and number. If they are equal according to power and dignity, and are uneven according to number, those which exceed in number are to be preferred, and that is to be preferred which is indicated by most, but if the Indicants are uneven in strength and dignity, that is rather to be preferred which is commanded by the more noble, or even by one more noble, but if those Indicants are equal both in strength and number, in all things they are to be regarded according to each several respect. From whence it is manifest that if the magnitude of Indicants be even, the vital indications are always to be preferred before the rest, and the greatest respect is always to be had to the strength, but if there be not a parity amongst the Indicants, that is rather to be performed which is indicated from that which most persuades, yet the rest if it may be are not plainly to be neglected. CHAP. IU. Of indicateth. AN indicate is that which helpeth, An Indicate. and is shown that it is to be used by the Indicant, it is also named Sumpheron, that is, profitable, Prospheromenon, that is aid, that which is required, the scope, and 'tis called the second scope, to distinguish from the first (for so the Indicant is sometimes called) also a remedy in the Curatory or restoring part. An indicate is divided into something to do as they speak, Division of an Indicate. or into the very essence of the remedy and nature of it, and into the use, or right Administration of that matter fit for remedy. What is to be done is known by its self from the nature of the true Indicant, What is to be done. whereby is known that the body is well or ill affected and confists in two things, and the Physician propounds to himself two things principally to be performed, namely that he may preserve the strength, and drive away those things which are contrary to nature, as a disease, the cause of a disease and Symptoms, from whence and, what is to be done, as the indicants above show, is divided into Curatory, which is a remedy taking away the disease; Preservatory, which is a remedy taking away the cause, and vital, which is helpful for the prefervation of life, to which as is said may be added, mitigation of urgent Symptoms In these oftentimes contrary indications do meet, and that which is persuaded by one, is dissuaded by another, for the strength requires giving of nourishment, contrary to which a disease and the cause do indicate, for they are increased by the exhibition of aliment, but then that is to be helped, which hath most need. But in giving contrary things, this principle is to be observed, that the remedy may be given contrary to the indicant, very exactly, but since that which is equally contrary may be given two ways, either by applying such a thing once which is equivalent to the regression from the natural state, or oftener by exhibiting contraries, not so directly contrary at several times, the first kind of remedy is to be used in two sorts of diseases, namely in those which are weak, and in those diseases, which are extreme, dangerous, but the latter way of remedy is to be used in those diseases, which aremoderate as it were the middle betwixt the extreme dangerous, and the weak disease. Moreover that which is to be done, as of indications, so of indicants, one is generical, another subalternate, another specifical, another appropriated, one is profitable, another unprofitable, one is artificial, another inartificial. But the use and right Administrations of help are comprehended under quantity, Use and right administration. place and time which aims Practitioners commonly name how much, when and where to act or do, yet it is here to be observed that those circumstances and manners of Administrations have place both in the help itself, and in the matter fit for cure. As for what belongs to quantity, Quantity whence Indicated. since that it may be taken both for a de finite degree of Administering of a remedy, in which respect quantity, and what is to be performed by a specifique agent are the same, and for the dose, plenty, and bigness of the matter of cure itself: quanttity or magnitude of the essence indicating denotes quantity taken in the former sense, for example sake, great heat shows that it must be much cooled. Yet hear is to be considered whether the part be situated deep in the body, for then a stronger Medicine is to be chosen that it may come to the part affected, with its full force. When, or the time is shown from the time or presence, of the Indicant, Time. for then help is to be Administered when that which requires it is present. Order also belongs to time, for that which in simple, Order of doing. is Time, incomplicate is order, and the presence of a vehement Indicant shows the order of performing, but that is first to be done which is shown by the Indicant, which over rules the rest in indicating, and that overcomes the rest in indicating, by which the greatest danger is threatened, and without the removing of which the rest cannot be taken away, and therefore three things being observed, we may proceed in a right order of cure; if first we weigh what urgeth most, and from whence there is fear of greatest danger, for that is first to be opposed, which strives most, or from whence the greatest danger of life is threatened. Secondly, if we consider what regard it hath of the cause, and what of the effect, for the cause is to be taken away before the disease. Thirdly, if we consider what may be in the stead of an impediment, and what before what, and what with what, and what after what may be cured, for whatsoever may be a hindrance in the taking away of a disease, or the cause of a disease are first to be removed, and therefore it is to be considered whether a disease be joined with a disease, or with the cause of a disease; if a disease be joined with a disease, it is to be considered whether those diseases agree or not, if they no way agree but are resident in divers parts, you may cure them severally, or together, each by their proper remedy, and 'tis no matter to which you apply the first remedy, yet regard is to be had of the parts wherein those diseases reside, for those which are in noble parts, or those parts which serve the noble parts, or have consent with them, or which perform any public duty, they are first to be taken away, but if the diseases have some agreement, and are some way united, it is to be considered whether the cure of the one is beneficial to the cure of the other, or at lest no way hinder the cure of the other, or whether the cure of the one may bring any impediment or hindrance to the cure of the other, or whether they partly consent, and partly descent; if the cure of the one bring no impediment, or bindrance to the cure of the other, or also if it promotes it, as if a distemper of the liver, and an obstruction thereof concur, you may cure them severally, or together, and begin with which of them you please; also when a reason thereof may be had from that which urgeth most, if they are not of equal force, but if they are so joined together that the one is more dangegerous than the other, you must begin with that which is the other, neither of them is to be cured by its self, but the remedies shall so be tempered that they may both be cured, most dangerous, qut if the one be no more dangerous then both be cured, Lastly, if they partly agree, and partly disagree, you are to begin with that, the cure whereof hinders not the cure of the other, and without removal whereof the other cannot be taken away; if a disease be joined to a cause, the cause is first to be removed, but in the removing of causes it is to be observed, that they are to be taken away in that order wherein they follow one another, so that you are to be begin first with that which was first in generation and last in dissolution, from thence you are to go on to the next, and so to go on forward in order until we come to our desired end, and that we may briefly comprehend all the matter, the presence of the Indicant which overcomes the other Indicants, and the absence of the prohibiting Indicant, shows when to act, and the order of performing; and moreover it teacheth whether the same remedy be to be repeated often, for so long and so often, it is to be repeated, as the Indicant remains present, and no hindering Indicant happens. The place, or substance of the Indicant showeth where, and the place of applying remedies, and the place is to be found out in which, by which, and to which as they commonly use to distinguish. In all alterations the place in which is principally to be taken notice of, in evacuations the place from which, Manner. and by which, if the matter be carried out of one place into another, the place to which As for what belongs to the place of application of matter fit for remedy, since a contact or touch of the matter and Indicant cannot always be immediate, that is to be chosen by or through which the matter of cure may come to it, that there may be a touch, and action and passion thereof and of the Indicant. As for Mode, if it regard the remedy itself without consideration of matter, How the matter medicinal answering to the Indicate may be found out. it seems not to differ from quantity, time, and place, but rather to be a Symmetry in measure, and equity to be observed in these; but if it be taken for the form of a medicine, that is delivered in the doctrine of the composition of medicines. The help or Indicate being found out, that the Physician may be careful of the matter of cure 'tis very requisite; which is taken from three heads, Chirurgery, Ingredients, and Diet, the same Indicate shows matter, circumscribed and determinate with its conditions, quantity, time and place, for that matter is proper and fit, which can perform that, which the determinate Indicate requires by its rules, and which may have force, but if there be more indicateth, or matter to be sought which have more faculties, or if these be wanting more shall becompounded together. But because always as is said, regard is to be had of the strength also, and it is to be weighed, whether by the application of this matter, there may come more good or not, the nature of the whole body, and of the part to which the medicine ought to be applied is to be considered, in which business not only manifest, but also occult qualities ought to be weighed, and 'tis to be enquired by the Physician whether the sick have any peculiar hatred to any particular thing, which therefore is in no wise to be given in the cure, but in parts affected in their kind, the excellency of a part is to be weighed, the sense, situation, conformation, for if a part be a principal one or performs a public Office, no Medicine is to be given which can much hurt it, and disturb its Office and Duty, for then loss would redound to the whole body, so to the mouth and chaps poisons and things ungrateful to the taste and sordid are not to be exhibited, nor stinking things to the Nostrils, nor gnawing and biting things to the eyes, nor those things to be applied to nervous parts affected, that cause pain. The same rules which we have now even propounded in the right use of remedies, Quantity of matter. eaten to be observed also in choice of matter, the quantity of matter regards the measure, & wa●ght thereof, which was indicated by the Indicant, and is for the performing of the Indication; the quantity of the matter is found two ways, first in what quantity any medicine whatsoever is to be given, and what are those bounds betwixt which if it be given it performs that which it ought, and no way hurteth, is manifest by experience only, but in what dose, whether in the highest, lowest, or middle, the medicine be to be given, to this or that sick person, what the quantity is of the matter to be administered, that is known from the magnitude, or extent of the Indicant, and if the quantity of the Indicant be great, the quantity of the medicine ought to be great likewise, in which matter the condition is to be weighed and the strength of the whole and of every part, for if a part to be altered is more remote in place, a greater quantity of the remedy altering is required, namely that it may come with its full force to the part affected. But the time of Administering of matter is taken not simply from the presence of the Indicant, Time. but is that when it can help, but this time is known, and the knowledge of the matter to be administered, and the nature of the part to which it ought to be Administered, for some things work presently, others after some space between; the action of of some things continues long, of others it ceaseth presently. The part as it is open, or placed deep, so it regards the action of the Agent presently; the Administration of the matter is to be prohibited when it doth more hurt than good, but it may do hurt, when it may preserve any thing contrary to nature which ought to be taken away, or when it may take away that which ought to be preserved. The place of Administration of matter, is that place where the matter is to be given, may help and perform that which 'tis required to do, for since every action is performed by contact, the Physician ought always to endeavour that the matter which he ●seth might penetrate to the place where the Indicant is, and may touch the Indicant, but some parts are Externall, others Internal, in Externall the matter is plain, for there the matter of the medicine is to be applied where it is to work, or where the Indicant is, since the Externall parts may be immediately touched with the medicines, but medicines cannot be so immediately applied to the Internal parts, and therefore when we are willing to evacuate, common ways are to be chosen, and the next through which the matter may be evacuated; if we are to alter in the interior parts, either manifest ways are to be found ●ut or occult passages, through which the matter that is given may penetrate, and indeed as for manifest passages, the widest and nearest are always to be chosen. But concerning the measure, Manner. or manner shall be shown hereafter, part the 3 d. Sect. 3 d. where various forms of medicines, both simple and compound shall be proposed. CHAP. V What Morbifique causes indicate, and peculiarly of purging of a juice in the body which causeth ill digestion. FOrasmuch as hitherto we have explained the universal Method of healing, now peculiarly we will propound the Method of taking away of Morbifique causes, removing diseases, and preserving strength, and will begin from the causes. What the differences of causes are, is spoken before in the 2 d. Book, part the 1. Chap. the 3 d. for of what kind soever they are, whether begotten in the body, or externally, or admitted into the body, and become as it were internal or stirring up, cherishing, and increasing a disease without, they all require removal. But whereas causes offend either in the whole substance, or quantity, Causes what they show. or quality, or motion, or place, first, all things which put on the nature, of a cause, as in their whole kind they are contrary to nature, they indicate, an absolute ablation of them out of the body, or as latter Physicians say, an Eradication. But that here we may treat only of humours, What things show in their whole nature preternatural. several ways there are of rooting out and evacuating corrupt humours out of the body, for sometimes they are purged through the paunch, sometimes they are ejected by vomit, sometimes discussed by sweats, sometimes cast out by urine, of which we will now speak in their order, and first of purgation. Purgation taken in the largest sense is indicated from a cacochymy; What shows when to purge. or juice which causeth ill digestion and bad nourishment, and a purging medicine taken in the largest signification is the matter of remedy, indicated for a Cachochymie; but that this doctrine of purgation may be more evident, in the first place tis to be observed, that Physicians in respect of purging medicines, divide the body into three common Regions, into the first, which is without the liver, and is extended from the stomach, through the middle part, home to the liver; the second which is dilated from the middle of the liver, through the greater veins, to the outside of the body; the third, which comprehends the habit of the body with the lesser veins: private parts also have their excrements and peculiat ways to void them, and hence one evacuation is called universal, Universal evacuation. another particular, universal is that which evacuates humours from the common Regions of the body, such is evacuation of blood after what manner soever, purging by the paunch, vomiting, voiding of urine, sweat, Particular. insensible transpiration; particular is that which evacuates some private part, as the brains, lungs, womb. As for universal purgation which evacuates the common Regions of the body, cacochymy consists of what indicateth it, either on this side, or beyond the liver; cacochymy which consists in the first Region of the body, by its self, and properly indicateth those medicines which have power without any manifest agitation of evacuating superfluous humours through the paunch, which stick in the first Region of the body, although sometimes if the matter have an inclination upwards, and the sick can easily endure a vomit, by vomit also humours may be purged out of the first Region of the body, so that those things which cause vomiting are not purging, and vehement, but gentle, such like are as abovesaid part the first, Sect the first Chap the second: Lenitives. others are called Encoproticks, only such as loosen, and mollify the belly; which evacuate only by softening, and washing away, and drawing away, others by a singular propriety, purge peculiar humours, whose force notwithstanding since it cannot be extended beyond the liver, by some are called Lenitives, by others, gentle purges; both of them and first the former, since they evacuate without much troubling the body, the strength easily endures them, and therefore they may be secrely given in what age soever, sex, or time of the year, so that the use thereof be lawful, namely that they are given in their due quantity, and before meat a little, and in fevers not near the fit. But excrementicious humours, Purges properly so called. which consist beyond the liver are to be evacuated by Cathartick medicines, so called peculiarly, or purgers, stronger, and strongest, and Catharsis or purgation in particular so called is an evacuation of excrementitious humours abiding beyond the liver by Cathartick medicines through the paunch, and by vomit, and is indicated from excrementicious humours, and such as are unprofitable for the nourishment of the body, and some of those are natural, others contrary to nature, the natural are those which are generated by the purpose of nature, as sweet phlegm, Melancholy, choler, for these if they abound, and are generated in the body in greater plenty than they ought, constitute a Cacochimy, but preternatural are those which are generated contrary to nature, and unto which natural humours degenerate, both of them, if they so offend that they can neither be taken away by diet, nor any other milder kind of evacuation, as by sweats or insensible transpiration Indicate purgation. But as Cacochimy subsisting beyond the first passages, and that being greater, indicateth purgation, so such require such kinds, as purge a definite humour; namely phlegm requires Phlegmagogues; Choler, Chologogues; Melancholy, Melanagogues; watery humours, Hydragogues; mixed humours require mixed. Yet it is to be weighed what the strength permits, Permission of purgation. and prohibits in purgation appointed, by a Noble medicine, and whether the strength can endure purging, and the sick be apt, or unapt to purge, and whether more profit or hurt will ensue by purging. All the rest of the signs which are said to forerun purgation, belong to the strength, whether they are strong or weak, of which kind are Temperament, habit of body, age, sex, of which Hippo. 4. Apho. 1. speaking of purging women with child says: Those that are pregnant are to be purged if the humour be un●bridled after four months, and until the seventh month, although these less, for those that have lesser or greater young are more warily and religiously to be meddled with, the kind of life, custom, property of nature, constitution of Air and such like. As for the Temperament, hotter and drier bodies endure with more difficulty cold and moist indifferently, hot and moist easily: strength of body admits of purgation, imbecility very little, a lean habit of body warily, a full body easily, a fat body hardly, of age it is principally to be noted that sucking children are most conveniently purged by medicines given to the Nurse: as to custom, those that are wont to be purged, more boldly; those which are not accustomed are more ringly to be purged: of Air you must know that neither the hotter, nor the colder; but purging is principally in the spring time to be appointed: concerning the nature of a disease it is first to be noted that in hot dileases, if the disease will bear it, cooling things are to be administered before purging, moreover because in them the store of ill humours is rather to be taken away by loosning things then by true purgation. Thirdly because those which are apt to a Diarrhaea, Cramp, etc. are not casy to be purged. But principally you must observe whether the sick be prepared and fitted for purging, namely whether the ways through which the matter ought to be conveyed, are open, and the humours themselves fit to be evacuated, of which it shall be spoken. CHAP. VI Of the time fit for purging of a disease. BUt although peccant, Time of purging. corrupt and putrid humours always Indicate their own taking away, and evacuation out of the body, yet because they are not always apt for purgation, you may not evacuate them at any time, but are to inquire of the time and occasion of giving purges The convenient time of purging is, when the humour Indicating purgation is present, and other Indicants permit it, and nothing hinders it. But in the beginning you are to be admonished here, that those things which are to be purged either may stir up a fever, or other diseases without a fever; if the fever be absent, the ways open and the humours themselves prepared for motion, you may purge them at any time, so in the Scab, cachexy, pain of the head, Palsy, Trembling, pain of the Teeth, you may purge during any time of the disease, when nothing prohibits, it and that a concoction is not expected, when those humouts are not properly crud, the are ill drawn hither by some A●ho. Hippo. 22. Sect. 1. things concocted, are to be purged not crude, but the whole disputation of the fit time for purging of a disease is of Fevers, and that acute, especially wherein the humours are properly crude, although the time of a disease show not, yet there is a sign which shows either the prohibiting, or permitting virtue; for since that in the augmentation of a disease, nature gins a combat therewith, in the state there is a great conflict between them, let him endeavour this one thing with all his industry that he may overcome the morbifique cau●e, and having overcome it may drive it out of the body, and all the Symptoms if they are greater, nature is neither to be opposed any more with purging medicines then, nor to be called away from its good purpose, nor being debilitated enough by the Morbifique matter, and most grievous Symptoms, is it to be hindered; there remains therefore two times, namely the beginning of a disease, and that after the state, neither notwithstanding is it equally profitable to purge in which you please of these in all diseases, but always to consider whether more profit, or more inconveniency will ensue by purging, but what it is to be done here. Hippo, teacheth in the 22. Apho. Sect 1. which Galen, in 4, of preferving health Chap 5. calls an Oracle, he says, concocted, and ripened humours are to be purged and moved, not crude. Out of which it is manifest that the most convenient time of purgation is after the state, Purging is the best in the declination of a disease. and when the humours are concocted, for if we purge concocted humours, that is such as are overcome and tamed by nature, and separted from the profitable blood, we have nature our helper, and the humour more aptly follows the leading of the purging medicine, but if we endeavour by purges to evacutate crude, humours, that is such as are not as yet Elaborated, and become benign, nor as yet separated from the profitable, the sick will receive more damage than benefit from thence: neither have we nature to a fist us, nor are the humours apt for purgation, wherefore either the purge performs not its purpose and brings out nothing, or very little, or if the medicine be very strong, it draws out not only the unprofitable, but profitable humours, (since they are hitherto mixed,) it melts, and consumes the body, disturbs the humours more, and confounds them, brings forth obstructions in the first passages, the matter being stirred and not sufficiently evacuated, whence grievous Symptoms do arise, but if any voluntary purge shall happen, and that sufficient, or that any future looseness be expected, there will be no need of any purging; according to Hippo. 1. Apho. 20. those things which are perfectly judged, and tightly confirmed are in no ways to be removed, Sometimes you may purge in the beginning. neither moved, neither with purging, medicines, nor other endeavours, but are to be let alone. But although the best time for purging is after concoction, yet sometimes you may purge in the beginning, by the command of Hippo. 2. Apho. 29. where he saith, in the beginning of a disease, if any thing seem fit to be moved, move it, but when you may, purge it in the beginning of a disease: It is variously disputed amongst Authors; Galen shows it clearly, whilst 1. Apho. 24: he saith, that then only purging is to be used, when greater profit may follow by the evacuation of offending humours, than the detriment is, which the body receives from purging medicines; or when any present danger doth more urge, than crudity of humours; but Hippo. shows the cause, and that danger, 1. Apho. 22. whilst he writes. That purging is not to be used in the beginning of a disease, unless the matter raise tumors, or be angry: for if hot humours, acrid and biting wander up and down in the body, and it be doubted lest the strength should be debilitated by the agitation of the matter, or lest the matter being stirred up should rush into some principal part with violence, or into some part, which may draw a principal part with violence, or into some part, which may draw a principal part into consent, or lest the native heat should be extinguished, you may purge them presently in the beginning of a disease, especially when they also of their own accord are movable, and easy to be evacuated, and nature wearied out by them, affords its assistance towards their expulsion, and indeed that should be done in the very beginning, Apho. 10. Sect. 4. of Hippo. To purge in very acute diseases if the humour swell, the very first day, for delay in diseases of this kind is dangerous. CHAP VII. Of preparation and concoction of humours. AT another time, Concoction and preparation of humours differ. Concoction of humours the work of nature. concoction of humours is to be expected before purging be appointed, and the Physician shall study to prepare those things which further concoction, and cause more commodious evacuation, for we must distinguish betwixt concoction and preparation, and concoction is attributed to nature, preparation to Art, namely nature only concocts humours, and Elaborates them, and draws them to that perfection, and better state by putrifying which they can receive, that they may the more conveniently and without prejudice or detriment to the sick be evacuated, but it is not in the power of Art to concoct humours, yet it may be helpful to the native heat, concocting both by cherishing and strengthening it. Besides this true concoction which is the work of nature only, Preparation of humourst wofold. Digestion. there are yet other preparations of humours, which are appointed for the more happy concoction, and more profitable evacuation sake, which the vulgar call concoctions also, and medicines effecting them, they call Concoquents, or as they commonly speak Digestives. These preparations are of two kinds the one is that which preceds the concoction which is performed by nature, The first prepation of humours. the other is that which follows it, the former is that which takes away all things which are impediments to nature whereby it may the less begin, or happily perfect concoction, and commonly useth to be called concoction; the quality of humours besides their quantity, hinder concoction; therefore what qualities soever hinder concoction are to be taken away by their contraries, and hot humours are to be cooled, cold to be heated, dry to be moistened, moist to be dried, in like manner humours that are too thick are to be attenuated, those that are to thin and sharp are too be thickened and allayed, and those that are tough to be wiped away or purged. Namely phlegm which is cold, Phlegm how to be prepared. Choler. moist, thick, and dull, requires heating, drying, attenuating, cutting, and detergent medicines. Yellow choler since it is hot and dry, 'tis to be corrected with cooling and moistening things, but as it ●s thin, and by its too much tenuity may molest the body, it is to be thickened, the other kinds of choler which are produced by too much adustion, sichence they are now thicker, require extenuation. Moreover the melancholy humour since it is cold, Melancholy. dry and thick, is prepared with things modernately heating and attenuating and moistening, but black choler, since 'tis a hot humour very dry and thick, requires cold things, much attenuating and moistening. The other preparation is that which is appointed when putrid humours already concocted, Another preparation of humours. or others also not putrid, by reason of some impediment are not evacuated without difficulty, unless that be taken away. But since humours which ought to be evacuated, aught to be movable, and the ways through which they ought to be moved open, hence it easily appears that there are two hindrances, which impead the happy purgation of humours, namely thickness of humours and obstruction of passages. And therefore the Physician which would purge as Hip. commands 2. Apbo. 9 must well prepare, as Galen explains it, 'tis to extenuate the thick and dull humours, and open the passagesthrough which they ought to be traduced, and drawn by the force of purging medicines. CHAP VIII. Of the quantity of purgation. THat we may purge as much as is convenient, How much to purge. and no less, we are to use diligence, first to know the quantity of the peccant humour, that from thence the quantity of the purging medicine may be determined, for the quantity of the purging medicine ought to be such that it may evacuate all the peccant humours, lest any part thereof remain in the body, and corrupt the other humours, and afterwards cause a ralapse. But whether the peccant humours ought to be evacuated together, and at once, Whether the peccant humours are to be evacuated at once or several times. or at several times is to be known from the store of humours, and strength or weakness of the Patient; for if the matter be much, and if the strength be great, yet it is better to divide the purge, nor by too large evacuation rashly to debilitate the strength, but if the matter be too little, and the strength great, you may purge all the humour at once; if the strength be weak, and many, or few humours are to be evacuated, 'tis more commodious to evacuate at several times, then to debilitate the strength by one strong purge. Permittents and Probibents. Moreover you must attentively consider how the strength will endure purging, and all those things which may discover present strength as well as that is to come, and all those things are to be weighed which are numbered amongst permitting things, and such as prohibit purgation: amongst which the first is the natural propriety of body, for some having taken stronger, and greater doses are scarce moved by purgers, others are purged very easily having taken any purging medicine, therefore if the propriety of natures be not sufficiently discerned, 'tis better to try with gentle things, then rashly to meddle with the strongest; custom also and habit of body is to be known, and 'tis to be considered whether the sick can bear strong medicines or not. The perfect fignes of purging Hippo. Signs of perfect purgation. delivers 1. Apho. 23. he saith Excretions are not to be valued by their quantity, but if they are such as they ought, and so go out that the sick can easily endure it; whereof the first is if such as ought are evacuated. Secondly if the sick can well bear it. Thirdly thirst happens through evacuation, according to Apho. 19 Sect. 4. whosoever are purged having taken a purge, and do not thirst, the purge hath not reached home to the mark before they do thirst. But if due evacuation be not made it shall be promoted sparingly by moderate exercise of the body, More s●aring purgation how to be provoked. Overmuch how to be hindered. as 'tis in Hippo. 4. Apho. 14.15. but if it be too much, you must use sleep and rest. Too great evacuations are hindered by Ligatures, and rubbing of the extreme parts, by sweats, Cupping-glasses applying to the navel, astringent Topical Medicines put to the Region of the stomach, taking of new Treacle, or old, with a grain of Opium, as also with meat, drink, and Medicines given, that have astringent qualities. CHAP. IX Of the place by which purgation ought to 〈◊〉 made. LAstly the place, What show the part to be purged. by which purgation ought to be made the residence, or as I may say the inclination of the humours show, for a humour is to be evacuated through that place, through which, both in respect of the place wherein it resides, and of its own nature, it is fit to be evacuated so that the strength will permit it, which Hippo. also admonisheth 1. Apho 21. we ought to lead out humours that way which they are most inclined to go, thither they are to be led through convenient places. But the convenient places are those through which nature at other times rightly acting, evacuates what is offensive, and indeed there are two ways by which purgation is to be appointed, the one is that by which we vomit, the other through the paunch, By vomit. but by vomit those humours are conveniently evacuated which are apt both in regard of the place where they reside, and in respect of their own nature to be carried to the stomach, or such as tend upward, namely such as are generated, and reside in the stomach, as those also which are contained in the Spleen, Cavities of the Liver, and Pancreas, as also thin humours, hot and choleric; but by the paunch those which remain in the inferior parts and tend downwards, as also thick and cold humours, By the paunch. hence Hippo. writes 4. Apho. 6. those that are lean, and easy to vomit are to be evacuated upwards, being careful of the Winter. As for example, those which abound with choler which tends upwards; but on the contrary those which are hard to vomit, and are somewhat thicker, and of an indifferent habit of body are to be purged downward being cautious in the Summer, because they more abound with phlegm. Moreover the time of the year shows the humour, Time of the year. and from thence also the place of purgation, hence Hippo. 4. Apho. 4. in the Summer the superior ventricles, in the Winter the inferior are to be purged, for in the Summer yellow choler and hot humours abound, and by reason of the heat all things in our bodies seem to tend upwards, in Winter, phlegm rather abounds which is heavy, and by nature tends downwards. Symptoms also show the nature of humours, Symptoms. and whither they incline, as Hippo. teacheth 4. Apho. 17. the loathing of meat by one that is not in a fever, the griping of the mouth of the stomach, a Vertigo with Apparitions of shadows, and bitterness of the mouth show that there is need of purging upwards, all which Symptoms signify that choler is willing to ascend to the mouth of the stomach, and the same Apho. 18. pains above the Midriff, whoever wants purging, they signify they are to be purged upwards, but those which are beneath, downward, and the same Hippo. Apho. 20. if there be gripe, and frettings in the guts in fevers, and heaviness of the knees, and pain of the Loins, they show that you are to purge downward. Yet in provoking vomit we must consider whether the sick be easy to vomit, or not, and whether the stomach or any of those parts, which may be moved by vomit and to which the humours, or at least the vapours stirred by vomit may flow, be weak, and affected, for than you must abstain from giving a vomit. CHAP. X. Of the due Administration of Purgers. AS for the hour of giving a purge, Particular time. purging medicines are to be given at the fourth, fifth or fixth hour in the morning, but if there be any thing which impeades purgation at that time, or requires a purge to be given sooner, it may also be taken at another hour, for fits hinder, which if they come in the morning, the medicine is to be exhibited in the Evening, but a violent disease forceth us to purge, since it threatens present danger, in which case purging is not to be deferred, but to be given, although in the Evening, the purge being taken, you must abstain from mere four, five or six hours, after the medicine is taken, those which are given to drink should be given, hot, not cold, nor lukewarm. Some are wont to mingle purges amongst their meats, Whether purgers may be mixed with meat. but they did not well, for the force of the medicine is hindered by the meat; and the meat is defiled and corrupted by the medicine, and the humours which are drawn; its concoction is hindered, and being uncocted, the medicine stimulating, it is expelled; and 'tis to be feared, lest some excrements, mixed with the meat, should be distributed into the Liver and veins, or that the meat it self, being not enough concocted, or rather corrupted, should breed some inconveniency in them. CHAP. XI. Whether it be lawful to sleep having taken a purge. WHether we may sleep having taken a purge Physicians disagree, but there is need of a distinction; for if the purging medicine be gentle and benign, having taken it we ought not to sleep, lest the medicine should be carried away and overcome by nature, and its action hindered, but if the purging medicine be stronger, and requires greater heat that it may be brought into action, sleep may be granted to the sick, yet moderate, which may only further the activity of the medicine, but not impead evacuation, but afterwards to abstaire from sleep until perfect and sufficient purgation be made; moreover for the same reason, after taking strong purges 'tis lawful to sleep a little while, that the malignity of the medicine may be resisted by the more plentiful heat, occasioned by sleep, and those troubles which the medicine occasioneth may less be discerned in sleep, and so the medicine retained without trouble or molestation, may rightly be reduced into action. CHAP. XII. Whether it is best after purging, to use cleansing, and abstergent medicines. 'tIs the custom at this day, some hours after taking purging medicines, to exhibit cleansing broths, and such as wipe away, and that is rightly done, for 'tis profitable before food be taken, that the remainders of the medicine, and the residue of its qualities, and if any vicious humours are drawn by the medicine, and remain in the stomach, they are to be washed away, and drove downward, and the loathing, and disdaining of meat, which is wont to be occasioned by purging, may be freed and taken away. CHAP XIII. Of Evacuation by Urine ALthough the watery humour is principally evacuated by Urine, which remains of the drink, Evacuation by Urine. and is mingled with the blood, and the gibbous part of the Liver, Reins, Bladder, and Vessels sub-servient to these, are principally purged by it, yet the other humours attenuated, and principally the serous, thinner phlegm, the choleric humour, and all the nerves and veins, may be purged by the same. But seeing those things that cause Urine cleanse the body by degrees, 'tis most profitable in those diseases, wherein 'tis convenient to evacuate matter by degrees, and sparingly; but in those where there is need of sudden excretion, and of evacuation to be made on a sudden, in such evacuation of Urine is not so helpful. But what the difference is of medicines provoking Urine is spoken before, Diuretics properly so called are useful only as often as thick humours residing in the Reins, bladder and parts sub-servient to them are to be evacuated, or if thick humours stay, or stick in the veins but those which move Urine only by affording aqueous matter, are convenient in those diseases which are bred of thick and adust humours, for by the mixture of aqueous substances, these are rendered more fluid. Permittenes and Prohibients. Those things which permit, and prohibit also, are here to be considered, the strength easily endures this evacuation so that it be so administered that more profit than damage may redound to the sick, for if either in the whole body or about the liver, many ill humours stick, there is danger, lest by their plenty and thickness whilst they get to the strait passages, they should obstruct them; and therefore first a purge for the belly is to be appointed: Diuretics also are not so convenient for hot and dry diseases, as fevers arising from hot humours, nor for such as are lean and withered, as also if the Reins, bladder, and passages and vessels appointed for this evacuation, are ulcerated, or inflamed or affected with some such like disease, Time. The time of drinking medicines causing Urine is not not convenient in the beginning of a disease, since the matter is as yet more plentiful, and thicker, but in the declination when the matter is somewhat abated and thinner, but they are most profitably given before meat, and on an empty stomach. CHAP. XIV. Of evacuation by sweat. LAstly vicious humours also may be expelled by sweat, Sweat whence it evacuates. for although sweat evacuate in the first place from the circumference, and habit of the body, yet it may evacuate humours also from the rest of the body, and indeed first out of the greater veins and Arteries, and afterwards out of all other parts, namely from whence humours may be driven to the veins, and from thence to the superficies of the body, for they are not conveniently thrust out from the cavities of the stomach, guts, womb, and such like, to the extremities of the body, and there are other ways by which they are far more easily evacuated, What humours are evacuated by sweat. but the watery humour is evacuated by sweat, which also may be evacuated by Urine, and so may every thin humour and choleric, as others also if they are attenuated, but principally sweats are profitably provoked by art in inveterate and cold discases, and diurnal distillations, in the Palsy, the Sciatica, and other pains of the joints. Yet you must be careful here what the strength can permit, for this is a powerful remedy, Things permitting. and requires great strength, but principally hot and choleric persons endure sweat less, and not long, nor do very hot things agree with them; much matter prohibits provocation to sweat, for 'tis to be feared, least being dilated to the skin, it should shut its small breathing holes, or pores, and so either generate, or increase putrefaction. As for how much, How much. we must be careful that we do not over much provoke sweat, for sweat, if it be too much, weakens the strength exceedingly, resolves the body, and makes it lean, wherefore 'tis more commodious to cause moderate sweats often, then to debilitate the strength with one that exceeds measure. But the fit time for provoking sweats is the beginning of a disease, but after universal purging of the body, When. and in the declination of a disease, but the particular time, when the meat is concocted, and in the declination of diseases, in those which have paroxysms. But medicines provoking sweat are especially to be exhibited with profit in pestilential diseases and in all malignant matter, by which the malignant matter, In what diseases. the pestilent and venomous matter to the great benefit to the sick is driven from the internal parts, and those that are next the heart to the extremities of the body, and is evacuated by sweat. But Sudorisiques, which are given in such diseases, aught to be of the number of those that resist poison, that they may together infringe and debilitate the venom. In Administering of which, there is no need of all those rules or observations, which are necessary to be observed in provoking sweats in other diseases, but presently in the beginning of a disease those Sudorifique resisters of poison 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 brain. Errhines. if any vicious humours are collected in the brain, it may be evacuated two ways, by the Nose, and the Palate. By the Nose, first Errhines call out phlegm, which is spread about the brain, and films 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 brain, and by the force thereof humours which lie deeper may be cast forth, of both of these this in general is to be noted, that such remedies are not to be used, unless universals have preceded, and that the whole body be purged, but or the matter and form 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 brain, they are not conveniently given to those, the inward part of whose mouth, throat, gullet or Larynx is exulcerated, and such as are obnoxious at other times to distillations to the Chaps 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 Rheims 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 Air; not so viscide, as to stick in the mouth of the Lungs, and therefore if the humours are viscide they are to be moistened and cleansed with sour things but if too thin, to be somewhat thickened. The stomach is evacuated by vomit or by the paunch, Things purging stymach, Liver, Reins, Womb. the guts with glisters, and medicines purging the belly; the cavities of the liver, through the belly; the gibbous parts, by urine; the reins, and urinary passages, by urine, the womb by the cources. Of which 'tis now spoken in universal evacuation. CHAP. XVI. Of the abating abundance of blood with Leaches, Cupping-glasses, Scarrifications etc. 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 shows the fault concerning quantity. What offends in quantity. and that which is diminuished, may be increased, but since nothing can be said to abound, unless 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 natural excrements in this second manner may be the causes of diseases, as also milk and seed, and moreover the spirits and solid parts of the body, all which if they are deficient in quantity, aught to be increased, but if they exceed are to be deminuished; natural excrements are seldom desicient in quantity, but they often exceed; but since the same reason is of evacuating natural excrements, which there is of the humours, in their kind preternatural, 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 shows. the blood is to be diminuished, and that which aboundeth to be taken away, and too great plenty of blood indicateth diminution of the same. But concerning the manner how we abate the blood, The manner of abating blood. some perform it more strongly, others more weakly; frications, Sweats, Baths, Exercise, Fast perform it more weakly; Leaches, opening of the Hemethodes, provocation of courses, Cupping-glasles, and Scarrifications perform it more strongly; but the most generous, and powerful remedy here, is opening of a vein. Frications, sweats, Baths, and Exercises, they diminuish the blood one way, because they stir up the heat in the body, which dissolves and dissipates the substance of our bodies. But fasting doth not evacuate by its self, 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 heat, and denies necessary aliment to the body; but because fasting evacuates the whole body equally, 'tis 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 'tis endured when the strength is powerful, 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, gripping or biting in the Orifice of the stomach, vomiting, flux of the belly. Leeches by opening the mouths of veins, 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 help diseases of many parts to which they are applied, and evacuate, sometimes a greater, sometimes a lesser quantity of blood, as they are applied to a greater, or lesser vein, 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 applied for the evacuation of the whole, they are to be put to the great and prominent veins, in the Legs and Arms or Hemerhodes, yet in women that are with child, they must be applied only to the Arms; but in regard of peculiar diseases they are to be applied 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 vein, but otherwise the Physician in opening of them shall labour with little profit, unless happily they are opened by leeches putting to them; but since the Hemerhodes are twofold, external and internal, the external are opened to abate a Plethory, as also for diseases of the Reins, Womb, Back, Hips, and other diseases arising from the hollow vein with profit; as in diseases which proceed from the Hypocondries, the Liver, Spleen, Mesentery, the internal may be conveniently opened; but the external are opened with frications, the leaves of a Fig, course rags, Leeches applied, the juice of an Onion, the juice of Century, or Showbread, the Gall of a Hog, or Bullock, or with rags wet in these, but the internal with suppositers and sharp Glisters. The courses whilst they flow exacuate also and diminish perfluour blood; Courses. but nature appointed that flux, which if it be suppressed is to be opened; in which business this is to be observed, that in provoking them, the Physician should make use of that time, when at other times they use to flow, for if he should endeavour it at another time, he loses his labour. Cuppings, which Scarification also, Cupping with scarrisying. but by die, evacuating blood by themselves, and sensibly, but by degrees; for which reason they are something applied for good reasons, sometimes instead of opening a vein; if they are applied with good reason, they are indicated from no great fault of the blood. But when they are used instead of Phlebotomy they are applied for some great fault in the blood, which indeed requires the breathing of a vein, 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 poured into the capillary veins from the great veins, 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 application, if they are applied 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 remedy; yet in those that are pregnant, they are not to be exhibited to the inferior parts but rather to the Arms. Lastly simple scarification also without cupping, Scarification. may evacuate blood; which truly is used sometimes instead of opening a vein; and 'tis appointed in the Legs especially, by which means it may not only evacuate but also revel from the head, and superior parts, yet sometimes in the Arm and back also, but in its proper use 'tis exhibited, when there is a purpose to evacuate only out of some one part, but especially when we would evacuate some acrid, malignant, and venomous 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 vein. BUt the most efficacious remedy for evacuation of blood is the breathing of a vein, which nevertheless hath other uses, What indicateth a breathing of a vein. whereof we will here speak together, for 'tis a question of great moment when the breathing of a vein, or evacuation of blood by opening of a vein is to be appointed, where first this is to be noted, that the opening o● a vein is not some one Indicate, but the matter of remedy which is profitable in many indicateth. There are two general benefits in the opening of a vein, The use of opening a vein. to evacuate, blood, and by accident, whilst it draws away the blood, the vehicle of heat, to cool; again in evacuating it performs two things, for it both takes blood out of the body, and always the course, and violence of humours in the veins; first the way it both takes away the ill blood, and only diminuisheth it offending in quantity, but the latter way it can revel, and draw back and derive the blood flown into a part, and the blood which is flown in whilst it is yet movable, can draw it to the parts near thereunto; so that the opening of a vein may wholly perform five things, namely to evacuate corrupt blood, to diminuish blood, to revel, derive, and refrigerate. For first the vicious and putrifying blood may be evacuated by opening of a vein, Putrid blood evacuated by the opening of a vein. as that which is contained in veins, and they being opened it flows out, and indeed 'tis most profitably appointed in beginning of diseases, since nature for the most part in fevers use to drive no small portion of the peccant matter to the extremes, and those greater veins under the skin. Secondly, breathing a vein is an excellent remedy to diminish the blood. The cutting of a utine devinuisheth blood and revels. Thirdly, the opening of a vein is used for revulsion, for a vein being opened, the violence of the blood is turned and drawn back to the contrary part, and therefore 'tis a very efficacious remedy to stop flow of humours, contained in the veins. Fourthly, the opening of a vein may derive the blood, which newly flowed into the part, It derives. and is not yet settled there, but as yet fluid; a vein being opened nigh at hand it may, I say drive the blood to a neighbouring part. Fifthly, Cools. opening of a vein cools by accident, but if distemper only be present, which may be corrected by other remedies, and no other fault of the blood be joined with it which requires breathing of a vein 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 perform, or some other fault of the blood be joined, which by the same means, opening of a vein may help, for this cause also you may open a vein. From whence it is manifest, For which Indicants cutting of a vein serves. that the breathing foe a vein may be profitable, whilst the blood either putrifyes, and is corrupted, or offends in quantity, or flows to any part, with violence, or oppresseth a part, or burns vehemently. Yet it is not always necessary to open a vein when these ●inconveniences are present, since we can take them away by other means, but then only breathing a vein is conveni●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 vein. the Indicant to which by mediation of the Indicate, as being the matter of help, opening of a vein 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 grows 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 vein. Yet we may not always open a vein when these Indicants are present, Things permitting opening a vein. for since the opening of a vein 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 vein, if it be weak 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 weak, either oppressed with store of humours, or loosed, in the latter imbecility only breathing of a vein is prohibited, but in the former it is profitable. All other things which are said to permit, or prohibit the breathing of a vein, besides strength, they do it only in this respect, namely as they are the tokens or signs of strength, or debility of nature, as Age, which flourishing admits of opening a vein, Childhood and old Age prohibit the same, Se●. the Sex, as to women with child, especially in the last months, the opening of a vein is prohibited; unless some disease enforce it and there be store of blood, property of nature, custom, habit of body, course of life, constitution of Air, some Symptoms, as large evacuations, watch and such like, which dissipate the spirits, and substance of our bodies, and loosen our strength, unless they are taken away by opening of a vein. How much blood to be evacuated. The quantity of letting blood is indicated from the greatness of the fault depending on the blood, and according as that hath greater or less force, so blood is to be evacuated more largely, or sparingly, yet the strength, as also things permitting are here to be weighed, an● all those things, which are the signs of strength, and weakness; and 'tis to be considered whether the strength will bear 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 several times, the greatness of the disease, and the strength do show; in a most violent evils, 'tis convenient to evacuate the blood at once, in milder at several times; also strong bodies will bear one large evacuation of blood, but if they are weak, 'tis better to do it at several times. The presence of those Indicants which serve for the letting blood, Time. shows 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 meats are in the first passages, and in diseases wherein there are certain intermissions, and wherein the fits return at certain 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 hour, Hour. if a disease that is violent, provokes or urgeth, in what hour of the day soever, or even at midnight, no preparation being made before, and no delay being made, you may open a vein, at other times, one hour or two after sleep is most convenient. But where, What veins to be opened. or the place, and vein to be opened, although what veins soever be opened it may evacuate the whole body, yet the larger perform this best, and regard is to be had, to the fountain of blood, and the rise of the evil, which are principally the liver and spleen, the veins therefore in the right or left cubit are to be opened, according as the disease requires, the internal, external, or middle, and especially the internal, but what veins are to be opened for Revulsion and Derivation sake shall be shown 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 natural 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 natural 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 flows contrary to nature, unless happily nature unburthens itself conveniently by that means, or the body puts away humours that trouble it to some ignoble part of it, but we may satisfy this indication several ways, 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 ways, through which it ought to flow, lastly if we prohibit its coming, 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 pain: 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 vein, scarrifications, leeches, flowing of courses, Hemmerodes, purging by the Paunch, vomitings, urines, sweats,: By heat and pain they are drawn back, by those things which have power of inciting heat and pain, or have power of performing them both, as are frications, ligatures, lotions, fomentations, vesicatories, caustics, and such like. An so, How many ways the motion of humours may be hindered although there is one Indicant, namely a fault of the humours in motion, so there is one Indicate, namely, remedy hindering motion, and averting the humour from the part to which it flows, yet the manners of performing these are various, namely four, Revulsion, Derivation, Interception, and repulsion. Revulsion, Revulsion, what. which the Greeks call Antispasis, is an averting of a humour flowing into some part, into the contrary; But humours are Reveled, 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 it tends, but to a contrary; hence it follows, that Revulsion ought not to be to the next, but to the remote and opposite parts, and principally according to length, and breadth. As for the other oppositions some observe them also, whilst they make a twofold Revulsion, the one which is simple and absolutely such, or a universal Revulsion as it is called, Universal. which observes contrariety in respect of the whole body, & in it regards contrary terms, from whencesoever the humours flow, as when we revel from the head to the legs and feet. Particular. But there is another particular Revulsion, or local, which in one member only regards contrary terms and opposition of the parts of the same member, and in the same member revels from the anterior parts to the posterior, or from the hinder to the former parts: Which nevertheless scarce deserve, the name of a Revulsion: And this former in the beginning of diseases, when the body is as yet very full, is most proper: But the latter is not convenient in the beginning of diseases; also whereas in revulsion the flowing humour ought to be drawn to the contrary part is manifest, flow are to be drawn back together to the beginning; hence when humours flow from the whole body, or the beginnings of fluxes lie hid, the revulsion is fitly made to the remote parts, but when the beginning of the flux is certain, to that the flux is to be re-called, although it be not the remotest part. In particular, as for the revulsion by opening of a vein, Revulsion by opening a vein. although that also is to be appointed in a distant, and remote place, yet not simply the most remote part is to be chosen for the opening of a vein, but that part which is exactly on the contrary, or which also hath communion of veins joined to it, or Euthyory which is a certain direction of vessels, by which the reduction of humours may conveniently be made, and may easily flow from one part into another, and therefore veins, which are open for revulsion sake, rather communicate with the part sending, then receiving, as it is necessary; so we recall blood flowing to the place from whence it gins, and we cause a contrary motion for it; namely we ought here to choose veins which are remote to the part affected, and have communion with the part sending, which are directly opposite to the part affected, either according to longitude, or latitude, hence an inferior part being affected, a vein in the Arm of the same side, a superior part being affected a vein in the Arm of the contrary side, the liver affected the interior vein of the right cubit is to be opened. As for the Administration of a Revulsion, The right Administration of revulsion. the quantity of revulsion answers to the quantity of the flux, and strength tollerating, but that is greater which is made with the letting out of a humour, then that which is without it, and there are certain degrees and differences of magnitude in every kind, every one whereof answers to the certain error in the motion of the peccant humour. As for the time of flowing since revulsion ought to be of humours flowing, 'tis principally to be administered, The time. when the flux gins, but if the flux be more lasting, it ought to be exhibited after the beginning also; but if the flux be less so that it may be stopped by derivation, or repulsion, there is no need of revulsion. The places, to which revulsorie remedies are applied, Place. are various, according to the variety of the parts affected. CHAP. XIX Of Derivation. DErivation regards that matter which newly flows into the part affected, Derivation what. but as yet is not spread abroad into the space of the part without theveines; but as yet it flows in its veins, and it is an averting or drawing away of the humour offending the part, to the adjacent parts, and an evacuaion of it through the same, and in this evacuation, namely that which is made by opening of a vein, the communion of the veins with the part affected is observed, whereof mention is so often made by Authors; also if the matter in the body be plentiful, derivation is not to be appointed unless that plenitude be first abated. The quantity of Derivation of a humour which flows into the part, Quantity. answers to the quantity which so flows, and to the strength of the sick, but in letting of blood the measure, and limits of Derivation in inflammations Hippo, commands us to learn by the changing of the colour: the second of the reason of diet in ac. T. 10. so that the strength will bear it. The convenient time of Derivation is when the matter flows into the part, Time. and the store of matter is taken away, and the flux is abated, yet it ought to be performed before the matter besme are the part. The situation of the part shows the place; Place. which in general aught to be near the part affected, and to communicate with the passages. CHAP. XX. Of Repulsion. REpelling things drive away the humour flowing, Repelling: to another place, and hinders its coming to the part affected, and that which newly hath flown, they free the part from by pressing of it out But you may not exhibit Repelling things in all fluxes, Repellents not convenient ser fluxes. for first they are not to be given in ignoble parts; Secondly, when the flux is nigh to a principal part, lest the matter repulsed be carried to the principal parts. Thirdly, to parts placed too deep. Fourthly, if the matter be malignant, and venomous. Fifthly, when a wound is inflicted by the stroke, or biting of a venomous Creature. Sixtly, if nature rightly acting, drives any matter into a part critically. Seventhly, if the humour be much, and the body as yet full. Eightly, if the humour be fixed in the part. Ninthly, if there be vehement pain. The most convenient time for Administration of repelling things, is the beginning of the flux; Time. but when the beginning proceeds towards the augmentation, Digerents are to be mixed. But since as is said before, some repelling medicines are cold and moist, others cold and dry, and astringent, those do best agree when the humour shall be thin, and little, and is in the extremities of the body, or when fluctuations happen by reason of two great heat of the parts, or when they have great heat adjoined, or if the pain be vehement, but these when pain doth not so provoke, and fluctuations are made through the debility of the parts. The place to which repellents are to be exhibited is the same from whence we ought to repel. Place. CHAP. XXI. Of Intercepting. SUch things as do intercept, Intercipients. for the most part agree with those things that do repel, and they differ only in respect of place from them; for repellents are exhibited to the part affected; but intercipients to the ways through which the humour flows; such like are Defensitives, commonly so called, which being endued with a cold faculty, dry, earthly and astringent, stop the coming of the humours in their passages, and hinder them that they cannot come to the part affected, and since some are more powerful, others more mild, the strongest are to be used in a grosser habit of body, when the vessels are wider, and the condition of the Air hotter, which loosens, and dilates the passages, and that there is greater violence of the humour flowing; if the matter be otherwise, the milder are to be applied. But they are most fitly applied to places void of flesh wherein the vessels are more evident, and open. Place. 