Two discourses concerning the soul of brutes which is that of the vital and sensitive of man. The first is physiological, shewing the nature, parts, powers, and affections of the same. The other is pathological, which unfolds the diseases which affect it and its primary seat; to wit, the brain and nervous stock, and treats of their cures: with copper cuts. By Thomas Willis doctor in physick, professor of natural philosophy in Oxford, and also one of the Royal Society, and of the renowned college of physicians in London. Englished by S. Pordage, student in physick.

THE SECOND PART PATHOLOGICAL: OR Of the DISEASES which belong to the Corporeal Soul and its Subjects, viz. The Brain and the Nervous Stock. (Book 2)

CHAP. I.

Of the Headach.

THE pain of the Head is wont to be accounted the chiefest of the Dis∣eases of the Head,* 1.1 and as it were to lead the troops of the other Af∣fections of that part; for that it is the most common and most fre∣quent symptom, to which indeed there is none but is sometimes ob∣noxious, so that it is become a Proverb, as a sign of a more rare and admirable thing, That his Head did never ake.

The Headach, though it be a most frequent Distemper, hath so various, uncer∣tain, and often a contrary original, that it seems most difficult to deliver an exact Theorie of its appearance, containing the solutions of so manifold, and often opposite things.* 1.2 This Disease being constant to no temperament, constitution, or manner of living, nor to no kind of evident or adjoyning causes; ordinarily falls upon cold and hot, sober and intemperate, the empty and the full bellied, the fat and the lean, the young and old, yea upon Men and Women of every age, state, or condition. Hence, because they cannot satisfie any one sick with this Distemper, with the causes of it, most commonly they say, they all proceed from Vapours. Further, the Cure of this Disease is more happily instituted, not so much by certain Indications, as by trying various things, and at length, by collecting an Extempory method of Healing, from things helping and hurting. Wherefore, if I should go about to untye this hard knot, by drawing forth the matter more deeply and more accurately, I must ask for pardon, if I am carried, by a long compass, thorow the various Series and Complication of Causes: and if at length, by any means, the Aeriology or the Reason of this Disease may be fully detected, a more certain way to its Cure may be opened.

Therefore,* 1.3 that we may go on more fully to institute this Pathology, or shewing the Causes or symptoms of this Disease, we ought first of all to unfold the Subject, and the formal reason of this Disease, together with the Causes and differences; then to sub∣joyn the Curatory method, and to illustrate it with some more rare Cases and Ob∣servations.

As to the former, as all pain is a hurt or violated Action, or a troublesome sension or feeling, depending on a Convulsion, or a Corrugation of the Nerves, the Subject of the Headach are the most nervous parts of the Head, that is, the Nerves them∣selves, as also the Fibres and Membranes, and such as are more and most sensible, seated both without and within the skull.* 1.4 But the parts of this kind, which are af∣fected with pain, are first the two Meninges, and their various processes, the Coats of

the Nerves, the Pericranium (or skin compassing the skull) and other thin skinny Mem∣branes, the fleshy Panicle of the Muscle, and lastly the skin it self. As to the Brain and Cerebel, and their Medullary dependences, we affirm, That these Bodies are free from pains,* 1.5 because they want sensible Fibres, apt to be wrinkled and distended: the same, for the like reason, may be said of the Skull.

2. But whensoever pain is excited any where about the nervous parts of the Head, its formal reason consists in this, That the Animal Spirits being drawn one from ano∣ther, and put to flight, cause the containing Bodies to be pulled together and wrinkled, and so stir up a troublesome sension or feeling: But that which so distracts the Spirits, that from thence a troublesome feeling arises, is some improportionate thing, rushing upon the Spirits themselves, or on the Bodies containing them, which entring the Pores of, and spaces between, the Fibres, pulls them one from another, and so drives the spirits dwelling there into disorder.

* 1.63. As to the differences of the Headach, the common distinction is, That the pain of the Head is either without the Skull, or within its cavity: The former is a more rare and a more gentle disease,* 1.7 because the parts above the Skull are not so sensible as the interior Meninges; nor are they watered with so plentiful a flood of Blood, that by its sudden and vehement incursion, they may be easily distended, or inflamed above measure. Secondly, The other kind of Headach, to wit, within the Skull, is more frequent, and much more cruel, because the Membranes, cloathing the Brain, are very sensible, and the Blood is poured upon them by a manifold passage, and by many and greater Arteries. Further, because the Blood or its Serum, sometimes passing thorow all the Arteries at once, both the Carotides and the Vertebrals, and sometimes apart, thorow these or those, on the one side or the opposite, bring hurt to the Me∣ninges, hence the pain is caused that is interior;* 1.8 which is either universal, infesting the whole Head or its greatest part; or particular, which is limited to some private region;* 1.9 and sometimes produces a Meagrim on the side, sometimes in the forepart, and sometimes in the hinder part of the Head.

There are many other differences of this Disease, to wit, That the Pain is either light or vehement,* 1.10 sharp or dull, short or of continuance, continual or intermitting; its approaches sometimes periodical and exact, sometimes wandring and uncertain. Also by reason of the Conjunct Cause, which (as shall be declared by and by) some∣times is the Blood, sometimes certain excrements of it, as either the Serum, or nourish∣ing juice, or vapours, or wind; sometimes it is the nervous liquor, sometimes a con∣gression or striving of it with the bloody liquor: The Headach may be called, either bloody, and that either simple, or else serous, vaporous, or otherways excrementiti∣ous; or else Convulsive, from the humor watering the nervous Fibres, and irritating them into painful Corrugations.

* 1.11Concerning these, that we may proceed methodically, we shall rehearse in a certain order, the various kinds of this Disease, with their Causes; and it seems good, that we distinguish the Pain of the Head to be either accidental, or occasional and habitual: The former is wont to be excited without any foregoing cause, or previous disposition, by the solitary evident cause▪ as when an Headach happens almost to all men after the drinking of Wine.* 1.12 Surfetting, lying in the Sun, or vehement exercise, also in the fitts of Feavours; to wit, forasmuch as the Blood being incited, more than it was wont, and boiling up immoderately, very much blows up and distends the Membranes it passes thorow;* 1.13 yea the Serum and Vapors, copiously sent forth, from it, then grow∣ing hot, and rushing on the Membranes, pull and provoke the nervous Fibres.

Secondly, The habitual pain of the Head, hath some procatartick or more remote Cause fixed somewhere, by reason of which it is troubled, either constantly or often; so that though it sometimes intermits, yet it often returns of its own accord, and is excited also upon every light occasion: but this, whether it be continual or intermit∣ting, hath neither always, nor only, the Suffusions or too great Evaporations of the Blood or Serum, for the Conjunct Cause, (although these are often present, where notwithstanding they are rather instead of the Evident Cause, than the Conjunct) but beside, an evil procatarxis, or a certain predisposition, is always affixed to the part affected, or wont to be distemper'd; by reason of which, the aforesaid Causes, also the inordinations of the Nervous Liquor, and the meeting and growing hot of it with the bloody Serum, or the Nutritious Juice, raise up the fits of pains.

Although the more remote Cause of the Headach be manifold and diverse, so that its several kinds can scarcely be number'd, yet for the constituting it, these two, to wit, either one or both of them, do chiefly or for the most part lead the way, viz. First, The evil or weak Constitution of the affected part. Secondly, Then, because of the more easie and ready heaping up of the Morbi••ic matter in it.

As to the former, the parts of the Head obnoxious to pains, are the Nervous Fi∣bres, belonging to the Membranes, Tendons, the Musculous flesh, and other sensible Bodies; the Morbid provision of which consists in their evil conformation or de∣bility.

Of these,* 1.14 that the former is sometimes innate and hereditary, appears from hence, because the Disease is often delivered from the Parents to the Children: and seems to be done chiefly by this means: because the covering of the Head being made more thick, or more close than it ought, neither the humors, nor the vapours do easily pass thorow; wherefore being by these restrained, and hindred in their Motion, and so heaped up, the Meninges, Pericranium, and other sensible parts, being too much stuff∣ed, or inflated, or hauled, receive pains: to which happens, that sometimes, by rea∣son of the original intemperance of the Brain, the Humors or Vapours about the parts, hanging like an arch over it, are variously heaped up together.

2. But it more often comes to pass,* 1.15 that the Vices of an evil Conformation, by which these or those parts of the Head are disposed to the Headach, are contracted a∣new, and that by a various kind of production: for sometimes by Cold taken, by rea∣son of the Northern winds, Snow, or Rain, the Pores of the skin in some region of the Head, yea and the nervous Fibres themselves, are so closed up, or otherwise perverted or weakned,* 1.16 that they are not able to bear the outward air, nor the agita∣tions of the Blood or Humors, but presently the Headach arises.

Nor is the predisposition of the Headach less rarely produced,* 1.17 in the disorderly use∣ing the six not natural things. For the Blood being stirred up above measure, upon any cause whatsoever, impresses by its boyling up, or by the insinuation of the Serum or Vapours, a breaking of the unity in some nervous parts, or some other sort of hurt; for which reason, as there is a present Headach, by and by stirred up, so after∣wards there is a disposition to the same,* 1.18 upon every light occasion. But oftentimes a disposition to the Headach not easily blotted out, is induced by a vehement Passion, Surfeit, Drunkenness, also by a blow, wound, or contusion of the Head: so that either the proper or excrementitious humors being heaped up, and standing in those parts,* 1.19 being afterwards moved of themselves, or growing hot with other inflowing juices, stir up inflations, or painful haulings or pullings. Yea, I have known Inflamma∣tions, Imposthumes, Whelks, Scirrhous tumors growing to the Meninges with the Skull, and other Diseases of an evil conformation, excited in the Membranes of the Brain; by which, at first for a long time, frequent Headaches, and most cruel, and then afterwards a sleepy and deadly distemper hath been induced; the cause of the Disease not detected, but after death by Anatomy; and indeed it is to be suspected, that inveterate and pertinacious pains in the Head, which return, and dayly become more tormentive, in spight of all Remedies, depend upon some such invincible cause.

2. Not only an evil conformation,2 1.20 or the breach of unity, but also sometimes a meer weakness or enervation, renders some parts of the Head obnoxious to the Head∣ach; for when as the Fibres are somewhere so infirm, that they are neither able of themselves to rule the proper humor, nor to resist the incursions of a strange humor; the part so disposed, by reason of any light occasion, is moved into painful wrinklings: These kind of debilities of the Fibres, sometimes external accidents, as the excess of cold or heat; sometimes also errors in Dyet or living, as Surfeit, Drunkenness, and especially sleeping at noon; moreover great Catarrhs, and a long lodging of a sharp Serum are wont to bring in.

So much for the primary more remote cause of the Headach, which is also fixed and rooted: The other cause of it, secondary and moveable, consists in a ready and easie heaping up of the Morbific matter about the predisposed parts, from which come the fits of pains, and their approaches: But as the matter is manifold, it is wont to be heaped up after a diverse manner, and to excite pains which affect after a diverse sort: This, as we have said, is either the Blood, or its Serum, or the nourish∣ing Juice, or the nervous Liquor. Every of these being variously disposed, or imbued with feculences or dregs, are by degrees heaped up about the predisposed parts of the Head, sometimes before the fit; and sometimes, that coming, they are plentifully cast down. But sometimes one only humour with its plenitude and acrimony, distends or provokes the sensible Fibres; sometimes more meeting together, by their mutual growing hot, pull or haule the Fibres, and so stir up painful Convulsions. We shall briefly take notice of the several kinds of these, with their signs, and the manner of their being made. When therefore a part of the Head, as chiefly the Meninges, or some re∣gion of the Pericranium, is predisposed, by reason of an evil conformation or debility, to the Headach; the approaches or fits of the Disease are wont to be excited, by rea∣son

of the various incursions or coming together of the following humors, sometimes of this, sometimes of that humor, and sometimes of many together.

* 1.211. Sometimes the Blood it self being incited into a more rapid motion, and boiling up into the Head, is straitned or stopp'd in its passage about the predisposed places, and from thence, being by and by heaped up there, distends the Vessels, greatly blows up the Membranes, and pulls the nervous Fibres one from another, and so brings to them painful corrugations or wrinklings. For this reason those obnoxi∣ous to the Headach, are forced to shun all occasions by which the Blood should grow hot above measure, as drinking of Wine, Exercise, Baths, &c.

2 1.222. The Serum being more copiously heaped up in the bloody Mass, oftentimes conceives a sudden Flux, either of its own accord through meer fulness, or stirred up by an evident cause, and so presently running forth from the Blood doth not only rush into the Lungs, but very often into the Head, and being poured upon its Mem∣branes or Muscles, is copiously heaped up about the parts predisposed to the Head∣ach, and there induces painful Corrugations and Inflations. Further, the Serum car∣ries with it infestous Recrements, as sulphureous, saline, sharp, acid, bilous, or me∣lancholic, or of some other kind, and fixes them to the nervous Fibres, which cause an acute or dull, a shorter or a longer pain. The Headaches arising by reason of this kind of remote cause, infest more grievously in the Winter time, in a moist Air, and in a Southern Wind: Moreover, Catarrhs of the Face, Mouth, Larynx, and of other parts, oftentimes accompany this Disease.

3 1.233. The nourishing Juice, or fresh Chyme, being carried from the Blood to the so∣lid parts, and laid upon them, by reason it becomes improportionate to some parts of the Head evilly disposed, is wont to excite periodical fits of the Headach. For this provision being laid up near some nervous Fibres, because it cannot be assimilated, begins to trouble them or burthen them, after some stay, and at length provokes them into wrinklings to expulse that which troubles them. An Headach proceeding from such a cause, as I have observed in many, doth dayly come at so many hours af∣ter eating, and continues a like space of time; yea the times alter according to the manner of taking their repast, both as to the quality and quantity, and so also the fits of the pains are wont to vary.

4 1.244. The nervous Liquor, is a cause of pains, by its inordination, as oftentimes in other parts, so also not seldom in the Head; for this either degenerating from its temper, or being imbued with dregs or filthiness, does not pass thorow so freely the nervous Fibers, but is apt to stagnate, and to be heaped up in them to an irritative fulness: and that chiefly within the Fibres made weak beforehand, or of an evil con∣formation (such as are sometimes the Membranes of the Head) because in these pre∣disposed, the watering Liquor being hindred in Motion, easily arises to an aggrava∣ting or provoking fulness;* 1.25 so that the Fibres being so filled, like the stomach too much crammed, enter into Convulsions and painful wrinklings, for the putting away their contents, nor do they cease from them, till they are freed of their burthen; which notwithstanding, afterwards being heaped up again, sometimes sooner and sometimes later, cause from thence others, and so again other fits of pains. The Headach ari∣sing from such a cause, springs oftentimes without any notable turgescency of the Blood, and gently and as it were of its own accord, without any errors in dyet or living; yet sometimes it may sooner arise by reason of disorders in the non-naturals, and other accidents: This is wont to come more often in the Morning, and after long sleeping, when the nervous Fibres have drunk in this humor more largely.

5 1.26In the aforesaid Headaches, the Morbifick matter is made up for the most part of one singular humor, and so the fits of the pains are something more gentle, and often∣times sooner pass over. But there is another Cause of this Disease, when two humors (like divers kinds of Salts) meet together, and grow mutually hot, and so from the strife of dissimilar particles, the Fibres are very much pulled, and moved into very acute and cutting pains, and are most commonly longer infested with them. In this case one of the champions is always the nervous liquor, but the other, either the se∣rous water or the nourishing juice. We exempt the Blood, because it only washes the passages of the Nerves, and does not enter them deeply; but the nervous humor, by reason of the vices but now recited, sometimes of it self, pulls the containing Fibres, and provokes them into painful Convulsions. If that another humor, either the Nu∣tritious or Serous, (for both of them are wont to be guilty) being little of kin, be plenti∣fully poured upon this so predisposed, and copiously heaped up within the Fibres; pre∣sently all the particles being raised up, strive among themselves, and so by a mutual ef∣fervency, notably distend and haule the Fibres, that from hence from their being long and greatly wrinkled, most sharp and long remaining pains are induced. Whether it be

this or that humor, meeting with the nervous juice, that causes the Headach, may be easily known from the proper irregularities, above described, of either peccant humor by it self.

By what means,* 1.27 and for what more remote causes, the humors, either Nutritious or Serous, offend, as often as meeting with the Nervous humour, contained within the Fibres, move the fits of pains, shall be declared anon: in the mean time, I think it suffici∣ently appears, that the more frequent and habitual Headaches are produced chiefly by the fault of the nervous liquor, because this is most intimate both with the Fibres themselves, which are wrinkled, and the Spirits which are moved into painful distra∣ctions; also because the pains of the Head sometimes arise without any disorder or tu∣mult of the Blood, Serum, or nourishing Juice, and these being emptied or allayed, after what manner soever, oftentimes the Headach most pertinaciously continues.

But concerning the nervous Liquor,* 1.28 when it is the cause of the Headach, we observe that its fault is sometimes universal, and sometimes private: for sometimes it doth acquire its evil from the distempered part: to wit, forasmuch as being constrained to subsist or stagnate within the Fibres, hurt by their conformation, it is so perverted that at length being infested, fermenting either by it self, or with some other humor, it irritates them into painful Corrugations: Yet sometimes, and especially in the more grievous Headaches, we may suppose that the whole Mass of the nervous Liquor is in fault, but the nervous parts of the Head partake of its evil, before any others in the whole Body; because these are the chief and nearest springs of the nervous Liquor, and are also highly sensible: wherefore, the nervous Liquor, when ever it is vicious, either swelling up of its own accord, or growing hot by another humour being poured unto it, within the Meninges and other Membranes of the Head, more than in the other parts of the Body, becomes painful. The thing appears to be so, because a long and grievous Headach is wont to be Cured, not so much by Remedies applyed or pro∣per for the Head, as by those which restore the Crasis or Constitution of the nervous Juice, and the bloody Mass; and such are Chalybeats, or Steel Medicines, and Antiscorbu∣ticks, or Medicines against the Scurvy. Which certainly argues that the nervous Li∣quor, where-ever it is in fault thorow the whole Body, chiefly punishes the parts of the Head.

Thus much for the causes of the Headach,* 1.29 both the procatartick or foregoing, and the Conjunct: there yet remain others more remote, called Evident, which raise up the former, and provoke them into act, or the painful means of affecting. But they are of a various kind, and of a divers operation: to wit, Whatever things are apt, first,* 1.30 to transfer the Morbific matter from another place into the part affected; or secondly, to move it before lodging in it; or thirdly, and lastly, which impress on the Fibres themselves, predisposed to painful Convulsions, this Distemper, by the consent of the other parts afar off, they belong to this rank.

As to the former, the Blood and its inmate humors, to wit, the Serous and nu∣tritious; also the bilous, acid, and otherwise vicious recrements, are apt to be moved from various Causes, and to be transferred into the Membranes of the Head, viz. many accidents from without ordinarily effect this, as great and sudden mutations of the Air, or the season of the year, excess of heat or cold, or of moisture, plentiful feed∣ing, drinking of Wine, Bathing, immoderate Venus, violent passions; yea many other occasions sufficiently known, and to be avoided by all subject to Headaches. Fur∣ther, these humors sometimes swell up of their own accord,* 1.31 and without any exter∣nal Cause, or other ways evident, being moved, drive themselves forward into the Head: in which place, when they come, and settle upon the Fibres before indisposed, though they constitute a part of the Conjunct Cause, yet they, when they are first in mo∣tion or flux, become the means of the Evident Cause. Wherefore, when we have first unfolded, by what means the Blood, with its contents, being carried to the distempered Membranes, stir up Headaches; we shall then shew by what means, and upon what occasions, the same humors are wont to be moved, and to be snatched in∣to the Membranes.

And first the Blood growing hot of its own accord,* 1.32 and by reason of the strife, and intestine motions of its particles, imparts its trouble to the Head: Its frequent and wandring turgency or boiling up, happens not only in the fits of Feavours, but also without any cause or suspicion of disease, which in others scarce perceiveable, those obnoxious to the Headach sufficiently take notice of and feel; neither doth the blood only bestow the hurt to the Head, from its own proper provision, but re∣ceiving it elsewhere, sends it thither. Oftentimes the Blood receives the incon∣gruous matter from the Stomach, Spleen, Mesentery, Liver, and other parts, or In∣wards, infestous to it self or nervous Stock; which growing hot a little time after,

that it might extrude or thrust it forth;* 1.33 it pours it upon the Membranes of the Head, and so produces the Headach, commonly called Sympathetick, viz. by a consent ex∣cited in other parts; which kind of Distemper being transmitted from other parts to the Head, sometimes also it happens after another manner, as shall be by and by de∣clared.

When the Mass of Blood abounds with Serum, it is sometimes excited to the put∣ting it off by meer fulness, wherefore it conceives a flux, or as it were a certain melt∣ing, to wit, by which the thin and watery part may be separated from the thick and bloody. Then, because the Blood becomes more diluted in its swelling up, and passes more swiftly and more copiously thorow the Arteries, than can be carried back by the Veins, almost all that is serous is sent away by the spaces between the Vessels, being poured sometimes on these parts, and sometimes on those, as falling down in many places, it causes tumors or Catharrs, so lying on the Membranes of the Head, it stirs up fits of pains.

* 1.34But the serous heap, from many other causes sweating forth from the Blood suffer∣ing a flux, rushes on the Meninges and the Pericranium, and causes in them most trou∣blesome Headaches. A sudden Constipation or closing of the Pores by Cold or Wet, almost constantly produces such a Distemper in most, obnoxious to this Disease. Sharp and thin Wines, Cyder, yea and Beer, that by reason of its soureness is apt to ferment, because they fuse the Blood, and precipitate its serosities, are forbid to those troubled with Headaches, as so much poyson: And lastly, whatever is wont to cause a Flux in those troubled with the Gout, the same also for the like reason causes it in these, for the rising Serum, in either, flows to the distemper'd part, where it oftentimes grows hot with the nervous humor.

* 1.35Further, not only the meer and simple Serum of the Blood, dropping forth upon the Membranes of the Head, stirs up pains, but sometimes other humors joyning toge∣ther, and by this passage being admitted to the distemper'd part, encrease the tragedy of the Disease; it often happens, that a thin and watery humor doth suddenly flow forth from the Lymphic Vessels, the Glandula's, and perhaps from the Passages and Pores of the solid parts (in which it is gathered together) and is poured forth into the Blood in the Veins; from whence presently passing thorow the bosom of the Heart, and being confused with the Arterious Blood, and by that soon separated, is cast back by any way it can find; therefore, being partly sent away by the Reins, it causes a flowing down of a clear and copious Urine, also sometimes partly redounding on the Brain or Nervous Originals,* 1.36 produces Sleepy or Convulsive Distempers, as we have elsewhere shown. Yea sometimes, a certain part of the same limpid humor, be∣ing snatched with the Serum into the Membranes of the Head, raises up fits of a most cruel Headach: For indeed, I have observed in many, a watry and very plentiful Urine, either to precede or accompany the fits of this Disease.

But we may believe other manner of recrements, of the other parts, viz. bile from the Liver, black bilary feculencies from the Spleen, and perhaps incongruous humors from the Stomach, Reins, Pancrace, &c. are supped up by the Serum of the Blood, and deeply boiled with it, by which, whilst it is infected, it more readily conceives Effervescencies, and so rushing impetuously into the Cephalick Vessels, and there fermen∣ting with the nervous Liquor, brings forth Convulsions, and painful and very trouble∣some pullings or haulings.

* 1.37The serous heap, whether it be simple, or as we have shown, complicated, is suffi∣ciently infestous to the Head, whenever its usual evacuation, thorow its due and ac∣customed ways, is hindred: viz. whether if the Pores being bound up, transpiration be inhibited, or by reason of the evil distemper of the Reins, an Evacuation by Urine is not copiously performed; either defect greatly punishes those subject to Headaches. Further, the Membranes of the Head are oppressed, by reason of the passages of the Blood being obstructed in other places: for if the lower or middle parts of the Belly, and especially the Liver and Lungs, are troubled with an obstruction, so that the Blood can scarce pass thorow in those places, its more full torrent is directed into other parts, and especially towards the Head; so that for this Cause, I have known to have followed, not only Headaches, but also soporiferors or sleepy, and sometimes deadly distempers.

3 1.383. As the Serum in the bosom of the Blood, so the nourishing Juice, that is the fresh Chyme made out of the Aliments, lodges there too, and is circulated with it, and for∣ced to follow its inexorbitances, being as it were in the current of the same River. Wherefore, when the Blood, presently after eating, is carried impetuously or inordi∣nately to the Head,1 1.39 and the nourishing Juice being half Concocted or depraved, is fixed there to the Membranaceous Fibres, it causes painful pullings or haulings to follow;

for hence it is, that exercise, bathing, violent passions, reading, or any serious in∣tention of the Mind, upon a full stomach, hurt those troubled with Headaches.

Sometimes the nutritious Juice is not presently or easily mixed with the Blood,2 1.40 but being carried fresh to it, by and by stirs up a turgency, so that many, constantly after eating, are troubled with an high Colour, and oftentimes also with an Headach. This commonly, but amiss, is imputed to the obstruction of the Liver, when indeed it proceeds from an evil disposition of the Blood, hardly bearing the mixture of the fresh Chyme. Wherefore, such a distemper, follows for the most part dangerous Fea∣vours, and especially the Small Pox, and sometimes great Surfeits.

4. There yet remains another sort of Evident Causes,* 1.41 (to wit, by which the leading Causes, or predispositions to the Headach are actuated) plainly different from the for∣mer irregularities of the Blood, Serum, and nourishing juice; to wit, when Headaches very often most terrible, follow, by reason of Convulsions, begun in other parts, and from them continued to the Head. 'Tis an usual thing for a certain sense, or feel∣ing, of a Formication, or little pricking, to creep forward from the Hypochondria, as also from the region of the Stomach, Mesentery, Womb, yea sometimes from the Members or outward parts, to the Head, and by and by sometime after to excite a pain that will last for a good while. This kind of Distemper, which is wont oftentimes to be the forerunner of the Vertigo, also of the Epilepsie, or the Apoplexie, is commonly believed to be the ascent of Vapours; when indeed it is only a Convulsion, begun in the extremity of some Nerve, which creeping upward towards its original, and then coming to the Skull, for as much as it either is communicated to the parts within the Head, or to the Meninges, either one or both of them, it stirs up Convulsions or pains. Which passions notwithstanding,* 1.42 follow this Formication or tingling, brought from elsewhere, sometimes as a sign, and sometimes as the cause. We have in another place largely enough unfolded the reason of the former, to wit, it being shown, that when the Morbifick matter possesses the beginnings of the Nerves, or the nearest parts to them in the Head, a Convulsion oftentimes beginning from the ends of the same Nerves, being carried thence upwards towards the places first distemper'd, ascends as it were by a creeping forward: wherefore not only upon the Vertigo, but upon the Headach, a Vomiting comes very frequently.

But further,* 1.43 an Irritation in some distant Member or Viscera, is sometimes the occa∣sion, and in a sort the cause of the Headach; to wit, when the Morbifick matter is heaped up, even to a fulness of Turgency in the part of the Head already disaffected, there is need only of a light Vellication or pulling of the Containing Fibres, that this matter being stirred, should cause a fit of the Disease; to which movement, it often suffices, that by intimate concent of some distant Inward, as the Ventricle, Spleen, or Womb, with the Head, the nervous Fibres should be pulled or hauled; for pre∣sently from thence, the trouble being communicated by the Nerves, some Membrana∣ceous Fibres of the Head, being evilly disposed, and burthened with the Morbific Mat∣ter, begin to be strained and wrinkled, and so when the Mine of the Disease is moved from its moved Particles, the Fibres are urged into grievous and continual Corruga∣tions.

Headaches that seem to begin after this manner from the Viscera,* 1.44 and commonly cal∣led Sympathetic, are wont to be ascribed to Vapors, viz. by supposing a Mine of the noxious humor to lye hid in some Inward, from which being moved, whilst the Effluvia ascend into the Head, and there sharply pierce thorow and p••ll the nervous Fibres, pains are excited. We have already so plainly refuted this doctrine, that there is no need here to bring any other reasons to oppose it. But in the mean time, let us in∣quire whether pains of the Head do not arise also by other means, besides a Convul∣sive communication thorow the Nerves, by reason of the Morbific Cause lodging in the Stomach, Spleen, and other places.

Concerning this, we may suppose, that Matter oftentimes degenerate, is heaped up in remote parts, which carries its hurt to the Head, by the passage or Circulation of the Blood.* 1.45 'Tis a usual thing for Corrupt humors, viz. sometimes sharp, sometimes acid or austere, to be heaped up in the Ventricle; Bile in the Liver, atrabilary or me∣lancholic dregs about the Spleen, yea and other sort of degenerate Matter about the Mesentery, Womb, or other parts: from which being heaped up to a fulness of swel∣ling up, a Fermentative Miasm or Infection is fixed to the Blood; from which, that, being as it were imbued with rage, impetuously grows hot, and partly by its swelling up, and partly by transferring what is incongruous into the Membranes of the Head, stirs up fierce and cruel fits of pains.

As to the Ventricle,* 1.46 that it is so, some obnoxious to this Disease have plain ex∣perience. Because some of them, after the Bile or Choler flowing in the Stomach,

and others after a noted soureness, and ravenous hunger, most certainly expectia fit of the Headach. The reason of which seems partly to be, that those contents of the Ventricle being supped up by the Blood, make it hot, and stir up in the same a Cephalic Tur∣gency or swelling up; moreover, from this kind of sharp Vitriolick, or otherways infestous matter, being heaped up and moved within the Stomach, a Convulsion, or Corrugation very troublesome, is impressed on the Fibres and the extremities of the Nerves there inserted, which immediately being continued into the Head, by the pas∣sages of the same Nerves of the eighth pair, and of the Intercostal, is communicated to the Membranes, and the nervous Fibres, predisposed to painful wrinklings.

* 1.47By reason of the same Reciprocal Communication, between the Stomach and the Head, a nauseousness and Vomiting, as we said but now, follows upon the Headach, viz. the Membranes being stirred up into painful wrinklings, by the Morbifick matter (even as is wont by a blow or wound) and transferring the evil by the passage of the Nerves to the Ventricle, guiltless of it self, a vain endeavour of Vomiting sometimes arises, nothing remaining within the Ventricle, that should be cast forth: yet some∣times, from a cruel shaking of the Inwards, in striving to Vomit, the Gallish or Pan∣creatick humor, either one or both of them, being thrust forth into the Duodenum, and cast forth by Vomit, is ignorantly taken for the Cephalick matter.

2 1.482. The pains of the Head are wont to be imputed no less to the Spleen, than the Ventricle; and indeed 'tis ordinarily observed in Hypochondriacks, obnoxious also to this Disease, when a Pain, Inflation, a Rumbling, or some other Perturbation of the distemper'd Spleen, happens in the left-side, that the Headach, as if raised up by it, by and by frequently suceeds; hence, presently 'tis the voice of the people, that these Va∣pours being sent forth from the disturbed Spleen, stir up the pain of the Head: But in∣deed, we may grant that the Headach arises sometimes from the default of the Spleen, yet reject this opinion, that it ought for this cause to be imputed to Vapors, but indeed either to an evil Ferment, transmitted into the Blood from the Spleen, or from a Con∣vulsion, from thence communicated to the Head, by the Nerves: because in the Spleen evilly affected, the Melancholic humor being degenerate, sometimes into a Vitriolic Nature, sometimes a biting, sometimes a sharp, or otherways infestous, is oftentimes heaped up, which of its own accord being shaken forth, by reason of plenitude, or occasionally by reason of some perturbation, and being confused with the Blood, im∣presses a Fermentation upon it, by which its Liquor rushing by it self on the Membranes of the Head, or growing hot with the nervous Liquor, causes painful pullings or haul∣ings. Further, it is no less probable, that sometimes a Convulsion being excited in the nervous Fibres, which are very much disposed about the Spleen, brought thence by the passages of the Nerves of the wandring and Intercostal pair, and continued to the Head, impresses the like Distemper to the Membranes predisposed to it.

* 1.493. A reason may be also rendred, according to the same Pathology, to wit, either from an evil Transmission of the Ferment, or a continuation of the Convulsion, for Headaches which are said to be raised up by consent, from the Liver, Mesentery, the Womb, and other parts.

The habitual Headach, the Aetiology, or the Reason of which, we have already sufficiently handled,* 1.50 is yet divided into certain kinds, to wit, it is either Continual, or Intermitting; but the periods of this are sometimes determined to a certain time, and are sometimes wandring and uncertain: we shall speak briefly of each of these.

* 1.511. Sometimes therefore it happens, that some are afflicted with a Continual pain of the Head, to wit, for many days or months, little intermitting, unless when sleep helps; in which case we suppose, that there is not only present a Procatartick or lead∣ing cause, but also a Conjunct, somewhere fixed and constant. For besides that the parts affected, or that are wont to be affected, are weak, and their watering liquor much depraved, is apt to stagnate, or to grow hot with other humors; there is moreover oftentimes excited in them, a breaking of the unity, to wit, an Inflammation, a red and painful swelling, a Scirrhous tumor, or Imposthum, or of some such kind; about which, whilst the humors of divers kinds do meet together, and are heaped up, there arise almost perpetual pains, by reason of the nervous Fibres being continually pulled or hauled. These kinds of Headaches, do not rarely end in sleepy distempers, and at length deadly; for when I have opened the Heads of many dead of these Diseases, the signs or footsteps, declaring the aforesaid kinds of Morbific causes, have appeared; some examples of these shall be added hereafter.

* 1.522. The habitual Headach, is for the most part Intermitting, whose sits, as they are certain and Periodical, or coming at a set period of time, are wont often to return in the space of half a day and night, or once in twelve hours. Some more rare cases I have known, which exactly repeating the Fits, came every other day, yea once in a

week, or a month. It is an usual thing, for Headaches, that seem to be driven away, to return again about the Equinoxes or Solstices; to wit, because at these times, the Blood and Humors conceive greater Turgences or risings up, than are wont, and therefore are more apt to grow hot with the watering Liquor of the nervous parts of the Head,* 1.53 and to renew the wonted fits of pains. But when about these times of the year, Headaches return, they are not prorogued by a longer accession for a great while, but for the most part, having gotten subordinate periods, they are wont to infest at some certain standing hours, for the space of twelve hours.

When therefore a Periodical Headach hath its daily fits, for the most part the rea∣son of these, as of Intermitting Feavors, ought to be sought from the fault of the Mor∣bifick Matter, arising to a plenitude at a set time, and then growing hot. For it may be supposed, that the proper Liquor is perverted somewhere about the Membranes of the Head, and the nervous Fibres evilly disposed, or doth not well pass thorow them; wherefore, when the nourishing Juice, placed also on the same parts from the Blood, is not presently assimilated, nor doth well agree with the other humor; at length, from both of them heaped up together and disagreeing, a mutual growing hot arises, and from thence a painful pulling of the Fibres: but for that the fits of the pains, are not always at the same distance after Eating, but arise in some sooner, and in others later, and sometimes before sleep, and sometimes after; the cause is, that partly the offices of Concoction, and distribution of the Aliments, are performed sometimes sooner, sometimes later; and partly, because in these the nervous Liquor, and in those the nutritious Juice, is most in fault: wherefore, as the fulness of this happens sooner, and of that later, so the times of the fit vary: we shall illustrate these afterwards, with observations made concerning the cases of sick persons.

3. When the fits of the intermitting Headach are wandring and uncertain,* 1.54 the Pro∣catarxis, or foregoing cause of the Disease, is neither great nor constant, nor is the Evident Cause continual: Wherefore, when that either cause is oftentimes absent, and one of them often wanting, the fits of the Disease are not tyed to certain times, but in some, they are as it were by chance and accidental, in others, in whom a predis∣position to this Distemper is a little more firmly rooted: the pains of the Head more frequently molest, and are ordinarily excited, by reason of various occasions, yea and for some, they are wont to be most certainly expected. The reasons of the fits so variously happening appear clearly above, from the Aetiology delivered of this Disease; besides, the whole business shall be illustrated anon, by examples.

CHAP. II.

The Prognostick and Cure of the Headach.

SO much for the Causes of the Headach,* 1.55 which being so various and diverse, and their Series so perplex'd and intricate, it will not seem easie to keep one Method concerning all cases of the Sick, whereby we may be led presently to the true knowledge and Cure of this Disease; nor is there less difficulty concerning its Prognostick: But common experience affords some observations, from which it may be gathered,* 1.56 that the Cure of this Sickness is sometimes easie, sometimes dif∣ficult, or scarce possible; so that from thence it may be lawful to declare the event of the Disease, either safe, or very dangerous, or wholely uncertain.

Truly,* 1.57 if any one enjoying formerly a perfect Health, should fall into something a cruel Headach, and of some long standing, by reason of a more strong Evident Cause, as drinking of Wine, Surfeit, Venus, immoderate Exercise, or such like; for∣asmuch as the fore leading Morbid Cause is not as yet firmly laid, we may pronounce such a Distemper to be safe enough, and not pertinacious

But if the Morbific disposition should be inveterate, so that for many years the fits repeat often of their own accord, and upon every light occasion, this, though not dangerously sick,* 1.58 yet we predict it not easie to be Cured. Further, the Cure will be yet more difficult, if Hypochondriack or Hysterical Distempers, oftentimes trouble∣some, are oft wont to excite the Headach at every turn, or if the taint of an inveterate Venereal Disease be rooted in any distemper'd part.

If that the pain of the Head shall be not only inveterate,* 1.59 but almost continual, that we might suspect it to arise from an Inflammation, or a Scirrhous Tumour, an hot Swel∣ling,

an Imposthum, or Worms, there is none or very little hope of Cure; especial∣ly because the sick will refuse great remedies, as Salivation, or opening the Skull; which if they be made use of perhaps at any time with any fruit or success, yet the for∣mer and this two for the most part are wont to be tedious to the sick, before they can effect any thing worth the trouble and expectation.

* 1.60The pain of the Head either Continual or Periodical, if it be great, and hath joyn∣ed with it a Vertigo, Vomitting, or other Convulsive or Soporiferous Distempers, shews a suspicion of great danger: even which often passes into a deadly Apoplexie, and not seldom into an Epilepsie, Palsie, Blindness, Deafness, and other funestous and incurable Diseases.

The Curatory method of the Headach comprehends many Indications, and those of a various kind, according to the manifold Species, Causes, and differences of this Disease, which will not be an easie thing here to set down, and rehearse in order.

* 1.61The accidental Pain of the Head, with the remote Evident Cause, and its conse∣quences, ceases for the most part of its own accord, or at least is taken away by letting of Blood, Rest, and Sweat.

* 1.62The habitual Pain, by reason of the diversity of Causes, viz. both the Procatartick and also the Conjunct, suggests also different intentions of Healing; we shall here briefly touch upon the chief of these, and to which all the rest may be placed.

* 1.63In every habitual Headach, whether Continual or Intermitting, there are two chief scopes or intentions of Cure to be met with; to which all the other Curatory intentions ought to be aimed, and by which we should provide against either Cause of the Morbid Procatarxis.

1 1.641. To wit, in the first place, that all the Tinder or inkindling of the Disease be cut off, you must endeavour, that both the matter flowing to the distempered places of the Head, or those evilly disposed, or apt from thence to flow to them, be supprest, or called from thence to another place; then moreover, that Convulsions in other places excited, and that are wont to be propagated from thence into the Head, be pre∣vented.

2 1.652. Then secondly, it must be indeavoured (if it may be done) that the Disease it self, or its Conjunct Cause may be rooted out, that the places of the Head predispo∣sed to Headaches, (whether they be only enfeebled or hurt in their Conformation) whilst they are defended from the frequent Excursions of the infestous matter, may re∣cover their former state and vigour. Which kind of Indication, though it be very seldom suddenly or wholely performed, yet sometimes the Cure is by degrees laboured out, by diligence and care, however fixed and rooted the Morbid matter be.

* 1.66As to what appertains to the first scope of healing, which is first and especi∣ally to be regarded; we said, that the Matter or Humours, which are wont to be gathered together about the parts of the Head predisposed to the Headach, and to excite the fits of the Disease, are either the Blood or the Serum, or the nourishing or nervous Juice, or Liquor. Moreover, with every one of these Vapours and Efflu∣via's, as also Recrements, sometimes Bilous, sometimes Melancholic, sometimes Acid, Salt, Sulphureous, and of some others of a various kind, taken into the Blood, from the Viscera, sometimes from those, and sometimes from these, we have shewed to be transferred by its passages into the Head•• against the force and incursion of all these, Medicinal fortifications are to be instituted.

* 1.671. And in the first place, if the leading cause to pains, or a disposition thereto, lye about the Membranes of the Head, for that the Blood being hot, and apt to rise up, rushes by heaps into the Membranes of the Head, and when it cannot easily pass thorow them, distending the Vessels above measure, and pulling the nervous Fibres, excites the fits of this Disease (whose signs are a Sanguine temperament, heat, and a flushing or redness about the head and face, also an high pulse, and shaking, with veins di∣stended with Blood) presently it must be endeavoured, both that the Blood be made more sedate, that it may not be so readily moved into rage or swelling up; as also that it be not incited, and boiling up may not be carried with a greater tendency or inclination into the Head, than into other parts, nor in like manner be compelled to stag∣nate, by reason of the bosomes of the Meninges being too full. Wherefore, if the fit infests long, let blood in the Arm, or the Jugular Vein: out of the fit, sometimes it is expedient to take Blood from the Sedal Veins, with Leeches; to wit, by this means, that the Blood by chance boiling up, may be brought down towards that place, to which it often tends of its own accord. Let there be Medicines of Vinegar, Rosecakes, and Nutmeg, or some other Epithems or Medicines of the same nature applyed to the Head: Also give to drink Iuleps, Emulsions, or Decoctions, which allay the fervour or madness of the Blood. Let the Belly be cooled and kept soluble by the use of

Clysters. Moreover, for prevention, use at times Whey, or Spaw-waters; also drink∣ing of Water, a thin and a cooling diet help; the shunning of Wine, spiced Meats, Baths, Venus, violent motions of the mind or body, yea and of all hot things is to be ordered. Then for the fixing of the Blood, its Effervescencies or growing hot must be prevented, for which, Distilled Waters, Juices of Herbs, or Decoctions, Electuaries, Powders, and especially Crystal Mineral, are in frequent use. There is no need here to add a me∣thod or particular forms of Medicines, when in this case, almost every body labouring, is wont to be his own Physician, being taught by frequent experience, from things hurt∣ing or helping.

2. It is rarely,* 1.68 that the Blood alone or only by it self is in the fault; more often other humors, being carried by its passage to the Head, and there disposed, cause the hurt: Therefore, when ever the Serous Colluvies, or heap, goes out from the Blood (as was shown but now) it causes Headaches frequently, (the signs of which are Catarrhs about other parts, viz. the Nose, Mouth, or Throat, being infested with them) then abstinency and rest is to be ordered, and that the belly be emptied by a Clyster, for the allaying the flux of the Serum, and that the matter be suffered to evaporate from the Membranes of the Head; if these do not succeed, and that the Headach ceases not quickly,* 1.69 and of its own accord, oftentimes in a more hot Constitution, Phleboto∣my is convenient; to wit, because the Vessels being emptied of Blood, sup up the ex∣travasated Serum: But in frigid tempers, Vesicatories or Blisters are of notable use, applied to the hinder-part of the Head, or nigh the Ears. Then after the Belly is emptied by a Clyster, the Flux may be allayed, by the use of Anodynes, or more gentle opiats: that being allayed it may be convenient to exhibit a gentle Purge, then Me∣dicines, which either move by Urine or Sweat,* 1.70 or by both together, that so they may gently evacuate the superfluous Serosities.

Medicines fit for this purpose may be every where found in Books: which not∣withstanding are not to be made use of by Empericks rashly, and without distinction; but ought to be designed according to the judgment and skill of a prudent Physician, always having a respect to the Constitution, the temperament, and proper disposition of the Patient, and to other accidents and circumstances, and to be compounded or altered according as the matter requires; yea sometimes to be prescribed extempore. Wherefore, since it will be altogether needless, here to heap up many Receipts, and a great pile of Medicines, it shall be sufficient to propose in this place, one or two forms only, of every sort of Medicines, respecting the chief intentions.

Take Pills of Amber half a dram,* 1.71 Resine of Ialap four grains, of Peruvian Balsam what will suffice to make four Pills, let three be taken when the Patient goes to sleep, and the other in the morning, if they work not enough.

Or Take of sulphurated Scammony half a scruple,* 1.72 of the Ceruse of Antimony fifteen grains, of the Cream of Tartar eight grains; make a Powder, to be taken in a spoon∣ful of Grewel, early in the morning.

Take of the Sulphur of Antimony four grains,* 1.73 of the Refine of Ialap five grains, of the Cream of Tartar six grains, bruise them together, and with what will suffice of the Conserve of Violets, make a Bolus, to be taken early in the morning with care, or by government.

Take of the Roots of Butchers-Broom,* 1.74 Burdocks, Cherefoil, Avens, each one ounce; of pre∣serv'd Eryngo an ounce and an half, of the Florentine Iris three drams, of the lesser Ga∣langal a dram and an half, of the Seeds of Burdock three drams, of the dryed leaves of Betony, Sage, Vervine, female Betony, each half an handful; of Raisins of the Sun stoned two ounces; boil these in four pints of fair water, till a third part be consumed, then add to it of white Wine half a pound, strain it, and sweeten it (if need be) with sy∣rup of the Five Roots two ounces; take of this six ounces warm, twice or thrice in a day, a good while after meals.

For such as are indued with a more Cold and Phlegmatick Constitution,* 1.75 the like Decoction of the Wood of Guaicum, Sasafrass, Sarsaparilla, with the addition of the aforesaid Ingredients,* 1.76 make an Apozem, of which take six or eight Ounces, twice or thrice in a day warm.

For the poor, and oftentimes with good success for the rich, I was wont to prescribe a Decoction of the dry'd leaves sometimes of Sage or Betony, Vervine, or Rosemary, made of Spring-water, and impregnated with the tincture of the Powder of the Berries of Coffee, taken warm twice a day, about six or eight Ounces.

3. If that with the running out Serum, Saline, Acid, Bilous, or otherways In∣festous particles, received either wholely from the Mass of Blood, or by its means from

the Viscera, are carried into the Membranes of the Head, and being there fixed, bring forth great, acute, and continual pains, then it will be convenient to iterate spare∣ingly, the taking away of Blood, yea and sometime a gentle Purge, to apply cooling Medicines, Anodynes, and sweetners to the distemper'd places; so oftentimes also to exhibite more gentle Hypnoticks, or Medicines causing sleep, at every turn; also Apo∣zems, and the Juices of Herbs pressed forth, which allay the fervour of Choler, carry it forth gently by Stool or Urine, and are of known use: but in the mean time more sharp Medicines, or the more strong, whether they be purgative, working by Sweat or Urine, helping it, for that they too much fuse and shake the Blood and Hu∣mors, are carefully to be shunned. I have frequently observed in those labouring with an acute and pertinacious pain in the Head, the Serum swimming in the Blood being let forth, to be dyed with a yellowness, or Bilous Recrements being boiled in it; also in this case, let Phlebotomy be sparingly but often celebrated, and the drinking Whey, or Spaw-waters plentifully, have helped before any thing else.

