Mikrokosmographia a description of the body of man. Together vvith the controuersies thereto belonging. Collected and translated out of all the best authors of anatomy, especially out of Gasper Bauhinus and Andreas Laurentius. By Helkiah Crooke Doctor of Physicke, physitian to His Maiestie, and his Highnesse professor in anatomy and chyrurgerie. Published by the Kings Maiesties especiall direction and warrant according to the first integrity, as it was originally written by the author.

QVEST. V. VVhence it is, that when the right side of the Head or Brayne is wounded or enflamed, a Convulsion falleth into the opposite partes.

WEe haue a double Probleme heere to discusse. The first, how it commeth to passe, that when the right side of the Head is wounded or enflamed, it oftentimes falleth out that the lefte parts of the bodie suffer Convulsion. The second, why one part of the Braine beeing smitten or obstructed, it sometimes happeneth that the contrary side of the body is resolued or be∣commeth Paralyticall.

Both these questions haue in them many difficulties. For the affections or diseases al∣most * 1.1 of all the parts are communicated 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, that is, by rectitude, not 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, that is, by Contrariety, because the right side with the right and the left with the left are 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, that is, haue a similitude of substance. And therefore when the Spleene is affected the left side is pained and when the Liuer is offended the right. And in the second Section of the sixt Booke Epidemi••n. The paines of the sides, as Pleurisies and such like are è di∣recto, that is on the same side; so also is the Tension or swelling of the Hypochondria, the tumor of the spleene and the bleeding at the nose. Wee will first therefore entreate of Convulsion and then of the Palsie.

That the opposite parts suffer Convulsion Hippocrates first of all men taught vs in his Booke De vuineribus Capitis. By opposite parts he vnderstandeth sometimes of the head * 1.2 alone, sometimes of the whole body. Of the Head alone, whereas he writeth that the Veines which run through the Temples are not to be opened, because there is daunger of Convulsion, of the right side if the left Veine be opened, and on the contrary.

Of that convulsion which affecteth the rest of the parts of the body, he maketh men∣tion in the same Booke. If (saith hee) the Bone be purulent, then will Pustles arise in the tongue, then the patient wounded will dye idle-headed, and for the most part the other side of his * 1.3 body suffereth Convulsion, for if the right side of the head be wounded then will the Convulsion occupy the left parts of the body, and on the contrary.

In the fift Booke Epidemi••n he telleth of a wench whom he calleth Puella Omiloea, who had abruise on the right side of her head in the middle of Summer and suffered convul∣sion on the left parts. Antoninus had both his hands conuelled when he was stricken with a stone in the middle of the synciput or fore-part of the head about the mold.

In the seuenth Epidemiωn. In the History of the sonnes of Phanius and Euergus who were wounded in their heads. In such (saith hee) it happeneth that they fall to vomiting and * 1.4 suffer Convulsions, and that in the left parts if the right side be wounded, and in the right if the left. Wherefore I gather out of Hippocrates these two things. First, that Convulsion doth not alwayes follow, but onely when there is suppuration made, or whilst it is sup∣purating, or when there is a great inflamation. Againe, that all that are wounded doe not suffer Convulsion but the most, so that it it not perpetually or vniuersally true, that if one part be wounded, the contrarie part is conuelled.

To assigne the cause of the first Convulsion it is not hard; for if the right tempo∣rall * 1.5 Muscle be wounded or resolued, yet doth not a Convulsion properly so called pri∣marily and of it selfe fall vpon the opposite Muscle, but onely by euent, because all the Mus∣cles are either Antagonists that is aduersary, or Congeneres that is a Kin: if they bee Con∣generes then the resolution or section of one causeth the Convulsion of the other: but if they be contrarie or aduersary so that their motions succede one the other, then one of them perishing the other is necessarily taken away. For if the muscle which extendeth a part bee cut, the part will indeede be bent, but it will so alwaies remaine; because it can no more be extended, and so the Convulsion is accidentary and improperly so called.

But the Nature of the other convulsion which is of the rest of the parts of the body not of the head alone, is much more obscure, notwithstanding Hippocrates in the places before quoted seemeth to acknowledge the cause to bee the malignity of the pus or * 1.6 matter, which launcing the Membranes which are of an exquisite sense and pricking the originall of the sinnewes stirreth vp a depraued motion. Now there passeth from the wounded part into the sound part sometimes a breath alone, somtimes a portion of the malignant Ichor or humor. The breath vapoureth away thorough insensible passages, but how the Ichor or thin humor shoulde passe from the wounded part to the opposite side it is not easy to declare.

It must needs be either transmitted, or must fall downe, or be Propagated or finally Ex∣pressed. * 1.7 No man will say it is transmitted out of the wounded part into the sound, because the weaker part doth not vse to exonerate it selfe into the strōger; neither doth it fall down because all such sinking downward is perpendicular, that is, directly downeward, for it fol∣loweth the motion of the humour, which motion seeing it dependeth vpon the Elementa∣ry form, as Philosophers conclude it must be right and simple: wherefore it is either propa∣gated or expressed, and both these I heere acknowledge. It is propagated if it abound in quantity, if the substance of it be very thin, if the quality bee very sharpe: so Choler which is of Temper exceeding hot and raging when it breedeth an Erisipylas or Saint Anthonies * 1.8 fire in the inward parts, diffuseth it selfe sometimes euen to the outward parts also. So saith Hippocrates in a Squinsey of the Larynx or throttle, both the neck and top of the Chestare * 1.9 very red, per 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, that is, by consequence or succession. What therfore shal hinder the diffusion of a thin Ichor through the whole membrane if the inflamation bee come to his height? But if there be not that plenty of Ichor that it can be propagated, yet may there be made an Expression of it out of the right side into the left; and often there is from lower partes to the vpward a 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, that is, a Compression. Nowe Expression is made by compression, Compression by suppuration, which whilest it is a making doeth distend the neighbour parts, because the woorking or boyling humour occupieth a greater place; and hence come paines and Agues in the time whilest the Pus or Matter is in confecting, and therefore Hippocrates sayeth that convulsion is especially then induced when suppuration is a making.