'tis contrary to the error of humours in motion, Motion of humours taken away. when those things which ought to be moved, are not moved at all, as when the months, Hemerhodes, or other accustomed Evacuations are suppressed, for then the humours which lie still are to be attenuated, and heated, and the passages to be relaxed, and the straightness to be taken away, of which in their place, which if they help not, we must come to those things, which can stir up humours by violence, which we have accounted before, namely which draw humours into some part, by reason of heat, pain, and vacuity. CHAP. XXII. Of discussing. THe last fault of the humours, Humours offending in any part. is according to the place where, namely when some humours abide in some part where they ought not, the humours therefore which cleave to that part are to be taken away, which is done either insensibly, by the secret pores, or by Evaporating, whilst the humour being dissolved into vapours is discussed, or the humour is plainly evacuated and under the form of a humour is drawn our. Those which take away the humour by insensible transpiration, Discutients in what diseases convenient. are called Discutients, Resolvents, and Digerents; but they are most profitably administered, when the humour is thin, sticking under a soft skin, to which the force of the discussing medicines may penetrate; for you may not use Diaphoreticks if there be plenitude in the body, but rather must evacuate the body first, The most convenient time for exhibiting Discutients is the state, Time. and the declination at hand, yet in the augmentation they may be used, but not alone, but mixed with such as repel. But since some Diaphoretick medicines are stronger, and hotter, some not such, we use the gentlest when the matter is in the superficies of the body, the part affected soft and lose, the stronger are given when the matter is situated in a deeper place, under a thick and gross skin, and itself is colder and thicker. CHAP. XXIII. Of Softening and Ripening of matter. EMollients are necessary as often as the matter is thick, Emollients. and hard; for as often as the matter is thick and hardened, in vain we exhibit Diaphoreticks, since that such matter cannot be discussed by them, but they are forced to be softened; of Emollient medicines 'tis spoken before. Yet if the matter cannot be dissolved, and discussed, Suppuratives. 'tis to be turned into quitture, whereof if the Physician see that the humour cannot be discussed by Evaporation through pores, in this part he ought to help nature, and to exhibit ripening medicines, but if there be hope that the humours may be discussed, he must abstain from suppuration, 'tis to be noted also that all humours cannot equally and aright be turned into purulent matter; blood indeed is easily turned into quitture, but in diseases arising from choler, and Melancholy suppuratives, or ripening medicines are scarce to be exhibited without danger, since by the use of these, those humours often times do so degenerate, and are corrupted, that they may excite a cancer, and other malignant ulcers. Neither are they safely administered to every place; In the internal parts suppuration is not rashly to be procured; amongst the external parts, suppuratives are not safely used about the joints. THE FIFTH BOOK, PART II. SECT. II. Of showing how to cure. CHAP. I. Of diseases of Intemperature. AFter we have finished the Indication Preservatory, now we come to the Curatory, and are to show the way of curing diseases, and first diseases of the simular parts, and indeed what belongs to diseases of Intemperature. Distemper what it shows. Of Intemperature there ought to be an alteration by contraries, namely a hot distemper, indicateth medicines cooling, a cold heating, a moist drying, a dry, moistening, hot and moist requires a medicine cold and dry, hot and dry a medicine cold and moist; cold and moist require hot and dry, cold and dry Indicate hot and moist. But not only in alteration is contrariety to be observed in general, How a degree of contrariety is to be observed. but also certain degrees of contrariety, as much as may be; and therefore a disease which receds very much from the natural state, wants more vehement remedies, and on the contrary a disease which differs not much from the natural state, requires gentler remedies; hence a hot disease in a body by nature colder, than those that are well, is to be resisted with cold things. And a cold disease in a body hot by nature, requires hotter remedies: A moist disease in a dry body, and hard by nature, requires exceeding drying Medicines: A dry disease in a moist body, and soft, requires things that moisten exceedingly. On the contrary, a hot disease in a body, hot by nature, requires milder cooling remedies: A cold disease in a colder body, requires weaker heating remedies. A moist disease, in a body moist by nature and soft, wants dryers not so powerful: A dry disease in a body, dry and hard by nature, hath need of remedies moistening less. Moreover in alterations, Contraries appropriated. not only a Medicine exactly answering to the present distemper, as near as may be should be opposed; but it ought to be appropriated, and have a peculiar agreement to the nature of the part affected. Also we must beware lest the Medicine have some other quality joined with the quality which is necessary to correct the distemper which may hurt the part. Also sigh hence in the cure of simple distempers, Simple contrary Medicines do best agree, if they are not always in a readiness, that quality which doth not agree, or which is hurtful may be taken away by the mixture of others; As on the contrary compound distempers, if we cannot have a Medicine which is convenient for the compound contrary qualities, that which is wanting must be supplied by the mixture of others. From all these it is manifest, Distemper of the brain. that in curing diseases of the head, 'tis not easily to be altered beyond mediocrity, lest the native heat should be weakened and dissipated; yet 'tis more safe to heat then cool. In diseases of the Breast and Lungs, The Breast. you must always beware that you dry not too much, lest the matter should be thickened and unfit to draw out. But when there is need of cooling, first beware that cold astringents are not given, but moistening, for cold things are very hurtful to the Breast, 5. Apho. 24. not only applied outwardly, but taken inwardly. In the cure of the heart Medicines are always to be mixed which have a corroborating power, Heart. and therefore moderate astringents, and odoriferous, and Bezoa ticks as they are called, should always be mixed with the Medicines which are given to the heart: But always beware of vehement coolers and heaters, The stomach is easily hurt as well by too much heat, Stomach. as by too much cold, and in a hot distemper 'tis to be warily cooled, by degrees, and by little and little, but in a cold you must take heed lest the innate heat, be too much dissipated by hot things; and therefore somewhat astringent and strengthening is all ways to be added, which may hinder the dissipation of the innate heat and Spirits. In curing the Liver, Liver. these medicines are to be chosen, that have some binding and strengthening faculty with tenuity of parts; such like are those that are astringent and are bitter; but you must abstain from sweet things, by which the Liver, as also the spleen do easily swell. The Spleeen requires, and endures the strongest medicines, Spleen. and therefore they may safely be applied outward, yet so that the humours contained in it may not increase by sudden cooling, or be hardened by drying; but they are scarce safely given inwardly, lest the other bowels be offended by them, and therefore what is wanting in vehemency, is to be be made good by daily use of them. In a disease of the womb, Womb. you must abstain from vinegar, for pleasant things are more grateful to the womb, yet such as are great must abstain from them. The Eye since it is very sensibly it doth not endure sharp medicines, The eye. or such as may bind, and exasperate it. But in the cure of distempers, not only contraries convenient are exhibited, but the use of likes are altogether to be avoided. Yet if the distemper be with matter, Distemper with matter. alteration alone doth not suffice, but the cause from whence it is cherished is first to be taken away; and therefore Indication in distempers of this nature, is evacuation and alteration, where notwithstanding by the name of a cause are not only understood causes simply so called, but also diseases and affects, some of which excite, and cherish other diseases, for these in like manner are to be taken away in the first place. CHAP. II. Of curing diseases of the whole substance. IN curing diseases of the whole substance, the occult malignant quality is to be driven out by its contrary, and a remedy against poison; and the venomous cause to be taken away, and rooted out of the body; and therefore poison which is drunk or taken in at the mouth, is to be cast out by vomit, or presently to be drawn out through the paunch; but if it be drawn in with Air, or hath passed beyond the liver, 'tis to be expelled by sweats; but those which are communicated by the biting, or striking of venomous animals, are brought by drawing after what manner soever to the body, first of all we must labour to draw back, and extract, and to hinder it all manner of ways, lest it penetrate and creep within the body; but principally, every sort of poison is to be expelled by those remedies, which experience teacheth to be most repugnant to them, and with those the heart is to be strengthened; yet to observe the manifest qualities also in poisons, is a great part of the cure. CHAP III. Of the cure of diseases of Conformation. AS for the Errors of Conformation, Cure of figure in diseases. What they show. if the bones are set awry, and ill shaped, in those which are growing, the cure is possible; but in those that are come to ripeness of years, and which grow no more, they are incurable. But 'tis a general Indication which supplies the fault of the figure, a changing of the part of the viticus figure to the contrary, until it acquires the figure which naturally it ought to have, but this is performed two ways, by fashioning, and alligation or binding; How corrected. by fashioning that mending of the figure is to be taken, which by drawing and prossing with the hands, by little and little and often, is perfected; by binding, that correction is understood which is performed by swathings, and Ferrules, or Canes, namely by which part of the vicious figure by swathings is drawn contrarywife, and retained by splintors, lest it should bend back again towards its erroneous figure. The second sort of diseases of Conformation are in the hollow places, which two general indications do help, The cure of diseases in the channel or passages. namely to open that which contrary to nature is shut, and to shut that, which contrary to nature is opened. But amongst diseases in defect the most common is obstruction of passages, Of obstruction. whose common Indication is, apertion of obstruction But sigh thence the causes of obstruction may be various, particular indications are taken from them, and those being taken away, the obstructions are also opened: Therefore that obstruction which is made by thick and viscid humours, requires attenuating, cleansing, and cutting medicines; amongst which, sometimes the weaker, sometimes the stronger are used, according to the nature of the humour itself, and the condition of the place wherein it resides: But if obstruction be made by many humours, and they contrary to nature in their whole kind, the cure thereof consists altogether in evacuation. But if the humour be not contrary to nature in its whole kind, but only offends in quantity, the Indication is Apokenosis, i. e. That which abounds is to be abated, according to its abundancy: But although all the obstructing causes should be evacuated, yet they differ as well in other things, as also especially in this, that each of them require their peculiar and convenient places: Those which obstruct the Breast and Lungs, are to be ejected by cough, nor can they easily be evacuated any other way: But those which are contained in the Liver, or in Veins, or in Arteries, or in the Reins, are cast out by Urine, the belly, or vomit. The other kinds of straightness, Coalescense when the causes are taken away, they are likewise taken away, things growing together, or Coalescents, since it comes to pass by the growing together of parts and sides of a passage Indicate a Medicine breaking and taking away that Siccatrizing again. Constipation indicateth the cause to be taken away, Pressing & closing. Compression. which make that straightness. Compression since it proceeds from external causes, resting upon the passages, the Indication is common, namely, to take away that cause of pressing together, and shutting the passage, but the special Indications are various, according to the variety of causes, and the whole cure consists in the ablation of those causes which shall be shown in their own place. Lastly, Subsidence, if it be caused by too much humidity, the part is to be dried: If the part be wrung hard, and as it were contracted, with drying things, and too many Astringents, and cold, the contraries, namely, Relaxing and moistening things are to be exhibited. On the other side, if the passages, Cure of the opening of Vessels. and vessels which ought to be shut are opened, and humours flow out from thence, the common Indication is, that the opened vessel is to be shut, which may be performed in the external parts, with convenient Medicines applied, and bound: But if the opening be in the inward parts, the manner of performing that is various, according to the variety of causes: If it be an Anastomesis, or opening of the mouth of a vessel, the orifice of the opened vessel is to be hardened and bound. If by a Diapedeses, thickening and incrassating Medicines are required: If by a Rupture, the broken vessel is to be united, and shut: If from Erosion, Sarcotticks first, afterwards consolidating medicines are required. Thirdly, If the part which naturally ought to be smooth, Cure of diseases of the superficies. should become rough, 'tis to be made smooth again, which is performed in the Windpipe and Tongue: If that which is evacuated be filled up, or that which is extant be taken away; That is performed in soft parts by Medicines which moisten, and have a clammy nature: But this with abstergent Medicines; But in bones whether they are eroded, Of roughness. or have any superfluity annexed to them, the roughness is conveniently taken away by shaving. Smoothness contrary to nature, Of smoothness. requires a contrary way of cure, and the natural roughness is to be brought again, by abstergent Medicines, and indeed such as throughly cleanse, namely, such as can free the glutinous humours, tenaciously cleaving to the outsides of the parts, and restore the natural roughness to the part. CHAP. IU. Of the cure of Diseases of number. Disease's in Number, since they are twofold, in excess, and in defect, either of them require their Indication, Diseases of number what they indicate. and that which is wanting, and naturally aught to be present is to be restored: But that which abounds is to be taken away and removed; but since that which is wanting only can be a natural thing, 'tis the part of Nature only to make up and regenerate that which is wanting, but the Physician is only the servant of nature in these things whilst he defends the strength of nature, Administers fit matter, and removes impediments, but this general indication is varied according to the variety of parts, and cannot always be reduced into action: for it proceeds in one manner in the generation of flesh, in another of a bone, in another of a nerve, and other parts, of which in the solution of unity. Moreover since some parts are simple, others compound, if compound are lost, neither the same in particular, nor any thing like unto them, can easily come in their stead; in which the third scope is to find out a certain comeliness, or to make something, which may some ways do the office of a lost part, yet later Physicians have invented a way of curing imperfect parts, whereof above, part 2 d. Sect. 1. Chap. 16. On the contrary excess requires its removal, but since those things are various which ought to be taken away, each of them deserves its peculiar cure, according to the substance, dignity, situation of the parts, and differing also in other respects, for we always beware of this, that other parts may not be hurt, or at least to do our endeavour that they may receive very little hurt, and that there may come no greater loss to the body by the taking away, then that was which came by the thing abounding. But the Instruments wherewith a Physician may appoint the ablation of things which abound contrary to nature, are three, Iron, Fire, and medicines; by Iron all acute Instruments of every kind which are fit for the cutting of● superfluities, are understood: by fire, actual eauteries are understood, whilst that which abounds is burnt with Iron, Silver, or fired Gold. Medicines for this purpose most convenient, are those which are called potential cauteries, Cathareticks, namely, septics and Escaroticks, all which are mentioned before. CHAP. V Of curing diseases of magnitude. WHen either the whole body, Magnitude increased what it shows. or any member thereof is increased contrary to nature, so that the natural actions are thereby hindered, the Indication is that the magnitude increased may be diminished: and indeed since the substance of the part is not sound, when 'tis increased in magnitude, as in wounds, and ulcers, the same medicines are to be exhibited as to those abounding in number; but if either the whole body or any part be equally increased, and it too much increaseth through the whole, you may not use Iron, or Fire, nor corrasive medicines, but there are two special aims, namely, to draw away the too great plenty of aliment from the parts, and to consume it, or take it away by Digerents, and discutients, wherefore fasting and spare diet, are then convenient; and such use of the non-naturalls as may attenuate and discuss, and medicines of the same nature. tumors also have their peculiar aims which that general Indication satisfieth, Cure of tumors. which commands us to diminish that which is increased contrary to nature; of which in its own place. The magnitude diminished on the other side indicateth its increase, but this is performed by new nourishing, Bigness diminished what it shows: or restoring, and by generation, by renutrition; that which is wanting is restored by good and plentiful aliment, and the part acquires a greater, and natural bigness, but generation is then necessary when any thing is lost of the substance of the part: for there that is restored by the re-generation of flesh which was lost, and the cavity of the ulcer filled up. CHAP VI Of curing diseases in situation and connexion. MOreover Organic diseases, Diseases in position and connexion without they show. since there are diseases in position, and connexion, that which hath lost its natural place, indicateth its reposition into its natural place, but that, which is not joined to those which it ought, indicateth its conjunction with them; the first indication performed, and bones out of joint are cured by bending and forcing them from the opposite part to that from whence they were removed; which by what means it may be performed is shown before part 1. Sect. 2. Chap. 4. so other parts are to be reduced into their own places. But if the parts which according to nature ought to be separated, are joined together, and grow together contrary to nature, they are to be freed and separated: But that separation is made either by Chirurgery, and the help of an Incision Knife, and Iron, or with a silken string, or with a Horse hair, or with caustick Medicines and septics. But the other kind, Diseases in connexion. when the part is not joined with those with which it ought, indicateth that, that which contains should be rendered more firm and solid: And therefore those parts ought to be strengthened and contained. CHAP. VII. Of the cure of Solution of Continuity. THe first, Unity dissolved, what it shows. What to be done by the Physician. and most usual Indication of Solution of Unity, is uniting, or unity dissolved indicateth that the parts that are separated should be united; which thing although it be the work of nature, yet the Physician is the Servant of nature in this matter: For these are the principal duties of the Physician here. First, he is to be careful that nothing fall into the part affected, which may impede conglutination. Secondly, That the extremes, or lips in the dissolved unity are rightly joined again, and are mutually applied to each other. Thirdly, That the extremes so joined may be kept together. Fourthly, That the Temperament of the part itself may be preserved, and the help of nature is necessarily required in agglutination. Fifthy, That the Symptoms which may ensue be prevented and corrected. But these aims are not always performed in all parts alike: The cure of wounds. For in wounds, every extraneous thing is to be taken away out of the Wound, than the lips of the Wound are to be joined 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 joined, the rest of the work is to be committed to nature, 'tis the parr of the Physician only 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 certain Symptoms which may hinder the cure, do follow, as hemorrhoids, pain, convulsions, they are to be resisted, and principally care is to be taken that no inflammation ensue. In the cure of Fractures, Of Fraciures. the Physician propounds to himself two aims. First, that the broken bones may be rightly joined together again, and that the natural Position and Figure may be restored to them: The other that being joined they may be kept together and retained, and grow in their natural 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 Physician ought to help nature, which he doth if he beware least any inflammation 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 'tis spoken before. CHAP. VIII. Of the cure of oppressing and urging Symptoms. THe third sort of preternatural things remains, Symptoms urging, & how many. namely, Symptoms. Symptoms as they are preternatural Indicate in general 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 always be expected, or waited, until the cause, or the disease be taken away, somethings necessary Indicate, which 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 Symptoms 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 Symptoms belongs to an action hurt, that is neceslary, not absolutely for life, but for amendment, or if it be curable, 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 Symptom; those Symptoms are commonly accounted but few, principally pain, watch, and immoderate Evacuations, yet there are some others. Pain indicateth a medicine taking away or mitigating pain, Cure of pain. but since pain 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 meets with, and advertency of the mind, if one of these be wanting neither sense nor pain is, and therefore those things which take away, and hinder one of these, are contrary to the pain: and as for what belongs to the sense in the part, we may resist pain two ways, 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 heat, and brings forth a pleasant, anodynes. and sweet sensation when touched, which are anodynes (or medicines mitigating pain) properly so called, as a bath of fresh water, common Oil, the far of Animals, Muscillages, and other things endued with a temperate and pleasing heat, of which above P. 1. S. 1. Chap. 7. Moreover Narcotticks mitigate pain, Stupefactives. or Stupifactives, which stupefy the Spirits, and together provoke sleep, and so do it, that the Dolorifique subject is not perceived. Secondly, Intentiveness of mind is hindered if it be averted to other objects. Over much watching indicateth a medicine causing sleep, Cure of over much watching. sleep may be occasioned four ways; first if all things may be removed which may excite any sense to operate. Secondly, if the mind be drawn away from the agitation of the external senses, and the animal spirits are pleasantly invited, from motion to rest. Thirdly, if those things are exhibited, which alloy hot, dry, and sharp vapours, and send pleasant fancies into the brain, whereby it is moistened, and as it were stupifyed. Fourthly, if those things are exhibited which by a peculiar faculty make the animal Spirits drowsy, 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 indicateth 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 stopped by astringent things. Blood slowing indicateth a remedy that stenches blood; but it is stopped two ways, either by prohibiting, that the blood cannot return to the place, out of which it came, or if the vessels 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 pass if it be not drawn back by it, if it be repelled, if it be drawn to another place, t●s not drawn back if the causes, by reason of which 'tis drawn back be taken away, as heat, pain, troublesome thirst: 'tis repelled by the use of the Refrigeratives, and astringents, 'tis drawn 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 f●● things, are pure Air, excellent and O doriferous Wine, and spirits distilled of it. But not only actions hurt, but other Symptoms also sometimes trouble, if the Arm pits stink and smell rank, 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 vital Indication. CHAP. I. What doth Indicate Diet in those that are sick. Sigh hence, it is spoken by what means things preternatural are to be taken away, now it remains that we speak, 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 vital, 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 vital and Preservatory indicateth. But since as above in the 4. Book, part 2. Chap. 1. it is said there are three vital, 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 shows the Aliment, The strength what it shows. in this respect because 'tis placed in spirituous, solid, and fleshy parts, having a just quantity, and doth use them as an Instrument; and the vital 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 meat increaseth the morbifique constitution, and also to regard this, that 'tis not to Indicate Aliment, but to prohibit it, for when meat 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 indicateth its Evacuation, and therefore commands nature to be at leisure for itself alone, and so prohibits Aliment, whereby nature would be called away, and hindered from its work, you must be careful, what urgeth more. In brief: strength only indicateth Aliment; the morbifique cause permits, or probibits; the rest, as age, custom, Time of the year, the state of Heaven, and such like are the signs of firm strength, or of weakness, or such as may show the force, and greatness of the morbifique cause. CHAP. II. What things belongs to Diet. ALthough Diet consists principally of meat and drink, Things prohibiting to Diet. yet other things also called non-naturalls, as Air, sleep and watch, 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 Air, meat 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 help that those things which are the true materials of Aliments, may be more commodiously turned into Aliment: such are sleep, and watch, 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 Diet, and which agrees to which diseases. BUt Diet is threefold, Diet threefold, Thick. Indifferent. Thin thick, thin, indifferent, or betwixt both, thick or full Diet 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 Diet 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 cream of ptisan, or ptisan strained; the thinner is that wherein water and Honey is mixed; the thinnest Diet was that of Hippo. wherein nothing was put; the middle sort was made with bread dipped in broth, or also with the fl●sh of fowls. But regard is to be had of custom, places and Countries, since in some Countries, full Diet is more in use, in others more sparing, and according to that, the matter of thin Diet is to be moderated. But what kind of Diet agrees to what diseases, the comparing of the strength which indicateth food and the morbifique causes, What food is fit for what diseases. which hinder the same, do show; for by how much the more nature is busied, in opposing the morbifique cause, by so much the more sparing Diet is convenient; but by how much the less it is busied, by so much the more plentiful Diet may be given; but by so much the less 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 Diet is to be more sparing, so that the strength can endure with it, until the state, but 'tis known when the strength can endure and subsist until the height, but when it cannot, the nature of the sick is to be considered: for if the body is made bitter with choler, hot and dry, abounding with choler, especially about the stomach, he cannot endure thin Diet, or fasting; for such body's motion is easily hindered, regard also is to be had of age, for as it is in Hippo. 1. Apho. 13. old men easily endure fasting as also those of middle age, young men less, boys lest of all, and amongst them, especially those which have sharper, and quicker wits. But as for the nature of a disease, Diet in long diseases. in long diseases there is need of an indifferent or full Diet, and so much the more plentiful, by how much the diseases are slower, but in acute dises, thinner is requisite, lest if we should give too much meat, we should cherish the disease; but since there are degrees of acute diseales, so much the thinner is to be given, by how much the disease is the more acute. Yet it is always safer, to give thicker Diet than is fit, Whether more error is committed in full or spare Diet. rather than thinner; as for the quantity you ought rather to study substraction according to Hippo. 1. Apho. 5. In thin food the sick do faint; whence it comes to pass that they are hurt the more, for as much as every fault here, is greater than it useth to be in a little more plentiful Dy●●. CHAP. IU. Of the right Administration of the Diet of sick persons. IN the same manner as in medicines, so in vitals, Quantity of meat. a threefold these may be observed; namely the highest, middle, and lowest, which may be administered in all Dy●t, whether thick, indifferent, or thin. But which dose is to be given, and when, is collected, by comparing of the strength, and morbifique cause one with another; for since the morbifique matter sometimes urgeth more, sometimes less, and sometimes the help of nature is more required in resisting the cause of a disease, the same form of Diet may be observed, sometimes a greater, sometimes a lesser is to be given, according as nature is sometimes busied more, sometimes less in the combat with a disease. Namely in the beginning of a disease, nature contends not much as yet with the morbifique cause, neither whilst it is yet employed in concoction, and Evacuation; wherefore you may exhibit victuals, which are convenient for the disease, than the highest dose. But in the Augmentation because nature gins to contend with the disease, In the Augmentation. and is more busied about the morbifique matter then in the beginning, than some of the quantity is to be abated, and Diet is to be given in a middle dose. But in the state when the combat of nature, In the state. and the disease is most violent, and nature is most busied in concoction and evacuation of matter, the victuals are to be administered in the smallest quantity, and nature not to be called away from its purpose. The time, The time of giving food to the sick. and when meat is to be given, as for that in continued diseases, and such as have no differences of fits, Diet is to be administered according to custom, principally at that time when the sick use to eat before; But in diseases which have fits, when meat is to be given Hippo. shows 1. Apho. 11. It behoveth to take away meat in the sits themselves, for to give it is hurtful, and when by circuit diseases return, in the Paroxysms themselves you must abstain, which nevertheless is not simply to be taken, but if a fever be from a sharp and biting humour kindled by the Sun, anger, fasting, labours, and the sick be thin, and lean in body and in Temperament, and especially in Summer time if he be hot and dry, either a little before the fit, or in the fit itself meat is to be taken, otherwise he easily falls into a burning fever or Hectic, swooning, or convulsion, or such like, and endangers the loss of his strength. THE FIFTH BOOK, PART III. Of the Compositions of Medicines. SECT. 1. Of preparing and compounding of Drugs in general. CHAP. I. Of the necessity and profit of preparing and Compounding simple Medicines. THere remains now the pharmaceutical part of Physic, which prepares and compounds simple medicines, for the word Pharmacopia comprehends them both, namely the alteration of simple medicines by the help of Art without mixture of others, and the mixture of simple medicines. But this part of Physic is necessary, Why it is necessary to compound medicines. for many and great causes, for first the cause may be in the medicine itself namely if the substance of medicines be not so proper, and troablesome to the sick, by preparation and composition that which is wanting may be supplied and that which is unprofitable, troublesome, and hurtful may be taken a way; sometimes a medicine hath a supper fluous quality which we do not then want, therefore we ought to allay that by mixture of the contrary; some simple qualities are easily corrupted, wherefore there needs digestion, distillation, concoction, to be used, or to preserve, or pickle those things with Honey, Sugar, Vinegar, Salt. The strength of some medicines is easily taken away, whence we are to effect by the mixture of more viscid things, that so it may not be easily dissipated, moreover the causes in effect itself contrary to nature, for if simples are not to be found which have all those faculties, which are requisite, in one sick person oftentimes, and in the mixture of diseases contrary to nature, than one medicine is to be compounded of several simples, which may perform all the Indications; which kind of medicines the Greeks call, Polychreston. Thirdly since that simples are not always supplied by nature which may agree to the Temperament, Sex, kind of life, and various constitution of the parts of every one, there is need of preparation and composition. Lastly, for the several forms also whereof this is more pleasing to this, that to that person, nay in regard of the disease also 'tis necessary to prepare and compound medicines. O● that we may briefly contract these things, there is need of compounding medicines, for two reasons, either for the strength of the medicines sake, or for its use and application sake; for if the virtue of the medicine be weak 'tis to be strengthened by mixture with more vehement, if any faculty be deficient, 'tis to be mixed, if a medicine be stronger than it is required, something is to be added by which i● is to be abated, or corrected If a simple have any superfluous quality or hurtful, that is to be mixed, by which that hurtful quality may be taken away. But that the medicine may rightly be applied and drawn into action, 'tis necessary that the medicine maybe preserved, least before administration it looseth its strength, by mixture of some preservative, for example, with Suga, or some other. Moreover that it may come to the place, a vehicle is to be mixed, which leading it, it comes the easier thither, and lest it should be weakened by the way, 'tis to be mixed with the stronger, that it may come to the part in that degree which it ought. Lastly, 'tis necessary, that the medicine applied to the part affected, may continue, whence are requi●ed medicines which may retain those things which go away, or do not adhere to the part, in the part. CHAP. II. What things are necessary for the artificial preparation and Composition of Medicines. ALL those things which are requisite for the composition of Medicines may be reduced to sour heads; What things are required for the compounding of medicines. The basis of medicines twofold. Simple. first a medicine which may supply the Indication whereby a disease or the causes of a disease, or the Symptom itself which offends, may be opposed: and such a medicine, in composition is called the basis because on that as on the foundation, the edifice is builded, the whole composition depends on it and all the rest are referred to this, & are mixed together, for its sake, and that its strength be great in the compound 'tis necessary; But the basis is sometimes simple, sometimes compound, and indeed not in one manner, for that is called a simple basis, which satisfies one Indication, and brings forth one effect, although it doth not always consist of one, and a simple medicine, but oftentimes is compounded of more, but that is called a compound basis, Compound. which can perform more uses, but at other times that is called a simple basis which consists of one medicine, a compound which consists of many, but a compound medicine takes its denomination, sometimes from the basis, sometimes from the medicine, set down in the first place in the prescription. But that the basis, or medicine, Correctors and Helpers. which is opposed to the disease contrary to nature, should be accommodated in all respects, besides preparation, oftentimes correcting and helping things are required; for since that sometimes the basis is weaker, thicker, or flower, or stronger, and more powerful than it ought, or hath any malignant, and hurtful, quality or is ungrateful to the smell or taste, or any other way troublesome, and have any strange and unprofitable quality; the dull and idle are corrected by the mixture of whetting things, and such as increase strength: thick qualities, are to be amended by mixture of thin; sharp, vehement, too hot or too cold, or malignant are to be corrected by the addition of their contraties: in unpleasant savour, or taste, by things having pleasant savour; those things which are endued with an ungrateful and unpleasant smell, by those things which have a fragrant and pleasant smell, and by all other pleasant things are to be corrected, and all hurtful qualities or unprofitable, are to be amended and taken away, by the mixture of their contraries. Thirdly, Directors. If medicines of their own accord cannot conveniently come to the part affected, there is need of Directors, as they call them, namely such as either are familiar to the part affected, or open a way for the medicine. Lastly, Preservers. To the composition of a Medicine those things are required which preserve from injury and corruption, and give it a certain form and consistence: H●●●e ●ome are preserved with Honey, others with Sugar, others with Oil, and receive from them the form either of an Electuary or of a Syrup, or a Conserve: But some are rendered fit to endure, or keep, by preparation only. CHAP. III. Of the weights of Medicines. BUt before we come to the preparation and composition of medicines, by which two Pharmacopeia is finished, something is to be premised of the weights and measures of Physic, and of the dose of medicines, for things out of which the forms of medicines are prepared, are esteemed either by number, or a heap, or weight, or measure. Fruits and Pulse, What things are accounted by number. By heap. By pugil. Little handful. Bundle. and the greater seeds, are numbered, and when the number ●is equal, they are divided into pairs, or couples, and 'tis written, Par. 2.3. But the quantity of medicines is described by heap, by little handfuls, by great handfuls, and little bundles: and Physicians use these principally in leaves, herbs, flowers, barley, and certain seeds, salt, and other things: A Pugill is as much as can be comprehended by the extremities of the fingers joined together, and drawn together, and 'tis called by some a little handful: A handful is as much as can be held or comprehended in the hand: A little bundle is as much as we can take between our arms. By weights, as by the balance and scales, By weight. they weigh dry things for the most part, but liquid things they measure, although they also may be described by weights. And the measures are no other than such as are described by pounds and ounces. But although there be great variety of weights, By measure. we will propound only those which Physicians use at this day every where up and down, and are most necessary for the reading of Authors. The least of all weights is a Grain, A Grain. which moreover is constant, and aught to be one and the same amongst all Nations; for although without doubt, it took its name from a grain of Barley, or Wheat, yet since there is not the same weight of these in all places, not these but the smallest Money, which in all Nations is the same, and is kept unchanged, and is to be accounted for the foundation and beginning of all weights: But it is noted by Physicians in this manner, Gr. g. A Chalcus with the Greeks, consists of two grains, Chalcus. which kind of weight the Arabians named Kestuf, commonly called Aercolum, or two grains. Dicalcon makes four grains, Siliqua. with which agrees Cheration: Siliqua or four grains, which the Arabians call Chirat. Hemiobolon, or Hemiobolion, Semiobolus. a Semiobilon is six grains. Obolon, Obolus. or Obulum consists of twelve grains, the sixth part of a drachma. Four and twenty grains make a scruple, A Scruple. for a scruple consists of two Obolaes'. Whence with the Greeks a Diobolon, is the same with the scruple, whence it is also called by the Greeks Gramma, that is, a Letter, to wit because an ounce contains so many in it, as the Greeks have Letters: and it is the four and twentieth part of an ounce. But amongst later Writers, for the most part, those which followed Nicholaus, and Venetous, a scruple contains only twenty grains, and it is thus noted, ʒ Thirty six grains make Hemidrachmon, or Triobolon, Semidrachma. that is half a drachma, which they call an Egyptian bean, or an Alexandrian bean, ʒ ss. Seventy two grains make an Attic drachma, A Drachm. which is used by Physicians; but the drachm of Nicholaus and Venetus, which at this day, for the most part, is used every where, contains only sixty grains, Drachimi, and Darchimie, or Darchimet, with the Arabians, the word being corrupted, is called Drachmas, in English a Drachm. By Serapio, and the same Arabicks it is also called Aureus, and by the same these names, Drachma, and Aurei, are often confounded: But at other times, Nummus Aureus, or Denarius contains four scruples, namely a whole Drachm, and the third part of a Drachm; eight Drachms make an ounce, and it is thus marked, ℥ i. Twelve ounces make a pound, lb. Deunx makes eleven ounces, ℥ XI. Dextans hath ten ounces, ℥ X Dodrans hath nine ounces, ℥ IX. Bes hath eight ounces, ℥ VIII. Septunx hath seven ounces, ℥ VII. Semios or Selibra hath six ounces, ℥ VI. Quincunx hath five ounces, ℥ V. Quadrants hath four ounces, ℥ IU. Triens hath three ounces, ℥ III. Hereunto belongs the Table * CHAP. iv Of Physical measures. AS dry things for the most part are weighed, A Description of measures. so liquid things are measured, although the manner of measures be appointed by Physicians, according to the manner of weights: But measures may be explained two ways, either greater by less, or on the contrary, less by greater; or by weights: For if it be asked, what a Pint or a Pound is, 'tis answered, to be the half of a sextary, or to contain fix Cyathos, or Cups, or it's answered, it contains nine ounces of Oil: For the former way of describing measures, is certain and stable, but the latter way of explaining them is not always the same; for although the capacity of measures be not changed, yet the weight of the things that are measured by the same measure are not the same; whence Physicians at this day, since in liquid things they rather regard the weight than measure, and they use measures only for to save the labour of weighing. Three kinds of measures of liquid things are used; namely, some for measuring of Wine and distilled Waters, others are appointed for Honey, others for measuring of Oil; all which measures, although they are distinguished by the names of Ounces, yet the weight of liquid things in the distinction of ounces: for since Oil is light, more of it goes to an ounce, Wine since 'tis heavier than Oil, less of it goes to an ounce; Honey since it is heavier, then both, a small quantity, in comparison of the other, makes an ounce. The first and least of measures which are tried, not by weight, but only by quantity, is a spoonful, and the division of measures doth not go beneath it: But a Cochlear, or a spoonful, is ; The least, that a little bigger, a great, the greatest; the least contains half a drachm in weight, of a thing that is of a middle weight; that a little bigger, a whole drachm; a great, a drachm and half, or two drachms; the greatest contains half an ounce in weight. A common little Spoon is half a cup, Mustrum. and contains in weight of Oil, six drachms, of Wine or Water twenty scruples, of Honey nine drachms. A Cyathus or a Cup, is the sixth part of a pint, Cyathus. by common observation, it holds in weight of Oil twelve drachms, of Wine or Water thirteen drachms and a scruple, of Honey eighteen drachms. Acetabulum, which by the Greeks is called Oxybaphum, Acetabulum. is a Cup and half, the common observation it holds in weight, is eighteen drachms of Oil, twenty drachms of Wine and Water, twenty seven drachms of Honey. Quartarius, or the fourth part of a sextary, Q●a tarius. contains three cups. Hemina or Cotyla, is the twelfth part of a Congee, Hemina or Cotyla. half a sextary, it contains six cups, but in weight nine ounces of Oil, ten ounces of wine and water, thirteen ounces and half of Honey, (this measure contains three quarters of a pint.) The Italian sextary is the sixth part of a Congee, A Sextary. it contains two Heminaes' (or a pint and half) twelve cups; but in weight it contains eighteen ounces of Oil, twenty ounces of wine and water, 27 ouncse of Honey. A congee is the eight part of Amphore, A Congee. (which is a Tankard, or Roundlet,) containing eight gallons:) it contains six Sextaries, twelve Heminaes', but in weight, nine pound of Oil, ten pound of Wine and Water, thirteen pound and half of Honey. Urna, Urna. Amphora. is half the Italian Amphora, but the third part of the Attic, for a Greek Amphora which is called, Cadus, and Merreta, is greater than an Italian, it contains 48. Sextaries, but in weight it holds seventy two pound of Oil, ninty pound of Wine and Water, one hundred and eight pound of Honey (this Urn of our measure contains four gallons and half.) Culeus is a measure containing twenty Italian Amphoraes, Culeus. 'tis the greatest of measures, but of these things 'tis spoken more at large by others. CHAP. V Of Doses of Medicines. ALthough in this darkness of man's understanding, 'tis not so easy to define, by what Rule and proportion, Elements agree in mixture, yet by the most, the opinion of Alchindus is retained, and a Geometrical proportion is appointed in degrees, not an Arithmetical, and that for this reason, because betwixt the nearest degrees, there is a far greater difference, and inequality, than there is between two numbers, immediately following one another. Hence from two scruples to two ounces is accounted a temperate dose: the dose of a medicine, in the first degree from a scruple to an ounce; in the second from half a scruple to half an ounce; in the third from five grains to two drachms: in the fourth from two grains, and a half to a drachm: yet it is here to be observed that in every degree as appears by the dose, there is a certain latitude in the highest degrees, you may not always ascend to the highest dose, nor may all those things, which are in the fourth degree be given to a drachm, but according as some are in the beginning, others in the middle, and others in the end of the fourth, so the dose is to be moderated. Moreover 'tis here to be noted that regard ought to be had of occult qualities also, and therefore experience is especially to be consulted with The Doses of Purgers. AS for the doses of purging Medicines, The Dose of purge●s. they may be limited according to degrees, but since that in every degree there are three mansions, 'tis not lawful to give what medicine you please of what degree soever from the lowest to the highest dose of that mansion. But every mansion hath its highest and lowest dose. The dose in the first mansion of the first degree is from two ounces, or three to six or seven ounces; such like are Syrup of Roses selutive, and Honey of Violets solutive. Those which are in the third mansion of the second degree are given from ℥ 2. to ℥ 3. or ℥ 4. to these belong juice of Roses and Violets, Manna, Cassia, Syrup of the flowers of Peaches, juice of Flower-de-luce. Medicines in the first mansion of the second degree are exhibited, from half an ounce, or five drachms, Of the second degree. to an ounce and half, or two ounces; hitherto are referred Tamarinds, and Cassia; in the second mansion of the second degree they are given from half an ounce, to an ounce and half, as Turpentine. In the third mansion of the second degree they are administered from 3. Drachmas to 7. Drachmas, of this kind is Epythimum. In the first mansion of the third degree the dose is from a Drachm to half an ounce, Of the third degree. hereunto are referred Myrobalans, Rhubarbe, Agrick. In the second mansion of the third degree, purging medicines are exhibited from a scruple to two drachms, in this rank are Aloes, the seed of Fleabane, Polypodie, the leaves and powder of Sena, Mechoacan. In the third mansion, the dose is from half a drachm to a drachm, hitherto belongs Asarabacca, Carthamums, or bastard-safron, Soldinella, Hermodactiles, Turbith, Lapis Armenus, Lapis Lazuli, Opopanax, Sagapenum, black Hellebore, the roots of Jalap. In the first of the fourth degree, Of the fourth degree. Purgers are given from ten grains to half a drachm, hitherto belongs Mezereum, the seed of Thymelea, or Oneorum, or Granum Gnidium, i. e. Mountain Widdow-waile, Coloquintida, Elaterium, Hyssop. The dose in the second mansion of the fourth degree is from five grains to fifteen grains, in the end of this mansion, is Scammony. In the third mansion of the fourth degree, they are given from three grains to ten grains, of this kind is Euphorbium, Spurge, Antimony. But of the dose of these simple purgers, is spoken particularly, above, part. 1. Sect. 1. Chap. 11. But as for the doses of compound medicines they are first found out by the qualities of the simples which are mixed together; Secondly, from the degrees of their strength; Thirdly, from their quantity, of which in the Institutions. In the finding out of the dose therefore of compositions, The Doses of compound medicines how they are to be found out. first 'tis to be considered, how many doses of purgers are in any composition, afterwards the weight is to be determined, of the whole composition, and hence by the rule of proportion you must inquire how great a part of the whole compound may be given for one dose; as for example, if we examine, Pillulae Cochiae, there are in that composition of Hierapicrae ten drachms; which in its self contains ten high doses of Aloes, of Coloquintida three drachms, and a scruple, which contains seven doses, of Scammony two drachms and half, which hath ten doses, Turbith five drachms, which for the most part make four doses, Siechadoes five drachms, Syrup of Stechadoes, for the most part ten or twelve drachms. And so since the whole composition which contains twenty four of the highest doses, hath for the most part thirty six drachms, a drachm and half answers to one dose, and the highest dose of Cochiae pills shall be a drachm and half. The doses are 24. The composition 36. drachms. Therefore the dose is 1. drachm and half. THE FIFTH BOOK, PART III. SECT. II. Of Operations necessary for the preparation, and composition of Medicines. CHAP. I. Of the parts of Pharmacopoeia. THE whole art of an Apothecary may be divided into two parts, The art of an Apothecary. whereof the first handles the operations by which the Apothecary obtains his desired end, and whereof oftentimes in the preparation of one Medicine they are more, and the same are required in divers preparations; The other teacheth, to prepare certain remedies by those operations, and to reduce them into a certain form, and when it is needful, to join and compound many of them. To the former part belongs Chemistry in some measure. But since, that is largely spoken of in the tract of consent and descent of Chemics, and Aristotelians, as also in the Institutions, I am unwilling to repeat those things here in this compendium. CHAP. II. Of the kinds of heat. AS for what belongs to operations, The degrees of heat. and performances, since all Apothecaries whatsoever have need of heat and fire, as being the most common and useful Instrument, first let us treat of hear. But in heat in the first place, the degrees thereof are to be considered and the manners, of adding of fire; the degrees of heat in general and absolutely are accounted four; The First is that which appears pleasing and mild or gentle; the Second is that which is quicker and almost not to be endured by the hand; the Third destroys, the Fourth is the highest: but every of these degrees have a great latitude, and therefore not undeservedly every degree may be divided again into its degrees, in rightly showing whereof much discretion is required, but for the most part 'tis better to err in defect, then in excess, for if any thing be once corrupted by the violence of the fire, it cannot be restored to its self again, and oftentimes glasses are corrupted, and other dangers are accumulated, but if there be any error in defect, by continnance and increafing the degree of heat, it may be recompensed, although the time of operation be prolonged. But the degrees of heat may be made up divers ways, How they may be varied. and depend on divers causes, the chief whereof we will propound. For first fire may be used divers ways and manners, for sometimes the matter with a fit vessel, or without a vessel, naked and open, is put to the fire, which again is done several ways, for either it is circular, which in plain incompasseth the vessels and is removed from a distant place by degrees nearer to the vessel, until at length, 'tis heaped up over the vessel, or else the vessels are put in a fit furnace or the fire is made above the vessel Reverberatory, or striking back when the flame is repercussed by the cover, or door of the furnace, it strikes as it were the matter, and so it flies round every way. At other times the matter with its vessel is not exposed to the open fire, A dry Bath. but is setagainst another body intervening, and that divers ways; for first, if a pot to put sand or such like matter into, put on a vessel standing on a Trivet containing the matter to be prepared, be empty, 'tis most conveniently called a dry Balneum or a dry Stupha, but if the vessel be not empty, a various heat according to the variety of matter which is put in it, may be afforded, and may be called by several names; if it be filled with water and the vessel together with the matter to be distilled, be set into the water; it is simply called Balneum Maris or Mariae; Balneum Maris. a Bath also may be prepared not only of water but of the sawdust of sawed wood or Hay filling the vessel and then moistening it, and so cover it with a glass, but if the vessel with the matter to be elaborated be not set in water, but be so placed, that it may receive only the vapour of the heated water, it is called Balneum Vaporosum, afterwards let the pot be filled with the dust of Bricks, with Sand, Sawdust, the filings of Iron and such like. Secondly, the moderation or governing of the heat, depends on the store of fuel, the quantity whereof in the kindled coals, the Artist can at pleasure abate or increase, or make it how he please, and that either by the plenty or want of coals, or by the more free eventilation of Air, and the shutting out interception of the same; for a greater quantity of coals make a greater and stronger heat, if they can by the fuming of the Air, and by opening of breathing holes, be kindled, all which may be better shown then described. Thirdly, for the variation of the fire, the dishes commonly called Cappellae do make it according to their various distance from the fire; for if they are moved nearer to the fire it is increased, but if further off, the heat is remitted. CHAP. III. Of the first rank or form of operations of Breaking, Sleeking, or making plain, In the institutions Chap. 3● 4.5.6.7. The kinds of operations pharmaceutical. Shaving and Fileing. NOw for what belongs to Workmanship and operations, although all these may seem to be referred to conjunction and separation, yet it pleaseth us in this place according to our purpose to reduce them into three forms, and to comprehend them in the three following Chapters, In the first we may contain those operations which pertain to the dissolution and corruption of a thing; In the second we will put in those things which are separated, and the detraction of any thing, In the third, we will explain those which are appointed for the alteration, immutation, perfection, and preserving of a thing. In the the first rank are breaking, or grinding, shaving, sleeking, filing, melting, or dissolving, draining, burning, turning into ashes, or incineration, calcination, praecipitations, fumigation, putrefaction and fermentation. As for breaking or grinding, Tritura. the chief end thereof is, that things may reduced into their smallest parts; that afterwards they may the easier, and more exactly be mixed with others, and their virtue may be drawn out. Sleeking, Laevigatio. or levigation, is nothing else then a most exact breaking or grinding, whereby some Medicine, red marble, or some other polite stone, a convenient liquor being poured in, or else without liquor, 'tis so long wrought with a little kind of Mil stone, by the turning of the hand, that it is reduced into the form of fine flower, and wonderful small dust, in that manner painters use to prepare their colours. Next to these are Section, Shaving, and Filing: Leaves, Staulks and roots of plants, Cutting Shaving Filing are cut with Scissors, or Knives, and by this means they are prepared, for boiling, infusion, or grinding, other things are shaved, or lessened by a turn, as woods, horns, hoofs, or nails, teeth of living creatures, for the same purposes. But those things which can neither be lessened by cutting or breaking, should be filled with an iron File, and reduced into the smallest parts, such like are most metals, as iron, and others, and also woods, horns, and bones of Animales. Melting is a reduction of harder things, Melt Dissolving. into a more liquid substance. Dissolving differs not from this, unless because that is done always by the benefit of heat, and for the most part without adding of moisture; but this is always done with moisture, and oftentimes without heat, so they melt fat, butter, marrow, wax, Pirch●osin, certain kinds of gums, as also metals by a greater strength of fire, but for the most part with powder added that they may the better run; all kinds of salt, are dissolved tears, juices, many kinds of gums, Rosins. draining or dissolving is a peculiar sort of solution when a body is made fluid, by moist air, Deliquium. which insinuates itself into it, so salts, allome, nitre, and such like melt, all which turn into liquor, also lime, or chalk, of which the greatest part are dissolved into liquor, or some thing of them only melt, according as they contain more or less salt. To these belong burning, and torrifying, Burning. Toasting: yet they differ in this, that these are performed with the less, they with the greater fire, whence, in toasting things are rather dried, then burnt, and if any thing be burnt, 'tis the outside, but in burning as well the internal parts, as