* 1.774. Further, by the fault of any Inward, as the Stomach, Liver, Spleen, or Womb, or of any other (by reason of the transmission of an evil Ferment) the parts of the Head suffer, then in the Cure of the Disease, Remedies for the Spleen are to be given, with Cephalicks, or such as are proper to the Head: Hence the Stomach being also in the fault, these often times are helpful to such as are troubled with Headaches, Elixir Proprietatis, the Elixir of Vitriol of Mynsich, the sacred Tincture, Vitriol of Steel, the Powder of Aron Compound, and others ordinarily had for the Stomach; for others whose heads partake of the evils of the Spleen, Chalybeats, or Medicines made of Steel often yield help. Some Women troubled with Headaches have felt ease from Hysterical Remedies. In like manner, when the vices of other parts contribute to the Head∣ach, let there be joyned with the former shown you, things to be taken for those parts.

* 1.785. Sometimes the nourishing Juice (as we showed already) is the cause of the pe∣riodical Headach, viz. forasmuch as this being poured on the Blood, and not rightly assimilated, by reason of disagreeing particles, causes a swelling up in it, so that the Blood boiling up into the Head, carries its leavings or superfluities into the Meninges, or into some of their predisposed parts, and by this means stir up the Fibres into painful Convulsions. I have known many for this cause, to have been obnoxious to dayly Headaches, whose Mass of Blood hath been vitiated after the Small Pox, Mea∣sels, and other Feavours,* 1.79 and sicknesses: viz. so many hours after eating, sometimes sooner and sometimes later, first a flushing of redness in the Face, then a fullness in the Head, and a pain would infest them, and especially after drinking of Wine, or eating of Meats apt to swell up, they would be more vexed. The coming of the Disease is wont to keep its distance, according as Meats are taken more or less, as the Chyme begins to swell up, either a little after its first entring into the Blood, or af∣ter a little stay in it.

* 1.80This Distemper is free from danger, and for the most part is easily enough Cured. After a provision of the whole, a gentle Purge, and sometimes Blood-letting being ordered, Remedies profit most which restore the Complexion of the Blood, such chiefly are Antiscorbuticks and Chalybeates.

* 1.81Take of the Conserve of Fumitory, of Tansie, and Wood-Sorrel, each two ounces; of the Powder of Aron Compound three drams, of Ivory, Crabs-Eyes, Coral prepared, each one dram; Powder of yellow Saunders, and Lignum Aloes, each half a dram; of the Vitriol of Steel one dram, of the Salt of Wormwood a dram and a half, of the Syrup of the Five Roots what will suffice to make an Electuary. Take of it in the morning, and at five a clock in the afternoon the quantity of a Chesnut, drinking after it three ounces of the following liquor.

* 1.82Ta••e of the water of the leaves of Aron, of Vervine, of Elderflowers, each six ounces; of the Water of Snails, and the Magisterial of Earth-worms, each two ounces; of Su∣gar one ounce: Mingle them.

* 1.83Hither may be brought various Remedies, that are wont to be made use of against the Scorbutick Dyscrasie, or evil disposition of the Blood, and may be given with good success: For Headaches, which are so familiar in the Scurvy, oftentimes proceed from the vice of the Blood perverting the nutritious Humor, and carrying its Recre∣ments to the Membranes of the Head: Wherefore Remedies against that Distemper, in another place noted by me, may be used here.

* 1.846. There yet remains another humor, to wit, the nervous Liquor, which being heaped up within the Fibres of the Meninges, and of other parts of the Head, some∣times

becomes improportionate, by its proper incongruity, to the Fibres, because sharp or otherways degenerate, sometimes pulls the containing parts, and provokes them into painful Convulsions, or Distentions, because it grows hot with some other Humor flowing thither, to wit, the Nutritious or the Serous.

The Nervous Humor,* 1.85 when it is so Morbific or faulty in its whole Mass, carries its evil to the predisposed Head, or if of it self innocent, is perverted within the distem∣per'd Fibres, and so secondarily becomes Morbific or Diseased; then the Cure of it depends upon the restitution of the containing parts; to wit, if the Debilities, or the hurt Conformation of the Fibres may be mended, presently the Humor watering them will be free from fault. We shall tell you by and by, by what Remedies the vices of the parts predisposed to Headaches may be taken away.

In the mean time,* 1.86 if the nervous humor, being degenerate in the whole Mass, im∣parts its evil to the Head prepared for pain, those kind of Medicines, and method are to be made use of, by which it being reduced to its due Constitution, passing thorow those Fibres, it little or nothing provokes them. For which end, neither letting of Blood, nor yet strong Purges are at all convenient, because those things which shake the Blood and Humors, and lessen strength, impress by that means a greater sharp∣ness and rage to the faulty Nerve. But gentle Solutives, and a sparing taking of Blood, sometimes may be useful, whereby the Inwards may be cleansed, and the bloody Mass somewhat purged, and a way made for other Medicines, that may better succeed.

But Medicines,* 1.87 which render the nervous Liquor more friendly and benigne to the Membranes of the Head, that are wont to be troubled by it, are of that sort commonly called Cephalicks, whose particles being active, thin, and subtil, pass thorow the Blood without trouble or tumult; then insinuating themselves with the nervous Li∣quor, gently move it, and so cause the nervous passages to be unfolded, so that the Animal Spirits,* 1.88 more freely beam forth thorow all the Bodies, both sensible and mo∣tive, and inspire them without any lessening, Convulsions, or irregular distenti∣ons.

These kind of Remedies,* 1.89 although they are not always effectual, yet they often∣times take away some Headaches not much inveterate, and in some, help sometimes how pertinacious soever they be. Further, the same which are prescribed with good success for the pains of the Head, are also for the distempers of the Brain and Ner∣vous Stock; and so on the contrary, what are used for these, also for those; to wit, the virtues of those being unfolded within the Head, against the Apoplexy, Palsie, Lethargy, and other Diseases a-kin to them, help also within the moving Fibres, a∣gainst Convulsions and Convulsive Motions; besides, putting forth their virtues with∣in the sensible Fibres, they often give help to pains.

A very large field of these Medicines are opened in physical Books,* 1.90 yet so, that the poorness of them, and their abundance, bring confusion to the Method of heal∣ing; for oftentimes among so many various and different Remedies, heaped up to∣gether, lye hid or obscured, what may be of great use, but even as Wheat among Chaff, harder to be separated than that to be thorowly sifted out from the husks.

Therefore in this case, a provision of the whole being made, and applyed, and things given which by Dyet or Medicine, restrain the Inordinations of the Blood, and immediately allay them; Medicines called Cephalicks, or such as take away the disorders of the nervous Juice, are prescribed to be carefully taken. I shall add some few forms of these.

Take of the Conserve of the Flowers of Betony,* 1.91 of Clove-gilliflowers, each three ounces; of the Powder of the Root of the male Poeony half an ounce, of Cretick Dittanny one dram; of the wood Aloes, and yellow Sanders, each one dram; of red Coral pre∣pared, of Pearl, of Ivory, each one dram and a half; of the Salt of Vervine one dram and a half, of the Syrup of the Flowers of Poeony, what will suffice: make an Opiat, take of it to the quantity of a Chesnut, drinking after it of the following Iulep three ounces.

Take of simple black Cherry water, and of Walnuts, and of Vervine, each four ounces;* 1.92 of Cowslip Flowers three ounces, of Poeony Compound two ounces, of Sugar-Candy six drams.

Take of the Flowers of Vervine,* 1.93 Misleto Berries, each ten handfuls; of the male Poeony Roots two pound, of Mace and Nutmegs, each half an ounce; of Coriander Seeds one ounce, cut and bruise them and put to them eight pints of new-milk (or else seven pints of Milk and one pint of Malago) Distil them in a common Still, and mix all the liquor together: Take of it three ounces at a time.

* 1.94Take of the Powder of the Root of the male Poeony half an ounce, of red Coral prepared two drams, of Ivory and Pearls prepared, each one dram; make of them all a very fine Powder, add to it of Sugar what will suffice; boil them to the consistence of Tablets with six ounces of black Cherry-water, of the Tincture of Coral one dram; make of them Tablets according to Art, to the weight of half a dram: Eat three or four in the Morning, and at five of the Clock in the Afternoon, drinking after them a draught of Tea.

* 1.95Or Take of the Tincture of Coral one ounce; take of it from fifteen to twenty drops twice in a day, in a little draught of Iulep, or of the distilled water.

* 1.96They who are of a Phlegmatick or more Cold temper may take a Dose twice a day, either of the Tincture of Antimony, or of the Spirits of Armoniac, impregnated with Amber of Coral, or of Spirits of Harts horn, or of Sut, in a proper Vehicle.

* 1.97We ought not to omit, or postpone the use of Millepedes or Woodlice, for that the Juice of them, wrung forth, with the distilled Water, also a Powder of them pre∣pared, oftentimes bring notable help, for the Curing of old and pertinacious Head∣aches. I might here propose divers other kinds of Medicines; yea all those which I have formerly heaped up, against Convulsive Distempers, may be brought hither. But yet the most difficult knot of the Cure of the Headach, remains to be untied, to wit, how the conjunct Cause of this Disease, and fixed, consisting in the weakness, or hurt Conformation of the Fibres, may be healed or taken away

Although this is sometimes incurable, to wit, when as a Scirrhous, or Callous Tu∣mor, or some other old and fixed swelling, has possest the Meninges; yet, for that the knowledge of this is uncertain, and that the leading Cause, how cruel soever it seems, is sometimes overcome by a long course of Physick; therefore in every Head∣ach, so long as the Patient will admit of Remedies, let it not seem troublesome to the Physician, to prescribe those things which seem most convenient.

* 1.98Therefore, first of all, which we hinted before, you must carefully endeavour that the nest, or feeding of the Disease be cut off or intercepted, and that the frequent coming of the fits be hindred; for so the indisposed Fibres, so long as they are no more affected only by the means of Nature, will recover health.

In this case the helps of the Medical Art, are rather to be sought from the Chirurgical part, than from Physick: for whatsoever is taken at the mouth, going about by long turnings and windings, spends all the vertue before it comes to the Membranes of the Head.

Among Chirurgical Remedies, first Topicks are met with, and among these, Plasters are of most profitable use, and oftentimes give the greatest benefit: Let not these be very hot, which may rather draw the humors to the distemper'd place, but moderate∣ly discussing and strengthening. I was wont to prescribe Plasters of Red-Lead, and of Sope, with double of the proportion of the Plaster of Paracelsus, to be applied to the part, it being first shaven, and to be let remain there for some time The An∣tients frequently administred Plasters made of Mustard, and such as raised wheals or whelks over the parts,* 1.99 and it is a daily practice to apply sometimes to all the hinder part of the Head, and sometimes to the former, Vesicatories or blistering Plasters, against most cruel Headaches: when ease is got from these more hot Topicks, it is be∣cause by these administrations, plenty of the more sharp Serum is drawn away from the disaffected part.

* 1.100Liniments of Oyls and Oyntments, though often made use of, effect little; because (as I think) if they should penetrate deeply into the tones of the Fibres, they would loosen them more; so that they would more easily lye open to the Incursions of the Morbifick matter: Further, they stop up the Pores of the skin, whereby the Effluvia's do less evaporate. Almost for the same reason, as hot stupes or Fomentations made of boiled Spices, or other Cephalicks, oftner hurt than profit; forasmuch as they draw the humors towards the distemper'd parts, and also open the Pores and passages, whereby they are more readily admitted;* 1.101 it is that a Bathing of the Head, or an Em∣brocation or washing of the Head, at the pumps in hot Baths, is used with no better success for Headaches: When on the contrary, it hath been beneficial to many, to pour cold water every Morning and Evening on the temples, forehead, and forepart of the Head: yea to wash or pump the whole Head, every Morning with cold water, or at least to dip it into a Bucket or Pit of water.

* 1.102Another Chirurgical help, especially for an inveterate and cruel Headach, and much cry'd up, is wont to be the burning or cutting of Issues, in several parts of the Body. It is without doubt, that these being made in the Arms or Legs, are both less trouble∣some, and do bring something of help: because they draw away the feeding of the

Disease in part, and call it away far from the distemper'd part. Besides, Issues in the nape of the Neck, and a Seaton in the hinder part of the Neck, behind the Ear, or near it; also a piece of the root of wild Hellebore, being put into an hole made in the Ear, because they evacuate much serosity, and draw it to other Emunctuaries, to wit,* 1.103 the Glandulas, are oftentimes administred with benefit. But indeed, there hath been a talk, and much expectation from Cauteries, made on the grieved place, or near it, and so large Issues have been made on the top of the Head, or nigh to the joyning of the Sutures. If we should measure this practice by the fruit or success, it will ap∣pear to be rarely beneficial, but more often unlucky. For I never knew any healed, but many troubled with Headaches, to be much the worse for it. And truly, reason plainly tells us, that where a Fontinel is made, thither the Serous Humor flows, from the whole bloody Mass, and by consequence from the whole body, and often∣times is there heaped up more copiously than can constantly be put forth by that Emis∣sary: wherefore, there ordinarily arise about Issues, a red swelling, pustles, and various humors. Why should I not then believe, that a Cautery made nigh to the grieved part of the Head, should rather cause the Morbific matter to be there heap∣ed up?

There is yet another Chirurgical operation cry'd up by many for a pertinacious Headach,* 1.104 but by none (that I know of) yet attempted, to wit, an opening of the Skull, near the grieved place, with a Trypaning Iron. This our most ingenious Harvey en∣deavoured to persuade a Noble Lady, labouring with a most grievous and inveterate Headach, promising a Cure from thence; but neither she, nor any other would ad∣mit that administration. Indeed, it did not appear to me, that there could be any thing of certainly expected from the opening of the Skull where it was pained; if an Imposthum lay hid there, this had been the only way of Cure; but that would rather have caused sleepy distempers, or deadly Convulsions than the Headach. If that a red swelling, or pustles, or a burning boil, should be in the enfoldings of the Head, I know not if those Tumors, exposed to the open Air, would more easily evaporate, or whether Remedies applyed to those naked places, would effect any thing or not; because, if the pains arise by reason of the Meninges being beset with little whelks, a Scirrhous or a Callous Tumor, I think the opening of the Skull will profit little or nothing.

But letting this alone till it is practised, we shall pass over to other things; and now in the next place, we shall consider, whether Salivation for the Curing old and confirmed Headaches is to be administred.* 1.105 Indeed, if the pains of the Head arise from the Venereal Disease, no doubt but that evil Remedy ought to be applyed to that evil Distemper: But having tryed that kind of remedy in Headaches arising from other Causes, I found not the harvest worth the pains, and I confess some exam∣ples in those kind of cases, have terrified me from that method. A certain noble Lady (whose sickness is below described) for the Curing of a cruel and continual Headach, un∣derwent a plentiful Salivation three times, viz. the first by a Mercurial Oyntment, by the counsel of Sir Theodore Mayern, and afterwards twice by taking the lately famous Powder of Charles Huis, without any help, I wish not with some detriment: for af∣terwards for many years, even to this day, the disease being by degrees increased, she suffer'd under its heavy tyranny. It happened somewhat worse, so that noted man Doctor G. D. to whom a Mercurial Oyntment was applied for his akeing Head, for the Cure of an old Headach, by which a Salivation being excited, and the Dis∣ease not Cured, he fell into blindness. Indeed these kind of effects from Quicksilver, rashly given, every one, rightly weighing its operation on an humane body, ought to fear. For the Mercury, I shall not say is malignant or wholely venomous, because it brings little or no hurt, its particles being united, so that oftentimes a great quantity may be taken safely enough; yet the Mercurial little bodies, being divided and separated one from another, (whether it be done by Chymical Salts, as in the Mercury sublimate, and precipitate, or by straining thorow the Pores of the Skin when they are anointed) immediately become fierce and untameable, and stir up, be∣fore any other Medicines,* 1.106 great perturbations in the humane body: They sometimes bring trouble, first to the nervous parts, whereby oftentimes happen, (by reason of the Fibres of the Ventricle, Intestines, and other Viscera's, being pulled or hauled) Torments, horrid Vomitings, sharp and frequently Bloody-stools, Heart-burnings, Swoonings, and other most terrible Distempers, a little after the Medicine is given. Yet sometimes the particles of the Mercury, when they are not presently dissolved, go forth without any great hurt to the Bowels, and before their strength be deduced into the bloody Mass. Therefore they easily enter into this, being highly active, and unfolding themselves on every side, and immediately infecting the whole,

shake it, and frequently (when fully dissolved) stir it up into a great burning. Then the Blood, that it might put away from it self, the incongruous little bodies, Fer∣menting, delivers the same which way it can, and boils it with the humors, contain∣ed within its bosom, to wit, the Serum and the nourishing Juice, and so endeavours, with those imbued with that preternatural mixture, to put it off. But this succeeds not plentifully enough by Urine and Sweat, because the meltings of the Blood, by the particles of the Mercury boiled in it, like the ladder of a Wash-Ball, become more clammy and thick, so that they cannot pass thorow the fine strainers of the Reins and the Skin, but oftentimes breaking forth (unless hindred) into the Caeliac Arteries, go forth, by exciting a Diarrhoea or Dysentery; but by that the intent of Salivation is hindred or frustrated: but more often, the Liquor imbued with the Mercury, remaining within the Blood, in a manner also infected, is carried about with it, hither and thither, impetuously thorow the Arteries and Veins, and is separated into various parts, and either breaks forth what way it can, or is forced upon the Bowels, Membranes, and other parts, oftentimes with great hurt. Also it is seen that some Mercurial parti∣cles do penetrate the Brain, and insinuating themselves into the nervous Juice, are diffused, not only into the whole Head, but into all the nervous parts, and so in some measure ferment the nervous Liquor.

But in the mean time the Mercurial Serosities, residing in the Blood, are laid up for the greatest part into the Glandula's, which are the nearest Emunctuaries of the Arteries: wherefore, when the Glandula's about the parts of the Mouth (by which great plenty of Serum is destinated for spittle) being both many and great, are there placed, and that from these passages lye open, by the Excretory Vessels, into the cavity of the Mouth; surely by this most certain way, the invenom'd li∣quor of the Blood, finds a passage forth, when it cannot easily elsewhere. Where∣fore, a spitting at the Mouth being excited, the Blood long Fermenting, casts forth whatsoever is extraneous, and not agreeable, either that lyes in its bosom, or that it licks up elsewhere from the Bowels, or receives from the solid parts, or from other humors, like working Ale or Wine, thorow the Salival passages, and innumerable pipes opening every where into the Mouth. Further, it is most likely, as the purg∣ings of the Blood, so also of the liquor watering the Head, and the nervous Appen∣dix, being excited by the Mercury entering therein, are also put forth by this way, to wit, by the Salival passages.

Therefore, a Salivation induced by Mercury, if by chance it succeeds rightly, it sometimes takes away difficult and untameable Diseases, not to be dealt with by any other Remedies; because this operation thorowly purges the Blood and nervous Juice, and other humors, by a long purgation, destroys all exotick Ferments, over∣comes the enormities of the Salts and Sulphures; yea, and shakes, and oftentimes carries forth the Morbific matter, where-ever remaining or impacted.

* 1.107But this Medicine is not without danger, forasmuch as the Mercury becoming en∣ormous, and carrying with it abundance of most sharp, and as it were poisonous Se∣rum, rushing on the noble parts, and especially the Head, with the Medullary and nervous appendixes, or on the Lungs, and parts about the Heart, brings to them an incurable and sometimes a deadly evil. Wherefore in a more grievous and old Headach, there is danger lest the indisposed Fibres should be more irritated, by the Mercury going thorow them, with much, and corrosive Serum, and should move them into more painful Convulsions and wrinklings; further, lest it should invade the Brain, by a great falling of the Humors upon the Head, by which means, as it often happens to the Brain, sleepy and Convulsive distempers are caused. I should have said many things more concerning this, but that we expect shortly to be made publick, by the Learned Physician Doctor Needham, an exact method of Saliva∣tion, and a full account of it, as to its measures and effects, and its benefits and hurt.

* 1.108There is yet a celebrated Remedy remaining among Chirurgical helps, viz. a cut∣ting or opening an Artery. This was of great esteem among the Ancients, and some of the Moderns make use of it, and very much cry it up. But it appears to our ob∣servation, that this so cry'd up success most often fails. Nor no wonder, because rea∣son holds not at all, on which the Ancients depended, that the Arterious Blood was different from the Venous, or that of the Veins, and was in greater fault and more rageing, and therefore to be let forth. Nor indeed is there any reason wherefore the Blood being drawn from the Artery, rather than from the Vein, near the pained place, should bring ease; but rather on the contrary, more help ought to be expect∣ed from opening of the Vein; because, the Artery being emptied, receives and draws nothing from the distemper'd part; but the Vein being opened, draws from

the place of the effused Blood, and from its whole neighbourhood, and oftentimes sups back, and renders to a Circulation the Blood, and other Humors, heaped up and stagnating near the nest of the Disease. But however, that we may not recede too much from the practice of the Ancients, we shall grant, that sometimes it may be helpful, though attributing nothing to the section of the Artery, and not immediate∣ly, yet causally,* 1.109 and only by consequence and by accident: to wit, forasmuch as the ends of the Artery being cut, grow fast together, so that the passage of the Blood by that way is shut up for the future; from hence when as a lesser provision of Blood is carried by the Artery towards the place: and the like still carried away from it by the Veins, it therefore sometimes happens, that the nest of the Morbific Matter some∣times lessened, and its mine is by degrees consumed. For this reason, this administra∣tion oftentimes succeeds happily in diseases of the Eyes.* 1.110 Further, Farriers make use of the like practice for the Curing of evil tumors in the Legs of Horses; to wit, they take and bind the Artery, by which the Matter flows to the distemper'd part, and in the mean time, that which was impacted, partly evaporates, and is partly supped up by the Vein. And I have heard, that the same has been try'd by our Harvey, and not without success,* 1.111 for the Curing also of Strumous and Scirrhous Tumors in the humane body. I might here subjoyn many other kinds of Remedies, yea also the pre∣scriptions and forms of Medicines, which are wont to be administer'd for the Curing of Headaches, both by Physicians and by Empericks: but enough of these are to be had in Physical Books. It will be to our purpose, that after the delivering the Aetiology, or the reason of this Disease so confusedly shown, and its Therapeutic or Curatory part sufficiently shadowed, for the more clear illustrating of these things, that we add some more rare cases of sick persons, and examples of a continual and most grievous Headach, which also for an invincible cause was oftentimes deadly.

A Woman of about fifty years of age,* 1.112 after she had labour'd for about six months with a most grievous pain in the Head, troubling her almost perpetually, under the Sagittal Suture (or the seam that goes thorow the length of the Skull, dividing it in∣to two parts) yielding to no Medicines, or method, at length fell into a Lethargy, with a partial resolution of her members; from which notwithstanding, being short∣ly recovered by timely Remedies, she awaked with the Headach, as cruel as before; moreover,* 1.113 within two or three weeks after, relapsing into the sleepy distemper, she de∣parted this life. Her skull being opened, there grew from the side of the third bosom, to the Membranes, a Scirrhous Tumor three fingers broad, by the coming between of which, both the Dura mater for a little space was grown to the Pia mater, and the sanguiferous Vessels, which should open there into the cavity of the bosom, were stopped up. Further, the cranklings or turnings in of the Brain, both the exterior and the inward cavity, was filled with a clear water. From these things being ob∣served, the invincible and at length deadly cause most clearly appeared: to wit, the most sensible Fibres of the Meninges being continually pulled and torn, partly by rea∣son of the breaking of the unity, and partly from the humor belonging to the Nerves, being there heaped up and stagnating, together with others flowing thither, and grow∣ing hot with it, were provoked into Convulsions perpetually, or painful Distentions: Afterwards, when the Blood being for a long time hindred in its circulation, by rea∣son of that Tumor, or that at least it could not pass thorow it, by any means, sent copiously away from it self the Serous Water (as its manner is whereever it finds an hindrance) and at length a Dropsie in the Brain was raised, which was the cause of the deadly Lethargy. I remember I have seen the like case in another, whom I have opened. Further, as I think, the disease in many troubled with Headaches, doth de∣pend on the like invincible cause; I will however describe one example yet living, of this kind of Distemper.

Some years since,* 1.114 I was sent for to visit a most noble Lady, for above twenty years sick with almost a continual Headach, at first intermitting: She was of a most beau∣tiful form, and a great wit, so that she was skilled in the Liberal Arts, and in all sorts of Literature, beyond the condition of her sex; and as if it were thought too much by Nature, for her to enjoy so great endowments, without some detriment, she was extreamly punished with this Disease. Growing well of a Feavour before she was twelve years old, she became obnoxious to pains in the Head, which were wont to arise, sometimes of their own accord, and more often upon every light occasion. This sickness being limited to no one place of the Head, troubled her sometimes on one side, sometimes on the other, and often thorow the whole compass of the Head. During the fit (which rarely ended under a day and a nights space, and often held for two, three, or four days) she was impatient of light, speaking, noise, or of any moti∣on, sitting upright in her Bed, the Chamber made dark, she would talk to no body, nor

take any sleep, or sustenance. At length about the declination of the fit, she was wont to lye down with an heavy and disturbed sleep, from which awaking, she found her self better, and so by degrees grew well, and continued indifferently well till the time of the intermission. Formerly, the fits came not but occasionally, and seldom under twenty days or a month, but afterwards they came more often: and lately, she was seldom free. Moreover, upon sundry occasions, or evident causes (such as the change of the Air, or the year, the great Aspects of the Sun and Moon, violent passions, and er∣rors in diet) she was more cruelly tormented with them. But although this Distem∣per most grievously afflicting this noble Lady, above twenty years (when I saw her) having pitched its tents near the confines of the Brain, had so long besieged its re∣gal tower, yet it had not taken it: for the sick Lady, being free from a Vertigo, swimming in the Head, Convulsive Distempers, and any Soporiferous symptom, found the chief faculties of her soul sound enough.

* 1.115For the obtaining a Cure, or rather for a tryal, very many Remedies were admi∣nistred, thorow the whole progress of the Disease, by the most skilful Physicians, both of our own Nation, and the prescriptions of others beyond Seas, without any success or ease; also great Remedies of every kind and form she tryed, but still in vain. Some years before, she had endured from an oyntment of Quicksilver, a long and troublesome Salivation, so that she ran the hazard of her life. Afterwards twice a Cure was attempted (though in vain) by a Flux at the Mouth, from a Mercurial Powder, which the noted Emperick Charles Hues ordinarily gave: with the like suc∣cess with the rest she tryed the Baths, and the Spaw-waters, almost of every kind and nature: she admitted of frequent Blood-letting, and also once the opening of an Artery; she had also made about her several Issues, sometimes in the hinder part of her Head, and sometimes in the forepart, and in other parts. She also took the Air of several Countries besides her own native Air, she went into Ireland and into France: There was no kind of Medicines both Cephalicks, Antiscorbuticks, Hysterical, all fa∣mous Specificks, which she took not, both from the Learned and the unlearned, from Quacks, and old Women; and yet notwithstanding she professed, that she had re∣ceived from no Remedy, or method of Curing, any thing of Cure or Ease, but that the contumacious and rebellious Disease, refused to be tamed, being deaf to the charms of every Medicine. Further, this so long possessing the out-parts of the Head, though it could not invade the cloysters of the Brain; yet, when I visited her, un∣folding its ends in some other parts of the nervous kind, it had begun to stir up most cruel pains in her members, and also in her Loins, and bottom of her Belly, as is wont to be in the Rheumatism, and in the Scorbutick Colick.

* 1.116If we should inquire into the Aetiology or the Causes of this inveterate Disease, we can suspect nothing less than that the Meninges of the Brain, being from the begin∣ning more lightly touched, had afterwards contracted an habitual and indelible vice. It appears by the History, that the distemper at first arose from a Morbific matter, which was translated into the Head, after an ill cured Feavour. Then perchance, by reason of some hurt brought to the Membranes, the tone of the Fibres was so much endamaged, that afterwards, the Humors flowing in them, both the nervous and o∣thers, being heaped up to a fulness, or growing hot by mere aggravation, raised up the fits of the Headach. But at length the diseased cause growing worse, by reason of the frequent fits, it seems that the unity of those Fibres, were so much broken, that from thence little Tumors, or Scirrhous knots or swellings, being riased up in all the exterior Meninge, or in a great part of it, produced pains almost continual, and those apt to be made worse or imbitter'd upon every light occassion: Certainly it seems most likely, that the invincible and permanent cause of so long, and yet not deadly Headach, proceeds from some such thing, viz. a Scirrhous Distemper of the Dura mater, the Pia mater being in the mean time safe. For from any other cause, if there had beee a conflict of Nature and Medicine with the Disease, either a quick death or a joyful victory had far sooner been obtained.

* 1.117A noted Gentleman of about forty years of Age, strong and healthy, going a jour∣ney for a whole day in a continual rain, the wet beating on the hinder part of his Head, caught cold, and the next day he began to feel a pain in that part; which in a short time after becoming very bitter, afflicted him night and day, and kept him al∣most continually without sleep. For the Cure of this Distemper, Phlebotomy, Purg∣ing, Glisters, Blisterings, and Remedies to cause rest; yea and many others of every kind, though diligently applyed, by the Counsel also of many Physicians, helpt lit∣tle or nothing. When the Disease notwithstanding these, grew every day worse, af∣ter a fortnights time, preternatural swell'd kernels and painful arose all about his Neck, the pain in his Head nothing remitting: Further, the Tendons of his Neck

being very much distended and stiff, became very troublesome to him; to which, in a short time, succeeded Convulsive motions, and a sudden leaping of the Tendons, in several parts, with a delirium, and at length, the sick person worn out with pains and watching, yielded to death.

Though we had not leave for the dissecting the dead body,* 1.118 yet it may be suspected, that both the Pericranium, and the Meninges in the hinder part of the Head, cloathing the Cerebel, where they are more thick and very nappy, were first affected; and then from thence the evil was afterwards communicated to the whole Head, and wandered into all the nervous stock: when as in those Membranes, transpiration was hindred, from the cold and the wet, and also the tone of the Fibres very much hurt, it is proba∣ble, that the nervous Liquor watering them, being then hindred in its motion, and stagnating, did burthen the containing bodies; then that being depraved in its Com∣plexion, grew hot with other humors flowing thither, and being at length coagulated with them, grew together into Scirrhous and Strumous Tumors, and so laid the copi∣ous seed-plot of a most grievous Headach: Then afterwards, when through watching and perpetual pains, a great inordination of the Spirits, and a great Discrasie of the Juice watering the Head, were produced; for that reason, the knotty Concretions in the Neck, the stifness of the Tendons, and at length Convulsions and Convulsive Mo∣tions followed in the Brain, and in the whole nervous Stock: and so, when as the ani∣mal oeconomy or regiment was much decayed, and that the motion of the Praecordia could not be continued, the vital flame expired.

Sometimes deadly and incurable Headaches are no less raised up from a fiery swel∣ling and Imposthum,* 1.119 than from these kind of knots, and little pimples of the Meninges. Sometime since, a young man of the University, whenas he had complained for a fort∣night of a most grievous pain in the Head, incessantly afflicting him, it was at length increased by a Feavour, and afterwads, waking, Convulsive motions, and talking idly followed; at which time a Physician being sent for, letting blood, Clysters, Plasters, Revulsives, Blistrings, also internal Remedies which call away the Flux of the Blood and Humors from the Head, being carefully administred, profited nothing; so that death soon followed. His Skull being opened, the Vessels leading to the Meninges were full of Blood, and very much distended, as if the whole Mass of Blood had flowed thither, so that the bosoms being dissected and opened, the Blood presently rushing forth, flow'd to the weight of several ounces above half a pint: Further, the Mem∣branes themselves being distemper'd thorow the whole, with a fiery Tumor, appear∣ed discoloured: These coverings being taken away, all the infoldings of the Brain, and of its Ventricle, were full of a clear water, and its substance being too much wa∣tred, was wet, and not firm. Without doubt in this case, the incursion of the heat∣ed blood into the Meninges, and the heaping of it up there, exciting the Phlgemon or fiery swelling, was the cause of the Headach, and of the following Delirium: Then the Blood being accumulated there, when it could not circulate, flung from it self plenty of Serum, by which the whole inward part of the Head was over-flowed; so that the Disease, at first perhaps curable by Phlebotomy, from thence afterwards became mortal.

I remember another Academick,* 1.120 who after a long Headach, under the temporal Suture, tormenting him perpetually for three weeks together, immediately fell in∣to a deadly Apoplexie. His Head being opened, a fiery swelling had grown in the Meninges, near the place where the pain was, from which, being ripened and broke, the filthy bloody matter falling on the Brain, had distemper'd its substance with a rottenness and blackness. Besides, these invincible causes, detected by Anatomy, I observed more chances after the same manner, as of other sick people; by which we may conclude its Aetiology, to be the same, or very near of kin, with the signs and symptoms of the like nature, and but now described.

But although a continual Headach (especially if it be without intermissions for ma∣ny weeks) is not without danger:* 1.121 yet we ought not therefore to despair of its Cure, because the cause of this, how fixed and immoveable soever it seem, oftentimes by the long use of Medicines, and sometimes without them, is helped by Nature and time: however, in a case almost desperate, there is need of some Medicines, lest the present Distemper should pass into a worse, to wit, a Soporiferous or Convul∣sive. Thus much for a Continual Headach: it now remains, that we should pro∣pose some more rare examples and instances of the Intermitting.* 1.122

Therefore, that we may let alone here, the Headaches, whose fits being wandring and uncertain, proceed from the Blood or Serum rushing on the distemper'd places, as cases very well known, and commonly seen; we shall now shew you now some select Observations of this Disease, either periodical, or caused by the consent of some

Inward: As to the first, we have shown the periodical fits of the pains of the Head, to be produced by the nutritious Humor, or by the nervous Juice: we shall now shew you Examples of either.

* 1.123A venerable Matron of about forty five years of Age, of a lean habit of Body, and indued with a Cholerick Temper, after she had lived for a long time obnoxious to Headaches, wont to be caused occasionally, she began about the beginning of Au∣tumn, to be troubled with a periodical pain of the Head: This Distemper invading her about four of the Clock in the Afternoon, was wont to continue till midnight, when being wearied with pain and watching, she was compelled to sleep; then af∣terwards awaking out of a profound sleep, she found her self well again. She being sick after this manner for three weeks, suffered the daily fits of this Disease, and forbore to take any Medicine, which she greatly abhorr'd; but at length her Ap∣petite being lost, and her strength worn out, being forced to seek for Cure; after letting blood and a gentle Purge, she took twice a day for a week or two, the quan∣tity of a Chestnut of the following Electuary, and grew perfectly well.

* 1.124Take of the Conserve of the Flowers of Succory and Fumitory, each three ounces; of the Powder of the Root of Aron Compound two drams and a half, of Ivory one dram and a half, of yellow Sanders, and of Lignum Aloes, each half a dram; of the Salt of Wormwood one dram and a half, of Vitrial of Steel one dram, of the Syrup of the Five Roots what will suffice to make an Electuary.

* 1.125In this Case, that after a disposition to the Headach, the fits of the Disease became at length periodical, after the manner of intermitting Feavours, the cause without doubt was, the assimilation of the Chyme, or nourishing Humor, into Blood, being hindred: because, when its provision being received into the Mass of Blood, could not be overcome, it was wont after a little stay to disagree, and with its particles, to grow hot; therefore presently the Blood swelling up, that it might shake off the incongru∣ous mixture, laid aside its recrements, as in other parts, so especially and with a greater sense of trouble into the before weak Fibres of the Meninges, or hurt in their conformation: This Matter being poured on the Head, or rushing of it self thorow the sensible Fibres, or growing hot with the Juice watering them, raised up the fit of the pain but now described; which continued until the heterogeneous par∣ticles growing hot, with their mutual coming together, were either subdued or ex∣haled.

* 1.126A very comely Woman, tall and slender, being for a long time grievously obnoxi∣ous to distempers of the Head, was wont sometimes to be troubled for many days, yea weeks, every day as soon as she awaked in the Morning, with a most Cruel Head∣ach, afflicting her for three or four hours: and in the mean time, she was vexed with a weight of her whole Head, a numness of her sences, and a dulness of mind: which kind of Distemper, together with the pain, like discussed Clouds, vanished before noon, and left her quiet and calm: Then again the next morning, it possessed her Head like a dark Cloud.* 1.127 For the Curing of it I prescribed the use of Purging Pills, Phleboto∣my sparingly, besides a Blistering, and Spirits of Harts-horn, or of Sut, with Cephalic Juleps or Waters.

* 1.128That in this Lady, otherways than in the other sick Lady, the pains of the Head rather followed after sleep, than were healed by it, the reason seems to be, because in this morning Headach, the Morbific Matter resided in the nervous Juice, whose more notable crudity, and fuller aggestion about the Head, happen immediately after sleep, as we have elsewhere shown at large: But the other Evening fits of this Dis∣ease, depended upon the fulness and swelling up of the nourishing Liquor within the bloody Mass, and therefore happening so many hours after dinner, was not allayed but by sleep, which quiets the disorders of the Blood.

* 1.129It doth no less clearly appear, that the fits of the Headach do arise, sometimes by consent from other parts, viz. the Womb, Spleen, Stomach, &c. and though the complaints, and the experience of the sick, declare it to arise from Vapors, yet from the Histories of them, and their appearances rightly weighed, 'tis most clear, that this proceeds from another reason, than from Vapors carried to the Head from the distempered inward. And in the first place, as to the pains of the Head, that seem to arise from the Womb, there is nothing more frequent than that upon the suppres∣sion of the Monthly Flowers, or the Lochia after being brought to bed, or (as they call it) the flooding, for cruel Headaches to succeed. Further, although the Terms do rightly flow, yet some at the instant of its flowing, others at the stopping of the same, are wont to be troubled with a cruel pain of the Head. But indeed,

though at the same time, as the Head, the Womb also is distemper'd: however it doth not follow, that the evil is transferred from hence, thither immediately: but the Blood it self, which fixes the Morbific Matter to the Head, carries it, sometimes begotten in its proper bosom, and destinated to the Womb, wrongfully into the Memin∣ges of the Brain; and sometimes snatching it from the parts of the Womb, delivers it with greater malice to the Head. This same reason may also serve for the Headach, commonly attributed to the Stomach, Spleen, and other parts.

A beautiful and young Woman,* 1.130 indued with a slender habit of body, and an hot Blood, being obnoxious to an hereditary Headach, was wont to be afflicted with fre∣quent and wandring fits of it, to wit, some upon every light occasion, and some of their own accord; that is, arising without any evident cause. On the day before the coming of the spontaneous fit of this Disease, growing very hungry in the Even∣ing, she eat a most plentiful Supper, with an hungry, I may say greedy appetite; presaging by this sign, that the pain of the Head would most certainly follow the next Morning; and the event never failed this Augury. For as soon as she awaked, being afflicted by a most sharp torment, thorow the whole forepart of her Head, she was troubled also with Vomiting, sometimes of an Acid, and as it were a Vitriolick, Humor, and sometimes of a Cholerick and highly bitterish: hence according to this sign, this Headach is thought to arise from the vice of the Stomach.

That I may render a reason of this, first it appears, that a Vomiting will succeed a hurt upon the Head, to wit, after a blow, or wound, or a fall; yet a pain of the Head rarely or never follows, upon Vomiting, the pain of the Heart, or the Sto∣mach, any otherways labouring,* 1.131 unless the Blood comes between. Wherefore in the aforesaid case of the sick person, as it appears plainly that the Meninges of the Brain were before disposed to Headaches, its fits were stirred up by every agitation of the Blood; hence it is obvious to be conceived, when the heterogeneous particles are heaped up together to a fulness, in the bloody Mass, by reason of the vice of the Chyle, presently a flux of it arising, for the expulsion of the trouble, those being but evilly match'd, being separated by the Blood, and partly poured forth out of the Arteries into the Ventricle,* 1.132 do raise up its Ferment, and so produce hun∣ger; and partly rushing into the predisposed Meninges of the Head do there dispose the tinder, or rather incentive of the Headach about to follow. This sick Gentle∣woman, averse to all Physick, when she would undergo no method of Medicine, at length became obnoxious also to Paralytick, and Convulsive distempers. Out of these it will be easie to design the reason of every other Headach, viz. of the Hy∣pochondriac, Hepatic, or otherways Sympathetical, so that there need not here to be added any more Histories or Observations.

CHAP. III.

Of the Lethargy.

THUS far we have described, by what Disease chiefly, and after what sort, the out-skirts of the Head, or the coverings of that enclosed within the Skull, are wont to be affected;* 1.133 and now descending to its more internal part, and which lyes next to the Cortical or shelly substance, we shall see to what distem∣pers this part is found to be chiefly obnoxious. We have shew'd at large in ano∣ther place, that the Cortex or shelly part of the Brain is the seat of the Memory, and the porch of sleep: wherefore, we rightly referr the Disease, which is wont to cause an excess of sleep, and an eclipse or defect of memory, to wit, the Lethargy, to that Cortical part of the Brain.

The word Lethargy is wont to signifie two sorts of Distempers,* 1.134 which are as it were the act and the disposition of this Disease; for those who are said to labour with this Disease, or are sick of its great assaults, are overwhelmed with so great sleepiness, that they can scarce be excited by any impression of a sensible object, yea if by chance being prick't or pinch't, they open their Eyes, or move their members, presently they let them fall again, and become insensible; and oftentimes when left to themselves indulging a perpetual sleep, by an easie transition, they pass into death it self, whose type this Disease is; which kind of fits, have often a Feavour joyned with them, which when the sick awake, and return perfectly to themselves, for the most

part ceases of its own accord.* 1.135 Or secondly, they are accounted Lethargical, who being oppressed with an immoderate torpor or numness of the senses, are found to be almost ever prone to sleep; so that in the midst of a journey, yea at dinner, or though busied about any thing, they presently fall into a drousieness. But as there are di∣verse degrees,* 1.136 and various manners of this sleepy distemper, so also they constitute the various kinds of this Lethargick disposition. We shall for the present speak first of the former Lethargy, and properly so called, and afterwards of continual Sleepi∣ness also of the Coma, Caro, and other soporiferous Diseases akin to it, and likewise of Continual Waking.

In the mean time, it is to be noted, that almost in every kind of Lethargy, there is always as its Pathognomick sign, a Torpor or Sleepiness, and oblivion or forgetfulness. Those who suffer the more grievous fits of this Disease, if they are awakened by any force in their declination, forget all things, nor are they able to remember their own, nor the names of their Friends: also, those who have drunk more sparingly of this forgetful cup, as much as they are proclive to Sleep, so much are they deficient in Memory; so that they forget late actions, and oftentimes repeat things done, and very often ask the same questions: As to the other faculties, as Reason, Phantasie, the sensitive and loco-motive powers, the failings or defects of them, are proportionate according to the enormities of Sleep and Memory. Wherefore, that the formal reason, and the causes of the Lethargy, may be the beter known, we should here first of all discourse concerning sleep and oblivion, and for what causes they are ex∣cited.

* 1.137But having already discoursed concerning the former of these, we shewed that the es∣sence of Sleep did consist in the corporeal souls withdrawing it self by little and little, and contracting the sphere of its irradiation, left destitute and as it were shut forth of doors, the outmost compass of the Brain, or its shelly part, and so the exterior, and all the organs of sense and motion, from the emanation of the spirits; so that they for refreshment sake, being called inward, lye down and give themselves to rest; in the mean time, the Pores and passages of the outward part of the Brain, being free and empty from the excursions of the spirits, are prepared for the coming of the nervous Liquor, stilled forth from the Blood, for a new provision of Spirits. In ac∣customed and natural Sleep, these two causes, conspire and happen together, as it were out of a certain mutual compact of Nature; viz. at the same time, the Spirits give place, the nervous Humor enters: but in unnatural sleep, or that which is ex∣traordinary, sometimes this cause, and sometimes that is the former; for the Spirits being wearied or called away, first withdraw themselves, and so offer an entrance to the nervous humor heaped up before the doors; or else the nervous humor driving to those places more plentifully, and as it were making its way by force, repels the Spirits, and entring into their passages, does as it were drown them: we have parti∣cularly assigned the various occasions of either of these, and after what manner they come to pass. Concerning the eclipse or desect of the Memory, we need not speak much here, because it is wholely from the same cause, as immoderate Sleep, to wit, the exclusion, and an interdiction for a time, of the passing up and down of the Ani∣mal Spirits, from the exterior passages of the Brain, full of some humor.

* 1.138Preternatural Sleep, or an insatiable sleepiness (which is the chief symptom in the Lethargy, and sleepy Diseases) seems to arise wholely from the same causes as non-natural Sleep, carried forth only with greater force or energy; to wit, either the Animal Spirits, being first distemper'd, leave the outward compass of the Brain, and give an entrance,* 1.139 not only to the nervous, but to the serous, and some other vicious Humor; or else, the superfluous and excrementitious humors, together with the nervous, break thorow the cortical doors of the Brain, and as it were overflowing its Pores and passages, drive thence and repel the Spirits; sometimes this is chiefly the cause, sometimes the former, and sometimes both together. We shall first speak of that which is the more frequent cause of the Lethargy, to wit, the eruption of either too much, or too incongruous humor, upon the confines of the Brain, and then afterwards of the departure of the Spirits from the affected part.

I have often found by Anatomical observation, that the Lethargy doth arise from the Serous heap rushing into the outward infoldings of the Brain, and entering into its Pores and Cortical passages; for in many dead of this Disease, I found the spaces between the foldings of the Brain, full of clear water, yea and its outmost substance soft and infirm, from too much wet; moreover in some I found the interior cavities swelled with water, and the whole frame of the Brain overflowed with a Dropsie, or rather a flood. When therefore in a great and mortal Lethargy, it hath appeared that it has been after this manner, we may well suspect in a lesser and cureable sleepi∣ness,

that the out-borders of the Brain, are at least too much watered with humor, and the tracts of the Spirits overflowed; especially if there appear any signs of water or of Serum, abounding about other parts of the Head.

A grievous sleepiness is wont to be excited,* 1.140 not only from the Serum being too much, or from the over plenty of any other Morbific humor, but sometimes from its malignity: for it often happens, that a certain infestous and virulent matter is in∣stilled from the Flood into the Brain, which entering the Pores of the Cortical sub∣stance, profligates the Spirits, and either extinguishing them, or driving them away inwards, so that this region being left destitute of them, a sleepiness and forgetful∣ness succeeds. There is none almost who hath not taken notice, that this often happens in malignant and ill handled Feavours: also in the Scorbutick Cachexie, the Yellow Iaundice, and certain other Chronical Diseases, oftentimes a sluggish and vapid or tastless water is sent in, instead of the subtil and spirituous nervous Juice, that is the parent of forgetfulness, and of sleepiness.

This Conjunct Cause of the Lethargy,* 1.141 to wit, the heaping up of too much Humor, or too incongruous, within the shelly part of the Brain, depends upon other Causes, to wit, more remote leading causes, and also evident causes. As to the former, they are wont to be in fault, both when the Blood supplies the distemper'd part with Mor∣bific matter, and also because that the Brain it self too easily admits it.

For indeed,* 1.142 the Blood transfers to the Head in some, a great quantity of a wa∣tery humor, and in others of a salt or scorbutical humor, also again in others excre∣mentitious humors, and deadly to the animal government, sometimes taken from these bowels, and sometimes from those; and as occasion serves, instills them toge∣ther with the nervous Juice, out of the Arteries on the outer borders of the Brain, and there by little and little insinuating this kind of Morbific Matter, by a long con∣gestion, causes a dark cloud, or else by a sudden transportation of it, overflows at once all the outward part of the Brain, and drives away the inhabiting Spirits, like a Sea breaking in, and compels them to run more inwardly.