In Puella Omilaea it is likely that the Ichor was not diffused, but expressed out of the wounded part into the part opposite. It may happen that a very little as it were a droppe * 1.10 of the Ichor may moue a convulsion, as also a venomous vapour, by goading the mem∣branes of the nerues which are of most exquisite sence. VVherefore the humour which breedeth the convulsion is oftentimes expressed or propagated from the diseased into the sound part, neither is it necessary alwaies that an Ichor should be expressed or propagated it is sufficient if a malignant ayre breath out of it.

But here we obserue two things very obscure and intangled. First, how the Ichor can * 1.11 passe out of the wounded side into the contrary, seeing that the braine is distinguished into the right side and the left by a proper midriffe of his owne and that exceeding thick, which is a duplication of the Dura Meninx called the Sythe, because it is like a Mowing Sythe or Siccle? The other why when as the same Acrimony of the Pus or quitture pricketh the Membrane of the wounded part, it doth not stir vp convulsion in the same but in the oppo∣site part.

The dissolution of the former is fetched from Anatomy. The hard membrane which * 1.12 toucheth the Skull in the vpper and exterior part is wholly continuated and lined as it were or smeared ouer with a watry humour; betwixt it and the bone of the Skull is the purulent matter gathered, which may be both Expressed and Propagated out of the right side into the lefte by the continuity of the membrane, and furthered by the orbicular figure of the head.

A small portion of the Ichor expressed out of the affected into the sound side, some∣times by reason of the tenuity sweateth through the membranes into the marrow of the braine, and out of it into the nerues; whence comes their inflamation: sometimes by the outside of the membranes it falleth into the spinal marrow which is inuested with the same membrane, where goading the originall of the nerues it procureth a convulsion by sympa∣thy or consent, so that when the membranes are vellicated or enflamed a convulsion soo∣ner ensueth then if the internall or marrowey substance of the nerues were affected.

But why is the convulsion not in the wounded but in the opposite part? It is obserued that sometimes when the right side of the head is wounded the right parts of the body are also conuelled, sometimes the opposite parts onely, oftentimes both together When (saith Galen) the Inflamation toucheth the originall. It is not therefore perpetually true, that when one part of the head is wounded the opposite part is conuelled, but because it hapneth so for the most part, let vs enquire the reason thereof.

The convulsion is in the opposite not in the wounded part, because the purulent mat∣ter * 1.13 which is expressed or diffused out of the wounded into the sound part hath no issue but is there stabled or gathered and breedeth an inflamation; and from thence comes the con∣vulsion: but the sanies or Matter which gathereth in the wounded part hath free egresse by

the wound and by the section of the bone, and so the Membrane is not affected. And this haply Hippocrates meaneth when in the history of the wench he saide, that the left parts suf∣fered * 1.14 convulsion because the contusion was on the right side. VVe may also assigne ano∣ther reason of this convulsion and that very probable. The wounded part is not conuel∣led * 1.15 but the opposite, because the faculty of the wounded part is extinguished and dissol∣ued, and the temperament which is the cause of all actions is notably depraued; where∣fore though the faculty be prouoked yet it answereth not, neyther doth any motion fol∣low such prouocation.

Now that vpon a suppuration or notable inflamation the part is almost mortified Hippoc. is witnesse in his book de vulneribus Capitis: but the opposite part hauing a quick sense is presently contracted & draweth into consent with it all the nerues of the same side; and so convulsion followeth 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 by a rectitude of vessels. And this our coniecture the place of Hippocrates aboue named maketh good. For when the convulsion falleth vpon * 1.16 the opposite part then the case is desperate, pustules arise in the tongue, and the patient dyeth in a delirium or light phrensie.

Notes

• * 1.1

  The affectiōs of the partes are commu∣nicated accor¦ding to Recti∣tude,
• * 1.2

  That the op∣posite partes are conuelled Hip. authority
• * 1.3

  Many Histo∣ries.
• * 1.4

  Two thinges gathered out of Hippocrates.
• * 1.5

  Why one tē∣porall Muscle is convelled when the o∣ther is woun∣ded.
• * 1.6

  The cause of opposite con∣vulsion is a malignant quality.
• * 1.7

  How the Ichor is carried out of the scund part into the offended.
• * 1.8

  Instances.
• * 1.9

  Hippocrates
• * 1.10

  Puella Omilaea.
• * 1.11

  Two obscure questions.
• * 1.12

  How the I∣chor passeth into the oppo¦site part.
• * 1.13

  Why the woū¦ded part is not conuelled
• * 1.14

  Hippocrates.
• * 1.15

  Another rea∣son of it.
• * 1.16

  Hippocrates.