those on the outside are burnt together. This drying is performed in a Platter, or Frying pan, especially of iron, wherein medicines put to the fire may often be stirred about, that either the superfluous humidity may be consumed, or the quality that abounds in the medicine may be taken away, but burning, when any medicine, as heart's horn, man's skull, ivory, oils enclosed in a potter's furnace, are burnt, and being burnt, and as yet hot are extinguished in a convenient liquor, and afterward rubbed, or crumbled to dust. Cinefaction, or a reduction into ashes, Burning to asks. is so called when the moisture, which was in the combustible matter, by which the parts hung together, is consumed by the fire, which is performed, two ways; First, the fire being opened the thing itself is cast in naked, and is reduced into ashes, moreover in a Vessel that is closed, matter is burnt and turned into ashes, which combustion differs from the former in this, for in the former, whatsoever is volitile flies into the air, but in this some volitiles are retained, and fastened with the fixed. Calcination is a pulverisation of a thing by fire caused by the privation of the moisture of the part joined with it. Calcining. This principally takes place in minerals, and metals, and other things which of themselves do not burn, and are more firmly united, and 'tis appointed either that a thing may be made the fit for solution, or to lose the acrimony, which it hath, although on the contrary some things become the sharper for burning whilst the aqueous humidity, whereby the acrimony is occasioned is consumed by fire. But this is performed two ways, either by actual fire, when things are fired, and the bond of continuity is broken by actual fire; or by potential fire, when things to be calcined, are corroded, by strong and corrasive waters, and other caustics. That calcination, which is made by actual fire is again various, for some things are calcined by themselves, and without any addition, but other things, with additamentents, which either prohibit the fusion, or else burn and corrode. But that calcination in particular, which is made and corrasive powders mixed therewith, Cementing. is called Cementing, and 'tis performed when a crucible is filled with thin plates of mettle, and corrasive powders, one rank above another, First Plates, than Powders, than Plates, than powders, etc. As the manner is in doing, after the crucible is exposed to a circular fire or Reverberation by degrees, yet some things are extinguished first by certain waters, before they are calcined, some are corroded first by their own waters and afterwards are Reverberared; on the contrary some things are Reverberated first, afterwards corroded. Calcination which is done by potential fire is finished by corroding, Corroding. precipitating, or Fumigation. Corrosion is a solution of metals, or such like by waters and sharp spirits Precipitation is when a mettle descends to the bottom, Precipitation. Fumigation. in the likeness of Chalk, and is separated from the water that dissolves it; but Fumigation is when some body is corroded and brought into a body like chalk, by the exhalation, or vapour of a corroding thing. Hitherto pertains Amalgamation, Corroding of metals by Quick-filuer. Putrefaction. which with the Chemists is an operation which is nothing else then a corroding of metals by Quicksilver and Mercury. Lastly putrefaction, which others call Fermentation, and digestion, is that operation whereby a mixed body is someway dissolved by a moist heat, and losing its natural juncture, or Union, is rendered the more fit for artificial separation. CHAP. IU. In the Institutions Chap. the 8.9.10.11.12.13.14. the second form of operations. Of the second rank or form of operations. TO the second form of operations we refer those things, which are employed in separation and detraction of any thing; and in separation of Homogenialls from Heterogenialls, of pure from impure, of Profitable, from unprofitable, such are sifting, washing, infusing, boyleing, straining, fumeing, Clarifying, Filtering, Digestion, Expression, Distillation, Sublimation, Exsiccation, Evaporation, Exhalation and Coagulation. Sifting is not only a separation of things beaten, Sifting. and brought into powder, of the finer part from the thicker, by means of the seive, but also for the most part, a casting of moist and boiled things through a hair seive. Washing is not appointed for that end only, Washing. that medicines defiled may be cleansed, but that some superfluous quality may be taken away from the medicine, or a new, may be introduced. Infusion is nothing else but a steeping of a medicine in some liquor, Infusion. whereby the medicine may be moistened within and without, that its force or strength may be drawn out, or increased, or its malignity corrected, or that which is hard may be softened. Next to infusion, is boiling, or seething, Seething. which differ only in this, that medicines in infusion are moistened with longer time and less heat, but by boiling 'tis performed sooner and with greater heat. Straining is that whereby moist things, Straining. either first heated, as the thicker and more viscid things, or lukewarm or eold, as those that are thinner, are cast through a thick, or thin strainer, the thicker parts and dregs being left behind in the strainer, they become the purer. Scumming is when during the time of seething the froth swimming on the top, is often taken away with a spoon, Scumming. for the most part perforated. Clarifying, Clarifying. although it may be taken in general for any sort of separation of filthy, and thick things, which may be performed many ways, either by standing still whilst the seculent matter, descends of its self to the bottom, and settles or by straining, or by froathing, yet principal with the Apothecaries, Clarification is that purification of things boiled by despumation, having added the white of an egg, namely whilst the white of an egg is beat with a Spatula, or spoon, until it come into froth, and afterwards is mingled with the Syrup or decoction hot to clarify it, and when it hath contracted any blackness 'tis taken away, and a new is put in so often till the liquor become clear. By Filtration, Filtering. or straining through a brown paper, that which is thick and feculent, mixed or confused in any liquor is separated, namely whilst the pure liquor descends through the strainer, whether it be a linen rag or brown paper, into the Vessel that is under it, but the impurity is left in the strainer. Digestion, although sometimes it signify putrefaction, sometimes a certain exaltation, Digestion. and circulation, since that in general, to distribute or dispose in order, is to concoct, and digestion is concoction, yet in this place, by digestion, we understand such a conction only whereby that may be separated, which is as yet foul in things, whilst the substance of the liquor is attenuated, and separated from its earthy impurity. Hereunto belongs Expression, Pressing. by the benefit whereof by a strong endeavour, either with the hand alone or with a press, we separate the liquid and moist from that which is dry and earthy. Distillation is nothing else, Distillation. but a collection of exhalations elevated by heat, out of something exhalable, by the help of a Vessel, and receptacle, thick, and cold into a liquor. This is commonly accounted threefold, the one is that which is by ascent, the other is that which is made by the sides, the third is that which is made by descent. By ascent Distillation is said to be, Distillation by ascent. when the exhalations and vapours ascend upward, from the Alembick, or the head of the Furnace. And the Vessels which contain the matter to be distilled, the head being put on in it, 'tis condensed into a liquor, which distils drop by drop through the beak or nose into the receiver, and it is gathered together. This is performed, either by the Sun beams or by fire, sometimes lying open, sometimes not manifest, namely some other body intervening, as sand, ashes, water, etc. Hitherto also may be referred conveniently Distillation by a Glass like a ball so called, Distillation by a glass. whereby oil of sulphur is prepared, namely when the brimstone is kindled, glass, hammers receives the vapours, and condense them into oil. Distillation to the sides, Distillation to the sides. or else it is called by inclination, when the exhalation, and spirits do not ascend strait upwards in the Alembick, but tend towards the receiver by the sides and obliquely, This is performed either when the fire is opened to it, or when some other body comes between, as sand, ashes, etc. By a Vessel which they call a Retort, or a Strait gourd, yet placed obliqne in the furnace, that the Alembick may incline downwards. Distillation by descent is when a liquor, Distillation by descent. is not carried upwards, from the dissolved exhalations, nor to the sides; but tends downwards, and drops into the supposed Vessel. This again is performed, the Vessel lying immediately on the fire, or sand, ashes, etc. intervening. To distillations belongs Rectification, or Cohobation, Rectification. whereof that is no other than a repeated distillation of a thing, to purify and exalt it the more, the dregs being left in the bottom, or to separate the phlegm from oil, or the spirit from phlegm, but this is said, when the humour which was distilled, is poured off, and again, and again, is drawn, and distilled in the same Vessel, where the matter was left. Sublimation, Sublimation. which is performed sometimes by fire that is open, sometimes by some intervening body, as Sand, Ashes, etc. 'tis the nearest to distillation by ascent and differs from it only in this, that as in distillation vapours, which are exalted, come together into a liquor, so in sublimation exhalations ascend dry, and being carried up on high, stick to the sides of the Alembick like atoms. Precipitation seems to be contrary to this, Precipitation. which is done when bodies dissolved by waters and corroding liquours, are again separated from the liquor, that the form of chaulk or dust may remain, which cometh to pass, when any thing is cast or poured into the solution, by whose force the dissolving liquor, or that which was the cause of solution in the liquor, is separated from the dissolved body. Drying. By Exsiccation the superfluous moisture is taken away, whether in the shade, or in the Sun, or whether it be done in an Oven, or in a Frying-pan over Coals, both for that the Medicines may the better be preserved, and may not contract thirst by their superfluous humidity, and putrify, and be corrupted, and also, that they may the easier be contained, and made into powder. By Evaporation the aqueous humidity expires, Evaporation. Exhalation. as by exhalation, dry exhalations are elevated by heat, as that which is superfluous in the thing being dissolved into vapours and exhalations may go out, and the more useful part only may be left. To these operations is added Coagulation, Coagulation. which is nothing else but a reduction of a liquid thing to a solid substance by the privation of moisture. CHAP. V Of the third manner of Operations. THe third form comprehends those operations which are appointed them, The third form of operations. for alteration, immutation, and perfection of a thing, and aim at this, that a thing may be reduced to a better state and more noble degree. But although some do reckon more such operations, and perhaps there are more, yet in this place all of them are properly called by the name of Digestion, Digestion. and as it is distinguished from the two higher kinds of digestion, whereby a new quality of a thing newly elaborated, is introduced, so that if the thing contains any thing that is hurtful, it puts away that, or if any thing is wanting to it, it begets that; and if there are any others to be here repeated, they ought to be accounted for certain ways of Digestion; Institution Chap. 15. and 16. Circnlation. For all of them for the most part, in the same manner by a gentle external heat, exciting the internal force of a thing are performed, which here is the primary agent. But amongst the manners or kinds of digestion, the chief is Circulation, 'tis called by some Pelicanation, from the vessel wherein it is performed, where by a gentle external heat being exhibited, the matter which is circulated, is exalted continually in the form of vapours, and is again condensed, and so by that continual concoction and this circular motion of refolution and condensation, it attains to the highest degree of perfection in its kind. Hitherto belongs conditing, Conditing. preserving, and confecting; fruits, flowers, roots, are condited or pickled with Honey, Sugar, Vinegar, Salt, not only that they may be preserved the longer, but that they may be the more pleasant to the taste. In confecting, Confecting. fruits, roots, seeds, sweet smelling spices, are preserved and candied with Sugar, more for the taste sake then preservation, or augmentation of the strength. Nutrition of medicines is a certain humectation, but such whereby the thing is presently wet, Nutrition. or moistened, and immediately dried again by the Sun or fire, and is to be wet and moistened again; which labour is to be repeated thrice, sour times, or so often until the medicine hath sufficiently imbibed that humour which we desire. THE FIFTH BOOK, PART III. SECT. III. Of the Forms of Medicines. CHAP. I. The Division of Medicines. AFter we have finished the operations necessary for an Apothecary: The Division of Medicines. It remains that we now come to the preparations themselves of Medicines, which are perfected by those operations. The differences of Medicines, are taken either from the substance or from the parts to which they are applied. Medicines being considered the former of these ways are, some full of Vapours, others Corpulent; Corpulent are either fluid, or having a consistence, Fluid are various, as distilled waters, Spirits, Liquid tinctures, Vinegar, Medicinal wine, Hydromel or Hony and Water, clarifies Juices, Oils, Emulsions, Decoctions, Infusions, Julebs, Syrrups, Baths, Clystets, etc. Again those that have a consistence, some of them are actually moist, others dry; Of the former sort are Conserves, Electuaries, Eclegmas, Juices, Extracts, Boles, Muscillages, Fat Lineaments, Balsams, Unguents, Cataplasms: Those that are actually dry, are either continuous, and the parts cohaere together, or else they are discontinued. Of the former kind are, Pills, Troches, Rotule●, Morsels, Plasters, Cerates, Suppositers, Glasses, Regulus, and certain things sublimed: Of the latter sort are, several Species and Powders, Meal or brann, Flowers, & things precipitated. But in respect of the parts to which they are applied, some are called internal, Internal. others external. The internal are those which are taken into the body that common and usual way as we take in meat and drink, all the rest whether they are applied to the body, or spread over the body, or any other way applied to the bodie●, or if they are cast into the body any other way, External. as, at the fundament, ears, nostrils, womb, we call them externals. The forms of Internal Medicines are various; The difference of internal Medicines. for some are fluid, others not fluid, and these are either soft and liquid, or altogether dry, The fluid are, Decoctions, Infusions, Medicinal Wines, Honey and Water mixed and boiled together, wine mingled with honey, vinegar, and honey, and barleywater, Juices, distilled waters, Spirits, tinctures, and Liquid extracts, Oils, Sirups, Julips, Emulsions; Soft and not fluid are, Extracts, Conserves, Preserves, Medicinal Juices thickened, Electuaries, Eclegmaes, or Medicines to be licked or supped, Boles, Not fluid, and plainly dry are, powders, Sweet meats, Salts; Saffron-flowers, Precipitates, Comfits, little round Cakes, Morsels, or little snips, marchpanes, And those which belong to these, as Troches, and Pills. But externals are either sent into certain parts of the body, Of Exterternal. or they are only applied, or exhibited to the superficies of the body, or they are only hung about, as Ammulets, and Periapticke medicines, or medicines to hang about ones body; Suppositers and Clysters are injected, and cast into the body; Clysters, and pessaries, are also injected into the womb, also certain Liquors are injected into the yard and bladder; into the mouth are put gargarisms, to wash the mouth, or throat with, Apophlegmatismes to draw away Phlegm, Dentifrices to rub and cleanse the Teeth, To the nose Erhines, Sneezing-wort; Odours, Suffumigations, peculiar injections into the Ears, Collyries, or medicines, applied to the eyes. To the outside of the body only are exhibited, and applied, oils, balsams, ointments, linements, cerots, plasters, Cataplasms, Dropases, or ointments to take away hair, Sinapismes, Phaenigmaes, or medicines causing the body to break out in blisters, or Pustules, Epithems, or medicines some what softer than plasters to be applied to the body, fomentations, or any thing applied plaister-ways to assuage pain, little bags, powders, embrocations, washings of the extreme parts, baths, washbals, searing irons or cauteties. Some others do best agree with certain other parts; What Medicines are are applied to the Head. all external things for the most part, communicate their strength to the head, as distilled waters and spirits, oils, extracts, decoctions, infusions, syrups, conserveses, preserves, comfits, electuaries, little round cakes, morsels, pills, powders. But external medicines applied to the head, in the form of powders, little bags, round balls, oils, balsams, ointments, unguents, plasters, cerots, cataplasms, oxyrhods, that is medicines with vinegar and roses, epithemes, or the softest plasters, embrocations, suffumigations, perfumes of divers sorts, as also washings of the Feet are profitable for the Head. To the eyes. To the Ears. Externally waters, and Collyries, ointments, fomentations, unguents, cataplasms, are convenient for the eyes. Into the ears distilled waters, Juices, decoctions, oils, and other liquours are infused and dropped, and other Medicines in the form of evaporation, and fumes are sent into the ears, also liniments, ointments, fomentations, epithemes, Cataplasms are applied. For the teeth are convenient, lotions for the mouth, To the Teeth. liniments, small pills to be put into hollow Teeth, unctions for the Jaws, powders for rubbing the Teeth, and also troches, and pencils made in the form of suppositers are convenient for the Teeth, and being dried, and hardened, the Teeth are rubbed therewith. Medicines applied to the mouth, and Chops are lotions, For the mouth and Chops. For the Breast. and gargarisines, ointments made of honey, of syrups and juices, lohocks. Most internal things are good for the Breast, but especially, lohocks, troches, and little rolls, such as they use to hold under their tongues, the thicker sort of syrups, vapours, and fumes drawn in with air, externally, the samemedicines may be applied in the form of oils, ointments, unguents, cataplasms, plasters and cerots, little bags, fomentations, and epithemes. Medicines are applied to the Heart, To the Heart. for the most part after the same manner, and moreover fumes, or steames, which are profitable for the recreating and refreshing of the spirits. Internal Medicines may be conveyed to the Stomach in all forms, To the Stomach. but principally those which are taken in at the mouth, but externally, in the form of oils, unctions, fomentations, liniments, unguents, cataplasms, plasters, epithemes, bags. Moreover, To the Liver. all internal things may penetrate to the Liver. But external in the form of Ointments, Fomentations, Linements, Cataplasms, Unguents, Plasters, little bags, Epithems, are applied. In the same manner Unctions are exhibited to the Spleen, To the Spleen Reives and Bladder. and Bladder; Baths also, and Tubs of waters to fit in, are useful for the Reins, Bladder and spermatick Vessels; and Clysters injected are good for diseases of the Reins. All the same things are convenient for the womb, and moreover injections into the womb, Pessaries, Errhines or medicines to put into the nose, fumes, and Evaporations, Lotions of the feet. And all these sorts of medicines shall now be explained in their order, as far forth as this compendium will admit of. CHAP. II. Of Decoctions. DEcoctions which the Greeks call Apozemes, are potulent medicines prepared by the boiling of plants and of their parts, Decoctions what. How many fold. are potulent medicines prepared by the boiling of plants and of their parts, seldom of Animals; all Decoctions may conveniently be reduced into two forms; namely into Decoctions altering, and purging; under Decoctions altering, we will comprehend all those that have any other verrue besides purging, and do alter the body, whether they are given in regard of themselves only, or for some following purge; which Decoctions are then called Preparatives, Digestives, or Apperatives, that is opening things. But the matter to be decocted is taken out of the rank of Vegetables, The matter of them. wherein are variety of parts of plants or herbs, seldom of living Creatures. But as for the quantity of the materials to be decocted, Quantity. if a weight be to be assigned generally to what ever is to be boiled, it gins from an ounce or two ounces for the most part, and ascends sometimes to half a pound, nay sometimes to a pound, a pound and half, and two pound, but as for the dose of the several kinds Decoctions are prepared. Of the Roots and Barks ℥ 2. ℥ 3. and ℥ 4. Of Leaves, 3.4.5. or 6. handfuls. Of seeds 3.4.5.6. drachms Of Fruires, in number 1.2.3. couples or pairs 5.6. Of flowers, pugils 4. or 5. Half an ounce, five drachms or six drachms answers to a little handful, two drachms or three to a pugil, but it is not necessary to mix all those together in every decoction, and to heap up a mixture of them all, but when a few will perform the intentions, 'tis in vain to put in many, yet if the decoction be provided to be given at many several times, such a quantity of materials ought to be taken, as that the decoction made of them may be powerful to perform the aim of the Physician. But in the seething, Preparation of the matter. Or of boiling. the preparation of the things to be boiled, and the manner of seething, is to be observed, for first if the materials are too thick or hard, they are first to be cut or gently bruised, or filed or beaten in a mortar. In the manner of seething, order is to be observed in putting in the things to be decocted the fire and instruments and Liquor which is decocted; and time also is to be observed. Order of boiling is to be observed, that all the things may not be put in together, but the Roots, Barks, Woods, which are the more solid things, and without smell, should be put in first, than the Leaves, and seeds, last of all flowers, and Aromatic things, and all those things which smell strongly, and those things which may disperse their strength by much boiling; but this cannot be observed except the vessel be opened, but if the decoction be made in a thing that is covered, it matters not much to put in all the things altogether, and if any of them are more difficult to be seethed, those should first of all be bruised by themselves. The fire should be clear and equal, but very gentle, since the virtue is easily called forth, but stronger when there is need of much boyleing. But decoctions are made by the Apothecaries commonly when the vessel is open and the fire also, but 'tis more convenient, lest the strength of the medicines should vanish in boiling, to make a decoction in a Biploma, as they call it or a double vessel, the vessel being shut, or if a decoction be made the fire being open, 'tis convenient to set on it a close Alembick, or if it hath a beak, o● snout, to fit it with a receiver to take the liquor, and to mix it with the strained decoction. The Liquor in which the things are boiled aught to be such as may perform the intentions of the Physiti●●, Liquor for the De coction. as water of the Fountain, distilled water, Barleywater, Chaly-beate, Water, Whey, water mixed with Honey called Hydromell, sometimes Wine is taken, seldom strong Beer is used, sometimes some Vinegar is put in, that the viscid and tough humours may more powerfully be cut thereby, and the medicine may penetrate the more; sometimes Roots alone, before the decoction is made, are brayed in Vinegar. Distilled waters also are often used for decoctions with no great profit but with great charge, unless the decoction be made in a close vessel, since so long boiling takes away all their strength. The quantity of the Liquor ought to be such as may satisfy for the decoction, The quantity of Liquor. and aught to cover the medicines three or four finger's breadth; which for the most part is left to the discretion of the Apothecary. But if the proportion be appointed by the Physician, the Liquor is for the most part fourfold, six-fold, eight-fold, in proportion to the medicines, according as the Herbs are dry, or full of juice, thick, or thin, and may imbibe more or less of the Liquor, and they ought to seethe a little, or long. Sometimes before boiling, the medicines are somewhat cut, or bruised, and sometimes they stand a while (after decoction) before they are strained. But they are boiled to the consumption of half or of a third part, or of a fourth part only of Liquor, or till but a third part remains, according as the medicines and the scope of the Physician requires: for those whose virtue easily vanish and are in a thin, and separable substance are to be boiled the less time: but those whose substances are thicker, the strength cannot be drawn forth without longer boiling, the decoction is strained with, or without squeazing, according as there is need of the thinner parts only, or thicker, and such as lie deeper. A decoction is prepared either for one dose or more; for one, three, four, or five ounces may suffice, if for more, the decoction should be made that the remainder may be a Pint, or a Pint and an half, and afterwards of things making it pleasant, for one Dose an Ounce, or an Ounce and an half may be added, yet more than a Pint, or a Pint and an half of a decoction, at one time, is seldom made, (except the decoction of Guiacum and such like) since that if more should be prepared, it would easily be spoiled before it would be taken by the sick; Unto three four or five ounces of the decoction strained are added, of Sugar, which often is ●used or Honey, six drachms, or an ounce, or of some convenient Syrup in every dose an ounce, or an ounce and half: Sometimes the juices that are most convenient of Herbs, or Fruits, and often other Liquors, as Aqua vitae, Spirit of Vitrioyle, Copper, Saltpetre, some drops thereof are added, and indeed only one of these is added sometimes to an Apozeme, but of lenitives more, as more Syrups, or juices & Syrups, or of juice and Sugar, when juices are adminiistred, for the most part; Sugar or Syrup is mixed with them, and sometimes pleasant things; that they may be the better mingled, a gentle ebullition is appointed at a weak fire; if it be convenient, the white of an egg may be added, that the Sugar and Honey, and decoction also may be clarified; or if that clarification doth not suffice, the decoction is to be put into the Balneum Mariae, till the thick dregs settle in the bottom, and they by settling in the bottom, and pouring off of the clear Liquor are separated, and that is to be repeated sometimes if it be needful; sometimes the decoction is to be made pleasant either for the acquiring of a good taste, or smell, or some other virtue, namely the Aromaticks a little before the end of boiling being reduced into into powder, or Aromatic species fitted for the disease, half a drachm, or a drachm thereof in each pint, is to be hung in a thin skin, or bladder in the decoction, and are often pressed out, or else a little after, the decoction is removed from the fire, the decoction being as yet hot, they may be cut, or bruised more grossly, and so injected, and after they have stood together some time in a vessel well covered, it is strained again. Musk also, and Amber-greaze, if it be convenient, may be also given to the dose of a grain of each; or a drachm or two of Cinnamon water may be added. If Wine or Vinegar be necessary, 'tis more convenient to add them after the boiling, or a little before they have done boiling. They are given for the most part in the Morning, The time of giving. or Evening, or two or three hours before dinner, or supper, the stomach being empty and the decoction being first warmed, three four or five ounces thereof is given at a time, and that is often performed two, three, foute or five days following, and either once only, or twice a day; if the decoction; are prepared for many doses, they are to be kept in cold places under ground, for they will scarce continue above a week although it be in the Winter: but in the Spring and Summer, for the most part they are renewed every way. Hereunto belong restorative Broths as they call them, Restorative broths. which are made of Hens, or Capons, to which Veal, or Goat's flesh may be added, and there are of three sorts; the first they call a complete, Jus Consum matum. or a perfect broth, because 'tis most absolute, and fittest to nourish: it is prepared as ordinary broths are, only that they boil longer, and indeed so long until the sixth, eighth, or sometimes the tenth part only remains; Gelatina. the second is called Gelatina, which is made if these meats are boiled in a double vessel without pouring off the water, and the juice is pressed out from thence, from which after it is cooled, the fat swimming on the top is to be scummed off: Contusum. the third is called Contusum which is prepared when the meats first sodden or roasted, afterwards are beaten in a mortar, so long until they may melt when broth is put to them, and afterwards are strained. Purging Decoctions. PUrging decoctions differ not from other decoctions, The manner of prepuring purging of decoctions. unless in respect of materials; namely that simple purging medicines are mingled in purging decoctions, the manner of preparing is the same: for purging medicines convenient for the evacuation of the humours are taken, and that for one and more doses, yet because in seething their strength will decay, or waste they ought to be taken in a greater dose, then in the substance, the strongest for the most part double, but of the milder purgers, . Of which before in the doses of medicines. Other things are added to these, which may either resist and correct the malignant, and noxious qualities of the purge, or may prevent the mischeives which may befall nature by theuse of strong purgers or which may increase and stir up the dull faculty of a medicine, or extimulate them to work more speedily, or may bridle them if they work too strong and quick, or such as have regard to some private part, and may lead and direct the purging medicine thither; Aromatic powders or species are added to the decoction strained, for to please the palate, halfe an ounce or an ounce of Syrup is appointed and prepared. 2. Oftentimes something that purges is added to the decoction as Syrup and Honey of Roses and Violets solutive, also Cassia, Manna, which are dissolved in the decoction, which is again strained. 3. Sometimes purging electuaries are mixed and dissolved in the concoction, in such quantity that they make one dose when they are mingled with many things that are boiled together. 4. But because decoction, by the mixture of electuaries become thicker; 'tis not inconvenient if they are strained again, and also clarified, but then the Electuaries may be used in a larger quantity. 5. Sometimes, some of the purging powders are added to the Liquor or decoction. 6. Or some quantity of a purging extract is dissolved in it: 7. Lastly, decoctions are oftentimes made of purging and altering medicines together. Hereunto belongs decoctions to cause vomits, Vomiting things etc. sweats Urine, examples whereof are extant every where. CHAP III. Of Infusions and other purging Potions. INfusions are next unto decoctions, Infusions. and differ only from decoctions simply so called, in that they are wont to be prepared only by boiling without macerating them before hand: but these are when the medicines are broken, or beaten before, and put into a convenient Liquor for some certain time that they may leave their virtue in it The m●nner of preparing. They are prepared of medicines of all sorts, but most commonly of Purgers, which should be given in somewhat a greater weight, then in the substance, namely half so much in the substance, and double in the Infusion, with their correctors and directors being cast in also in a due quantity, (sometimes in a nodule or little bag of fine linen, shut) in a Liquor convenient for the purpose of the Physician: the Chemists at this day, that the extract may be made the easier, put to the menstruum or prepared matter some drops or spirit of Salt of Vitriol, or Oil of Vitriol is added, which is made by draining, which they call per deliquium. The quantity of the Liquor ought to be such as may cover those things that are macerated, and may be something higher than they, being infused in this manner, fix, twelve, or twenty four hours in a warm vessel stopped or shut, they being beaten or cut in pieces should so long lie in it until the Liquor hath extracted all their strength, which may be known by the taste and smell. But if, which often happens, there be urgent occasion, the medicines cannot be macerated for want of time, that defect may be supplied by gentle boiling of them, afterwards that which is strained with or without squeazing is appointed for use, and indeed without squeazing or pressing that which is strained is more cleansing and pleasing to the taste, but weaker: but with expression 'tis more troubled and thicker, but more efficacious. You may add to the infusion things that sweeten it or other purging things as 'tis said before of decoctions. Sometimes Decoctions, and Infusions are given together; namely a Decoction is prepared in the same manner as is said before. In a sufficient quantity of that decection are infused purgers with their correctors, and the rest of the things are afterwards mixed as in other infusions. Another way also a Potion is made of insusion and decoction mixed, or an infusion with a decoction, namely the decoction is prepared by its self, and the insusion by itself, both of them according to the method formerly described, and these two Liquors are afterward mingled together. To these purging decoctions, A purging Potion. The menner. and infusions, by reason of their fimilitude we add a purging Potion peculiarly so called by some, which is prepared in this manner, first a sufficient quantity is taken of any sort of Liquor, decoction, distilled water, Whey, water and Honey mixed, Broth, Wine, Juleps of Violets, sufficient for a draught, namely two 3. or 4. ounces, in the Liquor a sufficient quantity of Cassia, Manna, or a sufficient quantity of any one purging electuary, or more, is to be dissolved for one dose; sometimes of some Syrup half an ounce, or 6. drachms, or some of the Aromatic powders are added, and these potions are taken as the rest, which we have spoken of heretofore, hot in the morning fasting. 2. Secondly, as 'tis spoken of pu●ging things, so here also straining, and Clarifying may be appointed, but then the electuaries are to be taken in a greater quantity, then if they are given without straining. 3. Thirdly, purging Potions may be prepared of purging extracts, but seeing that extracts are wont to be given in a smaller dose, they require less quantity of Liquor, and therefore are more grateful to the affected: sometimes two or three ounces of other Liquors are taken instead of Muskadine, and the extract is dissolved in them, and if there be danger of being too hot, some Sorrel, or Lemons, or some other convenient things may be added. 4. Lastly, purging Potions are prepared of powders as well simples, as of compound purging medicines, as also with purging Rolls, but the dose of such powders, ought not to be much more than a drachm, otherwise the Potion will be too thick, and ungrateful: and sometimes some powder is mingled with dissolved electuaries. In the same manner also, Potions and infusions for vomits. Infusions and Potions for vomits, sweats, and medicines provoking of Urine may be prepared. CHAP. IU. Of Medicinal Wines, drinks of honey and Water sodden together, of Wine mingled with Honey, of Oxymel, of Medicinal Vinegar, Decoction or Barleywater, also of Clarified Juices. OUT of those things which have been hitherto spoken of Infusions and Decoctions, Medicinal wines. it will easily appear how medicinal wines are prepared, and they are either altering, ●r purging and altering together. They are prepared, either of Must; or of Wine that is re●ined, those that are prepared of Must, have a more plea●ant taste, and they are thus done; The dry Medicines are ●ut into little wooden Casks; when the Must is somewhat abated, and the Wine cleansed, and made clear, it should ●●e drawn out into another Vessel, and kept for your use. In the same manner Physical drink may be prepared, Ph●sica●l ●●●nkes. of Wormwood, Heart's tongue, Bittony, Sage, Rosemary, and other herbs, and also of purging things: but for the most part, the herbs are first bruised in the drink, after 'tis brewed, being as yet warm, and afterwards in due season things to make it work, being put in, they are suffered to cool. Of Wines so cleansed, Medicinal Wines are prepared; Dry medicines are cleansed, cut, and broken, and are put into a glass, or earthen Vessel, sometimes into a Nodule, or little Bag of fine linen, or thin linen sewed up; a sufficient quantity of good white Wine is poured in, so they stand in infusion, in a Vessel that is shut, afterwards strained, unless they are enclosed in a little Bag. But this proportion for the most part is observed, that to a pound of medicines, there is taken of Must, or Wine eight Pints, twelve, nay, to twenty five, nay thirty, or thirty six, so that an ounce may answer to the proportion of two or three Pints. Medicinal Wines also that altar, are prepared if distilled Oils are added to them being first mixed with Sugar, or Spirits, or tinctures, spirit of Wine drawn out of simple medicines, or moist extracts. Sometimes medicinal Wines are sweetened with Sugar or Honey, Claretum. and are called Clare●s, and Hippocratick Wine, they are profitable in cold durable diseases, they a●e made in this manner: Aromatic things or roots also and seeds grateful to the smell and taste, principally are grossly beaten, or cut, and such as have great efficacy, are infused in sweet Wine, so they are to stand sometime in the Infusion, in a warm place for some hours, or let them simper in Balmum Mariae, for half an hour, especially if you may accelerate the work, or to prepare Wine mingled with Honey; afterwards there is added a sufficient quantity of Sugar to make it pleasant to the taste, so that to two, three or sour parts of Wine, one part of Sugar may be taken, and oftentimes Wine is drained through Hypocrates sleeve, that it may become clear, some of the distilled waters that are convenient, may be mixed with the Wine. Some infuse the Aromaticks in spirit of wine, about eight or ten parts whereof is used to one part of the Aromaticks, and when the spirit of wine hath drawn out the tincture, they separate it by declination, and straining or filtering, and keep it for their use, but when 'tis convenient to make hippocratical wine, they power some drachms, and withal an ounce or two ounces, to one measure of Wine, a sufficient quantity of Sugar to sweeten it. But such Wines and Clarets, may be prepared not only to alter, but also to purge, with the same dose for the more choice sort of persons, namely with purgers, principally the Leaves of Sena, Mecoacam, Agrick, Turbith, with their 〈◊〉 recters are put into a sufficient quantity of Rhenish Wine, and being heated in water lukewarm in a glass afterwards must stand in a warm place, six hours in Infusion, afterwards add of Julep of Violets, or Roses halfe an ounce, or let them be sweetened with half an ounce of white Sugar and be strained, and filtered through a brown paper, let three ounces of that which is strained be perfumed with two drops of Oil of Cinnamon; Manna also may be taken instead of Sugar. If the Wine be sweerned with Honey instead of Sugar, Wine mingled with Honey. 'tis called Oinomell. Mulsum, or wine mingled with Honey, is prepared of one part of Honey, and two or three parts of Wine mixed and boiled together: and Aromaticks of every sort may be added, and it may be prepared at the time of gathering of Grapes, namely if one part of Honey be taken and two of Must: of water if it be convenient three parts or five parts in quantity, and let them heat together. Hydromell, and Mulsum, and Melicratum, Hydromell. Mulsum. Melieratum. are names of medicinal Potions of the same nature, namely made of water, and Honey, and sometimes of other things boiled therewith, or if there be any difference amongst those, 'tis only in comeliness, for Melicratum is made suddenly for present use of a mixture of Honey and water; but Hydromell is prepared to keep longer, and is neater made; of Mulsum some is more cleanseing, others purer, so that there is a several proportion of Honey to the water, according to the various scope of the Physician, and temperature of him that takes it. To prepare it eight, ten or twelve times the quantity of Fountain water is to be taken: but this is made of one part of Honey and five or six of water, boiled till the fourth or fifth part be consumed. Amongst the kinds of Mulsum, which can keep, Meade. the most noted at this day, is that drink which is called Mead, and the best indeed is prepared in Li●uania. But Hydromell is prepared not only of water and Honey but also of several Aromaticks, Herbs and Roots, as Clary, Hyssop, Bettony, and others, both kinds are made, that which is for present use, and that which is more durable, and will keep longer, it is prepared for present use, if in a pint of the water of Plates, a drachm, or at most two drachms are boiled, the 10th. or 12th. part of the best ●●ney be added, to every pint of the decoction. Hydromell is made after the usual manner: But sometimes Hydromell is compounded, when the simple Hydromell is scented with these only, although no other thing be boiled in it. Besides the compound Hydromell which doth alter, a purging Hydromell is also prepared, which is nothing else but a purging decoction made with simple Hydromell. The next to Mulsum, Oxymell. is Oxymell, which differs from it, only by the mixture of Vinegar, a drink very usual amongst the Ancients; but the old Physicians did not make Oxymell alike, but severally and added Vinegar according to the nature of a disease and of the diseased and other circumstances, and they gave it not only mingled with other medicines, but alone to quench thirst, and other purposes to drink, but that which is most cleansing, and may also be used in fevers was made of twelve parts of water two of Honey and one of Vinegar; they were gently boiled and scummed, and the fire not being fierce, and by the addition of the white of an egg were clarified, and afterwards strained through a woollen cloth, till it become clear and pure. There are prepared by the Physicians other kinds of Oxymells compounded of more medicines; such is the Oxymell Helleborated of Gesner or rather of julian. To this head we refer the water, Barley water. or decoction of Barley which is made of whole Barley boiled in the water till it comes to a Ptisan, and some is simple when nothing is boiled besides Barley; another is compound when certain other things also are added to the Barley, namely Raisins, Liquorish, Aniseed, Fennell-seed, Cinnamon, Sugar: of Liquorish is added, from two drachms to half an ounce or six drachms, Raisins from an ounce to two ounces of such as are stoned, half or a whole drachm, Cinnamon to one drachm, or 2. drachms, for a pint and half or z, pints of Liquor. Sometimes a sour medicine is prepared, Medicinal Vinegar. as with Squills, Roses, the rinds of Scordium, the Flowers of Elder and many others, and not only of one, but more simples by infusion and materation of them in the same manner, as in medicinal wines. Moreover to this Head we may refer clarified juices, Clarified juices. which being pressed out of new gathered Plants are purified, either by the white of an Egg, or by straining, often repeated, principally by filtering, or by separation. CHAP. V Of distilled Waters and Spirits. THose things which are prepared by distillation are called distilled things, which are of divers kinds, Things distilled. yet all of them may be reduced to two forms, for either the things distilled are in the form of waters, or Oils; Water. those that are of the same consistence with water are again twofold, for either they come near the nature of water, and are plainly called waters, or else they are spirituous, Spirits. and are called Spirits, yet these names are often confounded, for oftentimes that which is spirituous is called a water. 1. First distilled waters are prepared of divers things: Manner of distilled waters. of herbs and Flowers, all for the most part are distilled by ascent; and principally of fragrant flowers, and other thinner and colder things, whose force easily vanisheth, for the most part, waters good enough are distilled in a crooked glass, by the Balneum Mariae. 2. Others bruise the flowers, and herbs that are to be distilled, and press the juice out of them, and out of that juice by distillation through an Alembick they draw out water into the Balneum Mariae. Some cut in small pieces the Plants to be distilled, or bruise them, and being bruised they they fill the Gourd having a narrow mouth all most full, and the patellis the glasses being put on with the powder of the glass of Copper and borax Hermetical, they shut and afterwards they put the glass full of water into a Cauldron, and boil it six or seven hours, afterwards they put the glass when 'tis taken out of the water, into a warm place to cleanse it, until the drops cease to stick to the sides of the glisse, and the digestion be absolute: they distil the matter digested in Balneo Roris, they separate the Oil from the water they power out the water with the relics again and repeat the distillation. 4. But the hotter, and Aromatic Herbs, and those whose strength do not so easily vanish and lies deeper, are not so conveniently distilled by Balneum Mariae, but in vesica, but in this distillation by a vessel of water, some diversity also is observed, for some bruise the herbs, or cut them into small pieces, and fill the fourth part of the Vesica besides for them, than they pour of the pure water that three parts of the Vesica may be filled therewith, and one quarter for the most part remains empty, and a Refrigeratory vessel, being applied and the worm also (if you desire merely a spirituous water) or with an Alembick with a Refrigitory, and their conjunctions or joints shut, and a convenient fire being kindled and placed under the Vesica they distil water gently and by drops. 5. Others having poured in hot water into a vessel close shut, first they bruise the herbs, twenty four hours for the most part, they think it most profitable if the herbs are not only macerated in warm water a day and night space, but being bruised, or beaten, they should stand in digestion, and putrefaction in Horse dung, or Balneo Roris, or Mariae, for ten or fourteen days, afterwards they should be distilled. That water which first drops out is the best: but that which comes out last is like water itself; distilled water, if it be convenient, may be poured off, with new herbs to be digested, and distilled again. 6. But since that water and spirit ascend together, they must be separated, which is most conveniently done by the Balneum, namely all the water is to be poured into a crooked glass or Viol, and by a gentle heat only the spirituous part is to be distilled, by which distillation if the heat be rightly governed, the separation happily may be made at once, yet if it shall not so happen the first time, the distillation is to be repeated, and that rectification which was first made by a Gourd, afterwards rectification is appointed by a Phyoll. Examples may be seen in the Institutions. CHAP. VI Of Oils. FOr the most part it comes to pass that with the water in distillation of hot herbs, Oils. and Aromatic seeds, Oil comes forth together, which is to be separated from the water; but this is performed first by a kind of tunnel which they call a Separater or Tritorium, afterwards through a filter or a course woollen cloth, thirdly through brown paper: the Precepts of which operations are to be sought out of the Institutions. Yet certain Oils are distilled also without waters; so Oils are drawn by distillation from Amber, Mastic, Frankincense; Of which in the Institutions. CHAP VII Of Syrups and Juleps. SYrups, and Scraps, The name of Syrups. derive their names from the Arabicks, and therefore are not to be written with a●y, which the Arabicks want, and 'tis drawn from the root Schareba, which signifies to sup, and therefore it signifies a Liquor to be Supped; Syrups therefore are fluid medicines prepared of a convenient Liquor, whether it be boiled, or infused, or a juice made up with Sugar or Honey, and boiled for the most part to the consistence of Honey: Syrups are invented both for delight to the taste, and for durability, that convenient medicines may be in a readiness at any time of the year. Some of them are simple, Differences. which are made of one simple medicine only, and with Sugar, or Honey; compound which are prepared of more; both kinds are appointed for several uses, of them are some altering and strengthening, others purging, and the liquor is taken from decoctions, infusions, clarified juices and Vinegar. This is the manner of preparing, Manner of preparing Syrups. First the decoctions art taken; to the Decoctions are added Sugar or Honey, according as the use and scope of the Medicine requires; namely, two pounds of Sugar or Honey to a pound, or a pound and half of the decoction, as it is desired to be thicker or thinner, and aught to be kept more or less time: Then afterwards it is to be clarified by adding of the white of an Egg, that the decoction by a gentle Fire may seethe to the consistence of a Syrup: If Honey be added, it ought to be boiled less, because being cooled it easily becomes thick. Syrups also, like an concoctions, may be made with Aromaticks, or Aromatic Powders. 2. Seconldy, they are prepared of clarified Juices, to which is added half the quantity of Sugar, and boiled to the consistence of a Syrup. 3. These Syrups are better if fresh flowers are infused 24. hours in the expressed juice in Bal. Mariae, and are again expressed, and that repeated as often as it is fit. Then the juice is to be clarified by digestion, and half the quantity of Sugar to be mixed with it. 4. Others boil the juice till half be consumed, than they strain it, and suffer the decoction to stand and settle, that the juice may be the purer, the which when Sugar is added, they settle to the consistence of the Syrup. 5. Sometimes the juice pressed out is poured into hot clarified Sugar, and exposed to the heat of the Sun, to consume its aqueous humidity. But, if the heat of the Sun be not sufficient, it may be performed by gentle boiling. 6. Syrups are also made of Infusions, Sugar being added in the same manner as of Decoctions. 7. And sometimes other things are infused in juices, and afterwards when 'tis strained, Sugar is put to it, and the Syrup is made according to art. 8. Syrups may be made of extracts also, if a little Sugar be added to the extract being thickened by abstraction of the Menstruum. 9 Syrups may also be made of soft Electuaries, if the Electuary be dissolved in six times or eight times the quantiny of warm liquor, and strained, and half so much Sugar added thereto, by a gentle heat without boiling, the liquor should evaporate to the consumption of the third part. 10. Also Syrup is prepared of Sugar and Vinegar only, namely four pound of Sugar, and two of Vinegar, and according to some five Pints of water, and 'tis called Syrup of Vinegar simple. 11. Moreover, Syrrups are made much more artificially, especially of hot and dry Plants, if only so much water is poured off as that so much of the liquor may be left after straining without concoction, as otherwise useth to be left after concoction is made, and the matter infused on this manner in a Glass or other convenient vessel, such as Fire-vessels, or earthen vessels, whose orifices may be fitted with a cover made for it, that is round and channelled, which should be put into the Balneum, three or four days to digest, and afterwards should be strained, and that which is strained should again be put alone in Balneo, or because of straightness of time, it should be clarified with the white of an Egg, what ever is feculent in it. Afterwards Sugar should be taken and clarified, and boiled to such a consistence, as is observed in the Confection of Penides, and it should be mingled with the clarified infusion. The nearest to this is Oxymel, Oxymel. which is to be had in the Shops, which is prepared of one part of Water, one of Vinegar, and two parts of Honey, whereof divers compositions may be made also. Syrups are seldom given alone in Diseases of the Breast and Stomach; The manner of administration. but oftentimes are mixed with double the quantity of distilled waters, or decoctions; and an Ounce or an Ounce and an half of Syrups may be drank with two or three Ounces of Water or Decoction at one time. To Syrups and Juleps belong Rosated water, A Potion of Roses and water. which is a Potion compounded of Roses, and Water, and Honey or Sugar: Oribacius put into sixty Pints of warm water, ten pound of Rose-leaves, he shut the Vessel till they were perfectly boiled, afterwards the Roses being taken out, he infused of boiled and clarified Honey thirty pound, and put it into a Cellar. Actuarius took ten Pints of water, and five pound of Sugar and boiled them together to a convenient thickness, afterwards he infused a pound of the juice of Roses. The likest to Syrups are Juleps and Zulaps, Juleps. as they are called, from the Arabic word Sialaba, which is to heal or make sound, without doubt it is derived from thence, so that indeed Physicians often times take them for the same Medicine, and Potions that are mixed of Water and Syrups called Juleps, but the name of Juleb is often extended farther now than with the Arabians, who invented this Medicine to be made; for the name of Juleb was absolutely given by them, when Sugar only is dissolved in Rose-water, and boiled, as Julep of Roses is, otherwise called Alexander's Julep. But a Julep, if there be any difference betwixt it and a Syrup, is a Medicine clearer than a Syrup, and therefore more delicate and grateful, and it is made of distilled waters, clarified Juices and Sugar. They are made with, The manner of preparing of Juleps. and without boiling; without boiling on this manner, Common or distilled water is taken, or a decoction of Barley, to the which some Juice also of Citrons, Limmons, Pomegranates, Quinces, or Vinegar may be added, and white and clarified Sugar is poured in, or instead thereof common Juleps of Roses and Violets, which being boiled to the cosistence of a Syrup, are kept for use, and are diligently mixed together, and if there be need, are drained through Hippocrates' sleeve. But the proportion of Sugar, or usual Juleps, which is observed to the waters and juices is various, as the present occasion requires it. For the most part the Palate of the sick is their guide, and sometimes the proportion of water and Juices to Syrups and Sugar is threefold, sometimes fourfold, sixfold, eightfold, or twelvefold. Sometimes Juleps are made with Aromatic Powders, or convenient little Tabulets are dissolved in them. 'Tis most convenient also in some Diseases to add Spirit of Vitriol. 2. Moreover, Juleps are prepared of Conserves and medicinal Juices, if distilled waters that are proper, or a Decoction of Barley be poured into them in a sufficient quantity, and are stirred with a Pestle in a Mortar, or are mingled together over a gentle fire, and strained. 3. But those Juleps which are said to be prepared with decoction, are nothing else but the pure and finer decoctions of Syrups, and the same manner of preparing of them which is of decoctions and Syrups, only that they are removed from the fire before they receive a thicker consistence. CHAP. VIII. Of Emulsions and other Mixtures, bringing or causing milk, and of strengthening things. AN Emulsion is so called, Emulsion. because it is like Milk, and is prepared as it were by milking; for 'tis a potulent Medicine prepared of the pith and strength of seeds and certain fruits, especially of sweet Almonds (Which Emulsion in particular by some is called Amgydalatum) by the affusion of convenient waters, or of some other liquor, and by pounding and pressing of them, to which the Pulp of a Capon or Pullet may also be added, if you have a desire to nourish. They are prepared for several purposes or uses, The use. according to the variety of the matter, namely, to quench thirst, to cause sleep, to provoke sweats, and other things; and sometimes externally in stead of Epythems, and may be exhibited for the heat of the brain, and to mitigate pain, and cause sleep. They are prepared in this manner, Manner of preparing. Sweet Almonds are blanched, so are the four great cold Seeds, and other things, the Kernels also are beaten in a stone or marble Morter, pouring in by degrees some fountain water, or of Roses and other convenient distilled waters, or clarified with a convenient decoction that is pleasant to the taste: The proportion of the liquor is uncertain, sometimes more, sometimes less, according to the strength of the seeds and fruits, and according as the Emulsion is required to be thicker or thinner: But at the least a threefold, oftentimes a six-fold, eight-fold, tenfold, etc. quantity of the liquor is required; being beaten they are strained, and if convenient, Syrups or Julips that are proper, as of Violets or Roses are added: The Emulsion being made sometimes it is to be sweetened with Sugar, or Rolls of Diamarg. frig. manus Christi perlati, or the Juleps lately mentioned: Sometimes there may be added some Cinnamon water, if the disease will suffer it; and sometimes conserveses, Comfits, and liquid Electuaries may be added, from half a drachm to a drachm, two drachms or more. Pearls also, Coral, Heart's horn burnt, and other powders and Spices, may be added to Emulsions. Sometimes potulent Medicines may be made of Pearls only, Coral, Heart's horn, and such like, with convenient waters, which also by reason of the colour of Milk, which they have, are called Emulsions, and are very frequent, with modern Physicians. Oftentimes Juices also that are drawn out by expression, as of Pomegranates, Lemons, or other liquours also are mixed with those waters (yet so that the distilled waters for the most part exceed the rest in quantity) sometimes, but seldom, some convenient Syrup. But because Physicians for the most part desire a white colour in this water, for the most part they omit all those things that may discolour it. CHAP. IX. Of Tinctures, and Extracts, and liquid dissolutions. AN Extract is nothing else but the pure essence of a thing separated from its grosser body by a fit menstruum (whence they are also called Essences by many) which whilst it is as yet in a more liquid substance, An Extract. and joined with the menstruum, it hath also the colour of the thing, and therefore is called a Tincture; alth ough sometimes they are called Tinctures also, when the essence of a thing is now separated from its menstruum which extracted it. Essences or Tinctures that are liquid, Essences. are prepared either of green Plants, or of Juices: when they are prepared of green things, the Herbs are bruised, and a little spirit of Wine is put in for the preservation of them, and the juice is pressed out, which being cleansed is called an Essence. Those that are properly called Extracts are prepared of dried Plants, from whence if the whole menstruum be not separated it is called a Tincture, or liquid extract: But menstruums, that is, Liquors exhibited for the drawing out of the essence of a thing are various, according to the diversity of the matter, and use; they of spirit of Wine, distilled Waters, Whey, Vinegar, and such like, are exhibited. In choosing a menstruam, first you are to consider whether you desire a liquid tincture, or an extract, or a thicker or grosser body: For if a liquid tincture be desired, a menstruum is to be taken, which is of the same kind and faculty: But if the menstruum ought to be separated, it is no matter, although it be of another kind than the Tincture is of. But since it is required in a menstruum that by the subtlety of its substance it may penetrate the matter, and by its familiarity entice out the purer parts, and without spoiling and corrupting of the Extract itself, may again be separated from it: Spirit of Wine may easily be esteemed the best amongst them, and take the first place; but May-dew, distilled Vinegar, Spirit of Salt, of Turpentine, etc. are used also according as some present occasion may require. If compound Extracts are prepared, The manner of preparing Extracts. and the simples be of divers natures, each of them severally, or those which are nearest one to the other, are drawn off by their Menstruum, and afterwards the Extracts are mingled. The way of preparing Extracts is plain of itself, namely, the Menstruum is poured into the matter, that is beaten and powdered, which sometimes by the help of an external heat, when the essence of a thing is drawn out, and the Menstruum coloured enough, 'tis poured out, and another is put in, and that so often repeated, till all the strength and virtue is extracted; afterwards the Menstruum is separated by heat, which if it be not separated whole, 'tis called a Tincture or liquid Extract; but if almost whole, and of the consistence of Honey, 'tis called a simple extract; examples may be seen in the Institutions. Nor are such Extracts as well liquid as thicker prepared simply alone, but also compounded: to these belong Elixir, of propriety, purging Extracts, and universal purgers, Laudanum opiated. To Extracts belong those Rosins also which are prepared of Scammony, Mechoacam, Jalep, and such like, containing in them a kind of gummy substance. Of Tinctures, of Gems, Corals, Metals, as of Balsam of Venus, may be seen in the Institutions. CHAP. X. Of Conserves, Preserves, and medicinal Juices. THe name of Conserve is given principally to Flowers, The manner of making Conserves. and sometimes to Herbs, and certain soft and tender Roots, which being made up with Sugar are kept many years: they are prepared in this manner, the Flowers or Herbs newly picked or cleansed, and (if they abound with too much humidity) first a little dried in the shade, let them be mingled and brayed in a stone-morter, with a wooden Pestle, with twice or thrice the quantity of Sugar, and afterwards the mixture is to be put up in a Glass or glazed vessel. If the Plants are moister, 'tis profitable to heat the Conserves when they are made, by a gentle Fire. 2. Others take a Glass, and cover the bottom of it with Sugar, than they put in the Flowers to be condited, the depth of three Fingers breadth, and then they put in Sugar again, and in this manner heap upon a heap, and the Glass close shut they expose it to the Sun some certain weeks. 