But indeed the Morbific Matter,* 1.143 how copiously or infestous soever it be, and poured on the Head, doth not induce the Lethargic Distemper, unless the very weak or vici∣ous, constitution of the Brain be also in fault: for if this be strong and of good tem∣per, it easily resists the assaults of all those; yea it bears, without hurt, the errors and enormities in th•• six non-naturals.* 1.144 Those who have this part too humid, or too cold, as Children and old Men; also, those distempered with Cacochymical Humors, the Dropsie, Scurvy, or Humors gathered about the mouth of the Stomach, are very prone to sleep, and sometimes, fall from a stronger Evident Cause, into a continual drowsiness. Besides, those who have a weak Brain, and their Pores too lax or open, that by that means the feculencies obtruded from the Blood find a more easie passage, often become obnoxious to sleepiness, yea and to the Lethargy: for such as are given to Surfeiting and Drunkenness, are wont presently after to fall asleep, which weakens the tone of the Brain, and fill, and too much open its Pores, with a crude and filthy Juice; so that when it hath been for a long time accustomed, by reason of these occa∣sions, to admit into them the Serous superfluities, it afterwards refuses nothing brought to it, but that its passages, like a course or wide strainer, suffers all the grosser par∣ticles, both Saline, watery, and earthy, easily to pass thorow them.

Besides these more remote leading causes (which become the act of the stirred up Morbific) there are more strong Evident Causes,* 1.145 for so great danger does not hang over the Brain, as that its whole compass should be invaded, from every morbid pro∣vision, nor upon every light occasion, But there are many and diverse occasions, by which the sleepy assaults are seen to be incited: the chief of these are great Sur∣feits, Drunkenness, especially of Wine, or the Drinking immoderately of Strong-waters, then after such excess to lye all night, or sleep in the open Air: further, an evacuation of the Serum, by otherways, after having been long suppressed; also if Spaw-waters being drunk in a larger quantity, and not again render'd presently by Urine, threaten a Lethargy. And so also do recrements of other Diseases, either not well or not at all Cured, being translated to the Head; so as a continual sleepiness of∣ten happens after acute Feavours, or such as continue long, and other Chronical Dis∣eases, and especially the Headach, Frensie, Empyema, or collection of gross Humors upon the Lungs and the Colick.

Thus much of the Lethargy,* 1.146 whose assault proceeds from the Cortex or shelly part of the Brain, being affected; to which succeed either an eclipse or an exclusion of the Spirits there inhabiting, with a sleepiness and oblivion. But as non-natural sleep, so sometimes what is preternatural, begins from the Spirits being first dejected; and which is usual to succeed another Cause. It is obvious to any one, that this ordi∣narily

happens from more strong Opiates, without any previous flood or stopping of the cortical part of the Brain: for it is not probable that Narcoticks stir up the Humors, and send them to the Brain, when it plainly appears, that all the effervescen∣ces and flowings of these, are allayed by them. But if it should be asked after what manner, and by what means, Opiates cause sleep, and sometimes a deadly Torpor or sleepiness, we say; That this Medicine is a certain kind of poison, beating down or extinguishing the Animal Spirits, by its blasting; the Blood and solid parts in the mean time being almost untouch'd:* 1.147 Wherefore, when the Animal Spirits become raging, and as it were struck with madness, running hither and thither, and will not be quieted and allayed, Opiates being administer'd, like water flung upon a flame, de∣story some of the outmost bands of them, so that the rest being lessened, and flying inwards, quietly lye down. We have at large discoursed of these things in a parti∣cular Tract, Of the Operations of Medicines on the Humane Body: For the present we shall note (which is to the purpose) that Narcoticks (or Medicines causing rest) being taken at the mouth, do put forth their powers partly in the Ventricle, and indeed immediately, and partly in the Brain, both that and the Mass of Blood mediating. By what means Narcoticks do operate, whilst in the Ventricle, and provoke sleep, we have shewn, Chap. XV. When they are moderate, in either province, they gently intoxicate some unquiet Spirits, and so immediately quiet the rest; but if any one takes Opiates in too large a Dose, he shall presently feel hurt both in the Ventricle and in the Brain, and a little after being insensible, shall suffer a greater evil in either: to wit,* 1.148 a mighty heaviness, and as it were an immoveable weight in the Stomach, which seems to opress both it and the neighbouring parts; indeed by this sign, the Fibres of this place (the Spirits which before actuated them being broken) become without life, and as it were dead; then by reason of the Opiate, particles being carried about with the Blood, to the frame or compass of the Brain, and in∣stilled into its Cortical or shelly part, the Spirits being driven away from thence or extinguished, an irresistable, and oftentimes a deadly sleep follows: yea, I have sometimes known, from a more grievous hurt inflicted on the Ventricle, only by the use of a more strong Narcotic, Death it self to have followed before sleep could creep upon them,* 1.149 coming by a long way about. A strong man vexed with a most cruel Colick, for ease sake (whilst a Physician was sent for) took rashly a great quantity of Opium; a little after he had taken it, he complained of a great burthen oppressing, and mightily weighing down the Ventricle: His Friends and the by-standers gave him Cordial waters, Wine, and Strong-Waters, but without any ease: This oppressi∣on creeping wider ahout the Precordia, raised up pains and swoonings; but still being awake, and constant in mind, he cryed out, that his spirits more and more failed him; till about three hours after, complaining that his sight was gone, he presently dyed.

* 1.150But that we may return to the Lethargy, as it is a Disease and not the effects of Opium, whence we digressed; concerning which we are yet to enquire, whether it may arise from a Narcotick Humor begotten in us, as some Chymists assert? We shall tell you our conjecture, that we think this 'tis sufficiently plain, that there are other sorts of Morbific particles produced in our Bodies, than those commonly called Ele∣mentary and Humoral, and that they do affect after a various manner, viz. besides the Watery, Earthly, Bilous, Phlegmatick, or Melancholic, we may find others Vi∣triolick, Nitro-sulphureous, and others participating of enormous Sulphurs and Salts, and active to our evil. The Convulsive Pathology can by no other means be delivered and explained, unless by supposing that some extraneous little bodies, and as it were Nitro-sulphureous, which sticking to the Spirits, and at last cast off by them, stir up the Explosive,* 1.151 that is Convulsive force: In like manner we may think, that others of another nature may perhaps be begotten, such as are of a Sulphureous, Vitriolick, or Narcotick nature, which when they creep into the Brain and nervous Stock, fall up∣on some Animal Spirits, which they by chance do meet, with extinguishing and fixing them, ordinarily induce their losses and eclipses, such as happen in the Vertigo, Apo∣plexy, or Palsie, as we shall more fully shew hereafter. In like manner, in a great fit of the Lethargy, though it be improbable, that these kind of Narcotick particles should be in heaps derived from the Blood into the Brain, in so great a quantity, that they should at once overturn the spirits dwelling in its whole precincts, and fix them; yet we may believe, that this may be some part of the Cause. Wherefore, in every long sleepiness, or Lethargick disposition, we do suspect the Animal Spirits, to be burthened with such a Lethaean Copula, and that we should direct the darts of every Medicine against it.

Thus much concerning the formal reason,* 1.152 subject, and causes of the Lethargy, pro∣perly so called, the summ of all which is, That the Animal Spirits, the inhabitants of the exterior Brain, being hindred from their wonted motion and emanation, lye down in a profound and inextricable sleep: but they are hindred either by the pro∣per vice of themselves, because having taken or being distemper'd by some Narco∣tick, they are as it were coagulated and become immoveable; or because their ex∣terior tracts or paths in the Brain, are obstructed and possessed by some strange guest, so that there is no fit space granted them for their expansion.

The symptoms of this Disease,* 1.153 which now come in order to be explained, the chief are Sleep, and forgetfulness, or a cessation of every other knowing or sponta∣neous function, unequal and slow breathing, a Feavour, and oftentimes, the distem∣per growing worse, Convulsions, a leaping of the Tendons, and at length universal and deadly Cramps or Convulsions.

As to the too former of these,* 1.154 we mentioned before, that Memory is deficient alto∣gether for the same reason, as Sleep exceeds; to wit, forasmuch as the Spirits inha∣biting the outward part of the Brain, being either bound up or expulsed from their tracts, do not irradiate or beam forth from the Callous Body, into the Cortex or shelly part of the Brain, by which imagination or waking is made; nor do they, be∣ing carried inwards, and repeating their former footsteps, represent the Ideas or Images of things before acted. Indeed, Sleep, Watching, and Memory, are affecti∣ons of the same parts and places: of which it is no light sign, and which vulgarly appears by experience, that Opiate Medicines, by which Sleep is provoked, being of∣ten given, hurt the Memory. Yea I my self knew one, having taken a strong Hyp∣notick, or Medicine to cause sleep, after being sick with a Feavour, lived many nights and days without sleep, and almost wholely lost his Memory, especially as to any thing long past.

As to what respects the other faculties of the Corporeal Soul,* 1.155 to wit, the Imagi∣nation, Appetite or desire, Sense, and Motion, although no Narcortick or sleepy chains are cast upon the Spirits destinated to these offices, and that the Pores and pas∣sages of the interior Brain, within which they are wont to expatiate, are seen to be open enough, yet these Spirits, because during the fit, they are denied their com∣merce with the others bound up, of themselves lye down, and are overcome by Sleep. For as a continual sleepiness beginning about the root of the sensitive Soul, to wit, the Cortex or shelly part of the Brain, immediately its whole province is obscured, as it were with a veil, to wit, the knowing, desiring, and self-moving part of the Soul, and also the intellect it self, its windows being every where shut up, hardly speculates, or beholds any thing.

Further,* 1.156 the power or force of this Disease, is seen to be extended to the other part of the sensitive Soul, presiding o're the Cerebel and its Regiment; wherefore, during the fit of the Lethargy, the respiration and Pulse are altered: for that be∣comes unequal and slow, sometimes drawing the breath deep and long, sometimes short, repeated, and as it were double: and this being great and swift, diffuseth a feavourish heat thorow the whole body.

The reason of the former,* 1.157 if I am not deceived, is this, to wit, that the same Mor∣bific Cause, which infects the outward part of the Brain, and its inhabitants, in∣fects also in part the Cerebel, and the Spirits there serving for the motions of the Precordia; which being by that means disturbed and hindred, though they omit not thir tasks, yet they perform them difficultly, and with interruption; hence the Dia∣phragma and Muscles of the Thorax, do not so easily and swiftly as before, perform their Systoles, but laboriously and with a longer straining or endeavour, and some∣times with repeated tryals or forces. This kind of unequal, long, and difficult breath∣ing, frequently happens also in a Phrensie; wherefore, some judge the cause both of this and that,* 1.158 to be from the inflammation of the Midriff or Diaphragma, but amiss, because the symptom in both these Cephalick Diseases depends on the Cerebel, partici∣pating the hurt of the Brain, grievously distemper'd.

As to the Feavour of one troubled with a Lethargy, to be known by the great and quick Pulse, hot breathing, with a burning of the Tongue and Mouth, without any heat in the extream parts, some deduce this from the same cause as the Lethargy, to wit, either from Phlegm putrefying in the Brain, or from a cold inflammation of the Brain Others on the contrary, affirm the Feavour to be the primary effect, and thence the Morbific Matter to be carried into the Head, from the burning Blood.

Concerning these,* 1.159 we grant, that a Lethargy comes often after a Feavour, but we can say nothing of the Phlegm putrefying in the Brain, or of its frigid Inflammation, which is as much as to say, icy fire; for if this be malignant, or of evil custom, hap∣pening

also to Children, old Men, and other Phlegmatick, Scorbutick, or very Cae∣cochymical persons, or such as are full of ill humors, about the height of a Disease, not well Cured, oftentimes in the place of a Crisis, the feavourish matter being snatch'd into the Head,* 1.160 induces a cruel and oftentimes a deadly Torpor or sleepiness; which notwithstanding ought not to be esteemed the symptom of the Disease, but of that Feavour. After this manner I have often observed, and elsewhere have particu∣larly described, that Soporiferous Feavours, and as it were marked with a certain sleepiness, have raged and become Epidemical, at sometimes, by reason of the evil constitution of the year.

But it is no less usual when a Lethargy is the principal distemper, for a Feavour to follow, and to owe to it as much its original, as its Cure; for a Feavour beginning after a continual sleepiness, that being shaken off or discussed, ceases soon of it self; such a Feavour we think to arise,* 1.161 not from the Blood growing hot by reason of the strife of intestine particles, but because of the impulse of the containing and neigh∣bouring bodies, variously altering and disturbing its course. For indeed the right tem∣per of the Blood very much depends, not only on its particles being truly mixt and overcome, but also upon the motion impressed on the Heart and the Vessels, or the Organical Circulation;* 1.162 to wit, that its Liquor may every where flow with an equal and alike flowing and ebbing; which, if finding any where a stop or Remora, it be retarded, its motion is made more impetuous, and with a Feavourish tumult in the whole channel besides. This manifestly appears in violent passions, acute pains, a breaking of the unity, in all, which the Blood being obstructed in one place, or strait∣ned, it is snatched more vehemently in others, and conceives a Feavourish heat; for this cause, to wit, lest the thread of its circulation should be broken, on which life necessarily depends;* 1.163 wherefore as the Proverb says, None dyes without a Feavour: For how poor or deficient soever the Blood is, and that the strength of all the move∣ing parts are weak, yet in the instant agony of Death, by the mere impulse of Na∣ture, they either pursue their functions, or the nervous Fibres every where erect them∣selves, and put forth their utmost endeavours, that they might drive forward the Blood flowing in them, and Circulate it with a rapid motion. I once visited an il∣lustrious Lady, who for some time had been miserably afflicted with Colick and Convulsive distempers, and quite worn out, and at length fell suddenly into a dead∣ly Lethargy. When I perceived her Pulse to beat strongly, I prescribed that four ounces of Blood should be taken out of the jugular Vein, which immediately leap'd from the opened Vessel, with such force that, I believe, if it had been suffered, the whole Mass of Blood would have flowed thence: for the next day after, her dead body being opened, I found scarce four ounces more of Blood in her whole Body, and yet she dyed thus in a Feavour. The reason of the Lethargick Feavour is whole∣ly the same, which is seen to arise only from the Vital Organs, being very much incited by labouring Nature, and therefore vehemently driving about the Blood.

* 1.164The prognostick of the Lethargy is shut within a strait limit; for the fit of the Dis∣ease being for the most part acute, is soon terminated either in Death or health, and for the most part it is wont to give more of fear, than of hope. If it comes up∣on a malignant Feavour or hard to be cured,* 1.165 or if it comes upon other Cephalick or Convulsive Diseases, as the Headach, Phrensie, Madness, Epilepsie, or also upon a long and grievous Colick, or Gout, the Physician can predict nothing but evil: nor is it less to be feared if it happen in a Body full of evil Humors, or one long sick, or in an old Man.

* 1.166In like manner it is an evil omen, if the sick, being presently overwhelmed with a great Torpor or stupidness, and almost Apoplectick, cannot be awakened, and if he breaths unequally, and slowly, or with a great snorting, then the Disease increasing, and the sick troubled with tremblings, Cramps, leapings of the Tendons, and at length with Convulsive Motions, it is to be esteemed desperate or without hope.

* 1.167But if the Distemper be excited, without any great foregoing Cause, with an on∣ly Evident Cause, as a Surfeit, Drunkenness, or by the use of Narcoticks, a blow on the Head, or some not deadly stroke, we may expect the event to be less deadly or mortal.

* 1.168Then if the Distemper, arising from such occasions, happens to a Body before whole and strong; if it does not wholly take away the Sense and Memory at the first assault, and after a short time the symptoms begin to remit a little, of such a sick person you ought not to despair.

* 1.169In every Lethargy, if any Cause of the Disease is seen to be cut off and removed, so that if by the help of Medicines, or the instinct of Nature, copious and helpful evacuations by Sweat, Urine, or by Stool do follow, with ease or help, or if by ap∣plying

of Blistering Plasters a great deal of water flows forth, if a swelling or great whelks or pustles break out behind the Ears, or in the Neck, if frequent sneezing happens, or water flow from the Eyes or Nose, thence a certain hope of health may be expected.

Hippocrates l. Coac. c. 145. mentions a Cure of the Lethargy,* 1.170 to be often made by the distemper of the Thorax; saying, That many Lethargicks that are stuffed with Phlegm have recovered: Which words are wonderfully wrested by Interpreters. Mercurialis understands by suppuration, the putrified matter of the Disease, to be evacuated by the Ears and Nostrils. Prosper Martianus will have Hippocrates to be understood in the word Lethargy, not the disease of the Head, but of the Breast. But where∣fore are all these subterfuges? when it often happens that the Morbific matter, at first fixed in the Head, and stirring up a continual sleepiness, or Lethargy; the same being thence supped up by the Blood, and deposited in the breast, doth produce an Empyema,* 1.171 or a spitting like those whose Lungs are wasted. In the description of a Soporiferous Epidemical Feavour, which raged in the year 1661. we noted the same to have happened to many.

Concerning the Cure of this Disease,* 1.172 for that it has no respite or truces, it is not to be deliberated on: after a sharp Clyster being given, let a Vein be opened pre∣sently, for the Vessels being emptied of Blood, they are more apt to sup up the Se∣rum, or other Humors deposited in the Brain.* 1.173 Further, in this case, I advise ra∣ther to open the Vein in the Neck, than that in the Arm. Because by this means, the Blood being very much heaped up, within the bosoms of the Head, and per∣haps standing still, is more easily reduced to an equal Circulation.

Letting blood being performed,* 1.174 immediately other remedies of every kind are to be made use of: Let Vesicatories or blistering Plasters be applied largely to the Neck and Legs; anoint the Temples and Face with Oyl of Amber, or Cephalick Balsoms; lay over all the Feet a Cataplasm or Poultis, made of Rue, Crowfoot, and Pepper∣wort, with black Sope and Bay-salt; use hard frictions or rubbings to the Members, frequently apply to the Nostrils Salt of Urine, or Spirits of Sal Armoniac.

Then let there be administred Cephalick Remedies.* 1.175

Take of the Water of Poeony Flowers,* 1.176 of black Cherries, Rue, and of Walnuts, simple, each three ounces; of the Water of Poeony Compound two ounces, of Castor tyed up in a rag and hung in the glass two drams, of Sugar three drams; mix them and make a Iulep,* 1.177 let it be given about four or five sponfuls every three or four hours; also with every Dose of this, give twelve or fifteen drops of the Spirits of Amber, or of Sal Ar∣moniac, or a paper of the following Powder.

Take of the Powder of the Root of Poeony the male,* 1.178 of a Mans Skull, of the Root of Vir∣ginian Serpentworth or Snakeweed, of Contrayerva, each one dram; Bezoar, and of Pearl, each half a dram; of Coral prepared one dram, make a Powder, and divide it into twelve parts.

Further,* 1.179 here it is to be considered, whether an evacuation, either by Vomit or Stool, should not be made. I know that this is variously controverted among Au∣thors, and I have also known it performed with various success: which being weigh∣ed and laid together, I shall briefly propose my opinion.

If the Lethargy should arise upon a Surfeit,* 1.180 or a late Drinking, or if from taking some disagreeable things, or Narcoticks; presently let a Vomit be given; where∣fore, you may give Salt of Vitriol, with Wine and Oxymel of Squills; or in strong bodies an Infusion of Crocus Metallorum, or of Mercurius Vitae, with black Cherry wa∣ter. Let it be given, and if it doth not work of it self, provoke Vomiting with a Feather thrust down the Throat.

But if the fit of the Disease comes upon a Feavour,* 1.181 or any other Cephalick Di∣stempers, or if it be raised up primarily, or of it self, by reason of some foregoing cause before lying in the Blood or Brain, then a Vomit or Purge being given at the beginning, when the matter is flowing, doth oftentimes more hurt than good; because the Humors whilst in motion, are more shaken and agitated, and when they cannot be subdued and brought away, they drive them into the distempered part.

On the second day,* 1.182 if the numness doth not remit, let Phlebotomy be repeated, if the Pulse shew it fitting; or else instead thereof, take forth blood from the Shoulders, after Scarification by Cupping Glasses; then a little after (if nothing hin∣ders) let a Vomit or Purge be administred.

* 1.183Take of the Sulphur of Antimony five grains, of Scammony sulphurated eight grains, of the Cream of Tartar six grains; mingle them, make a Powder; let it be given in a spoonful of the afore prescribed Iulep.

Or Take of Scammony sulphurated twelve grains, of the Cream of Tartar fifteen grains, of Castor three grains; make a Powder, and let it be given after the same manner. In the mean time, let altering Medicines, or such as derive the matter from the place, the same or such like, be still continued.

* 1.184On the third day, and afterwards ought to be applied such things, which are forbid at the beginning of the Disease, for fear of a new Fluxion, viz. Errhines, or things that Purge the Head at the Nose, Sneezing Medicines or Powders, Apophlegmatisms, or Medicines which draw the Humors from the head by the mouth. Further, it is then sometimes expedient to apply the warm intrails of some animal new killed, to the forepart of the Head, after the hair is clipped or shaven off, and often changed: also sometimes to foment those places with a Discussing and Cephalick Decoction, or Fo∣mentation: but before all other Topicks,* 1.185 I have known great help brought from a large Vesicatory or Blistering, with many running sores made all over the compass of the Head. I saw two sick with the Lethargy, after the Disease held long, and that not only the Memory, but almost all knowledge was lost, Cured chiefly by this Remedy: for in both of them, the ••••eyed places, when they could not be easily covered, poured forth great plenty of thin matter, about half a pint every day. It will not be need∣ful to set down any more Medicines of this nature, being commonly and every where to be had; it now remains, that we illustrate what we have said, with some Histories of sick people, which I shall here add.

* 1.186A Country-man about thirty years old, of a Phlegmatick Complexion, something in∣clining to Sanguine, being a long time obnoxious to frequent Headaches, about the beginning of Winter, became sleepy and very stupid; and one day, whilst he was following the Plow in the Fields, lying down on the ground, he fell into a profound sleep, and when he could not be awakened by his servant and others calling him, he was carried home and put to bed; his Friends in the mean time expecting that after he had finished his sleep, he would awake of himself. After the space of twelve hours being past, when he could not be awakened by pulling, thumping, noise, and other means, they sent for me; as soon as I came, I applied Blistering Plasters, large ones, all about the hinder part of the Neck, then taking from him about sixteen ounces of Blood, I caused him to take a strong Clyster, and his Face and Temples to be a∣nointed with Oyl of Amber, and Frictions and painful Ligatures to be applied to his Legs. Also I prescribed him to take oftentimes in a day, Spirit of Sut, with a Cephalick Julep. Notwithstanding he lay all that day stupid, without any sense; and if being provoked by some strong or hard pulling, he lifted up himself a little, and opened his Eyes, presently falling down again, and shutting them, he fell into his continual sleep again. About Evening I took care to have Cupping Glasses, with a great flame to be applied to his shoulders, which done, he began a little to awake; and about that time he had a great stool, and very much Serum flowed forth from the Blisters, the Plasters being taken off, then we had great hopes of his health. And therefore at every turn, remedies being applied that night; awaking in the morn∣ing following he knew his Friends, and answered aptly to those who interrogated him: But as yet the whole cloud was not vanished, but that being sleepy, he remained several days oblivious, till at length, being purged twice, he perfectly grew well.

* 1.187This case has the exact type of the Lethargy, properly so called, where for the con∣junct Cause, it had an heaping up of abundance of Serum about the compass of the Brain, and then a breaking in of it into its infoldings: and when by a timely use of Remedies, the flowing in of new matter was hindered, and that which lay up∣on the part was partly supped up into the Blood, and partly being rarified into Va∣pours and Effluvia's, was shaken off, the Cure of the Disease quickly and wholely followed.

* 1.188An Oxford Gardiner being sick of a Feavour, about the height of the Disease, in∣stead of a Crisis he fell into a continual Sleep, and lay drowned in it for three or four days, so that he could not be awakened by the use of any Remedies: But at length, his Head being shaven, Blistering Plasters were applied all over his Head, and many running sores left open, and awakening he recovered the use of his senses a little: But his Memory being almost wholely lost, he became so stupid, that he remembered the name of no Man, nor their words, and remained like a Bruit. When he had thus remained foolish for the space of almost two months, and still very sleepy, the

cloud began a little to be dispelled: and at length, he returning to his wonted la∣bour, was in indifferent good health; but he never had afterwards the same vigor of mind and wit, as he had before this Disease. In this case you have an example of a Lethargy coming upon an ill Cured Feavour, in which the Morbific Matter, by a sudden translation of it into the outward part of the Brain, had for a little while filled, not only all the Pores and passages, but also had so hurt their Conformation, that the Spirits being for some time excluded, and at length freed, they could not re∣cover their former paths, or wonted tracts, till of a long time after.

I remember very well,* 1.189 the example of a Lethargy, arising from the use of Opi∣ates, in a Country Village where I lodged by chance one night, by reason of the foulness of the weather. For being about to go to bed, mine Host asked me if I would visit two poor people his Neighbours, distemper'd after a wonderful and miserable manner. When I shewed my self ready to do the office, not only out of Charity, but led also by curiosity, I was carried willingly into a small and poor Cottage, where I found the Father an old Man, and his Son, both of them in two Beds in one and the same Chamber, overwhelmed with a most profound Sleep, which had oppressed them the day before, after they had eaten some roots, which they had dug up in the Garden, being it seems Henbane, which they took for Parsnips.

After they had both Oyl and Oxymel poured down their throats,* 1.190 and a Feather thrust down a great way, that made them vomit, I prescribed for them tincture of Castor, with a spoonful of Treacle-water (which Remedies I had then about me) to be given them at every turn all night: besides, that they should anoint their Nostrils and Temples with the same Tincture; and if it might be done, that a strong Clyster should be given them: the following day the old Man first, and afterwards the Son awaking, returned to themselves, the sleepiness being almost wholely shaken off. In these distemper'd, after the reliques of the Narcotick were cast out by Vomit, left they should do further hurt, there was only need, that by fit Medicines (among which Castor deservedly is esteemed to be contrary to the venom of Opiates) the Spirits being excited, should be set free from the sleepy poison afflicting them.

CHAP. IV.

Of some other sleepy Distempers, viz. a continual Somnolency, the Coma, or heavy Sleeping; and the Caros, or a deprivation of the Senses.

IN the former Chapter, we have fully shown what doth belong to the knowledge, prognostick, and Cure of the Lethargy, properly so called. But we did not only therefore affirm, that the seat of this Disease was in the unequal compass, the cranklings, or infoldings of the outward part of the Brain, because we had there as∣signed the repository of the Memory, and the porch of Sleep, (although we might from hence conclude it;) but besides, because it hath appeared so to me from Anato∣mical observations very often,* 1.191 that the Lethargy does not arise (as is commonly thought) from the interior Ventricles of the Brain being distemper'd: for we have known, these to be frequently overflown with water, and sometimes distended with ex∣travasated Blood, and yet the sick whilst they lived, were free from the Coma, or any great stupidity. I must confess, that sometimes the Dropsie of the whole Brain causes the continual sleepiness: but in this case not only the internal Cavity, but also the Intersitia, or the spaces between the outward Infoldings, are filled with a flood of wa∣ters.

The Lethargy therefore being confined to the outmost borders of the Brain,* 1.192 we so constitute its limits, that those circlings about, being almost wholely possessed, together with the interspersed Marrow, perpetual and inexplicable Sleep, or hard to be rid of, with oblivion or forgetfulness, is induced; in the mean time, the middle part of the Brain, or the Callous body, from whence the Animal Spirits irradiate, or beam forth, into all parts both sensible and motional, being almost unhurt; for the total eclipse of this causes the Apoplexy, as shall be shewed hereafter. But indeed on either sides of these ends or limits, other soporiferous distempers are ordinarily found, which though of kin to the Lethargy, yet some of them are lesser than it, as Somno∣lency or continual sleeping, and the Coma; only one is greater, as the Caros. There∣fore

we shall now, and in order, speak briefly of every one of these, as also of some opposite passions, viz. thorow waking, and the waking Coma: and first of Continual Sleepiness.

* 1.193Most Authors call this not a Disease, but an evil habit, or a sleepy disposition, for the distemper'd, as to other things, are well enough; they eat and drink well, go abroad, take care well enough of their domestick affairs; yet whilst talking, or walk∣ing, or eating, yea their mouths being full of meat, they shall nod, and unless rouz∣ed up by others, fall fast asleep: and thus they sleep continually almost, not only some days or months, but (as it is said of Epemenides) many years; wherefore we ought to believe this a Disease, and worthy of Cure, which defrauds one of more than half his life.

* 1.194The seat of sleepiness, as that of the Lethargy, is to be placed in the outward part of the Brain; but with this difference; that the material or conjunct Cause of this Distemper, though it vexes, or troubles always without doors, yet it penetrates less deeply than the Lethargy; yea it disturbs or affects almost the whole superficies of the Brain, or the mere Cortical substances of the infoldings, the included marrow be∣ing almost untouch'd:* 1.195 in which respect, it differs not only from the Lethargy, but the Coma also; for in the Distempers which we described, though continual sleep presses on them, yet 'tis easily broken off; then besides, being fully awakened they remember many things, and converse with their Friends, though immediately prone again to sleep: whence it appears, that the cause of this Disease sticks only in the outer border of the Brain, nor does it enter deep into its compass, as other sleepy distempers do.

* 1.196But indeed it may be suspected, that while the Blood every where washing the border of the Brain, with thick rivulets, and instils every where into it a subtil wa∣ter, for the matter of Spirits, oftentimes a great plenty of water flowing thither with it, and entering together the Cortex, and remaining there, mightily fills it, and (like an Anasarca in the Body) swells it up: But this Cortical or shelly part being swelled up after this manner, and as it were dropical, so presses the Medullary infold∣ings, every where lying under it, that the expansion of the Spirits being hindred, by reason of the Pores of the exterior part of the Brain being something bound up,* 1.197 sleepiness is induced; to which it happens, that the Blood, that by reason of the Cortex of the Brain being intumefied with water, as it were between the Skin, Cir∣culates less expeditiously, thorow all the neighbouring parts, and so is apt to fill the Vessels and bosoms, and to stagnate in them; by which means it comes to pass, that the exterior border is yet more compressed,* 1.198 and so the spaces requisite for the emanation of the Spirits, are also more streightned. Indeed this appears to be part of the cause, from hence, because this kind of sleepiness, by reason of the Blood not freely circulating in the Head, and therefore apt to stagnate, is wont to make red the Face, with a certain blueness and blackness: Further, whilst the subtil Liquor, which is for the matter of Spirits, passing thorow this pond or deluge heaped toge∣ther in the Cortex of the Brain, goes forward into the Marrow lying under, it is probable, that with it do creep thorow some extraneous, and as it were very small Narcotick particles,* 1.199 which growing to the Spirits immediately render them torpid or stupid, and prone to sloth of their own accord.

This Distemper, as I have observed in many, is not very dangerous, for as it of∣ten happens, it is wholely Cured, or at least remaining for many years, without the Carus or Apoplexy (which is wont to be feared) it doth not become mortal or terrible. The Cure of this Disease often happens, the seat of it being changed, to wit, when clearing the Brain, the Morbific Matter is transferred to the Cerebel, which coming thither, produces tremblings of the Heart, the Asthma, loss of Spirits, and other troublesome Symptoms, commonly taken for Hypochondriacal,

* 1.200The Curatory Method suggests chiefly these intentions, to wit, that after a pro∣vision or foresight of the whole, that (where it is convenient) Phlebotomy be per∣formed, and a Purge given; then those Remedies to be diligently administred, by which the Blood and the Brain may be freed from the watery deluge, and this lat∣ter may be strengthened, whereby it may for the future receive and retain the Se∣rous superfluities. For those ends, once or twice a week, may be given Pills of Amber, or of Cochiae, with the Refine of Ialap; at other times, let there be taken daily Morning and Evening, a Dose of a Cephalick Electuary, or Spirits of Tincture of Sal Armoniack, Amber, Sut, with a Cephalick Julep: the forms of which may be picked out of those above described. At eight of the Clock in the Morning, and at five in the Afternoon, let them drink a draught of Coffee, or the Liquor prepa∣red of that Berry, first boiling in it, the leaves of Sage or Rosemary, till it has got a

greenish Tincture. Let them drink for their ordinary drink, a Decoction of Lignum Sanctum, adding towards the end, the leaves of Sage or Betony, or other Cephalicks. Further, it is expedient that two large Issues be made between the Shoulders, and also frequent Blistering Plasters be applied about the Neck. The hair being cut off, let a quilted thing of Cephalicks and Spices be worn under the Cap. Let them also hold their noise often over a Vessel fill'd with Salt of Urine, or the Spirit of Sal Armoniack; let care be taken that they keep to an exact order of diet, and that those attending the sick, do not only rouse them from sleep, but daily at some set hours keep them waking.

A certain Gentleman of a Sanguine Complexion, and when he was young, of a sharp and cunning wit,* 1.201 but afterwards growing aged, being given to idleness and drunkenness, became dull and stupid, and also Dropsical, with a great paunch, and his thighs and legs swelled. Yet from these Diseases (which he frequently fell into) when he abstained at any time from drinking, and took Physick, he oftentimes quickly grew well. But at length, though he was freed from the Dropsie, he was oppressed with so heavy a sleepiness, and that almost perpetually, that in what place soever he was, or what ever he was doing he would sleep; then being awakened by his Servants or Friends, his mind appeared well enough, and for a few minutes he would discourse of any thing well enough, then immediately fall again to sleep. To this man I prescribed, after he had taken in vain several Medicines,* 1.202 that every Morning and Evening he should take of the Powder of the Leaves of Betony dryed in the Sun, and kept in a Glass, a spoonful in a draught of the distilled water of Lavender Flowers. By which Re∣medy finding ease, after a few days, he was perfectly Cured within a month, and enjoyed perfect health for four years after: Afterwards by reason of his evil manner of living, the same returned again, but the same Remedy found not the same success; yea there was need of other Medicines besides; sometimes he took the Spirits of Harts-horn, or of Sut, with an appropriate Julep; sometimes Cephalick Conserves and Powders, to which sometimes Steel was added. When he would indulge him∣self by Drinking, instead of Wine or Beer, he drunk Coffee; but for his ordinary drink, he had sometimes Ale, with the leaves of Scurvigrass, Sage, and Spices infused in it; and sometimes with Woods, Spices, and Cephalick Herbs boiled with it: He lived thus for many years after, almost always intemperate, and full of gross humors, yet free from the Lethargy; at length a Cachexy or evil state of Body inva∣ding him, and wasting with a Cough and Asthma, by degrees, he dyed.

The next sleeepy Distemper before spoken of,* 1.203 greater than this last, and yet lesser than the Lethargy, is that which is commonly called the sleepy Coma. Those trou∣bled with this, are for the most part oppressed with an heavy sleep, which they almost still indulge, and lye with their mouth gaping, and their lower Jaw fallen down, more like dead than living persons; being rouzed up by some strong pulling or pinching, they look about, speak to those standing by, answer their questions, but immediately sleeping again; they are much troubled to be hinderd or disturbed from sleep so pleas∣ingly creeping on them. And thus indisposed after this manner, they continue for many days, yea sometimes months, sleeping without any Feavour accompanying, or follow∣ing it, nor have their breathing hurt, and not very forgetful, in which it differs from the Lethargy: Again, they differ from those sick of the Distemper but now de∣scribed no less; because, those sick of this Coma, are for the most part fixed to their Bed or Chair, and walk not abroad as the others, nor take any care of their houshold affairs. They answer to any short questions properly, but they cannot dis∣course, or deliberate about doing any business.

Without doubt,* 1.204 the Cause of this is of the same nature as the former, but of a middle degree between those two but now described; for indeed, it may be well su∣spected in this Distemper, that the Morbific Matter doth penetrate the Brain a lit∣tle larger than in a Continual Sleepiness: to wit, the turning cranklings, or Corti∣cal infoldings, together with the small Rivulets of the included Marrow are invaded: But yet they reach not to the greater bosoms of the Marrow, within the Callous Body, that are wont to be possessed in the Lethargy.

The Coma sometimes beginning first and of it self,* 1.205 like the Lethargy, proceeds either from a Serous deluge poured forth from the Blood into the Cortex of the Brain; or else from a Narcosis, or a sleepy stupidness inflicted on the spirits dwelling there; and then, by how much this Distemper is lesser than the Lethargy, by so much it is esteemed less dangerous. But this Disease more frequently comes upon other Chro∣nical or acute Diseases, to wit, the Headach, Convulsions, and frequently ill-judged Feavours, especially in Children, old Men and Women, and Phlegmatick people. Some time since, I observed in the Epidemical Feavour of the Nerves, (which I have else∣where

described) as some were Lethargical, so many were troubled with this Sleepy Coma; of whom many grew well, the Morbific matter being translated from the Head into the Breast. Further, in other cases, this Distemper of a doubtful event, between hope and fear, requires the careful pains of a prudent Physician.

* 1.206In the primary Coma, the Curatory Method suggests almost the same intentions of healing as in the Lethargy: as to the Morbific Matter, indeavour must be had, both that a new flowing into the Brain may be prevented; and also that what is already impacted, may be discussed or taken away. Further, the Animal Spirits ought to be rouzed up, or excited, and all sleepiness or stupidity shaken from them. For this end, ought to be applied Purging, Blood-letting, Cupping-glasses, Blistering Plasters, repelling and discussing Topicks, and Cephalick Medicines to be given, and chiefly such as are impregnated with a Volatile Salt, and many other means of administrati∣ons already recited.

* 1.207But if this Disease coming upon other Distempers, happens to a person, whose Body is already much worn out, the Blood vitiated, or greatly depauperated, you must seriously deliberate before taking away of Blood, or Purging: yea, also ab∣stain very much from them. Yet sometimes that the Conjunct Cause, or matter of the Disease impacted in the Brain, may be put into motion, it may be expedient, to take away Blood moderately, either from the Forehead or Temples, by Leeches, or from between the Shoulders by Cupping-glasses and Scarification. Here Blistering Plasters are in chief esteem, to be applied not only to the hinder part of the Neck, or Head, but to the Legs and Arms, and other parts of the body, by turns. Further, let there be given frequently the Spirits of Harts-horn, of Sut, of Sal Ar∣moniack, Amber, or a Mans Scull, Coral, and others, impregnated with other Ce∣phalicks, with a Iulep, or any other proper Liquor. The forms or Receipts of these, and of other Remedies,* 1.208 used in these cases, together with the Histories of the sick, and examples of Cures, are extant in the description of the aforesaid soporiferous Feavor; so that there is no need to inculcate here again, the same, or such like.

3 1.209There yet remains an other sleepy Distemper, or kind of Lethargy or continual sleeping, commonly called Carus, which is greater than the Lethargy, and somewhat lesser than the Apoplexy, and is so near akin to this, that it often passes into it; but yet it is wont to be differenced from either: For those sick with the Carus, breath well for the most part, and when they are strongly pulled, they move their Mem∣bers, sometimes lift themselves up,* 1.210 open their Eyes, and often speak, which Apople∣ctical persons do not; yet the same, though excited or moved, do scarcely understand any thing, or plainly discern, in which respect they are distinguished from such as have the Lethargy.

* 1.211From these it appears, that the Conjunct Cause of the Carus, doth penetrate deep∣er towards the middle part of the Brain, and hath its seat in the outmost border at least of the Callous Body; wherefore the Animal Spirits, being restrained from their wonted expansion, within this Emporium, the acts of the Imagination and Me∣mory cease, and although the Species being impressed from a more strong sensible, is directed inwards, and oftentimes the local motion is retorted to it, yet because this impression reaches not to the Callous Body, by reason the Spirits are there a∣mazed or stupefied, the sick know nothing what they feel or do.

* 1.212The Conjunct Cause of this Disease therefore, is very often the same, but some∣what more strong, than that of the Somnolency, Coma, and Lethargy: The Morbific Matter is seen to possess both the Cortex of the Brain, and the Marrow lying under, and being carried forward, some greater bosoms of the middle part, and the upper borders of the Callous body; yea sometimes, as this matter is partly carried forward by degrees, these Diseases arise, and every next is but the augmentation of the former.

* 1.213But sometimes the Morbific Cause; without any gradual progress thorow these parts, affects the middle part of the Brain at the first assault, and there (as it is more lightly or more deeply placed) causes the Carus or the Apoplexy. In which case, it is not to be thought, that the whole compass of the Callous Body, like the Cor∣tical part of the Brain, should be possessed by the soporiferous matter: because it is sufficient, this matter rushing into any one place, and invading some part of the middle Marrow, that presently for that reason, an Eclipse, or at least a beating down of the Spirits follows, in all that region. After this manner it is wont to be, when the Carus comes upon a malignant or ill handled Feavour, or upon the Headach, or some Convulsive Distempers, or when it is excited by a blow on the Head, or by a fall, or by reason of an Imposthum broken in the Meninges: for by reason of these accidents, the interior Marrow of the Brain is wont to be so pressed together, shaken,

or otherways altered, that presently the tracts or paths of the Spirits are oblite∣rated or blotted out.

The prognostick of the Carus for the most part is but evil,* 1.214 especially if this Dis∣ease comes upon a malignant, or a long continued, a gentle and not Cured Feavour, or on a Woman in Childbed, no less danger is also threatned, if it follows after other Cephalick Diseases, or is excited by reason of a Wound in the Head: but yet in these cases, all hope of Cure is not presently to be cast off; for I my self have observed, some sick after this manner, and esteemed desperate or past all hope, to have reco∣vered.

The event of this Disease is wont to be various,* 1.215 either in Death or in health. The Carus passes not rarely into a soon killing Apoplexy, that after first the animadvertive faculty being lost, with a short breathing, and without motion, then by reason of the evil being transmitted to the Cerebel, there follow alterations of breathing and the Pulse, and quickly death it self.

But sometimes the Morbific Matter setling more deeply,* 1.216 and falling from the Callous Body, into the streaked Body, one or both together, the Brain clears up a little, so that the sick look about them, talk, and know things, yet in the whole body besides, a Palsie, or Dead-Palsie on one side follows: but so, that life is not out of danger: for oftentimes, when the Brain begins to be restored, the Cerebel grows worse, that for that cause the Spirits there being evilly disposed or affected, which perform the offices of the vital function, and merely natural, either Convulsions are stirred up in the Bowels, and Precordia, or deadly impediments of the Pulse and respiration; yet sometimes when the Morbific matter is not so plentiful, nor very malignant, it is partly supped up into the Blood, and partly shook off, so that the sick grow perfectly well again.

The Curatory Method suggests the same intentions of Healing,* 1.217 and requires wholly the same Remedies, as those which are wont to be administred in the Lethargy and the Apoplexy. Wherefore, there will be no need to add here a company of Indications, nor to heap together a great pile of Medicines. But what seems more to the pur∣pose, that I give you one or two Histories of sick people, of which I have many by me.

A known person of about forty years of Age,* 1.218 who having through Intempernace lost his health, took I know not what Medicines, prescribed by an Emperick, and fell into the Carus; perchance it was because the Morbific Matter being moved and agi∣tated by the Medicine, it rushed into the Head. Visiting this Man on the second day, I found him buried in a profound sleep, and almost insensible; for although he opened his Eyes, moved his Members, when prick'd or strongly pull'd, yet presently sleep∣ing again, he perceived nothing of what he did or suffer'd. Though in this case, I could prognosticate nothing but what was sad, however I did not desist from giving him my Medicinal help: abstaining from letting of blood, his strength being worn out, and his Blood depauperated, I took care for a large Blistering Plaster to be applied to the hinder part of the Neck, and a strong Clyster as soon as I could, to be given him, made of a Decoction of Briony Roots, with Carminative Flowers and Seeds, adding thereto of the Species of Hiera two drams: his Nose and Temples were a∣nointed with Balsoms. Cataplasms of Rue, and the Roots of Bryony were laid all over his Feet. Besides, every other, or every third hour, I order'd him to drink a Dose of the Spirits of Harts-horn, with a Cephalick Iulep; yea, and I took care to have ad∣ministred several other administrations, used in this case. By which, when the Dis∣ease did not wholly give place on the following day, I prescribed a Purge of pre∣pared Scammony to be taken in a spoonful of Broth; by which, when he had gone often and plentifully to Stool, he began to open his Eyes, speak to, and to know those standing about him, and a little after returning to himself, he fully awaked. This Disease therefore (as I think) was easily and quickly Cured beyond hope, be∣cause that cloud, being by chance sent into the Brain by Physick, might the better be deduced thence by the help of other Physick.

A noble person about fifty,* 1.219 fat in body, and in time past obnoxious to the Vertigo, and to Asthmatical Distempers, using for two years Physick every spring and fall, having also a large Issue between his shoulders, lived in indifferent health: The Sum∣mer coming on, and he living in the Country, neglected his Issue for several weeks, so that the recrements there, flowed much less than they were wont; yet he was still well, till about the Solstice (or middle of Iune) when one morning chearfully talking with his Friends, sitting in the Porch of his House, rising suddenly he complained, that he was not well; and going into the House, sitting down in a Chair, immediately leaning backward, fell into a profound sleep, and lay so buried in it, that all that

day he could not be awakened. Coming to him in the Evening, I took care to have Phle∣botomy administred, and also a Clyster, a Vesicatory, and many other Remedies, proper in such a Case. On the next day, his Brain began a little to grow clear, so that he looked about him, and spake a few words; he seem'd to know his Friends, but could not utter the name of any; but by reason of this matter sinking down more deep∣ly into the Brain, a Palsie seized his whole right side. Further, when as yet his great sleepiness continued, that day Blood was taken out of the other Arm, and also other Remedies as the former, were continued: On the third day, being less stupid, he knew many, and could tell the names of some of them, he perceived then his own sickness, and began to be careful for the taking of Remedis. But in∣deed, whilst his Brain grew better, the evil spread it self on the Cerebel, and the nervous Stock; for on the fourth day, his breathing became unequal, and more labo∣rious, his Pulse weaker, and his whole body troubled with a stifness, and Convulsive shakings: On the fifty day, more cruel Convulsions and Cramps did more often infest him; then his Pulse by degrees lessening; on the sixth day, though more freed from his sleeping, he dyed. In this case, and in others like it, 'tis probable that the Morbific matter did at once invade the Brain and the Cerebel, but whilst it stuck in the Cortex of this latter (contrary to what happens in the Brain) it caused no sensible hurt, because this part, which was hurt, was neither the seat of Sleep nor of the Memory; but afterwards, perhaps on the fourth or fifth day, the matter sinking down from thence, to the middle parts of the Cerebel, whilst as to the other Distemper the sick grew better, the vi∣tal function, by reason of the spirits destinated to it being oppressed in their foun∣tain, began to faint, and afterwards suddenly declining, took away unexpectedly all hope of recovery, which before seemed favourable.

CHAP. V.

Of thorow or long Waking, and of the Waking Coma.

EVEN as Light and Darkness, so Sleep and Waking, being placed nigh toge∣ther, best illustrate the natures of one another; so that it will be to the pur∣pose, after the Sleepy Distempers, to discourse here of preternatural Watch∣ing, or Waking; to wit, forasmuch as it exceeding its limits, and hurting some functions, is both a Disease, and requires Cure. In this rank there are commonly two Distempers, to wit, thorow or long Waking, and the Waking Coma; of both which we will now speak in order.

* 1.220Concerning thorow Waking, we must here first distinguish, to wit, that it is a symptom coming upon some other Disease, as a Feavour, Phrensie, Madness, the Co∣lick, Gout, or such like; then the Cure and consideration of it belongs to that distem∣per, whose issue it is: or else immoderate Waking, arising of it self, without any notable sickness, is seen to be a Disease almost solitary or alone of it self. So I have known some, free from any Feavour or pain, well in their Stomach, and fit enough for their business, being in Bed, could take no more Sleep than the Dragon of the Hespcrides. Some troubled with this kind of Waking, though destitute of Sleep, scarce seem to want it it; for their Spirits appear neither sluggish, or weary, or ex∣hausted: but others hardly bearing watching, become from thence languishing, and without Appetite, and are forced to fly to Opiates, which sometimes they use daily, and in a large Dose unhurt.

* 1.221We have before hinted, that the Cause of Natural Waking, which is interlaced with Sleep, consists in these two things, either in one of them, or both together; to wit, first that the Animal Spirits being sufficiently refreshed, and freed from the stocks of the nervous Liquor, do come forth lively, and are on every side streamed forth, and chiefly from the middle part of the Brain into its circumference; then secondly, although they obtain every where an open sp••ce, and especially in the ex∣terior compass of the Brain, then freed from the incursions of the nervous Juice, yet lest this expansion of Spirits (which is waking) should be protracted to their loss, lon∣ger than is fit, the Spirits by it being wearied, become faint, and as it were lye down of their own accord, and at the same time, the nervous Liquor being poured into the Cortex of the Brain, stops or shuts up their passages. Hence it follows, that pre∣ternatural

Waking,* 1.222 or that which is immoderate depends upon these two, either on one or both together; for either they being grown too outragious, and as it were struck with a fury, will not lye down of themselves, or the nervous Liquor doth not so fill and stop up the Pores of the outward part of the Brain, that from thence the Spirits may be compelled inward to rest: Examples of both of these are ordinarily to be met withal.

And first of all we shall take notice,* 1.223 that the Animal Spirits, sometimes becoming outrageous and so Elastick or shooting forth, or otherways enormous, that they will not only not lye down and be quieted, but scarce be contained within the proper sphere of their emanation; wherefore, being spread abroad in continual waking, so fill the Brain, and keep it extended, that the nervous Juice though it lyes heaped up at their doors, cannot be admitted; but if it enters of it self, and the Spirits are called back inwards, from the Cortex of the Brain, presently they being forced thither, or tumultuating within the middle part of the Brain, raise up many, and often most horrid phantasies, whereby sleep is driven away; or directing thence their declination further, into the nervous Stock, there stir up great disorders, which continually drive away, and break off Sleep, though it seems ready to creep upon them.

As to the former of these,* 1.224 I have often observed, that some being disturbed with waking, were afraid to sleep, though desiredly coming upon them; for as soon as they shut their eyes to sleep, presently leaping up, they would cry out they should grow mad, with a multitude of confused phantasms, so that they were necessitated to ab∣stain from sleep.

Secondly, whilst the Spirits become more outrageous, and are for sleep sake re∣called towards the interior compass of the Brain, sometimes they convert their rage into the nervous Stock, and then tumultuarily rushing in upon the Nerves, desti∣nated for the Precordia, or the Inwards, raise up inordinations in the respective parts: hence in those thus distemper'd, as often as they shut their eyes to invite sleep, either tremblings, leapings, and binding up of the heart, with loss of Spirits, and breathing stopped, or inflations, and rising up of the Bowels, with a sense of choaking, and other symptoms commonly called or taken to be Hysterical,* 1.225 follow: or else second∣ly, the Spirits being recalled from their watches, and turning on the nervous Stock, transfer their rage sometimes on the spinal Marrow, and the Nerves reaching from thence into all the exterior Members: Wherefore, in some, whilst they would in∣dulge sleep, in their beds, immediately follow leapings up of the Tendons, in their Arms and Legs, with Cramps, and such unquietness and flying about of their members, that the sick can no more sleep, than those on the Rack. Once I was consulted with for a noble Woman, who was in the day-time cruelly tormented with the pain about the heart, and Vomiting, but in the night she was hindred from sleep, though it seemed to approach, by reason of these kind of Convulsive Distempers invading her, with it; nor indeed could she sleep all the night, unless she had before taken a large Dose of Lau∣danum; wherefore, this Medicine at first being permitted her, only twice a week, af∣terwards she took it daily for three whole months, contracting by it no hurt, either in her Brain, or about any other function; and when in the mean time, by the use of other Remedies, the Dyscrasies of the Blood and the nervous Juice were amended, and the Animal Spirits were made more benign and gentle, she having after that wholly left off her Opium,* 1.226 could sleep indifferently well. These kind of sleep-destroying Distempers, stirred up either within the middle part of the Brain, or within the ner∣vous Stock, either more inward or more outward, do depend wholly on the evil con∣stitution of the Animal Spirits: for those who ought to be gentle, clear, and bright, and to actuate gently the containing bodies, and to influence them with a benign in∣fluence, become sharp and fierce, and like Effluvia's sent from Stygian Waters, unable to be restrained, do distend them too much, and refuse to be governed by the command of the will, and to be quieted by sleep; yea being restrained in one place, they immedi∣ately grow tumultuous in another. Such a constitution of the Animal Spirits pro∣ceeds from the acid, and oftentimes as it were Vitriolick Dyscrasies of the Blood be∣getting it, and of the nervous Juice cherishing and increasing it: as shall be more ful∣ly shewed hereafter, when we speak of madness.

In the mean time,* 1.227 as to what belongs to the Cure of thorow or long waking, (which we but now described) because it cannot be long tolerated, therefore those things, which may bring present ease, ought first to be administred; for this end, those things which sooth the Spirits, and gently moderate their disorders, are con∣venient, as those commonly called Anodynes, viz. Distilled Waters, Decoctions, Sy∣rups, and Conserves of the Flowers of Water-Lilies, Cowslips, Mallows, Violets,

Hearts-ease, of the leaves of Willow, Lettice, Purslain, also Emulsions, or Juicy ex∣pressions. If that the unquiet Spirits will not be allayed by gentle flatteries, you must compel them into quietness, as it were with bonds and strokes: plenty of them ought to be diminished, and the places also to be inlarged, in which they may expand them∣selves in freedom, and without tumult, and quitted from the intanglements of other Humors, to wit, of the Blood and Serum: For which ends, sometimes the opening of a Vein is convenient, and Blisterings are always to be made use of; also Diacodium, and Laudanum, if it be convenient, are frequently given; and in the mean time, whilst that Opiates give some truce to the Disease, the cause of it ought carefully to be root∣ed out by the use of other Remedies, as much as may be; wherefore, such as take away the sharpness of the Blood and nervous Juice, and render a sweetness to them, are to be administred, day after day, in Physical hours: In which rank are shelly Pow∣ders, Apozems, and Distilled Waters; Alterers, made out of temperate Antiscorbu∣ticks; the more gentle prepared Chalybeats, Spirits of Harts-horn, and of Sut, and almost before all other things, the Tincture of Antimony is much esteemed.

* 1.228There remains another sort of thorow or long Waking, the cause of which in some, if not in the greatest part, consists in almost a continual openness, or too much gaping of the Pores, or passages in the Cortex of the Brain: For besides, that the Animal Spirits becoming sharp, and somewhat outragious, refuse to lye down of their own accord, and to indulge rest; moreover, no stop or yoke is imposed upon them from the nervous Liquor, entring into the Pores of the Brain, but being free and quitted of all burthens, they are also expanded within the exterior spaces of the Brain, every where open: wherefore, for this cause, those troubled with long Waking, feel no sleepiness or heaviness in the fore part of their head, no desire or approach of Sleep. I have known some distemper'd after this manner, who, when they had lived for ma∣ny nights continually without Sleep, seemed still chearful, active, strong in their stomach,* 1.229 and ready for business, and not to want Sleep. The cause of this without doubt is, because the burnt and melancholy Blood, supplies the exterior part of the Brain with a nervous Juice, that is not soft and favourable, but too much parched, and stuffed with adust particles, which, for that reason, is apt neither to stay long within the Pores of the Brain, nor gently to embrace and hold the Animal Spirits. Further, the Spirits themselves, procreated out of it, become of their own nature too Elastick, and unquiet, so that they are not easily setled, or are prone of their own accord to Sleep: But these more fixed, do not readily fly away, nor being wearied, do sud∣denly grow faint, but indure for a long time, without any great refection, and yet remain lively.* 1.230 Concerning this waking disposition of the Animal Spirits, as it is the same in Melancholicks, we shall have an opportunity of speaking of it more large∣ly hereafter. We may also here take notice, that for the same reason (to wit, that the adust Particles of the Melancholick and torrid Blood, being poured into the Brain,* 1.231 together with the nervous Juice, causes waking) the drinking of Coffee also, (in use formerly among the Arabians and Turks) which is drunk by our Country Men, either Physically or out of wantonness, all sleepiness being driven away, doth pro∣duce unwonted waking, and an unwearied exercise of the Animal faculty; that some having a necessity to study late in the night, or presently after drinking, or a full meal, by drinking a due quantity of this Liquor become still waking, and perform any hard task of the mind, without sleepiness. Surely the cause of this is, because this drink insinuates adust particles (of which it is full, as may be perceived both by the smell and taste) immediately into the Blood, and then into the nervous Juice; which still detain the pores of the Brain open, by their agility and inquietude, and add to the Spirits, all sleepiness being shaken off, certain provocatives, and madness, by which they are excited to a longer performance of their offices. Further, we shall deliver afterwards, where we speak of Melancholy, those things which belong to the preven∣tive Cure of this long waking, or the removing of the Morbific cause: In the mean time, for the taking away immediately this symptom, as often as it is grievously trouble∣some, we noted that Opiates were little profitable; for a bare Dose being given, doth rarely cause sleep, and render the sick more weak and languishing: It often better suc∣ceeds, if they go to bed, and take some soft and pleasing Liquor, as our own Ale, clear and mild, or Posset-drink with Cowslip Flowers boiled in it, or an Emulsion of Me∣lon Seeds, and Almonds in a great quantity, to wit, two or three pints.

* 1.232I was some times past consulted with about an old Hypochondriacal person, who be∣sides other Symptoms usual in that case, was for many years obnoxious to frequent, very troublesome, and noisie belchings: he was wont every day, two or three times, for about two hours, continually to belch, with such a noise, that he might be heard far and near, at a great distance: But sometimes for a week or two, and sometimes

for a month, this belching would be changed into a long waking, for having that Di∣stemper much remitted, this Gentleman was kept without sleep almost whole nights; and when he had thus been for three days, and sometimes more, perfectly wa∣king, he seemed not to want sleep, and complained not of sleepiness, dulness, or languor of spirits. And when Narcoticks rarely brought to him any help, he took sometimes in the evening a Posset made of Ale and Canary Wine; and night com∣ing on, he sometimes drunk Distilled Waters, by the use of which, oftentimes he got some sleep; then afterwards, his waking perfectly vanishing by degrees; his belching returned: Hence it appears, there was but one cause for either, to wit, the adust particles, and irritative, being poured forth from the bloody Mass, some∣times into the coats of the Ventricle, and sometimes into the Cortical part of the Brain.

Secondly, besides these distinct Distempers of Sleep and Waking, or their inordi∣nations, there remain other conjunct, or complicated irregularities of them, in which, the acts of either function are prevaricated together. Which indeed is ob∣servable in that Distemper or affection called the Waking Coma; of which we shall now speak briefly.

Those sick with the Waking Coma,* 1.233 although they are continually prone to Sleep, yet they can scarce sleep at all, but after the manner of Tantalus, up to the chin in the Lethaean River, to tast which as soon as he stoops down, the water slides away from him and sinks lower. For they feel a cruel heaviness in their Heads, with a sleepiness or numness of all their senses, and faculties, that they hardly endure to turn themselves in their Bed, or to be disturbed by the by-standers with talking, and expect they shall presently fall into a sweet sleep; but when they would indulge it, and endeavour strongly to embrace it, various phantasms rolling about in their mind, keep them still waking; neither are they suffered to take any sleep at all, which seems to them to be still at hand. Upon this, not seldom follows a Delirium, that whilst the sick lye with their eyes shut, they perpetually talk absurd and senseless things, and fling a∣bout hither and thither their Arms and Legs excessively, and being raised up, they look about them doggedly. It is an usual thing for those sick of Feavours, to remain a whole night as it were drowned in sleep; and in the mean time are scarce silent a minute of an hour, but murmur various things to themselves; also sometimes cry out,* 1.234 houl, and leap out of Bed. If the reason of these be inquired after, we may say, that the Pores and passages in the Brain, which are the walking places of the Spirits, are very much possessed with a thick and so periferous matter, poured forth from the Mass of the Blood, that the Spirits being very much hindred from their wonted expan∣sion, and mutual commerce, an heavy and invincible sleep seems to hang over them; but because some sharp and highly active particles, like so many goads, cleave to these Spirits, they are perpetually incited into motion; and so some of them break thorow the ways, howsoever fast shut and stopped with mounds, and run forth either directly or obliquely as they can; and thus such motions of theirs, however confused and di∣verted, by reason of impediments, and not able to exercise compleatly the Animal function, yet they easily drive away or hinder its cessation and rest; for this reason indeed, such who are distemper'd with this Disease, are like those living under the Pole, who only see (when the Sun is in the Equinox) the light on the Horizon, and have neither perfect night, nor perfect day; so these only enjoy a kind of twilight betwixt sleep and waking.

The Waking Coma is rarely a Disease of it self,* 1.235 but for the most part it is a symptom coming upon other Diseases, as the Feavour, Phrensie, Lethargy, and the like; wherefore it requires not a Curatory Method peculiarly, but there is only need, that to the Remedies prescribed for the first or primary Disease, there should be added other Cephalicks, which may dispel these clouds and meteors of the Brain; or if both will not be expelled together, the same Medicine which cherishes the parts of the one, getting the better, will immediately overcome the other: so in the Wa∣king Somnolency, it is convenient to procure either perfect sleep, or perfect waking, and in this case I have often given Narcoticks with good success.

CHAP. VI.

Of the Incubus, or Night-Mare.

THUS much concerning the morbid exorbitancies of irregular sleep and wa∣king; which are almost proper, and as it were of the region of the Brain, and affect not the Cerebel but rarely,* 1.236 and that secondarily and collaterally, as hath been shown. But there remains a distemper, commonly called the Night-Mare, in Latine the Incubus, which is both peculiar to this Region, and also seems in some measure analogical to the sleepy diseases; forasmuch as its fits arise, for the most part from sleep, by reason of the Animal Spirits being bound in the Cerebel or suppressed; their eclipse or interruption (though short) about the exercise of the vi∣tal function, is induced.

* 1.237That the subject, nature, and causes of this Disease may be the better known, we shall first consider its Phaenomena, or the appearance of it. The fits of the Incubus, or Night-Mare, for the most part, and indeed only falling on one in sleep, are used to be excited mostly after the stomach is loaded with undigested meats, and lying on the back in Bed. They who labour with it, seem to feel the hurt chiefly in the Breast, and about the Praecordia, for respiration being suppressed, and very much hindred, they think that a certain weight lying heavily upon their Breast, doth oppress them, which weight mocks their imaginations with the Image of some spectre or other; and this, whilst they think to shake off, or put away, by the moving of their Body or members, they are not able to stir themselves any way: But after a long space, and sometimes till they are almost dead, they at last awake with a strugling about their heart, and being more fully rouzed from sleep, the imaginary weight suddenly vanishes, and the motive force of the body is restored, but for the most part a trem∣bling of the heart remains, and frequently a swift and violent beating of the Dia∣phragma. Then the fit being over, the deception of the phantasie, conceiving the horrid image of the Incubus or spectre, is perceived.

* 1.238The common people superstitiously believe, that this passion is indeed caused by the Devil, and that the evil spirits lying on them, procures that weight and oppres∣sion upon their heart. Though indeed we do grant, such a thing may be, but we suppose that this symptom proceeds oftenest from mere natural causes; though what they are, and in what place the Morbific matter doth subsist, is not agreed on among Authors, nor indeed is it easily to be assigned.

* 1.239Because the imagination is deceived, and the error being propagated further into the senses themselves, so imposes on the sight and feeling, that they believe they plainly see and feel a monster of this or that shape or figure lying upon them; and for that the loco-motive faculty of the whole body is hindred, in the mean time; some have placed the seat of this Disease wholly in the Brain, and would have the oppression of the breast to be merely phantastical: But although we grant the monstrous shape of the Incubus (which is conceived) to be a mere dream; the Precordia to be truly affected, is apparent, and the motion of the Pulse and breathing is suppressed or hindred; for that the heavy weight of the breast is plainly felt by most, in their waking; yea, and when thorowly fresh awaked,* 1.240 and when that is removed, the tremblings of the Heart and Diaphragma, and inordinate motions follow: whence it follows that these parts labour and suffer a real hurt.

* 1.241Wherefore others, that they might the more easily unloose this knot, dividing the Morbific Cause, assign a portion of it to the Brain, and another to the Breast; for they say, that the motion of the Lungs are hindred, by a viscous and very gross hu∣mor impacted about them, and that doth excite as it were the oppression of a bulk ly∣ing on them, with want of breathing; then Vapors being raised to the Head, do fill the principal Nerves, and so hinder the loco-motive force: which opinion (no more likely than the conceptions of those troubled with the Night-Mare) deserves not to be assented to; because there are not any signs of this humor heaped up about the Prae∣cordia, which appear before or after the fit, yea when this region is very much bur∣thened, as in the Phthisis, Asthma, or Dropsie of the Breast, the Incubus does not therefore infest more frequently or more grievously: Further it appears not, how the matter heaped up in the Praecordia, should be only troublesome in sleep, or by what passage or way, the Vapours from thence so suddenly inducing want of motion, should

be elevated to the Head▪ Wherefore, the Reason or Aetiology of this Distemper, I think to be taken or judged of far otherwise.

Therefore this heavy weight or load lying on the breast,* 1.242 seems indeed to be left, because the motion of the Heart, and the organs serving for breathing, is hindred; for from the motion of the heart ceasing, or being hardly performed, the Blood in its bosoms, and in the breathing or Pneumonick Vessels statgnating, and being there very much streightned, a sense of as it were a weight opresses the region of the breast: which also seems therefore the more grievous, because the Lungs, Diaphragma, and Muscles of the Thorax, being hindred in their motions, and as it were bound together, at the same time with the heart, do labour with a great endeavour, to exercise or to put forth themselves. But the most hard question yet is, concerning the Cause, by rea∣son of which the motion or action of the Praecordia is suppressed, or hindred. This seems impossible to be done by matter impacted in the organs themselves,* 1.243 of which indeed, there must be a very great deal, to suffice for the hindrance of so many parts, and some signs of it at least would appear somewhat out of the fit; wherefore, it seems that we may rather say, that the action of those parts are hindred, because the influx of the animal spirits are hindred or suppressed. This is frequently done in Con∣vulsive Distempers, as we have elsewhere declared, and have clearly shewed by Ana∣tomical Experiment,* 1.244 to wit, by tying the trunk of the Nerves of the eighth pair, in a living Dog: But in those distemper'd by the Incubus or Night-Mare, the obstruction of the Spirits, seems to be excited neither in the organs themselves, nor in their Nerves; for such a cause happening to those awake as well as to those sleeping, doth not be∣come presently moveable, but is fixed and permanent.

Wherefore,* 1.245 we think the fit of the Night-Mare to be induced, for that in sleeping, a certain incongruous matter is instilled into the Cerebel, together with the nervous Juice, which causing a certain torpor or benummedness in the first spring of the spirits, compells them immediately, by little and little, to cease from the offices of their functions; so that as it were another Lethargy being excited within the Cerebel, the vital actions suffer a short eclipse; during which, partly from a strife of the obstructed or bound together Praecordia,* 1.246 and partly from the blood very much heaped up and stagnating in them, that weight, or a sense as it were of a great bulk lying on them, is caused; then, because all the rest of the faculties depend upon the motion of the heart,* 1.247 therefore this being suppressed and hindred, presently those eclipses or disor∣ders of them follow; but especially because the flowing of the Blood into the Brain, for the making of Animal Spirits, is interrupted, therefore immediately the flow∣ing forth of these into the nervous System is suppressed, so that the sick, whilst they endeavour to shake off the imaginary load of the breast, are not able to move their Body, or any member; to wit, because the irradiation of the Spirits, (whilst they are destitute of the flowing in of the Blood) is kept from the moving parts: In the mean time, those which reside in the Brain, being spread abroad here and there, con∣ceive confused phantasms, and from the trouble impressed from the Praecordia, horrid dreams of spectres.

The fit of the Incubus is soon ended,* 1.248 because the matter, rarely or never entring deep∣ly into the Cerebel, is easily shaken off, or is supt back again into the Blood: for after the spirits became free from its embrace, and having got the liberty of motion within their wonted spaces, they repeat the exercises of their functions: wherefore, the afflux of the Blood then presently returning to the Brain, immediately the afflux or flowing forth, and emanation of the Spirits, are restored, like a light new kindled, both in its middle or marrowy part, and also in the nervous Stock: whence they be∣ing awakened, the motive force returns, and the error of the imagination is per∣ceived. But that there follow in the Heart and Diaphragma tremblings and most swift beatings,* 1.249 the reason is, because these Bodies, so long as they were hindred from their motions labouring with an endeavour of exercising, or putting forth themselves, are not able to contain themselves within their just limits, as soon as they are restored, but putting forth at once all their strength, and being too active, exceed due per∣formance of their duty: even as a wand, being held a while bent, being afterwards let go, recovering it self with a certain force, enters into a motion of trembling or shaking.

After this manner, the fit of the Night-Mare, because it immediately stops the vital function,* 1.250 as it were the first moving wheel in the animal Machine, compels forth∣wi••h all the other faculties to cease, yea the whole corporeal soul (more than the more grievous fits of the Apoplexy or the Lethargy) to shake, and as it were to suffer an eclipse. Notwithstanding, little danger is threatned from this Distemper, because the Morbific matter being poured forth from the Blood, into the compass of the

Cerebel, is not suffer'd to penetrate deeply; because the Spirits of that province, being always in a readiness and watchful, most swiftly run to meet the enemy, and oppose his entrance strongly, though the offices of the vital function be omitted in the mean time; further, the Animal Spirits which are in the region of the Brain, being awakened, fly presently to assist those of the labouring Cerebel: For those sick of the Incubus, if by chance they be awakened by any one lying with them, they sooner come out of the fit.

* 1.251But although it is rare, that any one dyes of this Disease only; yet those often ob∣noxious to it, if they are taken with other Cephalick Distempers, as the Lethargy, Carus, Apoplexy, or the Epilepsie, are in far greater danger: because the Morbific matter, being poured forth from the Blood into the Brain, easily invades the Cerebel so predisposed; so that the sick therefore suffering at once an eclipse of the vital and the animal function, are brought into greater danger of their Life. Hence 'tis a vulgar observation, that those who frequently are troubled with the Night-Mare, fall into the Apoplexy.

* 1.252There is wont to be another event of the Incubus, less dangerous, that leads often into the Cardiack passion, and other affections, commonly taken to be Hypochondriack. I knew several while young, grievously afflicted with the Night-Mare, who being freed from it in their riper Age, were troubled with the trembling and palpitation of the Heart, and other pains about the Praecordia, and Hypochondria; and also with Convulsions in those parts. We think the cause of this morbid commutation to be, because the Morbific matter, after it was wont so often to besiege the region of the Cerebel, at length an impression being made, it did penetrate more deeply into some private place, and passing thorow its frame, became impacted on the Nerves destinated to the Praecordia.

* 1.253As to the Cure of this Disease, there needs no help for the fits, because they pass away quickly of themselves. The method of Cure after a considering the whole, suggests Blood-letting, (where it is convenient) and a gentle Purge, and chiefly the use of Remedies, which are commonly called Cephalicks. Therefore, here Powders of Amber, Coral, and Pearls, with the Roots of the Male Poeony, Cretick, Dittany, Contrayerva; also Electuaries, Tablets, and Distilled Waters, Tinctures, Elixirs, and other things that are wont to be prescribed in the Lethargy and Apoplexy, have the chief place; but especially a right course of dyet being ordered, let gross and ill di∣gested meats be shunned, Pulse and Summer-fruits; nor let sleep, study, or reading be presently yielded to after eating: late and large Suppers, and lying on the back, are to be forbidden.

* 1.254Because Children and Youths, are often sick of this Disease (the sign of which is, that they are shaken in their sleeping, and waking cruelly cry out) and more often suffer its fits, which oftentimes bring them to Convulsive passions, therefore a method of healing them ought to be administered, as soon as they are seen to be distemper'd: you ought to inquire into the milk they suck, whether it be of it self pure and lan∣dable, and truly convenient for the Stomach: let them not sleep presently after they have sucked their fill: The Nurse using a good dyet, let her take also Morning and Evening a Dose of Cephalick Powder, or Electuary, drinking after it a draught of Pos∣set drink, with the leaves of Sage or Betony, or the Roots or Seeds of Poeony boiled in it: Let the Infant take twice a day, a spoonful of proper Distilled Water. Let him have an Issue made in the nape of the Neck, and let it lye sometimes on one side, and sometimes on the other, and rarely or never on its back. If a Neck-lace of Coral, or little balls of the Seeds or Roots of the male Poeony be worn about the Neck, or at the pit of the Stomach, it is not altogether useless; if that in sleep be∣ing often and grievously shaken, they are seen to be more dangerously troubled with this Distemper, let Blisters be raised in the hinder part of the Neck, or behind the Ears; also Evening and Morning let there be daily given a Dose of the Powder of Ammoniacum, or other proper Dose, in a spoonful of Distilled Water or Iulep.

CHAP. VII. Of the Vertigo, or a turning round in the Head.

HAving viewed the exterior compass of either part of the Head,* 1.255 and detected, the Diseases which beset the sensitive soul, about the first beginnings, and last springs of the Animal Spirits; we shall next descend to the middle part of the Brain, where the phantasie and common sense reside, and behold what kind of passions these parts are obnoxious to. Concerning this in the first place we shall note, that sometimes troops or rather mighty armies of Spirits, inhabiting these places, are affected, and sometimes also small handfuls or bands: then again many of them are affected together, or else only a few at a time; or they become Elastick from an heterogeneous Copula, and so are compelled into inordinate motions, or as it were explosive or shooting off, as in the Epileptick fit; or suffering an eclipse, as in the Apoplexy, are deprived of all motion. Concerning the former disposition of the Spirits, we have formerly treated largely enough, and the astonishing Disease we shall han∣dle afterwards. But in this place, we shall speak of a certain Passion or distemper belonging to these parts, viz. the Vertigo, in which a certain band or handful of the Spirits are affected, and their motions are seen to be partly perverted, and partly suppressed.

Being but little solicitous about the names by which the Vertigo is wont to be known,* 1.256 we shall describe the nature, or formal reason of it after this manner, viz.

The Vertigo is an Affection or Distemper, in which the visible objects seem to turn round, and the sick feel a perturbation, or confusion of the Animal Spirits in the Brain that they do not rightly flow into the Nerves: Wherefore the visive, and the loco-motive faculties, do often in some measure fail, that those labouring with it fall, and oftentimes are covered with darkness.

In this fit it is observed, that the imagination and the common sense are in a manner deceived, whilst they believe, the quiet objects to be moved, but the rational judgment remains; for we understand our error, and we presently ascribe this fallacy to the inordination of the Animal Spirits; for that we plainly know that the spirits flowing within the Brain do decline from their wonted irradiation or beaming forth, and do not rightly perform the offices of motion and sensation, during the fit.

That we may find out the Morbific Cause,* 1.257 and the preternatural manner of the Vertigo, we shall inquire after what manner this same affection or Distemper, how ex∣tempory or sudden soever it be, is wont to be excited from non-natural things; for men ordinarily become Vertiginous (or have a turning in their head) with a long turning round of the body, looking down from an high place, passing over Bridges, Sail∣ing, and by Drunkenness, and many other ways. It will be worth our while to con∣sider a little further, the means of affecting, by which these exterior actions stir up this turning or rolling about, from whence it will the better appear, what kind of in∣trinsick causes ••ay be able to excite this passion. In the first place therefore, when men are fo•• ••ome time turned about, both in that motion all things seem to be turned a∣bout, and also they ceasing from turning about, that still continues in the phantasie; so that the affected oftentimes fall to the ground; further, though they shut their eyes, they still perceive as it were a turning round, like the turning about of a Mill, in the Brain.

The reason of these is not,* 1.258 that the deception of the sight is first brought to the eyes, and afterwards continued for some time; because this affection is caused by the turning round of the body, whether they look with, or shut their eyes: But indeed the cause of this apparition wholly depends upon the fluid substance of the animal spirits. For that the spirits flowing within the Brain, are even like to water, or a thick heap of Vapors, inclu∣ded in a Phial, which being shaken round about, together with the Vessel, and made so to turn about, continues for a time that motion, though the Vessel stands still; in like manner also, when the body of a man is turned round about, the spirits inhabiting the Brain, from that turning about of the Head, like the containing Vessel, are agitated in∣to spiral or round motions; and when therefore they cannot irradiate the Nerves with their wonted influx and direct beams, from hence oftentimes a Scotomy or dizzness, and a failing of the feet, together with a rotation or whirling about of visible objects, are induced. The visible Hemisphere seems to turn round, because as the sensible impres∣sion

is received by the means of the recipient, so the objects, as the spirits, seem to be moved round about.

* 1.259Secondly, looking from on high, and passing over Bridges, stir up a Vertigo or giddiness in the Head, for that there is a terror cast on the imagination from unac∣customed objects, as also from the site of the body, or going in danger, whence that be∣ing very solicitous, how it should rightly order and more firmly direct the spirits into the bodies of the Nerves, calls them back into the middle part of the Brain, and so perverts them from their wonted afflux and irradiation; and whilst it indeavours to set their battel in better array, and to direct them more surely, by too great a care, drives them into a certain confusion and irregular motion. Wherefore 'tis observed, that drunken men, and very bold, because they are not careful or solicitous concern∣ing the guiding of the animal spirits, suffer no such thing. Sailing, or riding in a Coach, causes a turning in the Head by the like reason, as the turning round of the Body; because, the very fluid spirits being too much agitated, like water shaken in a Glass, leap hither and thither disorderly. Further, it is wholly for the same rea∣son, why many going by Ship, or by Coach, are subject also to cruel Vomiting; to wit, because the spirits being snatched into disorder, by too great a motion, and confused fluctuation, run inordinately into the heads of the Nerves of the wan∣dring pair, and for that reason stir up Convulsions and Convulsive motions in the Bowels.

* 1.260Thirdly, 'Tis observed, that the Vertigo comes upon Drunkenness, as a known symptom; and that to those unaccustomed, the drinking, though moderately, of Wine or strong Ale, also the taking of Tabaco, easily induces the same affection; the rea∣son of which is, because from the Liquor, or vapour so taken, certain fierce particles, and untameable, are carried into the Brain, by the passages of the Blood and nervous Juice; which being improportionate, and incongruous to the Animal Spirits, drive them hither and thither from their wonted tracks of flowing and reflowing or eb∣bing, and so move them into whirlings, and turnings about.

These are the chief occasions, or solitary evident causes, which do use to bring the Vertigo, or turning round in the Head to some men, how sound of constitution soever they be: which kind of effect, these occasions produce, forasmuch as the Ani∣mal Spirits, being disturbed beyond their set courses, and orders, are moved inor∣dinately, fluctuating here and there, both within the passages of the Brain, and also some of them, like a thred broken off, from their wonted irradiation, into the ner∣vous Stock.* 1.261 For these being always reciprocal, depend mutually one of another, to wit, a perturbation of the Spirits within the middle part of the Brain, and their flowing forth into the nervous Stock being hindered; for from what ever cause either effect is induced, the other immediately follows. A turning round of the body, going in a Coach, or in a Boat or Ship, also Drunkenness, and the unaccustomed fume of Tabaco, compel the spirits in the Brain to fluctuate and shake disorderly, which, for that cause, are presently inhibited from their wonted flowing into the Nerves, that those so affected, can hardly go or stand; in like manner, on the contrary, looking from on high, passing over Bridges, a languishment or syncope falling on them, re∣cal the spirits from their wonted emanation, who, for that cause tumultuating with∣in the Brain, or being moved inordinately, cause a Scotomy or dizziness, or a turn∣ing round of the objects.

* 1.262These things being thus premised, concerning the Vertigo, raised up by reason of an outward accident, or from a solitary evident and non-natural cause; we shall next inquire, how and by what means, it is wont to be induced, from an intrinsick and preternatural cause.

Concerning these take notice, that the Vertigo is sometimes a symptom depending upon some other Distemper, placed sometimes within the Brain, and sometimes without it: but sometimes this is a Disease of it self, which being raised up within the middle part of the Brain, becomes very troublesome, and often terrible, and ve∣ry hard to be Cured.

* 1.263As to the former, many Cephalick Diseases (or such as belong to the Head) viz. Acute pain, the Lethargy, Epilepsie, Carus, Apoplexy, with many others, do often ac∣company the Vertigo; to wit, because the equal expansion of the Spirits in the Brain, and therefore their irradiation into the nervous Stock, from such like various Mor∣bific causes, are easily hindred or disturbed; as shall hereafter appear, when we de∣liver the Aetiology or reason of the Vertigo, as it is a Disease of the Brain.

* 1.264But sometimes this symptom is wont to be produced, by reason of other Distempers, placed a long way from the Brain, and that chiefly by two ways or means. For first it is usual for a dizziness to arise, by reason of the flowing of the Blood being sud∣denly

called away from the Brain, as in a Syncope or Swooning, great want coming near it, wicked hard labour great Haemorrhagies or expence of blood, long fasting, in passions of violent sadness and fear; yea by reason of other occasions, when the motion of the blood is deficient or fails in the heart; so that the affected are proclive to faint∣ings and swooning away; presently, because the tribute of the vital liquor is with∣drawn, the animal Spirits growing deficient in the Brain, withdraw their radiation from the nervous Stock; for when their spring is cut off, those that remain, leaping back from their emanation, wander about confusedly in the Brain, and very often stir up the Vertiginous Distemper.

Secondly,2 1.265 an inordinate recourse or flowing back of the Animal Spirits, from some inward, or from some outward member, often causes the Vertigo: forasmuch as the Spirits being disturbed from the affected part, by a long series, thorow the pas∣sages of the Nerves, at length disturb others inhabiting the middle part of the Brain, and drive them into the like disorders; for this cause it is, that sharp humors gnawing or pulling the Fibres of the Ventricle, because the infestous and irritative matter being moved in the Spleen, Pancreas, or Intestines, causes light dizzinesses in the Brain. I have known from an accute pain, an Ulcer, or a mortified Inflammation in the Foot or Arm, frequent tremblings and failings, though short, in the Brain, to have been in∣duced. Whilst that the conceived inordination of the spirits, is transferred from the distemper'd part, thorow the Nerves into the Brain, a certain Formication or tingling, or as it were the ascent of a cold air, is seen and perceived; wherefore the cause of this Distemper is commonly ascribed to Vapours, arising up to the Head: which error we have elsewhere sufficiently confuted. Further, many are wont, when they have fasted, or stayed long beyond their hour of dineing, to have a dimness before their eyes, and their heads to have a turning, and then afterwards those clouds vanish, having eaten a little; this does not so happen (according to the vogue of the people) for that wind or vapours ascend to the Head, from the empty Stomach, which the aliments being taken in,* 1.266 do immediately suppress; but because the Fibres of the Ventricle, and the nervous Filaments or little strings, being destitute of the nervous Juice, with which they desire to be watered, are wont to enter into corrugations or wrinklings, and light Convulsions, which kind of Convulsions and disorders of Spirits, for that they are continued thorow the passages of the Nerves, into the Brain, produce the Vertiginous Distemper; which, as soon as the Fibres of the Stomach remit their wrinklings, ceases of its own accord. For this reason I have known some, by a Vomit being given, tearing the coats of the Ventricle, to have been taken with a cruel Vertigo: yea I do suspect, that this Distemper does sometimes arise from meats of ill digestion, and ungrateful to the stomach.

But the Vertigo is not only a symptom, but sometimes a primary Disease of it self; whose nature, that we may the better search into, we ought to inquire into its subject, the formal reasons, and causes of it; and then these being found out, and truly un∣folded, we will proceed to its prognostick and Cure.

Without doubt the immediate subject of the Vertigo are the Animal Spirits,* 1.267 which every one labouring with this Disease finds to be greatly disturbed, and wandring up and down; but the mediate subject are those parts of the Brain, in which the Ima∣gination and common sense reside, and whence the next way lies into the nervous Stock. These are the Callous and streaked bodies.

For indeed,* 1.268 the Animal Spirits love to expatiate themselves, and to he expanded or stretched forth on every side, within these medullary places, as in a most ample Field, and pleasant Garden; wherefore like beams of light, with a full and streight ray, they pass thorow all the Pores and most thick passages of the marrow: hence it is, that whilst they gently flow in one line, from the outmost border of the Callous body (to wit, from the streaked bodies, and turnings and windings of the Brain) towards its middle part, they represent pleasant imaginations and phantasies; and whilst in another line they flow forth, perhaps thorow other passages from the middle of the Callous body, into the infoldings or windings about of the Brain, they transferr thi∣ther signets or marks of notions for the Memory; and then, whilst they tend into the streaked bodies, and the beginnings of the Nerves, they actuate all the moving parts, and carry to them, as often as there is occasion, the instincts of the motions they are to perform.

But in the Vertigo,* 1.269 these equal emanations of the Spirits, as it were rays of light, seem to be intercepted, and diversly perverted in various places; because some bands or handfuls of the Spirits are obscured, others are bended another way, and moved hither and thither into turnings round and whirling about, and oftentimes snatched trans∣verse, or cross one another. Wherefore, confused phantasms, wandring and incon∣stant

images, or actions of sensible things are represented, in the Brain, by reason of the Spirits so disturbed: Then forasmuch as the irradiation into the nervous stock is lessened or hindred, a dizziness and failing of the motive function follows.

If that we should yet further inquire into what hinders or obstructs the ways, whereby the Spirits are compelled thus to go aside, or tumultuate within the Brain; it seems probable, that these inordinations of theirs do depend upon a two sold cause, viz. first,* 1.270 that certain fierce and extraneous Particles, being entred deeply into the Brain, together with the nervous Juice, stick close to the spirits, and move them in∣to enormous motions; but this, as appears from common experience, happens to eve∣ry one, on the immoderate drinking of Wine or Strong-waters, or the unaccustomed taking of Tobacco, by the eating of some Vegetables, or being anointed with Mercury; for that some Heterogeneous bodies and infestous to the Spirits,1 1.271 follow them, and are snatched with them, even to the middle part of the Brain: why may not such kind of Morbific particles and Vertiginous be supplied from the Blood, and other humors very much vitiated, and insinuated into the inmost conclave of the Brain? Then secondly,2 1.272 we may suspect, that when the serous foulness doth by degrees creep forward with the nervous Juice, and at length penetrated deeply, that it doth contaminate these pure marrows, and greatly stuff up its Pores, so that the Animal Spirits do not shine or beam forth with a clear and full light, but with a weak, broken, and as it were with many shadows mingled or interspersed with it.

* 1.273In an habitual Vertigo, and inveterate, it seems to be plain, that the Conjunct Cause doth contain both these, from the proof, and that not light, taken from things that are hurtful and helpful: For I have observed in many, that this affection or Distem∣per hath been altered, much for the worse or for the better, upon two occasions; for whatsoever things being inwardly taken, that beget turgid particles, and apt to grow too hot and rageing, as Wine, Strong-waters, spiced, pepper'd, and flatulous or windy food, always hurt those troubled with the Vertigo: and for the same occa∣sions, no less hurtful are those things, by which the brain is filled, and more stuffed, as Surfeits, sleeping at Noon, or overlong in the Morning, the Southern wind, a cloudy, thick, and moist air, a low and watry habitation; on the contrary, the same persons are much helped, as they easily perceive, by a slender and light dyet, also by a clear air, and an open soil, where the wind has a thorow passage.

* 1.274Thus much concerning the subject, the formal reason, and the conjunct cause of the Vertigo; now in the next place, let us inquire into its Procatartick, or more remote leading cause; by reason of whose morbid provision or predisposition, these two evils are wont to be induced on the spirits inhabiting the middle part of the Brain: But here we apprehend both the Brain it self, with the watering Liquor, and also the Blood with its infected humors to be in fault.

* 1.275The vice of this is most often, that it turns from its right temper, into a sour, acid, and otherways vicious disposition, and being degenerate, perverts the nourish∣ing Juice; and also gathers in its bosom a Serum, and filthiness of diverse kinds, which it is ready to pour forth into the Head. But there are many evident causes, to wit, an evil dyet, and errors in the non-naturals, also the Scurvy, a long or ma∣lignant Feavour, and other Diseases going before, by reason of which the Blood be∣comes so full of ill humors, and so hurtful to the Head.

* 1.276In the mean time, the crime of the Brain is, for that its temper is humid and weak, its frame loose and infirm, with its Pores too much open and gapeing, more than they ought, so that all the heterogeneous, strange, and elastick Particles, toge∣ther with the serous, or otherways diseased recrements, being poured forth from the Blood into the Head, are easily admitted into the Brain, together with the nervous Juice; and because of its more open Pores, fall down without any let or stop into the middle part, viz. the Callous and streaked Bodies. This kind of too dissolute or loose habit of the brain, is in some innate and originally; further, those who are of a tender constitution, to wit, delicate, soft, and luxurious Men and Women, whose spirits are not able to suffer any thing strongly, easily contract a Vertiginons Distem∣per, or rather increase it; to wit, because when the spirits of the Brain cannot resist the incursions of strangers, they give way to every matter that is drove to them: but in others, though strong, inordinate feeding, a sedentary life, frequent surfeiting, also intemperate sleep, and study, an inveterate Scurvey, evil gross humors, a long ••eavour, and other diseases of the Head, do very often cause this kind of evil disposition of the Brain.

* 1.277From what hath been said, the differences of this Disease are easily gathered; for that I may pass by what we but now mentioned, that it was either a primary Di∣stemper

of it self, or secondary arising or depending upon others: further we noted, that the primary Vertigo, so it were light and not deeply rooted, was only trouble∣some with fits excited from an evident cause; so that oftentimes the distemper'd are well enough, but by reason of their evil manner of living, or other accidents they become Vertiginous; but sometimes this Distemper becoming habitual, they are found to be obnoxious to it almost at all times. Secondly, As to the feat of this Disease there is a notable difference; for this is sometimes more outward as is seen happening in the Callous body, and hath almost only the tumults and failings of the Spirits, and the wandring, inconstant, and often confused acts of notions and sense, in the forepart of the Head; but sometimes the Morbific matter falling down more backward, about the streaked bodies, stirs up the Scotomy, or turning of the Head, and a loss or failing of the motive function, that oftentimes the Eyes are darkened, and they reel or stumble, and their Legs fail them.

As to the prognostick of this Disease,* 1.278 the symptomatick or accidental Vertigo, yea almost all the others, while fresh, are free from much danger, and are easily to be Cured.

But the habitual, and almost continual, although great danger and suddenly to fall is rarely threatned; yet because it admits of only a difficult and long Cure, it so tires out both the Patient and the Physician, that before the Disease can be Cured, they both become weary of one another.

The primary Vertigo being placed before, or more outward, which hath scarce a dark∣ness or falling accompanying it, is more safe, and healable, but is often changed in∣to an inveterate Headach, and sometimes also it is cured of it self, by an Haemorrhage, or bleeding at the nose, or by a flowing down of the Haemorrhoids; it is also often∣times taken away by Medicine.

The Vertiginous Distemper, arising behind, and intercepting the beamings forth of the Spirits into the Nerves, is far more dangerous, and oftentimes passes into an Apoplexy, or a Palsie, or into Convulsive Diseases.

There does not properly belong to the symptomatick Vertigo any Curatory Method.* 1.279 There it is only needful to joyn some Cephalick Remedies, discussing the clouds of the Brain, and quieting the disorders of the Spirits, to those other primary indica∣tions; or rather that we may speak to the capacity of the vulgar (which ought to be done sometimes, though feignedly) let some Medicines contrary to Vapors be added.

The accidental Vertigo, or any other fresh or newly taken, may be healed with Phlebotomy, and a gentle Purge, and sometimes iterated: but that the Disease may be more certainly extirpated, let there be besides administer'd carefully Cephalick Re∣medies, such as are anon described.

For the Cure of an habitual Vertigo,* 1.280 and become inveterate, there ought to be in∣stituted almost the like method, as is against most other Cephalick Diseases, which suggests these three chief intentions of healing, viz. in the first place must be endeavour∣ed that the root or nest of the Disease may be cut off, and that the brain may remain free from any new flowings in of the Morbific matter; for which end a right order of dyet be∣ing commanded, sometimes letting of blood, and most often a gentle Purge in the inter∣vals are convenient.1 1.281 Let a dry and open air be chosen, let immoderate and untime∣ly sleep and study be shunned, let morning and evening draughts be wholly abstained from; in the place of the former, let a draught of Tea or Coffee, with Sage leaves boiled in it, be given. Let an Issue be made in the Leg or Arm, and sometimes let the Hemorrhoidal Vessels be kept open with Leeches; let the distemper'd rise early in the morning, and wash every day the fore-part of his Head with water, and also his Temples, and rub them with a course cloth.

Secondly,2 1.282 The second curatory intention is, to take away the Procatartick or more remote foregoing causes; wherefore, endeavour that both the Dyscrasie or evil dispo∣sition of the Blood may be removed, and also that the weak and too loose constitution of the Brain may be mended: For the former, altering remedies chiefly are conveni∣ent, as temperate Antiscorbuticks, and sometimes Spaw Waters, or Whey. To which always may be added for the latter indication, Cephalick Medicines, to wit, such as are prepared of Coral, Amber, humane Skull, the root of the male Poeony, Misleto, the dung of a Peacock, and the like, the forms of which we shall shew you by and by.

The third Intention,3 1.283 which is properly curatory, endeavours to take away the Conjunct Cause of this Disease; which however the Procatartick Causes being re∣moved, for the most part ceases of it self: for if the coming of every extraneous Matter into the Brain be cut off, there will remain nothing but pure and clear Spirits, and they having gotten open and free spaces, within the Callous Body, will from

thence flow forth on every side: However, for the scope of healing this, you must prosecute it with the former; with Medicines indued with a volatile salt, whose par∣ticles being very subtil and active, do refresh the Animal Spirits, of which sort are chiefly Spirits of Harts-Horn, Sut, of Sal Armoniack &c. impregnated with Amber, and humane Skull, Tinctures of Coral, Amber, Antimony, Elixir of Poeony, &c.

* 1.284These things being premised, concerning the Vertigo in general, it will seem to the purpose, to draw or shadow forth the Curatory Method particularly, and as it were to direct you by a thred: and in the first place is shewn what is to be done for the Cure in the fit, and what out of it, for prevention.

1. As to the first, although the invasion of the Vertigo seem cruel, it is for the most part without danger, and easily passes over of its own accord; In such a case, if the Pulse shews it, let Phlebotomy be made use of, after having given a Glyster; but because the sick think themselves dying, and expect medicinal help, in that case let there be Blisters made in the Neck, and stinking things held to the Nose, as Ca∣stor, the Spirits or Salt of Harts-horn, or Urine, or of Sal Armoniack. Further, let these Spirits be given twice or thrice a day with a convenient Dose of Cephalick Iu∣lep: going to sleep, let them take a Bolus of Mithridate, with the Powder of Castor: let them take the next day, if the Distemper doth not yet vanish, a light Purge, or if the sick be prone or easie to Vomit, an Emetick, than which a better Remedy can scarce be taken.

Take Pills of Amber twenty five grains, of the Resine of Ialap six grains, of Tartar Vi∣triolated seven grains, of the Balsom of Peru what will suffice to make four Pills, to be taken going to bed, or early in the morning.

Or Take of the Sulphur of Antimony five grains, of the Cream of Tartar half a scru∣ple, of Castor seven grains; make a Powder: Let it be taken with care, expecting to Vomit.