3. Sometimes the Roots are boiled until they can be pounded, or without boiling, are washed and cleansed, and are beaten very small, to them so pounded, or to the Decoction strained through a Hair-sieve, the Sugar is added as it use to be for Syrups. The name of Condite although it may be taken for a compound medicine also, Things condited. as well as for a simple Plant mixed only with Honey or Sugar, so that Conserves also may be comprehended under the notion of Condites, yet in particular the name of Condite here, is given only to medicines which are not pounded, but whole for the most part, Preserved with Sugar or Honey, both that they may be kept longer, and rendered more grateful to the taste. Fruits in the first place are preserved, Manner of Preserving Roots, Barks, Stalks, and some Flowers, as of Citrons or Lemons, and Oranges: this is the Preparation, the softer Fruits, as Cherries, Blackberries, Barberies, Apritocks, Peaches, Pears, Moshcattellina, and the like, which are soft, being put into Sugar or Honey, that is hot, they are boiled, until the humidity of the Fruits 〈◊〉 consumed and the Sugar or Honey receive their former consistence; or if there be danger lest being boiled they should decay and lose their colour, the Sugar only being hot, they are poured out, and when the Sugar hath drawn their aqueous humidity, the Sugar alone is again to be boiled, till that aqueous moisture is consumed, and afterwards to be poured out again to the Fruits, to be preserved: but those which are more solid should first be bruised in Water, or boiled, until the bitterness and ungrateful taste be drawn out, and they become softer; yet you must observe that whilst we do strive to please the Pala●e, we must not lose the strength of the Preserve by too much maccration or boiling; afterwards we dissolve and clarify the Sugar, either in fair water, or in the water where the Medicine is macerated, unless it hath an ill taste, we pour out the clarified Sugar upon the Fruits or Roots, and then we seethe them again, until the aqueous humidity which remains be consumed. Lastly, being so prepared, they are kept in a Glass or carthen Vessel covered with a round wooden Cover, and clean stones being put upon the Lid, the Lid is depressed so as that it covers the Liquor. Next to these are thickened juices, Thickened juiees. and such as are fit for medicinal uses, which the Arabicks call Rob: They are prepared for the most part of the juices of Fruits, sometimes of Flowers also, that they may be useful in the Winter, when we want fresh Herbs and Fruits; and in this manner they are prepared, the juice being drawn out is boiled over a gentle Fire to the consumption of half, or the third part, then whilst as it is yet hot, the thickest is strained: that which is strained is permitted to be clarified by settling in the bottom, or it is clarified with the white of an Egg; that which is clear is boiled again, until it acquire its due consistence. But because the juices of themselves will not easily keep, unless they are boiled to a thicker consistence and all the watriness be taken away, for the most part less than half so much of Sugar or Honey, or a little quantity of one of them is added. Those purest, clearest, finest juices, Gelatinae. like icicles in frosty weather, as they call them, being poured out use to be kept, which commonly are called Gelatinae, or frozen juices, and they are prepared principally of juices that are made without expression, the purer and more delicate juice of Quinces, Apples, Pears, Goosberries, (or Currans.) That composition called Diacydonium, Diacydonium. which use to be prepared for the most part in the form of a solid Paste, unless you would rather refer it to the Electuaries. And Purgers may be mingled with those Juices, and of them pleasant Medicines are made for infants and more delicate Persons. CHAP. XI. Of Electuaries. THe name of an Electuary, although it be severally used by several, An Electuary what. yet we think that it is to be attributed to Medicines, which are reduced with Honey, or Syrup, or plain sugar, or some other convenient thing, being used to a thicker consistence than a syrup, and not ●o fluid, yet somewhat moist, this word is derived, or rather corrupted from the word in Greek Elleickton, or Elleickton, by which name they call a Medicine which may be taken as it were by licking, by some they are improperly called Opiates, Whence so called Opiates. not because they have Opium in them, but because they are of the like consistence, with those Medecines of the Ancients which had Opium in them, such as Treacle, and from hence they are called Opiates. Electuaries may be for several uses, according to the nature of the simples whereof they are compounded, for some are to alter, and strengthen, others against poisons, which because for the most part they have opium in them, they are called Opiates, as Treacle, Mithridate, Aurea Alexandrina, others are fit to purge, which are called cathartics. Difference of Electuaries. Electuaries are twofold, the preparation of the former is thus, Aromaticks, and other simples being beaten into a fine powder. In the first place clarified honey is put into it, or sugar, or some convenient waters, or syrups, or proper decoctions of proper simples in fair water, or a sufficient quantity of another liquor, or infusions, or juices pressed out of other Medecines strained and boiled with clarified sugar, or honey, to the consistence of a syrup, or of many of these together, whilst they are as yet warm by the fire. A third part is sprinkled in by little and little, which may conveniently be done through a Sieve, and is to be stirred about with a wooden Pestle in a Mortar, and should be exactly mingled and kept in a convenient Vessel. The other manner is thus, Conserves they are convenient for your present purpose, to which are added powders, and Aromatic Species, Troches, Conserves also, and medicionall juices, or Robs must be exactly mixed together in a Mortar, with a sufficient quantity of dissolved sugar, or a convenient syrup, or honey: But the proportion betwixt the Conserves and Powders, and Species are not so exact, as some do determine, but several times they may be three fold, four fold, six fold, eight fold, twelve fold: For a sufficient quantity of a convenient syrup being poured in, whatsoever the proportion be betwixt it and the Powders, they may be all reduced easily into the consistence of an Electuary, which is also to be held of Conserves. Sometimes also spirit of Roses, of Salt, of Vitriol, distilled waters compounded, or of distilled Oils, some drops are to be put in. And these kinds of Electuaries were called by some Condites, as is said before, 'tis so called by some from the mixture. Mixture. Purging Electuaries for the most part are so made. There is another manner like to this: Fruits, seeds, or roots are put in, or are boiled in wine or water, to the f●rm of a Poultice. Afterwards they are strained through a hair Sieve, sugar, or clarified honey is added, or Syrups, or Manna, and if it be needful are boiled to the consistence of honey, sometimes the Species, and Powders also. Spirits also of Vitriol, and Salt, and distilled Oils. Of Raisins and Pruants that are laxative, you may see the Institutions. CHAP. XII. Of Eclegmaes, and lohoch's. EClegmaes, or Eclectaes, from the Greek word Eclei●o, Eclegma. that is to take up with one's tongue, or lick of, the Arabicks called Lohoch, or Linctns, Lohoch. and things that are to be licked, as they are commonly called, are like unto Electuaries, nor do they differ from Electuaries, only in that they are of a moister consistence, and as it were the middle betwixt Syrups and Electuaries, and are appointed peculiarly for divers diseases of the Breast and Lungs. Species and Powders, Conserves, thickened juices, Honey, Manner of preparing. Sugar, Extracts, Muscellages, Syrups, Juleps, Oxymell, distilled Oils, the manner of preparing is the same also with that of Electuaries. The Powders are taken, which are most convenient, Gums of Arabic, Tragacanth, Juice of Liquorish, Rice, and all things are incorporated in a sufficient quantity of honey, or Syrups, or Juleps, or Muscellages, or Juices, or Insusions, or of some decoction for this purpose, prepared of roots, herbs, seeds, fruits, But principally of Muscellages, and visoid things being strained and expressed and boiled with honey, or sugar, to the consistence of a syrup, or any one, or more of these, and all of them are to be wrought so long in a Mortar with a wooden Pestle, until they are exactly mingled, and come to be of the consistence of honey, or rather the middle betwixt Honey and Electuaries. Eclegmaes may be prepared without the addition of Powders, and Species, if a juice, or Muscellage be boiled with honey, or sugar, to the consistence of an Eclegma. 3. Eclegmaes also may be made according to that manner which is explained last of all amongst the Electuaries, so that if it ought to be licked, the consistence ought to be the moister. 4. And such things are often administered alone to be supped up by the sick, or else they are prepared of them other things being mixed, a new Eclegma is made for the present occasion; for you may take as much as you please of the usual Eclegma; Conserves also are added, and convenient Powders, Sugar, and an Eclegma may be reduced into the form of a Syrup, with a sufficient quantity of Syrup, or Juleps or clarified Honey, or Sugar dissolved; To which sometimes some drops of distilled Oils are added. 5. Sometimes an Eclegma is prepared of Syrups alone, Sugar-canded, or Penedies being added. Hereunto belong medicines which by some are called Saponea, Saponea. from the similitude of white Soap not yet made hard, by others 'tis called Linctus, from a Lineament made of Almonds. Sweet Almonds are taken being blanched, and are pounded; to those that are pounded, clarified Sugar, or Penedies, or Sugar-Candy is added; being first dissolved in a convenient Liquor, they are boiled to the consistence of Honey; a little before they have done boiling a pound of Rice is added, to wit, unto two ounces of Sugar, an ounce of Rice, and another of Almonds, and a sufficient quantity of Rose water, and a little before it be ended some Ginger also, or Aromatic may be added. Others draw a milk out of Almonds with Rose water, or some other convenient Liquor, with some portion of milk; Sugar is dissolved, the Rice is razed in afterwards, and the other part also of the mulsion being poured in they are stirred with a gentle fire. The composition which is called Leucophagum, Leucophagum. is so named from its colour, and therefore may be referred to this, or the precedent head; 'tis prepared of swee● Almonds macerated in Rose water, and the flesh of a Capon, or Partridge boiled with it, being very much wrought in a Marble Morter, and strained through a hair seive, with a little of the beaten blanched Almonds, and Sugar, boiled to a due consistence, to which according to the several aims of the Physicians, Aromaticks, Corals, and other things may be added. CHAP XIII. Of Boles. A Bolus hath that name because it is a gobbet of Physic in a round figure, A Bole. almost as much as one's mouth will hold, whence it is calied Buccilla; but the name of Bolus agrees not only to purging, but altering Physic. Purging Bowls are thus prepared: The way to prepare purging Bowls. purging Electuaries are taken, and a convenient quantity of Sugar being added, they are made up in the form of a Pyramid, not much unlike an Olive, lest they should be loathsome, they ought not to be made of Electuaries that are ungrateful, and for that reason Hiera is scarce ever given in Bowls; the quantity ought not to exceed an ounce. 2. Sometimes some of the Powders or speties are added. 3. You may add conserveses. 4 Or instead of Sugar Conserves either alone, or with a little Sugar may be used. 5. Instead of Sugar, or sometimes with Sugar, especially in diseases of the reins, Licorish-Powder; or some other may be added, so may Turpentine also. 6 Moreover in the stead of purging Electuaries, Powders of simples that purge use to be taken, wherein something also which altars, or corrects the violence of purgers, or that give a pleasant ●mell or taste to them; or else they may be added for some other cause, or species of purging Confections, or Extracts purging, both simple and compound, which are taken and incorporated with the pulp of Cassia, the pulp of Tramarines, or Pruants, or some Conserve or Rob, or some convenient Syrup, and with a sufficient quantity of Sugar are made into the form of a Bolus. 7. Sometimes distilled Oils are ming lediwith a Bolus to corroborate, namely of Aniseed, Mace, Cinnamon, Cloves, some few drops, and sometimes the Bolus is covered with Gould. Bowls to cause vomiting, Vomiting boles. and they are prepared after th● same manner, and are made of some Emettick powder, sim ple, or compound, to which sometimes is added some of the things that altar or correct, some certain grains, or some Emittick extract, with a conserve or some confection of the like consistence, and with syrups. Bowls also may be exhibited for other uses, Altering. to alter, strengthen, and provoke sleep; but the composition differs not from the former. CHAP. XIV. Of Powders, and Trageiss, or Comfits. BUt as for the forms of dry Medecines, Powders, and Trageiss. Powders, are the plainest way of compounding amongst them, commonly called Trageas, without doubt corruptly derived from the word Tragema, which consists of one, or more Medecines compounded, if the taste be ungrateful, an equal part of sugar, or half so much sugar is to be added. But Powders are either thin, and subtle, which if they confist of pure Aromaticks, and Sugar, they are wont to be called generally Tragemats, or Trageae, or else more thick, and not so subtle; nay sometimes Aromaticks are not pulverised, but only cut asunder, and seeds hardened with sugar, or candied, called Comfits, are added to them, and Species that are cut, are also called gross Trageaes. They are used for several purposes, according to the various nature of the simples whereof they are composed, some of them resist poison, others purge the belly, others by vomit. To those that purge, simples which have in them a faculty of purging are taken, and correctors are added, sometimes also a grain of distilled Oils is mixed with a drachm of Powder, CHAP. XV. Of Salts. ALl things almost contain two kinds of Salts, Salt twosold. the one volatile, which endures not the fire and heat, but flies away and is dispersed, and vanisheth by burning, the other is fixed, which endures the fire, and is left in the ashes. Volatile Salt is collected in distillations, so of stolen Urine, Volatile Salt. Salt distilled by an Alimbeck in the first place, and by a Phiola or the bottom of a Glasse-Still; in the second place Volatile salt of Urine is collected, the same may be drawn out of other things. In the juices of Plants also, salt sometimes coagulates to the thickness of boiled honey, Fixed. in a cold place. But fixed salt is prepared of the ashes of plants and woods, whilst a Lie is prepared out of them, and that is boiled till all the water exhals, for then the salt is left behind, which is purified first by often dissolving, and coagulating. Secondly, If it be dissolved into a liquor by draining in a moist place, 'tis filtered, and afterward coagulated. Cream, etc. Of Tartar. Hereunto belongs the cream, or thick juice, and Crystal of Vitriol, and of Tartar, which are nothing else but salt of Tartar separated from the dregs that were mixed. Magisters. Also Tartar vitriolated, salt of Tartar. To these belong Magisters, or dissolvings of Pearl, Coral, Crabs claws, precious stones, Saccharum Saturni, which takes place so far, if salt that is volantile, of the menstruum that dissolves doth as yet stick in them: For then according to the manner of salts they are dissolved in waters and other liquors; but if they are precipitated by oil of Tartar, or Vitriol, and the salt that dissolves be separated from them, they rather belong to powders. CHAP. XVI. Of Croces. TO powders and salts we may well join those things which the Chemists call Crocos, stours, sublimates, Croci what. precipitates: The name of Crocos is given to some Medecines from the colour of Saffron, for Croci are nothing else but fine powders, or tinctures reduced into the form of a powder of Saffron-colour: But principally they are called Crocos of Metals, and Crocos of Mars. Crocus mettalorum is nothing else but Antimony burnt with nitre, Crocus mettalorum. and reduced into powder of Saffron colour, next to this is that of Venus of Antimony Gouden as it is called. Of which the Institutions may be seen. Crocus of Mars is prepared several ways, which may also be seen in the Institutions. To these we may well refer that which is called earth of vitriol, whose preparation is taught in the Institutions. CHAP. XVII. Flowers. Of flours and Sublimates. THose are called Flours by the Chemists, fo● the most part, which are the thinner, and more subtle parts of a body, separated from the thicker by sublimation, the most common flours are of Copper and of Antimony, as also Benzoes'; the reason of preparing whereof is to be had in the Institutions. Hereunto belong the other Sublimates, amongst which the chief is Mercury Sublimate simple, and Mercury Sublimate sweet. CHAP. XVIII. Of Precipitates. Of precipitates. ALthough those things in general are rightly said to be precipitated, which are dissolved in some Liquor by a peculiar Art, and separated from the Liquor, deseend to the bottom in the form of a Powder or like Chaulk, yet the name of precipitating principally belongs to Mercury, which after it is dissolved in Aqua Forci, and is separated from the water that dissolves it, and lettles in the bottom, 'tis called Mercury precipitated. Turbith. The name also of Tu●bith, or Turpeth, is in use amongst most Chemists, Mercury precipitate Gold of life. Bezoarticum Minerale Mercurius Vitae. which from whence soever it had its original, it signifies nothing but Mercury precipitated. The way of precipitating Mercury is shown in the Instistitutions: to which if any Gold be added, 'tis called Gold of life; of which in the Institutions. To these belong also Bezoarticum Minerale, as it is called: 'tis there also described, a● also Mercury of life and some others. CHAP. XIX. Of Glasses, Regalls and certain Chemical Powders. THose chemical Medecines which remain, Glasses, Regulus-chaulks, and certain Powders, we will annex in this Chapter. First, Glass is prepared from the chaulks of things; Glass. and vitrification, for the most part, is the last resolution of things: for Ashes, or Chaulk is to be poured into a very strong fire, and sometimes Borax is added to ripen the fusion, or other fusil Powders, but fulfil matter is poured into a Basin made hot, or upon some table. Glass of Antimony is predared in this manner; Of Antimony and Mercury. also Amber of Antimony, or as others would have it, of Mercury. Purging cups may be made of these Glasses, also Rings, Money: If glass of Jupiter, or glasses, or Amber of Antimony, Rings purging, Regulus of Antimony. Antimony, Diaphoretic. Lac Veneris. if they are set into the bottom of a cup, or into a Ring, or any Coin: Of Glass of Antimony golden; see the institutions, as also of Regulus of Antimony. Moreover, the next to these are chemical Powders and Chaulks; as for them, the first that is referred to them, is called Antimony fixed, or Diaphoretic, which is made if Antimony be burnt so often with Nitre, till it become white and fixed. Milk of Venus, how 'tis prepared, the Institutions show. To these belong dregs, or Faeculae, Faeculae. as they are called by later Chemists, which are certain Farinaceus Powders prepared of the juice of certain roots beaten, or expressed or extracted by some liquor, namely, if a juice, or liquor be put into a cold place, the Faeces of their own accord settle in the bottom, which when the moisture is poured off, are dried and kept; the chiefest that are in use are the F●ces of Briony, Wake Robin, Peony, and Orrice, as also of Dragon. CHAP. XX. Of Comfits, little round Cakes, and Morsels, and such like. THat the palate and taste may first be pleased, certain Medecines are found out by Physicians, preserved with sugar, and are made up into a dry body: Amongst which the first are those which are called Comfits, as we may speak in the manner of an Apothecary, with whom, Comfits are nothing else but Conserves dried, Seeds, Kernels, skinned or blanched Roots, and Pills or Rinds. Purging confections also are prepared, Of purging Comsits. and that two ways, first if the Sugar be poured in before it be cooled, the purging things are mingled, and stirred about together that they may stick to the Sugar; Secondly, which is more convenient, if the seeds, or Rinds, are macerated in a purging infusion, until they swell, and then being gently dried are hardened with Sugar. Morcover, The manner of preparing little Cakes. there are little Cakes which are prepared in this manner, take of the powders or species of medicines, of Sugar, either plain white, or of Roses or Violets, six times so much, sometimes eight-fold, to which simple or compound Manus Christi pearled, may be mingled, or aded; in purging Rolls, also double, triple, or a , quantity is dissolved, according to the taste of the purgers, which is dissolved in a sufficient quantity of Fountain water, or of some convenient distilled water, or juice, seldom of a decoction, or infusion; to this Sugar, Powders, and Species, are thrown in by degrees, and stirring are exactly mingled together: and are poured out by drops upon marble stone, or on a Cypress or other table of wood, that being cooled they may concreate in round Cakes and Rolls. Sometimes instead of Powders, Oils or extracts are taken, and of altering extracts, five, six, seven, eight, nine, or ten grains are taken, for an ounce of Sugar, so of distilled Oils three, four, five, or six dreps, for an ounce of Sugar, sometimes Powders, Extracts, and Oils are taken together. Manus Christi purging are made two ways, Purging Manus Christi. for either to every pound of Sugar, an ounce of Rosin of Scammony prepared is taken, and so ' its made up in the form of a Tabulet, or the faeces of Mechoacam instead of Rosin may be mingled in a three or fourfold quantity of Sugar. There is the same way for the most part of preparing morsels, Morsels. only that medicines for the most part, in morsels are nor beaten so fine, but in a grosser manner: to which others may be added which are not made easily into Rolls, or at least in a less quantity, as Fruits, and seeds, namely Almonds, Pine-nots, Pistack-nuts, seeds of Melons, Citrons, (or Pompions) Conserves, Preserves; the proportion is to be observed betwixt them which is most agreeable to the intention of the Physician: and all of them as 'tis said of Rolls in a sufficient quantity, that is for the most part six or eight-fold, sometimes also ten or twelve-fold; but in purgers a three or quantity of Sugar dissolved in a convenient Liquor is taken. 2. Sometimes Fruits themselves are not taken in their substance, but an Emulsion is made of them with convenient waters wherein the Sugar is dissolved. 3. Besides these Extracts, and distilled Oils may be mingied in the same manner as Rowles. 4. Sometimes instead of Sugar, Man may be used in purging things. When all things have been exactly mingled over the fire before they are cooled, the whole mass is laid on a marble stone, or Cypress Table, and is dilated, and folded, or is poured into a wooden Box made for this purpose, and are cut into Tables that are foure-square, or into what shape you please. 5. When the Tables or Morsels are prepared they may be moistened with distilled Oils, or with musk and Amber distolved in Rose-water, namely when we fear lest the strength of them in boiling should fly into the air. 6. Purging morsels may be made after another manner a due quantity of the purging extracts are taken, or some of the purging Powders are joined with them, to these are added Aromatic powders, or Aromatic Extracts, and with Manna or Sugar little Cakes are made, the proportion of Sugar is double, or triple to that of the Extract, and the proportion of Manna is the same, but these Cakes are not made of Fruits and seeds alone, but sometimes, the flesh of Capons or Partridges, or Cockes-stones are joined with them, namely when we intent to nourish, and especially in those which can eat no meat, whence such morsels, are called nourishers, or nutritives. Nourishing Morsels. Pandalaeum. To these may be added the medicine, which junior Physicians call Pandalaeum, which in matter and in the end (for which is used) agrees with an Eclegm●, and is appointed for diseases of the breasts and lungs, but in form it differs not from Rowles, Tables or morsels only in that Rolls and Tables are framed into a certain figure either round, or square, but Pandalaeum, remains without being form, and Powders are permitted to condense with Sugar in a Box in that which is called Pandalaeon, and when it is used a Lump of it is cut with a Knife, or taken up with a Spoon, and held in the mouth till it be consumed. Moreover, Diamygda●atum. to this rank pertain several Comfits which are principally prepared to restore health, and from the Basis they are commonly named, such are Diamygdulatum or Marchpane, Diatestudinatum, a composition whereof Snails is the Basis, Pineatum where Kernels of Pine-nuts are the Basis, and Sugar-bread. Marchpane is compounded of sweet Almonds wrought with Sugar and Rose-water well mingled and boiled according to art; but for Physical use, Fruits, Seeds, and Aromatic Conserves are added. Testudinatum is made almost in the same manner, Snails being only added. As Pineatum also of Kernels of Pine-nuts mixed with Sugar in the same manner. Sugar-bread is made of the whitest Flour, Sugar and Eggs being added, and sometimes mixed with other Medicines, and boiled in a Pot, or Furnace; of which see the Institutions. CHAP. XXI. Of Trochees. TRochees, that is, Rolls and Cycliscoi & Artiscoi in Greek, that is, Trochees. Pills or little round Balls are solid Medicines, cohering and consisting of convenient things, taken in a Liquor made commonly in the form of Lupine-seeds, their circumference sometimes round, sometimes with a corner, both of them smooth withoutside, invented principally for that end, that Medicines reduced into Powder may be kept the safer in this solid figure from the injuries of the air. There are a sort of Trochees amongst the universal Medicines, The way of preparing them. and such as are for all uses almost, and may be exhibited according to the nature of the Medicines whereof they are compounded, and afford convenient matter for many other compositions, for some purge, some open obstructions of the Liver and Spleen, others provoke Courses, others open the obstructions of the Reins, some mitigate heat, some are appointed for the Breast and Lungs, some strengthen the Brain, some stop Fluxes, and stench Blood, some are exhibited externally, or that may repress humours that are flowing, or take away proud flesh, such like are Pills or Lozenges, of Polyidae and Andronis; or to cause sums and suffumigations. The materials whereof they are made, are Medicines of every sort, which being macerated in a convenient Liquor, or made into some mussellage are reduced into one mass, which are divided into many Lozenges and Pills, wherein for the most part some impression is made; they are made either by a gentle fire, or rather are dried in the shade, and kept for use; not only Powders and Species, but thickened Juices also, Conserves, Extracts, Fresh-flowers, Eclegmaes, and distilled Oils, are made into Trochees. CHAP. XXII. Of Pills. PIlls are so called from their similitude to little Balls by the Latins, and from the solid form, Pills. the Greeks call them Cataposia from Catapineine, that is, Drinking or swallowing down: Pills are Medicines made into the form of a Globe or Ball, principally for this end, that they may be swallowed whole, and the unsavoriness of the Medicine may the less be perceived by the taste. They are made of Powders, the matter whereof they are made are Electuaries, Trochees, Flours, Salts, and whatsoever things are dry do afford: but Pills, since they ought to have great efficacy in a small quantity, the Medicines out of which they are compounded aught to be powerful, and therefore those things which have but small strength in a great mass are not to be put into them, such as are Flours for the most part. They are reduced into a mass with Syrups, thickened Juices, Extracts, and such like Liquors. But although all Pills for the most part do purge, and by Pills a Purging Medicine is understood, yet other Medicines may be reduced into this form. Pills are prepared in this manner, The manner of preparing them. convenient Medicines are to be taken, and reduced into a Powder, and mixed in a Mortar with some Liquor somewhat viscid, as with a convenient Syrup or Juleb, seldom with Honey alone, by the benefit whereof both the mass may stick together; and if they are to be kept long they may be preserved, so that the faculty of Medicines cannot easily expire and vanish; but the Aloes which commonly is given in Pills serves to incoporate. 1. If they are prepared for many Doses and daily use, the mass is to be kept in the form of a Pyramid, (which they commonly call Magdalias and Magdaleons) and in the beginning they should be softer, that they may ferment, and the virtue of the Medicines may be the more exactly mingled; then after two or three days 'tis wiped over with Oil of sweet Almonds, and covered with a Bladder or a Skin, and kept in a Box. 2. Of the usual Pills, and those which are kept in a readiness for daily use, the manner of the Preparation is thus, Take of the mass of usual Pills more or less, as much as is need, to which instead of a Goad are added some Diagrydium or Trochees of Alhandale, or else some other Purgers, that all together may make one Dose, and let them be mingled with some distilled Water, or with white Wine, or some other convenient Liquor, and brought into one mass, and let it be reduced into 10, 15, 20, 25, 30. Pills more or less. 3. Pills when they are made sometimes use to be covered with Gold, or Powder of Cinnamon, Nutmeg, Fennel, Licoris, as is convenient. 4. You may mingle Extracts with the other usual Pills or Powders. 5. Nay, Pills may be made of Extracts alone, if they are a little thickened, or, which is more convenient, if some of the Purging Powders be added. 6. You may also prepare Extracts out of the mass, particulars of usual Pills, and make Pills of them. 7. There may be added also for to correct, a drop or two of distilled Oils, as also of Spirit of Copper, Common Salt, Vitriol. 8. There is another manner also of making Pills, The Simples whether Altering or Purging are macerated for two days in Wine or some other Liquor, or else they are boiled, in it, or a certain juice is taken out of convenient things and one of these things are taken, or two or more of these Liquors severally prepared are intermingled, or being new-done they are poured again into some of these, or they are boiled, and afterwards strained: to the Wine or Liquor strained, or expressed, purging, or altering Species, and Powders, or Compositions of the Shops which may be powdered, as Trochees and Tabulets, somewhat less than the eighth part in quantity to the Liquor, or there abouts, or cathartick or not cathartick Extracts; to which distilled Oils also, some drops, or half a scruple, according as the bigness of the mass for Pills, is more or less, may be poured. Afterwards all of them by often stirring may be dried over warm Embers, or in a Stove, till they ●re brought into a mass, if it be convenient, the mass being dried, it may again be imbibed and wrought in the same Expression or Liquor, and dried; and you may repeat that the third time: but that they may continue the longer, some Aloes is to be added to them. But lest that Pills should cause loathing in swallowing, Manner of using Pills. the whole Dose ought not to exceed a Drachma, or four Scruples; and that the same loathing may be prevented in taking them, we have said, they are to be rolled in Aromatic Powders, or Licoris Powder; there are some who can easily swallow them alone; but others to take away the taste, and avoid the unpleasantness, and facilitate the swallowing, use divers means, Wines, Syrups, Pulp of roasted Apples, and other things please others, they are conveniently taken in a little Pulp of Bread in Beer. After the altering Pills, and those whose force can penetrate from the Stomach to the remote parts are taken, some liquid thing ought to be taken after them, to carry them to the Veins. There is another kind of Pills which are called Hypoglottides, Hypoglottides. because they are retained under the Tongue, till they melt by degrees, principally for the Cough, and Diseases of the Breast, simple Medicines are taken: to an Ounce, and half, more or less, and are beaten, and with a convenient Liquor, as with a Muscellage of Tragacanth, Quince-seed, Fleawort, Wine boiled to the third part with Honey or any pectoral Syrup they are taken and made into Pills; sometimes they are prepared of a Decoction, namely, to that which is strained, somewhat less than the eighth part of Tragacanth is added, the weight of Sugar, and Penides equal to that of the Decoction. Sometimes these Hypoglottides are prepared for preservation from pestilent air, and to corroborate the Brain, and cherish the animal spirits, as also for delight and pleasantness of smell, to correct the stink of the external air, or of the mouth within, the filth offending the nostrils, let them be made of sweet-sented things, with Muscellage of Tragacanth. CHAP. XXIII. Of Suppositers. EXternal Medicines are twofold, External Medicines. some are injected and put into certain parts, others are applied only to the Superficies of the body; of the former kind are Suppositers, and Clysters, both those which are injected into the Paunch, as those which are injected into the Womb; and Pessaries, Injections, which are made into the Yard and Bladder, Gargarisms which are in Mouth and Chaps, Aphophlegmatisms, Dentifrices, Errhines, Sternutatories, Odoraments, and Fumes; Injections into the Ears, Collyries, which we shall speak of in the first place. In the strst place, Glandes' or Suppositers Glandes', with the Greeks, Ballanoi, commonly Suppositers, are solid Medicines, which are put into the Fundament, in figure somewhat long and round, like to an Akorn or Wax-candle, four or five finger's breadth in length. But Suppositers are not always prepared for the same-use, Use. for they are often exhibited, that they may loosen the Belly, and stimulate the expulsive faculty; sometimes for other affects also, namely, when an Ulcer is in the Gut rectum, that it may cleanse, consolidate and dry; when pain is present, it may allay it, and draw it away; when the humours flow towards the upper par, that it may draw them back, and cause revulsion; when there are little Worms called Ascarides, to kill them. Suppositers irritating the expulsive faculty are exhibited, first, when the sick is so weak that he cannot take Clysters; moreover when the Siege clings in the Paunch, there is need of a Suppositer to be used before a Clyster, that it may make way for the Clyster. Thirdly, if Clysters injected do not work, or operate slowly, 'tis needful to stimulate nature to expulsion. Fourthly, when by reason of straightness of time we cannot prepare a Clyster. There are three sorts of these Suppositers, The kinds of Suppositers causing stool. Gentle ones which are sufficient for infants, and are made of Lard, a Fig the inside being turned outward, Bullocks fat, the stalks and roots of Beets, Cabbage, Spinach, the Herb Mercury, indifferent strong, are prepared of Honey, boiled till it be thick, a mouse's turd being sometimes added, the White of an Egg, Salt, and a little Saffron and Honey, with white Soap; the stronger are composed of Honey, Salt, and the Powder of purging Species, as with a sufficient quantity of Hiera, with Agrick, Hiera, Logadii, Aloes; the strongest of all are prepared with Species, convenient for Suppositers, the Powder of white Hellebore, Euphorbium, Scammony, Turbith, Colloquintida, Indian Salt, Amoniack, Salt-Peter, a Bull's Gall, which we use only when the faculty is stupefied, and we endeavour to draw back from remote parts. They are prepared in this manner, Manner of preparing them. Honey is boiled to spissitude, that is, so long till you can take it up with your fingers; into which other things are sprinkled which are needful, namely, half a Drachm or a Drachm of common Salt, Salt- Gemmae a Scruple, of the gentler purging Species a Drachm, of the stronger half a Scruple, of Juices half a Scruple, (or a Drachm,) of sharp Salts six Grains, or half a Scruple to an Ounce of Honey. Hence they are made out of the mass in form of a Pyramid, as big as one's little finger, and dipped in or anointed with fresh Butter or Oil; sometimes a Thread is tied to it, that it may be drawn out at pleasure. These Suppositers are properly applied to those who have Ulcers, Clefts, Inflammations, and other tumors in the Fundament. But when they are troubled with pain of the Hemerhoids they are not convenient to be used, for they exasperated pain. CHAP. XXIV. Of Clysters. CLysters which the Greeks call Clyster, Clyster. Clysmos, Clysma, and Enclysma, is so called from purging or cleansing, although it signifies every sort of Medicine in general, which pours in that which is liquid into any part, yet in particular, as also Enema from injecting, for the most part is taken only for a Medicine which is injected by the Fundament into the Guts. A Clyster is injected for several ends, Differences of Clysters. whence there ariseth various differences of Clysters; for some loosen the belly, and of these some do it by Emolliating, which are made of Emollients, proposed before, p. 1. S. 1. c. 6. Others purge, to which purging Medicines are added. Some cleanse, namely, those which are compounded of Barley, the herb Mercury, Pellitory, Wormwood, Agrimony, Century the less, Pease, Parsnibs, Lupins, Flour, Honey with Roses, Hiera. Some are composed for the discussing and breaking of wind, and are made of those Medicines that expel wind, above mentioned, pag. 1. sect. 1. cap. 15. Some bind and are prepared of Astringents, proposed in the same, cap. 6. Some glutinate, and are prepared of glutinating things, spoken of in the same part and sect. cap 9 Sometimes Clysters are made of anodynes, or Medicines that mitigate pain, for pains of the Guts and Reins. But Clysters are compounded in this manner, there are taken of Roots and Rinds an ounce or two, of Leaves three, four or five handfuls, of Seeds three, four or five Drachms: of Flowers some Pugils, of Fruits, Pears ten, that is, twenty; to which if a purging Clyster ought to be made, Purgers are added, Agrick, Colloquintida, Seeds of Carthamons', (all which least they should stickto the Guts, and offend them, are tied in a Linen-cloth) the Leaves of Senna; but there is no need of such variety always, but oftentimes a few simples suffice. All the simple Medicines are boiled in a sufficient quantity of water; of the Decoction take three, four to fifteen Ounces, according to the age, for infants three Ounces, hence those that are a little riper four, five or six may suffice; for one that is come to ripeness of years, for the most part they take a Pint, sometimes also fifteen Ounces; yet sometimes, namely, when we would retain the Clyster long, and lest the too great quantity should oppress the other parts, only eight or ten Ounces is taken in the Stone. In the Decoction strained those things which agree to our present purpose, we dissolve, as Oils from an Ounce to two or three. When we only are to emolliate, we put in Oils only or Butter, but indeed in greater quantity: those which have a purging faculty are then wholly to be omitted, lest by reason of the hard ordure sticking in the Guts, nature should be stimulated in vain, and humours being drawn greater evils do ensue. On the contrary, when you are to purge, to repel, and a sharp Clyster is required, the Oils whereby the force of sharp and purging things is resisted, are to be omitted, and purging Electuaries are to be added for the most part double the weight, which at other times they use to be taken in at the mouth, or Pills are to be dissolved, Salt also is to be added from a Scruple to a Drachm; also Abstergents, as Honey of Roses, or Sugar, in weight an Ounce or an Ounce and half; all of them being mixed, and moderately heated by a convenient and known instrument, they are to be injected into the Paunch an hour or two before meat. Those who are unwilling to have it done by others may give a Clyster, as they call it, to themselves by instruments described in many places, the most convenient whereof Guil. Fabricius propounds in his Chyrurgical Operations, Cent. 1. Obs. 78. CHAP. XXV. Of Injections into the Womb, and of Pessaries TO Clysters which are inje&ed into the Guts, Injections into the Womb. we may well join those which are cast into the Womb, and are therefore called Uterine Clysters; The Instrument, or Squirt, by which the liquor is cast into the Womb, is called by the Greeks, Metrencytes, but the Medecines which are injected they call Metrencyta. A due quantity is taken of simples agreeable to every one's disease, Way of preparing. 'tis boiled, and three or four ounces of the decoction, or instead thereof distilled water is taken, and two or three ounces of Oil are added, and powders, to the quantity of three drachms; and of those mixed together, three ounces are injected into the Womb. For the same causes, Pessaries. for the most part, for which Clysters as they call them, are injected into the Womb, Pesses, and Pessaries, barbarously called Nascalia, are put in. 1. The manner of preparing. There are many ways of preparing Pessaries, the first is cotton, or wool that is shore and well carded, and are mixed with a juice, or some liquor, either alone, or with some convenient powders mixed, twisted, or wreathed, about the bignisse and length of a finger, 'tis wet in it, and applied to the generative parts of women, the quantity of Medecines that are pounded for the most part is an ounce. 2. Moreover Medecines that are pounded are taken in convenient liquors, as with oil, fat, wax, Galbanum, Storax, honey, and are made up and mingled into a mass, and fashioned in the figure of a Pessary, to which a thread is tied, which also may be covered with fine linen, or a thin piece of silk. 3. Sometimes green herbs, and such as are full of juice, are a little bruised, and tied about with a thread, and bound in the form of a Pessary. 4. There is a time also when Powders only being taken in fine wool, or cotton, being made round, are put into a thin bag made of a fine rag. Nascalies, Nascasia. as they are barbarously called, are compounded of the same Medecines, which are taken with cotton, or soft wool, and applied to the external orifice of the womb, especially in Virgins, to whom you may not give Pessaries. CHAP. XVI. Of those things which are injected into the Yard, and Bladder. INjections into the Bladder, Injection into the Bladder. are liquid Medecines which are injected into it through the urinary passage; in the use whereof, the whole art consists in injecting, for sometimes 'tis sufficient to cast in this Clyster by a Squirt, sometimes a Catheter which opens the way, as it were, and 'tis necessary to precede. It happens also sometimes that there is need of injection into the Yard, namely, when it is either hurt by the stone, Into the Yard. or troubled with pain, or the passage within is ulcerated; 'tis prepared of those things which are agreeable to the scope of the Physician. But not only fluid Medecines are injected, but Unguents are cast in in this manner: Take a wax Candle, to which some Turpentine may be added, of that thickness and length which may answer to this passage and channel, this Candle is bedaubed with an Ointment, and is thrust in, but you must be careful that the candle may be so prepared, and stick so long, that it may not melt with the heat of the yard; you may boil also some convenient Plaster, and put the wax candle, or a little Instrument made of lead, into it. CHAP. XXVII. Of washings of the mouth, and Gargarisms COllutions of the mouth with the Greeks, Diaclysmata, Mouth-waters. they are fluid Medecines, which are contained in the mouth, and without swallowing, by the help of the tongue are agitated up and down, being principally appointed for pains of the teeth, and diseases of the Gums. Next unto these are Gargarisms, to wit liquid Medicines, Gargarisms. by which the Chaps are washed without swallowing, namely, whilst the humour contained in the mouth, flows towards the top of the Windpipe by its gravity, the head leaning backward, the breath breakking out is repelled, and is agitated by a reciprocal motion. Gargarisms are administered for divers purposes, Use of gargarisms. some to repel, others to resolve, and discuss, others to ripen, others to absterge, or wipe oft, others to consolidate: But of all medicines for what purpose soever they are intended, those are to be chosen which are not ungrateful to the smell or taste, nor have any venomous and malignant quality, since it may easily come to pass, that any thing may be swallowed contrary to the will. Some are prepared with distilled waters, Manner of preparing. others with decoctions, wherein Juices, or Syrups are dissolved, under a threefold, fourfold, or six-fold quantity, so that to a pint of distilled waters, or of a decoction, two, three, or four ounces are taken, to which sometimes some of the Aromaclck Species are added, and being mixed all are exhibited together lukewarm. CHAP. XXVIII. Of Medicines that draw away Phlegm. APophlegmatismes, Apophlegmatismes. are Medicines also, which are held in the mouth, and draw out Phlegm from the head, and neighbouring-parts, from whence they have their name, for the most part they are called Diamassemataes or Masticatories. But they are not all made alike, Manner of preparing. for first Apophlegmatisms are used in the form of Gargarisms, which how they are made is newly shown. Moreover, Medicines may be made by bearing, and with a convenient liquor, reduced into the form of an Electuary, wherewith the Palate should be anointed. Masticatories. The third are called Masticatories, which are retained and masticated longer in the mouth, partly by their heat, they dissolve Phlegm, draw it out, and entice it forth, partly by the strength wherewith they are endued, of stimulating the expulsive faculty of the brain, they irritate it, to eject what ever troubles it, which again may be done three ways. For first simple Medicines, either whole, The way of making. or a little cut only are detained and chewed in the mouth. Secondly, The same medicines pounded, and with a sufficient quantity of Honey, or Wax, which is taken, are made into Troches, like Lupine seeds, or Hazelnuts, being in weight a scruple. Thirdly, The same medicines stamped, being put in a linen cloth, which may be bruised and chewed with the Teeth. CHAP. XXIX. Of Medicines to rub, and cleanse the Teeth. DEntifrices, which the Greeks call Odontrimmata, Dentifrices and Smegmata Odonton, are principally prepared to whiten, cleanse, and strengthen the teeth, The way of making. and fasten the Gums when they are lose; But there is not one sort of them only, for first they may be washed with convenient liquors, or rubbed with cotton, or a linen rag, wet in a convenient liquor. 2. Moreover the form of an Ointment may be used, if the powders are taken in honey, simple Oxymell, with Squills, honey of Roses, or syrup of Roses. 3. The Teeth may be rubbed with powders. 4. Troches, or Penfills may be made in the form of suppositers, which being dried and hardened, the Teeth may be rubbed. 5. After Dentifrices, 'tis convenient that the mouth he washed, principally with Wine wherein Orice roots, or some other convenient thing is first macerated. CHAP. XXX. Of Medicines put into the Nose, and to provoke sneezing. ERrhines, Errhines. as the name shows, are medicines which are put into the nostrils, which is done for several ends; either for calling out Excrements from the brain, and to provoke sneezing, those that perform which in particular, are called Ptarmica, Ptarmica. or such as cause sneezing; or to open the obstructions of the passages, or to heal an Ulcer, or stench blood; whence the matter of Errhines, is not always the same but various according to the various intentions, which is shown before in the faculties of medicines. They are prepared also in several forms; Way to make them. for some are moist, and Liquid, others hard and dry; again, the Liquid are twofold, either they are poured into the nostrils, or the nostrils are anointed with them only expressed juices are poured into the nostrils, and are drawn in by and clarified them. 2. Or distilled waters are added to the clarified juices, Wine, Oil, Honey, somewhat less than double, or somewhat less than four times the weight, according as thicker, or more fluid Errhines are required, or convenient powders may be added, about a drachm in weight. 3. Or decoctions are prepared which are mixed with somewhat less than double, or somewhat less than four times so much Honey, and are put into the nostrils. But those things wherewith the nostrils are anointed, are most conveniently made of Oils and Powders, to which belongs Balsams, which the Nostrils are anointed with. Besides these, to the moist there seems to belong, those things which are put into the Nostrils in the form of a tent. But dry Errhines are made first of convenient Roots, Dry Errhiaes'. or Staulkes, as of Beets, Flower-de-luce, Showbread, which are fashioned in the form of a Pyramid, and afterwards macerated in the water of sweet Marjerom, or some other a fit water, or Oil, a thread being first tied about them, they ●re put in. 2. Moreover dry Errhines are made when simple medicines are reduced into a thin powder, and a grain or two or two of them is blown into the Nostrils, and so they use to call Errhines in particular Ptarmaca, or Sternutatories. 3. Thirdly, Errhines and Sneezing may be made of the same powders, if with a linen or woollen cloth, or a Linen bag, that is round, they are wrapped up in it, and either with juice, or convenient distilled waters; for example of Marjerom, the Sternutatorie powder be dipped in it or sprinkled with it, and put into the Nostrils. 4. Fourthly, medicines for the nose being reduced into a powder, are taken in a Muscellage, or Gumm, or Turpentine, or Oil and wax, and diligently mixed, are made up into Pessaries, in the form of a Pyramid, as it were in that bigness that they may be put into the Nose, to the end whereof a thread is tied, that it may be drawn out at pleasure. CHAP. XXXI. Of sweet Smells, Perfumes, and Odoriferous, Balsams. SWeet Smells also are taken in at the Nostrils, Things causing sweet Odours. Simples Odoriserous. but principally they are exhibited for altering of the brain, and recreation of the Spirits and are exhibited for the resisting of filthy and Pestilential smells. The materials of these things are all such as breathe a sweet Odour out of themselves, as Musk, Amber, Civit, Benzoin, liquid Storax and Laudanum, wood of Aloes, Rosemary, Lavender, Marjerom, Spike, wild Basill, Stechados of Arabia, Mace, Cloves, Cinnamon, Frankincense, Myrrb, grains of Juniper, Gallia Moschata, Camphir, and those things which are given cold, as Roses, Violets, Flowers, Kinds of Odour ferous things. of Nimphea, santalls. But they are exhibited several ways, and several kind of sweet smells, are made of those simples, for first they use to be reduced into powders, and are kept either in a Box, or wooden vessel, and as often as necessary, are put to the Nostrils, or else are included in a little bag, or nodule of silk. 2. Secondly, the same reduced into powder are taken with Laudanum, Wax, Liquid Storax, to which some Turpentine may be added also, and made into one mass in a hot Mortar, by pouring in of Rose-watar, of which little balls are made commonly called Pomander: 3. Thirdly Unguents and Linements, use to be made of sweet things, Balsams. which they call Balsams at this day, they are prepared of distilled Oils, to which is added Amber, Musk, Civit, Indian Balsam, whereof the whole force of them depends, which are mixed with a certain body which affords a convenient consistence, instead whereof although some take other things, yet extract of Plantine is conveniently taken, or Oil drawn out of Nutmegs, by which all the smell for the most part, colour, and taste is extracted by the Spirit of Wine, or which is most convenient, an extract and Oil of Nutmegs, together to this mixture a colour agreeable to the Balsam, shall be made of a juice or tincture of the medicines. 4. Fourthly, perfumed waters use to be prepared, wherewith the Garments use to be sprinkled, or the nose, hands, and other perts of the body use to be wet, the same waters being put in a convenient vessel upon the coals, are dissolved into an Odoriferous Vapour. 5. Fifthly, washballs are also prepared, or sweet balls to wash the hands, and feet, of which hereafter Chap. 42. 6. Fumes. Moreover, sweet Vapours, or fumes, belong to Odoriferous smells the Greeks Thymiamata, which although they are taken for the sweetness and pleasantness of smell, or for strengthening the brain, yet they may be appointed for other ends also, namely to stop distillations, for drying ulcers of the lungs, when they are stuffed with thick matter, peculiar suffumigations, also are prepared for the womb, and to provoke and stop courses, the falling down, and suffocation of the mother, & the coming out of the Fundament. 1. How prepared. But suffumigations are prepared, first of sweet medicines, that are cut, or poured, being thrown upon live coals, or hot ashes. 2. Moreover, the same powders are made into Cakes or Trochees, with a convenient Liquor, and with a Gum or Rosin. 3 Thirdly, the coals of Lime or Teile-tree or of Willow being mixed, Pyramids and Candles as it were are made of the same matter, which is kindled, when there is use for, them. CHAP. XXXII. Of those things which are put into the Ears. THose things which are put into the Ears to assuage their pains, for inflammations, Ulcers, Sing, Things to be injected into the Ears. Hum, and other infirmities, are exhibited, either in a Liquid form, and first dropped into the Ears. 1. Secondly, a hot Vapour of Decoctions, or convenient Liquors are injected into the Ears, (which they commonly call Embotum) or simples that are convenient are included in a bag, and boiled, and put into the Ears. 3. Thirdly, they are exhibited in the form of a Linement. 4. Fourthly, simple medicines may be reduced into powder, and blown into the Ears, or sent in, in the manner of a fume, or Vapour. CHAP. XXXIII. Of Liquid medicines for the eyes. COllytion, and Collurion, as much as to say Collurion, Collyrium. that is Colobon ten Ouran, or Colobee Oara, it is so called because it is like mutisarae caudae, in which form although various medicines appointed for various uses, were heretofore prepared: yet at this day by the name Collyries, are understood only external medicines proper for the Eyes. But medicines which are exhibited to the Eyes, and in general have borrowed their name from those dry ones, Way of preparing. are named Collyries, and are commonly divided into dry and moist, dry ones are made when medicines pounded very small, are made fine in a Mortar, and with a sufficient quantity of Whites of Eggs, or of some Muscellage, are made into the form of a Pyramid, or Trochees, and are dried in the shade when there is need of them, they are beaten again, in a marble, or Stone Morter, some convenient Liquor being poured in, and the Liquor, afterwards, which is then prepared, is dropped into the eyes. 2. Moist Collyries are twofold, for either they are dropped into the Eyes, in the form of a Liquor, which is made of juices, distilled waters, Decoctions, or many of these mixed, powders being added, and espcially of those medicines which will dissolve in a moist body. 3. Or they are made in the form of an unguent. 4. Lastly, convenient medicines also, are boiled in water, and the warm Vapour exhaling out of the pot, which is covered with a linen cloth, is received into the eyes. CHAP. XXXIV. Of Oils and Balsams. BUt as for what belongs to Medicines which are exhibited to the superficies of the body, Oils. the first amongst them are Oils; whereof some are natural, as Petroleum and common Oil, which is made of ripe Olives, and Omphacine, which is drawn of unripe Olives; others are artificial, which are made three manner of ways. 1. How to prepare them. For first; Unctuous juice is expressed, after which manner Oil of sweet Almonds, Pistack-nuts, Nuts, seed of Flax, Gourds, Cucumbers, Henbane, Hemp, and Oil of Poppy is prepared; by expression also, Oil of Yolkes of Eggs is made, 2. Secondly, Oils are prepared by Infusion many ways, for sometimes simple medicines are boiled with Fountain or distilled water, and Wine, or other convenient Liquor, in common Oil, to the consumption of the moisture, or juice; sometimes the same simples by a gentle heat are macerated in the Sun, yet it seems more convenient if dried Plants are steeped in Oil, in Balneo Mariae, twenty four hours, afterwards the Oil is expressed, and clarified by residence. Thirdly, Oils are prepared by distillation also, as is said before, amongst which some at this day are called Balsams; examples whereof are to be had in the Institutions. CHAP. XXXV. Of Linements and Ointments. A Linement, or Litus, with the Greeks Crisma, A Linement. and Syncrysma, and that which takes away wearisomeness, is called Acopon, that is, freed from labour, 'tis a liquid Medicine, externally applied, thicker in consistence then oil, but more liquid than an unguent, or of a middle consistence betwixt an oil, and an unguent. It consists of oils, butter, wax, fat, tallow, marrow, gums, juices, muscellages; for the most part they have no wax, or if any be used, they take only a drachm of wax to an ounce of oil, to these sometimes, flowers, powders, and rosins are mixed. They are prepared in this manner, The oils, fats, How prepared. or other things here named, are taken: to these powders are added, Juices, and such like, of that proportion for the most part, that to an ounce of oil, three drachms of fat, or two drachms, and one drachm of powders is taken, or that proportion is observed, as may make the consistence only a little thicker than oil; and all are mingled either without fire and boiling, or are dissolved at the fire as Gums, and Fats, or also by some ebullition, namely, to the consumption of the Juices, or Vinegar, if any such thing be mingled with it. Unguents which the Greeks call Myra, and Alleimata, Unguents. from whence Miropolae and Alyptae were the names that the Ancients first called them by, which for pleasantness were made of odoriferous things, and were distinguished from oils not in thickness, but in pleasantness of smell. But those things which are at this day called Unguents, are Emmota, so called by the Greeks, and are made of the same things whereof Linements are; But are somewhat thicker than Linements, and those things which thicken, are taken in a greater quntity in an Unguent, then in a Linement, but as for the liquid and oily things a less quantity is observed in compounding them, this is the proportion for the most part; that to an ounce of oils a drachm of powder, two drachms of wax may be taken, or a sufficient quantity, namely in those things where Unguents are made of oils, powders, or metals, or plants, and wax. But they are prepared either with fire, How prepared. or without fire, without fire they are prepared in this manner; 1. The powders being beaten, and sifted, are taken, which are sprinkled in the oil, and a sufficient quantity of wax being added, are reduced into the form of an Unguent. 2. Or usual Unguents are taken, and for the most part four fold, or eight fold, the quantity of powders, and species are mixed with some convenient oil. 3. Or fat, or marrow are taken alone, or with oil in equal weight, double, or half so much again, a few powders being added with a sufficient quantity of wax, an Unguent is made, 4. With fire also, they are made many ways, for either the grease, oils, or gums are melted, that the powders may the easier be mingled. 5. Or herbs, roots, seeds, are macerated, sometime in water, wine, juices, oil, afterwards they are boiled almost to the consumption of the liquor: to the decoction when 'tis strained, the other things are added, and with some grease and a sufficient quantity of wax, or a gumm, an Unguent is made. 6. Or they are prepared without oil, with grease, namely, herbs, flowers, or fresh roots, are bruised with grease, and wrought in a Mortar, until the herbs have imbibed the grease, and then they are melted by the fire, and pressed out. CHAP. XXXVI. Of Cerots, and Emplasters. THe name of a Cerat, or Cerot, the Ancients used for a soft medicine, namely for that which consisting of oil and wax is anointed. But at this day 'tis taken for a medicine, like unto a plaster, yet is not so hard as a plaster in consistence, and 'tis so called from Cera, that is wax, because the greater part of it is wax: And 'tis compounded at this day of powders, oils, Gums, Pitch, Turpentine and Wax, and sometimes Lard, Marrow, and Muscellages are added. But the proportion of the things that are mixed is various, neither can it easily be defined and comprehended by Rules, and the quantity of Wax to be mixed is left for the most part to the discretion of the Apothecary, who ascends by degrees, according to progress from a lesser quantity to a greater; yet for the most part the analogy of mixture useth to be desired, so that when they consist of Oil, Wax, and Rosin, one part of Oil is taken, half so much of Rosin, of Wax the third part: But when Powders are added, the proportion of Oils to Powders is eight-fold, to Wax, two three, four or six-fold; and to Rosin, that it may stick the faster, they use to add twelvefold; a Cerot becomes the harder three ways, namely, by defect of Oil and Grease, by boiling, and store of Pitch, Wax, or Powders. 1. They are made in this manner, How made. If the Cerot ought to be made of Powders only, Oil and Wax; the Oil and Wax should be dissolved together at the fire, and the Powders put in by degrees, and exactly mingled. 2. If Lard, Gums, or other things to be melted by the fire are taken, they should be melted with the wax. 3. If Gums are to be dissolved in Vinegar or Wine; first they must be dissolved in Oil, and mingled with Wax, that the Vinegar or Wine may be consumed with boiling, afterwards the Powders may sprinkled in. 4. If you are to add Roots, Fruits, or Seeds, these are first to be boiled, and the Decoction to be boiled again with Oil to the consumption of the moisture. Lastly, the things melted and pounded are to be added, and all to be mixed together, and to be kept for use. But when you may prescribe fresh things for present use, three Ounces and an a half may suffice for a great Cerot, for an indifferent one two Ounces, for a little one, one Ounce, & three or four Drachms of Powders are sufficient for an indifferent Plaster: and such Cerots use to be put with an Aromatic Powder sprinkled on them into a piece of Leather, or to be covered with fine Linen; the quantity and figure, if it may be, should answer and be conformable to the parts to which they ought to be applied. Plasters, Plasters. from Emplattein, that is, from fashioning, and soft anointing is derived, because they may be extended, and spread on a Linen cloth, or piece of Leather; they are medicines somewhat harder and more solid than Cerots, and are compounded of the same things whereof Cerots are, only that metals, and minerals, and for the most part, Litharge are added, which makes them of a more solid consistence. For the most part this is the manner of compounding them; How compounded. the wax for the most part is melted in Oil, if the lethargy be in readiness, that also should be boiled in Oil. If Juices of herbs, or decoctions, Musceilages, Vinegar, Wine or any other Liquor be to be mixed, then that also is to be mixed with the rest, and being mixed, are to be boiled so long, until the aqueous humidity be consumed; afterwards the Rosins, fat, thickened and concreate juices, and Gums, are to be put in sometimes, dissolved first, and strained, with Wine, Vinegar, and Oil; lastly Turpentine is to be mixed, and all to be boiled to a due consistence, which when 'tis done, and taken from the fire, the powders must be put in by little and little, and continually stirred about, that they may be brought into one mass, with the rest, of which being cooled, but before it grows hard, are to be fashioned, in the similitude of a Pyramid, or a long roll, or Rollers, and be kept for use, of the which when 'tis necessary, a part may be cut off, and if need be softened somewhat with convenient Oil, spread on Linen, and applied to the skin. The proportion of mixture, can scarce be defined exactly, and strictly, and if any error be committed, it may easily be corrected by boiling or mingling of more dry, or liquid things; but this proportion for the most part is observed, that to an ounce of dry things, there is taken of Oil, Fat, or Honey, three Ounces, of Wax a pound, of Rosin eight Ounces: But if boiled, and pounded Herbs are added, a little handful, requires an Ounce, or an Ounce and half of Oil, or Grease, so that the proportion of Wax to Rosin is six-sold, to Oil fourfold, to Powders double: but if the quantity of Rosin be greater, there needs the less Wax. Sometimes before the Emplaistick mass be cooled a Linen Emplastic Web. cloth that is worn out by age is dipped in, and when 'tis bedaubed with the substance of the Plaster, 'tis taken out, extended, cooled, and kept for use; which kind of Plasters, they called Emplastic Webs of cloth, and Sparadrapum, and applied them for cleansing of Ulcers, Glutinating, Cicatrizing, and other uses. And these are properly called Plasters, yet some things are referred to Plasters also, which are prepared without Wax, Pitch, and those Glutinous things, and without fire, and are compounded with Honey, Muscellages, and a certain thick juice, or Barm, or only with a little Wax, melted with Oil; of which kind is the Plaster of Bay-berries and de Grusta panis, and such like, which are as it were in the middle, betwixt Plasters, and Cataplasms. CHAP. XXXVII. Of Cataplasms. Cataplasms, which the Ancients called Pultases, A Cataplasm. are Topical medicines soft, and having the consistence of Pultases, and are prepared to assuage pain, repel, mollify, discuss, to ripen, and other ends. 1. They are either prepared without fire and boiling, How made. or with fire and boiling, from whence the one is called crude, the other boiled. Without fire, green Plants are pounded, and reduced into a Poultice, or dry, reduced into Powder, are mingled with a sufficient quantity, namely double, or treble, of Oil, or a convenient Liquor. 2. They are made with fire, and boiling, if the plants being beaten, and pounded, are boiled in a sufficient quantity of water, till they are soft; afterwards strained through a seive, which nevertheless, if they are well boiled, and bruised is not always necessary, to these are added Muscellages, Flower, and a sufficient quantity of Fat, and Oil, and are all boiled again to the consistence of a Poultice, sometimes plants also are immediately boiled in Oil. The Cataplasms being prepared, and put on a piece of linen are applied hot to the part. CHAP. XXXVIII. Of Medicines to take away Hair, Salves made of Mustard, Medicines causing Weals, or Pusties in the body, and Vesicatories, or Medicines that cause Blisters. A Dropax, or any thing to take away hair, a Synapisme, or a Salve made of Mustard, a Phaenigne, a Medicine to cause Weals, or Pustles, differ not from the form of a Cataplasm, yet for some certain peculiar effects which they produce, Authors have been pleased to separate them from other Cerots, Plasters, and Cataplasms. Dropax in Greek, A Dropax. with the Latins Picatio, is a Medicine composed in the form of a Plaster, or Cataplasm, powerfully sticking to the skin, which heretofore was exhibited to extenuate and relax the Member, to heat and draw more store of blood, as is spoken before, part 2. Sect. 2. Cap. 5. or to dry moister bodies; It is twofold, the one simple, Its differences. which consists of Pitch and Oil melted together, the other compound, which besides Pitch and Oil, hath in it, Pepper, Castor, Pellitory, Bittony, Galbanum, Brimstone, Nitre, or the ashes of Vine-twiggs, and other things which are needful; out of all which a Plaster is made with Oil and Pitch, which is put in a piece of Leather, or linen cloth, and applied to the member, being hot, the hair shaved before hand, and the part well rubbed, and before 'tis quite cold, is twitched off again, and put to the fire again, and applied to the part again, and that is so often repeated, until the part grows red, and is somewhat swelled. Synapismes are Cataplasms, A Synapisme. or Plasters, principally consisting of Mustardseed, from whence they have their names, or other things are compounded, which are of the same nature with mustardseed, and they are twofold, the one more mild and gentle, which the Greeks call Phoinigmon, because it makes the skin look red, and is to draw out the matter which lies so deep hid in the body, to its superficies. A Vesicatory. The other is stronger which also raiseth blisters in the part to which it is applied, which they properly call Vesi catories. The Ancients made Synapismes of Mustard seed, How to prepare Synapismes. or sheere-grasse, dry Figgs were macerated in warm water, the next day after Mustardseed pounded was mixed with that pulp, and if a stronger Synapisme were required, they would mingle two parts of Mustard with one of Figgs, but if weaker, one part of Mustardseed, and two parts of Figgs,: If indifferent equal parts, being mixed they were applied to the part affected,, and left there so long, till the skin run down with moisture, and looked red. Other Medicines also, both making red, How to make Vesicatories. and causing Blisters, are mentioned before, part the first, Sect. the first, Cap. 10. and are mingled with honey, Oxymell with Squills, Vinegar with Squills, Melle Anarcardino, Spirit of Wine, Turpentine, Soap, the crumb of bread, and G●mme, with sharp things and Plasters, and Cataplasms are made of them, whether to cause the part to look red, and burn only, or to raise blisters. The principal thing to raise blisters is a medicine compounded of Cantharideses, and Leaven. When a blister is raised by a medicine, and is broken, 'tis not forthwith to be dried, but to be permitted to run, that the humour which we desire to evacuate, revel, or derive, may flow out, and therefore some fat unguent, or a Fig, or the leaves of Coleworts, are to ●e put to it. CHAP XXXIX. Of Epithems (which are somewhat moister than Plasters) Medicines made of Vinegar and Roses, and of Medicines applied to the Temples, to stop fluxes of Rehume from falling to the eyes. Although all medicines which are externally adplied to the body may be called Epithems, Epithems yet by custom those only are called so at this day which consist of distilled waters, decoctions, or juices mingled with species and powders, and are externally applied, principally to the region of the Liver, Spleen, Heart, Stomach, forehead, and joints. As for the matter whereof they are made, 'tis various according to their several intentions: of distilled waters, Juices, Decoctions, Oils, either alone, or mixed, Epithemes are applied for the mitigation of heat, resisting of humours, that flow, strengthening the parts, and Liquors, or Powders that are appropriated to any part whatsoever, are to be applied. Epithemes are prepared two ways, How prepared. first of liquid things only, distilled waters or juices are taken convenient for the disease and proper for the part, to which sometimes, some Vinegar, or Wine for penetration sake is added: afterwards Species or Powders, beaten very fine a drachm and a half or two drachms, to a Pint, and sometimes more Powder is taken: the matter of the Epitheme is prescribed according to the magnitude of the part, from three Ounces to a pint, the mixture in the first place hath a linen or cloth Cotten, or Sponge dipped in it, and stirred about, when 'tis to be used lest the Powder should settle in the bottom, and for the most part 'tis applied warm, and as often as 'tis taken off, 'tis dipped into it again, and applied. Sometimes certain Powders are put in, but they are first macerated in fountain water. To Epithemes belong Oxyrhodes, Epithemes for the forehead. as they are called, which are Epithemes peculiar to the forehead, prepared of Oil of Roses, and Vinegar, to cool, and repel; The Ancients, took of Oil of Roses three parts, and of Vinegar one part, and stirred them well together, wherein they dipped a piece of leather, or skin and applied it to the forehead; At this day also other Oils, as of Violets, Myrtles, Nimphaea, or water Lilies, and sometimes distilled waters, and Powders are added Santalls', and other things. To these are referred anacollemata, Anacollemata. which are wont to be applied for diseases of the Eyes, and Hemorhodes of the nose, principally to the forehead, so called for this reason, whether they consist of medicines that fill up, glutinate, and have an astringent quality, because they stop the violence of humours that flow into them, or because by their clamminess, they adhere, and as it were stick like glue to the part to which they are applied. And they are prepared of Volatile or fine Flower, How prepared. Bolearmoniack, Dragons-blood, Acacia, mastic, Manna, Frankincense, and such like, mixed with the white of an Egg. 2. Yet they are often prepared without the white of an Egg, to mitigate the pain of the head, or cause sleep which are applied, either with a Leather, or a skin dipped therein, or enclosed in a little bag, and they are more properly called Epithemes, or Frontells. CHAP. XL. Of Medicines applied Plaister-wayes to mitigate pain, and of little Bags. LIke unto Epithemes, are Fomentaes, so called, Fomentations. because they do by their heat, as it were cherish the parts of the body to which they are applied, and they are exhibited either to heat the parts, or to cleanse, and discuss, or to mitigate pain, or soften that which is hard. Differences of Fomentations. Moist. 1. And they are twosold, moist, and dry; the moist are made either of hot water, Oil, Milk, or wine, or decoctions of Plants, made with warer, wine, Vinegar, Milk, whither a sponge, or linen cloth, answerable, to the magnitude of the part affected, is dipped whilst it is hot, and applied to the part, and when they begin to be lukewarm, or to cool, they are changed for hot, or the same are heat again in the Liquor. 2. Sometimes, simples, included in Linen bags, are boiled in water, wine, or Milk, and are applied hot to the part affected, for which purpose, 'tis convenient to prepare two Bags, that when the one is cooled, the other may be applied. 3. Sometimes, a Hogs Bladder, or an Ox his Bladder, is half filled with the Liquor of the decoction and applied hot to the part affected. 4. Fomentations, are made also, of living Creatures dissected, and as yet warm, especially Pigeons, as also of the parts of living Creatures newly slain, whilst they are hot, as the Lungs, Paunch, o● Oils made of the same. 5. Sometimes the steam only of Waters, of Wine or Vinegar boiled, is stirred up by the fire only, or by casting in of stones or Irons burning into the Liquor, or some of the Liquor poured on them is applied to the part; the vapour is taken by a Pipe or Tunnel with a wide orifice, or it is put about the part with some covering, whereby the steam being detained and included, it may act the stronger on the part affected. But dry Fomentations are made with Bags, Dry. the Bags are compounded of Herbs, Flowers, Barks, Roots, Seeds, Aromaticks, Gums, which are agreeable to the present intention, being cut and pounded proportionable to the figure and magnitude of the part affected, are put into a Bag, and applied to the part, for a cordial Bag an Ounce, or an Ounce and half may suffice, for the stomach a greater quantity is required. The Bag is prepared either of Linen or Silk, and being pricked through with a Needle is applied dry to the part, and sometimes it is wet in Wine or Vinegar, and put on a hot stone or brick heated by the fire, it is applied to the part affected and makes it warm. CHAP. XLI. Of Embrocations, Lotions, and Baths. THe likest to Fomentations are Embrocations, or Water, Lotions, and Baths, all which signify rather a certain manner of using, than any Composition and Form of Medicine, and they contain for the most part the same matter with moist Fomentations. Embrochee, Embrocations. is a certain distillation or dropping down of a moist humour from above like Rain: the dropping which is made on any part is performed, either by pouring water out of a vessel, with a long snout, or by dropping out of a Laver. 'tis applied principally to three parts; First, upon the coronal Suture, in distempers of the brain, and the moisture runs no further, than the sagittal suture. Secondly, from the beginning of the spinal marrow, in diseases of the Nerves and the moisture is terminated at the end of the spin. Thirdly, to heat or dry the stomach, and the matter is suffered to run over all the belly: if the guts also are weak, a Cerat with Santals' is to be applied to the liver, if there be fear of inflaming it, the matter to be so distilled is common water, water of Baths, decoctions, milk, oil, according as the part affected requires it. Some Lotions are exhibited to certain parts which are called particular Lotions, Lotions. others to the inferior parts of the body only, which are commonly calted Incessus, and Semicuoium, i. e. a Vessel that you may sit upright in, others are fit for the whole body, which are called Baths. Peculiar Lotions principally use to be administered to the head, hands, and feet, and are prepared as Fomentations of herbs, or fair water, or boiled in a lee, Wine, or Oil. Incessus, which the Greeks call Encathisma, Incessus. is a bath for the belly, and inferior parts wherein the diseased must sit up to the Navel, and such bathing Vessels serve for several uses, sometimes to mitigate pain, sometimes to soften and discuss wind, sometimes they are used to provoke courses. A Bath is a washing of the whole body, A Bath. and is administered either for cleansing and taking away the faults of the skin, or to relax the parts; or for some distemper of the whole. Some baths are natural, others are made by Art. The Differences. Amongst the natural baths the plainest is that of Fountain-water, which hath a power of heating and moistening, and therefore is convenient for such as are Hectic. Nature also affords baths, for the imitation of baths artificial, and of natural Baths, the Physician may prepare many things to supply the want of them. CHAP. XLII. Of Soapes. SOap also, Sapones. or Washballs are used to certain parts of the body, which are prepared in this manner; There is taken of Venice Soap made smooth, How mad● or of some other good and white Soap as much as is sufficient, to which is added six or eight times so much Powder, and all of them are mingled in a sufficient quantity of a water that is proper, and reduced into one mass, from whence round Balls are ᵉ made in the form of an Apple. They are exhibited principally to cleanse the body, or some parts thereof, and to give a pleasant sent to it. CHAP. XLIII. Of Cauteries. LAstly, Cauteries. That we may speak something also of Potential Cauteries, their preparation is manifold, and there is no man, but here will somewhat boast: But the most profitable which will make an Escarre soon without pain, and other Symptoms, is that which is thus prepared; Take the Lee, whereof black Soap is made and put it into a Frying-pan, till it become almost as hard as a stone, and when it grows cold cut it into the form of great Dice, and let it be kept in a glass close shut, lest it should melt, and it is commonly called the Corrosive stone; the use whereof is very frequent at this day; to quicken Ulcers, by the which humours may be diverted from the more noble parts, to the ignoble, and therefore they are called Issues, or fontanelles. HONOUR, GLORY, and THANKSGIVING be to GOD alone. FINIS. Books Printed for LODO LLOYD, and sold at his Shop next the Castle-Tavern in CORNHILL. Bvrtons' Anatomy of Melancholy, Folio. A Historical description of the Fast-Indies, by Ferdinand Mendez Pinto, Folio. Mr. John goodwin's, Redemption redeemed, Fol. Divine authority of the Scriptures, 4ᵒ. Antapoligies in answer to Edward's, 4ᵒ. Theomatica, or the danger of fight against God, 4ᵒ. Anticavilearisme, 4ᵒ. Hagiomastix, or a Scourge for the Saints, 4ᵒ. Vindication of the Sentence passed upon the late King, 4ᵒ. Reply to A.S. in vindication of the congregational way. 4ᵒ. Answers. 4ᵒ. Fresh discovery of a high Presbyterian spirit, 4ᵒ. Queries concerning the Government, 4ᵒ. Vindication of the change of Government, entitled Peace protected, 4ᵒ. Apologist condemned, 4ᵒ. Three several Disputations concerning the extent and death of Christ, with Mr. powel and Mr. Simpson. 4ᵒ. Exposition of the ninth to the Romans. 4ᵒ. Catabaptisme, in vindication of Infant's Baptism, proving not only its lawfulness, but divine Institution, 4ᵒ. Pagans Debt, and Dowry, 4º, Agreement and distance of Brethren, being a brief survey of the Judgement of Mr. J.G. on Justification, 4ᵒ. Defence of the true meaning of Rom. 4.3.5.9. in answer to Mr. Walker, 4ᵒ. Water-dipping, no firm footing for Church-communion, 4ᵒ. Return of mercies, 12ᵒ. Saint's interest, 12ᵒ. Behm's Mysterium magnum, or an Exposition of Genesis, fol. The principles of the Divine Essence, 4ᵒ. life, 4ᵒ. Four questions of the Souls original and nature, 4ᵒ. On the two Testaments, Baptism and the Supper, 4ᵒ. Mercurius Teutonicus, 4ᵒ. Way to Christ discovered, to which is added a Treatise of the Complexions, 12ᵒ. Tree of Christian faith. 4ᵒ. A true relation of the Author's life and death, fol. Considerations of Infant's Baptism, by Mr. Horn, 4ᵒ. Antipoedobaptisme, or a Treatise against Infant's Baptism, by John Tombs, 4ᵒ. Exposition of the eleven first Chapters of Job, by Mr. Joseph Carill, 4ᵒ. Some baptismal abuses discovered, 4ᵒ. A doubt resolved, or satisfaction for the Seekers, wherein the case touching an Administrator of Gospel Ordinances in these times, is handled by Mr. Wil Allen, 4ᵒ. Doctrine of Justification asserted and vindicated in answer to Mr. Wil Eyre, of Sarum, and Mr. Rich. Baxter of Kederminster, by Mr. John Eedes Minister of the Gospel, 4ᵒ. Monarchy or no Monarchy in England by Mr. Wil Lily, 4ᵒ. Divine Optics, or a Treatise of the eye, by Mr. Rebert Dingly, M. A and Minister of Brixton in the Isle of Wight, 8ᵒ. Astrea, or true love's Mirror, by Leonard Willan, Gent, 8ᵒ. The exceeding riches of Grace, advanced in Mrs. Sarah Wight, by H. Jessey, 8ᵒ. Gospel-liberty, by Mr. Cradock, 4ᵒ. The Prophecy of Daniel explained by Ephr. Huit, Pastor to the Church at Windsor in New-England, 4ᵒ. The Anatomy of Conscience, by Mr. Ephraim Huit, 4ᵒ. Supplication of Saints, by Thomas Sorocould, 12ᵒ. Saints daily exercise by John Preston, D D. 4ᵒ. The Christians daily walk in holy security and peace by H. Scudder, 12ᵒ. The pouring out of the seven Vials, by Mr. John Cotton, of Boston in New-england. 4ᵒ. The power of the Keys, by Mr. Cotton, 4ᵒ. Silex Scintillans, the second Edition enlarged, with a second part added thereunto, by Henry Vaughan Satirist 8ᵒ. A Tteatise of faith, by Fzekiel Culverwell, 12ᵒ. The Doctrine of faith, by John Rogers, 12ᵒ. Graces and Prayers for Children, 8ᵒ. Fire of the Sanctuary, by Mr. Bruges, 12ᵒ. Martyr's Flowers, by Clement Cotton, 12ᵒ. Balm from Gilead, by Mr. Robrough, 8ᵒ. Signs of a godly man, by Mr. Byfeild, 12ᵒ. The right use of Promises, by Jer. Lewis, 12ᵒ. A definition of faith, by Timothy Bat, 12ᵒ. Three questions of free justification, Christian liberty, and the use of the Law, by Samuel torshel of Banbury. 12ᵒ. The Saint's humiliation by Sam: torshel, 4ᵒ. Tree of life, or the blood of the Grape, by Tobias Whitaker, Dr. of Physic, 8ᵒ. Job Paraphrased, by George Abbot, 4ᵒ. The Works of Dr. Stoughton, 4ᵒ. Questions and answers on the Common Catechism, by John Ball Minister of Langton, 8ᵒ. Right receiving of Christ, by Daniel Dyke, being a Treatise of the Lords Supper, 12ᵒ. A Treatise of the morality of the Sabbath, by George Abbot, 4ᵒ. Reformation sure & steadfast, by Sam. Farecloth, 4ᵒ. Marrow of Sacred Divinity, by Dr. Ames. Saint's Nosegay, by Sam. Clark. An Exposition of the Canticles, by Thomas Brightman, 4ᵒ. A Treatise called the two Covenants from Sinai, and Zion, drawn up Catechistically, by Sam. Slater, 8ᵒ. Godly man's choice, by Mr. Scudder, 12ᵒ. The Anchor of hope for Gods tossed one's, by John Wells, 12ᵒ. The Spirit convincing of sin, by Peter Sterry, 4ᵒ. Christ alone exalted in the perfection and encouragements of his Saints (notwithstanding sins and trials) by Dr. Crispe. 8ᵒ. A small Catechism, called Milk for Babes, by John Cotton of New-England, 8ᵒ. Golden Sands, with a few short hints about the riches of grace, by John Bachilcr, 12ᵒ. Spaniard's cruelty and treachery in peace & war, 4ᵒ. Quakers quaking principles, by Ellis Bradshaw, 4ᵒ. Quakers Idol, by Josuah Millar, 4ᵒ. Magia Mdamica, or the antiquity of Magic, and the descent thereof from Adam. Lumen de lumine, or new magical light discovered and communicated to the world. Anthroposophia Theomagica, or a discourse of the nature of man, and his estate after death. (All three) by Engenius Philalethes, 8ᵒ. Expositions with observations on several Scriptures, by Isaac Pennington; Junior, Esq 4ᵒ. Postilion, or Prophetical Prognostics of the wars of Christendom, written in high Dutch, by Paulus Felgenhowre, translated in the year 1655 4ᵒ. Garden enclosed, Christ's Church, Christ's Garden, by Paul Hobson, 8ᵒ. The Protestants practice, or the Complete Christian, containing the sum of Christian Divinity, by a Reverend Father of the Church of England, 12ᵒ. The whole grounds of Physic and Chirurgery, by that great and famous Physician Dan. Synertus, Dr. and Professor of Physic, made English for the benefit of the unlearned, by I. O. late of Trinity College in Cambridge. 8ᵒ. Several Sermons and Discourses of Mr. Wil del, Mr. of gonvil and Cajus College in Cambr, 4ᵒ. The Orthodox Evangelist, by Mr. John Norton of Boston in New-England, 4ᵒ. The Chemist's Key to shut or to open, or the true Doctrine of Corruption and Generation, by that judicious and industrious Artist Henry Nollins, published by ‛ Eugenius Philalethes. Short Arithmetic, or the old and tedious way of numbering reduced to a new and brief method, by Edward Howes, Rector of Gouldenham in Essex, 12ᵒ. DOCTOR D. SENNERTUS OF AGUES AND FEVERS. Their Differences, Signs, and Cures. Divided into four Books: Made English by N. D. B. M. late of Trinity College in Cambridge. LONDON, Printed by J. M. for Lodowick Lloyd, at the Castle in Cornhill, 1658. To the Reader, HEALTH and SAFETY. WOnder not Reader, that you see these Rarities in the English Tongue, written by the learned Professor of Physic, D. Sennertus; neither be angry that the Mysteries of this Noble Art are laid open for the unlearned to peruse, for such I design them. The ancient Greeks as Hypocrates, Galen, etc. and the Arabians, as Avicen, Averoes, Mesue, Serapio, etc. wrote all in their own genuine language, as Celsus, Serenus, and other Latins also in their vernacular and mother Tongue. The Author teacheth the knowledge of those diseases that reign amongst us, and the cure of all sorts of Fevers, continued and intermittent (which are called Agues) he shows the way to cure the Small Pox, nay the Pestilence or Plague itself, when it is never so contagious. Kind Reader, I wish thee no greater happiness in time of sickness, than this Book to advise thee, where an able Physician is wanting; I hope it will find acceptance by thee, and be both welcome and profitable to thee. For my part, as I expect no thanks, nor desire no commendation, so I fear no ignominy or calumniation. May it prove as beneficial to all that read it in this Tongue, as he desires it may that writes it; for seriously, he assures the world, that all true Christians Lives are as dear to him as his own; and their health desired most candidly by him, that esteemeth and valueth nothing so much as the public good of his Brethren. Not long since, this Authors five Books of Institutions of Physic and Chirurgery, were published in the English Tongue; which incomparable Piece I recommend to thy serious perusal, as the best foundation for Practice) that any man hitherto hath laid; Without any further troubling of thee with these Epistolary lines, I refer thee to the Book itself; and so Farewell. The Table. BOOK I. Of Fevers in general, and of an Ephemera, and of a Synocha with putrefaction. OF the Nature of a F●ver, Chap. 1. p. 1. Of the causes of Fevers in general, ch. 2. p. 3. Of the Symptoms of a Fever in general, ch. 3. p. 4. Of the differences of Fevers in general, ch. 4. p. 5. Of the Cure of Fevers in general ch. 5. p. 6. Of the Fever Ephemera, ch. 6 p. 6. Of an Ephera of more days, and of a Synocha without putrefaction, ch. 7. p. 10. BOOK II. Of Putrid Fevers. OF putrid Fevers in general, ch. p. 12. Of the differences of putrid Fevers, ch. 2. p. 15 Of the sign● of putrid Fevers in general, ch. 3. p. 16 Of the Cure of putrid Fevers in general, ch. 4 p. 17. Of breathing of a Vein, ch. 5. p 18 Of Purging, ch. 6. p. 19 Of co-coction and separation of Humours, ch. 7. p 22 Of Sudo●ificks and Diuretics, ch. 8. p. 23 Of Diet in putrid Fevers, ch 9 p. 24 Of the differences of putrid Fevers, ch. 10. p. 27 Of a continued putrid primary Fever, and first of a Synocha in particular, ch. 11. p. 28 Of a Causus or Burning Fever, ch. 12. p. 31 Of continued periodic Fevers in general, and of a continued Tertian, ch. 13. p. 33 Of a continued Quotidian, ch. 14. p. 36 Of the Fever Epiala, p. 38 Of the syncopal Fever p. 39 Of a continued Quartan, ch. 15. p 40 Of Symptomatical Fevers, ch. 16. p. 41 Of Intermitting Fevers in general, ch. 17. p. 46 Of Intermitting Fevers in particular, and first of an Intermitting Tertian, ch. 18. p. 55 Of a Quotidian Intermittent, ch 19 p. 61 Of an intermitting Quartan, ch. 20. p. 62. Of compound Fevers, and Semitertians, ch. 21. p. 67 BOOK III. Of a Hectic Fever. OF the nature of a Hectic Fever, ch. 1. p. 71 Of the signs of a Hectic Fever, ch. 2. p. 72 Of the Cure of a Hectic Fever ch. 3. p. 73 BOOK iv Of the Plague, and of Pestilential and malignant Fevers. OF the Nature of the Pestilence, ch. 1. p. 75 Of the causes of the Pestilence; ch. 2. p. 77 Of Contagion ch. 3. p. 79 Of the signs of the Plague, ch. 4. p. 81 Of preservation from the Pestilence. ch. 5. p. 82 Of the Cure of the Pestilence, ch 6. p. 85 Of the nature of a pestilent and malignant Fever, and the difference of them from the Plague, ch. 7. p 89 To what kind of Fevers pestilent and malignant ones p●rtain, ch. 8. p 90. Causes of a pestilent & malignant Fever, ch. 9 p 91 Signs of malignant and pestilent Fevers, ch. 10 p. 92 Of the cure of malignant and pestilential Fevers in general, ch. 11. p 93 Of a malignant Fever, with the Measles and Small Pox, ch. 12. p. 97. Of the Spotted Fever, ch. 13. p. 105 Of the English Sweat, ch. 14. p. 108 Of the Vngarick Disease ch. 15. p. 110 Of a malignant Fever with the Cramp, ch. 16. p. 114 Of a malignant Fever with a Catarrh, and a Cough and the Squincy, ch. 17. p. 116 Of the Cure of Symptomatical Fevers, ch. 18. p 118 Book I. Of Fevers in General, and of an Ephemera, and of a Synocha with Putrefaction. CHAP. I. Of the Nature of a Fever. THat which is called by the Latines a Fever, The name. of a Fever by the Greeks (from fire) is called the fiery distemper; Hypocrates plainly calls it fire, if it be very vehement, as being by the consent of all men a hot distemper; For although some Germans call it Daskalte, yet that appellation belongs not to every Fever, neither doth it express the nature of a Fever, but only signifieth Cold, An intermitting Fever may be so called. A Fever is a hot distemper of the whole body, atising from heat, kindled contrary to nature in the heart, It's definition and nature. and by the mediation of the Blood and Spirits, conveyed through the veins and arteries to all the parts, and hindering natural actions, unless it be prevented. For a Fever is generated, when (as Galen 1. Aphor. 14. hath it) The native heat is become fiery; Generation of it. For seeing that all the parts of the body have a certain temperature, and all of them are actually hot, every one according to its own degree, and thereby are rendered fit to perform natural actions; If in the heart, from whence the vital heat is diffused over all the parts of the body, each part receiving its due temper from thence, a certain preternatural heat be kindled and spread over the whole body, so that to the natural temperature of the parts some degrees of preternatural heat are added, and that actual heat shall be increased; a certain excess of heat and a hot distemper is kindled in the whole body, which is called a Fever. Which distemper indeed formaliter, as some say, is contrary to nature, and is called a Fever; but materialiter 'tis not altogether contrary to nature, for unless there had been before some degrees of natural heat extant, the supervenient heat could not constitute this degree of heat. And indeed a hot distemper only constitutes a Fever; Dryness is no part of the Essence of a Fever. for although all feverish heat tend to dryness, yet that dryness is not sickness in all Fevers, neither is the body by feverish heat rendered unfit to perform its natural actions, it is so by dryness in every Fever that the natural actions are hindered; but although the feverish heat always tend to dryness, yet oftentimes the disposition of the body wherein that heat acteth, and moisture therewithal, hinders the production of a disease by dryness. The adequate Subject of a Fever is the whole body, The Subject. or certainly most of its parts, but the principal is the heart, as being that wherein that heat is first kindled, and from thence communicated to all the other parts of the body, unless it be hindered; nor can a Fever be generated, unless the heart first become hot. Indeed the whole body is the Subject of a Fever in regard of the similiar parts, and as it is endued with actual heat, which is as it were kindled by the innate and influent heat; For this heat when it is changed and converted into a fiery heat from a temperate and moderate, a Fever is stirred up. The immediate cause of a Fever is heat kindled in the heart contrary to nature, The proximate cause. and diffused over all the body; For as the heart whilst it is well and according to nature, is the fountain of natural heat, and disperseth the same over all the body, so if it grow hot contrary to nature, it distributes that unnatural heat over all the parts. For although a Fever may be kindled by the inflammation of other parts likewise, yet that happens not unless that heat be first sent to the heart, and afterwards from thence to all the parts of the body, whence it comes to pass that in every Fever the Pulse is changed. Nevertheless every kind of heat in the heart is not sufficient to cause a Fever, but such a kind of heat it ought to be, as can cause such a hot disease as can hinder the performance of natural actions. Whence 'tis manifest that a Fever is one thing, A Fever and feverish heat differ. and a feavourish heat another thing. A Fever properly is that hot distemper which happens in the living parts of a body, and renders them unable to act; but the feverish heat is also in the humours and spirits, and stirs up that hot distemper of the body, which constitutes the essence of a Fever. CHAP: II. Of the causes of Fevers in general. ALthough there is but one only cause of a hot distemper of the whole body, which constitutes the essence of a Fever, namely, preternatural heat kindled in the heart, and thence distributed over all the body, yet the causes from whence that heat in the heart ariseth, are several, as Galen of the causes of diseases, cap. 2. and in the first book of differences of diseases, cap. 3. recites five, Motion, Putrefaction, Contact of some hot thing, Cloasure of the pores of the skin, or a Retention of a hot stream; and lastly Mixture with some hot thing: And of these causes, some by themselves, and some by accident stir up heat. First from Motion, Motion. since the Spirits and humours of our bodies are hot, from the confluence of them into any part, according to the various motion of the body and mind, heat is increased, which if it be greater, and be either kindled in the heart, or communicated to the heart, a Fever ensueth. Secondly, Putrefaction excites heat. Putrefaction. For since all things that do putrify become hotter, and out of putrid bodies are exalted many hot vapours, thence heat is conveyed to the heart by the veins and arteries, and from thence a Fever raised. Thirdly, contact of a hot thing exciteth a Fever: Contact of a hot thing. As if the body wax hot by the Sun, Fire, Bath, or Medicine, and that heat be sent to the heart a Fever followeth. Fourthly, if the pores of the skin are closed, and a hot stream and hallituous excrements, Retention of a hot steam. which in concoction are generated in the body, and use to be sent out through the pores of the skin, be penned in, heat is thereby kindled, and a Fever bred. Lastly, when hot things are mingled with humours and spirits, as meat, drink, hot Medicines, all those communicate that heat which they contained in themselves to the Spirits and humours, which if they penetrate the heart, and from thence be distributed to the other parts of the body, a Fever is thereby kindled. And indeed the fourth of these causes, or the retention of the hot effluvium, is sufficient alone without the rest to cause a Fever: But the other causes without this can hardly do it. For although from Motion, Putrefaction, Contact, and Mixture with a hot thing, hot vapours are stirred up in the body; yet if the body freely ventilate, and that so much be daily evaporated and emitted of those vapours as are generated, a Fever is not easily occasioned, but when those vapours are detained, a Fever is soon kindled. But although these causes if they be powerful, Disposition of a body to a Fever. may raise a Fever in any body whatsoever, yet in bodies inclinable an ordinary power in the causes may suffice to beget a Fever. Now they are most inclinable to Fevers which abound with much heat, salt and sharp humours: For which reason Youths are more apt to Fevers, of which you may read, Galen 8 Of the Method of healing, cap. 8. where the whole order of Inclinations to Fevers are set down. 1. Hot and dry. 2 hot and moist. 3. hot only. 4. dry only. 5. temperate. 6. cold and dry. 7. cold only. 8. moist only. 9 cold and moist. Yet to another kind of Fevers other bodies are more inclinable. CHAP. III. Of the Symptoms of a Fever in general. WHereas in a Fever the temper of a body is changed, Symptoms of Fevers. and rendered hotter, hence certain Symptoms of Fevers must necessarily ensue: And first of all it is hence manifest, that those actions are especially hindered, which should be performed by the similar parts as they are such, and by the benefit of the temper of each such part, no organic part concurring. Such action since it is Nutrition, and those that are subservient thereunto, they are especially hurt in Fevers. Yet because the Instruments by which other actions are performed, consists of similar parts, that imperfection is derived to the hindrance of them, as of vital and animal actions. Indeed the vital actions are principally hurt in a Fever, because the feverish heat is first kindled in the heart. Whence in all Fevers the Pulse becomes more frequent and swifter; for since the motion of Pulses in all Fevers may be increased, first, a thick Pulse, as being most facile of all; but if that frequency satisfies not the necessity, celerity happens, which if that be not sufficient, than magnitude follows: So that the strength be not debilitated: The animal actions also are often hurt. As for other Symptoms, preternatural heat is observed to offend internally or externally. Also the excrements and qualities of a body are variously changed by reason of the hindrances of concoctions. CHAP. IU. Of the differences of Fevers in general. THe differences of Fevers are taken from their essence, Differences. or from their accidents. Hippocrat 6. Epid. comment. text. 29. propounds the differences taken from the heat itself of the Fever, that some Fevers are biring, namely, such as strike the hand of them that touch them, and by reason of that sharp vapour, which is stirred up by putted matter, it doth as it were prick the hand; but a mild one is such as hath troublesome heat, but not so violent. Moreover the heat o● some Fevers at the first touch is not sharp, and nipping, but if the hand be continued longer, afterwards it betrays itself. On the contrary others are quick at first to the touch, but if the hand continue longer, it is overcome by the hand, and a little abated. But those are the most proper differences which are taken from inherence in the Subject, and the cause of inhering, which Fevers are divided into Ephemeraes, putrid and hectic, the truest foundation of which division is, that one Fever is in habitude, the other in habit, for although the feverish heat in every Fever possess the similar parts of the body; yet some are so inherent in the body, that they require no cause to cherish them, and although they are not fed by the kindling of humours and Spirits, nevertheless they will continue, which sort are called Hectics. Another hot distemper is so inherent in the similar parts of the body, that unless it be cherished by the kindling of humours and Spirits it can no more subsist, which Fever is called a Fever in habitude, which in respect of the cause is twofold, an Ephemera, to which also a Synocha without putrefaction is referred; and a putrid. There is another thing worth the noting, that one Fever is Primary, another Symptomatical, Primary is that which follows no former disease, but depends on its proper cause: Secondary or Symptomatical is that which ariseth from the inflammation of any member. See Galen. 4. Aphor. 7. But of Symptomatical this is to be noted, that those which by the ancients were accounted Symptomatical, were indeed primary many of them, and inflammations of the parts, of the Membrane that covers the ribs, of the lungs or chops, rather happened to those parts, than the Fever to take its rise from them: Fevers accompanied. Which Fevers may be called Comitatae, or such as accompany the Fever. CHAP. V Of the cure of Fevers in general. NOw to the cure. Cure. A Fever as it is a Fever being a hot distemper, indicateth cooling things are to be used. Galen. 8. Meth. Med. Cap. 1. But because there is no small difference amongst Fevers, and that a Fever is often joined with its cause, regard is to be had of the cause of the same. Nay indeed because the cause often offends more than the Fever itself, the Fever is so to be cooled, as that the cause may not be cherished, and those things be detained in the body which ought to be evacuated. And oftentimes error is committed in this; whilst regard is had only of the heat, cold things are administered, by which the cause of the Fever being detained, the Fever is prolonged: Whereas on the other side, heating things, as likewise either opening or sudocifick things, without cooling medicines, often with happy success cure the Fever; For the cause being taken away, the Fever itself ceaseth of its own accord; Whereof more particularly hereafter. CHAP. VI Of the Fever Ephemera. THere are two sorts of Fevers whose heat are inherent in our bodies in habitude. Fevers in habitude. For that the hot distemper of the parts is cherished either by the heat of the Spirits or humours; and the humours are inflamed either with or without putrefaction. Those Fevers which are sustained by the heat of the Spirits and humours without putrefaction, The name Ephemeros. are called Ephemerae and Humorales without putrefaction: Those which are kindled by putrifying humours are called putrid Fevers. That Fever which is cherished by the kindling of Spirits, is called by the Greeks, Puretoes Ephemeros, by the Lattines, Diaria and Ephemera, by a name not taken from the nature of the disease, but from its duration. In respect of the Essence thereof, it may be defined thus: Definition It is a Fever arising from and depending on the heating and inflaming of the vital Spirits. The proximate cause of this Fever is the heat of the vital Spirits kindled contrary to nature, The next cause. which being spread over the whole body through the arteries, heats the whole against nature. That heat is stirred up from all those causes before mentioned in the second Chapter, only except from putrefaction; Remote cause. which sometimes immediately, sometimes remotely, by means of the natural and animal Spirits heat the vital; to wit, perturbations of the mind, sadness, fear, solitude, anger, over much watching, too much intentiveness of the mind; too much exercise of body, grief, hunger, thirst, hot meats and drinks, drunkenness, crudities in bodies choleric, heat of air, fire, hot Baths, retention of the hot Effluvium, inflammations of Kernels and Buboes, from the which heat alone without putrid vapours is conveyed to the heart according to the vulgar opinion. Yet it seemeth not impossible but that those putrid vapours by the veins and arteries next to the part affected, may be communicated to the heart. And so these Fevers should rather be Symptomatical then absolute, putrid then Ephemeral. Those that are hot and dry easily fall into this Fever, Disposition of body. in whom many hot dry vapours are coliected, which are easily inflamed by causes heating them more. Amongst the Signs by which this Fever is known and discerned from others, in the first place, Galen. 1 de differ. Diagnostic signs Febrium. c. 7. saith, it beginneth from some procatartick or evident cause; which indeed is an inseparable sign, but not a proper sign; for although a Fever that doth not arise from a manifest cause is not an Ephemera, yet every Fever which ariseth from a manifest cause is not therefore an Ephemera. 2. Moreover the Urine in substance, colour, and contents, is most like unto the Urine of healthy men, or at least recedes not much from them, which in an Ephemera, which proceeds from crudity, it useth to do, in which the Urine useth to appear more crude and whiter. 3. The Pulse is nearer to a natural one, then in any other Fever; only that it useth to be extended in magnitude, celerity, and frequency. Yet in regard of the cause which occasioned the Fever, some change may be made in the Pulse. 4. The heat of this Fever is gentle and weak in respect of other Fevers. 5. Nay in the very state and height thereof it is somewhat more gentle and moderate. 6. This Fever invades without shake, or tremble; it's increase and augmentation in heat and pulse is free and equal. 7. The declination is performed by moisture, or moist evaporation, by sweat like theirs who are sound in health, which by a little exercise more than ordinary comes forth, and a perfect apurexsie follows that moisture, so that after the declination no footing is left for the Fever, either discernible by Pulse or any other circumstances: And in case any footing be left, it is a sign that it will turn into another sort of Fever. The causes are most perfectly to be known by the relation of the sick, which may instruct the Physician whether from passion of the mind, exercise of the body, or any other evident cause this disease hath been occasioned. These causes also affords some signs of themselves, which the Physician cannot be ignorant of. These Fevers are the shortest of all others, Prognostics. and continue not above twenty four hours: There is no danger in them, unless some error be committed, and for the most part they are conquered by nature, wherefore Physicians are seldom called to their cures. Yet according to the diversity of their causes some are cured more easily, others with more difficulty. For those causes which are hardly taken away, and the humours are ap● to corrupt, a Fever introduced from such, easily degenerates into a putrid; which happeneth when it is extended above four and twenty hours, or no sweat appears, and pain in the head be present and persevere: And it degenerates either into a Synocha without putrefaction, if the body be youthful and plethoric; or into a putrid, if the body be cacochymick, or into a Hectic, if the body be hot, dry, and lean. And the proper signs of those Fevers show into what sort of them the transmutation will be made. Moreover since this Fever is a hot distemper of the whole depending on the heat of the Spirits inflamed: Indication●. 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 aught to be taken away. These Fevers are cured by good diet, The Cure. so that there is seldom any need of strong medicines; the food therefore ought to be cooling and moistening, the meat of good juice, and easy of concoction, principally cream of Ba●ey, the rest may be mixed with lettuce, sorrel, juice of Citron or Lemon, Vinegar. The drink should be barleywater, 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 its thickness, or crudity of the stomach, since they easily turn into putrid 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 rarify and open the same, by a bath of fair water lukewarm, soft rubbings, temperate and lukewarm oils, wherewith the body should be anointed. But if the thickness of the skin be occasioned by drying things, use moistening diet, and the body should be anointed with temperate and moistening oils. Lastly, if the Ephemera proceed from crudity, From crudity of the stomach. since that is twofold, the one called Acid, which proceeds from diminution of heat, the other Nitrous, which is caused by preternatural 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 easy concoction in a small quantity is to be taken, and the stomach to be comforted with hot oils; But if the crudity be great, than 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 stomach both with internal and external medicines is to be comforted. But if the crudity be unsavoury or nitrous, 'tis 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 choler, and as corroborate the stomach. CHAP. VII. Of an Ephemera of more days, 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 days: Yet it can be referred to no other sort of Fever than this more conveniently; therefore although Ephemera should signify the essence of the Fever, Ephemera is so called though with the addition of more days. Such Fevers are those which no ways 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 inflammation 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 plethoric body. This continues several days, 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, Diagnostic signs. only more evident: For the heat is somewhat greater than 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, Prognostics. 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 ordered 'twill degenerate into a Synocha with putrefaction, or into a Frenzy, Squincy, Pleurisy, or some other perilous inflammation. But when this Fever ariseth by the inflaming of the thinner blood and Spirits in a plethoric 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 conserveses with much sugar in them, unless they are much watered. If obstruction of the pores of the skin be present, 'tis to be opened as I said before. Their diet ought to be thin and little, Diet. such as hath force to cool and moisten, principally a Ptisan, the meat should be savoured with juice of Lemmon, Pomegranates, Goose-berries: Their drink should be barleywater or small beer. Fernelius 5. cap. of Fevers, Synoch. Bilios. Fernal. makes mention of another sort of Synocha, which is made by the kindling of the Spirits and choleric humours without putrefaction, and which ariseth from the same causes as an Ephemera, if it happen in a choleric body, which opinion indeed may take place if it be meant of the thinner and subtler part of the hotter blood, which sometimes useth to be called choler, but not if it be spoken of excrementitious choler. The end of the first Book. BOOK II. Of Putrid Fevers. CHAP. I. Of Putrid Fevers in General. WHereas there is a twofold sort of Fevers, whose heat is inherent in the parts according to habitude, whereof the one hath its rise, and is continued by the kindling of the Spirits, and thinnest parts of the blood, without putrid humours, the other hath its original from vapours and putrid humours; of the former kind 'tis already spoken; The next business is that we handle the putrid Fevers. That there are putrid Fevers many things show; Putrid Fevers. For neither is it dissonant from the nature of humours, but that they may putrify, since that may happen to every mixed body; and we see humours putrify otherwise in man's body, as it happens in inflammations, wherein quitture is generated, as Galen in the 1 of the differences of Fevers, cap. 6. he compares the putridness whereby the humours putrify in the brain, with that, by which Sanies is generated in the humours. And that they do actually putrify, sufficient reasons are given, which hereafter we shall propound, and the matter itself shows that humours do putrify in the veins. For both blood which cometh forth from breathed veins, and those things which are evacuated by stoo●, Urine, sweat, sufficiently by their smell and otherwise, argue putridity of humours. And the way of cure proves the same, for 'tis not performed by things that altar, but evacuate humours, which is partly instituted by nature, partly by the Physician. For if humoral Fevers could be made without putrefaction, they might also be cured by altering things only. And indeed such Fevers are not only malignant as some think, but the same signs appear, and the same way of cure is exhibited to intermittent and continued, What Putrefaction is. which are void of all malignity and pestilency. Aristotlc. 4. Met. c. 1. defineth putrefaction to be the corruption of the proper and natural heat in every moist body, by reason of external ambient heat, but by Galen 11 Meth. med. c. 8. without doubt not so much regarding the common and adequate subject of putrefaction, as to man's body, subject to medicinal consideration. It is (says he) a change of the whole substance of the body putrifying to corruption, by reason of extraneous heat; the ultimate end of putrefaction is the dissolution of the parts whereof the mixed body consists, and the corruption of the whole mixture. That we may here pass by the tedious disputations which are extant amongst Philosophers and Physicians concerning putrefaction, this is to be taken notice of, How manifold it is, that putrefaction in respect of the mixed body putrifying, the one, is according to the whole and perfect, according to the who● whereby mixed bodies are plainly dissolved into Elements, out of which they are bred: The other is in some part, and imperfect, whereby these which are full of moisture, in some part. putrify. For seeing the moisture wherewith it aboundeth cannot wholly be drawn out, only some parts thereof, especially the thinner are. And such putrefaction, namely, according to parts, agrees to humours also; namely, when some particles of theirs are really corrupted, and they lose their form: Yet the whole humour must not necessarily lose its form; thence it continues its name, and those corrupted parts being evacuated, it returns to its former nature; unless the corruption have so far gone, that mutation is made into another kind. Which putrefaction, is putrefaction indeed, and not alteration only. For although the whole be not corrupted, yet some parts thereof are really corrupted. Putrefaction in a body is caused by extraneous heat, The cause of putrefaction. and when the humours are no longer governed by the natural heat, but are destitute thereof, they are corrupted. Therefore all things whatsoever which may be an occasion to hinder the innate heat, so that it cannot in its due manner govern the humours, may be said to be the cause of putrefaction of the humours. Putrefaction of humours though oftentimes it be caused by obstruction, and bowels, and prohibiting of free transpiration, since that, as Galen. 11. Meth. med. c. ●. writeth, things hot and moist, in a hot and moist place not being fanned and cooled by wine easily putrify: Yet putrefaction may be occasioned without this, by the meeting with putrid things, and other causes, which debilitate the native heat, and bring in an extraneous heat. First, certain humours by reason of some internal defect, Default of humours. of heir own accord tend to putrefaction, or at least are easily overcome come by small causes of putrefaction, and having gotten the least occasion fall into putrefaction: Such vice humours contract first from bad meats, of the which they are generated, whether they are such by nature, or any other ways corrupted: Moreover by meats which are easily corrupted, such are fruits rareripe. Thirdly, from the ill dressing of meats, or ill concoction, or when they are taken in excess, or at unseasonable hours, or after a preposterous manner. Fourthly, by the default of the parts appointed for concoction, by reason whereof even the best aliment may be corrupted. Lastly by reason of other causes which either impede concoction, or retain execrements, as also the preposterous use of the six Non-naturals. Therefore by how much the more of such humours are cumulated in the body, by so much the more easily they putrify. For nature doth not defend excrementitious humours so carefully as those which are fit to nourish the body; whence they are easily corrupted and putrify. Blood also out of the veins, being out of its natural place, and of a hot and moist nature easily is corrupted. But although such humours turn to putrefaction of their own accord, and being in a hot and moist place; yet it happens sooner if any other cause be added. Nay good humours also in a sound body if they are the cause in p●sse of putrefaction may become putted. Amongst all these causes the first and chiefest is the hindrance of transpiration and ventilation, Transpiration hindered. whether it happen by straitness of the pores of the skin, or by obstruction of vessels & passages in the more inward parts of the body. For hot and moist things in a hot place unless they are ventilated, easily putrify. Narrowness of pores is occasioned either by constriction from cold, or astringent things, or dryness, as staying under the Sunbeams; or by Obstructions, which either plenty or vicosity, or thickness of humours brings forth. Moreover the internal passages are stopped, either through store of blood overflowing in the body, or plenty of it contracted up and down in many parts, or by the thickness and viscousness of humours. Secondly, Causae califacientes. those things cause putrefaction, which can kindle preternatural heat in humours, and call out the native heat; in which number is the Fever Ephemera, which for this cause is often changed into a putrid in hot and moist bodies: Moreover the other causes heating, as hot air, a hot bath, too much exercise of body and mind Meetings with putre● things. Lastly, the meeting with putrid things, seeing that which is touched by what is putrid, is defiled and putrefieth From all which it is manifest, that a putrid Fever is short, having its rise from hot vapours stirred up by putrid humours, and heating the heart, and thence the whole body against nature. CHAP. II. Of the differences of putrid Fevers. ALthough there are many differences of Fevers, nevertheless those which are necessary to be known for the performance of their cure, The difference of putrid humours. are taken either from the matter putrifying, or the place putrified. For first either solid parts putrify, or humours, or even the Spirits themselves; concerning which it is controverted as in its own place shall be shown. Humours that putrify are as well natural as preternatural: And those of every kind, blood, Phlegm, choler, melancholy; which both the variety of those things which are evacuated by stool, vomit and sweats, and the difference of Symptoms which happen in Fevers doth show, moreover the diversity of causes which went before it, whereof some generate this, some that humour, and moreover some afford matter for this, other for that humour. And the humours either simply putrify, or a malignant venomous quality and contagion is joined with it. Furthermore the place wherein the humours putrefy is not always the same; For sometimes the humours putrefy within the veins and arteries, sometimes without them. And that putrefaction which is within the vessels, is either equally in all the vessels, or in the greatest, or in certain parts of a vein. Whence these differences of Fevers do arise. First, some Fevers are simply putrid, without any malignity or contagion, others malignant, postilent, contagious. Moreover some Fevers are continual, others intermittent, according as the putrid vapour which is the cause containing of putrid Fevers, or heat stirred up by putrid humours either continually heats the heart, and from thence is diffused over all the body, or by certain intervals. Of either of which kinds of Fevers there are again many differences; For either the putrefaction is kindled in the common vessels, and not in private passages, whence arise continued Fovers, called Primary: Or the putredity comes by the inflammation of some peculiar part, and from thence putrid vapours are continually communicated to the heart, which Fevers are called Symptomatical. Primary continued again are twofold, for some have no augmentation, nor remission, which they call Fevers containing, or fiery Synochaes. Others are continued, yet there is some increase of heat, and sometimes remissness, which are called Synochaes, and by the general name of continual Fevers. The continual for the time of their increase and decrease of heat, some are called tertian, others quotidian, others quartan, according as the heat is exasperated, daily, each other day, or the fourth day likewise. Intermitting also according to the time of their invading, some are called, tertian, others quotidian, others quartan. Nay it is observed that there are Fevers that have a longer distance between the Paroxysms. CHAP. III. Of the signs of putrid Fovers in general. APutred Fever is known. The Diagnosticks. 1. From its heat, which is more gnawing and acrid, then of any other Fever, and that in the increase and state. For in the beginning of fits, the heat doth not at the first touch of the Pulse discover its acrimony, but if the hand be continued longer it may be perceived, which proceeds from fuliginous vapours which exhale out of putrid humours. 2. Because it gins without any manifest cause. Which indeed is a proper sign, but not an inseparable one, for as often as any Fever is kindled without any manifest cause, you may well determine it to be a putrid Fever: Yet sometimes humours are so disposed to putrefaction, that upon any light occasion they'll become putrid. 3. Urines in putrid Fevers either are crude or else at least afford but obscure notes of concoction, unless an Ephemeral be degenerated into a putrid Fever, otherwise there is no putrid Fever wherein the Urine in the beginning doth not appear crude or obscurely concocted. 4. The pulse is more changed then in other Fevers. 5. Putrid Fevers begin with a cold shaking. Which is a proper, but not an inseparable sign. 'Tis a proper sign because neither Diaries nor Hectics do ever begin with cold shaking; yet it is not inseparable, because all putrid Fevers do not begin with a cold fit, as a putrid Synocha. 6. It is the property of putrid Fevers to return by fits and Paroxysms; and no other Fever hath fits. Yet this is not an inseparable sign, because it doth not agree with all putrid Fevers. 7. Lastly, if any sign be present which is proper to any sort of putrid Fevers, 'tis a sign it may admit of the general appellation of a putrid Fever. Concerning the event of putrid Fevers in general not much can be spoken, The Prognostic. since there is great variety and difference of putrid Fevers, and the event various: Only this, that the event is best to be known by comparing the magnitude of the disease with the strength of the Patient; For if the patiented be very strong, there is much hope of a good end of it, if the party be weak, there is great danger. CHAP. IU. Of the cure of putrid Fevers in general. NOw seeing a putrid Fever is cherished by the cause containing, Indications in putrid Fevers. Indications in putrid Fevers are taken some from the Fever itself, others from the cause thereof. Nor indeed ought vital indications to be neglected. First, a Fever as it is a Fever, indicateth cooling things; Moreover as that heat of the whole depends on a hot putrid vapour, as on the cause containing, the removal of that is also indicated; but because putrid vapours depend on putrid matter, they cannot be removed, unless the matter putrified be taken away; putrefaction cannot be taken away except its cause be removed, as we said before. First, all evident causes which are present are to be removed; the antecedent causes and whatsoever is in the body, either of superfluous blood or peccant humours, they are to be prepared. and if occasion require, to be evacuated, straightness of passages if it be external or interal in the bowels, they are to be opened and free ventilation and respiration for the humours is to be procured, Putrefaction is to be resisted, and the putrid humours are to be cooled and dried; 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 administered 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 than the disease, and the cause of a putrid Fever being taken away, the Fever of necessity ceaseth. Yet if the greatness of the Fever enforce, 'tis 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, since that for the most 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 says 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 putrid Fever. especially when neither age nor want of strength prohibits 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 putrid Fevers: Yet 'tis clear he did it, that by evacuation of the blood, nature might be enlightened and freed from the greatest part of her burden, for when blood abounds, the opening of a vein, and purging of Cacochymy are the best remedies; furthermore when it is a plethoric 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 vicious 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 lessened some part of her burden, 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 burdensome 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 extreme 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 mixed with their blood, that bleeding is proper, and that at the beginning, that nature may be unladed of part of her burden, but if vicious 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 show 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 breathe 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 Symptoms, which use to be accompanied with Fevers, as of watch, pain, and such like. As for the time for letting blood, The time. 