* 1.285That Vomiting Medicines do oftenest help in the Vertigo, besides the testimony of Authors, appears plain enough also from common observation; and besides, since those troubled with the Vertigo do often Vomit of their own accord, many have been of the opinion, that the cause of this Disease most commonly lyes hid in the stomach; but it is much otherways, and as we have elsewhere shewed; Vomiting frequently fol∣lows upon the Spirits being disturbed in the Brain: But that Vomits help much in this Disease, the reason is, because this kind of Physick causes a great revulsion of the humors from the Brain, and very much restrains the Spirits tumultuating in it. When the Membranes and Fibres of the Ventricle, and Viscera planted nigh them, are pul∣led; various humors, viz. the nervous, serous, watery, pancratick, and cholerick are drawn into those parts, and so squeesed forth, so that the Head being freed from their flowing to it, doth easily shake off from it many impacted there before: then as to the Animal Spirits, we have shewed somewhere, that there is a most intimate commerce, and agreement between those inhabiting the stomach, and those dwelling in the Brain; to wit, that therefore the grateful or ingrateful affection of the Ven∣tricle, from things taken into it, might bring rejoycing or dejection to the Spirits dwelling in the Brain. Opiates whilst they lye in the stomach cause sleep; in like manner, it doth not a little help in the Vertigo, and other Cephalick Diseases, where∣by the Spirits of the Brain wandring up and down, and agitated enormously may be repressed, and returned into order; if their Companions or Kindred be striken down, by the working of the Medicine; because whilst many are called forth from the Brain, to their assistance; the others remaining, remitting their disorders, resume their wonted offices or functions: without doubt it is for this reason chiefly, Emeticks bring so often help in the Distemper of madness; so that Empericks do almost only use them.

* 1.2862. But to return from our digression, let us consider what is to be done for the Curing of an inveterate and almost continual Vertigo, out of the fit. Therefore, first a method being instituted concerning bleeding, and purging, according to the constitution and strength of the Patient, and after rest, to be repeated; let a Vomit also, by my advice, be taken once a month (if nothing to the contrary hinders it) for which end let there be given to the weaker, after the stomach is filled with slippery Meats, Wine, and Oxymel of Squils, to about two or three ounces, and after it let a great quantity of Posset-drink be drunk, with Carduus boiled in it, that the Patient may vomit of himself, or by provocation. To others may be given an Emetick of the Salt of Vitriol, or the Sulphur of Antimony, or of the infusion of Crocus Metal∣lorum:

as concerning Issues, Blisterings, the bleeding at the Hemorrhoidal Veins, Pla∣sters, or quilted Caps to be worn upon the Head, or other Topicks to be applied to the soals of the Feet, or to the wrists, for revulsion or derivation sake, let the Phy∣sician deliberate.

Take of the Conserve of the Flowers ••f the male Poeony fix ounces,* 1.287 of the Powder of its Root one ounce, of the Seeds of Poeony powder'd two drams, of Amber, Coral, Pearls powder'd, of each two drams and a half; of the Salt of Coral one dram, of the Syrup of Coral, what will suffice to make an Electuary: the Dose is one dram and an half, or two drams, Evening and Morning; drinking after it of the following di∣stilled water three ounces.

Take of the fresh leaves of Misleto six handfuls,* 1.288 of the root of the male Poeony, and of Angellico, each one pound and an half; of the whitest dung of the Peacock two pound, of Cardamoms bruised two ounces, of Cast••r three drams: all being cut small and mixt together, pour to them eight pints either of White Wine, or Whey, made of it: Let them be distilled in fit Stills, and the whole liquor mixed together.

Take of the Powder of the Root of the male Poeony half an ounce,* 1.289 of red Coral prepared, of Species Diambrae, each one dram and a half; of the Powder of the Flowers of the male Poeony fresh bruised and dryed in the Sun, one dram: make a Powder, to which add of the whitest Sugar, dissolved in the water of Poeony, and boiled to the consist∣ence of Tablets ten ounces: of this make Lozenges according to art, each weighing half a dram; eat one or two of them often in a day.

Because all things are not convenient to all Men, and that the Physician ought to try diverse Medicines, and institute various methods, and to try now this, now that, therefore we shall here add some other forms of another kind.

Take of our Syrup of Steel six ounces,* 1.290 and drink a spoonful of it in the Morning, and at five in the Evening, with the distilled water, but now described, or any other Ce∣phalick, to the quantity of three ounces; or take of our Tincture of Steel, from fifteen to twenty drops, in a draught of the same distilled water, twice in a day. I have known this to have given notable help to many.

Let there be given daily after the same manner,* 1.291 Doses, sometimes of the Spirit of Sut, Harts-born, or of Sal Armoniack, impregnated with Coral, Amber, or the Skull of a Man: or of the Tincture of Antimony, Amber or Coral.

Take of the Powder of the Root of the male Poeony one ounce and an half,* 1.292 of the Seeds of Poeony, Coral prepared, and of the whitest Amber, each three drams; of Pearls prepared, of the Powder of the Flowers of the male Poeony, fresh bruised and dryed in the Sun, of each two drams; of Sugar-Candy one ounce: make a Powder, and take one dram twice in a day with a draught of Tea or Coffee, or a Decoction of Sage or Rosemary.

For poor people may be prescribed, Powder of the leaves of the Apple-tree, Misleto, dryed in the Sun, and powder'd, to the quantity of a dram, to be taken twice in a day. Or take of the whitest Peacocks dung six ounces, of the Powder of the Flowers of the male Poeony one ounce, of Sugar two ounces: make a Powder, of which let them take a spoonful twice in a day, in some convenient liquor.

Let those troubled with the Vertigo drink for their ordinary drink, small Ale, with leaves of the Orchard Misleto boiled in it instead of Hops, and in the Vessel holding about four gallons, let a little bag be hanged, in which put half a pint of Peacocks dung, and three drams of Cloves bruised.

Examples of those labouring with the Vertigo are so frequently met withal and almost daily,* 1.293 that there seems no need to add here any; but however, that the image or type of this Disease may be known, I shall only mention some few and more rare cases.

A Divine about sixty years of age, after he had been troubled for about three months with a light Vertigo,* 1.294 or as it were a frequent coruscation or brandishing of the Spirits, in the fore part of the Head, at length the Disease growing worse, he became ready to fall, and with a darkness before his eyes; in so much, that in walk∣ing he sometimes would fall flat on the ground. Being sent for to Cure him, I pre∣scribed Phlebotomy, with a gentle Purge, and after a little respite, to be repeated a∣gain; further, I took care to have the Electuary, and mixtures given him, such as we noted above, with Blistering Plasters, and other administrations not to be neglected: A fortnight after, no ease following from these, I gave him a Vomit of the Salt of Vi∣triol, and the infusion of Crocus Metallorum, by which when he had easily vomited ten times, he began to find himself better, and by using further altering Cephalicks, for

about a fortnight more, he became perfectly well, and from that time, for six years, he took yearly spring and fall a Vomit, with some other Medicines; though he conti∣nued in perfect health.

* 1.295A certain Gentleman about sixty six years of Age, when he had lived for a long time obnoxious to a light Vertigo, and that was wont to be excited only occasionally, about the end of the last Autumn, labouring more grievously with this Distemper, he also became forgetful. Being sent for to visit this Man, after he had been sick about three weeks, I found him very much changed in his looks and countenance, the vigor of both being diminished. Seeing that he was daily distemper'd towards evening with a small Feavour, his Pulse beating high and vehemently: I first caused blood to be taken out of his Arm, and after six or seven days, out of the Hemorrhoidal Veins; and then I took care for Blisters to be made behind the Ears and hind part of the Neck, and two large Issues between the shoulders: Inwardly, at physical hours, he took dai∣ly Cephalick Medicines, almost of every kind. Within a months space he seem'd to recover, and began to walk abroad, and to take care of his houshold affairs, and other businesses: but in the beginning of the Winter, taking cold by going daily a∣broad, he fell into a little Feavour, with a greater perturbation of the spirits within his Head: for becoming every evening delirous, he hardly knew what he said or did. But within seven or eight days, blood being taken away, and a slender dyet used, the Feavour vanished, but the distemper of the Brain was changed from its former state. For the Vertigo wholly ceasing, he became very forgetful, and Paraly∣tick, in all his right side. As to his Head, being asked, whether it was clear, and free from the dizziness and confused Phantasms; he answered, that as to those things, he never was better in his life: For he well understood his infirmity, knew his Friends and Relations, and others who came to visit him, but could hardly remember the names of any of them; and when he began to talk of any thing, he wanted words to express his mind: Then as to his Distemper in his side, in his right Arm and Leg; there was not only a ••oosning wholly, and a want of motion, but in either there grew a great white waterish Tumor, in so much that not only the Cure, but his life was despaired of, to be long prolonged; yea, the Magistracy and Offices which he held, were sought for by others.

However I did not desist from my curatory work, the most skilful Physician Doctor Wharton being called to my assistance. Carefully administring to the sick by our joint counsels, we prescribed solutive Pills to be taken at times, and in Medicinal hours on other days Cephalick, Antiscorbutick and Antiparalytick Remedies: His head be∣ing shaven, we ordered a Plaster of Gumms and Balsoms to be laid upon it, and the loosened parts to be anointed with Oyls and Balsoms, and to be strongly rubbed. Whilst these things were doing, with some success as to the greater clearness of his intellect, I know not from what cause, he fell into a Feavour, in the midst of the Winter, so that for several days and nights, he grew extreamly hot, with burning, great thirst, and interrupted sleep; his tongue being scorch'd, and having a white scurf, his Pulse was high, his Urine red, and full of contents. We abstained from Phlebotomy, by reason of his Age and Palsie, and especially because of the Dropsie begun in the distemper'd side: but with a slender dyet prepared of Barly Broths, and Grewel, we order'd him day by day Iuleps, Apozems, and other Remedies moving Sweat and Urine; and when about this time the Issues between his shoulders flowed very much, the sick man began to grow better as to his Memory, and Palsie, and from thence pro∣fiting daily, and by degrees growing well, of both his distempers, together with his Feavour, he was restored to perfect health within a fortnight, and is still living in health.

* 1.296In this sick man there was a notable motion, and a various change or translation of the Morbifick matter; for what was at first in the middle part of the Brain, viz. sitting on the Callous Body, stirred up the cruel Vertigo; the same afterwards increas∣ed, and (as it is probable) being further diffused into the infoldings of the Brain, brought forgetfulness or oblivion to the former Distemper: Then forasmuch as the same mat∣ter being moved by the Feavour, and a little discussed, falling partly on one of the streaked bodies, brought the Palsie of one side, and being partly expulsed into the compass of the Brain, almost took away the Memory, the Callous Body in the mean time obtaining a clearness; and lastly, it was not without the help of the other Fea∣vour, that the Morbifick matter being discussed from these two last nests, was wholly carried away, the sick being restored to health.

* 1.297Lately being tired out with the continual complaints of a certain man, troubled with the Vertigo, after many other Remedies tried in vain, I prescribed at length, that for the space of a month, he should take daily, twice a day, about a spoonful of

the following Powder, drinking after it a draught of the Decoction of Sage or Rosemary, impregnated with the Tincture of Coffee.

Take of the Powder of the Roots of the male Poeony two ounces, of the Flowers of the same bruised and dryed in the Sun one ounce, of the whitest dung of the Peacock half a pound, of white Sugar two ounces; make a Powder.

It is scarce credible how much help he received from this Remedy; visiting me after a month, he seem'd a new and another man; being freed of the Vertigo, he not only confidently walked about, but was able to take care of his houshold affairs, and to meddle with any hard business, which he was not able to do before.

CHAP. VIII.

Of the Apoplexy.

As the seat of the Vertigo,* 1.298 so also of the Apoplexy, seems to be within the same more inward cloyster of the Brain, viz. the Callous Body; to wit, because in either Distemper, although in a far different degree, the imagination and the common sense are affected, viz. in the first, the irradiation of the Spirits is wont to be obscured in some places, and as it were broken with interspersed shades; but in the latter, the same is wholly darkened, and suffers a full eclipse.

The word Apoplexy denotes percussion,* 1.299 and by reason of the stupendous nature of the Disease, containing as it were something divine, it is called a Sideration or Blast∣ing; for those taken with it, being as it were Planet struck, or with an invisible Nu∣men, fall suddenly to the ground, and being deprived of sense and motion, and the whole animal function ceasing (unless that they breath) they lye a long time as if dead, and sometimes yield to death; But if they revive, oftentimes they are taken with an universal Palsie, or else of one side.

The immediate subject of the Apoplexy,* 1.300 and the nearest, are the Animal Spirits inhabiting that region of the Brain where the principle faculties of the knowing or understanding soul reside; to wit, the Callous Body: but we conclude the mediate subject, to be the middle part of the Brain; because from hence, the instincts of all spontaneous motions proceed, and in this, the perceptions of all sensible things are terminated: by what means the Cerebel and Praecordia, and all the other parts both Animal and Vital, are secundarily affected, we shall shew anon, when the symptoms of this Disease and their reasons are delivered. Upon the coming of the Apoplectick fit, all the acts of every spontaneous and knowing function (to wit, which depend upon the brain it self) are forthwith hindred and cease; the reason of which is, be∣cause the Animal Spirits being suppressed in their chief place of meeting, to wit, the Callous Body, both their next motion of expansion in that place, as also their flowing forth into the nervous appendix,* 1.301 is wholly defective: For therefore, by reason of such an eclipse of them in that place, an immediate and an universal darkness is caused in the whole animal region, which is under this government: yet in the mean time, the Pulse and respiration, as also the motion of the Ventricle and Intestines, are after a sort performed, either perfectly and freely, or at least interruptedly and with pain; forasmuch as their actions proceed wholly from the Cerebel, which is not at all, or but little hurt by the Morbifick matter.

But it will seem difficult to be explained, after what manner, and from what causes, the Animal Spirits are so suddenly, and all at once suppressed, and as it were ex∣tinguished, about their first spring of emanation; so that all sense and motion de∣pending thereon ceases every where.* 1.302 Concerning this, there are many and diverse opinions of Authors; whilst some place the cause of the Apoplexy in the Heart, and others in the Brain; then some lay the fault on the intemperance of that, and others on the evil conformation of this. Further, the obstruction of the Brain is said by some to cause the Apoplexy in the greater Ventricles, by others in its Pores or lesser pas∣sages: then the obstruction being taken for the cause of the Disease, and wholly binding up the lesser Pores of the Brain, is said to excite the fit, either because the afflux of the blood, for the begetting of Spirits is hindred from those parts; or be∣cause,

the flowing forth or emanation from thence, of the Animal spirits is kept back. It would be a tedious thing to examine the opinions of every one, and to con∣sider the weight of their reasons.

The Theory of this Disease seems to be very exactly delivered by the famous Web∣ferus; for in the first place, for the finding out of its so abstruse and hidden causes, he brings Histories or Anatomical observations,* 1.303 in which the Phaenomena are declared in many dead Carcases of those dying of this Disease; to wit, in three struck or blasted, he had found the blood extravasated or out of the Vessels here and there in great clodders, and had largely marked the substance of the Brain; in another the Se∣rous Colluvies had overflowed the whole head, both without and within the Skull. From these footsteps of this most hidden▪ Disease thus detected, the Author concludes,

That the principal places affected are not the greater Ventricles, but the middle mar∣rowy substance of the Brain and Cerebel, which is every where porous, and indued with very small passages, both that the vital spirits may flow in thither from the blood, and that the animal may flow forth: But indeed he affirms, That the whole cause of every Apoplexy doth consist in these two, viz. either in one of them, or both of them toge∣ther: to wit, either because the flowing of the blood thorow the Arteries to the Brain is deny'd, or else by reason that the flowing forth of the Animal Spirit from the Brain and Cerebel, thorow the Nerves and Spinal Marrow, is prohibited; or for both these causes together. As to the former, he proposes a threefold means, whereby the blood may be hindred; viz. First, Either by reason of the obstruction of the inner Carotid Arteries, and of the Vertebrals, to wit, which happens in the greater Vessels, and chiefly about the ascent of the Brain, from the blood concreted into cloddery pieces; or in the lesser Vessels, which pass thorow the brain from a Viscous Mat∣ter planted in them: Or, Secondly, the flowing in of the blood is detained from the brain, by reason of the compression of those Vessels, which sometimes happens, be∣cause the Paristhmia, or Kirnels of the hinder part of the Neck, do so swell up, from a Serous heap of watry Humors, that by pressing together the Arteries passing thorow, shuts forth the passage of blood to the Head. Or, Thirdly, The bloody flood may be hindred, because a Vessel being preternaturally opened within the Skull, great quantity of blood is poured forth, which should otherways go to the benefit of the brain. As to the other cause of the astonishing Disease, viz. from the flowing forth of the Spirits being hindred, he affirms that may be caused by two ways; to wit, either by reason of the obstruction of the beginning of all the Nerves, caused by a serous inundation, or by a sudden compression of the same; which is caused either by an heaping up of too much blood in the Meninges, or in some parts of the brain it self, or in its Ventricles; or else by a disposition of the Phlegmonodes.

* 1.304These most ingenious reasons indeed seem to challenge our assent, for that more probable or more likely are not easily to be brought; but because we think some of these are to be altered, and others to be added, therefore we shall here institute, though not a different, yet somewhat another reason of this Disease.

* 1.305And in the first place, though we grant that the flowing in of the blood, may be sometimes denyed to the Brain; yet we do not believe, that it only happens after the aforesaid ways, nor that, for that reason, the Apoplexy doth arise. We have else∣where shewed, that the Cephalick Arteries, viz. the Carotides, and the Vertebrals, do so communicate one with another, and all of them in several places, are so ingraffed one in another mutually, that if it happen, that many of them should be stopped or pressed together at once, yet the blood being admitted to the Head, by the passage of one Artery only, either the Carotid or the Vertebral, it would presently pass thorow all those parts both exterior and interior: which indeed we have sufficiently proved by an experiment, for that Ink being squirted in the trunk of one Vessel, quickly filled all the sanguiferous passages,* 1.306 and every where stained the Brain it self. I once o∣pened the dead carcase of one wasted away, in which the right Arteries, both the Carotid and the Vertebral, within the Skull, were become bony and impervious, and did shut forth the blood from that side, notwithstanding the sick person was not trou∣bled with the astonishing Disease; wherefore, it may be doubted, whether the blood excluded from the Brain, by reason of some Arteries being obstructed or compressed, doth bring forth this Disease. Certainly there is more of danger, that the cause of the Apoplexy, should be from its too great incursion and extravasation within the Brain, as it was in the three Apoplectick people, cited by the Author; and that not only, because the marrowie substance of the Brain was deprived of the Blood coming to its use, (for such a defect might have been supplied by the other Vessels, extend∣ing their branches every where) but rather, because by the extravasated Blood, and

not seldom being concreted into an hard and mighty bulk, the marrow of the Brain is pressed together, the passages of the Spirits being by that means shut up.

But indeed,* 1.307 though we deny this to the afflux of the blood into the Brain, being hindred in any part only, yet it may be granted to its total exclusion, for therefore we have often noted, a want of all motion to be caused: which Distemper however hath been rarely taken for the astonishing disease, but rather is wont to be called a Syncopy, or Swooning away, or the Hysterical Passion: If at any time the motion of the Heart be wholly suppressed, presently, the Blood being retained without the Brain, the Animal Spirits fall down, even as the light vanishes when the flame is put out.

The action of the Heart is stopped or hindred,* 1.308 either by reason of the improporti∣onate flowing in of the Blood, as in the violent passions of fear or sadness, or by reason of the Animal Spirits, which serve for its motion, being denyed by the Cere∣bel. This we think to happen sometimes, because of the Cardiack Nerves being Di∣stemper'd with a Convulsion, or otherways bound together, after which manner it is usual in Convulsive and Hysterical Passions; sometimes for the outward parts, as the Arms and Legs, and sometimes the Inward, to wit, the Praecordia and Viscera, one after another to be affected: but a want of motion follows the inordinations of these, in which the sick lie for some time without motion or sense, with a small or seldom beating Pulse as if dead. Which indeed so seems to come to pass, by reason of the Cardiack Nerves being contracted at that time, and so the Spirits which were about to flow being suspended; though we believe such a want of motion sometimes to be produced by the mere confusion of the Spirits within the Brain, but in this case, the heart it self is lively enough moved, and the Pulse is also strong and landable.

But besides,* 1.309 it seems most likely, that the motion of the Heart is ofen suppressed or inhibited, by reason of the Animal Spirits, destinated to the vital function, being suppressed in the fountain it self; to wit, within the Cerebel. We have mentioned this to be done in the Distemper of the Incubus: but without doubt it ought to be attributed to this cause, for that I have observed in some, a failing of the Spirits, with a sudden privation of all the Animal functions to follow, upon a great weight in the hinder-part of the Head, in which the sick become senseless and immoveable, with the Pulse and breathing very much lessened, and scarce perceivable, and lye quite cold for many hours; yea oftentimes, a day or two, more like dead than living per∣sons. I have known sometimes those distemper'd, to be stiff and cold, Pulse and breathing to be thought quite gone; and to be indeed esteemed quite dead, and put into their Coffin, yet after two or three days to have reviv'd again: but whoever awakes out of this fit, whether it be of short or long continuance, does not for that reason fall into a Palsie, or half Palsie of one side, as those for the most part do, who are distemper'd with the Apoplexy. Further, no doubt but that many die from such a Morbific cause, whose death wrongfully hath been ascribed, either to the mortal Syncopy, or to the Apoplexy properly so called. Truly the case afterwards described, can only have the like reason given for it.* 1.310 Wherefore, though it may seem a Para∣dox, yet it is not incongruous to reason, that we affirm, that there is a twofold Apo∣plexy, one in the Cerebel, which we but now described; the other seated in the mid∣dle of the Brain, into the causes of which, and the manner of it, we shall now in∣quire.

But here in the first place we must distinguish concerning the various assault or fit of this Disease,* 1.311 to wit, forasmuch as sometimes being excited, without any previous disposition, or Procatarxis, from a sudden and solitary cause, it is often invincible, and for the most part mortal; against this there can be no preventive method of healing, or preservatories instituted; and the Curatory method which is wont to be ta∣ken, proves very oft ineffectual. Or, Secondly, the Apoplectick fit having an antece∣dent cause, or previous Procatarxis, is brought into act by reason of various occasions, or evident causes.

As to what belongs to the blasting,* 1.312 or being stricken, of the former kind, to wit, suddenly and unthought of, its conjunct or next cause is, either a great solution or breach of the unity, happening some where within or near the middle of the Brain, by reason of which its Pores and passages being obstructed or pressed together, the whole emanation of the Spirits is suppressed: or else it is an huge and sudden profli∣gation of the Spirits, or an extinction of those dwelling in the Brain. We shall shew the formal reasons of both of them particularly,* 1.313 and the several ways of their being affected.

Extravasated Blood, the breaking of an Imposthum, and a great flood of Serous humor plentifully flowing forth, are wont to effect the greater breach of the unity within the Brain.

1 1.314From Blood effused or extravasated within the Brain, and there either growing together in clodders, or striking on the affected places, doth often times cause mor∣tal Apoplectick fits, as I my self have proved by Anatomical inspection in some o∣thers, besides the instances brought by the famous Webfer; but such Morbific extra∣vasations of the Blood within the Brain, proceed either from an external cause, as a fall from on high, or by a blow on the Head, or by hitting it against some hard thing, and the like; or from an inward cause, to wit, for that the Blood being sharp and thin, and the little mouths of the Vessels, and the places between being too loose, it growing more than ordinarily hot, either of its own accord or occasionally, and flowing forth thorow these, easily breaks into the soft and yielding substance of the Brain. Further, although we have assigned the seat of this Disease in the Callous Body, yet the blood, because effused somewhere nigh or above it; because it com∣presses the underlying Marrow, by intumifying the distemper'd places, causes the Apo∣plectick fit.

2 1.315Secondly, An Imposthum or Ulcer is rarely wont to be excited within the Brain, but often in the Meninges, and almost for the same occasions, by which the extrava∣sation of the blood happens: while it is ripening, it causes only an Headach or hea∣viness, but when it is broke, the filthy stuff flowing from it, into the shelly part of the Brain, gnaws and putr••••ies it, and then by degrees instilling its putrid particles, and very infe••tous to the Spirits, into the middle or marrowie part of the Brain, raises up at las•• the fit of the astonishing disease.

3 1.316Thirdly, The Serous heap or deluge being poured forth from the blood, into the Head, though rarely or never of it self, yet sometimes by reason of more strong evi∣dent causes, runs so suddenly into the Brain, that filling and stuffing soon all its Mar∣rowie Pores, causes astonishment or deprivation of sense and motion: And this I have known to happen to some, from drinking of sharp thin Wine, or Spaw-waters, and sleeping upon it; and I have observed the like effect, from a long and total sup∣pression of Urine, also in Haemorrhages (or fluxes of blood) being suddenly stopped: And lastly, the Serous Recrements in malignant Feavours, being translated to the Head, by a critical transposition, often causes a mortal senselessness, or becoming speechless.

* 1.317Another kind of evident causes, from which sudden blasting or being smitten is wont to be caused, consists in the sudden profligation or extinction of the Spirits, which indeed doth not seldom or rarely happen, from strong Narcoticks, or Medi∣cines causing sleep, and also from the immoderate drinking of hot waters.

Though we have already discoursed concerning the use and effects of Opiates, I can∣not however pass over their way of affecting, assigned by that most famous Doctor Webfer.* 1.318 This Learned Man affirms, That Narcoticks only do too much open and di∣late the Pores and passages of the Brain, and as it were open the doors of it, before fast shut, whereby every extraneous and incongruous thing is admitted into the Cham∣ber or sleeping place of the Spirits, together with the subtil liquor poured forth from the blood; and so by a violent incursion, dissipates their ranks and orders. But indeed it appears from what hath been above said, that Narcoticks do not only or al∣ways operate so; for we have shewn that whilst they are yet within the Ventricle, they often cause sleep, and sometimes death it self: Besides, it should follow from thence, that Opiates being often given should bring still a greater evil, because by dilating more and more the Pores of the Brain, they cause a much more easie entrance to all manner of impurities; but truly it is clear enough, that Narcoticks are most hurtful at the first time being taken, and afterwards being often taken do little hurt, so that some accustomed to Opium, will devour a great quantity of it without hurt; which is certainly a sign, that this doth not so much alter the conformation of the Brain as that it doth immediately agitate or work upon the Animal Spirits; whom at first (because so very improportionate to them) it slays with a mere blast; then afterwards there being a certain familiarity between them, and this Medicine, it di∣sturbs them not.

* 1.319Thus much concerning the causes of the accidental and sudden Apoplexy, which falls indifferently upon all men, though not at all predisposed: for which also there can be no preventive Medicines instituted, and it is rarely that it is cured. But besides, we observe, that this Disease is sometimes habitual, and that it remains as a constant disposition in some men, by reason of which, at first they are exercised only with light skirmishes, but after some time they become more grievous, and of which at last for the most part they dye. Concerning this therefore, we shall inquire, 1. what the Conjunct Cause of this Disease may be, and the formal reason of it. 2. In what the Apoplectick Disposition or Procatarxis of the Disease consists: Then 3. What Evident Causes it hath.

1. As to the first,1 1.320 we may suppose, upon the coming of the Apoplectick fit, that a certain matter before heaped up, and dispersed in the compass of the Brain, at length doth descend into its middle or marrowie part, and there doth assault all the Spirits, and suppress and beat them down in the very fountain of their emanation: Although it doth not plainly appear, whether they effect it either by stuffing only the Pores of the Marrow, or by driving away the Spirits themselves, or by inflicting on them a numness; notwithstanding it is likely, that it may be done by either of the ways. And indeed we say the medullary Pores of the Brain, may be somewhat stopped or obstructed, because the same matter, which at first setling on the Callous Body, caused senselesness, being sliden down from thence lower into the Callous Body, and then stuffing its Pores, is wont to excite the Palsie of one side. But yet we may not con∣clude, that the sideration or being struck, doth arise only from the Pores of the Brain being stopped, because then the fit would oftentimes creep on them gently, and by little and little; forasmuch as all the Pores cannot be possessed by the inflowing matter at once,* 1.321 but successively, and some after others: But when as this Distemper leaps upon one suddenly, and like lightning, what can we conceive less, than that the Spirits are struck down as it were by a blast, from the malignant contact of the mat∣ter rushing upon them? For it seems, that its particles descending on every side from the compass of the Brain, into its middle part or the Callous Body, and entring it from every part, do presently fill the passages how strait so ever they be, and drive to flight hither and thither the Spirits, and compel them into a close place, who being then beset and reduced to a strait corner, when they can neither resist long, or are able to penetrate into other Pores possessed by the Morbifick matter, at length are struck flat down, letting go every function of the knowing soul; but then they do not easily nor quickly rise up again, because they are not able to quit themselves from the embraces, or bonds of the malignant matter, nor pass any where into empty or open places; wherefore, they lie long suppressed, till at length sometimes per∣haps that matter, though leasurely, is dss••pated, or supped up into the Blood, or issuing forth from the little Pores of the Marrow, slides forward into the Ventricles of the Brain; or at length, that matter sliding a little lower, and being impacted on the Streaked Bodies, either one or both of them, causes the Hemiplegia, or half Pal∣sie, or the Palsie: In the mean time, as the Spirits, within the Callous Body grow free, and getting wider spaces, they resume their wonted offices; which they indeed execute, until new matter springing again in the compass of the Brain, and being by degrees increased, descending into the Callous Body, brings on another fit; out of which, if the Spirits get not, by either of the aforesaid ways, being wholly discom∣fited, they perish by degrees.

If you should ask after the nature or disposition of this Morbific matter;* 1.322 it may be suspected, that the Animal Spirits in the Apoplexy are plainly affected after ano∣ther manner, than in Convulsive passions; to wit, those obnoxious to this blasting ob∣tain a Copula contrary to the explosive, that is, Vitriolick, rather than Nitro-sulphureous; and so by it their spiritous-saline particles are wholly fixed, and are hindred from en∣tring into any motions or explosions, even as when the Vitriolick particles being bea∣ten and combined with the fulminating gold, they quite take away its explosive or letting off virtue, and congeal and render immoveable all other active particles, like the blowing of a freezing air. The Animal Spirits seem to be not unlike the same, and their Copula's have divers sorts of adjuncts, some of which induce an E∣lastick and very explosive virtue, as in the Convulsive Distempers, and others a stu∣por, numness, or immobility, as in the sleepy Diseases, and also in the Apoplexy and Palsie.

Thus much concerning the Conjunct Cause,* 1.323 and formal reason of the Apoplexy; as to its Procatartick or fore-leading Causes, they are much after the same manner as in most other Cephalick Distempers; to wit, both the Blood is in fault, for that it affords to the Head extraneous particles, and very contrary, or as it were destructive to the Texture or constitution of the Animal Spirits, either begotten in it self, or taken from some other place: and then the Brain is in fault, for that being weak in its disposition, and so its Pores and passages too dissolute and lax, so that it always and easily admits without impediment, the Morbific matter poured forth from the Blood. There is no need that we should here reherse or unfold particularly the peculiar reasons of either, and the various ways by which it is done; but we shall ra∣ther referr you to what we have already said very largely, concerning the foreleading causes of the inveterate Headach, and also of the Lethargy. Further, the like or the same evident causes, which were noted in those Distempers, and in other sleepy Dis∣eases, ought here to be taken notice of, to be shunned carefully by Apoplectick people.

* 1.324From what hath been said, the differences of this Disease may be easily known: 1. What we mentioned but now; The Apoplexy is either accidental, which is sud∣denly, and at once excited, without any foregoing cause, and almost indifferently in all, from some strong evident cause; or it is wont to be esteemed habitual, which de∣pending upon a previous disposition, hath frequent fits, by reason of several occasi∣ons: 2. From the reason of the subject, this Disease is said to be proper, either to the Brain or Cerebel, or common to both: previous and frequent Scotomies or dizzi∣ness with mists before the eyes, and the Distemper of the Vertigo, denote the Brain more obnoxious to this Disease: A frequent Night-Mare, intermitting Pulse, of∣ten Swooning and failing of the Spirits, argue the Cerebel to be evilly disposed.

3. In respect of magnitude, it is either universal, every function, both merely na∣tural and the spontaneous ceasing; or it is partial, this or that part being affected by it self, then for that the faculties of either, now all, now many only, yet none except∣ed suffer an eclipse; for in either regiment, the morbific matter descending to the middle or marrowie part, possesses sometimes all its whole substance, sometimes part of it, to wit, the fore part, hinder, or middle part. 4. In respect of the antece∣dent cause, the Apoplectical disposition is either hereditary or innate; or acquired by means of an evil dyet, or other accidents.

* 1.325The prognostick or fore-judging of this Disease is always denounced deadly or du∣bious; for the Apoplexy is never without present or future danger. But it is worst of all, in which, besides the abolition of all the spontaneous functions, the Pulse and breathing also are either deficient, or are performed laboriously; and then for the most part it happens, with a foam at the mouth, and snorting; upon which comes a sweat, which is often like melted greace, and indicates a very sudden death to be at hand.

Those who are blasted or strucken, and are presently deprived of Pulse and breath∣ing, and a little after growing cold, and seem dead or without any life, are not pre∣sently to be had from bed, or left destitute of Medicinal helps: further, though there be no hopes of life, they ought not to be buried under three or four days; because such do sometimes revive again, either of their own accord, or by the use of Reme∣medies: which certainly comes to pass, not because a vital heat is at last stirred up in the heart (for it is not there extinguished altogether;) but because the Morbific mat∣ter being discussed, or evaporated from the Cerebel, the motion of the heart is re∣stored, like a Clock when the weights are put on.

In the Apoplectical fit, if any help follows upon letting of Blood, there is hope of health. But if after this and other Remedies, the Distemper continues without intermission, above the space of a night or a day, or grows worse, the case is de∣sparate.

If after the first speechless fit being over, the sick person becomes more nummed and duller, and distemper'd with a Scotomy, and frequent Vertigo, it is a sign that he will be obnoxious to more fits of this astonishing Disease: for the aforesaid distem∣pers proceed from the Morbific matter, already laid up in the compass of the Brain, and there flowing sprinklingly, and thence descending thorow the very small Pores only, into the middle part: which matter whether Vitriolick or Narcotick, grow∣ing to a greater fulness, calls on this blasting or being suddenly smitten.

* 1.326The Therapeutick Method, is either Curatory, for the taking away the fit, when it is upon one; or preservatory to prevent it, that it may not return: the former be∣longs to every Apoplexy, the other only to the habitual.

The assault or fit of this Disease being come, (if it proceeds not from some out∣ward or vehement hurt of the head) although it is not known, whether it be excited or no from an invincible cause,* 1.327 such as the Blood being let forth of the Vessels, or the breaking of an Imposthum in the Brain, yet we ought carefully to endeavour the Cure of it. And because the blood being too hot or swelling up, is wont some∣times to bring in the Morbific cause, or at least to increase it, and the same sinking down, and becoming more setled, sometimes carries it away; therefore in the first place, you ought to deliberate, concerning the moderating its course. And h••re a question arises, concerning the placing of the Patient, to wit, whether he ought pre∣sently to be put to bed, or to be detained out of it for some time: some religiously observe the latter,* 1.328 and that not without reason; to wit, because in Bed there is a grea∣ter propensity to sleep, and the blood growing hot, and flaming forth more plentiful∣ly, by reason of the heat of the Bed-cloaths, pours forth still more recrementitious matter into the distemper'd Brain: on the contrary, whilst the sick is thinly cloath∣ed, and placed in a Chair, the blood flows more slowly, and the sinking Vessels seem more apt rather to sup back the humors out of the Head, than to send them thither.

Wherefore, if the Patient be strong enough, it will be expedient perhaps to let him stay out of bed for six or eight hours, till the f••ux of the Morbific Matter passes over, and the course of the Blood be made more quiet by Phlebotomy, and other Remedies carefully administred: but the weak, and who are of a tender constitution, let them be put to bed as soon as they are smitten. But let not the sick, whether in bed or up, lye upon his back, but with his head somewhat upright, and inclining either to one side or the other.

Phlebotomy,* 1.329 necessary almost in all Apoplectical persons, is not to be deferred: but the Blood is copiously drawn back by a strong Clyster. In the Clyster may be dis∣solved the Species of Hierae Diacolycinthia, and a troubled Infusion of Crocus Metallorum. Let a large Blistering Plaster be applied to the hinder part of the Head,* 1.330 and other drawing Cataplasms to the Legs and Feet: Let the Temples and Nostrils be anointed with proper Oyls and Bal••oms, and let painful rubbings be used almost to the whole Body: In the mean time, let things that stir up the Animal Spirits, and help them out of their bonds be given them; viz. Spirits of Harts-horn, Sut, and the like, with a Cephalick Iulep.

After this the sick being placed in the bed (if he be able and doth easily Vomit) let an Emetick be given him,* 1.331 of the Salt of Vitriol, Oxymel of Squills, or an Infusion of Crocus Metallorum, and then with a Feather put down the throat, provoke vo∣miting four or five times, drinking between whiles Posset-drink.

Vomiting being over,* 1.332 let there be given Comforters, as the Elixir Vitae of Quer∣citan, Spirits of Lavender, or Camphorated Treacle, Tincture of Poeony, or of Amber, or of Coral, with Apoplectical Water, or other appropriate Waters in a convenient Dose, and repeated as the business requires.

On the second day,* 1.333 the same Remedies being still continued, let dry Cupping-Glasses, or with Scarification, be applied between the shoulders, or to the hinder part of the Neck; or if more blood ought to be taken away, let the jugular Vein be opened; the Clyster repeated; apply to the Nose Spirit of Sal Armoniack, or a fume of Galbanum boiled in strong Vinegar. Besides, let Errhines or Sneezing Powders, and things to chew in the mouth to draw away Rheum be used. Then in the Even∣ing let a Purge be ordered of Pil. Rudii, or a Solutive Electuary of Roses, dissolved in some liquor.

None of these things helping,* 1.334 though there be small or no hope, the top of the Head being shaven, let glowing Iron be held over it, or a large Blister made upon it; and let the other part, especially the Forehead, and forepart of the Head, be bathed with Bez••ardick Vinegar; let Leeches be set to the Temples, or behind the Ears; let also a large Dose of Spirits of Harts-horn, or of Sut, be often poured down the throat; these and other the like administrations, are to be used till you see death at hand; which (as Celsus faith) these sort of Remedies only defer, but some times hasten life.

The Prophylactick or preventive Method,* 1.335 respects both those who have been trou∣bled with one or more fits, and also those who are seen to be prone to it, as those who are born of Apoplectick Parents, or are frequently obnoxious to the Vertigo, the Incubus, or Swooning away; also such who have short and brawny Necks.

Let Purging and Bleeding be ordered Spring and Fall,* 1.336 where it is convenient; as to the former, those who are easie to vomit, let them first take an Emetick, of the infusion of Crocus Metallorum, with the Salt of Vitriol, or of the Sulphur of Antimony; and then after three or four days, let there be given a Dose of Pil. Rudii, or of Amber; and after a due distance between, let it be repeated three or four times: Let two large Issues be made between the shoulders; or if that place doth not please some, let them be made, in one of the Arms, and in the opposite Leg.

On other days,* 1.337 free from purging, let altering and Cephalick Medicines be taken twice a day.

Take of the Conserves of the Flowers of the Lilies of the valley (or of the male Poeony) six ounces,* 1.338 of the Powder of the Root of the male Poeony half an ounce, of humane Skull prepared three drams, of the Seeds and the Flowers of the male Poeony powdered, each two drams; of red Coral prepared, of Pearls, and of the whitest Amber, each one dram; of the Salt of Coral four scruples, of the Syrup of the Flowers of the male Poeony, what will suffice to make an Electuary: The Dose two drams morning and evening, drinking after it two or three ounces of the following Water.

Take of the Roots of the male Poeony,* 1.339 of Imperatorian Angelica, each half a pound; of the Root of Zedoary, of the lesser Galangal, each one ounce; of the leaves of the Orchard Mifleto, of Rue, Sage, and Betony, each four handfuls; of the outer rind

of ten Orenges, and eight Lemons, of Cardomums, Cloves, Nutmegs, each half an ounce; all being cut and bruised, pour to them of white Wine (in which two pints of the dung of the Peacok hath been infused for a day) ten pints: let them infuse, close shut for three days; then distil it according to art, and let the whole liquor be mixed together.

* 1.340Take of the Species of Diambrae two drams, of the Powder of the Root of the male Poeony, of Zedoary picked, each one dram and a half; of Pearl one dram, of the Oyl of the purest Amber half a dram, of the whitest Sugar half a dram, being dissolved in six ounces of the water of Poeony, and boiled up to a consistence: make Lozenges accord∣ing to art, each weighing half a dram: Let the Patient eat one or two often in a day, at his pleasure.

* 1.341Within the fifteenth or twentieth day, that the Remedies may not be irksome, and may profit the better, let them be changed: therefore, instead of the Electuary let there be substituted for two or three weeks, sometimes the Spirit of Sal Armoniack, with Amber or Coral, or else impregnated with humane Skull or Castor; sometimes Elixir of Poeony, or Tincture of Amber or Coral, or Elixir Vitae of Querci∣tan, or the simple mixture: also instead of it, may be drunk compounded Waters, or Water of black Cherries, or Walnuts; or the simple Waters of Rosemary, or Lavender; sometimes a draught of Posset-drink, with Flowers of the male Poeony or the Lilies of the valley boiled in it;* 1.342 or a draught of Tea or Coffee in the morning, (let the water of which it is prepared have such ingredients first boiled in it) or let Chocolate be prepared after this same manner.

* 1.343Take of the Powder of the Root of the male Poeony, of humane Skull prepared, each half an ounce; of the Species of Diambrae two drams, make a Powder; to every paper add of the Kirnels of the Cocoe Nuts one pound, of Sugar what will suffice; of this make Chocolate: take of it half an ounce or six drams every Morning in a draught of the Decoction of Sage, or of the Flowers of Poeony, or such like.

* 1.344Take of the Powder of the Root of the male Poeony, of humane Skull prepared, each one ounce and a half; of the pick'd Root of Zedoary, Cretick Dittany, Angelica, Con∣trayerva, each two drams; make a fine Powder of them all, add to it of the yellow of Orenges and Lemons Candied, each two ounces; let all be beaten to a Powder: take about half a dram, or a dram an hour before and after meals.

For ordinary drink, let a Vessel of four gallons be filled with ordinary Ale, in which six handfuls of white Horehound dryed had been boiled, of Anacardine and Cardo∣mums cut and beaten, each one ounce and a half; of it make a bag to hang in it.

* 1.345First of all, a very strict dyet ought to be ordered; let a temperate, dry and open air be chosen; let good and wholesome meats be eaten, and slender meals. Let sup∣pers be sparingly taken, or none at all: Let noon-sleeps, drinking bouts, and other customary things about the non-naturals be shunned.

* 1.346I could here propose many Histories of Apoplectical persons, to wit, of some who were once or twice touch'd, and yet living; and of others who have dyed at the first assault, or in the second or third fit. The most Reverend Father in God the Lord Gilbert Archbishop of Canterbury, recovered of a grievous Apoplectical Fit, six years ago, (God prospering our medicinal help, to whom we render eternal thanks) and from that time, though he sometimes suffer'd some light skirmishes of the Disease, yet he never fell, or became speechless or senseless. But we shall not stay upon this or other examples to unfold them largely, because there is nothing in them very rare, that may illustrate the Aetiology of this Disease. Some of their dead Carcases I have dissected, but only of such as the cause of death was from some former great hurt of the head, as some blow, or by means of some blast; in all which the extravasated Blood, or an Imposthum was the cause of their death: We have been prohibited often by their Friends, from opening those dying of an habitual Apoplexy, who expecting to have them revive again, held it as a deadly thing, and so wholly forbid Anatomy: But I shall here relate a notable Anatomical observation taken about five years since at Oxford.

* 1.347An ancient Divine, an honest and a godly Man, indued with a fat body, a short and brawny Neck, being long unhealthy, and living a sedentary life, contracted a very Scorbutick evil disposition: being troubled with a difficult and laborious breathing, with an heaviness of the Head, and unwonted numness, was scarce able to endure a∣ny thing of labour or exercise, more than that he daily went and came from his Cham∣ber to the Chapel and Hall: one Morning he came to the Chapel a little before Prayers begun, and while he was on his knees, he was suddenly struck, and immedi∣ately

became speechless and senseless, and fell on the ground; but being carried thence, and his cloaths taken off, he was put into a warm Bed. I and other Physicians being presently sent for, and coming as soon as we could possibly, we found him not only without. Pulse, sense, and breathing, but all his Body cold and quite stiff; nor could he be recalled to life or heat, by any Remedies or ways of administrations, though used for some time: by which we suspected, that the Pulse of his heart was wholly hindred at the first stroke, and that its flame being put out, presently all motion of the Blood was suppressed.

The next day,* 1.348 seeing the Carcase dead enough, and stiff, we opened it, nothing doubting but that the Distemper so suddenly mortal, would shew clear marks of it within the Head. But there, or in any other part, was not the least shadow of this most cruel Disease: The Vessels watering the Meninges were moderately filled with Blood, without any Inflammation or Extravasation: The Brain, the Cerebel, and the oblong Marrow, with all their processes and prominences, appeared every where thoroughout firm, and well coloured, both without and within: nor was there any Serum or Blood poured forth any where, within the Pores or passages, nor yet with∣in the greater Ventricles, nor heaped up; yea the Choroeidal Infoldings placed both within the cavity of the Brain, and behind the Cerebel, seem'd free from all fault; so that the Morbific matter, equally thin and subtil like the Animal Spirits, whom it affected, remained wholly invisible, and we could only argue its presence by the effect.

But lest this should lye hid some where without the Head, after the contents of the head were diligently inspected, we came to the Breast: where the discoloured Lungs being through the whole stuffed with a frothy matter, manifestly shewed the cause of the short and difficult breathing. But the Heart was sound and firm e∣nough, free from any obstruction or fleshy Concretions. Further, neither in the neigh∣bouring parts, or in others about the Viscera, was found any Imposthum or Ulcer, by whose contact or stink, the Heart could be suddenly oppressed, or the Vital Spi∣rits (if this be possible) might be choaked.

Wherefore in this case, nothing could be suspected else, but that the Animal Spi∣rits implanted within the middle of the Cerebel, were put to flight, and as it were extinguished suddenly, by some malignant, or narcotick, or otherways deadly Par∣ticles, so that the motion of the Heart presently failing, like the first moving wheel in a Clock or Watch, immediately all the other functions, their impulses being taken away, wholly ceased.

CHAP. IX.

Of the Palsie.

THE middle of the Brain,* 1.349 or the Callous Body, to which we have assigned the seat of the Vertigo and Apoplexy, seems also to be the primary distemper'd place in the Epilepsie: Concerning which, as also concerning Convulsie Dis∣eases, since we have elsewhere largely treated, we shall therefore here pass over pur∣posely in this part of the Diseases belonging to the Head, and according to our wonted method, descend yet lower, to the other regions of the Brain, and its depen∣dences; and now we shall endeavour next to describe the Distempers which belong to the Streaked Bodies, Oblong Marrow, and also to the Nerves, and nervous Fibres.

We have formerly shewed,* 1.350 that these parts do perform all the functions belonging to motion and sense; wherefore, the failing or the enormities of these, are the af∣fections of those Bodies, or of the Spirits inhabiting them. But indeed sense and mo∣tion are hurt chiefly after two manner of ways: to wit, either is wont to be per∣verted or hindred; when Motion is perverted, Cramps and Convulsions; when Sense, pain arises; when either function or both together is hindred or abolished, the Di∣stemper is thence stirred up called the Palsie; which we are at present about to han∣dle. Concerning Convulsion and Pain we have already treated.