'tis to be done when 'tis 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 deferred 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 putrid 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 administered in the beginning of all putrid Fevers, because there are scarce any bodies wherein the stomach, 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 mixed 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: Syrup 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 remissness and intermittings, when the Fever lest 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 stomach and adjacent parts, whereof no concoction can be expected, the which useth to corrupt and putrify in the body, and oftentimes that is easily vomited out, which with great difficulty is purged out. Vomits. The Vomits are set down in the fifth Book of the Institutions part. 1. Sect. 1. cap. 12. Some give at this day the roots of Asarabecca, from half a drachm to a drachm. The Chemists use white Vitriol, Salt of Vitriol, Medicines prepared of Antimony; which do not open only the first passages, but stir the whole body: These are to be used with much caution, and as Hippoc. Purging medicines. 1 Aphor. 24. Not without skilful advice. Concerning Purgers at what time they are to be used, there is great controversy; for although vicious humours at any time during the disease, show that they ought to be taken away; Yet they ought not to be evacuated at any time, but instead of an Oracle, Galen admonisheth four of preservation of health, c. 5. the Aphorism of Hypocrates is to be had in esteem, 22. Sect. 1. Such as are concocted and ripe, aught to be purged and removed, not crude; neither in the beginnings, unless the matter trouble much, which seldom cometh to pass. But although some interpret this Aphorism otherwise, yet if it be diligently considered, 'twill be manifest, that Hypocrates meant to speak only of putrid Fevers, and of no other disease, and by crude humours intends those that by reason of their putresection in putrid Fevers ought not to be purged, being unfit; by concocted he intends such as are fitting to be purged: The words crudity and concoction, being translated from their proper signification of crudity and concoction to excrementitious humours. Although there are certain other preparations of humours for purgation both in Fevers and out of Fevers: Concoction of humours. Yet the name of concoction belongs not to them, and we must distinguish betwixt concoction and preparation of humours. Concoction, whereof Hypocrates speaketh, is a reducing of the putrid humours into a better condition, and less obnoxious to the body, and a separation of them from good blood, that they may the more profitably be evacuated out of the body; hence concoction belongs only to humours, which are contained in the Veins, and mixed with the blood, but those that are in other places, and not mixed with the blood, may be purged at any time. For these humours unless they are reduced to a certain mediocrity as they are capable of, and are separated from laudable blood, the Physician in vain, and with much detriment to the sick, endeavours to expel them by purging. For neither will the humours follow the foregoing medicine, neither hath the Physician nature for his assistant, since the matter is only stirred and troubled, and various Symptoms arise; either the strength is weakened by the violence of a strong medicine, or the native heat is consumed and weakened. Yet flatulent humours may be purged without concoction; Flatulent humours. For although these are not as yet concocted, yet because there is not only danger lest they should fall upon some principal part, but also because being thin, and already in motion, they easily follow their leading medicine; and the Physician hath nature to assist him, which alone sometimes expels such humours at the beginning, to the great advantage of the sick. But by flatulent humours here, we are not to understand only those which hitherto are moved to no determinate part, but also those which although they rush into some part yet they are still movable, and so disposed, that they'll easily remove into another part, and according to their manner, are hitherto wand'ring, but have not any fixed seat any where. Concoction, whereof we here speak, is the work of nature only, which when 'tis strong, gives what perfection they are capable of receiving, even to the vicious humours, as may be seen in the generation of quitture; and this concoction is made only in putrid Fevers▪ For whilst the humours ferment in the veins, like new wine, and the good and bad are mixed together, and cannot easily be separated: They are called crude, but when the humours are appeased and cooled, and the good may easily be separated from the evil, they are said to be concocted. CHAP. VII. Of Concoction and Separation of humours. ALthough the concoction of humours be the work of nature only. Yet a Physician may help her by his medicines, which may either cherish and strengthen the native heat, or take away impediments which may hinder nature in concocting, Digestive medicines. and reduce the excess of qualities to mediocrity. And medicines of the latter of these two kinds are called Digestives and Concoctives, namely, such as cool the hot humours, heat the cold, moisten the dry, attenuate the thick, incrassate the thin, and if there are any other excesses of qualities, reduceth them to mediocrity. So Choleric humours because they are hot to be allayed; Concocters of choleric humours. and tempered with cold medicines, and their tenuity if too much, to be reduced to mediocrity, and its power of inflaming to be prohibited. These perform this, Chichory, Endive, Sowthistle, Garden-Endive, Sorrell, Borage, Bugloss, Violets, Barley; the greater and lesser cooleing seeds, the juice of Lemmon Pomegranates, Goose-berries, Vinegar, Spirit of the salt of Vitriol, and medicines prepared of these. Phlegmatic humours because they are thick and dull, Phlegmatic. require attenuating, and cutting medicines; such are the opening roots, Hyssop, Bittony, Agrimony, Venus-hair, Vinegar, also Spirit of Vitriol. In a Melancholy humour, Melancholy. attenuating medicines are also useful, but such as moisten withal: Such as are Borage, Bugloss, Polypody, Caeterach or Spleen-wort, and such like. But because in all these Fevers, Resisting of putrefaction. corruption of humours is present, those things which resist putrefaction are also necessary, such are Vinegar, Juice of Lemmon, Citron, Pomegranates, Sorrel, Spirit of Salt of Vitriol. And those things which are spoken about concoction and crudity of humours, principally take place in continued and acute Fevers, which is manifest from Hypocrates, who 1. Ash. 24. adjoins, In acute diseases seldom, and about the beginnings, purging is to be used, and that with diligent premeditation, and 2 Aphor. 29. In the beginning of diseases if ought be to he moved, move it; but when it flourishes 'tis best to be quiet, namely, if the matter swell big in acute diseases, presently at the beginning 'tis to be evacuated, but if not, a concoction is to be expected, which nature alone performing, very often useth to expel vicious humours, which if it be not done, the Physician useth to do it: The same crudity and concoction is required in intermitting Fevers, for since their causes are situated in the Mesaraick veins, and the Mesaraick veins contain and elaborate blood of their own accord, if peccant humours be any where mingled with that blood, and begin to putrefy, crudity is said to be present: But when those humours are so conquered by nature, that they may easily be separated, concoction is performed. Although in intermitting Fevers in every fit some of the peccant matter be evacuated, yet notwithstanding the humour, which is the fuel of such Fevers, is not first taken away before the concoction be performed, and the bad are separated from the good: That which in quartanes useth to be long in doing; For although each Paroxysm some may be expelled, yet as Galen. 2. of the difference of Fevers. cap. the last teacheth, superfluities in the part wherein the fuel feeding the Fever is contained being left behind, cause new fits, and purgation is appointed in vain before the humour be concocted and rendered fit to be purged, whereof shall be spoken amongst the intermitting Fevers. Preparing of humers. But besides this concoction and preparation of humours, there is yet need of other things, which when the humours are concocted, are to be exhibited: For considering purgation that it may be happily used, the passages ought to be open and the humours fluid, if the passages are obstructed, and thick sluggish humours be present, the ways through which the humours ought to pass are to be opened, and the humours to be cut and taken away, CHAP. VIII. Of Sudorificks and Diuretics. BUt because nature for the most part expels the concocted matter by sweats, Causing sweat. so that almost no Fever without them ceaseth and is well cured. The Physician ought to imitate nature, and the body being evacuated, to discuss the remainders by sweats: The Sudorifiques that at this day are in use, are, Carduusbenedictus, Scabions, Fumetary, Tormentill, Zedoary, Hartshorn, Elder, Bezoar-stone, Mithridate, and such like, but no sudoriferous medicine ought to be administered, if any Crisis by stool, vomit, or Hemerrhodes at the nose be extant, lest nature should be disturbed in its work. They are most conveniently exhibited at that time, when nature herself useth to remove humours, which happens either before any paroxysm, or at the end thereof. By Urine also sometimes part of the feverish matter is evacuated, Urine provoked. and therefore Diuretics after other evacuations are to be appointed, and the most temperate amongst them are to be chosen, which together attenuate the humours, and free the passages from obstructions, as Maidenhair, Asparagus, Agrimony, etc. But those things which are cold, may timely be used also, since they correct the hot distemper of the humours and parts. CHAP. IX. Of Diet in putrid Fevers. LAstly concerning diet, Diet. and first, of meat and drink, not only regarding the use of them, for the comfort and refreshment of our strength, but in respect of what is to be permitted, and what prohibited; for when nature is most busied in concoction and evacuation of matter, she ought not to be called from that work to the concoction of meat, hence Hippo. 1. Aphor. 8. When the violence of the disease is great, diet is to be used most sparingly, and ibid. Aphor. 11. In the Paroxysm itself, food is to be taken away; for it affords mischief: and when by circuit the Fever returns in the fits we ought to abstain. In the administration of diet in Fevers, we are to observe, form, Form of Diet. quantity, quality, and time. The form of diet is threefold, thick, indifferent, and thin. Which of these are most proper for every one, is to be collected by comparing the strength of the sick with the morbifique cause; neither ought we to give more meat than the strength can concoct: and we ought to consider whether the strength do more require food, or the disease forbidden it, or the contrary: for by how much the busier nature is in oppugning the morbifique cause, by so much the less three ought to be burdened with food: She is by so much the more busied in opposing the disease, by how much the paroxysm is nearer at hand, hence Hypocrates 1. Aphor. 8. When the disease is in its vigour, then 'tis necessary to use the thinnest food, and 1. Aph. 7. When the disease is peracute, there are extreme labourings; and at height, the thinnest nutriment is to be taken. But when 'tis not at height, and that we may use more nourishing things, by so much is to varied from the thinnest of all, by how much the disease is remitted and abated, and ibid. 10. Those who expect the vigour forthwith to come, ought presently to take a little nourishment. They who expect it afterwards much, and should both in the vigour of it, and a little before it, abstain. But beforehand the sick should be more plentifully nourished, that he might be the better able to endure the disease. But how diet is to be moderated according to the strength, Hypocrates teacheth, 1 Aphor. 9 We ought to conjecture by the sick, whether he can hold out to the vigour of the disease by the prescribed diet or not, or whether he will first faint, and being insufficient with such food, should die before the disease departed and be overcome. And 1. Aphor. 13. Old men that are not decrepit easily endure to fast, according to these, middle aged men, young men less, children lest of all; and amongst them especially such as are endued with the choicest and most acute wits: Custom also and course of life is to be considered in prescribing of diet. The quantity of meat also is to be considered by comparing of the disease with the strength of the sick: Quantity. For since that we must never give more food than can be concocted at the time when nature is most busied in opposing the morbifique cause, the least quantity of food is to be taken, which is in the height thereof. Concerning the quality of meat, Quality. since it is to be considered either as it is meat, or as it is medicinal meat, in the former respect those meats are to be chosen that are of easiest concoction, full of good juice, facile to be distributed, and which hath the least excrements: But if it be considered as Medicinal, First, it ought to be contrary to the Fever, and therefore it should be cold and moist, 1. Aphor. 16. moreover it should be repugnant to the causes, and all excess of qualities in them. The time for food is most proper when 'tis indicated, Time. when the body requires nourishment, which is when the former meat is concocted, and no sign is present, which may prohibit the taking of it, to wit, no combat betwixt nature and the disease; therefore during the fits, we ought to abstain. 1. Aphor. 11. unless the strength be much decayed and spent. Care also is to be taken what drink is fittest in Fevers, for although it be easier concocted than meat, Drink. and by its cooling it mitigates the heat, and the dryness is hindered: Yet we are to be careful that nature be not burdened with it, and the concoction of matter hindered by it, and therefore in intermitting Fevers during the Paroxysm, we should abstain from drink as near as we can: But in continued Fevers, when heat, thirst, and debility of strength do require, you may give more drink; but since drink is to be considered, not as drink only, but as medicinal, hence it comes to pass, that at certain times, certain drinks are to be chosen. Drink considered as drink, aught to be given according to the rules for meat: But as it is considered as altering, by how much the dry heat is more intense, by so much the more, hotter drinks are to be avoided, and the colder to be chosen. Yet regard is to be taken of the cause, and oftentimes there will be need of attenuating and absterging drinks, and not of cooling only; and the matter being deeper fastened in the part, admits not cooling drink. The drinking of cold water is only useful in acute Fevers, 'tis never proper in intermittent. Fair water is often altered with barley, which is called a decoction, and barleywater. Instead of drink, Juleps are also exhibited, water mixed with Honey, Oxymel, Emulsions, Whey, strong beer, wine. But seeing certain drinks for certain Fevers are most convenient, we may more properly handle them severally amongst the different kinds of Fevers, of which sorts are peculiar for such a particular Fever then in general to treat thereof. The air in all Fevers ought to be pure, cold rather than hot, yet so tempered, Air. that the drawing in thereof may rather allay the feverish heat, then meeting with a naked body, cause it to shut its own pores, which hinders the discussion of vapours and sweats, and therefore the sick is to be covered with outward garments, but such as are light, that so the heat may be drawn to the outmost parts of the body. Sleep aught to be moderate. Rest in putrid Fevers is most advantageous: Sleep, rest. Excrements, passions of the mind. Excrements ought not to be retained beyond measure, but to be ejected in due time. The passions of the mind ought to be at peace, and sadness, and anger are to be avoided. CHAP. X. Of the differences of putrid Fevers. HItherto we have spoken of putrid Fevers in general, The differences of putrid Fevers. it remains that now we speak of them particularly. First their differences are a little more clearly to be explained. And they are taken chief from the matter putrifying, and the place of putrefaction. As for the matter, Feversarise either from choler, or phlegm, From the matter. blood or melancholy: To which not without reason is added a serous humour, especially that Ichor, which is very evil, easily obnoxious to putrefaction, A serous humour. and causeth the blood and other humours to putrefy more easily. Whence some are of opinion that Ephemeral Fevers, which commonly are said to arise from Spirits kindled, do all proceed from the ebullition of the serous part of the venous or arterious blood: And much more a Synocha without putrefaction; although the vital Spirits being heat may first allure the heat to the serous humour. The same show that all Synochaes or Fevers containing, as they are called, which have no periods, as well putrid as not putrid, do arise from the same aqueous and serous humour, whether putrefying or not putrefying; whereof the Tract of Fevers may be seen. Those Fevers which proceed from blood do all keep a certain continuity and equality; and are neither exasperated daily, From blood. Phlegm. Choler. nor each other day, nor the fourth day, but those which do arise from Phlegmatic, choleric, or melancholy humours, all have their periods, whether they are continued or intermittent. Besides these there are other Fevers, Melancholy. which although they are exasperated, yet have no certain periods, such are those which arise from inflammation, putrefaction, worms, corrupted milk; From other causes. as in Infants, blood out of the Vessels, chyle, and blood imperfect, putrefying in the Mesaraicks. The matter whereof putrid vapours are bred in Fevers, From the place. is either contained within the vessels or without. The vessels which carry the perfect blood, as the vena cava, and the arteries, or the more imperfect, as the Meseraick veins. within the vessels. Whilst blood putrifies in the vena cava, there arise continued Fevers, whereof some are called Synochaes, or containing Fevers, others continued instead of a genus and periodic continued. If excrementitious humours putrefy in the Mesaraicks, intermittent Fevers are stirred up, but if imperfect blood putrify in the Mesaraick veins, continued Fevers are raised, but calm ones. Putrifying matter without the veslels, Without the vessels. sending putrid vapours to the veins and arteries, kindles continued Fevers. Such are first Symptomatical, which proceed from inflammations of certain parts. Moreover calmer Fevers, which proceed from the stubborness of the guts and their obstructions. Thirdly, those that are caused by an Ulcer, Fistula, and all putrefaction. Fourthly, from corrupt milk, as in Infants, from blood putrefying without the vessels, also the matter of Catarrhs, whence they are called Catarrhal Fevers. Lastly, there are Fevers called Comitatae, or Companions, which are occasioned from matter putrefying in the veins, Fevers accompanied. part whereof when nature either expels out of the body, which happens in a Diarrhaea, Dysentery, and a Catarrh, or protrudeth into some part, which happens in the Measles, Small Pox, Straggling pains, Quinsey, Peripneumonie, Frenzy, Erisipelas, oftentimes. Another disease than accompanies the Fever. CHAP. XI. Of a continued putrid primary Fever, and first of a Synocha in particular. NOw concerning putrid Fevers in particular, A primary continued Fever. and first we will handle a primary continued Fever: A primary continued Fever is that which comes not to apurexie before it be plainly taken away; and hath its rise from putrid humours contained in the greater branches of the vena cava and artery. For since that thence putrid vapours are continually sent to the heart, a continued heat is also caused, thence until it fully be cured there is no absence of fire, neither doth it return by intervals, with tremble and shaking fits. Primary continued Fevers are twofold, Some without any remission or exacerbation of the heat, continue from the beginning to the end: But there are others, wherein the heat before the Fever be throughly cured, doth never totally departed, yet at certain periods is increased. The former are called fiery Synochaes, and Fevers containing; the other are called Synoches, or continued, instead of a genus. The Fever Synocha putrid, A Puered Synocha. is a Fever, which without any slacking or increasing afflicteth from the beginning to the end, arising from putrefaction of the blood in the greater branches of the vena cava. Although continued Fevers may arise out of vessels of determinate parts, yet such are Symptomatical: And if they are true Synochaes, which have their original from the default of any part, as from the womb offending: Yet that part only affords an occasion, the polluted, putredity being communicated, that the blood in the greater vessels might corrupt. But there are Fevers risen from determinate parts, for the most part continued Periodicks. So 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 putrid Synocha hath its original for the most part from transpiration hindered, 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 preternatural heat is so kindled in the veins, that nature can no longer rule it, it becomes putrid and is corrupted. Nor is there any need that the putrid blood should be turned into another humour presently. For blood of its own nature is apt to putrefaction, and in inflammations we see it changed to quitture, not into choler; 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 putrify, but some parts thereof, which so long as they are not separated from the good blood, crudity is said to be present, which afterwards by concoction are separated from the good blood, which being done, Nature appoints evacuation, by which the blood returns to its former purity again. A Synocha is threefold, Acmastick, i. e. when it remains always 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 always decresseth. Furthermore it blood which putrifies be temperate absolute, 'tis called a sanguinious Synoch a in particular: But if it be hotter, which useth to be called choleric, the disease is then called Synocha bilosa. The Fever is known first by this, Diagnostic 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 signs are present which are observed in a Synocha that is not putrid. A putrid Synocha is distinguished from a non-putred by certain signs. The heat in a putrid is sharper than in a non-putred. In a putrid the urine is red, thick and troubled, without any sediment, and crude, or a little concocted in the beginning; the Pulse affords signs of putrefaction, and all the Symptoms are greater than in a Fever that is not putrid. A Synochabilosa happens to those that are troubled with choleric blood, and the heat is sharper than in a Synocha proceeding from temperate blood, thirst is more troublesome, the urine thinner and sharper, and other signs which are usual in choleric Fevers are discerned. This Fever is the most simple amongst the putrid, Prognostics. and easiest to be cured. And being pure, seldom passeth seven days, but the spurious is extended to the fourteenth day, and is terminated sooner or later, as the signs 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 Symptoms are, by so much the better hopes; the more they are, the more danger is shown. The whole cure consists in taking away the cause, Indicatious. and altering the feverish 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 feverish 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 alloy the heat, free from obstructions, and resist putrefaction; namely, the juice of Sorrel, Lemmons, Citrons, and Syrrups and Conserves prepared of them, Syrup of Sorrel simple, Oxymel simple, Oxysauharum simple, Spirit of Vitriol, and the four cold seeds with cooling waters are to be administered. 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 feverish 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. Diet 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 feverish 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, extreme and unextinguishable thirst. A Causus properly and in specie so called, is again twofold, legitimate and spurious: legitimate is that which hath always, and that evidently, those two signs joined with it: an illegitimate is that wherein those two signs are not so evident. Whence it is manifest that burning Fevers, Burning Fevers. and such as properly and in specie are so called, are continued Fevers, and arise from choler. And so a Causus or burning Fever properly so called, is a Fever continued, Bilions, and indeed either Synocha bilosa, which we have newly handled, or a continued tertian, whereof we are to speak next. The Pathognomonick signs as we said before, are two, vehement and burning heat, and unquenchable thirst, although the sick shall drink; Diagnosticks. and the more legitimate the Causus is, by so much these signs are greater, yet the thirst is sometimes resisted if a little cough happen, which may draw humours from the neighbouring parts. Concurrent signs there are many, as a dry tongue, rough, black, watching, giddiness of the brain, difficulty of breathing, thick and great, and the sick continually blow, opening their mouth, that the hot spirits may the easier exhale. These Fevers if they are pure, Prognostics. never continue long. For nature cannot long endure such burning and vehement heat; and the Symptoms which accompany it with their vehemency. And for the most part they are terminated the seventh day, sometimes the ninth, eleventh, fourteenth: but the spurious are protracted longer, and all of them are dangerous according to Hypocrates 4. Aphor. 43. Fevers of what kind soever that have no intermission by the third day, are the stronger, and fuller of danger. Yet some are more dangerous than others, according to the violence of the heat, and of the Symptoms, and force of the strength, and by how much the greater digression is made from the natural state, by so much the more dangerous is the Fever. Hence if an old man be troubled with a burning Fever, which seldom happens, 'tis deadly, as Galen hath it, 1. Aphor. 14. They lie down in no less danger who are exceedingly burnt in cold air: Who if they have not great strength, neither the signs of concoction appear, it can not be that they should escape, as the same Galen 11. Met. med. cap. 9 writeth. To whom if vehement Symptoms happen, by so much the more dangerous the disease shall be, whether they are Pathognomonick or supervenient, yet if by the other signs, it be manifest to be a burning Fever, and that thirst be wanting, this also is dangerous, for it shows the sick either to be in a Delirium, or that the desiring faculty of the stomach faileth. Black urines are also evil, as also thin, crude, and such as have other ill tokens in them. But it is good if the sick can easily endure his sickness, the Symptoms being not without vehemency, if he can easily fetch breath; if he complain of pain in no internal part, if he sleep; if he find benefit by his sleep; if the body be equally hot and soft, if the tongue be not too dry, if the urine be good. But if when the signs of concoction appear, and that there is much strength, in a critical day there happen large Hemorrhodes, or bleeding at the nose, without doubt the sick escapeth: For it is proper if there be any other of the pure burning Fevers, that they should be cured by bleeding. Yet sometimes they are determined by Sweats, looseness of the belly, vomits, and imposthums. But there are many Prognostics of burning Fevers in Hypocrates in Prognosticis, Porrheticus, and Choacis praenotionibus, and there are many expounded in the Institutions, lib. 3. part. 3. But by what means burning Fevers are to be cured, appears by what hath been spoken of a Synocha bilosa with putrefaction, and those things that shall be said of the cure of the continued Tertian shall make manifest. CHAP. XIII. Of continued Periodick Fevers in general, and of a continued Tertian. ANother kind of continued putrid Fevers which they call in particular continued, comprehends those Fevers, Continus periodic Fevers. which indeed continually remain, and have no remission before they are plainly dissolved, yet at certain periods they are exasperated, whence they are called continued periodic and proportionated Fevers. But as Fevers containing have their original from the blood appointed for nourishing the body; so continued Periodicks, their causes. as also intermittints proceed from an excrementitious humour and cacochymy. Therefore continued Periodicks agree in this with Fevers containing, that both their causes are contained in the vena cava, but with intermittents in this that both proceed from excrementitious humours. But they differ from Fevers containing, in that they proceed from alimentary blood; these from an excrementitious humour: From intermittent because the matter which is the cause of continued Periodicks is generated in the second concoction, and contained in the vena cava: But that matter which is the cause of intermitting Fevers is contained in the first concoction, or certainly in those parts which are about the liver, which are not appointed for perfect sanguification. Namely, the matter of continued Periodick Fevers is generated in the Organs of the second concoction, if for any cause whatsoever it be not rightly performed. For then the peccant humours generated in the second concoction are sent with the blood into the veins, which there stirreth up these continued periodic Fevers. Which matter since it is not only confused with the blood, as in intermitting Fevers, The reason of its continuity. but from the very first original is mixed therewith throughly. Nature also cannot expel it before concoction, and therefore the Fever from the beginning continually lasteth. Yet these Fevers have exasperations at set times, because that from the instruments of the second concoction, fresh matter which is the cause of these periods is afforded, and indeed for the most part from the liver: Whence also continued Tertians are most frequent. These Fevers are generally known because they never come to apurexie, Signs. yet at certain periods they are increased and remitted. Neither doth cold, trembling, nor shaking fits precede their exasperation, neither doth sweat follow their remission. There are three kinds of these Fevers. For some are exasperated each other day, Differences. and proceed from Choler, and are called Tertians continued. Others every day which are caused by Phlegm, and are called continued quotidians. Others the fourth day, which arise from Melancholy, and are called Quartans continued. First a tertian continued is a putrid Fever, A Tertian continued. arising from blood with ill juice and choler putrefying in the vena cava, indeed continued, but afflicting most the third day. The causes of this Fever are all things which can increase store of choleric Cacochymy in the veins, The cause. and being cumulated there of choleric Cacochymy in the veins, and being cumulated there can introduce putrefaction; such as are before propounded. This Fever is thus known, Signs. in that it is continued, and the third day it is exasperated. Yet there are present other signs and Symptoms of continued and burning Fevers. But what is to be hoped concerning their event, Prognostics. is manifest from things which are spoken of the Prognostics of burning Fevers. Concerning the indications for cure, Cure. this Fever if it be pure, since it is exceeding hot and burning, and the cause thereof hot and dry, it requires extraordinary cooling and moistening, and indeed more than any other Fever. The humour itself indicateth evacuation; but crudity for the most part forbids it: but if the Fever be spurious, regard is together to be had to the humour which is mixed with choler: if the Symptoms need it they are to be resisted likewise. Therefore a vein is to be opened so that the strength will permit it, by which means both some part of the peccant humour may be evacuated, Opening a vein. and the blood cooled and revealed from the more noble parts. And nature herself sometimes useth to make evacuation by the nose in the beginning of these Fevers, whereby the Fever is wont to be abated; but the vein should be opened in the cubit forthwith in the beginning, or certainly in the augmentation, and blood is to be taken in such plenty as the strength of the patiented requires. But you are not to appoint purgation unless the matter be turged. Lenitives. Yet 'tis very necessary that the belly and first passages be evacuated before a vein be opened, but the medicines which perform that, aught to be cold and moist not hot; or if they are hot, they should be tempered with the mingling of cold. Afterwards altering, namely, Alteratives. cooling and moistening medicines are to be exhibited, both which prepare the humour appointed by nature for concoction, such as are, Syrup of Sorrel simple, Oxymel simple, compound, Oxysauharum simple, Syrup of Sorrel, Woodsorrel, the juice of Lemmon, Pomegranate, the accidity of Endive, Cichory, Violets, Gooseberries, the four greater cold seeds, Purcelane, Lettuce, th● flowers of Water-lillies, Santalum, Water of barley, Sorrele Endive, Cichory, Strawberries, Water-lillies, Purcelane, spec. Diamargariti frigidi, and such like, to which for the resisting of putrefaction and hindering inflammation may be added, Spirit of Vitriol and Salt, Nitre prepared is also commended: If Phlegm be mixed, opening and attenuating things are to be added; such as the roots of Fennel, Sparagus graminis, and medicines prepared of them, In leek coloured aeruginous choler, John Langius. l. 3. epist. 1. c. 4. commends Crystal. Topical medicines are also profitable to mitigate the heat, as Epithems, Oils, and Unguents, made of cooling things, Topics. which should be applied to the heart, liver, or back. Yet you must be careful that you close not the pores of the skin thereby, and hinder transpiration, and therefore before the height they are seldom used, unless it be when the heat is equally distributed through the whole body, and it is more commodious if they are applied hot then cold. The matter being concocted, that nature might be strengthened, and stimulated to expulsion, and that the matter might be expelled either by stool or sweat, the Ancients used great quantities of cold drinks, as Galen teacheth 9 m. cap. 5. and 4. the rat. vict. in acut. 12. But if so be that after concoction nature do not institute evacuation, Purgation it is to be done by the Physician, with Syrup of Roses and Violets solutive, the pulp of tamarinds, Manna, Rhubarb, Trypheta Persica, such as have Scamony in them are not to be admitted; yet sometimes some of Electuarii rosati Mesua, de psyllio and of juice of Roses may be given. For causing Urine in these Fevers an emulsion is profitable, prepared of the four great cold seeds, Diuretics' with the whey of Goat's milk, or barley and strawberry water, or with a decoction of the roots of Parsley. Sweats also aught to be provoked with medicines proper for that purpose, Sydorificks which hereafter shall be mentioned amongst malignant Fevers. Diet aught to be thin; but according as the height of the disease is nearer or farther off, Diet. it ought to be thicker or thinner. The meat and drink ought to be cooling and moistening, whence a Ptisan is profitable in these Fevers, the rest should be seasoned with juice of Lemmon and Pomegranates: The drink should b● barley water, or water boiled with the juice of Lemmon or Pomegranates, and suggar or small beer. The air should be cold, and if it be not so by nature, it should be prepared by art. If Phlegm be mingled with choler, and the Fever be a continued Tertian or burning Notha, blood is to be taken away more sparingly: In the preparation of humours, those things are to be added which attenuate Phlegm. Agarick is to be mixed with the Purgers. CHAP. XIV. Of a continued Quotidian. A Continued Quotidian vulgarly called Latica, because it hath a certain hidden and obscure heat, A continued Quotidian. is indeed a Fever continually lasting, yet having every day exasperations arising from indigested phlegmatic humours in the vena cava. The cause of this Fever is Phlegm mixed with blood in the vena cava, and there putrifying, Cause. and therefore those fall into these Fevers which are of such an age and nature as that their bodies are moister, as children and infants, as also old men and such as have grosser bodies, and are given to their bellies and to idleness, and dwell in moist places, but not young men and such as are choleric. The signs of continued periodic Fevers are also manifest in this Fever, only the violence is most about the evening. Signs. The heat first is gentle, a little afterwards more sharp, and sometimes seems to abate, and sometimes to increase, by reason of the thickness of the phlegm which purrisieth. The pulses are not so thick and frequent, the urine is not so fiery and red as in other Fevers but thicker, nor are the other Symptoms so vehement as in other Fevers. Concerning the event. 1. Prognostics. This Fever by reason of the thickness of the humour is long, and hard to be cured, and therefore dangerous. And by how much the thicker the phlegm is by so much the more violent and durable, so that it is not ended before the swetieth or sixtieth day, and the beginning is scarce passed before the twentieth. 2. It continueth lesser time where many evacuations happen. That which is pure is also longer than that which is mixed with choler, and by how much the worse Symptoms are present, and the strength weaker, by so much the greater danger there is, which if they are not, health is to be hoped for. 3. By reason of the duration of the Fever, and weakness of the Liver, the sick for the most part fall into Cachexy and Dropsy. As to the cure this Fever is more dangerous in respect of the cause, then of its heat; Cure. and therefore since it depends on phlegm that is to be heat, attenuated, cut, and afterwards being concocted and prepared, evacuated, and regard is to be had of the strength, principally of the stomach and Liver. Therefore in the beginning the stomach and first ways are to be opened and evacuated by Clysters and lenitive medicines, Lenitives. or else the matter inherent in the stomach is to be ejected by vomit. Opening a vein. But although the cause of this Fever be cold, yet because it is mixed with blood and putrefieth, some blood may be taken away by opening of a vein, in case that the urine be thick and red, and that the strength will bear it and the age, that nature may be eased of some part of her burden. Afterwards preparation & concoction of the matter is to be endeavoured with attenuating things which do not heat much; Preparing and altering. therefore in the beginning use Syrup of Sorrel simple, with honey of roses, Oxymel simple, Syrup of Hyssop, Bittony, with the water or decoction of Maidenhair, Asparagus, Grass, Fennel, Hyssop, and medicines prepared of those plants; also Spirit of Vitriol and Salt. When any signs of concoction have appeared you may exhibit some gentle Purger of phlegm, Purging. of Agarick, the leaves of Senna and such like: Hence you must come to stronger preparing and purging things, and so the matter which cannot be evacuated at once, is to be prepared, concocted, and evacuated at several times. And because a pure continued Quotidian seldom happens, but that either choler or melancholy is intermixed, we are to look to these humours also, and to add Cichory, Borage, Provoke urine and Sweat. Fumitory, Rhubarb, and the leaves of Senna. After the greatest part of the matter is evacuated, the remainder is to be emitted by urine and sweat using such medicines as occasion the same. But since that by reason of the duration of the disease the stomach and liver are especially offended, Strengthening Medicines. things that corroborate these parts are to be administered, troches of Wormwood, of Rhubarb, of Roses, with the powders of aromatici rosati and diaxyaloes. The Diet ought to be attenuating, Diet. cutting, and cleansing, the meats therefore ought to be of good juice, easy of concoction, and affording little excrement. Fish are not proper in this Fever, the flesh should be seasoned with Parsley, Fennel, Time, Hyssop, Savory, Rosemary, Cinnamon. In the beginning nourish somewhat more plentifully, that the sick may endure to the height of the disease, but when 'tis near the state abate aliment by degrees. Yet if crudities be in the stomach and first passages by sparing diet the three first days they may be abated and consumed, afterwards such a diet as we have mentioned may be observed. In the beginning the sick should abstain from wine, and in its stead use water and honey; yet if by custom it be required, give it small and mixed with water. Small beer is also convenient, when concoction appears, wine is more safely administered, whereby the concoction is assisted, the stomach strengthened, and the humours driven out by urine. Of the Fever Epiala. THe Fever called the Epiala is referred to continued putrid Fevers, The Fever Epiala. which itself is indeed continued and quotidian, yet differs from the other Quotidians in this, that the sick at the same time endure heat and cold, and the heat and cold together are dispersed through the smallest particles of the whole body, as Galen teacheth the inaeq. intemperie. cap. 8. and 2. the diff. Febr. c. 6. Galen in the place newly quoted, draws this Fever from acid and vitrious phlegm puttrefying; Cause. yet in his book of an unequal distemper, cap. 8. he addeth bitter choler, whence he infers that since heat and cold are perceived together in one place, it argues mixture of phlegm and choler; in another place he determines it to arise from vitreous phlegm, part whereof putrifying, exciteth heat, the other not putrifying causeth trembling and cold. Yet Platerus refers them to intermitting Fevers, and says that Epialaes are generated when intermitting Fevers happen together in one and the same day, and the cold of the one beginneth before the heat of the other be ended, or moreover when intermitting Fevers concur with continued, and the heat of the continued always remains, but the intermittent Fever coming, a trembling and cold fit is occasioned. The cure of this Fever differs not much from the cure of other Fevers arising from phlegm, The Cure. only that it requires stronger attenuating and cutting medicines, because there is greater frigidity and crudity in this then in the rest; also though the humour itself seem to require stronger Purgers, yet the weak cannot bear them, and therefore evacuation by degrees is to be appointed. Of the Syncopal Fever. MOreover to these Fevers belongs a Syncopal Fever, commonly called a humorous Fever, Syncopal Fever. in which there is more of pituitous and crude humours then in other Fevers that are phlegmatic; and moreover a debility of the orifice of the stomach is adjoined, whence the sick easily fall into a Syncope, especially when the Fever gins. This Fever is hard to be cured, since the sick by reason of their extreme weakness and danger of continual soundings, cannot endure necessary evacuations, The Prognostic. and especially if the pulse be weak, small and unequal, the Fever is exceeding dangerous. But evacuations are most properly occasioned by frictions, as Galen teacheth in his twelfth of the method of curing, cap. 3. Cure. Clysters and Lenitives also with medicines opening the first passages only and causing no commotion of the other humours. The first passages being opened and cleansed, we come to preparing and evacuating humours, as in other Fevers petuitous, and medicines to prevent the sounding fits are also to be administered. The meats should be not much, thin as to substance, easy of concoction, Diet. and generating as little phlegm as may be, and they are to be taken often. The drink should be wine which hath power to nourish, heat and attenuate, and doth not increase phlegm. Hydromel is also good wherein Hyssop hath been boiled. CHAP. XV. Of a continued Quartane. LAstly a continued Quartane is a Fever, A continued quartan. whose heat is indeed continued, yet the fourth day 'tis exasperated, it proceeds from melancholy mixed with blood putrifying in the vena cava. The cause is a melancholy humour putrefying in the vena cava, The cause. hence all things that can generate melancholy and crowd it into the vena cava, and putrefy, are the causes of this Fever. It is known by its continued heat, the Diagnosticks. raging the fourth day, without trembling fear or shaking fits going before, or sweats following afterwards, the pulse in the beginning is small and slow, afterwards great, full, and swifter than in an intermitting Fever, wherein 'tis most intended in the height. This is the rarest of all Fevers, prognostics. but dangerous and far more desperate than 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 add those things which may allay the heat of the putrifying humours, such as are in other cases convenient against choler. 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, Diuretics 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 Borage, Bugloss, Balm, flowers of Rosemary, Gillyflowers, Confection of Alkerms, and such like. Such Diet is to be appointed as in intermittent quartans, Diet. yet the diet should be thinner and cool more then in intermittent Fevers, since that the heat is greater and the height nearer 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 Symptom 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 feverish, 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 feverish, 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 inflammation of some internal part near the heart, or which hath consent with the heart, when from blood poured into the inflamed part and putrifying, vapours are communicated to the heart, and heat it; which in a Pleurisy, Peripneumony and Angina happens as we are commonly taught. But although it cannot be denied but that from the inflammation 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 burdened 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 public and Kingly seat as it were into lesser veins and smaller parts of the body, the blood with those vicious 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, wand'ring pains, the Gout of the joints, or running Gout, Catarrhs. For all these evils do arise when nature being oppressed with the weight of its burden 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 vicious 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 whilst the matter striving to go outwards, ceaseth on the Glandules under the Armpits, and about the groin; some of the humour that is stirred up, sticks there, and pain and swell are there perceived, till at length it manifests itself in the leg or some other external part which may be known by the heat, pain, and rosy 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 show putrefaction, which hath the same tokens of crudity and concoction as in other putrid Fevers, and nature sometimes critically, sometimes Symptomatically, expels 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 inflammation, 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 inflammation of any internal part, but principally of the stomach, and from blood and Spirits meeting in the part inflamed. The second kind of Symptomatical Fevers which is called Lenta, proceeds not from any inflammation 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 near 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, vapours cannot be transmitted to the heart, and so a Febris Lenta is stirred up, which therefore is unequal and keeps no certain order. This Fever is the gentlest of all, and molesteth not the sick with any grievous Symptom, so that the sick oftentimes thinks himself well. In the mean while the strength decays, that the sick can scarce go forward, and the body is no ways refreshed by aliment, but wasteth by degrees, whence sometimes this Fever is accounted with an Hectic, and therefore when there is any suspicion of this Fever, in the first place we must diligently search the Hypocondries and Hypogastries, to try whether any tumour be to be discerned in any of them; some signs of putrefaction also will appear in the urine, and discover themselves in the Pulse. This Fever is more durable, and goes beyond the terms of other Fevers, and often endeth not in forty days, nor is it gone until the humour fastened to the interal be consumed. The third sort of Symptomatical Fevers is, Fevers from putrefaction of interals. that which ariseth from the putrefaction of any interal, from whence putrid vapours through the veins inserted might be sent to the heart, heat that, and might stir up a continued Fever, whereby the body by degrees might be extenuated and whither. And this Fever is sometimes more violent, sometimes more mild, according as the putrefaction is more or less. This often happens in putrefaction of the lungs in such as are Phthisical; so 'tis found that the Caul or Kell, Mesentery, Womb, and other parts are corrupted, and thence a Fever kindled. In like manner from Fistulaes' penetrating into the internal parts a Febris lenta being stirred up, it is observed, that some do consume and waste. The fourth kind of Symptomatical Fevers is when either from corrupt milk, From corrupt milk. Putrified blood, Worms. which often happens in Infants, or from blood putrifying somewhere without the vessels, or from worms, putrid vapours are communicated to the heart, that is heated, and a Fever irritated. To these may be referred that Fever which ariseth from crudity, which is familiar amongst little children from their eating of sweet things, which hath with it a tumour and inflammation of the Hypocondries, which the Germans call Das Herngespam, from the abundance of crude humours collected in the stomach and neighbouring parts, which begin to putrefy and are turned into wind. Diagnostic signs: Symptomatical Fevers properly so called, are known by this, that they come after diseases of private parts, and the first sort of these Fevers is known from hence, because it follows an inflammation of some certain part: as on the contrary, Fevers called Comitatae, first appear and invade with rigour and trembling, to which afterwards a Fever happens. But those Lentae or slow Fevers are known by their slow heat, wherewith notes of putrefaction in the urine and pulse appear, the sick are weak scarce able to go, the body wasteth by little and little, and the Fever is lengthened for the most part beyond forty days; they are tormented by the use of purging. But when the cause of these Fevers is hidden, 'tis very hardly to be distinguished, and therefore the Hypocondries and other internal parts are to be observed with great diligence, and we are to inquire whether any tumour or pain be to be found there. But those which arise from the putrefaction of any part are more easily known, nor indeed can the corruption of the part be hidden, unless it be ignoble. So that Fever which proceeds from corrupt milk or blood is easily known by its signs; as also that which ariseth from crudity is manifest from their loathing things blowing up and swelling of the Hypocondries. Although these Fevers in respect of themselves for the most part are not dangerous because they are mild, The Prognostic. yet in regard of their causes on which they depend, we ought to doubt whether they are dangerous or not, as also whether they are long or short; for those which follow an inflammation of any part are short; since that the inflammation itself cannot be long, but the danger of them depends on the inflammation. The Febres Lentae are for the most part long, and often continue more than forty days. And although not by their violence yet by their duration they debilitate the strength; they are cured also with difficulty, because their cause pertinaciously inheres in some interal. Those Fevers are very dangerous and seldom curable which come from the corruption and putrefaction of any part; because the part can seldom be cured. But those Fevers which proceed from corrupted mill: and blood, worms or crudity, are often acute and dangerous, and bring with them grievous Symptoms, as Epilepsies, Convulsions; yet they last not long, neither are they hard to be cured, but the cause being taken away they cease. The way of cure ought to be aimed at by striking at the cause whereon it depends. The Cure. If therefore a Symptomatical Fever depend on an inflammation of any part, the cure is to be directed to the inflammation itself, which being cured, the Fever ceaseth. And therefore most remedies which are convenient to assuage inflammations are here useful. Yet in regard of the part affected, the way of cure sometimes differs, the part affected is diligently to be weighed: Whereof it shall be spoken in the cure of particular affects. The Febres Lentae since they proceed from extraordinary obstructions of the bowels, require opening, attenuating, and deterging medicines. And such are to be chosen as are appropriated to each part, and such as strengthen the tone of the interals, which for the most part is debilitated, yet by intervals gentle purgation may be used. Neither are Diuretics to be omitted in their season. Externally also if the part affected will bear it, Emollients and Discutients are to be applied. If the Symptomatical Fever proceed from the corruption and putrefaction of any part, that cure is to be instituted which agreeth to Ulcers and Fistulaes' of the internal parts. If it be occasioned by corrupt milk or blood, Worms, or crude and corrupt meats we are to endeavour that those causes be taken away conveniently, either by vomit or cleansing and evacuating medicines, and together to resist putrefaction and feverish heat. In the cure of accompanied Fevers, we are to look no less to the Fever than that conjunct disease or companion, and the metion of nature is not to be impeded, The cure of accompanied Fevers. lest the peccant humour retained in the body should cause more danger; and therefore although it be not profitable to hinder an inflammation when 'tis beginning: Yet the humour that is the cause or that evil is also to be evacuated, which is most conveniently done for the most part by breathing of a vein, which together affords evacuation and revulsion. Yet it shall be profitable also to empty the firft passages, since that oftentimes the matter is gathered together in them; and since the matter for the most part is thin, and often makes toward the extremties of the body, and is often full of malignity, 'tis conveniently expelled by sweat. CHAP. XVII. Of intermitting Fevers in general. AFter continued Fevers, intermitting are to be explained. Intermitting Fevers. But although the Ancients did extend the name of intermitting Fevers more largely, and attributed the same to all Fevers which admit of some change of heat, and are sometimes exasperated, sometimes remitted, and so to continued periodicks: yet afterwards use brought it to pass that those Fevers only were called intermittent, which sometimes cease and come to that apurexy or want of fire. The proximate cause of an intermitting Fever is a putrid vapour, their proximate cause. elevated from the putrefaction of excrementitious humours, not continually as in continued Fevers, but by certain intervals sent to the heart, and heating the same contrary to nature. But how it comes to pass, The fire place of Intermitting Fevers. that the putrid vapour is not continually sent to the heart but at certain times is very obscure. For the explanation whereof since the knowledge of the place wherein putrefaction ariseth, doth not a little conduce, and whence the putrid vapours are communicated to the heart, which Galen calls the Furnace and Chimney in his 2. of the differences of Fevers, cap. the last, and in his 15. of the method of curing. cap. the fourth, that therefore is first to be explained. But since 'tis beyond the bounds of our Breviary of Institutions to reckon up the various and different opinions of Physicians concerning it, we will here set down that opinion which we think truest. The Chimney or Furnace and place wherein the matter the cause of intermitting Fevers is generated, are the Mesaraick veins, wherein the matter which sufficeth to irritate each single Paroxysm, is generated during the time of its interval. And that many things which happen about intermitting Fevers do prove; namely Loathing, Vomiting, Dolour of the heart, Extension and pain of the Midriff, Intumescence about the Ventricle, Bitterness about the mouth, Belching, and such like; for in the beginning of intermitting Fevers pure choler is often ejected by vomit in great abundance, which out of the more remote veins could not be evacuated in that manner, and about the cava of the Liver. Fernelius says he hath found the quantity of a pound by weight after the death of a Patient. This choler being cast out the Fever is often cured, which is a sign that it is the cause of the Fever, and that it is collected in those first ways or passages. Which Fomentations also used to the Hypocondries at the beginning of a Paroxysm shows by the mitigation of the trembling and shaking. This matter is gathered together in the Mesaraick veins a long time before it brings forth a Fever, but when it gins to putrefy, grow hot, and be changed, its heat being diffused over the whole body it exciteth a Fever; which when it is dispersed, the feverish heat and Paroxysm ceaseth, and the Fever leaveth so long as till new matter which in like manner putrefieth in its due time, is generated. But although the matter which is the cause of intermitting Fevers be generated in the Mesaraick veins and first passages: the cause of intermitting Fevers contained in the v●na cava. Yet the whole doth not reside and continue included in them, but is sent to the vena cava and arteries, both during the fit and out of the same. Nor is it here necessary to seek for occult and blind passages, through which the putrid vapours should be sent to the heart during the Paroxysm, since there are manifest passages enough; for the branches of the Gate-vein are inserted into the substance of the Liver, and the mouths of these have communion with the vena cava, and the arteries going from the heart are joined in the stomach, guts, spleen and other parts to the Mesaraick veins. Yet 'tis probable that the feverish matter may be communicated to the veins not principally and only in the Paroxysm, but moreover some part thereof by that passage which is from the Meseraick veins to the Liver continually may be carried to them; whence both by Galen. 1. de cris. cap. 7. and other Physicians a Fever is called a passion of a venomous nature. And that is first manifest from the urines, which show evident notes of crudity and concoction in Intermittents. Hence also it comes to pass that urines during the Paroxisms are laudable and like to theirs who are well, since that the peccant humour is then protruded by nature out of the veins towards the circumference of the body, and so the blood in the veins is become purer, which again in the intervals of fits is polluted by the vicious humour proceeding from the chimney of the Fever. The same is manifest out of those things which happen at the beginning of a fit, and at that time which the Greeks call Episemasian; for then spontaneous lassitudes, stretching, compression of pulses, and other things happen which indicate that the matter which is to stir the Fever gins to be moved and as it were to swell in those common vessels, veins and arteries. That vicious humour accumulated partly in the Mesaraick veins, partly in the vena cava when in time it putrefieth, nature stimulated and irritated oftentimes strives several ways, first by vomit and stool, afterwards by sweats and urine sensibly to evacuate the same, as also through the pores of the skin, and by insensible transpiration it may discuss the same being resolved into vapours and steam. For since that peccant humour is not exactly mingled with the blood but confusedly, nature may easily separate the same from the good blood, and may shake it off each single fit; which being discussed, since putrid vapours cannot any more be communicated to the heart, the Fever also ceaseth and apurexie ensueth. But because that as long as the Fever continueth some seeds and sparks are left in the granary and chimney, Causes of the return of fits. and seeing that there is imbecility in the part, 'tis necessary that the humour flowing to it, although it be good, should be defiled with that pollution and excrement which was left as it were with leaven, and through the debility of the part be corrupted, and so new matter of a future Paroxysm be generated. And these fits continue, and so often return, until that those seeds, that putrefaction, and those sparks are fully taken away from thence, and the weakness of that part restored. Yet it seems probable that the whole matter which is the cause of a Fever doth not putrify together in the first Paroxysm, but that part which is apt to putrefaction, in the other fits the rest, until the whole be putrified and consumed. By these things it is manifest both where the matter that is the cause of putrid Fevers is generated, 'Cause of 〈◊〉. how it causeth a fit, by what ways it is evacuated, and how the matter which is the cause of a new Paroxysm is generated, and so the cause of Paroxisms and the recourse of intermitting Fevers is explained. But what the reason is why these Fevers return at set times, some sooner, some later, is now another question, and that most intricate, which is easier to ask then answer? But that we may here forbear to recite the opinions of others, which are very many, we will mention only that which seems most probable to us, so far as in this humane dimness of our understanding in so obscure a business we are able to discover. And first, that Fevers keep such certain periods, experience doth manifest; whereby it appeareth, that some Fevers return the third, some the fourth day, and that oftentimes it observes not only the same hour, but minute of invasion although the fits may sometimes anticipate, sometimes retard for certain reasons. But the cause why paroxisms return at certain times, we conceive is to be sought from the diversity of humours: For those effects, as Valleriola saith, in any one sort of things, which perpetually agree to the things, and are made in the like manner, into what body, and at what time soever they happen to come, these are to be referred to the proper substance of that of the which they are made; but to make return through certain days, and to irritate accessions, both agrees perpetually to humours and the recourses in this manner, always at equal intervals (unless a perverting of the order of periods happen from elsewhere) are made: Therefore it shall be from such or such a nature of humours that the recourse shall be made in the same sort; namely, the causes of periods and intermitting Fevers, are excrementitious humours. Choler, Melancholy; Phlegm; and those Fevers which return the third day, proceed from a Choleric humour; those on the fourth from Melancholy; those that come every day, so that they are not double Tertians, proceed from Phlegm. Yet the cause of periods cannot be drawn simply from humours, but as they acquire a peculiar quality from putrefaction or corruption, by reason whereof at a certain time, they wax hot and begin to be moved. For since this effect is definite and determinate, which carries itself alike in all individuals, 'tis necessary that it have a certain definite and determinate cause in all individuals that are alike; which since that neither disposition of parts, nor quantity of humours (for we see that although the store of matter decreaseth, and the fits are become shorter, nevertheless they do return at their usual time) nor manifest quality of humour, thickness, viscidity, tenuity, or some such like, which useth to vary, can be a quality; we must needs fly to a peculiar and proper quality and nature of a humour; which also when it is changed, the form of the Fever itself is changed; for when Choler is turned into Melancholy, the Fever which used to come the third day, cometh on the fourth; and this quality also may afterwards remain in the humour, when the putrefaction ceaseth, and the Fever depending thereon. Whence, as Fornelius in his to of Fevers witnesseth, the torments of the Colic, Pains of the Joints, and such like diseases arising after long continued Tertians and Quartans, do likewise keep certain periods, by reason of that disposition which they have received from the corruption or putrefaction of the humours. Yet if any one be willing to determine that the said occult propriety is derived, Order of the fits not from corruption only, but that celestial causes do also concur to its generation, I will not much contend with him; for we see that principally about the Solstices and Aequinoctials, such Fevers, especially the most durable of them, do begin and end. But although Fevers keep certain periods, yet there is a certain difference in them also; for sometimes the fit returns just at the expected time: sometimes the following paroxysm returns sooner than the former; which form is called proleptick: sometimes the following fit comes later than the former, and that form is called Hysterick; and indeed sometimes through the whole course of the disease, such a form is observed, and oftentimes from the beginning of a Fever, until the end of the same the paroxysms anticipate, or come after the expected time: but sometimes in some there is anticipation, in some post pofition, otherwise the fits comes at the same time. For the most part they say, The cause of anticipation and coming late. that anticipation happens when the humours by some error in diet are augmented, or are moved by medicines, anger, exercise, and such like causes. But the fits return flower, when the matter is diminished, or thickened: Which indeed when the accustomary paroxysm is changed, that it may be so, as we do not deny; so when the Fever keeps always some certain form, either proleptick or hysterick, the cause rather seems to be taken from the diversity of the humour; for although Choler, according to its manner, being corrupted, is the cause of a Tertian, Melancholy of a Quartan; yet Choler and Melancholy, according to the diversity of Bodies and Temperaments, do oftentimes vary something; Hence also it happens, that although that putrid leaven, or occult quality introduced by choler, be the cause of the circuit of a Tertian, Melancholy being brought in of a Quartan: yet according to the difference of a humour, it may happen so, that the effervescence, or fervency of humours, may come sooner or later by some hours. Concerning the longitude or brevity of some Paroxisms that depends on the paucity or plenty of matter, The cause of the length of Fits. disposition of the humours and body: For a plentiful quantity of humours is the cause of a longer fit than a small; so a thick humour causeth a longer than a thin, since it cannot be so soon discussed as a thin. If the strength of the body be great, which can more easily discuss what is offensive, then theirs who are weak; the shorter fit followeth: Also a thinner constitution of body, as being more apt for the discussing of the matter, is the cause of a shorter fit; a thicker, of a longer. And when all the causes which occasion a short paroxysm concur, a very short fit is raised: But when all those that produce a long are present, the paroxysm is extreme long. When certain causes are present which make a short fit, and some are wanting of them, an indifferent betwixt both happens. And so much of the nature, place, and motion of the proximate cause, which exciteth intermittent Fevers; The more remote causes of intermitting Fevers. But the more remote causes, and those things which conduce to the generation and corruption of that matter in the Meseraick veins, are meat and drink of evil juice, but yielding matter for peccant humours answering to their own nature; and an ill disposition of stomach, whereof meats turn into choler, or become sour, an intemperate constitution of Air; for although divers humours are generated 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, Phlegm, 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 mixed 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 daily 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, Choleric and Melancholy. For although Phlegm also, according to preeminency, and most principally, be called a crude humour; yet since it is exceeding cold, it can scarcely putrify 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 Physicians, 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 divers 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 paroxysm; 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 than itself: for those humours, both Choleric and Melancholy, are not always of the same sort; and moreover, the corruption also which they suffer, is not always the same; so that it is no wonder that the effect also varies, which proceeding from them is not always the same: And as in epidemical diseases, sometimes 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; Diagnostic 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. the diff. Febr. cap. 3. teacheth, they return with shaking, horror, or cold, For although that sometimes 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 than continued; Prognostics. and seldom, unless the strength be decayed, or in regard of age, or some other cause, or some error committed in diet, are mortal, since 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. the Febr. cap. the last is a twofold vicious disposition in a body, the one a certain pollution or putrefaction left after the former paroxysm; 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 since 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 vicious 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 vicious and excrementious humour, the cause of a Fever, in the mesenterics is mixed with blood, crudity also, and concoction, according to their manner are necessary; whereby the vicious humours may be separated from the good, and rendered fit for evacuation: and that often happens in a short time in Fevers full of Choler, and the choleric 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 vicious 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 than the Fever itself. As for breathing of a vein, Letting blood. 'tis not indicated from the primary cause of intermitting Fevers, which is generated in the meseraick veins, where the greatest part abideth: Yet because that sometimes blood also abounds, which may easily be corrupted and polluted by the vicious humours, and so if it be too plentiful, cannot be well governed by nature when it is weakened 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 sometimes 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 these evacuations, we are to endeavour that the causes of the returns of fits may be taken away, and moreover two things remain to be done; namely, that that disposition and weakness of the part generating vicious humours, may be taken away, which is performed by altering medicines, which together correct the fault of the humour, and discuss that pollution, and those seeds which were left out of the putrefaction of humours: and indeed that paroxisms depend on that pollution, and that when it is taken away the Fever ceaseth, appeareth from hence, That whilst that is driven by nature to the circumference of the body, out of the veins, and that Pustules are raised about the lips, nose, and other parts of the face, the Fever ceaseth Wann der Mundt oder die Nase auss schiaget. But 'tis principally taken away by Sudorifiques; yet there are also certain other medicines known both to Physicians and to the vulgar, Febrifuga. which take away feverish fits, and therefore are called Febrilia, Puretagoga, and such as specifically cause, and are called The flight of a Fever, or Febrifuga, which nevertheless cause no sweat, but without doubt some other way take away that seed, and by consequence the paroxysm, such as commonly are accounted the powder of shells of Cockles or Snails or of the Pearl bearing shells, or mother of pearl calcined, of River Crabs, and principally their eyes, which are so called prepared, and such like: But how they perform this, is not explained by Authors. That I may speak my own opinion, such like medicines seem by a certain precipitation to take away that force of heating and stirring up a paroxysm which is in the humours, to which Opiates seem to belong: yet such like cannot be given safely, unless the vicious humours, and those things which may afford the reason of the antecedent 'cause be first taken away; for otherwise those things which may be expelled by nature when it is irritated in a paroxysm, are left in the body, and afterwards may become the cause of a Chachexie, Dropsy, Jaundice, Colic pains, and of other grievous evils. Externally also are applied certain medicines to cure intermitting Fevers, of Cobwebs, oil of Spiders, and certain vesicatories, Topical Medicines. which without doubt, that which they do, is performed by drawing out, and evacuating of that Feverish corruption and pollution. CHAP. XVIII. Of Intermitting Fevers in particular, and first of an Intermitting Tertian. AFter we have handled intermitting Fevers in general, An intermitting Tertian. we will now go through them in particular; amongst them the most frequent is a Tertian intermitting, which ariseth from Choler putrifying in the meseraick veins. But there is a certain difference of these Fevers; for first, It's difference. Choler itself out of which these Fevers are generated, is not of the same kind; for sometimes the choler is like to that natural choler which afterwards is collected in the Galls bladder; sometimes it is preternatural green and aeruginous, such as sometimes by those that are Feverish, is evacuated by vomit or stool. Moreover, Choler either putrifies alone, or else hath some other humour mixed with it; Phlegm or Melancholy that causeth a pure, this a bastard Tertian. They differ also in respect of duration; for if the fits are not extended beyond twelve hours, they are wont to be called pure tertians; but in case the Fit be extended above twelve hours, they are no more called exquisite and pure tertians, but either simply tertians, or spurious tertians; and when the paroxysm is extended above twenty four hours, they are called extense tertians; but this is occasioned either by the thinness or thickness, plenty or paucity of the humour. For by how much the Choler is thinner or lesser, by so much the sooner 'tis discussed, but by how much the thicker, or more mixed with thick humours, or the more plentiful, by so much the longer the paroxysm continueth. The causes of this Fever are all those things which can generate excrementitious choler, namely a hot and dry distemper; The causes generating, Choler signs of a true Tertian. hot constitution of air, eating of hot meats, and drinking of hot drinks, using of hot medicines, watching, fasting, labour, and too much exercise: For although that in the Liver also yellow choler may be generated, yet it is very often generated by the error of the first concoction, and fault of the meseraick vein; therefore whether much choler be generated in the stomach by reason of meats, or by default of the stomach, and is carried to the meseraick veins with the chyle, and there is heaped up, and at length putrefieth, a Fever is kindled. If the causes generating Phlegm and Melancholy be annexed to those that generate choler, spurious tertians are bred. This Fever presently invadeth, A pure Tertian. if it be pure, with a shaking fit, as it were pricking the flesh; afterwards when the cold fit ceaseth, presently much heat followeth, sharp and biting, and in its vigour is extended equally over the body, whence the sick draw their breath much, and are troubled with thirst. The pulses in the beginning of a fit are little, weak, slow, and thin; but the fit increasing, they become vehement, swift, frequent, and in some measure hard, and void of all inequalities besides Feverish. When the fit comes to the height, and the sick drinks, many vapours are sent through the skin, vomiting of choler followeth, which oftentimes useth to happen after the cold fit also, the belly is loosened, choler is pissed out, or sometimes more than these happen. Afterwards a sweeting out of hot vapours ensueth over the whole body, and the pulse is swift, great, vehement, such as theirs use to be who are overheated by exercise. The Urine is of a light red, or deep yellow, and afterwards hath a white cloud or suspension. The fit lasteth not above twelve hours, and the causes which generate melancholy, have either gone before, or are then present. A bastard tertian is known from the causes which do not generate pure choler, A spurious Tertian. but to gather Phlegm or Melancholy: The heat is not so sharp as in a pure tertian, but more mild, neither is it presently diffused over the whole body. Neither is this Fever dissolved by vomiting of yellow choler, or by sweat, but certain vapours go out in the declination, and if any sweats come forth, they either are not universal, or if they are universal, they cure not the Fever. The Urine is not so fiery as in a pure tertian, and the signs of concoction do not appear so soon in it. The pulse in the beginning is hard, and that hardness increaseth daily, until the seventh paroxysm, then by degrees it becomes softer, and the Urines also appear more concocted. The paroxysm is often extended to eighteen hours and more: yet sometimes, to wit if the matter be less, and Nature strong, it is likewise terminated in twelve hours. It endeth not in seven fits, but often endureth till it comes to fourteen, and sometimes to twenty. But these Fevers are least dangerous amongst all the putrid ones 4. Prognostics. Aphor. 43. and such as are pure, do not long continue, but at seven fits they are accounted at the height, 4. Aphor. 59 Sometimes 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 sometimes cease at the fifth or seventh paroxysm, yet for the most part they scarce end at fourteen fits, and are often lengthened out to the fortieth day; sometimes they continue six months, and end with some disease of the Liver or Spleen, or else are also cherished by them. Although Tertians for the most part are not dangerous, yet sometimes they become pernicious. First, If any error be committed by the sick, or the Physician. Secondly, If the humour which Nature endeavours to expel, should fall upon any principal part. Thirdly, If the humour be exceeding thin, putrid, or filthy. Fourthly, If a thin humour have a thick one mixed with it, and stir the same, and inflame 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 indicateth cooling and moistening 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 vicious 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 putrefaction 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 herself at the beginning of the paroxysm 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 sometimes 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 paroxysm, 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 choleric humour exceeding, Preparatives. whereby it is troublesome to nature, and also the vicious disposition in the part generating excrementitious humours, and such as are contrary to that pollution which remains after putrefaction; such are cooling and moistening things, which together have a power of purging the first ways, and of resisting putrefaction; 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 add those things which are proper for Phlegm and Melancholy, the roots of Fennel, grass, asparogus, asarabecca, polypodie, carduus benedictus, century 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 oppugn Tertians; Specificks amongst which notwithstanding for the most part manifest causes may be rendered for it: such are Sowthistle, Camomile, Century the lesser, Plantain, Devil's bit. Altering medicines being given, Purgers. if the Fever be more pertinacious, sometimes purging and vomiting are convenient, which for the most part are to be administered on the intermitting day; but if it be advertised that the matter during the paroxysm doth incline towards the stomach, 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 paroxysm 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 Diuretics: In a pure Tertian an Emulsion of the four great cold seeds is profitable, made with the whey of Goat's milk, or the water of Barley, Strawberries, Cichory. In a spurious, a decoction of the roots of Grass, Sparagus, Fennel, Maidenhair, red Parsnips, Bindweed, flowers of Camomile and Wormwood are convenient. But principally the Physician ought to imitate nature, Sweats. which at the end of the paroxysm useth to move sweats, and should discuss the Relics of the vicious humours by fudoriferous medicines given either before or after the paroxysm; and indeed in pure Tertians, wherein nature usually causes sweat in the end of the fit, it often sufficeth that the sick drink only Barley water, or the water of Sorrel, or Carduus benedictus may be given with the Syrup of the juice of Citron or Limmon. In spurious, hotter medicines are to be used, such as hereafter shall be mentioned amongst malignant Fevers, which being given some hours before the paroxysm, often prevents or cures the same. If the Fever be not cured with these remedies, Coroloratives. and that there be any sign of viscous matter, and that the Liver and Spleen are likewise affected, regard thereunto must also be had; and since the Liver for the most part in bastard Tertians is obstructed by thick choler, or choler mixed with thick humours, which pollutes the blood, those things which cleanse the body from choler are to be used; to which purpose Wormwood is very good to be used, which hath a force of deterging choler, and bringing away the same by stool and urine, as also hath century the lesser, Troches also of Wormwood, of Rhubarb, Gentian and such like are also profitable; care also must be taken of the Spleen and Stomach, if they are debilitated. There are certain other medicines given sometimes, Febrifuga. which are called Febrifuga, of which 'tis spoken in the foregoing chapter. And besides these, Topical Medicines. there are yet others, which are externally applied to the body to cure Fevers; namely, a plaster of cobwebs, with unguento populio, the leaves of Shepherd's pouch, nettles, crowfoot, and other vesiccatories. Concerning Diet, Diet. in a pure intermitting Tertian, the same diet useth to be kept for the most part as in a continued Tertian, they are to abstain from honey, sweet things, and all those things which engender choler, wine is not to be drunk before concoction: but when the notes of concoction have appeared, you may use it, so it be thin and watery; meat is to be given when the paroxysm is past, unless Syncope imminent persuade the contrary, Galen 10. Meth. Med. c. 5. In bastard Tertians too things are principally to be observed concerning diet; first, that the disease by too plentiful a diet may not be increased. Secondly, that the strength by too slender a diet may not be debilitated, which should hold out most in a long disease; and therefore the magnitude of the disease, and the greatness of the strength are to be compared one with another; and in case the strength be greater, and the matter harder to be concocted, the thinner diet is to be used, but the larger diet, if the strength be weak, and the matter easier to be concocted. The drink should not only cool and moisten, but also cut, and therefore it may be mixed with Hyssop and wild Marjerom, and if water sweetened with honey be exhibited, Vinegar being thereunto added, that Choler may be thereby corrected. CHAP. XIX. Of a Quotidian Intermittent. THe second sort of intermitting Fevers is that which proceeds from Phlegm, A Quotidian Fever which because it takes them every day, is called a quotidian. Fernelius writes that this is the rarest of all Fevers, and that which scarce happens once amongst six hundred: Nay there are some who plainly deny it: and although many are affected every day, yet they are sick of a double Tertian, or triple Quartan. The cause of this Fever since it is Phlegm putrifying in the meseraick veins, all those things may be causes of this Fever, The cause which conduce to the generation of Phlegm, namely, weakness of the bowels, especially of the stomach, heat, cold and moist aliment, and too great plenty of them. This Fever is known by the causes generating Phlegm which went before, Diagnostic signs. and also by the signs of Phlegm abounding in the body, explained in lib. 3. of Institutions part. 2. cap. 2, This Fever chief comes to invade in the night, only with coldness of the extreme parts, and trembling: The heat after refrigeration slowly invades, so that sometimes heat, sometimes cold is perceived; and the heat at the first doth not seem sharp, but habituous; yet if the hand put thereunto continue some time, it appears a little sharp, and when it is diffused over the whole body, it doth not burn much, so that the sick do not breathe extraordinarily, neither are they very thirsty: The face is not very red, but for the most part yellowish, or a little puffed up; the eyes in the beginning are white, thin, and crude; afterwards when the matter is concocted, they become thick, troubled, and oftentimes also red. In the first paroxisms also they sweat not, but in the progress of the disease they sweat a little; the Pulse also is exceeding little, thin, and more than in Quartans, but equally slow; the paroxysm is extended to eighteen hours, and the interval, which is six hours, is seldom pure and free; nay 'tis often extended to four and twenty hours. But how long this Fever shall continue, Prognostics. may be conjectured by the signs of concoction appearing sooner or later in the Urine, and by the longitude and brevity of the paroxysm; for if nature timely aim at some evacuation, it affords hopes of shortness of the disease: But this Fever as being that which ariseth from a pertinacious humour is long, and continueth unto forty days three months or more, and is not without danger; and when the Stomach and Liver are much affected with it, the sick are often cast into a Dropsy and Cachexy. The cure for the most part is the same with a Quotidian continued; The Cure for the pituitous humour is to be prepared and evacuated, to wit, the first passages are to be opened with Clysters accommodated to the pituitous humour; breathing a vein is scarce used, but a Vomit is more useful then in any other sort of Fever, because the stomach is principally affected, but 'tis to be occasioned by seed of Radish, Orach, of Dill, flowers of Broom, in those that are strong, with Spurge, and others that are every where known. The Phlegmatic humour is to be prepared with convenient medicines; Preparers. the opening roots, Hyssop, wild Marjoram, Betony, Maiden hair, Agrimony, Groundpine, Camomile, and other things convenient for Phlegm, Syrup of Sorrel simple and compound, Syrup of the two and of the five Roots, Honey of Roses, Syrup Byzant, simple and compound, of Hyssop, Oxymel simple and compound with Squills, spirit of Salt and Vitriol. The matter in the first place being prepared, Purgers. it should be evacuated with Agarick, Mechoachan, Turbith, Troches of Alhandal, Elect. Indo Diaphaenico, Diacarthamo, pills of Hieca, with Agarick, 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 Stomach and Liver are to be strengthened. 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 sometimes natural by its own nature cold and dry, and sometimes 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 horror, in the progress of the disease the cold paroxysm is always 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 somewhat mild. The pulse is thin and slow, and although in the vigour of the paroxysm 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, watch, and other symptoms are more grievous. This Fever continueth the longest of all other, Prognostics. and oftentimes is not only extended to some months, 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. 'Tis safe and without danger, if it be legitimate, and without any disease of any of the bowels: But that which is joined with black choler is more dangerous, as also that which is with some grievous distemper of some of the entrails, and casteth the sick into a dropsy, the scurvy, or a consumption. As concerning the cure, Indications if this Fever proceed from a pure melancholy humour, that since 'tis cold, dry, thick, 'tis to be moistened 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 itself indicateth cooling and moistening; yet regard of the strength must be had, least by the duration of the disease that be impaired, as also of the stomach, spleen, and liver, lest they are offended. This Fever is to be handled gentl● at the first, Cure neither are strong medicines to be used at the beginning of cure, since the melancholy humour may be exasperated by the use of them, and out of a simple Quartan, a double or triple 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 clysters, 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, 'tis 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 vicious humours is to be corrected: And indeed, in case a Quartan Fever proceed only from natural melancholy, moistening 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 administered, Borage, Bugloss, Violets, Maidenhair, Cichory, Fumitory, Ceterach, Hearts-tongue, Germander, Ground-pine, Carduus Benedictus, the Roots of Marsh-mallows, Liquorice, 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 sometimes 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, Armoniac, beginning with the more mild 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 paroxysm, Treacle; the gentler Vomits are of the decoction of Dill and Radish with Oxymel; the stronger are Asarabecca, and Gratiola, or Hedge-hysop; The strongest were made by the Ancients of black Hellebore; at this day such medicines are made of Antimony. If the Hemorrhodes can be opened, Hemorrhodes. there will be much good expected thereby; seeing that the flowing of these, preserves and frees a man from many diseases arising from adust and melancholy humours. The opening and preparing things before mentioned, may also cause Urine. Moreover, Sudorificks. for the discussing the relics of the matter after purging, and that the matter is concocted, sudorifiques are to be exhibited an hour or two before the paroxysm. Galen hath two medicines in use for this purpose; the one ex succo Cyraniaco, and Treacle, which is also in use at this day. 'Tis profitable to use the use of Gentian, Carduus benedictus, Antidote Saxonica so called, and such like. To these belong those medicines also which may help by a certain propriety, or hidden quality, Appropriated medicines. whereof notwithstanding a reason may be given for the most part; to wit, such as may discuss and consume the relics of the humour, and strengthen the bowels: such are the juice of Wormwood, Vervain, Roots of Masterwort, Plantain. Others also commend other medicines, which for the most part provoke sweat likewise, and may safely be exhibited in due season. But Opiates, and such like, Hindering the fits. which only have power to check the fit, are not always safely to be administered, because they only stupefy the expulsive faculty, and dull it, and prohibit the endeavours of nature, and hinder the motion of the matter, and the humours offending being detained in the body, may cause other evils. Fruthermore above the wrists, and where the pulses beat, may be applied those things which we have mentioned before amongst the Tertians. In the mean time we should always be careful of the interall, and endeavour that they may be strengthened, and that the spleen may not be obstructed, swell, or become scirrous and hardened, which often useth to come to pass. Amongst other symptoms, Mitigatiof cold fits. for the most part cold shaking fits are most troublesome of the patiented, which may be mitigated by the giving of Treacle or Mithridate before the paroxysm, and anointing of the spin of the back with oil of Camomile, Dill, Costus, Rue, Pepper, Bayes, with Treacle and Mithridate. Also there should be applied to those parts that principally cherish the Fever, Topical things. and which are especially troubled with pain during the time of the fit, plasters, somentations, and unguents, especially to the spleen, and those to be made of Marsh mallows, Tamarisk, Broom, Dill, Camomile, Armoniac, Bdellium. As concerning diet, it should be meat of good concoction, and easy digestion, and no ways apt to generate melancholy humours, but rather such as may hinder the increase of them. The meat therefore should be moistening and heating in melancholy, and if an adust humour be mixed therewith, it should be somewhat cooling, yet so, that it may not be destitute or power and and force to attenuate that which is thick; the meats also mixed with Borage, Bugloss, Fennel, Parsly, Capers, Cinnamon, Saffron, and such like. Meats affording thick and viscous juices must wholly be refrained. If a Quartan arise of itself without any preceding disease, at first a little thinner diet is proper, than diet somewhat thicker is to be used, and at last towards the height, a little thinner is to be again administered: But if a Quartan succeed another disease, at first diet a little thicker is to be taken, and afterwards by degrees towards the height, somewhat to be detracted from that: And in case the sick will endure it, let him fast that day his fit cometh, or at least six hours before the paroxysm, let him eat nothing, according to Hypocrat. 1. Aphor. 11. and 19 For meats then given, afford not any nourishment to the body, but to the disease: And many Quartans, as also Tertians are prolonged, not by their own nature, but by errors in diet, especially because the sick either in the fit, or newly before it comes, do not abstain from meat and drink. Their drink should be white wine, thin, mature, and not austere, or Beer that hath worked well, and is not flatulent; and the wine and beer may be mixed with herbs good against the melancholy humour . Fevers which have longer periods, Quintan Fevers. and return on the fifth or seventh day, or afterwards, since they all proceed from a melancholy humour, or melancholy declining into a black and adust humour, or have a black humour mixed, as is manifest from the ●●●ation, and other symptoms, there is also the same reason of curing them as of Quartans: yet what the nature of the humour is, ought diligently to be observed. CHAP. XXI. Of Compound Fevers, and Semitertians. BEsides these simple Fevers hitherto mentioned, Fevers compounded. there are yet Compound Fevers, which is, when one Fever is complicate with another. They are divided into confused and explicit. They are commonly called confused, Confused when two Fevers begin and end at the same time, so that they can scarcely be discerned; namely, when several humours confused amongst themselves, putrify in the same place, and each or every of them preserves its own proper nature; which nevertheless how it might be done, scarce seems possible: Implicit But implicit are those that are so joined together, as that the nature and symptoms of either of them severally and peculiarly may be known. That complication happens many ways; for first, a non-putred is joined with a putrid, as a hectic with a putrid; moreover a putrid with a putrid, and that several ways; for first, continued are mixed with continued, and intermittent with intermittent; and that either of the same sort, whence there are double Tertians, double and triple Quartans; or different, but that is rarer, as a Tertian intermitting with a Quotidian intermitting, and a Tertian intermitting with a Quartan intermitting, continued Tertians with intermitting, when a Tertian intermitting with continued Quotidian, or an intermitting Quotidian with a continued Tertian is mixed, which Fevers are called Semitertians. There are three ways of composition of Fevers, Three ways of composition of Fevers. and three differences of compounded Fevers; Subintrante, Coalternate, and Communicant. Subintrante are, when the fit of the one Fever gins before the termination of the other: Coalternate, when one paroxysm being-ended, by and by after a short interval, another gins a Communicant are such whereof the paroxysm of the one doth begin forthwith after the end of the other, there being no interval. Compound Fevers are known by the signs of simple Fevers, and principally by the returns of cold tremble and shake after rest; Signs of compound Fevers. and in case a cold fit happens, and sweat do not follow afterwards, or that one sweat happen after many fits. The pulse also if in a continued Fever it be often contracted, motion of new matter, and of a new paroxysm, and so 'tis a token of a compound Fever. But these Fevers are for the most part more dangerous than others, Prognostics. since that they more afflict the patiented then simple, and a set time for their paroxisms is for the most part wanting, and especially in case the compound Fevers consist of several humours, and they are more difficult to be cured, seeing those things that are accommodated to one humour, are not fit for another. But their cure depends on the manner of cure of their simples, Cure and to every humour and Fever that is kindled, thereby are to be exhibited their opposite remedies. But that we may say something of compound Fevers, we will add somewhat concerning a double and triple Tertian and Quartian, and likewise of a Semitertian A double or triple Tertian is caused by choler putrifying in two or three places in the meseraick veins; A double Tertian. and indeed, if choler putrify in two places, a double Tertian is made, which afflicteth either every day once, or in one day twice, that the next day after the sick may be free from the fit: A triple Tertian. But in case it putrify in three places, a triple Tertian ariseth, which in the space of two days afflicts thrice, one day once, the other day twice. Nay choler may putrify in four or five places, and more, and so many, or such Tertians then will ensue. A double Quotidian is caused by Phlegm putrifying in two places, A double Quotidian. and invadeth the sick twice in the space of four and twenty hours. A double Quartan is caused by a melancholy humour putrifying in two places; A double Quartan and those that are troubled therewith, are one day free from a Fever, and the two next are troubled with it. But such as are troubled with a triple Quartan, are Feverish every day; Nay, 'tis not impossible but that those that are troubled with a compound Quartan, should be affected twice in one day. And indeed a double Tertian is often such from the beginning, A triple Quartan but a double or triple Quartan for the most part from the untimely use of medicines, especially of hot sodorifiques, 'tis become such, because the crude matter is only stirred up, but not discussed, but dispersed over more parts. Cure A compound Tertian and Quartan is cured as other Tertians and Quartans are: yet this is to be taken notice of, that the meats or medicines may be used at fit times in regard of the paroxysm. As for a Semitertian which by the Greeks is called a Semitertian fire, 'tis compounded of a Tertian and a Quotidian, Semitertian. the one continued, the other intermittent, and indeed principally of an intermitting Tertian, and continued Quotidian, and hath its continuity from Phlegm, its hoirour from intermitting, as commonly 'tis taught; whence these are also called horrid Fevers. But although I should not deny that humours putrify together in the vena cava, and the meseraick veins, and that from thence there may arise complicate Fevers, which have various exacerbations and mutations in their symptoms; yet it seems not absurd to call those Fevers also Semitertians, which by their nature are indeed intermitting Tertians, yet when 'tis joined with an inflammation of any Intral, a symptomatical continued Fever is stirred up; for when the Feverish part of the matter is thrust out with the blood into the Guts, Stomach, Liver, and parts adjacent, an inflammation is caused, and thence a continued symptomatical Fever, which being complicate with an intermitting Tertian, constitutes a Semitertian, which in respect of the intermitting Fever is horrid, in regard of the symptomatical continued. That which Physicians observations teach us, by whom 'tis found out, by the dissected bodies of such as have died in Semitertians, that there are inflammations about the hollow parts of the Liver, as also in the Stomach, Guts, Mesentery, Kell or Cawl, Spleen; Whence 'tis easy to give a reason of a trembling or shaking fit in this Fever; for it happens sometimes ordinately, according to the nature of the intermittent Fever; sometimes inordinately, when the inflammation seizeth on some new part, or when quitture or purulent matter is made; according to Hypocrates, 2. Aphorism. 4.7. Sometimes malignity happens to be joined with these Fevers, and then for the most part they are popular, and there are many affected therewith. This Fever is known, Signs: and if it be according as it is commonly described, compounded of a continued Quotidian, and an intermitting Tertian, by the signs of each Fever; for a continued Fever on the one humour, daily brings a paroxysm, but the other every third day, and so in one day there will be two fits, in the other but one. See Galen. 2. the diff. Febr. cap. 7. But if it proceed from an inflammation of any Intral adjoined, signs of an inflammation are present, and together therewith the intermittent Fever keeps it likeness; malignity, if it be present, Prognesticks. is known by its signs. This Fever is altogether dangerous, both in regard of its continuity, and of its symptoms, as also of its inflammation or malignity. The cure thereof depends either on the cure of an intermitting Tertian, Cure. or a continued Quotidian, or on the cure of a single or double intermitting Fever, and of an inflammation of entrails. The Third Book. Of a Hectic Fever. CHAP. I. Of the Nature of a Hectic Fever. ANd so these things of putrid Fevers are handled, A Hectic Fever. and consequently the first sort of Fevers, whose heat according to inclination, disposition, or habitude, is in the living parts of the body; It still remains that we speak of Hectics, wherein the Feverish distemper becomes as it were habitual, and so possesseth the living parts of the body, that although it be fostered by no cause, yet nevertheless it can subsist without it. There are two things necessary for the generation of this Fever, Causes aptness of the subject to receive and entertain preternatural heat, and a continual and vehement action of causes heating and introducing Fevers. An apt habit of body to take this Fever, is a hot and dry body, whether it be natural, or from what cause soever it proceed. These Fevers are generated two ways; Manner of generation. for either they follow other Fevers, whether burning or lasting, when their heat is vehement; or being durable, it possesseth all the parts, and consumes their moisture; or they arise from themselves, and from evident causes, which if they are weaker or lighter, they produce Ephemeraes; if stronger, they bring forth Hectics. But there are certain degrees of a Hectic Fever: The first is, Differences. when the rorid humidity is dried. The second, when the fleshy and fatty substance perisheth. The third is, when the heat likewise invadeth the 〈…〉: And indeed when the rorid humidity only grows 〈…〉 is not as yet consumed, 'tis called a Hectic without a Consumption; but when that humidity is consumed and dried up, 'tis called a Hectic with wasting or marasmodes. A Hectic also is sometimes simple and alone, sometimes 'tis joined with putrefaction. CHAP. II. Of the signs of a Hectic Fever. A Hectic Fever is known by its continual heat, causing no pain, Diagnostic signs. as being equal; and Hectic which indeed at the first touch is weak, afterwards it appears sharper: It is perceived more in the Arteries than the other parts: And moreover, the heat after taking food, within an hour or two is increased, and the Pulse either is changed, as to greatness or swiftness, yet so, that its ascending appears strong and free, and none of those things precede which forego the fits of putrid Fevers most commonly; and this mutation of pulse and heat, endures until the aliment be distributed. The pulse also in this Fever is little, Signs of differences. frequent, and moderately swift; and by how much the more the strength receiveth this Fever, by so much the more the body is consumed, and the strength debilitated, so that the sick can scarce lift up the eyelids, and together with it in the second place, fatness in Urine swims like cobwebs. Lastly, The same things which appear in an hippocratical face, as 'tis described by Hypocrates, are also discerned in a marasmodes or Hectic, with wasting. A Hectic with a Putrid, Signs of a Hectic with a Putrid. and an Intermittent conjunct, is known from hence; That the fit declining, the heat nevertheless, although remiss, some is left thereof, and there is great languishing of the strength, and all the other parts are more temperate, only the parts where the arteries are become hotter, and the pulse loseth not its swiftness and frequency, and the sick takes food, but is not strengthened thereby. A Hectic joined with a continued putrid Fever, is difficult to be known; yet it may be known from hence, namely, because the dry calidity remains after the end of the declination, or of the whole Fever, or its periods; and the body is more extenuated then otherwise it useth to be, the Urine also becomes oily, as may appear. It is hard to know a Hectic in the beginning of it; Prognostics. 'tis not so difficult to cure at the first: but that which is nearer to wasting, or a consumption, is easily known, but hardly cured, and at the last it becomes plainly incurable. CHAP. III. Of the Cure of a Hectic Fever. LAstly concerning the cure: Indications and Cure. The hot and dry distemper indicateth cooling and moistening, the strength requires preservation, and whatsoever of the humid and solid parts is consumed and dried, is to be restored with moistening things; and indeed moistening things are more safe; but in giving cooling things we must be cautious, lest that the native heat already being weak, should by that means be extinguished. But if a Hectic Fever have a Putrid one joined therewith, the Hectic cannot be cured, unless the other Fever be first taken away. Medicines cooling and moistening are, Violets, Borage, Medicines Bugloss, Waterlillies, Roses, Endive, Succory, Mallows the four greater cold seeds, Poppy. Out of which several medicines for present use may be prepared. Externally, A Bath of fair water may be used most profitably, External things, of which Galen 10. Meth. Medend. cap. 10. Which that it may moisten the more, Mallows, Violets, Bearsbreech may be added: 'tis convenient also to use a Bath of warm milk. After the Bath, let the body be anointed, but principally the spin of the back, with oil of Violets, sweet Almonds, Water lilies, Roses; Cooling and moistening medicines may be also applied both to the Breast and Liver, as also to the Reins. But the greatest hope of cure consisteth in Diet: Diet. The Air should be temperate, or moderately cold: Meats should be cooling and moistening, easy of concoction, and of good juice, having in them few excrements, and such as is not presently dispersed. In the first place Milk is profitable, which as Galen 4. de Simp. Medic. Facult. cap. 17. teacheth, 'tis cold and moist, easy of concoction, of the best nourishment, and hath great power of moistening and refreshing the substance of our bodies; Which lest it should be coagulated in the stomach, some Sugar or Salt should be mixed therewith; and it should only be taken in such a quantity as may well be concocted by the stomach. Strengthening and Restorative Broths are also profitable, of which 'tis spoken elsewhere, as also food of Almonds, Pine, and Pistack nuts, the four greater cold seeds, and of white Poppy. But meats in such as are sick in Hectics, should be given in small quantity, but often, by reason of the imbecility of their strength. Their drink in our Countries should be Ale or Beer, or Water and Wine, white and sweet. Their sleep should be somewhat longer. If a Putrid be joined with a Hectic, we must endeavour that the Putrid Fever may be first taken away, yet the Hectic not to be neglected, lest that whilst we use remedies only for the Putrid Fever, the Hectic may be increased; if we use means only to cure the Hectic, the Putrid may be increased. The Fourth Book. Of the Plague, and of Pestilential and Malignant Fevers. CHAP. I. Of the Nature of the Pestilence. HItherto we have finished the essential differences of Fevers; it remains that we now should speak of the accidental. Amongst which, the principal and most necessary to be known, are those that enfold the Pestilence, pestilential Fevers and malignant. And indeed concerning the Plague, with which, What the Plague is. although not always, yet most commonly a Fever is joined; That name is most noted to be attributed to the most pernicious and destructive of all others: But what the nature of that disease is, amongst Authors is much controverted. For first of all, since various and several kinds of diseases and symptoms may appear in the Plague: Yet because they are also often perceived without the plague, the nature of the plague is not to be placed in so many diseases and symptoms differing in specie, but in some peculiar sort: Nor doth the being epidemical or contagious, constitute the nature of the pestilence, since other diseases also may be universal and contagious. But since that this is granted by all, The plague a disease of the heart that the Plague spreads most, when many are infected together with the same disease, and they die, and others are infected: Hence it may easily appear, that the plague is primarily a disease of that part on the which life depends chief, and the which being hurt, a man is in very great danger of his life, namely the heart, the fountain of life, and store-house of vital heat: For although the humour wherein the venom inhereth may subsist in divers parts (whence the same diseases and symptoms in every pestilence are not the same to appearance) yet in what place soever it subsisteth, it hath a peculiar antipathy with the heart, and thereby destroyeth a man so suddenly. But from whence that force and quality so mischievous and inimicous to the heart, Whether the nature of the plague consist in putrefaction. hath its original, and dependeth, of that there is a very great controversy amongst Physicians; and indeed, some do conceive that the Pestilence only consisteth of putrefaction, and conclude, that by putrefaction the nature of the Pestilence may be consumed. But because they themselves acknowledge that all putrid Fevers are not pestilential, they strive variously to determine it in putrefaction, and that they divers ways strive to explain, but all in vain. Whatsoever therefore putrefaction is concluded to be, it sufficeth not to constitute the pestilence; for there are measures and degrees of putrefaction also whatsoever they are, since that they differ only according to magis and minus, they differ not in their kind, neither do they separate the plague from the rest of the putrid Fevers. Moreover the Plague hurteth in another kind than a putrid Fever doth; for it spreads itself for the most part in a moment, and brings forth pernicious effects, it diffuseth itself in an astonishing manner, and into whatsoever it enters, a very little of the pestilent venom may lie hidden any where a long time, and remain whole, and afterwards be taken into the body, and on a sudden produce such grievous symptoms, and brings forth such effects as are not in the power of the primary qualities, on which the ground of putrefaction depends: Moreover, if the plague should proceed from putrefaction only, a Fever also would never be without the pestilence: yet since it is observed that a Fever is without the plague, as out of Hypocrates 3. epid. comm. 4.25.55. Galen de simp. med. facult. de terra Armenia. Jac. de partib. in 1. quarti Avicen. cap. de Febre Pestilent. Alex. Benedicto, Fr. Valleriola loc. comm. lib. 3. c. 18. and out of others it is manifest. Lastly, the way of cure is far different from that of other putrid Fevers, and the pestilent poison indicateth and requires alexipharmall means, which in other putrid Fevers are neither indicated nor have any place. Therefore we have determined that the plague doth consist in a hidden quality, and in its nature wholly adverse to the heart, and that the pestilential poison is endued with such a quality, which by the effects of it, as we lately said, beyond the primary qualities doth prove. Contagion is joined with the pestilence, and pestilential poisons have always contagion joined with them as a proper accident, because it belongs to all plagues, but not only to the plague. Therefore we define the pestilence to be a venomous disease of the heart, from venomous matter, Definition of it. and in its whole substance peculiarly adverse to the heart, and gotten by infection, and therefore is of itself infectious, and suddenly and jointly hurting all the actions of the heart, very acute, deadly, introducing destructive symptoms of all sorts. But what the specifique nature of this venom is, and what its differences are in divers constitutions pestilential, no man can easily explain. To me it seems probable to be the highest degree of corruption, which indeed the humours in our bodies can possibly receive; to which through many alterations, mutations, and fermentations it comes, and into which diseases which went before, at length degenerate: Whence it comes to pass, that when the Plague reigns, other sporadick diseases that come not by ordinary means, and all benign diseases for the most part are silent, and those epidemical diseases that reigned before cease. CHAP. II. Of the causes of the Pestilence. COncerning the causes of the Pestilence, A cause or this great corruption, they are twofold; some of them generating the Pestilence, others propagating the same, which are comprehended under the name of contagion. In the former rank are Air, Stars, course of Diet, Poisons, imagination and terror. For first, Ayr. Air sometimes contains in it the seeds of the pestilence, which when by drawing in the air by our breath, men draw in that therewith, and so the pestilence is stirred up in them, and that when it happens, most grievous pestilential constitutions are occasioned, and is far more pernicious then to those to whom the contagion of the plague is only transferred. Air becomes pestilential, when there is in it excess of heat and moisture, which dispose bodies to putrefaction; such a constitution of air Hypocrates describeth 3. epid. comm. 3. yet the Plague may be bred also without such a constitution of air, and that very corruption itself is not terminated in the primary qualities; but 'tis necessary that certain occult qualities, and that somewhat divine, mentioned by Hypocrates should concur, but it takes its venenosity and pestilential quality first from heaven, whilst that the air by a peculiar influence from the stars, whether it be so disposed in the first qualities, that it should putrify and be corrupted, or in an occult manner also it be so disposed and affected, that in it poisonous seeds are generated, which in their whole substance are adverse to man. To which thing Astrologers teach, that Saturn doth principally act his part. Moreover the Air may receive its pestilential seeds from the caverns of the earth, whilst from thence venomous steams exhale, being generated in the air long penned up before; to which purpose Earthquakes much conduce, which move venomous steams in that manner, and open ways for their evaporation; so out of a chest which hath been long shut, being opened, the plague cometh forth, as Julius Capitolinus hath noted in Vero: The same may happen in standing pools and lakes, and corrupted waters in Wells. Lastly, Histori●● inform us, that the air hath been infected by the carcases of such as have been slain, and by the corruption of multitudes of dead locusts. Secondly, although the stars by corrupting of the air may be the cause of the pestilence whilst they so corrupt it, as that that pestilence which is contained in it, the seeds or sparks being communicated to man, they excite the plague in him: yet by itself also, by affecting of man's very body, they may cause the plague, whilst either they dispose the air so, that whether by manifest or occult qualities, 'tis rendered not fit for the preservation of mankind, but corrupteth the humours therein, so that they become of a pestilential nature; or also proximately and immediately by occult influences, they corrupt man's body, and principally the humours and spirits contained therein; concerning which thing Astrologers are to be advised with. Common Diet. Thirdly, Pestilential venom may be generated from common Diet. That which often happens in a long dearth of provision, in Camps and Sieges, where men are compelled to make use of corrupt and unwholesome meat, by reason whereof ill humours are generated; which being detained in the body, are more corrupted, and at length become pestilential; as Histories sufficiently testify. Fourthly Unguents and venomous powders being spread abroad may cause the plague, Poisonous things. being that which by mischievous persons hath been done and committed, as histories again inform us: yet if any one would refer this kind of cause to contagion or infection, Imagination. we will not contend with him. Fifthly, The cause is imagination, terror, and fear; and experience hath taught us, that some whilst they have beheld those that were infected with the plague, or dead of it, or seeing some go out of a house that was then infected, by reason of too much terror and fear, have fallen sick of the plague: I have observed the same to proceed from anger. CHAP. III. Of Contagion. ANd these are the causes, by means whereof the pestilent poison may be generated in the air, or in man's body; yet it often comes to pass, that neither the air, nor evil diet, nor any of the rest of these causes have stirred up the pestilence, but otherwise from elsewhere being brought into some place by contagion, and afterwards by contagion also it is diffused into more places. Infection. For although there are other diseases contagious also, yet the plague is the most infectious of all others. Contagion is a production of the like diseased or sickly affect in another body, by pollution sent out from a diseased body, but there are three things required to perfect contagion: A contagious body itself that may infect others, a disease or an affect contrary to nature, which is communicated to another, and the body which is infected. First, a contagious body is that which whilst 'tis sick of any disease, diffuseth not the disease itself (for the actident goes not out of the subject) but some of the morbifique cause out of itself, and communicates it to another, and so in this manner excites the same disease in it. For that which is communicated to another from out of a contagious body, is not the disease itself, but a certain body flying out of the diseased body, and received into another, having power of stirring up the same in it. The Greeks call it Noseras apocriscis, and aporroias, and miasmata: The Latins, the pollutions and seeds of contagion; and since that we see that such seeds have not only hurtful qualities in the smallest quantities, and that they easily insinuate themselves into the body, but also they endure a long time, and retain their strength entire, and they are most exactly mixed, and are some way spirituous, Infection how many ways it is spread. and 'tis necessary they should sow their store of strength by some occult quality. But contagion is not scattered after one manner, for sometimes it goes out by breathing, sometimes through the pores of the skin, or in the form of vapours, or of sweat and filth adhering to the skin, and is communicated to other bodies. And this seed goeth out most plentifully from an infected body, when the poison is too strong for nature, and overcomes it, which happens in those that are dying. The seeds of contagion are communicated either by immedidiate contact, or by some medium and vehicle. This vehicle is twofold; air, and some fuel, as they call it: Air, when it receives the seeds of contagion from infected bodies, it can carry them to places nigh, yea and sometimes more remote places. That hath the nature of fuel in it, which can receive the seeds of contagion, and communicate the same to another; which kind of bodies are thin and porous, as Flax, Cotton, Feathers, the hairy skins of animals, and garments made of them, feathers also of birds, and birds themselves; and it is found out for a truth, that those pestilential sparks have often lain hid in the cinders or ashes; and it may come to pass, that any one may carry the sparks of it about him in his garments, and not be infected, and yet they being moved and shaked, may infect another. But the seed of a contagious pestilence when 'tis received into a body, it brings in that disposition with it wherewith that body from out of which it came was afflicted, and that for the most part suddenly, yet sometimes it is found to lie hid some days in the body before it denudates itself. Thirdly, Concerning the body that receives the pestilent treasury, although no man can promise to himself immunity from the pestilent venom, yet it is certain some are more easily, some more hardly infected. The cause whereof without all doubt consisteth in some peculiar occult quality of the heart, by the power whereof it hath or hath not strength to resist the venomous pestilence; yet because the venomous quality is not transferred without a subject out of the infected body into another, it will more powerfully insinuate itself if it be received into a body proportionable and like unto that wherein it was generated: whence kinsmen are sooner affected than others. Yet there are also other things that occasion the more facile reception of the pestilence; for such as breathe stronger, and such as have wide and open pores of their bodies, easier take in the seeds of the plague, inhering in the Air, or any place apt to retain it. CHAP. FOUR Of the signs of the Plague. MOreover concerning the signs, Diagnostic signs that I may say nothing of approaching signs, desiring brevity, but only by what means it may be known we will speak. Indeed the plague when many have been infected, may easily be known; but before many have been overspread thereby, there is scarce any pathognomick sign by which it can certainly be known, that one or a few being affected are sick of the plague; afterwards when more are visited, it is not so difficult to be known, especially when all sporadick diseases for the most part are silent: For first, the plague seizeth on many, and the most it kills. Secondly, 'Tis contagious, and easily given to others, and 'tis more contagious than any other disease. Thirdly, by its violence it destroys the strength, and principally the vital spirits. Whence fourthly, when little, frequent, and unequal pulses are made, palpitation of the heart happens, lipothymy, syncope, and great anguish and perplexity altogether. Fifthly, If the disease be protracted, and the venom corrupt the humours, evils and symptoms happen of all kinds, and the whole order of the body is disturbed; Fevers happen, divers wheals or pustules, buboes, carbuncles; yet if there are no bushes, bubo, or carbuncle appear, we must not therefore conclude that the sick hath not the plague; for it often happens that before they come out, and can be drived out by reason of the debility of nature, the sick die with the violence of the disease. There happens likewise other symptoms of all sorts; for when the strength of the body is debilitated by the vehemency of the poison, the humours and spirits are corrupted, the excrements are changed, and the urine either becomes crude, or fully corrupted, the sweats are stinking and untimely, filthy, foetid, ill coloured excrements proceed from the belly, the qualities of the body are variously changed, and there is nothing at all in burning and malignant Fevers, which may not appear likewise in the pestilence: Prognostics But there is no disease at all to which the Aphorism of Hippocrat. 