The Palsie is described after this manner, to wit, That it is a resolution, loosening, or relaxation of the nervous parts,* 1.351 from their due tensity or stiffness; by which means Mo∣tion

and Sense, to wit, either one only, or both together, in the whole Body, or in some parts, cannot be exercised after their due manner.

* 1.352The nervous pats are loosened, because the Animal Spirits do not sufficiently ir∣radiate them, nor blow them up, nor actuate them with vigor. The cause of which defect is, either an obstruction of the ways, by which their trajection or passage is hindred; or the impotency of the Animal Spirits, for that they are distemper'd with a numness, or that being but few in number they do not lively enough unfold them∣selves. By reason of these various means of being affected, there arise diverse kinds of Palsies. For in the first place, as to motion by it self, this spontaneous faculty (which is chiefly and almost only lyable to the Palsie) is sometimes taken away in the whole, or altogether in some parts; but sometimes this, being only hindred, is lesse∣ned or depraved.* 1.353 Secondly, In like manner also one sense only by it self, or more to∣gether, is sometimes wholly taken away, and sometimes only much diminished or vi∣tiated. Thirdly, Sometimes it happens that both powers are hurt at once. We shall speak of each of these in their order; and first of the Palsie, in which spontaneous motion is abolished; which we say is excited from two causes chiefly; to wit, the ways being obstructed, and the Animal Spirits being touched with a numness, or as it were with a certain malignant blast.

* 1.354As to the former, an interception of the Spirits from the loosned parts, by reason of their passages being obstructed, that always existing above them, is wont to be caused in various places, and for divers causes; but chiefly it happens in the first sensory, viz. in the Streaked Bodies, or some where about the Medullar Trunks, or lastly in the Nerves themselves; and so, either in their beginnings, or middle processes, or in their extreme ends, (i. e.) the nervous Fibres. When the evil or hurt is brought to the Streaked Bodies, or the oblong, or spinal Marrow, it either ob∣structs the whole Medullar thread or rope, from whence arises an universal Palsie be∣low the distemper'd part; or one moiety of it, whence comes the Hemiplegia or Pal∣sie of one side; or it affects in one side, or in both at once, the little heads of some Nerves, whence loosnings or resolutions are caused in this or that member apart from the others.

* 1.355There are many means whereby the ways or passages of the Animal Spirits are ob∣structed in the aforesaid bodies. First, Either their passages are filled by an extra∣neous matter impacted in them: Or, Secondly, They are pressed together by Blood flowing out of the Vessels, a Serous deluge, or some Tumor lying upon them: Or, Thirdly and lastly, the unity or continuity is broken, as by a stroke, or wound, or bruise, also by excess of cold or heat. According as these several places are distem∣per'd, and the several means of their being affected, we shall run thorow the chief cases of the Palsie, together with the Aetiology, or reason thereof, with the ma∣nifold appearances of Symptoms in them; and in the first place we will speak of the Palsie arising from an hurt brought to the common Sensory, to wit, the Streaked Bodies.

* 1.356And indeed, that it so comes to pass, I have proved by ocular inspection, and shall be plainly demonstrated anon by Anatomical observation. Further, as often as an universal or an half Palsie follows, (as it is often wont to do) upon a Lethargy the Carus, or Apoplexy, any one may conceive, that such a change of the Disease, hap∣pens from a translation of the Morbific matter; for that this at length going out of the Pores and passages of the Callous Body, which it at first possest, and sinking down a little lower, runs into the Medullary tracks of one: of the Streaked Bodies or perhaps both of them. And so, when the Animal Spirits are hindred from their wonted out-flowing, or irradiation into the nervous Stock, the motive faculty on∣ly, or (if the obstruction be very great) both this, together with the sensitive, is hindred.

I have sometimes observed in a Palsie, coming after a grievous fit of some other Disease, that all the moving parts, of either side, have been loosened after a more light manner: For though they were not able to perform the more strong motive en∣deavours, yet for the most part they could extend, bend, yea and move their mem∣bers hither and thither, to wit, because the Morbific matter being diffused abroad, thorow both the Streaked Bodies, had not so closely filled every where all the pas∣sages: Moreover, on the contrary, I have known in a Palsie of one side, so suddenly excited, that there has been a far greater resolution, so that they so struck, were not able to move any way hand or foot, nor any other member on the distemper'd side. Further, sometimes it happens, from the Morbific matter being copiously fallen down, and obstructing closely all the Medullary tracts of one of the Streaked Bodies, that all the respective parts, have not only been destitute of motion, but some of

them also of sense; so that some members felt not any painful impression, how vehe∣ment so ever it was. Such a Distemper happening in a lesser degree, is wont to ex∣cite a sense of numness, or pricking or tingling, such as in members lean'd or lain upon.

If it be demanded,* 1.357 why sense is not always hindred as well as motion in every Pal∣sie, since as it seems either is performed by the same Nerves and Fibres, within the same Medullary tracts, so that one faculty is only the inversion of the other? as to this we may say, that as light beams thorow glass, when wind is excluded, so also sense being safe, oftentimes motion is lost. Besides, sense is only a passion, and a sensible impression, which is propagated from the organ, by a continuity of the ner∣vous process, to the common sensory, without any endeavour or labour of the Spi∣rits; which may be done, though the common sensory be in some measure obstruct∣ed, and the Spirits inhabiting it benummed: But motion is a difficult and laborious action, to which is required, that the Spirits expand or stretch out themselves lively, and not only put forth as it were explosive endeavours in the moving organs, but chiefly about the parts, where the beginning of the motion and its first force is, and from thence, in the whole passage thorow the nervous parts. Wherefore, as but a few Spirits and bound, suffice for sense; many, free, and expeditious as to their expansi∣ons, are required for motion.

But that the Morbific matter being slid down into the Streaked Body,* 1.358 the Muscles of the Eyes, Mouth, and Face, do still retain their motions; it is because that some of them, about the beginning of the Spinal Marrow, below all the Nerves, arising from the oblong Marrow, have their place of obstruction; I say, that it is so, because the Nerves destinated to the aforesaid Muscles, (the motions of which are stirred up by natural instincts) and brought from the fifth and sixth pair, even as the Nerves serving the Praecordia and Viscera, derive chiefly the influences of the Animal Spirits from the Cerebel; whose regiment, though the Streaked Body be distemper'd, remains often unhurt.

Not only an obstruction of the Streaked Body,* 1.359 but also a compression sometimes causes the Palsie, as shall be shewed by and by from Anatomical observation; to wit, when the blood is extravasated, and growing cloddery within the inferior cavity of the Brain (and perhaps a Serous deluge is there heaped up) and doth lie heavily up∣on the Streaked Body, and press it together, so that for that reason, the Medullary tracts being bound together, are hindred from the Spirits flowing into them.

Next after the Streaked Bodies,* 1.360 the seat of the Morbific Cause is in the oblong and spinal Marrow; also sometimes in these, though rarely an obstruction, but more often a compression, or a solution of the unity, excite the Palsie.

As to the former, it is not probable, that great plenty of Morbific matter should be sent from the Brain, into this or that part together and in heaps; for such a great and sudden flux hardly happens beyond the streaked Bodies. But it may be suspected, that Narcotick or otherways deadly Particles, being forthwith poured forth into the Brain, and from thence thrust forth into its appendix, doth at first stick within the more narrow spaces of the Medullary Trunk, and then by degrees being heaped up, causes the Paralytick obstruction, whilst these Particles are carried in the Brain here and there, in the Callous or Streaked Bodies they stir up frequent Vertigoes, and mists before the eyes, and sometimes in the motive parts short numnesses; but these being by degrees heaped up together within the Trunk of the oblong Marrow, or the spinal, foras∣much as they possess all or part of its passage, and by that means either obstruct all the Pores of the Spirits at once, or some ranks or orders of them, they bring forth either an half Palsie, or a loosening of some members, sometimes the superior, some∣times the inferior.

I have observed in many,* 1.361 that when, the Brain being first indisposed, they have been distemper'd with a dullness of mind, and forgetfulness, and afterwards with a stupidity and foolishness, after that, have fallen into a Palsie, which I often did pre∣dict; to wit, the Morbific matter being by degrees fallen down, and at length being heaped up some where within the Medullar Trunk, (where the Marrowy Tracts are more straitned than in the Streaked Body) to a stopping fulness. For according as the places obstructed are more or less large, so either an universal Palsie, or an half Palsie of one side, or else some partial resolutions of members happen.

But in either Marrow,* 1.362 and especially the Spinal, an interception or inhibition of the Spirits, creating a Palsie, most often happens from a compression, or a break∣ing of the unity: The extravasated Blood, or the Corruption flowing from the bro∣ken Imposthum, and perhaps a Serous deluge being deposited within the hollowness of the Back-bone; yea also an hard Tumor, being risen somewhere in it, by pressing

together the marrowy rope, shuts up the ways of the Spirits. Further, either a stroke, wound, or bruise of the Head, or spine; yea and a distortion of this latter, do of∣ten pervert or break off the Marrowy Tracts;* 1.363 yea an excess of cold taken in Frost and Snow, straitens and stops up the passages of the Spirits. Those kind of cases, and instances, being obvious enough to common observation, there will not be any need here to speak of them particularly, or to unfold them more largely.

* 1.364Thirdly, The Morbific cause being sometimes planted lower, possesses either the greater Trunks, or the lesser shoots of the Nerves themselves; and that likewise is either an obstruction or a compression, or a breaking of the unity, by reason of any of these ways, and according to the like means of affecting, within the nervous pas∣sages, as in the marrowy, it is wont to be excited.

The oppilative or stopping Particles being fallen down, from the Brain, and carri∣ed forward into the oblong Marrow, enter into the Nerves, destinated to the Mus∣cles of some parts of the Face, and by obstructing the ways of the Spirits in them, bring forth the Palsie in the Tongue,1 1.365 and sometimes a loosening in these or those Muscles of the Eyes, Eye-lids, Lips, and of other parts; and then by reason of the con∣trary Muscles being contracted beyond measure, they stir up a Cramp or Convulsion in the opposite part.

Nor is it less usual, for the same Particles, for that they are fewer, to be carried yet further, without any great hurt into the Spinal Marrow; and lastly going forth from it, to run sometimes into the several Trunks of the Nerves, and sometimes into some handfuls of them; and for that reason, to induce the Palsie to the several Muscles or members, or in some of them only. As often as for this cause, the Mus∣cles of one side of the Neck are resolved, or loosened, the other opposite being too much contracted, render the Neck twisted or awry. It ordinarily happens, by rea∣son of some private Nerves being so obstructed, for some Fingers of the Hand, or Toes of the Feet to be loosened. But if many handfuls of Nerves together happen to be stopped, a Palsie follows, oftentimes in the whole Arm or Thigh. It would be too tedious to mention every case here, by which the Nerves are wont to be stopped, about their beginnings, middle processes, or utmost ends, to wit, the Membranaceous or Musculous Fibres,2 1.366 by reason of compression, or breaking of the continuity, and so deny the exercise of the moving faculty to the respective parts: The reasons of these kind of Distempers are so clear and manifest,3 1.367 and so commonly known, that it would be superfluous to insist on the opening them any longer. But we shall ra∣ther pass to the other conjunct cause of the Palsie, which more immediately affecting the Animal Spirits, and sometimes striking down, and as it were extinguishing them, by mere contact, or as it were by a malignant blast, brings in a resolution or loosening in the respective parts.

* 1.368What we before affirmed in the Apoplexy, we now again do the same in the Palsie, that there are deadly Particles, not only oppilative or stopping, but sometimes Nar∣cotick or Stupefactive, and as it were extinguishers of the Spirits; which kind of af∣fection, if it be strong, causes sometime Paralytick Symptoms, without any great ob∣struction of the ways. The breath or steams of Antimony, Mercury, or Auripig∣ment, often causes weaknesses, tremblings, and loosening of the Members, in such as are long conversant among the Furnaces of Chymists, and of Metals. We may in like manner believe, that in some Scorbutick and very Cacochymical people, heteroge∣neous Particles, and as it seems of a Vitriolick nature (passing thorow the Brain, and its marrowy appendix) do enter into the nervous passages, together with their watering Juice, and cast down some handfuls of the Spirits in them, or suppress their motion. Hence suddenly arise stupors, numness, or looseness in the Members, or Muscles, sometimes in these, sometimes in those, and soon after vanishing in one place, presently spring up again in another: But at length, when these sort of Particles be∣ing abundantly poured forth into the Nerves, and laid up in heaps, they become variously fixed here and there; and moreover, shut up the ways of the Spirits, and so cause a fixed and permanant Palsie.* 1.369 And indeed, in every Palsie, made by obstru∣ction, the Morbific matter is not thick and cold Phlegm, (as Galen and many other Physicians have asserted) for such doth not pass thorow the Brain, much less the nervous passages; but it seems to consist of most subtil and very active Particles, though in∣festous or deadly to the animal regiment: But indeed the Palsie happens in Men, no otherwise than the blasting, or burning, or withering in Trees; because some winds being indued with very frigid or cold blasts, to wit, with a Nitrous or a Vitriolick Spiri•••• when they blow upon the green and tender sprigs of trees,* 1.370 cause them sudden∣ly to wither, for that the tender stalks like Nerves every where inter-woven with the sprigs and leaves, are bound together by the blast of the malignant air so fully,

that they receive not any more the Juice sent from the Trunk or Root, by reason of which defect they wither. Much after the same manner, extraneous Particles, and as it were Vitriolick, being admitted within the organs of sense and motion, for that they at once bind up the Pores, or cast down or suppress from motion the Animal Spirits, cause in the respective parts, as it were a withering or drying up. But this is not so caused by mere Phlegm, or a Serous ••••ood, as plainly appears, because those indued with a moist and cold Brain, have always their Nose and Eyes moist, with the distillation of a snotty or watry humor; yea those who are troubled with a Drop∣sical Brain, in which the Brain, and the tops of either Marrow do as it were swim in water, are not for that reason disposed to the Palsie, unless by the pressing toge∣ther of the Marrow.

We have hitherto described the various cases of the Palsie,* 1.371 and the means by which it is caused, together with their ••everal formal reasons, and conjunct causes. As to what belongs to the other causes of this Disease we must first distinguish, that it is either accidental or habitual: The former happens to some, from a solitary evident cause, such as a stroke, wound, bruise, and excess of either heat or cold, without any pre∣vious disposition; and besides this, and the conjunct cause, which for the most part is a compression, or breach of the unity, it hath none: The habitual Palsie depends upon a Procatartick cause, which is always an extraneous, and as it were a Vitriolick matter begotten somewhere before, and heaped up, which being from thence suffused into the organs of sense and motion, for that it stops up the marrowy or nervous Tracts or sometimes profligates the Spirits by mere contact, or effects both together, brings forth loosenings in the respective parts, by reason of the influence of the Spirits be∣ing deny'd them.

This kind of Procatarxis or foregoing Cause,1 1.372 depends upon a twofold antecedent or secret leading cause, to wit, one remote, which is a vicious Blood, carrying to the Head a Morbific matter, either begotten in it self, or taken from the Bowels, or some other place; and the other more near, which is an indisposed Brain, to wit, weak, and too lax or loose, or otherways evilly made, and so easily admitting heteroge∣neous, or strange and deadly Particles.

The Morbific matter being brought to the Brain,2 1.373 sometimes induces the Palsie primarily, but more often secondarily, and not but after other Diseases first ex∣cited.

The reason of the former, (to wit, that the habitual Palsie be a primary Disease, and by it self) requires these two things, viz. That the heterogeneous Particles be disposed chiefly for the causing or stirring up the Palsie; then that they be admitted by degrees, and but in small quantity, for if they enter in great heaps, they would first cause the Carus or Apoplexy: and if they be not of a plain Vitriolick nature or qua∣lity, when having passed thorow the Brain, they come to enter into the organs of Sense and Motion, they would first occasion in them Convulsive and painful Di∣stempers, yea sometimes the Colick, Gout, or Scurvy first, and then at length, the Palsie.

2. The secondary Palsie often succeeds Distempers for the most part Chronical,* 1.374 after the natural and vital faculties being by them very much hurt: a slow and long Feavour, strength being at length worn out, causes oftentimes enervations or resolutions of the whole Body, or of some Members. Long and immoderate sadness, a Consumpti∣on, a Scorbutick Atrophy or wasting, being long fixed in Bed, unhealthy old Age; yea and many other passions, after a notable evil first brought to the Brain, and ner∣vous Stock, at length brings on the Palsie. But indeed this Disease more frequently comes upon some other Distempers, either of the Brain, as chiefly the Carus and Apoplexy, or of the nervous stock, and such chiefly are the Scurvy, Convulsions, Colick, and Gout. By what means it succeeds Cephalick Diseases, we have already shewed in this; and how the Scurvy, in another tract: we shall now inquire how it is often the off-spring of the other three.

1. We have shewn already,* 1.375 that the Spasme or Cramp or Convulsion, doth some∣times bring in the Palsie, to wit, when from contrary or opposite Muscles, being one of them loosened and the other pulled together: Further, it is an usual thing, for those who are long obnoxious to Convulsive Distempers, to suffer at length de∣bilities in some members, and at length resolutions or want of motion. I have known many Epileptical persons, and others troubled with Convulsions, by reason of the motive function being abolished or inhibited, in this or that part, to become at first lame, and then Bed-rid; the reason of which seems to be, because the Morbific matter, being continually admitted within the tracts of the Brain and its appendix, both medullar and nervous, and often thrust forth, doth at length so debilitate and

dilate them, so that it gives an open passage besides to other kind of Particles, either Narcotick or Vitriolick; by reason of which, the Palsie comes after the Convulsion. Further, I have often observed, by reason of the diverse mingling of the Morbific matter, (like as when Rain and Snow happen together) that the sick have at once been infested both with Convulsive motions, and the Palsie. A notable example of this, with the reason of it, we have fully described in our Tract of Convulsive Diseases, Chap. IX. p. 115.

* 1.3762. They who are frequently and grievously obnoxious to the Colick, at length be∣come also Paralytick. The case is so frequent here, that the succession of this Disease is accounted among its prognosticks; for those who are wont to suffer cruel fits of tor∣ments in the Belly, returning by intervals, or are troubled with pains about the Viscera of the Abdomen, cruel and almost continual, at length have wandring pains in their Body and Members, and then afterwards stupors or numness, and lastly resolu∣tions or want of motion. The cause of these effects proceeds, both from the seat of the Disease, and the Morbific matter being changed, to wit, this, which being very small but sharp and irritative, runs only into the Sphlanchnick Nerves, and so by reason of the Fibres of the Viscera being pulled, did stir up in them Cramps and pains; after∣wards becoming more copious, and also duller and Narcotick, pours down thorow the Spinal Marrow, and entering into the Nerves destinated to these or those Mem∣bers or Muscles, brings forth resolutions in the respective parts. We shall more large∣ly shew the reason of this, when we treat of the Colick▪

3 1.377It is a very ordinary observation, that the Palsie comes upon the Gout frequently, in the Members obnoxious to it; the reason of it is easily known, forasmuch as in this sickness the Morbific matter is twofold, and doth depose salt and as it were lixi∣vial Particles thorow the Arteries, and as we suppose others sourish or acetosous to come to them by the Nerves; (as shall be more largely shown hereafter) it is no wonder, if that at length, other sorts of Particles become companions to them, by other beaten ways, and at length either by filling or by compressing, obstruct the very small passages of the Spirits.

* 1.378As to what belongs to the evident causes of the Palsie, to wit, for what fore-causes or occasions those disposed to this Disease contract it the sooner, or that having been taken with it already, are yet wont to be more grievously tormented; I say, what∣soever doth more vitiate the Blood, also those things that stop up the Brain and its nervous appendix, or stir up suffusions of the Morbific matter in it, also what do in∣flict a Narcosis or stupefaction to the Spirits, or lessen their numbers, may be brought hither. In this rank first occur the disorders in the six non-naturals, an evil man∣ner of living, drinking thin clear Wine, or strong hot liquors, too much sleep, or too untimely, an idle and sedentary life, immoderate Venus, too much loss of blood, a moist Air or Marshie dwelling, an House new Plastered, Metalick fumes and va∣pors, frequent use of Narcoticks, or stupefying Medicines, or too much taking To∣bacco, excess of cold, heat, or moisture, vehement and long passions of sadness or fear, with many others, all which we have not here leasure to recite.

* 1.379Thus much concerning the Palsie, in which the loco-motive faculty is abolished or lost, or very much hindered; by reason of the ways of the Spirits being obstructed, and themselves affected with a certain stupefaction, in the whole, or in the respective parts. There follows another kind of this Disease, depending up∣on the want and fewness of Spirits, in which, although motion be not deficient in any part or member wholly, yet it is not performed by any but weakly and depra∣vedly only. For though the distemper'd are free from want of motion, they are not able however to move their members strongly, or to bear any weight; moreover, in every motive indeavour, they labour with a trembling of their limbs, which is on∣ly a defect of debility, and of a broken strength in the motive power. For when strength is wanting for the lifting up of any member firmly, and at one essay or en∣deavour, Nature flagging, acts with a more often repeated tryal or endeavour, and so the part being in motion, is compelled as it were to shake and tremble. To which happens, that when the nervous Fibres flagging or growing weak, they are not able to sustain the Tonick endeavour, or the stiffness in the Animal regiment, and these endeavouring or striving to exert or put forth their utmost power, enter into mo∣tions as it were Convulsive, and reiterate them perpetually. Wherefore, in some Paralyticks, there is always a trembling and shaking in all the limbs.

Those who thus become Paralytick, by the paucity or want of Spirits, and so from their small or diminished dispensation into the nervous System, are made ob∣noxious to such a Distemper, by reason of various causes and occasions.

First,* 1.380 Extream or unhealthy old age, or immoderate loss of blood, or the genital humor, induce this kind of Paralytick disposition in many men; to wit, because from the wasted blood and almost liveless, there is stilled forth into the Brain but a very small stock or provision of Animal Spirits.

Secondly,2 1.381 Almost for the same reason, the loco-motive faculty grows weak or fails in persons greatly Scorbutick, and such as are full of indigested juice; for such not being fit for any strong exercise, go infirmly and weakly, and are very much tired by any long or swift walking; further, by any more heavy endeavour, they suffer of∣ten times a numness in their limbs, with an impotency of moving them. For indeed, the bloody Mass is in these very watry, and stuft with impurities, and for that the Brain being weak and loose, as to its Pores, admits easily all sorts of filthinesses into it self; wherefore, fewer Animal Spirits being only created, and those not clear and sub∣til, but dull and hindred, by the adhesion of a more thick matter (although there is not always an obstruction of the ways, or a Narcotick disposition) they are not a∣ble to unfold themselves into motive endeavours.

Thirdly,3 1.382 Not only Scorbutical persons, but also many others, hardly and long growing well from some Chronical Disease, are distemper'd with Members very much loosened from their due vigor and strength, and with a languishing of their Limbs; that though they are well in their stomach, and have a good and laudable Pulse and Urine, yet they are as if they were enervated, and cannot stand upright, and dare scarce enter upon local motions, or if they do, cannot perform them long: yea, some without any notable sickness, are for a long time fixed in their Bed, as if they were every day about to dye; whilst they lye undisturbed, talk with their Friends, and are chearful, but they will not, nor dare not move or walk; yea they shun all motion, as a most horrid thing. Without doubt in these, although the Animal Spirits do after a manner actuate and irradiate the whole nervous Stock, yet their numbers are so small, and in so few heaps, that when as many spirits ought to be heaped together somewhere in it for motion, there is great danger lest presently in the neighbouring parts,* 1.383 their continuity should be broken. Wherefore, when the spirits inhabiting the Brain, are conscious of the debility of others disposed in the Members, they them∣selves refuse local motions, for that it would be too difficult a task to impose on their companions; wherefore, the sick are scarce brought by any perswasion, to try whe∣ther they can go or not; Nevertheless, those labouring with a want of Spirits, who will exercise local motions, as well as they can, in the morning are able to walk firmly, to fling about their Arms hither and thither, or to take up any heavy thing; before noon the stock of the Spirits being spent,* 1.384 which had flowed into the Muscles, they are scarce able to move Hand or Foot. At this time I have under my charge a prudent and an honest Woman, who for many years hath been obnoxious to this sort of spurious Palsie, not only in her Members, but also in her tongue; she for some time can speak freely and readily enough, but after she has spoke long, or ha∣stily, or eagerly, she is not able to speak a word, but becomes as mute as a Fish, nor can she recover the use of her voice under an hour or two.

In this kind of spurious Palsie,* 1.385 arising from the defect, or rather the weakness of the Animal Spirits, than from their obstruction, it may be suspected, that not only the Spirits themselves, as to their first numbers of them, and particular originals, are in fault; but besides, that sometimes the imbecillity and impotency of local motion, doth in some measure also depend upon the fault of the explosive Copula, suffused every where from the blood, into the moving Fibres. For indeed, from a very Cacochymical blood, or full of juice, and for that cause vappid, and liveless; as the Animal Spirits are but few, that are instilled into the Brain, so it is probable, that those themselves derived from the Brain, into the Nerves, being disposed at length with∣in the muscular Fibres, do meet with other Nitro-sulphureous Particles (which we have somewhere shown to be necessarily required to the Musculary motion) from the so vitious blood that are but dull, and degenerate, from the Elastick power; where∣fore indeed the Spirits being concreted so evilly within the Muscles, even as Gun-powder being full of more thick feculences, rarely and weakly perform the acts of explosions.

As to what belongs to the other species of the Palsie,2 1.386 in which the sensitive faculty is also affected, we say, that this is hurt either by it self, or together with the mo∣tive; and such an hurt of both together, doth almost only happen, forasmuch as the passages and ways of the Spirits are more firmly shut up, so that whether they tend forward or backward all their irradiation is intercepted: That sometimes hap∣pens, though rarely from the Morbific matter fallen down from the Brain into the ob∣long Marrow, but more often by reason of a grievous hurt of the Spine or Back-bone,

as from a fall from on high, stroke, or wound inflicted on them: For from such oc∣casions, by compressing the marrowy cord, or by too much distending or writhing it, all the tracts of the Spirits are blotted out.

3 1.387Sometimes the sensitive faculty is hurt by it self, the motive being still safe; this is sufficiently obvious, and the reason very clear, of the organs, whose Nerves are only sensible, to wit, as of the sight, hearing, tast, and smell. But indeed, that in the extream habit of the body or members, the touch or feeling sometimes perishes, the loco-motive power being unhurt; as is ordinarily discerned in Lepers, those distem∣per'd with the Elephantiasis, and some Mad-men, who are wont to go naked, and lye on the ground, whose skin and musculous flesh are so benumned, that they feel not the gashes made in their flesh with a Pen-knife, nor Needles any where thrust into them;* 1.388 this I say seems very hard to be unfolded. But as to this it may be said, that perhaps the same Nerves, carry the instincts of motions, and the impressions of sensible things forward and backward, or to and fro, but that the same Fibres, which are loco-motive, are not altogether or chiefly sensible. We have elsewhere shewed, that its power is performed by the tendinous and musculous Fibres; but the sensible Species, is almost only received by the membranaceous Fibres; wherefore, the outer skin is the primary organ of feeling; after this, the Membranes covering the Mus∣cles, and lastly those constituting the Viscera, are somewhat affected by the Tangible object.* 1.389 Wherefore, the loss or hurt of feeling arises, by reason of an hurt, brought to the exterior Membranes; to wit, when the Fibres of these are obstructed by a Vitri∣olick matter, or are benummed very much by excess of cold; so that the Animal Spi∣rits, which ought to receive their impressions, are excluded from their organs. And indeed, from hence it appears, that these inhabiting the exterior Membranes, are on∣ly affected, because sense being lost, the members wither not, as when deprived of motion, but remain full and round; which is a sign that the Animal Spirits entring still the Nerves, and fleshy Fibres, do contribute their virtue to the office of nou∣rishment; after what manner we have already shewn; but when motion is lost, the Spirits are almost wholly banished from those parts, and the flesh consumes, because the nourishing matter, though carried thorow the Arteries, is not assimulated. We have largely discoursed of this in our Treatise of the Nerves.

* 1.390The Theory of this many-form'd Disease being now at length finished, its kinds and differences, all, or at least the most and chiefest of it, together with the reasons of each of them, being rehearsed in order, we shall shew next those things which belong to its prognosticks and Cure.

1 Every Palsie, whether accidental or habitual, and either of them, whether uni∣versal or partial, or whether suddenly excited or by degrees, if it happens that the knowing and vital faculty be unhurt, it ought not to be accounted an acute Disease; but being free from sudden danger, admits a long Cure, or at least an endeavour of it.

2. This Disease coming from a solitary evident cause, as from a stroke, a fall, wound, &c. or coming upon the Apoplexy, Carus, Convulsion, the Colick, or other Distempers of the Brain, or nervous System, if it be not in a short time altered for the better, or gives not place to Medicines, it remains for the most part incure∣able.

3. If that a total resolution follows, from a total obstruction in the beginning of the oblong Marrow, or from the Back-bone being vehemently hurt, and that sense and motion are both taken away, the Distemper is hardly, or scarce at all to be Cured.

4. Those who are once cured of a Palsie, arising from an evident solitary cause, do not so easily relapse into the same, as when the Disease depends upon a procatartick cause.

5. A Palsie, happening to men of years, to Cacochymical, very Scorbutical, and in∣temperate persons, although the Distemper be not very great, is difficultly Cured.

* 1.391As the Palsies are manifold, and are from diverse causes, so the Cure is not to be instituted always after one manner, but after a various method, to wit, appropriate to every kind of this Disease.* 1.392 For the most part there are these three kinds of it, or rather there are three means of healing; of which there ought to be had con∣cerning the Cure of this Disease, now this, now that, or now another; to wit, be∣cause resolution (whatever, or in what place soever it be) is either caused, 1. from an external accident, as a stroke, a fall, a wound, excess of cold, or the like, suddenly: Or 2. It succeeds to some other Distemper, as the Apoplexy, Carus, Colick, or a long Feavour: Or, 3. It is primary and a Disease by it self, by degrees excited, and de∣pending upon a procatartick cause, or a previous provision. Concerning each of these, we shall speak particularly.

1. Therefore,1 1.393 when the Palsie is caused, by reason of some accident, with a vehe∣ment hurt, there are not many intentions of healing; but only that the part hurt may recover its pristine conformation. And first of all, that the Blood and other humors flow∣ing to it, being weak and distemper'd, and staying there, might not increase the hurt, Phlebotomy is most requisite in this case, and presently to be celebrated; then the belly being made slippery by the use of Clysters, and a slender dyet, if the matter requires it, let there be instituted either easily digested meats, or moderate Hydroticks, or water meats; to wit, that whilst the sick is kept in bed, he may continue in a gentle sweat, that all the superfluities may copiously exhale from the hurt part, and that the Spirits being gently agitated, may repeat their former ways and tracts, within those Pores and passages, so unlocked by the warm Effluvia's.

For this end,* 1.394 the Powder ad Casum, described in the Augustan Pharmacopoea, or as it is in ours, is of common use; let there be given of Irish Slate, to the quantity of about a dram, in a draught of white Wine warm'd, or of Posset-drink made of it; and repeated every six or eight hours. Besides, if there be at hand the Decoctum Traumaticum, let it be taken ever now and then, frequently in Posset-drink, or a Decoction of the Roots of Madder, or of Butter-bur, or of St. Iohns-wort Flowers.

Further,* 1.395 in the mean time, let the distemper'd part be carefully lookt to, which may be easily known, partly from the hurt inflicted, and partly from the loosened members. If there be any thing dislocated in it, you must take care that as soon as it can, it may be put again in its place; if a Tumor, Contusion, or a wound be ex∣cited, they are to be succour'd by Balsams, Liniments, Stuphes or Fomentations, or Pultesses: But if nothing preternatural appears outwardly, let a Plaster of Oxy∣crocium and of Red-lead, each alike, what will suffice, be laid upon it, and let the sick be kept quiet, and in a moderate heat, for three or four days. If the resoluti∣on remains confirmed, and the afflux of new matter be not feared, let more resol∣ving and discussing Remedies be applied to the distemper'd places; wherefore, make use of Fomentations, and hotter Oyntments, yea natural Baths, if they are at hand, or at least artificial. Sometimes it may be expedient for the distemper'd Members to be wrapped in Horse-dung, or in warm grains, and to be kept so for some time; and lastly, between whiles, besides the use of these, to add Clysters and gentle Purges. But if no help follows these administrations, the sick ought then to be handled with the like long method, and with the same Remedies, as those that have an habitual Palsie, or any other coming upon other Diseases and confirmed; which means of Cure, for every common Palsie more deeply rooted, shall be shewed anon.

2. When the Palsie coming upon a Feavour,2 1.396 Apoplexy, Carus, or other Cephalick or Convulsive Diseases, is greatly and suddenly excited, first the Physician ought to endeavour the taking away of the conjunct cause, which hath almost ever its seat in the oblong or spinal Marrow. Wherefore, at the beginning of the Disease, Blood∣letting, and Purging (if nothing shews the contrary) Clysters, Vesicatories, Cupping-glasses, Sneezing Powders, Oyntments, and other administrations used in Cephalick Diseases, to wit, which by any means may shake off, or pull away the deadly matter, fixed to the Medullary Trunk, or to the little heads of the Nerves coming from it, are to be made use of. If that at first, the force of Medicine effects nothing within fif∣teen or twenty days, for that the Distemper is radicated, and become habitual, it must be expunged by a long method, and equally by preservatory as well as curato∣ry Indications; of which we shall speak anon.

3. The habitual Palsie,* 1.397 depending upon a procatartick cause, whether it be in fieri or in disposition, or whether it be made, or in the nest or bird, either requires a pe∣culiar means of healing

There are two chief causes of the former,* 1.398 in both which the Curatory Method, re∣specting only the fore-leading Causes, is designed after the like manner, to wit, whe∣ther any falling dangerously ill of the Palsie, or growing well of it, relapses into dan∣ger, the same Remedies almost are to be insisted on.

The intentions therefore of healing are,* 1.399 First, That the offices of Chilification, and of making of Blood, be rightly performed, and matter for the procreating the Animal Spirits be supplied, both laudable and sufficient to the Head; then, Secondly, That the Brain being still firm and well made, the heterogeneous Particles being excluded, it may admit all that are fitting, and rightly exalt then into Animal Spirits. For these ends, I think convenient to propose the following method, which ought to be varied, according to the various constitutions of the sick,

In Spring and Fall, that they enter into the ordinary course of Physick, yea the whole year besides, some Remedis are in constant use. Blood-letting is not always convenient to all men: But though we forbid this, it is not for the same reason with

the Ancients, supposing the Palsie to be a cold Disease, but because the Animal Spi∣rits, are both procreated out of the Blood, and become also Elastick in the motional Fibres, by reason of the bloody Copula; therefore, if plenty of this be taken away, they grow weak and deficient. Which thing indeed I have observed in many, and for the most part languishings and tremblings to have been begun in the Arm, out of which the blood had been taken.* 1.400 However in some, indued with a sharp and hot blood, and apt to flame forth too much, though disposed to the Palsie, it is sometimes convenient to let blood a little and sparingly.

* 1.401About the Aequinox, a Purge ought to be instituted, and after due times between, to be iterated three or four times. But first, if nothing oppose, let a Vomit be given, of the Salt of Vitriol, Sulphur of Antimony, or an Infusion of Crocus Metallorum, or of Mercurius Vitae; then let there be taken Pills of Amber, or of Aloephanginae, by it self, or with the Resine of Ialap, every seventh or eighth day. At other times we prescribe Cephalick Remedies,* 1.402 such as in the sleepy Diseases: viz. Electuaries, Powders, Spirits, and Volatile Salts, Tinctures, Elixirs, with distilled Waters and Apozems, sometimes these, sometimes those, or others. Let Issues be made in the Arm or Leg, yea in fat people, and such as are full of ill humors, in both together, or between the shoulders. Let them drink all the year medicated Beer of Sage, Betony, Ste∣chades, Sassafrass Wood, and Winterines Bark. Wine and Women ought to be for∣bidden, or but moderately to be used.

2 1.403If that the Palsie be excited, after a previous disposition, either of one side, or in some members, and that it still continues, notwithstanding the first attempt of Me∣dicine, a long and complicated method is always requisite, and oftentimes doth not suffice; for not only the Disease, or its conjunct cause, or its foregoing severally, but all together ought to be opposed: for which ends Phlebotomy being for the most part interdicted,* 1.404 only a gentle Purge and rarely is convenient. Besides, some chief Ce∣phalick Medicines, and Antiscorbuticks are wont to help against the foregoing cause of this Disease. But all of this sort, are not convenient to all; yea as we have observed in the Scurvey, according to the various Constitutions of the Sick, there are also Re∣medies of a diverse kind and virtue. For to Cholerick Paralyticks, to wit, in whose sharp and hot Blood there is much of Salt and Sulphur,* 1.405 and very little of Serum, the more hot Medicines and indued with very active Particles, are not agreeable, yea are often hurtful; which things notwithstanding are very profitable to Phlegmatick per∣sons, whose Blood is colder, and contains much of Serum, and but few active Ele∣ments. Wherefore, for this twofold state or condition of sick persons, it seems con∣venenient that we institute here a double Method of Cure, and two classes of Medi∣cines, of which these may be given to cold Parlyticks, and those to the hot.

* 1.406In the former case, for the taking away the Procatartick cause, after Vomiting and Purging being rightly instituted, I was wont to prescribe according to these follow∣ing forms.

* 1.407Take of the Conserves of the leaves of the Garden Scurvy-grass, of Rocket, made with an equal part of Sugar, each three ounces; of Ginger Candied in India half an ounce, of the rinds of Oranges and Lemons Candied, each six drams; of the Powder of the Claws and Eyes of Crabs, each four scruples; of the Species of Diambre two drams, of Winterens Bark one dram and a half, of the Roots of Zedoary, the lesser Galingal, of Cubebs, the Seeds of Water-Cresses, Rocket, each one dram; of the Spirits of Scurvy-grass, Laevender, each two drams; of the Syrup of Candied Ginger, what will suffice to make an Electuary. Take of it about the quantity of a Walnut, at eight of the Clock in the Morning, and at five in the Afternoon, drinking after it a pint of the following Decoction,* 1.408 warm, or Coffee, with the leaves of Sage boiled in it six ounces, of or ••per Wine three ounces.

* 1.409Take of the shavings of Lignum Sanctum six ounces, of Sarsaparilla, and of Sassaphras, each four ounces; of white and yellow Sanders, of the shavings of Ivory, of Harts-horn, each half an ounce; infuse them according to art, and boil them in sixteen pints of Spring water, till half be consumed, adding of Crude Antimony in Powder, and tyed in a rag four ounces, of the Root of the Aromatick Reed, of the lesser Galingal, each half an ounce; of the Florentine Iris one ounce, of Cardamums six drams, of Co∣riander Seeds half an ounce, six Dates; make a Decoction to be used for ordinary drink.

* 1.410Going to sleep, and first in the morning, let a Dose of the Spirits of Sut, or Harts-horn, or of Armoniacal Amber, or of Blood, &c. be taken, with three ounces of the following distilled water.

* 1.411Take of the leaves or roots of Aron one pound, of the leaves of Garden Scurvey-grass,

of the greater Rocket, of Rosemary, Sage, Savory, Thyme, four handfuls; of the Flow∣ers of Lavender three handfuls, the outer rinds of ten Oranges, and six Lemons, of Winterans Bark three ounces, of the roots of the lesser Galingal, of Calamus Aroma∣ticus, the Florentine Iris, each two ounces; of Cubebs, Cloves, Nutmegs, each two ounces; all being cut and bruised, pour to them of white Wine, and of Brunswick Beer or Mum, each four pints: distil it in common Stills, and let all the liquor be mixed together.

Sometimes in the place of the Electuary may be taken for fifteen or twenty days a Dose of the Tincture of Sulphur Turpentined,* 1.412 of the Tincture of Antimony, or of Am∣ber: Also sometimes Elixir Proprietatis, or of Poeony; let them be taken in a spoon∣ful of distilled Water, drinking after it three ounces of the same: Also sometimes the following Powders or Lozenges may be taken by turns, in the medical course.

Take of the Powder of Vipers flesh of Monpillier prepared one ounce, of the hearts and livers of the same half an ounce, of Species Diambre two ounces; make a Powder, take one dram once or twice a day with the distilled Water three ounces, or with Viper Wine, with a Decoction of the leaves of Sage, of the root and seeds of the Burdock, and the Candied roots of Eringo, made of Spring-water, what will suffice, and boiled to one moiety; six or eight ounces in the Morning warm, expecting to sweat after it.

Take of Bezoartick Mineral Solar half an ounce,* 1.413 of Cloves powdered two drams; min∣gle them, make a Powder and divide it into twelve parts, let one be taken after the same manner, twice in a day; between these kind of Remedies, gentle purging may be often used.

Take of the Powder of the picked roots of Zedoary,* 1.414 the lesser Galingal, each half a dram; of Species Diambre one dram, of the Powder of the seeds of Mustard, Rocket, Scurvygrass, Water-Cresses, each half a dram; make of them all a fine Powder, add to it of the Oyl of the purest Amber half a dram, and with white Sugar dissolved in the compounded Poeony water, and boiled up to the consistency of Lozenges six ounces: make Lozenges according to art, weighing each half a dram: Eat of them three or four twice in a day, drinking after every Dose, of the liquors before mentioned.

Take of the Powder of Virginian Snakeweed two drams,* 1.415 of the lesse•• Galingal one dram, of the gummed extracts of the remains of the distillation of the Elixir Vitae of Quer∣citan two drams, of the Flowers of Sal Armoniack, (or the most pure Volatile Salt of Sut or Harts-horn) one dram, of the Balsom of Peru one scruple, of the Balsom of Capivus what will suffice to make a mass; let it be made into small Pills involved in the Species Diambre. The Dose is half a dram evening or morning.

Take of the Resine or Gum of Guaicum three drams, of the Species Diambre one dram, of the Chymical Oyl of Guaicum rightly rectified one dram and a half, of liquid Am∣ber what will suffice to make a mass: let it be formed into Pills, to be taken after the same manner.

If that the Palsie happens in a Cholerick temper,* 1.416 or to a young Man, it admits on∣ly of milder Medicines, and all the more hot things, and Elastick, do but imbitter the Disease: The following forms are in use, for the taking away of its foregoing cause.

Take of the Conserves of the Flowers of Betony,* 1.417 of Fumitory, of Primroses, each two ounces;; of the Species Diambre one dram, of Ivory, Crabs Eyes, and Claws, each four scruples; of the Powder of the Flowers of Poeony two drams, of Lignum Aloes, of yellow Sanders, each one dram; of the Salt of Wormwood one dram and a half, and with the Syrup of the Flowers of Poeony what will suffice, make an Electuary. The Dose is two drams twice in a day, drinking after it, either the simple water of the Flowers of Aron, or of the following Compounded Water three ounces, or of the Decoction of Sage, with the leaves of Tea infused in it four or six ounces.

Take of the Roots of Aron or Cuckopint,* 1.418 of the male Poeony, Angelica, Imperatoria, each half a pound; of the Flowers of Sage, Rosemary, Marjoram, Brooklime, Water-Cresses, each four handfuls; of the rinds of six Oranges, and four Lemons, of Prim∣roses, Cowslips, Marigold flowers, each three handfuls; let them be all bruised and cut, and pour to them of new Milk six pints, of Malaga Wine one quart; distil them in common Stils, and let the whole liquor be mixed together.

Sometimes instead of the Electuary may be taken between whiles,* 1.419 for fourteen or fif∣teen days, of the Syrup of Steel, of which let one spoonful be taken in three ounces of the distilled Water: It may be made after this manner.

Take of the whitest Sugar dissolved in black Cherry Water, and boil'd up to a consistency, eight ounces, adding to it of our Steel in Powder three drams; let them be stirred to∣gether over the fire, and then by degrees pour to it of the Water of Rosemary warm twelve ounces; let it boil gently for a quarter of an hour, scumming it, and pouring it forth warm thorow an hair sieve or strainer.

There may be also made steeled Lozenges after this manner, to wit, with Sugar sufficiently boiled with Steel, adding of the Chymical Oyl of Amber or of Rose∣mary half a dram, and presently let it be poured forth that it may flow into a con∣sistency of Lozenges: The Dose is two drams twice in a day, drinking after it of distilled Water, or of the following Apozem six ounces.

* 1.420Take of China Root one ounce, of the shavings of Ivory, Harts-born, each half an ounce; of white and yellow Sanders, of the Wood of the Mastick-tree, each half an ounce; let them be infused in warm water and close stopt for a whole night, six pints; in the morning add to them of the Roots of Chervil, of sweet smelling Avens, of Broom, and Parsley, each one ounce and a half; of the dryed leaves of ground Ivy, Sage, Germander, Betony, each one handful, of Coriander seeds three drams; let them be boiled till half is consumed, then add to it of white Wine half a pint, and strain it in∣to a jugg, upon the leaves of Water-Cresses bruised two handful: Let it infuse warm and close shut, for two hours, strain it again, and keep it in a close Vessel well stopt.

In the Scorbutick Palsie, the Juices and expressions of Herbs, do often bring no∣table help.

* 1.421Take of the leaves of Brooklime, Water-Cresses, and Plantan fresh gathered, each four handfuls, bruise them together, and pour to them of the distilled Water but now descri∣bed eight ounces, squeese the juice strongly forth, and keep it in a glass, and take of it twice or thrice in a day three or four ounces.

At the extream Physical hours, viz. Morning and Evening, may be taken these following Pills.

* 1.422Take of Millipedes prepared three drams and a half, of Pearls one dram and a half, of the Root of the Cretick Dittany one dram, Venice Turpentine what will suffice to make a mass: let it be formed into small Pills, the Dose is half a dram, drinking af∣ter it a draught of the distilled Water.

For ordinary drink, let there be prescribed, either a Bochet of Sarse, China, yel∣low Sanders, &c. or small Ale, with the dryed leaves of ground Ivy, boiled in it; and of Sage, with the Wood of Sassafras, infused therein.

2. Whilst these things are doing, for the taking away the foregoing cause of the Disease, there is no less a curatory care required, for its conjunct cause; to wit, that all obstructed places being opened, they might admit the Animal Spirits, free from stupefaction, and that they may pass freely thorow.

There are two chief kinds of Remedies, which conduce to those ends, viz. one particular and private, to be applied to the distemper'd places: to wit, that by Fo∣mentations, Oyntments,* 1.423 Plasters, and such like outward applications, the sleepy Spirits might be awakned, and their passages opened: the other universal, to wit, that the Blood and Spirits, and the other humors (and the active Particles flowing in the whole Body) being very much agitated, and put into a rapit motion, like a tor∣rent, they might cast down and remove all impacted heaps or stays, by which the Spi∣rits are obstructed.

The administrations used to the distempered parts are so ordinarily and common∣ly known, that it were superfluous to insist here on the describing them more largely. First Liniments, made out of Oyls, Oyntments, and Balsoms, are to be applied ac∣cording to the temper of the Patient, more or less hot, and with frictions or strong rubbing twice a day. Sometimes, before these are made use of, Fomentations made of Cephalick Herbs, or spices boiled in Spring Water, adding to it sometimes Strong Waters, Wine, or Bear or their Lees. Further, oftentimes it is convenient to make about the distemper'd places Blisters, and to use Cupping-glasses, and Medicines to take away the hairs, and to raise pimples. Little Bags and Plasters often help. More∣over, if the business will admit it, let the Paralytick members be covered over with

hot grains, or with the refuse of the Grapes when flung out of the Wine-press; or let them be thrust into the belly of a Beast new slain, or bathed in an artificial Bath, or in the natural Baths, and be kept for a long while in any of these.

But if these help not,* 1.424 you must then come to universal Remedies, or great Reme∣dies; of which sort, in the first place, are Diaphoreticks or sweating Medicines, Mer∣curial Medicines stirring up Salivation; and strong Vomiting Medicines: of each of which we shall speak briefly.

In the Cure of the Palsie,1 1.425 sometimes Diaphoreticks, or Medicines causing sweats, do very much help; and that they sometimes are hurtful, the common people do ordi∣narily observe. Wherefore it is very requisite, that we should unfold the reasons of this so different effect; and that so indications may be taken as to the use or rejecti∣on of them.

Therefore,* 1.426, a plentiful sweating is wont to be helpful sometimes to Paralyticks, chiefly for two reasons; to wit, for that it doth thrust forth or exterminate in a great measure the impurities of the Blood, and the nervous juice, being apt to breath forth; so that the Morbific matter doth not flow any more to the Brain, and the di∣stemper'd parts; and that whatever hath already flowed forth from them, is partly conveyed forth of doors. Then, Secondly, Because the Effluvia's of heat falling away from the boiling blood, do very much open the nervous Passages before obstructed, whilst in evaporating they pass thorow them, and make an open way for the Spirits. Wherefore this administration is chiefly and almost only convenient for those, whose Blood is not stuffed with fixed Salt and Sulphur, but is diluted with a limpid and saltless Serum. For on the contrary, Paralyticks whose blood and humors are full of fierce, Exotick, and fixed Particles of enormous Salts and Sulphur, and unfit to be exhaled,* 1.427 do often receive great harm by a violent and forced sweating. Of this kind of effect we have assigned these two causes, to wit, because that the Morbific Particles, by reason of agitation being too much exalted, become more outragious; then second∣ly, because these being more plentifully brought to the Brain and nervous Stock, they oftentimes increase the old obstructions, and not rarely produce new.

That a plentiful sweating or Diaphoresis may be easily provoked, both internal Me∣dicines, and outward administrations are wont to be made use of. The former stir up either the Blood or Serum into an heat, or provoke the heart into more swift moti∣ons; and for that cause (whether one or both be done) when the bloody liquor is ra∣pidly circulated thorow the Heart and Vessels, and is wrought into a frothy swelling up, there is a necessity, that very many Effluvia's, which are the matter of sweat, should go away from it.* 1.428 For this end, Medicines of a various kind are commended to Paralyticks, of which the most noted are, a Decoction of Guaicum, Sarsaparilla, &c. Spirits and Oyl of Guaicum, the simple mixture, Flowers and Spirits of Sal Armoniack, Aurum Diaphoreticum, the Salt of Vipers, as also the Powder and Wine of the same: the solar Rezoartick minerale, Tincture of Antimony, &c.

External administrations move sweat, because they hold in, and stir up the mode∣rate heat in the whole body; and so the blood being made hot, is compelled to move more swiftly, and to evaporate more, and at the same time, the Pores of the skin, being unlocked, readily let forth all the Particles that are apt to exhale. For this use, besides the Bed-cloaths (which only hold in the Effluvia's of heat sent from the body, about it still) there are little sweating Chairs, or Stoves, made hot with Coals or with the Spirits of Wine:* 1.429 also Hot-houses and Baths of various kinds and forms, and our natural Baths, are wont to be made use of: But of all of them, our natural Baths of the Bath (if they agree with the temper of the sick) are thought to be the best Remedy; which the many Crutches, hung up as so many trophies of this Disease being overcome, belonging to many Cured of the Palsie, do sufficiently shew.

But as the best Medicines,* 1.430 if they prove not a Remedy to the Disease, often pass in∣to poisons; so the use of Baths, when it cures not some Paralyticks, renders them much worse; so that when as the sick had before many members distemper'd and resolved or loosened, there was no other occasion for them of leaving behind them there their Crutches, unless it were because they could use them no longer. We have above shewed the cause of this; to wit, because bathing, shaking, or moving the blood, and all the humors, more exalts all the Morbific and extraneous particles, and they becoming more outragious, drives them from the Viscera into the bloody mass; from whence (when they cannot easily evaporate) entring into the Brain and nervous Stock, increase the Paralytick Distemper, and very often adds to it the Convulsive. For this reason Bathing sometimes actuates or stirs up the Nephritick, and the Gouty disposition; and further, in many where there was not a disposition, it causes a spit∣ting of blood, the Asthma, or Consumption. Wherefore Baths ought not to be tryed

without the advice of a Physician, and then having tryed them, if they seem not agree∣able, they are to be soon left.

* 1.431I have by my own experience sufficiently try'd, and known also by that of several other Physicians, that some Paralyticks have been cured by Salivation excited by Mer∣cury. But I think this kind of Remedy, is only to be used to the habitual Palsie, to wit, which hath its foregoing cause in the Blood and Brain, easily moveable, and its conjunct cause, in the nervous appendix, not very fixed. But when this Distemper is caused from an outward and great hurt, or follows upon the Carus, Apoplexy, or Con∣vulsions, a Salivation or spitting is attempted in vain, and sometimes not without great hurt. But whoever are indued with a weak and too loose a Brain, and are obnoxious to frequent Convulsive motions, are not rashly to make use of Mercury. Yet some∣times a Salivation in an habitual Palsie, are not very fixed, hath highly profited, for∣asmuch as by taking away the impurities of the blood, it cuts off all the nourish∣ment of the Disease; also, because some Mercurial Particles, whilst passing thorow the Brain, and entring the nervous passages, divide the Morbific matter impacted in them, and drawing its parts one from another, variously disperse some forward, and others backwards; when oftentimes it is the fault of other Medicines, that they only urge forward the heap obstructing the ways of the Spirits, so that if they pull in not to pieces, they drive it more firmly into the obstructed places.

* 1.432In some measure it is for this reason also, that Vomits do frequently yield notable help in the Cure of the Palsie, to wit, because they draw away the nourishment of the conjunct cause, yea and do not always drive forward, but pull back the matter impacted in the Nerves, do greatly shake, and often break it in bits; so that when the continuity of the heap is broken, the Animal Spirits themselves easily dissipate the Particles of the Morbific matter, loosened one from another. We have before mentioned another reason of the help of Emeticks in the Sleepy Disease, which also may have a place in the Palsie.

* 1.433Instances and examples of Paralyticks are so ordinarily and almost daily met with, that their various Types and Histories would fill a Volume, if they should be described. Wherefore I shall only add here some few and more rare ones, to wit, one or two, by which the chief kinds of this Disease may be illustrated. For as it will be little to the purpose, to describe the resolutions of members, excited by outward acci∣dent, as from a fall, wound, or stroke; I shall insist only on those cases, where the Palsie either arises by its self, after a previous disposition, or comes upon some other Disease.

* 1.434Some time since, a certain Gentleman, strong, and well flesh'd, and beyond the tenth lustre of his age, almost ever healthful; at length being given to a sedentary and idle life, and from thence becoming more dull and heavy than usual, refused any ex∣ercise, and more hard motion of the body: moreover he was wont to be melancho∣lick and sad, upon any light occasion, yea sometimes to break forth into weeping and tears, without any manifest occasion. This man a little after (which I also ob∣served in many others) was distemper'd with an imbecillity and trembling of all his members, and then with a resolution of the lower parts; to which Disease (for that he was melancholick, and soon weary of Medicines) he gave himself up as overcome, and by degrees being made more weak and languishing, he dyed within six months.

I remember many others, but especially two committed to our Cure, who were highly ingenious and very learned, in the former part of their life; but afterwards in their declining age, partly through the evil disposition of the body, and partly through the perturbation of the mind, became dull ••nd forgetful, and after that (not∣withstanding the use of the Remedies in the beginning of the Disease) Paralytick.

* 1.435In these kind of cases, first the Brain it self, as to its temper and make, seems to be so weakened, that the Spirits inhabiting it, becoming torpid, and wandring out of their tracts, did not rightly perform the acts of Memory and Imagination; then by reason of their failure and disorders in their first spring or fount, (which are not enough taken notice of till they become uncureable) there is a necessity, that an im∣potency or an eclipse of the motive faculty, should succeed in the nervous appen∣dix. But the Cure of these Distempers, as often as they are excited from such an occasion, is ever very difficult, because the antecedent cause is hardly or scarce ever taken away.

* 1.436A young man, of a Sanguine temper, ingenious, and for the most part healthy, sitting in a Chair after a large supper, and immoderate drinking of Wine, was so distemper'd with a numness or stupidity in his right hand, that his Gloves which he held in it, fell of themselves out of his hand; then getting up, and endeavouring to walk, he felt a resolution or loosening in his Thigh and Leg of the same side, and

a little afterwards falling into a certain hebetude or dulness of mind, and stupefaction, yet without an Apoplexy; for he was still himself, answering aptly to questions asked him, though but slowly and with difficulty, and doing those things that were bid him. Presently a skilful Physician being sent for, Phlebotomy, Vomiting, and Purging, were celebrated in order, Cupping-Glasses, Scarification, Oyntments, Frictions, and other fit administrations were carefully applied: Nevertheless the Palsie increased, that besides the motion of his members on the right side being taken away, he also lost the sight of that eye; yet still being stupefied and sleepy, he was compos mentis, and knew his Friends, and being conscious of his infirmity, and solicitous for the re∣covering his health, he took all remedies were given him; but notwithstanding all this, the animal functions daily more and more languished, and at length by their consent the vital; so that about the seventh or the eighth day, from thence, falling sometimes into a Delirium, and sometimes into Convulsions, or other distractions of the Animal Spirits, his strength being at length quite lost, he yielded to Death.

His Head being opened,* 1.437 the anterior cavity of the Brain was filled, partly with Ichorous Blood, partly concreted and in clodders or gobbets, with plenty of Serum: Hence, as it is easie to conceive, from this deluge, pressing upon one of the Streaked bodies, and binding up its Pores and Passages, the flowing of the Spirits into the ner∣vous appendix of that side was hindred, and for that reason, the resolution in the re∣spective members was excited; and because of the optick chamber, where it is in∣serted into the Streaked Body, being also pressed together, the Eye of that side lost its sight; further, because the Callous Body, chambring that den, was somewhat pres∣sed by the heaped matter, from thence the hebetude and stupefaction of the chief functions of the soul were excited, yet without their subversion or inordination. By reason of the evil being fixed on the substance of the Brain, and the Spirits inhabiting it, these sorts of Distempers do proceed, and not from the impletion of the Ventricle, as appears clear enough by this instance, and by what we have elsewhere mentioned.

A Servant to a certain Nobleman,* 1.438 being about forty years of Age, indued with a sharp Blood, and Cholerick temperament, and for some time obnoxious to the Ver∣tigo, whilst he was riding in the Country to a certain Village, being taken sudden∣ly with a dizziness in the Head, he fell upon the ground headlong, and being instant∣ly taken up by the inhabitants, and put to bed, he lay for many hours insensible, and as if dead. But afterward being awakened, he felt an universal Palsie, and all his mem∣bers loosened on both sides. Visiting this Man the day after, I took from him pre∣sently about twelve ounces of Blood, and prescribed forthwith some other Remedies, both outward administrations and also inward Medicines to be carefully given him, and indeed with good success; for after five or six days, he began to bend and stretch forth his hands, and feet, yea, though slowly, to move them about hither and thither; then by the constant use of Remedies, within two months, he was able to rise up, to stand on his feet, and to walk a little with the help of Crutches; then using at home for some time daily a temperate artificial Bath, he got strength and motion by degrees in his members; at length as soon as the season of the year served, going to the Bath, within a fortnights time, by the use of the Baths, he grew perfectly well, and leaving his Crutches behind him returned whole.

In this case,* 1.439 the Apoplectick matter falling down out of the middle of the Brain, be∣ing divided and largely poured forth, entered both the Streaked Bodies, and so caused the universal Palsie; but forasmuch as being more stretched abroad, the same was the less thickly impacted in the Marrowy Pores, therefore being more moveable, and apt to be shaken off, it did admit so easie and quick a Cure. To this man the more hot Remedies were not agreeable, so that I was compelled sometimes to iterate Phlebotomy, and to give him only temperate Medicines. That the Palsie doth sometimes succeed, not only Cephalick Distempers, but also the Colick, and Scurvey, (as we have already hinted) the following History, (of which we have somewhere made mention as to its Scorbutick reason,) will manifestly declare.

A young and handsome Woman,* 1.440 after being brought to bed, fell into a Tertian Feavour, this coming at length daily upon her, and protracted, brought in a most cruel and continual Colick. The pains at first tormented her only in her Belly, with vomiting and most sharp torments. Being a long while vexed with these, and almost worn out; at length she began to be molested with a stupefaction, and a sense of tingling, such as comes upon a member laid upon. Nor was it long after that but a Palsie (which this other Distemper very often foreruns) follow'd in her whole Bo∣dy. In this condition being brought to Oxford, she was committed to our Cure (the noted Physician Dr. Lydell being also called to our assistance.) In this sick Gentle∣woman, not only all her greater Members, as her Arms and Legs, but almost every

lesser joynt or limb, was almost wholly loosened, that she could not move hand nor foot, or the fingers or toes of either. Further, she was so distemper'd with a wast∣ing away, that she was nothing but skin and bones, however (and from which only we had any hopes) she had a good Pulse, and a lively aspect.

* 1.441After we had administer'd to her for many weeks, most choice Medicines, both Antiparalytick and Antiscorbutick, almost of every kind, and according to the various methods, without any success; at length we proposed to her, and to her Friends, Sa∣livation, as the most powerful, though also most dangerous of all other Remedies; they not long deliberating upon it, resolve to try a Medicine rather doubtful than none, and though the same should be wholly inefficacious. Therefore by God's help, we gave her in a small Dose, precipitate of Mercury cum sole, and the next day repeated it. On the third day, a moderate and easie Salivation beginning, gently succeeded for a week, without any malignant symptom; but then the sick complaining of a grievous Headach, and Vertigo, began to be afflicted with Convulsive motions; so that there was a necessity to let her lye down, and depress the Salivation, and as soon as we could, to break off this course, by the Serous Flux of water being called away from the Head, to the other parts; which indeed Clysters, frequently given, Epispatick or drawing and revulsive Plasters, applied to several places, toge∣ther with Cordials and Opiates inwardly given her, did quickly effect; and then pre∣sently this Gentlewoman finding her self a little better, began to strech forth and bend her fingers and toes, and sometimes to move her members from one place to another. Her spitting ceasing, being gently purged, she took for many days a De∣coction of China, Sarsa, Saunders, Ivory, &c. with the addition of the dried leaves of Betony, Sage, female Betony, &c. and between whiles with that, Spirits of Harts∣horn, or of Sut, Cephalick and Cardiack Confections, also Powders and proper Iuleps. Within a months space, being held up by her Servants, she could stand on her feet, and walk a little in her Chamber; moreover, sleeping and eating moderately, she every day got flesh and strength, and at length by the use of the temperate Bathes at the Bath, she grew well.

* 1.442The reason of the aforesaid case seems to be after this manner: First, the vitious blood had contracted an intermitting Feavour, then by reason of the long stay of that Feavour, the same being made more vitious, did also impart its evil to the Brain and nervous Stock; the matter being poured forth from the blood on them, together with the nervous juice, being only at first Spasmodick or Convulsive, and entering much into the Intercostal Nerves, excited the Colick; but then, that being more large∣ly poured forth into the Nerves of the spinal Marrow, brought on painful contracti∣ons in the nervous Fibres, in almost the whole habit of the Body; and when from the assiduous and plentiful incourse of the Convulsive matter, the passages of the Brain and Nerves being very much unlock'd, became very open; at length the more thick and vitriolick Particles entering with them, disseminated the Paralytick Di∣stemper thorow the whole Body. Concerning its Cure, the Remedies used before Salivation did not profit, because they urging this Morbific matter still forward, drove it more deeply and closely into the nervous passages; but the mercurial Parti∣cles, because they dissolved the matter so compacted, first opened the way of Cure, which afterwards being much helped daily by Cephalick Medicines, it was at length consummated by the use of the Baths.

* 1.443But that Baths are not profitable to all Paralyticks, yea (as we said above) very hurtful to some, this following History (whose mournful catastrophe happened whilst we were writing these) will manifestly declare. A Merchant of London having put his foot out of joint, became upon it lame in that part, but as to all things else he was sound and strong enough; when he had tried for some time several kinds of Topick Remedies, and they effecting nothing; at length, by the counsel of a Physician, go∣ing to the Bath, he began to try the temperate Baths, by the use of which growing pre∣sently worse, and beginning immediately to have a Palsie in his other Members, he had abstained from them, but that the Physician, then present, promising him that he should afterwards be better, exhorted him to persist; wherefore he again enter'd in∣to the Bath, for about thirty days, until at length all his lower members, to wit, from the Os sacrum to his Feet, being wholly loosened, withered away; besides in his Breast was excited a very great difficulty of breathing, and as it were Asthmatical: For that his breast was not able to be dilated sufficiently, by introducing the breath deep∣ly, the Muscles dedicated to respiration being as it seems also affected with the Palsie; wherefore growing short-winded, he laboured with a continual endeavour of those parts, and with an agitation of the whole Thorax. In this condition leaving the Bath, he was bid by his Physician, to abstain for a whole month from any Remedies taken

from Medicine; which when he had strictly observed, out of hope to grow well a∣gain, that time being elapsed, it was then too late to deliberate on the use of any Medicines; for besides his Paralytick and withered members, his belly swell'd, his breathing was yet more hard and troublesome, that he could now scarely draw breath: His Pulse was very weak, and upon any motion of his Body, he had frequent swoon∣ings away, and loss of Spirits: Hence, as there 〈…〉〈…〉rce any place left for purg∣ing, Cordials and Antiparalytick Remedies were only to be insisted on, but notwith∣standing the use of which, this sick man, within a fortnights time, labouring for ma∣ny hours under a Dyspnoe or want of breath, at length expired. The immediate cause of whose Death I suspect to have been the manifold concretions of the blood in the Heart; for when the motion of the Praecordia for a long time was very much hin∣dred, there seems nothing more probable, than that these kind of gobbets as it were fleshy, should increase within the Ventricles of the Heart.

For the illustrating of the Theory of the Palsie, a little more, and also of the Le∣thargy and Carus, I shall add this other example, with Anatomical observations; which happened whilst the former were in the Press.

A little one a little above three years old,* 1.444 of a moist or humid Brain, as appeared by most grievous sore Eyes, and the watry whelks or pustles of the face, to which it was sometimes obnoxious; falling ill about the beginning of Autumn, with a slow Feavour, and lost Appetite, it became very torpid and sleepy, so that it would sleep almost continually day and night; but being awake, he knew those standing about him, and answered very aptly to their Questions. To this Child, fit Remedies being presently and diligently given, viz. Clysters, Blistering Plasters, Purges, also Juleps, Spirits of Harts-horn, Powders, with many others used in these cases, they prevail∣ed so much, that within six or seven days the sick Child being free from its Feavour, waking enough, and desiring Food, seemed to grow well, and to have scarce any more need of a Physician: But in a short time after (by what occasion uncertain) fal∣ling into a relapse, and again sleepy, was presently seised with a most grievous stupefaction, so that it was hardly to be awakened, and scarce knew any one, or what it did it self; the next day being plainly stupid, though being strongly pulled, it did open its Eyes, it would roll them about hither and thither, and saw nothing; but within a day or two, a Palsie follow'd in its whole right side. The former Re∣medies were repeated, and besides sneezing Medicines, chawing Medicines to draw down Rheum by the mouth, a taking away of Blood, with Poultisses applied to the Feet, and all its Head being shaven, drawing Plasters were put all over its Head, with other Medicines, and ways of administrations prescribed in order, nothing profited, but that this sick Child, after its lying so insensible for four or five days, at length its breath and Pulse failing, dyed.

Its dead Body being opened, we found almost all things sound enough in the low∣er and middle bellies, (i. e. in the Belly and Breast) unless that in the right Kidney, a whitish mattery Humor, or as it were a thin Corruption, had begun to be heaped together, which plentifully flowed forth out of some parts of the Kidney being dis∣fected and squeezed together: This did seem to have been the beginning, or a certain rudiment of a future Imposthum, and perhaps by reason of the Serum not sufficiently separated here, its greater plenty had slowed to the Brain.

For the top of the Skull being taken away, the anterior region of the Head, almost to the insertion of the fourth bosom, swelled up, being covered with clear water, shining thorow the Membranes, which presently flowed forth, when the Meninges were dissected: Further, in this place, portions of the Brain being by pieces cut off, appeared too wet, and without any red or bloody pricks: but in the hinder border of the Brain the Vessels were red with blood, and the Cortical substance appeared without tumor, or deluge of water, more close and firm: From these (as we have affirmed before) it manifestly appeared, that the cause of the Lethargy did depend upon the watry flood, or as it were Anasarca or Dropsie of the outward part of the Brain.

The Brain being cut piece-meal, and an hole made in the anterior cavity, disten∣ded by the water, the clear water being before as it were penned up, within a more narrow space, leaped forth, a great plenty of which had filled all the Ventricles to the top, and (as it seems) by compressing the Optick chambers, (as in the other case above described) brought in blindness, and by entring or pressing together one of the Streaked Bodies, or its Pores, caused the Palsie.

The Choroeidal Infoldings appeared as it were half boiled, whitish, and almost without blood. It is probable, that the water did flow forth of these Vessels, by which the Ventricles of the Brain were overflown, all, or at least the greatest part

of it; although in this case, if (as some think) the watry Latex or Humor sliding down lower from the shelly part of the Brain, the Brain being at length thorowly passed thorow, did rain down into these bosoms, we may from thence aptly fetch a reason, wherefore the Lethargy at first thought to be cured, returned afterwards more cruel, accompanied with blindness and the Palsie; to wit, because at first the stock of the sleepy matter falling down, from the shelly part of the Brain, into its cavity, the animal function was a little cleared; but afterwards, when new matter sprung up in the Cortex of the Brain, and this sliding forward into its bosom, was heaped up to a fulness, for that reason happened the relapse of the former Disease, with those companions of blindness and the Palsie.

But although the Dropsie of the interior Brain, or the inundation of its Ventri∣cles, by compressing either the Streaked Bodies, or the optick chambers, raised up the Palsie or blindness, or by pulling the beginnings of the Nerves, the Convulsive Di∣stempers; yet it appears most evidently by our late Anatomical observation, that the Lethargy did not arise from any such cause, but only from the exterior part of the Brain being overflowed, or pressed together.

A certain Gentleman a long time unhealthy, after he had laboured almost for five months with the Colick, or rather with a wandring Scorbutical Gout, in which not only the Viscera and Loins were troubled with great torments; but moreover the Membranes and Muscles of the whole Body, were almost continually tormented; and at length he suffered sometimes most horrid Convulsions in his Members, some∣times resolutions, and sometimes a Phrensie in his Head, and sometimes as it were Apoplectical fits, or a darkness in his Eyes, so that being worn out, his strength and spirits wholly exhausted, he dyed. Almost seven days (except the last but one) before he dyed, being more strong as to his Sense and Intellect, he lived almost per∣petually without sleep; though gentle or the more strong Opiates were given him, yet he could not sleep at all. A little before this waking, from a Vesicatory applied to the hinder part of his Neck, an immense quantity of water flowed; and from that time even till he dyed, it still flowed forth; hence, as I suspect, he became so waking by reason of the watry humor being so greatly drawn away from the Brain.

The head of this dead Man being opened, the interior cavities of the Brain, or all the Ventricles being filled to the top with clear water, appeared as if they were distended; yea the medullary cord it self, about the top of the Back-bone, seemed to be drowned and compassed about with water laid up there. Without doubt, for this reason, the Pains and Convulsions so cruelly tormented him in his Loins, Members, and all over his Body; and by reason of the deluge in the Ventricles, he became obnoxious to blindness of his sight, and to frequent loosenings of his limbs: Nevertheless, hence no Lethargy, but a waking was induced, by reason of the waters being so much derived from the compass of the Brain by the Blistering Plasters. He had also a Dropsie in his Breast, by reason of his Lungs being much vitiated. His Liver appeared of a mighty bulk, besprinkled every where with white spots, and al∣most without blood: so that to these faults of the Viscera, the vices of the Blood and nervous juice ought in some measure to be ascribed.

CHAP. X.

Of the Delirium and Phrensie.

THUS much concerning Cephalick Diseases,* 1.445 by which the Animal Functions by themselves, and as they are Corporeal, without any respect to the Animal Soul, are wont to be hindred or perverted: In some of which, viz. the Ver∣tigo and Palsie, the Intellect for the most part remains clear and lively, and in the rest, like the eye placed in an obscure place, it beholds the species, either not at all, or a few objects only of a more rude appearance, but is not easily snatched into any great error or fury; which kind of symptoms are ordinarily induced by reason of other Distempers of the Head, and of the Spirits inhabiting it, of which we are now about to treat. For if at any time the Imagination is so disturbed, or perverted, that it falsly conceives, or evilly composes or divides, the species and notions brought from the Sense or Memory;* 1.446 presently for that reason the intellect beholds or forms con∣ceptions and thoughts only deformed, distracted one from another, and very confu∣sed: Which indeed are represented to it from the Brain evilly affected, and as it were monsters from a multiplying or distorted Glass.* 1.447 As there are many ways, by which the Imagination, and by consequence the mind and will, and the other powers of the superior soul, are wont to be perverted or depraved, all of them are noted by the common word Foolishness, or talking idly. But this Distemper is distinguished into shorter, which is called a Delirium; and into a longer or continual; which is either conjoined with a Feavour, and termed Phrensie; or it happens without a Feavour, and then their is joyned with it, either raving, sadness, or stupidity, and so it is divided in∣to madness, melancholy, and morosity or foolishness: we shall speak of each of these in order; and first of the Delirium and Phrensie.

Although the Delirium is not a Disease of it self, but only a symptom proceeding from other Distempers, yet because it happens in some of them, that for the most part it is cured by Remedies appropriate to it, therefore it will not be amiss for us to inquire a little more strictly into the causes and nature of it. This word taken after an especial manner,* 1.448 is the same with 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, or a going crooked, or out of the right or straight way, and denotes an hurt of the same Animal Function such as ariseth in fits of the Feavour, Drunkenness, and sometimes in the passions called Hysterical, and induces men for a short time to think, speak, or do absurd things, either some of these, or all of them together.

The Delirium is excited,* 1.449 forasmuch as the Animal Spirits being either too much irritated, or acted into confusion, are carried tumultuously into disorders hither and thither, within the globous compass of the Brain, where the Phantasie and Memory have their seats; and so whilst the various images of the imagination and the memory being excited at once, are confounded together, they object only incongruous and absurd phantasies to the rational Soul, and so both the acts of the intellect and the will, are only inordinately chosen or drawn forth. In like manner it happens, by rea∣son that the Animal Spirits being moved, within the middle of the Brain or the Callous Body, that incongruous conceptions, and confused thoughts, are objected to the rati∣onal Soul; as in a long circumgyration or turning about of the body, the images of visible things are carried to the common sense, whence all things seem to be turn∣ed about, and sometimes to be lifted up, and sometimes to be depressed to the ground; that nothing is beheld stable or standing in its due place, and position. In a Brain rightly disposed, the motion of the Animal Spirits are performed, as it were in certain numbers, ways and measures; whilst some Spirits are raised up in these tracts, others lye still in those, and so they succeed one another in their motions; and the several acts of e∣very faculty are made distinct, like so many wavings of water in a River; but in the Deli∣rium, all the Spirits leap forth at once, and meeting one another tumultuously, or vari∣ously laying hold on one another, are agitated like mad Bacchanals. Further, even as these being struck with such a fury within the compass of the Brain, do stir up manifold and ve∣ry much disturbed cogitations; so whilst they are carried without its confines into the ner∣vous original, they produce incongruous speeches, absurd gestures of the body, and mem∣bers, and not rarely Convulsive motions. But for that such a rage of the spirits, (other∣ways than in the Phrensie or Madness) presently grows cool, and their tumult being over, none of their wandring tracts are imprinted in the Brain, the Delirium soon passes

over, and the distemper'd come immediately to themselves again, without any marks left of their foolishness or idle raving.

If it be demanded, from whence this short fury is impressed on the spirits, inhabi∣ting the Brain, that the Reins of the mind being shaken off, they turn thus all things upside down in their government;* 1.450 we say, that they conceive this kind of inordinati∣on, from a twofold reason; to wit, this rage or madness is brought immediately to them,1 1.451 from the blood washing the frame of the Brain; or some Animal Spirits, outwardly dwelling in the nervous Stock, enter first of all into some disorder; then the same being communicated by the nervous passages, affecting in like manner the spirits there inhabiting,2 1.452 stirs them into a Delirium. There are various causes and kinds of either of these: the chief of which we shall here touch upon; and first shall be shewed, how, and for what occasions, the Blood, being either swelled up with too much heat, or being pregnant with an invenomed matter, is the parent of the Deli∣rium; forasmuch as it insinuates into the Pores and passages of the Brain, either fierce and untameable particles, or such as are malignant and deadly to the Animal regi∣ment.

* 1.453First, As to the first, in the fits of intermitting and in the height of continual Feavours, the blood growing hot, by an immoderate burning, sometimes stirs up the Delirium, by the mere force of its Ebullition or boiling up; to wit, for that it swel∣ling up very much, whilst it passes thorow the small shoots of the Arteries, every where diffused thorow the outward compass of the Brain,1 1.454 it very much blows them up and distends them; and so pressing together the substance of the Brain, variously drives in the Spirits, and as it were compells them into very confused troops: More∣over, from the blood so swelling up, with a frothy rarefaction, the Effluvia's of heat, and with them heterogeneous particles, entring into the Pores and passages of the Brain, agitate the Spirits, and tumultuously snatch them hither and thither.

2 1.455Secondly, Almost for the like reason Drunkenness, a deep Sleep, or a Delirium, is brought in; to wit, forasmuch as the bloody mass doth insinuate the spirituous particles of the Wine, (by which it grows hot) into the Pores and passages of the Brain, by which the Spirits dwelling in them, are either plainly overturned, or are moved into inordinate and confused motions. For that the untameable little Bodies of Wine or Beer plentifully drunk, open the shut places of any Brain, how sound and firm soever it be, and penetrating deeply into the Marrowy passages, disturb and plainly overturn the Acts both of reason and of the imagination.

3 1.456Thirdly, The blood suggesting not only feavourish and turgid, or vinous and un∣tameable particles, but sometimes malignant, and as it were venomous to the Animal regiment, stirs up a Delirium, either with or without a Feavour. As to the former, in the Plague, Small Pox, malignant Feavours (although the heat be but moderate) the malignant matter being translated to the Brain, because it dissipates a great com∣pany of Spirits (rather than that it drives them into tumults) brings forth abrupt, incoherent, and at length distracted notions.

4 1.457For the like reason also, some intoxicating and venomous things taken inwardly, and (as some affirm) outwardly applied, quickly cause a Delirium. This is common∣ly reported of the furious night-shade, Mandrakes, and some other plants; as for the roots of wild Parsnips, the thing is very well known. A certain intimate friend of mine told me, and he was a Man that might be credited, and also very learned, That he entring into the House of a certain Gentleman, found the Mistress of the Fa∣mily, her Daughters, and all her Maids (excepting one) become all at once Delirious, and speaking absurd and incongruous speeches, run up and down and leaped about the House; and for that he plainly thought them all mad; he learnt of the sober Maid, who had her reason, and was her self, that all that had happened from their eating of Parsnips, which she had not tasted: Which indeed the event shewed to be true; for after they had tired themselves, and fallen to sleep, they all at length awakned so∣ber. We have not here leasure to examine, whether this or other kinds of intoxica∣ting things, infestous rather to the animal government, than the vital, do communi∣cate to the Brain their evil, by the passage only of the Blood, or also in some mea∣sure, by a contact of the spirits residing in the Ventricle.

5 1.458But moreover, we advertise you, that sometimes a Delirium is excited from a want, and great dissipation of the Animal Spirits; because their series or orders being kroken off, and drawn one from another, like as if they were tumultuarily heaped together, cause confused and incongruous notions. Hence it is observed, that some have be∣come Delirious by great Haemorrhagies, or long watchings, and excessive want of Food; for this reason, many are wont to die delirious, and talking idly.

There remains the other kind of Delirium,* 1.459 in which the Blood being faultless, the Animal Spirits flowing some where in the nervous flock, first enter into disorder; then the same affection creeping thorow the nervous passages to the Brain, stirs up the Spirits inhabiting its middle part into a Delirium. This is sufficiently obvious in the passions that are called Hysterical; to wit, after a swelling up of the Belly, and an oppression of the Heart, doth succeed sometimes a lying speechless, sometimes a talking idly, with weeping and laughing. In like manner I have observed in a most cruel Colick, that sometimes after great torments about the Bowels and the Loins, they have fallen into a Delirium, then a little after this ceasing, the torments have returned. I knew a young Maid (as we have somewhere else mentioned) from the taking of an Emerick Potion, whilst it worked, was wont constantly to fall into a Delirium. I have also often noted, that a Gangrene beginning in some external mem∣ber, has caused a Delirium. And this in a Wound or Ulcer, is ordinarily noted for a mortal sign; because it denotes the Animal Spirits in the distemper'd part to be slain.

Nor doth this symptom coming upon those who are long sick and almost worn out,* 1.460 give any better prognostick; in the fits of intermitting Feavours, it is almost ever safe; but in continual Feavours dubious, and of something a suspected event; in malignant it more often fore-speaks evil; in Convulsive Diseases, the first assaults of a Delirium for the most part are free from danger, but yet its frequent coming, frequently turns that disposition into a Carus, Apoplexy, or Palsie.

This Distemper,* 1.461 as often as it is seen to be safe enough, requires not a Cure; for the fit quickly and easily passes over: yet, because some, who have a loose and weak Brain, and the Animal Spirits too easily dissipable, and apt to flight and con∣fusion; being disturbed by any light occasion, are wont presently to grow Deliri∣ous and to talk idly; therefore there is need of Medicine for these, not only of Hel∣lebore, but also Cephalick Remedies, which may strengthen the Brain, and fortifie it against the incursions of the Morbific matter; also which may fortifie the Animal Spirits, and render them more fixt and strong for resisting. We have above descri∣bed the forms of these kind of Medicines, and their manner of administration, which are profitable for the taking away the foregoing cause of any other Cephalick Dis∣ease.

A Delirium coming upon continual and malignant Feavours, requires a peculiar was of healing: for in the first place, it shews the morbific matter dangerously tran∣slated towards the Head, and therefore ought to he called back from thence, by any means; for which end may be laid Plasters that draw blisters to the hinder part of the Neck, other Plasters or Pultisses, or the flesh of living Creatures, or their warm bowels to the feet; inwardly may be taken temperate Cephalicks, as Powder of Coral and Pearl, black Cherry Water, or Water of Cowslip Flowers, or Poppy Water, and others sweetning and cherishing the spirits.

These being thus premised, concerning the first and most light manner of foolish∣ness or talking idly, we will proceed to its higher degree, viz. the Phrensie, which is far longer, and more durable, than the former Distemper. In the Delirium, a perturbation of the Spirits, inhabiting of the Brain, being excited, is like a waving of waters, from a stone flung into a River; but in a Phrensie, their commotion seems as it were the storm of waters, raging in a tempest.

The Phrensie is defined,* 1.462 to be a continual dotage, or deprivation of the prin∣cipal faculties of the Brain, arising from an Inflammation of the Meninges, with a continual Feavour.* 1.463 To this Disease there is another of kin, viz. the Paraphrensie, commonly called, or additional Phrensie, whose cause is not an inflammation of the Membranes which cover the Head, but as they affirm of the Diaphragma. Further, in either Distemper (as also in the Pleurisie but falsly) it is affirmed, that the Fea∣vour doth arise as it were only symptomatical, from the same conjunct cause, viz. from the Inflammation of some part. But indeed, that the Phrensie doth rather suc∣ceed the Feavour, and is produced, because the boiling blood doth transfer its a∣dust or burnt recrements to the Head; Hippocrates long since, and now every com∣mon body, observes: to wit, for that the Urine of one sick of a Feavour, be∣ing changed from a troubled and thick, into a thin and waterish Urine, shews a Phrensie at hand: Wherefore, from hence, the cause of this Distemper is concluded to be a translation of the Feavourish matter into the Brain.

But as to the conjunct causes of the Phrensie,* 1.464 and Paraphrenesis, we may easily shew, that the former doth not always proceed from the Inflammation of the Menin∣ges, nor this latter from the Inflammation of the Midriff. I have often seen in Ana∣tomical Dissections, the Meninges, yea sometimes also the exterior compass of the

Brain, beset with an inflamed tumor, and the sick not distemper'd with a Phrensie, but on the contrary with a stupidity, and have dyed with a Carus, or some other sleepy Diseases.* 1.465 And truly, that it is so, reason plainly declares; for the Meninges being inflamed, and by that made more tumid, press together the Brain very much, and about its compass shut up the ways and passages of the Spirits; so that the functi∣ons of waking and memory being hindred, the Lethargy (as it appears de facto) necessarily follows: Nothwithstanding, far otherways in the Phrensie, all the passages and Pores of the Brain, for the excursions of the Spirits, seem to be too largely o∣pen, because the Images hidden or laid up, are raised all at once, out of the utmost, and all the places of the memory, which together with others, suggested from the Phantasie to the common sensory, tumultuously, bring forth such manifold and high∣ly confused notions. There is only wanting to the sensitive soul, for its expansion to be straitned or loosened, within the Head (which certainly the inflammation of the Meninges would effect) rather than that it should be dilated above measure, and that all the Pores of the Brain should be unlocked and carried beyond its wonted compass. Perhaps it may happen, from a long continuance of this Disease, that the Blood being greatly heaped up within the Vessels of the Meninges, and there stag∣nating, that it may at length bring forth an Inflammation in them; and then for that rea∣son, we may suspect, (because it often so falls out) that the Phrensie doth pass into the Carus, or Lethargy, of which phrensical persons often dye.

* 1.466No less do we reject the Inflammation of the Diaphragma, which cause of the Pa∣raphrenesis, Galen in times past, and moved by this authority, most Physicians in every age since, asserted: Anatomical observations plainly prove the contrary. Some time since, dissecting the dead Carcase of a Maid, dying of a sudden Leipothymy or swoon∣ing away, we found in the fleshy part of the Diaphragma a great Imposthume, with a bag full of filthy matter, and watery little bladders; yet she was not troubled ever with a Delirium or Phrensie. Some time since also when we had made an Anatomi∣cal Inspection of a Gentleman of the University, (of whom we have made mention in a late Tract) who dyed of a long spurious Pleurisie, it manifestly appeared, that a great Imposthume being ripened in the Pleura, and the intercostal Muscles, and broke inwardly, that a vast plenty of matter had flowed forth into the cavity of the Thorax, which gnawing the Diaphragma lying under, had made a great hole in it; nor was this man however in all his sickness Delirious, or Frantick. Wherefore, I think this Distemper scarce ever to be produced from such a cause: but that opinion seems to arise from hence, because oftentimes in a true Phrensie, together with a continual raving, the motion of the Diaphragma is wont to be hindred or perverted; as is gathered from the unequal and difficult breathing, to wit, sometimes anhelous or breathing short, and as it were suspended, sometimes short and swiftly repeated, with sometimes a double breathing;* 1.467 which kind of symptoms, and also at the same time the alienation of the mind, are said to proceed from the Midriff being inflamed, and for that reason convulsed; wherefore the Ancients called the Diphragma Phrenes: But there was no need for this, if they had consider'd, that the whole action of the Diaphragma, doth depend upon the flowing forth of the Animal Spirits from the Ce∣rebel, and therefore there is a necessity, if the Phrenetick matter invading the Brain, some part of it should with it rush into the Cerebel, that besides the raving, the mo∣tion also of the Midriff, though of it self innocent, should be altered; as we have shewed elsewhere more largely.

* 1.468Therefore the formal reason of the Phrensie seems to consist in this, that the Ani∣mal Spirits being at first very much irritated in the whole Brain, are driven into inor∣dinate, very confused, and also impetuous motions; so that the acts of every Ani∣mal Function are depraved, and variously perverted; and at the same time, very many Ideas of things being raised up out of the memory, the old are confounded with the new, and some evilly joined, or wonderfully divided, are confounded with others, the imagination suggests manifold Phantasms, and almost innumer∣able, and all of them only incongruous; and the common sensory represents the images of sensible things distorted, double, or incoherent; that hence the mind and the will, choose or pick out nothing but ridiculous and impertinent conceptions and passions; and cause the actions of the body to become almost only irregular. More∣over, the spirits being struck as it were with madness, tumultuate not only in the Brain, but also in the Cerebel, and every where in the nervous Stock; wherefore, Frantick people not only talk idly, but breath unequally, speak aloud, strike with their fists, fling about their hands and feet, yea and stretch forth all their members with a mighty strength, and a most strong force, that indeed the whole Soul seems to grow hot and furious in the whole body, to be mad, or rather as it were to be

inflamed with a sudden burning. And truly a Phrensie cannot be more aptly defined, than that it is a burning or inflammation of the whole sensitive soul, or animal spirits, as to their whole Hypostasis or Constitution. This burning always beginning from the spirits inhabiting the Brain, and wandring from thence into the other parts of the sensitive soul,* 1.469 seems to receive from the Blood, first growing hot and raging with a Feavourish fire, both the first incentive matter, and then the constant food of the burning. For indeed it is probable, that the blood burning Feavourishly, doth pour forth on the Brain sometimes sulphureous Particles, together with the spiri∣tuous, which being half inflamed, and after a sort burning forth, penetrate together with the others, and from thence immediately entring into all the marrowy and ner∣vous passages, adhere every where to the spirits, and so render them being inflamed, highly rageing and implacable. Certainly it is more likely, that the Phrensie is rather excited after this manner, by an inflammation of the Spirits, than from that of the Meninges or of the Brain, which more surely causes an Headach or Lethargy, than a Fury, as we have frequently found by Anatomy.

And indeed, that it is so, is not only ours, or any new opinion, but that great fol∣lower and best interpreter of Hippocrates, Prosper Martianus, who hath affirmed the same thing, almost in express words, viz. Comment on his Book De Morbis 3. vers. 99. pag. 151. he says,

That Hippocrates doth call the Phrensie a Delirium with a Feavour, which is continual, and depends upon a firm and stable Distemper: to wit, from an inflammation of those parts, which serve to institute Nature, Reason, and the Mind; For so the Animal Spirits, whose viciousness cause the Delirium, do not grow hot as it were by a simple quality, but are altered as to their substance.

This Man manifestly distinguishes between heat and flame, and affirming that to be in respect of quality, and this an alteration in respect of substance, plainly ascribes the cause of the Phrensie to the inflammation of the spirits. He has in the same place more things apposite to our matter, to wit, that the containing cause of the Phrensie was not the inflammation of the Meninges, but of the Spirits, whose substance is in∣deed altered, that is, forasmuch as it is become fiery, such a continual Delirium is excited.

I have oftentimes compared the production of the Spirits from the Blood into the Brain,* 1.470 to a Chymical Distillation; of which it is observed, if the spirituous sulphu∣reous liquor be provoked with too strong fire, that in Distilling it sometimes takes fire, and ascends in the Alembick with a very great flame. This is known of Oyl of Turpentine, of it self, or with the Flowers of Sulphur, to the great loss of some. In like manner we may believe,* 1.471 that the blood growing more strongly hot, doth often communicate also a burning to the Spirits distilled out of it, viz. that some half burnt Particles, do insinuate themselves into the Pores of the Brain, which rushing into all the passages of the Spirits, both there and in its appendix, every where inkindle the Spirits, and compel them into most swift motions, almost like Lightning.

But because the Phrensie doth not come upon all Feavours,* 1.472 but only on those high∣ly burning, the reason is plain by what follows; to wit, the closure of the Brain ought to be so shut up, that not only any extraneous thing might not be poured into them, but that the more intense flame of the Blood, however burning it be, and though planted round about, might not be able to break thorow; wherefore, some distem∣per'd with a burning Feavour, although the Blood grows hot thorow the whole, the Bowels burn, the Marrow rages, the Tongue and Jaws rosted like a coal, yet the Brain being still firmly shut up, all the Animal Functions remain whole and sound. But on the contrary, others who have a weak and too loose a Brain, and their Blood more sulphureous than it ought, become Phrensical not only from a burning Feavour, but sometimes from a more gentle visit. By reason of what foregoing cause, and for what occasions, or evident causes, this is wont to happen, is the next thing we shall inquire into

Hitherto hath been shown that the immediate subject of the Phrensie is the sensitive Soul, or the Hypostasis of the Animal Spirits, and that the formal reason of the Dis∣ease doth consist in their Inflammation,* 1.473 and that the conjunct cause is the sulphu∣reous particles poured forth from the Blood into the inclosures of the Brain, and there continually inkindling the Spirits; and now it is no difficult matter to assign its procatartick or foregoing causes, which we find partly in the Blood, and partly in the Brain and its inhabitants.

The previous disposition of the Blood,* 1.474 disposing to the Phrensie, is sometimes sim∣ple, sometimes twofold; the former is an hot, sharp, or bilous constitution of it, to wit, that contains very many sulphureous Particles in it self, which are apt to inflame

the Blood in a Feavour more than ought to be, and to insinuate its burning into the Brain. This disposition, when it is very potent and active, often produces this Disease of it self; but for the most part, there is another disposition of the Blood, which helps that former, and renders it more efficacious, to wit, that, besides the sul∣phureous and inflameable Particles, there are others sharp and penetrative, which enter into the Pores, and open them, so that the former more easily enter in, or are intro∣duced: This the saline little Bodies, conjoined with the sulphureous, do in a manner effect; hence Cholerick and Melancholick persons growing Feavourish, are more prone to become furious; but much more do the Heterogeneous Particles, implanted in the Blood, and moved by a Feavour, open the doors of the Brain, and intromit all that are inflameable: wherefore a Phrensie frequently comes upon the Small-Pox, and ma∣lignant, and Pestilential Feavours.

* 1.475The other provision to a Phrensie, which is of the Brain, consists partly in its tem∣per and conformation, and partly in the disposition of the Spirits inhabiting it: As to the former, those indued with an hot and dry Brain, are found to be most prone to a Phrensie; not because that constitution is more obnoxious to an inflammation or burning, (for to this it is less apt) but because in such a Brain, otherwise than in an hot and moist, or cold and dry, the Pores and passages are more open, and too much gaping, and so give an entrance to the incentive matter, suggested from the Feavour: which besides, they much more easily admit, if the Spirits being very fugacious or apt to flight, or pathetick, or passionate, are upon every light occasion ready to fall into passi∣ons of sadness, fear, anger, or hatred; so that they resist not the incursions of the ex∣traneous matter, and more readily conceive a burning themselves.

* 1.476The evident causes of the Phrensie are either more remote, viz. whatever things are wont to excite a Feavourish intemperance; as Surfeits. Drunkenness, a very ve∣hement disturbance of either body or mind, usual evacuations being suppressed, with many others; or more near, as a Feavour, and its dependences and adjuncts; to wit, if it be pestilential, malignant, or after an evil manner; if it arises by reason of a Surfeit taken from very incongruous Meats or Drink, or if it succeeds violent passi∣ons, as of Love, hatred, envie, indignation, or sadness; or immoderate studies: for these kind of occasions render the Blood and Animal Spirits, growing Feavourishly hot, very propense to the frantick Distemper.