19 sect. 2. doth more agree: for oftentimes when the plague flatters most, it brings unexpected death; and on the contrary, those that have seemed desperate, often recover when past hope. But there is the more hopes when tumours come forth suddenly in a place that is not dangerous, and after their coming forth the symptoms abate, also if the wheals are of a good colour, and with remission of symptoms; if medicines, meat and drink are not vomited up again, if sweats come out with lightsomness to the sick, and other signs are discerned, which use to be present in salutary Fevers. But the greatest danger is, when tumours come not enough out, and carbuncles draw near to the heart, or vanish again; if giddiness in the head, watch, a coma, or convulsion fits are present, if the sick shall say every thing stinketh, if trembling of the heart, fainting of the spirits be present, if all things are thrown up by vomiting, if the extremities of the body wax cold, if the sweat be cold, if the excrements are of divers colours, black, and stinking, and if the other ill symptoms of malignant Fevers be present. CHAP. V Of preservation from the Pestilence. BUt because 'tis safer to prevent the Plague, Preservatives. then being present to expel it out of the body, we should therefore be careful first to prevent it. The way of preservation (with God's assistance, which we ought to seek by prayers) consists in two things. The first is, That all those causes that may occasion the sickness may be avoided. Furthermore, that the force of those causes when they cannot be avoided, may be broken, and our bodies rendered less apt to entertain them, and more able to resist them. First therefore if the Plague reign any where, all commerce with the infected is to be avoided, and if any one be certainly infected, he should be separated from the rest with all his householdstuff, indeed for many weeks, and the house infected (as hereafter shall be showed) cleansed; and in case it be doubtful whether any one be sick of it or no, 'tis better to be too cautious then careless. But if the pestilence be now sown in any place, 'tis safest to remove from thence, according to that common verse, Mox longe tarde, cede recede redi. Forthwith far from it go, Returning come back slow. The reasons of which do not prove that he should change his place, the assistance of God being implored, he should often use medicines against poison, and fortific the body with those things that resist contagion, as also he should endeavour that his body should be free from all excrements, and preserved in its natural state. And that we may begin a posteriore, Purging. the body is not to be rashly weakened with strong medicines; yet if any vicious humour shall be in the body, lest that the force of the Alexipharmacal medicines should be debilitated, or the venomous poison should easily take root in the body, it is to be purged by little and little with lenitives; to which purpose the most profitable are pills of Ruffi, so called from the author's name, and by custom called Pestilential pills; out of which also is made the Elixir proprietatis, oil of Vitriol being thereunto added: Syrup of Roses solutive is also profitable, and Rhubarb, Agarick, and medicines compounded with them, which are every where extant. If blood abound, it may be abated by opening of a vein. The Diet ought to be such, Diet. whereby vicious humours may not be cumulated; and with meats and drinks most principally things good against poison should be mixed; and also, if as it may easily happen, any of the vicious humours be cumulated, let them be purged by the said medicines. And forasmuch as Fontanels take away excrementitious humours by little and little, and hence take away the provision for the plague, they also in pestilential times are profitable. Mediocrity also is to be kept in exercise and rest, sleeping and waking, and the passions of the mind, and principally as much as 'tis possible, intentive thoughts of the plague, and fear of the same is to be shaken out of our minds. Besides these, two things more are yet necessary for our preservation from the plague: First to take heed that none of the pestilential seed be attracted; Furthermore, if that happen, we being ignorant thereof, our bodies should be fortified against it. First therefore we should endeavour that the Air wherein we live be pure; The Air how to be purified. and therefore first public places are to be cleansed from all filth, and the air should be purified with fire, principally of the wood of Juniper, Oak, Pine, Bays, and odoriferous plants being kindled; furthermore, every one should avoid company, and therefore solemn and frequent meetings are justly forbid by the Magistrate. The windows likewise towards places infected should be kept shut, and the air (as I newly said) with woods, or with vinegar bezoarted, being poured upon hot bricks, or with suffumigations, or with pyrion powder kindled, should be purified. No man should go abroad until the Sun be an hour or two high, How every man ought to fortify himself against the Plague. neither fasting, nor unarmed with alexipharmacal things, therefore balls of Amber, Nodules, sweet Limments mixed with Treacle, oil of Rue, Znezedoaric, Angelica, Citron, Juniper, and such like should be held to the nostrils, and under the tongue convenient troches should be held, cordial bags should be applied to the region of the heart. Annulets likewise of poisonous things are commended by many, Annulets as Arsenic, powder of a Toad, Quicksilver and such like being prepared, descriptions whereof are every where extant: which whatsoever they do, without question they perform in such manner, that they draw the venomous poison to themselves, by the similitude of their own substance, and turn it from the heart; as those that are wounded with a Scorpion, with the oil thereof being externally anointed, are forthwith healed: yet you must take keed that those bags, or mass of such things be not heated by motion, lest the strength of the poison should be communicated to the heart through the pores of the skin. But the greatest hope of health and security, Alexipharnicks. is in medicines that resist poison, out of which those are to be selected which by long experience have been approved; The simples are, Angelica, Valerian, Tormentil, Carduus Benedictus, Sorrel, Dittany of Crete and white, Rue, Swallow-wort, Scordium, Scabicon, Divels-bit, Burnet, Olsnicium, Fluellin, Vipers-grass, Marigolds, Wormwood, tansy, Zedoary, Masterwort, Gentian, Juniper berries, Walnuts, Hartshorn, Bolealmanick, Terra sigillata, an Emerald, a Hyacinth. Out of which are various compounds; amongst which those that excel, and are approved by long use, are Mithridate, Treacle and Confectio Liberantis, as also that antidote which is ascribed to 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 'tis called, Dioscordium, Tracastory, Antidote Saxonica, Antidote 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, than the store of them here: And amongst so great plenty, 'tis more safe nevertheless to depend on those that have been approved by long use and experience, than 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 Hartshorn, 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 Air, 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 acetoes. Citri, Sorrel great or small, Pomegranates. For there is no depending upon one medicine against poison, 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 'tis manifest, that that occult quality indicateth a medicine alexipharmacal contrary to it, and shows 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 aught to be done, is controverted amongst Physicians. For first, since that neither Phlebotomy, Breathing a Vein. nor Purgation are indicated by the pestilence, quatenus 'tis 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 venom, nor the cause, 'tis rarely to be used, and in that Pestilence which is occasioned by evil Diet, 'tis wholly to be omitted, as also in that which ariseth from a pestilential constitution of Air, 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 putrid Fever should happen, which may become no less dangerous to the sick than the Plague itself, 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 breathe 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, 'tis safer to omit bleeding, because the strength being debilitated with the violence of the poison, 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 Armpits, or a Carbuncle in the superior parts, a Vein should be opened in the Arm on the same side; but if a Bubo come in the Groin, 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 weakened, 'tis convenient to open a Vein in the contrary leg; for neither is the motion of nature hindered by this means, but the matter is drawn from the superior parts towards the inferior, 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 joined with danger: and for as much as Nature for the most part expels the pestilent venom to the outparts of the body, this motion of Nature by Purgation is hindered, and the pestilent venom 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 poison, 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 venom, 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 'tis 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 poison 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 Air, 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, acetoes. Citri, of Pomegranates, red Gooseberries, with cordial and odoriferous waters applied to the Nostril, and sprinkled about the Bedchamber. 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 Armpits, that it may draw the venom to it; The sweat being ended, the body should be rubbed and dried with clean warm linen clothes, being careful that no cold air be admitted, and the sheets and cover of the beds should be changed. After the sweat, the sick should be nourished with meats that afford good juice, and easy 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 hindered if it come on a critical day) such medicines are to be continued as hinder putrefaction, 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, acetoes. Citri, of Sorrel, Pomegranates, 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 outparts of the body, Cure of Buboes. and occasions Buboes and Carbuncles: If the venom perfectly, or most part of it be driven out into a Bubo, which may be known by the remission of the Fever and Symptoms, we must expect ripening, although not perfectly, as in other tumours, yet it must be helped by all means; for if either a Bubo come not enough out, or be increased overmuch, and still the Fever and symptoms abate not, and the sick no ways mends, we must endeavour that a way may be opened for the letting out the venom. Therefore either vesiccatories must be applied, or the skin must be scarified, that the poison may freely expire, and the pestilent humours fly out; a young chicken also, or pigeon, the feathers about the rump being pulled off, should to the great advantage of the sick be applied to it, although no incision be made, and that should be often repeated; or a dried Toad being moistened with wine, should be applied: 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 mundified with proper medicines, and it must not be healed up, until all the venom be come out. But Carbuncles are forthwith to be scarified, Cure of Carbuncles and that deep enough, that the pestilent and corrupt humour may come forth, afterwards some convenient plaster must be applied, such as may be of the soot of a chimney, and others, described up and down in Authors: Some apply the plaster de Magnete Arsenicali, 'tis proper to apply a dried Toad also, being first powd'red, in wine, to the places adjacent, lest the venom should return to the internal parts; some defensitive of cooling, drying, and binding things must be applied; some make a circle with a Saphire stone about the Carbuncle, lest the poison should creep farther, and thereby extinguish the same; and if the Carbuncle be too much increased, 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 plaster of Houndstongue is to be applied. 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 venom 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 merely 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 showed: And therefore the Plague itself also, when it hath a Fever joined 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 humours hath not yet attained that high degree which may constitute the nature of venomous pestilence, yet they contain in them somewhat like to that venomous and malignant pestilence, and moreover either are not pernicious, or contagious as the plague, if they are both of them, yet they are less destructive than 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 itself 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 itself: But concerning malignant Fevers, although they by a general name signify 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, sometimes there is none. And that the matter may be handled in few words, if it appear by the symptoms in any Fever, that besides putrefaction there is a lso some occult and malign quality, and yet but few die thereof, whether they are epidemical Fevers, or sporadick, or contagious, or not contagious; this is the first degree of corruption, and such a Fever in particular is called malignant; but in case many die, and yet others are not infected, or although there be some contagion, and some destruction, and yet neither the contagion nor destructive power have attained to the highest degree, and many continue well in health, 'tis a pestilent Fever in particular. Lastly, if so be many which begin to be visited die, and that most every where are infected, and that the contagion be spread over remote places, 'tis the plague. CHAP. VIII. To what kind of Fevers Pestilent and Malignant ones pertain. MOreover since there are three kinds of Fevers, To what kind of Fevers pestilent and malignant ones belong. Ephemeral, Putrid, and Hectic, and again of putrid Fevers, there are some differences: 'tis now enquired to what kind of Fevers malignant and pestilent do belong, or whether malignancy and pestilency belong to all Fevers, or to some certain kind only. But we have already determined that there are no Ephemeraes nor Hectics pestilent and malignant, because that in all pestilent and malignant Fevers, there are manifest tokens of corruption or putrefaction of humours, although that malignant and pestilent humour have likewise a manifest antipathy with the spirits, and may stir up a dangerous Fever. But all putrid pestilential Fevers are continued, since the force of the venomous putrefaction is such, as that it can easily diffuse itself into all the veins and arteries, and may easily corrupt the humours. But malignant Fevers in particular so called, may also be intermittent, as experience showeth: Neither is it impossible, that even in the first passages of the body, the putrifying humours may acquire some malignity; and seeing that in such Fevers the force of the venom is not so great, nothing hinders but that Nature may appoint certain excretions at appointed periods. Continued pestilent and malignant Fevers, are particularly addicted to no sort of them, but according as putrefaction happens into this or that sickly preparation, so this or that continued Fever is stirred up, sometimes a Synocha, sometimes a periodic; whence various symptoms likewise do arise, according to the sickly provision. Moreover concerning the differences of malignant and pestilential Fevers, The differences of pestilent and malignant Fevers. since that in every such Fever there are found two things, the putrefaction itself, from whence the Fever ariseth, and malignity; in respect of these also, do the Fevers differ. For sometimes equally from putrefaction and malignity, danger is at hand; which Fevers, if the putrefaction and malignity be great, are exceeding dangerous; but if neither the malignancy nor putrefaction be much, the Fevers are not dangerous. Sometimes there is more putrefaction, but the malignancy is not much; and then the Fever comes nearer to the nature of other putrid Fevers: but sometimes the putrefaction is not much, but the malignant quality vehement, and such Fevers seem to be mild but they are most fraudulent and dangerous. Concerning the nature of Pestilency and Malignity, although it be occult, yet from its effects we may apprehend a certain variety, whilst sometimes spots, sometimes Measles, sometimes wheals come forth; sometimes too great sweats, sometimes Catarrhs, Pleurisies and other evils, according to the antipathy which the venom hath with this or that particular part. CHAP. IX. Of the causes of a Pestilent and Malignant Fever. AS for the causes of these Fevers, Cause. because their malignancy is less than theirs of the pestilence, and through this, as it were by degrees, we ascend to the Pestilence, those which are the causes of the Plague, for the most part, are the same with those of malignant and pestilent Fevers; but more mild, as principally air, heaven, course of diet, and contagion. Namely malignant Fevers in the first place do arise from a sickly provision of the body; for it ariseth from meat that is bad, fit for corruption, and very obnoxious to putrefaction, whereof Galen may be seen, in his book of Meats affording good and bad juice, and the humours may be so corrupted in our bodies, as that they become venomous, of which I have spoken in the Institutions in the second book, part 2. cap. 12. Furthermore from common causes likewise, namely unprofitable constitution of Air, as also from the influence of Stars. But pestilent Fevers so called in particular, have the same causes, but more grievous, which at length if they are increased, produce the pestilence; whence Fevers malignant and pestilent long continuing, at length turn to the plague. CHAP. X. Of the Signs of Malignant and Pestilent Fevers. IN the same manenr is it about the Diagnostic signs: The Dianostick signs of pestilent Fevers. for in a pestilential Fever peculiarly so called, the same signs almost appear as in the plague, only fewer, or more gentle; and such Fevers are not so dangerous nor so infectious as the Plague itself. But as to the signs of their differences, if both malignity and putrefaction be very much, the strength will be much weakened, and grievous, nay the most dangerous symptoms appear: If the putrefaction be very great, the malignancy little, the feverish symptoms which accompany putrefaction are vehement enough, but the strength is not so much debilitated. But if the putrefaction be not great, but the malignant quality vehement, the symptoms which accompany the Fever are gentle enough, but the strength is exceedingly weakened. If the humours only are affected, there appear Buboes, Carbuncles, Imposthumes, Spots, Pushes, and other tokens of putrid Fevers, if the spirits are much infected, these signs are wanting, neither is the heat great, the strength suddenly languisheth, and the sick are troubled with faintings, the pulses are unequal, weak, and languishing, and the Fever itself in one two or three days space is terminated by health or death. Lastly, if the heart be much infected, great defect of the strength is present, and the sick do not complain of any great heat. As concerning Malignant Fevers; Of malignant. they are very difficult to be known at the first, because the malignity often lies hid, and shows not itself, unless when it take strength; wherefore all signs are diligently to be weighed, and if any thing be suspected, it must be seriously pondered; but all the signs of a malignant Fever are greater than those of a Fever; and the symptoms which appear, are more vehement than those which can proceed from a Fever, namely weakness of strength, unquietness, more anxiety than the feverish heat would occasion; the pulse is freqnent, little, weak, or if it seem to be natural, other evil symptoms are present, the Urine sometimes is like unto those who are in health; sometimes thin and crude, having in it no sediment, or in case it have any, 'tis more like an excrement than a sediment; sometimes 'tis thick, discoloured, troubled, muddy, having a red and troubled sediment; the heat is more mild than the nature of the disease, and symptoms seem to afford: the face or countenance is much changed from its lively and natural state; and therefore by these signs pestilent and malignant fevers may be easily known: yet there are other things happen, heaviness to sleep, watch, diliriums, pains of the head, noises and deafness of the ears, loathing or vomiting, flux of the belly, hemorrhodes of the nose, tumours arise behind the ears, under the armpits, and about the groin, also divers specks, and almost no evil which can be observed in other perilous Fevers but may here be discerned. Concerning the prognostics, and first of pestilential Fevers, Prognostics. there is the same with them for the most part as of the pestilence; for by how much the more grievous the symptoms are, and the strength more debilitated, by so much the more danger is portended; but by how much the milder the symptoms are, and the strength firmer, by so much is there the more hope of health. There is the same reason in malignant Fevers for the most part, and what is to be hoped concerning the event in every such Fever, is manifest out of those things which are spoken in the Institutions, Book 3. part 3. chap. 4, 5, 6, 7, 8. CHAP. XI. Of the Cure of Malignant and Pestilential Fevers in general. COncerning the cure of pestilent and malignant Fevers, Cure. since there are two things in these Fevers contrary to nature, venom, or malignity, and the Fever; by what means the Fever may be resisted, is manifest from those things that have been said hitherto concerning Fevers: how malignity also may be resisted out of those things which are already spoken concerning the pestilence, is plainly showed. The greatest difficulty here is in this, to which of them we must have an eye first, and which last, and how the malignity may be taken away without increasing the Fever, and on the contrary, the Fever may be regarded without increasing the malignity. Which that it may rightly be done, the pestilent venom and malignity, and the putrefaction and Fever are to be considered and poised together amongst themselves, and regard to be taken whence the greatest danger may arise; and in the first place look to that, yet so, as that the other may not totally be neglected. Wherefore in a pestilential Fever, The Cure of the plague in particular. Sudorificks Bleeding as being that wherein malignity most troubleth, presently we should fly to Alexipharmicks and Sudorifiques; yet those are to be rather chosen which are the more temperate, such as were formerly proposed against the pestilence; afterward if need be, a vein should be opened, and that timely, and scarce after the fourth day, before all things shall be disturbed in the body, and the strength be weakened, namely, when blood doth either abound in quantity, so that it distendeth the vessels, or it is a burden to the strength, or is stirred by some motion, that it may be feared lest it should be carried to some principal part; but if the disease have made some progress, and the strength now labours, the breathing of a vein is more safely omitted then untimely appointed; but in case the strength will not suffer a vein to be opened, cupping with scarifying is fit to be used to the inferior parts. But purging at the beginning of these Fevers is not convenient, Purging. unless such as may purge only the first ways without any manifest agitation of the rest of the humours; but stronger are not convenient, because they stir the humours, and mix the venom with them the more, and often cause dangerous fluxes of the paunch. If the matter tend upwards, Vomits. and there be any nauseousness, vomit is to be provoked by the weaker sort of medicines causing them. Hence we are to come again to the Alexipharmacal medicines, which notwithstanding should be such, as that the humours should not thereby be increased: Therefore those are to be exhibited that are more temperate, and together do resist putrefaction; such are Sorrel, Citrons, Pomegranates, cinquefoil, Tormentil, Hartshorn, the bone of a Heart's heart, Bezoar stone, Bolealmenack, Terra Sigillata, and such like, and medicines prepared of these, but principally Bezoar water is often to be administered, as being that which doth forthwith penetrate, which may be so tempered, as that it may resist the Fever and putrefaction; and therefore with such medicines, Syrup of Sorrel, Limmon, Pomegranates, Sorrel, Vesicatories. and young Sorrel, and such like are to be mixed. The matter being diminished, vesiccatories may be applied to the Legs and Wrists, Cure of a malignant Fever in particular. Purging, to the advantage of the sick, since that they draw the venomous matter from the interior parts to the exterior, without any trouble or weakening of the strength. But if it be a malignant Fever in particular so called, and the putrefaction more than the malignity, the first passages are first to be purged, and not only with lenitive Clysters, but lenitives also are to be given, as Syrup of Roses solutive, Manna, Cassia, Tamarinds, Agarick, Rhubarb, Tryphera Persica, especially if the matter swell: But we must wholly abstain from the strongest, as Scammony, Coloquintida, Turbith, and such like. And indeed, if the putrefaction presently increaseth, and a more vehement Fever is thereby kindled, and especially if the humours swell, presently that is to be done, and that before the third day. But these things in general cannot sufficiently determine; these tracts in particular of these Fevers, show the way more clearly; for such pestilent and malignant Fevers are sometimes propagated by infection, when it is most safe that the pollution in what manner soever taken, should be expelled by Sudorifiques and Alexipharmicks out of the body, and afterwards, if occasion do require, to appoint purgation and Phlebotomy; sometimes likewise nature itself expels the matter to the circumference of the body, as it useth to happen in the Measles and small Pox; but then Nature is also troubled in her work, and the matter which is thrust out to the exterior parts of the body, ought not to be called in again by purging, but 'tis rather to be helped by Sudorifiques and Alexipharmicks in its work; but sometimes the Fever is occasioned by vicious preparation of the humours, or is cherished thereby, and the peccant matter in the Stomach, near the Midriff and first passages, manifesteth itself by vomit, pain, heat, bitterness of the mouth, anxiety, and other tokens, which necessarily should be avoided by vomit or purgation. The first passages being opened, and the body evacuated, Bleeding. presently the opening of a vein is to be appointed, if it be needful, and that before the fourth day. After purging the body and opening a vein, Sudorificks. if occasion require, 'tis convenient to use some Sudorifique, but such as may not increase the Fever, such as we have already proposed; and although sweat doth not always follow, yet such medicines are to be continued and exhibited daily, that so the body may by degrees be apt to sweat, and that nature at length of its own accord, in its own time, may expel peccant humours by sweats; but the stronger Sudorifiques at the first, debilitate Natures strength; and since the humours in these Fevers are not always so disposed that they can be discussed 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 putrefaction, 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, cinquefoil, juice of Citron, Pomegranates, 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; Symptoms also, if any urge and debilitate the strength, are to be taken away and mitigated, as in their own place shall be showed. Concerning Diet, Diet. the meat should be of good juice, and of easy digestion; and to beware that when the strength languisheth Nature be not overburdened; the meats also should be mixed with such things as resist this Fever, we must abstain from wine, unless swooning fits happen, but 'tis more convenient to use small beer, a decoction also of Hartshorn 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 putrefaction, and resisteth malignancy; of Aegyptii, as Prosper Alpinus in his fourth book of Medicines Egypt. chap. the fourth. Pulp. of Tamarinds and Barberries, the fruits being dried, 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 putrefaction 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 shows itself by the effects and symptoms, whence also certain differences of malignant Fevers are are appointed, of which we will now speak in particular. First, there happen Fevers wherein bushes or eminent tubercles break forth, and sometimes certain spots show themselves: the Greeks call them Exanthemata, and Ecth●mata the Latins 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 bushes full of humours, which for the most par● suppurate, which the Germans call die Biatterne and Bocten; but they call those Mobilloes, 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 symptoms, 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 Lupins, Differences. and shining like Crystal, out of which a certain waterish substance issueth; which some therefore call Crystals, 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 befalls children often without a Fever, and are presently healed; so that Infants seldom take their beds for them, To the Pox or Measles certain small red tubercles do belong, which invade with heat, and a cough and other symptoms of the Pox, yet less dangerous than the pox; the Germane call them die Rittein, or die Rottein, because they are red; sometimes they come alone, sometimes are mixed with the Pox, and sometimes come after the Pox is healed; which disease Halyaabas calls Rubcolam, lib. 8. Theoric. cap. 14. Moreover there are other break out which seem to be referred to Pox, which the Neapolitans call Rossoniam and Rossaliam, as Johannes Philippus Ingrastiat of tumors 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 tumors, 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 bushes 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 entrails, and on their skin without side the Pox have been settled. Concerning the cause of these, Cause. there is difficult and great controversy amongst Physicians; 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 it; for they say, that this filth being left in the body, doth lie still, like unto leven, until stirred; so that the whole blood, boils like new wine, and so whatsoever is in it of impurity, is separated and sent to the outside of the body; and they therefore say so, because they observed that almost all men at some time are troubled with the Pox or Measles, and those which have had them once or twice, for the most part are free from them ever after. Others are against this opinion, and say, that it proceeds from some occult celestial cause, whose impression, children being more infirm, are apt to take, than those that are strong and in years; neither do they think it probable, that Infants are nourished in the womb with unclean blood, or that this impurity can lie hidden so long in man's body, since 'tis known that not only Infants, but youths, nay such as are well in years, and old men also some times fall sick of the small Pox, which formerly have been sick of Fevers, and troubled with scabs, in whom (in case any impurity had been in the blood, it ought to have been then taken away. But in regard both opinions contain difficulties in them, and both seem to be held up with probable arguments; let us join them together; for if the Pox and Measles are epidemical and infectious, 'tis not to be denied but that they then arise from a certain peculiar malignant disposition of air,: Then Infants, as being more tender, sooner are infected; although it cannot be denied, that from an external cause, an infirmity lying hidden within, may be brought forth into action, yet if the power of the malignity be greater, those of ripe years may sometimes be afflicted: But if the Pox or Measles come forth scattered here and there, 'tis probable that they proceed from the impurity of the womb, whereby a vicious disposition of the body is contracted by the party in the infancy especially if there be no fault in the Air; for although an infant in the womb be nourished with the purest blood of the mother, yet when it becomes bigger, and wanteth more nourishment, it cannot be but that it must draw some of the depraved humours which are cumulated in the womb with it. Whence it is known, that Infants have been born sick of the small Pox, or had them come forth presently after they come into the world: Yet 'tis not impossible but that from ill Diet the same viciousness may be contracted, as from the menstruous blood in the womb, and that may happen to those that have had the small Pox twice or thrice, although it may likewise happen by reason of the first pollution and defilement, of which some relics were left. The small Pox and Measles always come forth with a Fever; Whether any and what Fever may be joined with the Small Pox and Measles. for they are stirred up by a certain crisis, and that ebullition not only happens to the subcutanial veins, but also to the greater; whence heat is communicated to the heart, and a Fever is kindled, and that Fever is made a putrid Synocha, as may appear by the equal heat, and the matter contained in the Pox; and that which is gentle, often vanisheth within a few days, neither is it regarded by Infants, nor the standers by; but that which is more vehement, if the disease be to determine with safety, will abate when the Pox comes forth; sometimes these Fevers become pestilential, and then many Infants are extinguished. And thus the small Pox and Measles are generated from internal causes; yet external causes likewise do often concur, as humours corrupting in this manner, or lying hidden, have force of moving: The first is Air, by reason of the influence of Stars, or causes otherwise so disposed, as that they may corrupt the humours in this manner. Moreover contagion, when a certain sickly effluvium or steam from bodies diseased of the small Pox or Measles, is communicated to another body, and causeth the same disease therein. But of Pox and bushes there is certain differences, as hath been said, in substance, quantity, and quality. According to substance, some consist of this, some of that humour; according to quantity, some are big and many, others small and few: according to quality, some are white, others red, yellow, livid, violet colour, etc. Some come out suddenly, others slowly; some are presently healed and vanish, others continued long; some afflict only the external parts of the body, some the internal also. But when the Pox or Measles are coming, Diagnostic signs. there is present pain in the head, eyes, and throat, an itching of the nostrils, sneezing, terror in sleep, fits like epileptical ones, pain on the back, burning and pricking in the skin, difficulty of breathing, a dry cough, trembling of the feet, yawning, retching, palpation of the heart, which actions so hurt, proceeds from the ebullition of the blood, and fuliginous vapours sent from the heart, and dispersed over all the body. Their Urine is often like unto theirs who are in health, the peccant matter being thrust out to the extremities of the body; yet sometimes 'tis troubled by reason of the great ebullition of humours, the hemorrhodes of the Nose are frequent, tears use to fall from the eyes of their own accord, or the eyes show as if they were ready to weep; sometimes vomiting happens, the face and eyes are red, the skin rough, the voice hoarse, and lastly, a Fever by the ebullition of humours is kindled; If these signs therefore for the most part are present, and are increased on the third or fourth day, and certain red spots appear in the skin, 'tis a sign that the Pox or Measles are at hand; and this suspicion is increased if the Pox reign thereabouts. A little afterwards those specks are exalted like grains of Mellet, and afterwards changed into pustules full of quitture, and are become Pox, or are extended abroad, and small tubercles are made, and the Measles are produced. The nature of humours is principally known by the colour, Signs of Causes, and of the part affected. for if the pox proceed from a choleric humour mixed with blood, they are more red, and do itch more from Phlegm, they are whiter, from melancholy blacker: sometimes likewise they are of violet colour, green, lead colour, and with greater corruption of humours: If they possess not only the skin, but also the internal parts, the Fever is greater, thence comes great difficulty of breathing, straitness of the breast, a greater cough, pain in the stomach and guts most vehement. Small Pox and Measles are numbered amongst acute diseases, Prognostics. and are terminated within fourteen days; they come forth commonly about the fourth day, they increase till the seventh, the height is manifest the eleventh, and from thence to the fourteenth is the declination; but the drying of them continueth till the twentieth day sometimes. The Fever adjoined, the magnitude of symptoms, the manner of the Pox, and the strength or the sick show the event. For if the Fever and all the other symptoms after the coming out of them do abate, if large hemorrhodes of the nose have preceded, if the pustules are great, white and red, soft eminent, not alike, come forth quickly, and are soon ripened, a good event is to be hoped for. On the contrary, the Fever if it be great, and be not mitigated after the coming out of the Pox, and the tubercles are violet colour, green, livid, haad, contiguous, come forth and ripen slowly, and the symptoms which use to be in malignant Fevers be more grievous, the strength weaker, they portend danger, and either bring death, or some great evils in the eyes, nose, chaps, gullet, lungs, guts, liver, reins, and leave filthy pits and scars in the skin. There is in a manner the same reason of the Measles, which the more mild the Fever and symptoms are, the less danger; but by how much the greater, the more danger is adjoined with them; they are sooner discerned, neither are they so loathsome to the sight; red ones likewise, and those that soon appear are more mild, but those that are green, violet colour, black and come forth slowly are worst. But the worst is, when the Pox or Measles come not throughly out, or do vanish again, for then by the matter left within, or returning in, a greater Fever is kindled, symptoms become greater, and the sick, for the most part, perish. The chief scope of the cure must be, Indications and Cure. that since Nature strives to expel the matter to the remote parts of the body to assist it: the second is, That the pravity of the matter may be corrected: The third, That the strength may be fortified: And lastly, To take care that no part of the body receive any detriment. The endeavours of Nature are furthered if the humours are driven out to the circumference of the body, and the impediments that may disturb the matter in its coming forth, whether it be store of matter, or pravity of it, or obstruction of the bowels must be taken away. But because this evil principally invades Infants, Bleeding. breathing of a vein is not necessary, since their age will not tolerate it, but if it happen in an age that will bear it, and the abundance of blood require evacuation, presently at the beginning before the becoming out of them, a vein is to be opened, that nature being eased of part of its burden, may the easier expel the remainder. Strong Purges are not to be used, lest nature should be hindered in its endeavour, or a dangerous looseness should be occasioned; yet if the body be bound, it may be relaxed by a lenitive Medicine or Clyster, which together allays the heat of the humours, and strengthens the internal parts. Moreover we must observe whether Nature do its office in expelling; Expelling thing. for then there is no need to help it with many medicines, especially heating ones. But if the Pox come out slowly, Nature should be helped with expelling Medicines; yet such things should be mixed therewith, as may strengthen the internal parts, mitigate the heat of the humours, and resist malignity. The expelling Medicines are, Roots and Seeds of Fennel, Turnip, Carduus benedictus, Columbine, Limmon, the Roots of white Dittany, Burnet, Maidenhair, Marigold flowers, decoction of red Parsnips, Scordium, Scabions, Myrrh, Figs, Lentiles, and other things that resist malignity. These things cool and resist malignity, Sorrel, Cooling things. young Sorrel, Lettuce, Waterlillies, Purcelane, Barley, Tormentil, Endive, Cichory, Juice of Limmons, Oxysaucharum, Rob of Currans; In giving of which, regard must be had to the malignity and Fever together, and according as need shall require, the medicines must be chosen or mixed. Medicines of Figs, Lentiles, Lacca, and Tragacanthwere, in use amongst the Arabians, which were likewise used by latter Physicians; yet if the malignity be great, you may sly to more exquisite resisters of poison. But principally we must endeavour to beware that the sick take not the fresh air, but be rather placed in a hot place, that the pores of the skin may be kept open, and that nothing may hinder Nature in expelling, And we must be careful also, that the eyes, nostrils, How the parts are to be defended. and internal parts may not be hurt; and therefore the Lungs are to be fortified and strengthened with medicines of Poppy, Lentiles, Violets, Tragacanth Roses, the guts with strengtheners, and moderate binder's, the eyes, and nose with such like, as their infirmities do show they have need of. The mouth and chaps should be washed with decoction of Plantain, red Roses, flowers of Pomegranates, Prunellas, Syrup of Pomegranates, and such like. Whilst the wheals are ripening, there will be much itching, but beware of scratching, lest you thereby cause scars in the skin; if the quitture be white, and the pustules not too great, 'tis best to commit the whole business to nature; but if they are great, or many of them joined together, when by their whiteness, softness, and freeness from pain they shall appear to be ripe enough, they may be opened with a silver or golden needle best. Concerning Diet, Diet. the sick by all means must be kept from the cold air, neither must he be kept too hot, lest it make him faint: The manner of Diet as in other acute Fevers, is to be appointed, namely thin; yet to Infants, if their stomaches will bear it, some meat may be given, because their bodies are not diaphoretic, and by reason of their store of innate heat, cannot so well endure fasting: from meats that are salt, acrid, flat, which may increase an ebullition of humours, we must refrain, and those that moderately cool and bind, and allay the heat of the blood, must be administered. Wine at the first is not convenient, but rather small Beer, or Barley water; but in the progress of the disease, when the symptoms slacken, to those that are accustomed to it, a little of the smallest wine may be granted. There aught to be temperate moderation of the other non-naturals likewise, watch and sleep, the sick should sleep moderately: In the beginning of the Pox or Measles, there should be gentle frictions of the legs and arms used, whereby the humours might be called out to the circumference of the body. 'Tis in use to put a red cloth to the bed in the sight of the sick, to cause motion of humours to the exterior parts. The Belly should be kept open with a gentle Clyster, if need require: Lastly, all vehement perturbations of the mind must be avoided, especially anger and fear. CHAP. XIII. Of the Spotted Fever. MOreover, another sort of malignant Fever is, Patechiae when certain spots like the biting of gnats appear in the skin; There are of divers colours, but principally red, called by Authors Puncticulae, Peticulae, and Patechiae, whence the Fevers are also called Peticulares, Patechiales, Lenticulares. These spots are without all itching, extuberancies, and ulceration, as in Pox; 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 always obvious to the external Ayr. These spots have their original from the thinner parts of the putrid 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, Pomegranate colour and black, when melancholy, putrefieth. 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 join together, Diagnostic signs. they show malignity more plainly. But what event of these Fevers may be hoped for, is manifest by the prognostics of malignant Fevers in general. Prognostics. 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 show that store of matter is present; yet they shake it not of, and therefore they portend danger rather than health: Neither is their paucity always good, and although it signify no store of matter, yet it also denotes debility of nature: These spots (if they lie hidden) are evil signs; because they show 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 pomegranate colour and black most dangerous. Although such as come out at the first appear symptomatical, 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, 'tis evil; for that happens either by reason of the thickness of the matter, into which if the malignity fall, 'tis not easily overcome, or else by reason of density of the skin, which hindereth 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 loosened either by Clyster 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 showed in the Institutions lib. 5. part. 2. sect. 1. cap. 17. But since nature itself strives to protrude the matter we see to the extremities of the body, and 'tis profitable in all malignant diseases to drive out the matter from the greater to the lesser vessels, and to free the bowels from vicious 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. Sometimes 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 fortify nature, Pearls, Coral, Hartshorn, juice of Pomegranates, 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 venom 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 bourn, and that pains in the head, deliriums, a lethargy, and other symptoms 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, Zealand, 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 happened 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, sometimes till death. But the cause of this disease was inherent in the most subtle 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 some evil disposition of Air, and other corruption; whence also this disease in many places in the Low Countries with cloudy air, suddenly invaded men, and the birds also were found dead under the Trees, and 'twas observed that they had pustules under their wings like Vetches or Tares: But what manner of corruption of the Air it was, can scarce be explained. For this was a most cruel disease, Prognostics. and within the space of twenty four hours, it either killed men, or left them senseless: and indeed at the first when this disease did invade any City, it troubled them fifty or sixty times, but it scarce troubled them the hundredth time. But the chief business of the cure consisted in the promotion of sweat, Cure. and weakening venom, which nature of its own accord endeavoured; for all those that did not further the sweats, nor use cordials, and took fresh air, died within four and twenty hours. In occasioning Sweats, the strength must be regarded, which in case it be weak, the sweat must so be moderated, that thereby it may not be debilitated more, and dejected: for 'tis observed, that by too much causing sweat, and whilst the sick beyond their power to suffer, are covered in their beds, abundance of men have been stifled: During sweeting, the sick should be hindered from sleep. They used to occasion sweat, and infringe the malignity, water or Sorrel, Scabious, Terra Sigillata, Bolearmenick, Dittany, Carduus benedictus, Zedoaric, Tormentil, Waterlillies, Borage; Species liberantis is also proper, and such like, which use to be applied in malignant Fevers, and the Pox. During the Sweats, the sick should be refreshed with the juice of the Syrup of Citron, Pomegranates, Sorrel, and other things before mentioned about the plague. Odoraments should also be applied to the Nose. When the sick hath sweat enough, some of the weight of the clothes should be abated by degrees, and the sweat at last diligently wiped off and cleansed. CHAP. XV. Of the Ungarick Disease. AMongst the malignant Fevers, Of the Hungarian disease. there is also a disease called the Ungarick, because it was first known in Hungary in the year 1556. and thence 'tis thought 'twas spread almost over all Europe, Indeed some think the patechial Fever, and the Ungarick Disease are the same; and 'tis true that spots often happen in that, but not always is it so, and the name of a patechial Fever is extended larger than the Ungarick disease; for this is a certain kind of malignant Fever, or if it have spots, and is patechial, yet this disease is bred in Camps by reason of evil Diet, whence we think it to be properly called the Military disease, or the Disease of the Camps, because that not only in former times in Hungary, but elsewhere, it wandered up and down in the Camps hitherto, and thence is dispersed up and down. But there is a malignant and infectious Fever called Morbus Ungaricus; 'tis continued, and hath great store of vicious humours about the stomach and first passages joined therewith. The proximate cause of this Fever is putrefaction, The causes. the causes and malignant corruption of the humours in the vena cava. But they are cumulated and corrupted by errors of Diet, and first by default of the Air, which in Hungary is extreme thick and in the night filled with clouds, or if they are discussed, 'tis very thin and in the Summer time most hot; and otherwise, likewise in the Camps 'tis not most profitable; because that in them it is most common to lie under the open canopy, and to draw the vapours which come from the air and the rain, and when their clothes are wet, cannot change them, and in winter time are often penned up in little hothouses. Moreover bad diet may be a cause of this disease, wherewith Soldiers (for want of better) are forced to make shift with, and those for the most part which are accustomed to far better; hence because good chyle cannot be generated by evil diet, and the errors of the first concoction cannot be corrected in the second, many filthy humours are collected within the first passages, which with the chyle are carried to the Liver, and thence into the veins, and from that evil chyle bad blood is generated, which even voluntarily tends to corruption and putrefaction, and at length an unprofitable disposition of air coming, it doth not only putrify, but becomes malign. Whence not only a putrid continued Fever, Nature of the Ungarick disease. but also a malignant is stirred up, and one that is also infectious, which may also infect those that have no ill humours in their bodies, whence the symptoms do something differ. And as according to Diet, situation, and other circumstances, the matter occasioning a disease is not always the same, so there happens differences in the symptoms joined with the Fever. Nay in the Fever itself there ariseth certain differences in regard of the peccant humour, whence from some arise putrid Synochas, from others burning choleric Fevers: But although great store of peccant matter, as hath been said, occasioned by evil diet, be collected for the most part in the stomach and first passages, yet that is not the containing cause of the Fever, but only symptomatical, stirred up by the Feverish heat, especially in the beginning of the disease, that it causeth pain in the heart, anxiety, burning about the midrif, and vomiting, and increaseth and cherisheth the Fever itself. And all other symptoms which appear in other malignant Fevers, may here also be present, Diagnostic signs: and for the most part spots and specks appear; but amongst other things, the pain of the head for the most part is exceeding troublesome; thence this disease amongst the vulgar took its name die hauptcranctheit. Most that take this disease from ill diet, do complain of pain in the stomach, and under the pointed gristle, where a certain retention and hardness is likewise observed. There is great thirst presently at the beginning, and the tongue dry and rough, a little after they are troubled with deliriums, which are gone again when the matter falls down to the ears, and then deafness ensueth. 'Tis an acute disease, Prognostics and is terminated at most in about fourteen days commonly, yet in some not until twenty days. But what event of this disease may be hoped for, is manifest by what hath been already said concerning malignant Fevers in general; namely, by how much the strength is the greater, and the symptoms lesser, by so much is there the more hopes of recovery; on the contrary, by how much the symptoms are the greater and more, and the strength weaker, by so much the more danger; with some when a looseness happens, 'tis a good crisis, but to most when the matter ascends to the head, and thence down to the ears, and deafness followeth, 'tis an argument of health. But as in other malignant Fevers, so likewise in this, the curing must be performed by taking away what feeds it, and resisting the malignant quality, yet the symptoms are not to be neglected. And first concerning the Fever, Purging. and its cause in those that have contracted this disease from ill diet, or in the camps, this thing happens that the vicious humours are not only contained in the vena cava, as in other Synochas and burning Fevers, but there is great store of humours lies hidden in the stomach, and about the first passages, which is known by the antecedent diet, pain in the stomach, anxiety, heat about the midrif, and vomiting; for then that matter is forthwith to be evacuated, as being such as doth severally exist, separated from the other humours, it will not come to any concoction, but corrupts both meat and medicines being taken, and Sudorifiques and other medicines which are taken, are carried into the more destructive parts of the body, and it increaseth the Fever. But this may be done by purging, Purging amongst the medicines Agarick is principally commended, then also Vomits, by which oftentimes great store of Phlegmatic and Choleric humours, of all kinds are evacuated, which lay hidden about the stomach: But for those which took the disease only by infection, and in whom peccant humours are not collected in the stomach by reason of ill Diet; there is no need of Vomits or Purgation, but 'tis sufficient only to evacuate the first passages by lenitives. When the first passages shall be freed from peccant humours, Bleeding forthwith the first or second day a vein must be opened, if it be necessary, and the strength of the sick will bear it; but in case some days are slipped over, and the strength be weakened, and the party be troubled with vomiting, or have a looseness, the breathing of a vein is to be omitted. The vein should be opened in the arm, or if the party be weak, in the ankle, which likewise conveniently refels the matter from the head, and in this disease is very profitable. Nature being thus eased of its burden, Sudorifiques. forthwith Sudorifiques, and such medicines as resist malignity are to be given, yet they are so to be tempered, as that they may not increase the heat of the humours, nor augment the Fever. Here Hartshorn prepared, bezoar stone, Antimonium, Diaphoreticum, Bez●ardicum minerale, Terra Sigillata, Pulvis Caesaris rubeus, Montaynanae, Species liberantis, and other such like before mentioned about malignant and pestilent Fevers in general is manifest. If we may use Mithridate, Treacle, and such like, that are hot, by reason of the vehemency of the malignity, lest the heat should be increased, they are to be allayed with cold waters and vinegar, to which there may conveniently be added spirit of Vitriol and Tartar, but 'tis not sufficient once only to use such medicines to provoke sweat, or twice, but again and daily to corroborate the spirits, resist malignity and putrefaction, yet in a lesser quantity then usual, and moreover species Elect. de Gemmis, temperate Cordials, Diamargarit. Frigid. Confectio de Hyacintho, Sper. Viniol and Tartar, Bezoar water, and other things before mentioned in the cure of the Plague, and other malignant Fevers. Externally likewise to the heart is to be applied, External things. and to the Pulses Medicines, as also the spirits are to be preserved with odoraments, and the malignity to be resisted; which were also mentioned before in the cure of the Plague, and other malignant Fevers. Lastly, Diet. the Diet should be the same as in malignant Fevers is expressed, and indeed the aliment to resist putrefaction should be dry; to abate the Fever, cold, and mixed with Cordials, or have cordial qualities: Wine in this Fever is hurtful, and for the most part those that refrain it not, die. CHAP. XVI. Of a Malignant Fever with the Cramp. THere are likewise other malignant Fevers, A malignant Fever with the Cramp. which had accompanied with them certain other diseases, namely the Cramp, Catarrhs, a Cough, and the Squincy; for in the year 1596, and 1597. in the Bishopric of Collen, Westphalia, the County Waldestein, Wittenstein, and Hassia, there reigned a disease joined with a Fever, which they then called die Kriebeltcranctheir, Kriempstsucht, oder Bichende Senche. It seized upon men with a twitching and kind of benummedness in the hands and feet, sometimes on one side, sometimes on the other, and sometimes on both: Hence a Convulsion invaded men on a sudden when they were about their daily employments, and first the fingers and toes were troubled, which Convulsion afterwards came to the arms, knees, shoulders, hips, and indeed the whole body, until the sick would lie down, and roll up their bodies round like a Ball, or else stretch out themselves strait at length: Terrible pains accompanied this evil, and great clamours and schrietching did the sick make; some vomited when it first took them. This disease sometimes continued some days or weeks in the limbs, before it seized on the head, although fitting medicines were administered; which if they were neglected, the head was then presently troubled, and some had Epilepsies, after which fits some lay as it were dead six or eight hours, others were troubled with drowsiness, others with giddiness, which continued till the fourth day, and beyond with some, which either blindness or deafness ensued, or the Palsy: When the fit left them, men were exceeding hungry contrary to nature; afterwards for the most part a looseness followed, and in the most, the hands and feet swelled or broke out with swell full of waterish humours, but sweat never ensued. This disease was infectious, and the infection would continue in the body being taken once, six, seven, or twelve months. This disease had its original from pestilential thin humours first invading the brain and all the nerves; The cause but those malignant humours proceeded from bad diet when there was scarcity of provision. This disease was grievous, dangerous, and hard to be cured, for such as were stricken with an Epilepsy, were scarce totally cured at all, but at intervals would have some fits, and such as were troubled with deliriums, became stupid. Others every year in the month of December and January, would be troubled with it. The Cure consisted in evacuating of the peccant humours, and corroborating of the Nerves. First, Cure. therefore the vicious humours are to be purged out of the first passages with Hermodactils, Turbith, Spurge prepared, Diagrydium Electuary, called Diaphenicum, of the juice of Roses, there being added Caster, Costus, seed of Rue and Commin. Afterwards Medicines against the Convulsion, were given of Peony, Birdly me of the Oak, Caster, Sage, Man's skull adding thereto medicines resisting malignity, with the root of Swallow-wort, Devil's bit, Treacle, Mithridate; and so purging and altering medicines are to be taken by turns, and continued: The external parts were anointed and fomented with those medicines which were proper for other Convulsions. CHAP. XVII. Of a malignant Fever, with a Catarrh, and a Cough, and the Squincy. Sometimes an Epidemical Catarrh and Cough accompany Malignant Fevers; A malignant Fever with a Catarrh and a Cough. such a Fever in the year 1510. 1557. 〈◊〉 1580. and 1591. and especially in the year 1580. spread over most parts of Europe under the Northern Equinoctial And that disease was then called a Feverish Catarrh, and a Chatarrish Fever, also a suffocating Fever, der Bien und Schafshusten, Shafteranctheit und hus Nerwehe. This Fever came with heaviness in sleep, pain of the head, a dry cough, pain of the breasts, hoarseness, pain of the stomach, difficulty of breathing, which even when the cough ceased would continue till the fourteenth day. This Fever proceeded from the moistness of the fort-going years; The causes. for when peccant humours were cumulated in the body, by reason of that irregularity of the air, and at length became putrid, and malignant, and adverse to the head and breast; thence a continued Fever was kindled, and with part of the peccant humours gotten into the brain and breasts, a catarrh and cough was generated. This disease, although most men had it, yet it was not mortal; for almost all men had it, and scarce one of a thousand died therewith. This Fever was cured as other malignant Fevers, Cure. also by regarding the putrefaction and malignity, and lastly, in having respect to the head and breast, which were principally troubled with this Catarrh and Cough. Breathing a vein was not then proper, and it was found by experience, that for the most part they all died that were let blood. But lenitive purgers were proper, because the matter did reside in the first ways; afterwards there was administered such things as might alter the matter in the head and breast, as use to be given for a Catarrh and a Cough, and those things that resisted malignity were not to be neglected. Lastly, A malignant fever with a Squincy. sometimes a Squincy, Pleurisy, Peripneumonia, is joined with a malignant Fever, and spreads over many places, as it happened in the year 1348. as Fracastorius relates, and in the year 1557. as Dodonaeus in chap. 21. of his observations witnesseth, and in the year 1564. likewise. Which Fevers for the most part did arise from the contrariety of air, and principally from its over-moist constrution, even as epidemial dysenteries arose from precedent dryness of the air, such as happened in the year 158●, and 1626. Those Fevers were cured as others that were malignant. But this is to be noted besides, Cure. that regard must be taken of that part wherein the force of the disease or symptom joined therewith resides most, and the disease and symptom which accompany the malignant Fever should be cured in the same manner as is propounded in the cure of particular diseases. CHAP. XVIII. Of the Cure of Symptomatical Fevers. LAstly, Symptomee of Fevers. there often happens in Fevers various symptoms, which are no less troublesome to the sick than the Fevers themselves, and therefore they require cure by themselves, and should be taken away, or abated. Such are first pain of the head, too much watching profound sleep, delitiums, convulsions, ●p●epsies, dryness of the tongue, thirst, pain of the heart, looseness, faintings and swoonings: All which proceed from the humour that was the cause of the Fever, or from vapours and fumes proceeding from it, and so molesteth this or that part either with its plenty, excess of primary qualities or malignancy. Universal Pu●gers first used, these symptoms are taken away by revessing, repeling, eissipating that matter from the part affected, to the more remote parts; as need shall require that excess o● qualities wherewith they are most troubled, to be altered and corrected, or even the malignity, if there be any, must be oppugne● with contrary remedies, and the parts, if occasion requisie, strengthened; or the symptoms themselves must be resisted with proper remedies. All which how to be performed, in particular to explain, is beyond the purpose of our Institutions, but practical books should be advised with concerning it, and especially the cause of each symptom must be diligently sought out; because the same symptom often proceeds from divers causes; and moreover cannot always be be cured with the same Medicine. Glory and Thanksgiving be to God. FINIS.