* 1.477Since that this Disease depends rather and more immediately upon the Soul than up∣on the Humors or solid parts being distemper'd, its kinds and differences are neither various nor manifold: In respect of magnitude, the Phrensie is either great or mode∣rate, also continual or intermitting; to wit, according as the Animal Spirits are more or less inflamed, and as they receive the food of their burning continually from the Blood, or by turns. Secondly, As the burning begins only in the Brain, or together with it in the Cerebel, it is commonly distinguished into the Phrensie, or the Paraphrenesis; which is as much as to say, that either the spontaneous Animal Functions are only or chiefly hurt, or else together with them the vital also. But this Disease as to the Fea∣vour, on which it depends, hath its nature and manner malignant, or free from malig∣nity; also according to the temper of the sick, the Phrensie is distinguished into San∣guineous, Cholerick, Phlegmatick, or Melancholick; and this not improperly, for the Animal Spirits are wont to grow hot and burning, after a diverse manner, in this Disease, according to their various dispositions.

* 1.478The Prognostick in this Disease is always doubtful, and the event is to be instituted with an evil suspicion: For the Phrensie of it self (as Trallianus says) is a most acute and most dangerous Disease; then, if it comes upon a Pestilential, or malignant Feavour, or of some other evil kind, we cannot but expect the end of it to be mortal.

If a Phrensie happens in a sound body, well habited, of a Sanguine temperament, and young, there is greater hopes of health, than if it were sickly, aged, lean, or Cholerick, and obnoxious to violent Passions.

If the Phrensie remitting by frequent turns, have lucid intervals, it is better than if the fury should be undiscontinued: But if the sick sometimes seem to be better, yet after moderate sleep to awake always furious, it is a sign that the Disease is pertina∣cious, and for that reason dangerous; for that a new stock of incentive matter is from thence carried to the Brain; which indeed we have elsewhere shewn to be made far more plentifully in sleep than waking.

A Phrensie is in a short time terminated with the Feavour, either in health or death; or else it is protracted, and remains after the Feavour; or at length it is healed, or passes into other Diseases, to wit, the Lethargy, or Madness, or Melan∣choly.

If the Feavour having a laudable Crisis, either by Sweat or great quantity of Urine,

is fully cured, for the most part the Phrensie also ceases; but if the Feavour be not cured and carries still the Morbific matter to the Head, so that besides the Animal Functions being depraved, the vital begin to fail (which appears by the Pulse and breathing being altered for the worse) if the Urine be pale, if that frequent bleeding at the Nose, if Vomiting, and Convulsion happen, the Physician concludes death to be at hand.

Sometimes a Feavour, though it be not at once or fully Cured, yet passing away afterwards slowly and by degrees, leaves a Phrensie, or a talking idly behind it; which, if it doth not by its stay obliterate the former tracts of the Spirits in the Brain, either will end by little and little of its own accord, or is to be healed by the help of Remedies.

If that by reason of the Phrensie being long protracted, the Meninges, or the Cortex of the Brain, be possessed from the Blood, or Serum, there heaped up, and stagna∣ting; with an inflamed tumor, or a serous deluge, the Lethargy, or sleepy Diseases fol∣low; the Cure of which is often very difficult, or not at all. But if from a long Phren∣sie, either the Animal Spirits (though their burning should cease) contract a vicious nature, or that the passages and Pores of the Brain are perverted, a perpetual raving oftentimes succeeds, the former Disease passing into Madness, or Melancholy, or fool∣ishness or stupidity. Wherefore it is vulgarly said of those that are Frantick, and not soon Cured, that their Brains are crack'd or broken, so that after that, they are always Mad or raving.

In the Cure of the Phrensie,* 1.479 we ought to respect at once the Feavour and the Fury. The Feavourish burning of the Blood, or its immoderate growing hot (which for the most part is the antecedent cause of the other effect) ought in the first place to be appeased and allayed, and the Animal Spirits to be cherished, and freed from any great burning. If the Phrensie happens about the beginning of the Feavour, or the middle of it, the same Remedies in a manner, and the same method or curing conduce to either end: But if this Distemper comes upon this, whilst it is at a stand, or at its height, the means of Curing are oftentimes repugnant to either, and there is need of great caution, lest whilst we endeavour to help one Disease, we do not increase the other; in this case, the vital indication concerning the preserving of strength, obtains the first place; and the taking away of blood, or purging, is not to be rashly and copiously celebrated.

In the former case,* 1.480 when the Feavour and the Phrensie are almost both of an age, Phlebotomy rarely or never is to be omitted, but is presently to be performed, and if strength will bear it, let it be afterwards repeated. For nothing depresses and dimi∣nishes the immoderate flame of the blood, like to this Remedy, and nothing more averts or recals its burning from the Animal regiment: Wherefore▪ if the matter re∣quires it, let a vein be opened, sometimes in the Arm or Hand, sometimes in the Leg or Foot, and sometimes in the Neck or forehead: perhaps sometimes it may be expedient to open the temporal Artery: yea also to take away blood in other places by Leeches, and sometimes by Cupping-Glasses. For this gives the chiefest help, and according to Galen, is the most powerful and principal Remedy, and is wont to fulfil very many indications in a Phrensie.

But for the prevention of the Feavourish matter being carried from the Bowels into the Head,* 1.481 Clyters are of chief use; with which, if need be, let the Belly be continually kept slippery. Vomiting Medicines, and Purging, unless very gentle, have very rarely any place here. Cataplasms of Rue, Chamomel, Vervine, Bryony Roots, red Poppies, with Sope, may be laid all over the Feet; or instead of them, may be applied Pigeons or Chickens, cut up and laid warm: In the mean time, as you see occasion, there ought to be prescribed Iuleps, Apozems, Powders, and Confecti∣ons, by which the rage of the Blood, and the burning of the Animal Spirits may be allayed.

Take of Pipin Water, Black Cherry Water, and Cowslip Water,* 1.482 each four ounces; Wa∣ter of the whole Citrons two ounces, of Pearl powder'd one dram, of Syrup of the juice of Citron one ounce; mingle them and make a Iulep: let three ounces be taken three or four times in a day.

Take of Grass Roots,* 1.483 of the Leaves of Wood-Sorrel, and Pimpernel, each one handful; of Barly half an ounce, of Apples cut, of Currans, or Strawberries, or Rasberries, one handful; let them be boiled in four pints of spring-water, till a third part be con∣sumed; clarifie it, and strain it; then add to it of the Syrup of Violets one ounce, and of Sal Prunella a dram and a half.

* 1.484Take of the Leaves of Borage fresh gathered and young, four handfuls, of Wood-Sorrel two handfuls, two Apples sliced, of Sal Prunella two drams, the pulp of one Orange, of white Sugar one ounce; let them be bruised together, and pour to them of spring-water two or three pints▪ let them be strongly squeezed forth, and kept in a Glass, and cleared from its setling; let six or seven ounces be taken of this often in a day, when they will. For the quenching of thirst, let the excellent drink of Palme∣rus, viz. Spring-water with Sugar, and the juice of Lemons, or Water, or Posset∣drink with Elm leaves, or Pimpernel infused or boiled in it, be drunk: Emulsions of the Decoction of the roots and flowers of Water-Lilies, with Melon-seeds; or else Spring-water distilled with the pulp of boiled Apples dissolved in it.

* 1.485Hypnoticks or Medicines causing rest, are often very necessary in this Disease; but yet the stronger are not convenient in the beginning, nor let them be frequently used; because sleep caused by Opiates, carries more morbific matter to the Brain, and fixes it more deeply there.

Take of the Water of Cowslip flowers four ounces, of the Syrup of Poppies half an ounce, of Pearl one scruple; make a drink to be taken at night late.

Take of the Seeds of white Poppy two drams, of Sugar-Candy a dram and a half; bruise them together, and pour to them of white Poppy Water six ounces; make an expression, to be taken after the same manner.

Narcoticks or Stupefying Medicines, which are made of things meerly cold, are cau∣tiously to be exhibited; because they agree not with some, who have the Fibres of their Stomach very tender and sensible. I have often observed these kind of Hypno∣ticks, to have stirred up a great oppression in the Ventricle, and then presently an Inflation or blowing of it up; and a little after distractions and inordinations of Spi∣rits use to follow in the Brain, yea in the whole Body; so that there was not only a frustration of sleep, but great disquietness was stirred up.

Take of liquid Luadanum, prepared with the Salt of Tartar, or the juice of Quinces, Let a Dose of it be taken in a convenient liquor.

* 1.486Things inviting Sleep, as Epithems or moist Medicines applied to the Temples and Forehead, are often used with success; of which sort are Rose-cakes dipt in Vinegar, Rose-water, and grated Nutmeg, and Embrocation or washing with Water or Milk, Oyntments of Oyl of Nutmeg by expression, Oyntment of Poplar, to which some∣times may be added of Opium five or six grains; or a Cake of Poppy flowers, with Vinegar and Nutmeg, &c. Further, for this end, rather than for the taking away the inflammation of the Meninges, the hot Lungs of a Lamb or Weather, as also Pigeons or Chickins slit in two,* 1.487 do often give notable help. Also for this use Housleek bruised, and mixt with a Womans Milk, and applied to the hinder part of the Head being shaved, is wonderfully praised; Also the Epithem of Penotus, of twelve grains of Nutmeg, of Cam∣phir half a scruple, and the Tincture of Rose-water impregnated with red Sanders twenty ounces, is commended by some.

Further, they are wont to apply Epithens not only to the Head, but also to the Heart, Liver, and other parts: A little bag of silk may be applied to the Praecordia, with Cardiac Species being sewed or quilted in it, with silk, and sprinkled with Rose-water, or Vinegar of Roses; also rags wet in Rose Vinegar, may be laid to the Testicles: The Feet way be hathed with a Decoction of Willow leaves; Lettice, or the heads of white Poppy. But these kind of cooling Topicks only, and cherishers are to be used in the beginning of the Disease; but in its height, resolves and softners, are to be added, as the Flowers of Chamomel, Melilot, Elder, &c. also the leaves of Mallows, Orage, Marjoram, Hysop, and such like: In the declining of the Disease, resolvers only, and those sparingly are to be administred.

* 1.488In the mean time, there ought to be great means used, for keeping up of strenght, for that too much failing, all hopes of Cure is lost. For strength is quickly worn out, by reason of great watchings, the perpetual agitations both of the body and mind, a thin Dyet, and Phlebotomy sometimes often requisite. Wherefore, great care must be had, lest whilst we endeavour to root out the Disease, by Purging or frequent letting of Blood, we should suddenly debilitate the Vital Function: If this begins to fail, the Phrensie being let alone, a better dyet may be granted, and especially Cordialls are to be used.

Take of the Tincture of Coral half an ounce,* 1.489 take of it twenty drops, twice or thrice in a day, with a Dose of a Cephalick or a Cordial Iulep; or let it be given with Co∣ral dissolved in Milk, made with the juice of Oranges, one spoonful often in a day.

Take of the Rob or Conserves of Rasberries, and Barberies one ounce, of prepared Pearl, of Magistery of Coral, each one dram; of Confection of Hyacinthae two drams, Syrup of the juice of Alchermes, what will suffice; make a Confection, and let the quantity of a Nutmeg be taken three or four times a day, drinking after it of the following Iu∣lep three ounces.

Take of the Water of the Flowers of Water-Lilies, red Roses, and of Elm leaves, each three ounces; of the Syrup of Coral two ounces, of the Cordial Water of Sax∣ony one dram▪ mingle them.

Take of the Conserves of the Flowers of Water-Lilies, and of Violets, each one ounce; the Stalks of Lettice candied or preserved half an ounce, of the Powder of red Co∣ral, bruised in a morter with the juice of Orange and dryed, two drams; of the Spe∣cies of Diamarg. frigid. one dram, of white Poppy seeds one dram and a half, with what will suffice of the Syrup of the juice of Wood-Sorrel; make an Electuary; let the quantity of a Nutmeg be taken often in a day.

In the Phrensie, not only the Belly, but also the Bladder, and their offices, ought to be thought on, and often solicited or provoked.

Wherefore, the sick are to be warmed, and the Urinal given them, and asked to make water; but if they will not, or cannot, let the region of the yard below the belly be bathed with a Decoction of Pellitory of the wall, Elder Flowers, and of the Seeds of Parsley, and wild Carrot Seeds, or daucus; with a Spunge; and after the Fo∣mentation, anoint it with Oyl of Scorpions, and Oyntment of Dialthaea: In a long suppres∣sion of Vrine, you may put up to the bladder a piece of Wax Candle.

The Histories and cases of Frantick people are so many,* 1.490 and so diversly described, and so accurately by Hippocrates in his Books De Epidem. that there seems little need here to add others; especially, because it would be an immense work and tedious, to relate the various manner and cases of Mad-men: In the mean time, as to the event of the Disease, there is great diversity; for that for the most part the Feavour being cured, the Phrensie ceases by little and little; or else, that having no, or an evil, Crisis; either death, or a long raving follows. But that our Hypothesis, of the In∣flammation of the Spirits, may be illustrated, I shall propose here one more rare in∣stance.

I was one time sent for to Cure a Maid,* 1.491 that was strong, and having a Feavour, was highly raging, being continually bound in her Bed. I took from her a great quantity of Blood, and caused it to be again iterated; I often took down her Belly with Clysters; yea I ordered all the other administrations in order, usual in this case; in the mean time she took Iuleps, Emulsions and Hypnoticks: But these little or no∣thing availing, she continued still for seven or eight days without sleep, and furious, perpetually calling and bauling for cold drink; wherefore an Hydropick being granted her at her pleasure, yea to satiety; she was nevertheless not any thing less quiet, or thirsty: I therefore bid them (for that it was Summer time) that in the middle of the Night she should be carried by Women forth of doors, and put into a Boat, and her Cloths being pull'd off, and she tyed fast with a Cord, should be drenched into the depth of a River, the Rope being tyed only about her middle, that she might not be stifled in the Water; but there was no need of that, for the Maid of her own accord, fell to swimming, that scarce any Man could do it better, who had learned the art: After about a quarter of an hour, she came forth of the Water sound, and sober, and then being had to Bed, she slept, and sweat very much, and afterwards, without any other Remedy she grew well. This Cure succeeded so happily and so suddenly, foras∣much as the excess both of the Vital and the Animal flame, being together immensly increased, was taken away by a proper Remedy for the more intense Fire; to wit, by the moistning, and cooling of the Water.

CHAP. XI.

Of Melancholy.

* 1.492AS the Phrensie arises from the burning of the Animal Spirits, (as we have else∣where shewn) or as Prosper Mart. seems to affirm, from their substance be∣ing inflamed: so indeed other Distempers of raving arise from their substance being altered by other ways, and from their genuine nature being changed, from a spirituous-saline, into an acetous or sharp disposition, like to Stygian Water, or else into a liveless; which therefore are either Melancholy, or Madness, or Foolishness or Stu∣pidity: of which we shall now speak in order, and first of all of Melancholy.

Melancholy is commonly defined to be, a raving without a Feavour or fury, joined with fear and sadness. From whence follows that it is a complicated ••istemper of the Brain and Heart: For as Melancholick people talk idly, it proceeds from the vice or fault of the Brain, and the inordination of the Animal Spirits dwelling in it; but as they become very sad and fearful, this is deservedly attributed to the Passion 〈◊〉〈◊〉 the Heart.

It would be a prodigious work, and almost an endless task to rehearse the diverse manner of ravings of Melancholy persons; and there are great Volumes already of Histories and examples of this sort; and more new and admirable observations and examples daily happen. Fabulous antiquity scarce ever thought of so many meta∣morphoses of men, which some have not believed really of themselves; whilst some have believed themselves to be Dogs or Wolves, and have imitated their ways and kind by barking or howling; others have thought themselves dead, desiring pre∣sently to be buried; others imagining that their bodies were made of glass, were afraid to be touched lest they should be broke to pieces.* 1.493 There are extant manifold and various kinds of the Imagination so depraved, concerning which may be common∣ly observed; That the distemper'd are Delirious as to all things, or at least as to most; so that they judge truly almost of no subject; or else they imagine amiss in one or two particular cases,2 1.494 but for the most part in other things, they have their notions not very incongruous. We shall first inquire into this more universal Distem∣per, for that the Imagination is prevaricated concerning very many things; to wit, by what causes, and with what difference of Symptoms, this is wont to come to pass; afterwards we shall speak of the special raving or idle talking.

* 1.495Although the universal Distemper of Melancholy contains manifold Delirious Sym∣ptoms, yet they chiefly consist in these three; 1. That the distemper'd are almost continually busied in thinking, that their Phantasie is scarce ever idle or at quiet. 2. In their thinking they comprehend in their mind fewer things than before they were wont, that oftentimes they roll about in their mind day and night the same thing, never thinking of other things that are sometimes of far greater moment. 3. The Ideas of objects or conceptions appear often deformed, and like hobgoblins, but are still represented in a larger kind or form; so that all small things seem to them great and difficult.

After this manner the Phantasms in the Brain evilly affected, are objected to the Intellect, almost after the same manner as the visible images are shewed to the Eye, by the interposition of some Optick Glass; to wit, where every object appears an horrid and huge monster, and for that reason a small portion only of the visible matter or thing, being increased to that immensity, is received by the aspect; then by reason of its horrid and unusual appearance, the image being once conceived, is not easily or sud∣denly let go: we will now consider by what affection of the Brain and Spirits, these appearances happen.

* 1.496Here we shall first of all inquire into the disposition or preternatural Constitution of the Animal Spirits: For inasmuch as they are after an irregular manner, they always or for a long time continue in their irregularities; and when the Palsie, Apoplexy, Ver∣tigo, or Convulsion, are not joined to this Distemper of theirs, which argue obstructi∣ons of the Brain, it may be inferred, that the Animal Spirits, not fetching their force elsewhere, are driven into such inordinations; nor do chiefly conceive their disorders, by reason of the Pores and passages of the Brain being obstructed; but ra∣ther, in this case, they cause these aforesaid Symptoms in the sick from the default of their own Nature.

Such an indisposition of the Animal Spirits is wont to be described after this man∣ner;* 1.497 to wit, that they, when as they ought to be transparent, subtle, and lucid, be∣come in Melancholy obscure, thick, and dark, so that they represent the Images of things, as it were in a shadow, or covered with darkness: The explication of which does not seem incongruous; forasmuch as we have already shewed, that the Animal Spirits flowing forth from the inkindled Blood, go forth after a manner, as the rays of light from a flame. And it sufficiently appears, that the light shews and illustrates it self diversly, according as it proceeds from the burning of bodies, flaming forth after a various manner; as of Spirits of Wine, Oyl, Fat, Mineral Sulphur, Nitre, and others: in like manner the Animal Spirits, forasmuch as stilled forth from the Blood, having got this or that, or some other disposition, they are either subtil, clear, or dull, thick, and as it were sooty, they variously pass thorow and irradiate the organs of the Animal Functions, and so for that reason, diversly pervert their actions.

But further,* 1.498 when as the Animal Spirits are not wholly loose and free as the little bodies of light, but mutually cohere or stick together, and left the continuity of the soul should be broken off, they ought to be contained in a certain Latex; there∣fore these, with the Vehicle to which they cleave, may be very aptly compared to some Chymical Liquors, drawn forth by distillation from natural mixtures. Which Analogy indeed seems fittest for the unfolding the mad distempers.

1. Liquors Chymically Distilled,1 1.499 are, according to the active Elements after a vari∣ous manner combined in them, of a diverse kind: the chiefest of these, by the con∣sent of all, are said to be such, as in which the Spirit being united with the Salt, doth volatise it, and on the other side is sharpned by it, and after a sort fixed or kept. Of this sort they conceive the great Elixir and the Liquor Alcahest to be; and indeed in a manner are the Spirits of Blood, of Harts-horn, of Soot, and such like, very subtil, volatil, and penetrating, yet not apt to be inflamed, or suddenly to be dis∣sipated. And indeed, the Animal Spirits seem to be after a manner, having obtain∣ed a sound and legitimate disposition, like a spirituous liquor stuffed with a volatile Salt, which is distilled from Blood; besides, to this there is given from the fire an high Acrimony and Empyreuma, or smatch of burning, which are wholly absent from the liquor watering the Brain and Nerves.

2. Other Chymical Liquors are sulphureous and burning,2 1.500 as the Spirits of Wine and Turpentine, which consisting of Spirit and Sulphur combined together, are easily inflamed, and depart one from another of their own accord, and fly hither and thither what way they can find; the Animal Spirits of this nature, as we shewed in the former Chapter, seem to be in the Phrensie.

3. Some Liquors or Spirits are produced by Chymical operation,3 1.501 in which the fixed Salt being carried forth to a Flux, hath obtained the dominion; of which sort are such as are distilled from Vinegar, ponderous Woods, and some Minerals, with a gen∣tle fire; whose particles are very moveable, and unquiet, but of a short activity; so that Effluvia's do not long flow from them, that if they should be distilled in Balneo, nothing but an insipid Phlegm would be carried into the Alembick. And indeed, the Animal Spirits in Melancholick Distempers, are to be suspected to be of this kind of acetous nature, with the dominion of a fluid salt, as shall hereafter be more large∣ly shewed.

4. Some Stagmas drawn forth by Spagyrick art,4 1.502 are sometimes most sharp, to wit, in which the untamed Particles of a fluid Salt, and also Sulphureous, and Arsenical, being combined together, are exalted; as are the Stygian Waters distilled out of Ni∣tre, Vitriol, Antimony, Arsnick, Verdigriece, and the like, all which are of a fierce nature, very penetrating and not to be broken, so that their Effluvia's are agitated with a perpetual motion, penetrate every thing, and are also diffused far and wide. And these kind of Liquors, may be aptly likened to the disposition of the Animal Spirits, acquired in Madness, as shall be anon declared.

But for the present,* 1.503 that we may deliver the formal reason and causes of Melan∣choly, let us suppose, that the liquor instilled into the Brain from the Blood (which filling all the Pores and passages of the Head, and its nervous Appendix, and watring them, is the Vehicle and bond of the Animal Spirits) hath degenerated from its mild, benign, and subtil nature, into an Acetous, and Corrosive, like to those li∣quors drawn out of Vinegar, Box, and Vitriol; and that the Animal Spirits, which from the middle part of the Brain, irradiating both its globous substance, as also the nervous System, and do produce all the Functions of the Senses and Motions, both in∣terior and exterior, have such like Effluvia's, as fall away from those Acetous Chy∣mical Liquors. Concerning which there may be observed these three things, 1. Their

being in perpetual motion:* 1.504 2. Not long able to flow forth: 3. not only to be carried in open ways, but to cut new Porosities in the neighbouring bodies, and to insinuate them∣selves into them. From the Analogy of these conditions, concerning the Animal Spi∣rits, it comes to pass, that Melancholick persons are ever thoughtful, that they only comprehend a few things, and that they falsly raise, or institute their notions of them. We shall consider of each of these a little more largely.

1 1.5051. Therefore we shall take notice, that the Effluvia's falling away from these distil∣ed Acetous Liquors, are perpetually in motion: for the Spirits of Vitriol, or of Vinegar, or Sea Salt continually evaporate: the reason of which is, because those Particles of the fluid Salt do scarcely agree with any others, but where ever they are stopped, being apt immediately to leave their subjects, seem to endeavour to get new consorts. And hence some have thought nothing more like to perpetual moti∣on, than the Acid Spirits of Minerals, shut up and Hermetically seal'd in a Phial; for so the Vapours or Effluvia's will creep about the sides of the Glass, with a con∣tinual Circulation.* 1.506 In like manner we may suppose, That the nervous Acetous Li∣quor is instilled from the Blood, sometimes stuffed with a fixed Salt, or with Vitri∣olick Particles, or other heterogeneous, into the Brain, for the matter and Vehicle of the Animal Spirits; and so these being admitted within the middle part of the Brain, for the acts of the Animal Functions, do not quickly pass thorow and irradi∣ate all the Pores and Passages, but like little acid Atoms, creep about here and there, slowly, but incessantly, and as it were with a certain unquiet motion of tingling or creeping, diffuse themselves by little and little thorow the whole neighbourhood: Hence a storm of thoughts is perpetually stirred up, by which the Brain is wont to be busied without intermission; so that Melancholic persons have continually, day and night, disturbed Phantasies; for that their Animal Spirits consist of a continually moveable matter; Hence also they look with eyes turned inwards, or fixed, or obliquely, and sullen or dogged, and exercise the other faculties both sensitive and loco-motive inad∣vertently; because the Spirits being worn out and distracted by continual motion, do not well actuate or beam into the nervous System.

2 1.5072. Though the Effluvia's continually fall away from an Acetous Spirit, prepared by Chymical Art, yet they do not go far, but gather together on an heap thickly, near the superficies of the liquor, and penetrate only the neighbouring bodies, not touching those that are at a distance: Hence the Spirits of Vitriol, Salt, or Vinegar, will not ascend out of the Cucurbit into the Alembick unless urged with a very strong heat; but being included in a low Phial, they shall corrode and pierce thorow the stop∣ple.

* 1.508It is after the same manner, concerning the Phantasie of Melancholick persons; for inas∣much as the Animal Spirits being degenerate into an acid nature, do not irradiate or quickly pass thorow the whole compass of the Brain, as before, but flowing in the mid∣dle part, are carried with its force only into the nearest Pores and Passages; therefore cogitations raised up from thence, though they be continual, yet they comprehend but a few things: and so, as when many bands of Spirits are thrust together in strait bounds, every small object, and of very little moment, seems to them very great and of notable weight;* 1.509 certainly after the same manner, and for the same reason, as when the visible images passing thorow a Microscoptick Glass are carried to the Eye; for, because many beams of the same thing are concenter'd, its magnitude seems to be increased into an immense greatness; so when as every intentional Species or Image, by the conflux of very many spirits together, is formed in the Brain, it appears to the soul greater and of more weight than usual. Every one may experiment this truth in himself: For when as we become thoughtful, from eating gross or melancholick meats, or by reason of the passion of sorrow (the reason of which affection is, because the Animal Spirits are unfit for a more free expansion) then we are very solicitous and fearful, concerning every little thing, as if then our health or fortune were for ever in danger. Hence also, because the Animal Spirits, though almost ever in motion, are notwithstand∣ing still limited within the same short bounds, Melancholick persons persist a long while in thinking and revolving in their mind often the same thing.

3 1.5103. But there yet remains another similitude of the Animal Spirits, with those di∣stilled from Vitriol, and other saline bodies, to wit, that as the Effluvia's sent away from these kind of Acetous Spirits, do not evaporate so much from open spaces and tracts, before made, as they cut out Pores and Passages that are new, for themselves, in an objected body; so that they easily pass thorow, and render friable or crumbling, the Cork or stopple to the Vessel where they are; which happens not from the Spirit of Wine, to any thing that stops up the Phial; so indeed in Melancholick persons, it is usually wont to be. For because the Animal Spirits, being as it were pointed with

saline Particles, whilst they flow from the middle of the Brain, they observe not their former tracts and ways of their expansion, but they thickly make for themselves new and unwonted little spaces,* 1.511 within the globous substance of the Brain: Hence cogi∣tations are brought before the Soul, not such as they were wont to be, but new and incongruous, and for the most part absurd. But indeed, because the Phantasie is prevaricated, about the Conceptions of things, and by reason that the acts of judg∣ment and reason are falsly framed, the only cause is, for that the Animal Spirits leaving their former walks, and going backward and forward in their ways in the Brain, being carried hither and thither obliquely and transverse, affect altogether unaccustomed and bye ways, which indeed is proper for them to do, out of the Ace∣tous disposition, with which they labour; to wit, forasmuch as the Effluvia of those kind of Liquors expand themselves not in a direct or free emanation, as the rays of light; but by a bending motion, and as it were creeping, they craul on every side in∣to the neighbouring part.

Thus much for the primary Melancholick Distemper,* 1.512 to wit, a Delirium or Raving, being excited by reason of the vices of the Spirits inhabiting the Brain: The begin∣nings of which, although they proceed chiefly, and oftentimes, almost only from the Acetous disposition of the Spirits, yet afterwards, the conformation of the Brain it self is often brought to be a part of the cause; to wit, forasmuch as the Recrements of the Melancholick Blood, being perpetually poured forth, renders its substance more thick and dark, and the primary tracts or paths of the Animal Function being near blotted out, new, oblique, and by-paths are made; insomuch, that the Spirits, though better should be begotten, could not easily irradiate the Brain, or presently recover their former passages.

Melancholy is not only a Distemper of the Brain and Spirits dwelling in it,* 1.513 but al∣so of the Praecordia, and of the Blood therein inkindled, from thence sent into the whole Body: and as it produces there a Delirium or idle talking, so here fear and sadness; but by what means we shall now see.

First,* 1.514 in Sadness, the flamy or vital part of the Soul is straitned, as to its compass; and driven into a more narrow compass; then consequently, the animal or lucid part contracts its sphere, and is less vigorous; but in Fear both are suddenly repres∣sed and compelled as it were to shake, and contain themselves within a very small spaces; in either passion, the Blood is not circulated, and burns not forth lively, and with a full burning, but being apt to be heaped up and to stagnate about the Prae∣cordia, stirs up there a weight or a fainting; and in the mean time, the Head and Members being destitute of its more plentiful flux, languishes. The formal reasons of these Distempers, and their causes, we have before exposed.

But because these are habitual in Melancholick persons,* 1.515 the cause is partly in the Blood, and partly in the Animal Action of the heart. For the Blood, because of the saline particles being exalted, becomes less inflamable; from whence it is nei∣ther sufficiently inkindled in the Lungs, or doth it burn with a plentiful and enough clear flame within the passages of the Heart and its vessels; but is apt to be repressed, and almost blown out with every blast of wind: Hence, when that the vital flame is so small and languishing, that it shakes and trembles at every motion, it is no won∣der if that the Melancholick person is as it were with a sinking and half overthrown mind always sad and fearful. By reason of this kind of saltish Dyscrasie of the Blood, Melancholicks rarely have a Feavour; yet being taken with it, by reason of the ir∣regular burning of the Blood, they are more in danger.

No less doth it come to pass,* 1.516 by the fault of the Heart, that Melancholick persons become sad and fearful, by reason of the course of the Blood being retarded, and cal∣led back from thence: for, because that Muscle is actuated but with an inflowing of weak and enormous Spirits, it cannot perform its contractions strongly enough, and constantly, whereby the Blood may be driven forward into the whole body, without stop or leaping back: So the Blood and the Animal Spirits affect one another mutu∣ally, with a reciprocal evil, and bring hurt one to the other. That is, the Melan∣cholick Blood consisting of Saline Particles, carried forth together with Sulphureous, begets Animal Spirits, indued with an Acetous nature, as hath been shown; and these Spirits wrongly performing the offices of the Vital Function, cause such an evil disposition of the Blood to be increased.

Thus much of Melancholy in general,* 1.517 viz. of its Essence, Conjunct Causes, and chief Symptoms, together with the reasons of them. Before we proceed to the kinds and differences of this Disease, we ought to explain, from what kind of causes, both Procatartick and Evident, it is wont to arise, and to be cherished; and first, from whence either part of the Soul, viz. both Animal and Vital, doth acquire their morbid disposi∣tions.

* 1.518First we say, the former of these to be Acetous, like to the Spirit of Vitriol or Vine∣gar, and this to be Salino sulphureous, or Atrabilary or Melancholick; further, as the one doth cherish the other, so they at first beget one another. For sometimes Melan∣choly beginning, and for a long time persisting, from the Animal Spirits being distur∣bed, and driven into a certain confusion, causes the Melancholick disposition of the Blood; and sometimes also the Blood, at first contracting this evil disposition, perverts the nature of the Spirits.

That Melancholy doth very often arise from the Animal Government, every common body doth sufficiently note; to wit, forasmuch as the Animal Spirits conceive inordi∣nations from violent passions of the mind, in which, when they remain long, they bend the whole Soul, yea and the Body, from their due temper and constitution: So especially destroying Love, vehement sadness, panick fears, envy, shame, care, and immoderate study, are wont oftentimes to excite this Distemper. For by reason of these kinds of occasions, the Animal Spirits being thrust down, beyond their wonted paths of expansion, and remaining in their error, by reason of the assiduity of Passion, at last they go into these deviating tracts, which afterwards observing, they are hard∣ly reduced into their former due ways. Then, forasmuch as for that reason, the mo∣tion and vigoration of the Heart (as hath been shewed) is lessened; therefore the Blood is defective in its due temper, and sanguification, and is from thence made more fixed and Salino-sulphureous, and the Animal Spirits coming from it, are but degenerate into a sourness; and so the Blood being depraved by the latter, encreases to the Melan∣cholick disposition, begun from the Spirits.

* 1.519No less often doth it come to pass, that the seeds of Melancholy, being at first laid in the Blood, do at length impart their evil to the Spirits: For this reason, some are made obnoxious to this Disease from their Parents. But an inordinate living, long in∣termission of wonted exercise, usual evacuations, as of the Menstrual Blood, or the Piles, or bleeding at the Haemorrhoidal Veins, also the Seed, or the Serous Matter, be∣ing suddenly suppressed, and many other occasions, easily infect, and foul the Blood, and render it Melancholick; whose depraved disposition is of necessity communicated to the Spirits.

* 1.520But we cannot here yield to what some Physicians affirm, that Melancholy doth arise from a Melancholick humor, somewhere primarily and of it self begotten, and they as∣sign for its birth, several places, to wit, the Brain, Spleen, Womb, and the whole habit of the Body; for besides, for that no such mines of such an humor appear, unless perhaps some be planted in the Spleen; moreover the Blood it self is it, which con∣ceives at first the Melancholick intemperance, or any other by it self, and then deposes the Recrements of the same nature, in proper emunctories or receptacles. For nei∣ther is the yellow Bile or Choler laid up in the Gall-Bladder, or the black Bile so called, or Melancholick humor in the Spleen, unless the bloody Mass begets those hu∣mors before hand: If at any time these, or other Recrements, being any where laid up, are received of the Blood, they produce its effervescency or growing hot, but not presently or easily its intemperature.

* 1.521Therefore, because sometimes the original of Melancholy is ascribed to the Head, and the intemperature of the Brain from these, to wit, too hot, and accused to be from those, too cold, I rather think it ought to be affirmed, that this Distemper doth some∣times at first begin from the Brain, and the Soul dwelling in it: because Hippocrates also plainly asserts it, 6 Epidem. Sect. 8. T. 58. For distinguishing Epileptical and Melan∣cholick persons, beings made so together, or else successively, as to the formal reasons of the Diseases, he saith, The defluxion which floweth from the Brain, from the ill affecti∣on, state, or temperament thereof, if it flows into the Body causeth the Falling-sickness; if into the cogitation or the mind, Melancholy. So in Melancholy he grants, the Soul distinct∣ly, and as it were apart from the Body, or Brain, to be affected.

* 1.522Secondly, Because sometimes the original of this Disease is deduced from the Womb, it is not to be thought, that the Melancholick humor is there at first generated, but the occasion of Melancholy doth proceed from thence; either bacause the whole Blood being infected, and made degenerate by reason of a stoppage of the Menstrua, strives to go into a Melancholy Dyscrasie or intemperature; or because, by reason of the pro∣vocations of Venus or Lust, being restrained, not without great reluctancy of the Cor∣poreal Soul, the Animal Spirits being for a long time forced, and restrained, become at length more fixed and Melancholick.

* 1.523Thirdly, It is a common opinion, and also ours, that sometimes Melancholy is ei∣ther primarily excited, or very much cherished from the Spleen, being evilly affected, and so from thence is called by a peculiar word, Hypochondriack; as we have shewed at large in another Tract of Convulsive Diseases. But the Blood is first in fault, beget∣ting

in it self fom the beginning Melancholick foulnesses, deposes them in the Spleen, which receiving again, after their being exalted into the nature of an evil Ferment, is more vitiated in its disposition, by their foulness.

Fourthly,* 1.524 But besides, it is said, there is another kind of Melancholy, distinct from the Hypochondriack, and the former, that is begotten in the whole Body together; this is nothing else, than the Mass of Blood being degenerated from its true nature, by reason of errors in the six non-naturals, and for many other occasions, doth acquire at Atrabilary or Melancholick disposition; that is, where the Spirit being depressed, the Sulphureous Particles, together with the Saline, and also with some Earthy, are car∣ried forth; for the Melancholick disposition of the Blood is very much a-kin to this Sulphureous-saline, which we have shewed oftentimes to excel in some kind of Scur∣vy. For what causes, and upon what occasions, this is wont to be produced, may be sufficiently known from the Aetiology of that Disease, being at large explained.

The differences of this Disease may be easily gathered from what hath been said:* 1.525 for in respect of its first subject, which is sometimes the Soul, sometimes the Body, or ra∣ther the Blood,1 1.526 it is called either Animal or humeral Melancholy. Again, it is im∣pressed according to that, with various powers, to wit, it is first impressed either on the Rational Will, or the sensitive, concupiscible, or irascible Appetite; also it is divided into very many kinds, as it is employed about diverse things, to wit, either Sacred, or Magical, or Humane, the huge cense or bead-roll of which is almost infinite; the chief of which, that are wont to come within the Cure of Medicne, are Religious, Amo∣rous, and Jealous Melancholy.

2. By reason of the temperament of the sick,2 1.527 according to which, the Particles of the Melancholick blood, being made sometimes Sulphureous, sometimes Saline or Earthy, the Spirituous being depressed, are exalted more or less, a Delirium, or sadness, fury, or stupidity, are more or less variously joined to Melancholy.

3. The Disease is either continual or intermitting,* 1.528 according to the conjuct cause, either stronger, both the Hypostasis of the Spirits, and also the bloody Mass, being both together vitiated; or else lighter, and less deeply fixed; so that the Distemper'd some∣times are well enough for many days or months, yet apt to relapse upon any great oc∣casion.

4. In respect of the hurt Imagination,* 1.529 there are very many types of Melancholicks to be met with, yea almost innumerable; yet the chief difference of which is, that some are dilirious in all things, and others in one thing only.

The Prognostick of this Disease,* 1.530 though as to health or death, it is for the most part safe; yet by reason of the event, it is very uncertain: For some quickly grow well, others not of a long time, and others are never cured.

This Distemper suddenly excited, from a solitary evident cause, as a vehement Pas∣sion, is far safer than by leasure invading, after a long Procatarxis or foregoing cause. For the former, if the evident cause be presently removed, often ceases of its own ac∣cord, or with a little help; but in this latter, for that the Mass of Blood, and the whole heap of Animal Spirits, are departed from their due disposition, and not rarely the conformation of the Brain, as to the tracts of the Spirits, is altered; The Cure very difficultly, and not under a long time succeeds.

Melancholy being a long time protracted, passes oftentimes into Stupidity, or Fool∣ishness, and sometimes also into Madness; further, sometimes it brings on Consulsive Distempers, or the Palsie, or Apoplexy, yea sometimes a violent Death.

As to the Cure, there is little or no hopes, if the Distemper'd being very contuma∣cious and refractory, reject all Medicines, and every method of Physick. Further, there is scarce any better thing to be expected from them, who lying sick with only imaginary Diseases, take all Remedies, and require still more, and of diverse kinds, to be given them.

As the Cure of Melancholy,* 1.531 as it is always difficult and long, so it is wont to be migh∣ty intricate and perplexed; for that it ought to be diversly and variously instituted, in respect of the evident, Procatartick, and Conjunct causes of its kind, also by reason of the Symptoms daily arising. Neither is it only behoveful oftentimes to change the Remedies, and Method of healing, but also variously to make use of between whiles, warnings, deceits, flatteries, intreaties, and punishments.

But first of all,* 1.532 the Evident Cause of this Disease, if any noted thing went before should be inquired into; and if it may be, either presently removed, or else its removal to be in some sort feigned. Further, the affections of the mind being vehement, and stirred up from thence, are either to be appeased, or subdued by others opposite. Wherefore, to desperate Love ought to be applied or shewed indignation and hatred; Sadness is to be opposed with the flatteries of Pleasure, Musick, a desire or vain glory,

or also a pannick terror. In like manner, as to the rest of the Passions, you must pro∣ceed to quiet, or elude them.

* 1.533The Curatory Method, accommodated for the healing of Melancholy, suggests many other indications, the chief of which, and to which the rest may be the better placed, are these three, commonly noted, viz. Curatory, which respects immediately the Dis∣ease, and its Conjunct Cause; Preservatory, which cuts off the Procatartick, and Evi∣dent Causes; and Vital, which is imployed about conserving of strength.

1 1.534As to the first Indication, the intention of the Physician is so much to lift up, make volatile, and corroborate the more fixed or dejected Animal Spirits, that being also apt to go backwards, or out of the way, that afterwards they may irradiate more freely, being stretched forth, the whole Brain, with a full and not broken beam, for the Acts of the Imagination, Judgment, and other principal faculties; and so lively actuate the Praecordia, and make them to vibrate or beat strongly, that the Blood being more plen∣tifully inkindled, it may be projected from thence, without stop or stagnating, into the whole Body.

Therefore,* 1.535 for the healing of the Spirits, first of all it is to be procured, that the Soul should be withdrawn from all troublesome and restraining passion, viz. from mad Love, Jealousie, Sorrow, Pity, Hatred, Fear, and the like, and composed to chearfulness or joy: pleasant talk, or jesting, Singing, Musick, Pictures, Dancing, Hunting, Fishing, and other pleasant Exercises are to be used. They who care not for Sports or Pleasures (for to some Melancholicks they are always ingrateful) are to be roused up by imploying them in more light businesses; sometimes Mathematical or Chy∣mical Studies, also Travelling, do very much help; moreover, it is often expedient to change the places of habitation, in their native soil. Those who will still stay at home, are to be warned, that they take care of their Houshold affairs, and that they should go∣vern their Family; that they should build Houses, plant and order Gardens, Orchards, or Till the Ground. For the mind being busied with necessary cares or duties puts aside, and at last deserts more easily, vain and mad cogitations. Melancholy persons are sel∣dom to be lest alone, for that then they indulge their airy phantasies and speculations, and suffer them to continue longer. The Soul sinks down inwardly, and leaving the body, enters into a certain Metamorphosis, and puts on a new shape, and oftentimes dif∣ferent from humane manners. Wherefore, the Distemper'd ought to be disturbed al∣most always with the discourses of their familiar Friends; to wit, that the Animal Spirits, being called outwards, may be solicited from their diversions, into their former and accustomed tracts. But if the sick be seduced with phantastical illusions, and ima∣gine some prodigious things of themselves, and firmly believe them; their mind is to be drawn from them, by artificial inventions; very many causes and examples of this sort of Cure are to be found in Books, and a discreet Physician may institute the like as occasion serves.

* 1.536Although a fresh Melancholy may be cured sometimes by the mere discipline and in∣stitution of the mind and Animal Spirits, yet in a long or inveterate, where the Spirits have contracted an acetous nature, and the Blood an Atrabilary or Melancholick dispo∣sition, and that the Brain is hurt, as to its Pores and passages: other Indications called Preservatory are required,* 1.537 for the taking away of the Procatartick causes. Concerning this thing, the Medical intentions are first, that the Blood be reduced to a better tem∣per, and genuine, to wit, a spirituous saline; then to enliven the Brain, and to render it bright and clear, its Pores being unlocked; and also to corroborate the Animal Spi∣rits, and to excite them into a lively flowing forth. For which ends, the following me∣thod I think good to propose, which notwithstanding ought to be varied, according to the various constitutions of the sick.

* 1.538The taking away of Blood has place almost in all Melancholicks, and sometimes it is often to be iterated. For the adust and liveless Blood, being at times drawn away, a new and more spirituous comes in its place. Concerning the quantity, place, and man∣ner of celebrating this Remedy, Authors have various opinions; but the motion and the affections of the Blood, being truly weighed, it will at first suffice to take a moderate quantity out of the Arm, and afterwards if need be, a lesser, or to draw it from the Sedal Veins by Leeches. How the Salvatella Veins being opened (as is said) should bring such notable help to Melancholicks, I confess I cannot understand: perhaps it may help them, if the Melancholick persons be firmly perswaded, that this Phlebotomy will cure them before any others: the frequent opening the Hemorrhoidal Veins, invites Nature to an endeavouring afterwards for that evacuation, which succeeding of its own accord (as Hippocrates says) does not seldom Cure this Disease.

* 1.539Purging, for that it draws back the nourishment of the Disease, from the firsts ways, and removes the impediments of other Remedies, ought to be celebrated at the begin∣ning,

and repeated at intervals. But that some think, for the sooner rooting out of this Disease, Hellebore or Elateriums are chiefly to be used, and cite Hippocrates for their Author; we apprehend, if the success be minded, those things do not ordinarily agree with, yea more often do hurt to the sick: For indeed, more strong Purgers do not take away the cause of the Disease, to wit, the Dyscrasie of the Blood, but rather encrease it; besides, they more debilitate and strike down the Animal Spirits, before dejected. But Hellebore was so often prescribed by Hippocrates, because in his Age other Cathar∣ticks were scarcely known, or at least they were not in frequent use: But now it is thought much better, gently to draw forth the receptacles of the humors, by more gen∣tle and easie Purgers, and to cleanse only the Viscera and the first ways, without any great commotions of the Blood and Spirits.

Vomiting Medicines (as in most Cephalick Diseases free from a Feavour) are wont to help after a peculiar manner in all mad Distempers.* 1.540 The reason of this partly consists in this, because the viscous load of the Ventricle, which (as we have elsewhere shewn) doth very much burthen the Soul, being purged forth, the Spirits by that means being more free, expand themselves more lively and chearfully. Further, forasmuch as Vo∣miting presses together and evacuates the neighbouring receptacles of the humors, to wit, the Gall Bag, the passage of the Pancreas, and the Glandulas of the Mesentery, procures that their contents be not transferred into the Head.

Take Oxymel of Squills one ounce and a half,* 1.541 of Wine of Squills one ounce, of the Syrup de Peto two drams; mix them, and make a Vomit: if it doth not work, or but slowly provoke Vomiting with a great deal of Carduus Posset-drink.

Take of the Decoction of the middle bark of Elder four ounces, of the Salt of Vitriol one scruple to two scruples, of Oxymel simple three drams; mix them, and take it after the same manner.

To robust and well-set persons may be given of the Infusion of Crocus Metallorum, or of Mercurius Vitae, also the Emetick Tartar of Mynsicht, or the Sulphur of Anti∣mony.

Take of the Root of Polypodium of the Oak half an ounce,* 1.542 of Epithimum three drams, of Sena half an ounce, of Tamarinds six drams, of the seeds of Coriander three drams, of yellow Saunders two drams; let them be boiled in fourteen ounces of Spring-water, till it comes to ten ounces; adding to the Colature, or when it is strained, of Agarick two drams, of Rhubarb one dram and a half, being clarified, add of the Syrup of purging Apples two ounces; let six ounces be taken, and repeated within three or four days.

Take of the best Sena three drams, Epithym, Rhubarb, each one dram and a half; of Yellow Saunders half a dram, of Coriander seed two scruples, of the Salt of Wormwood half a dram, of Celtick Spike a scruple; put these into white Wine, and the Water of Pipins, of each four ounces, kept close all night; to the liquor being strained five ounces, add of the Syrup of Epithimum six drams, of Aqua Mirabilis two drams; mix them and make a Potion. In strong bodies or hard to work on, may be added to these, of the strings of black Hellebore macerated in Vinegar one dram or two.

For those who had rather make use of Pills, Boluses, Powders, or Syrups, take the following.

Take of the Pil. Tartar of Quercitan,* 1.543 or of Amber of Crato half a dram, of the Resine of Ialap or of Scammony six or eight grains, or Tartar vitriolated half a scruple, of Am∣moniacum dissolved in Aqua Mirabilis, what will suffice to make a Pill: let four be taken going to sleep, and unless they work first one in the morning following.

Take of Calamelanos, of the extract of black Hellebore, each one scruple; of the Resine of Ialap six grains, of Ammoniacum solut. what will suffice; make four Pills, let them be taken with Government.

The Powder of Haly,* 1.544 the Powder of Valesco de Tarenta, of Peveda, and others, are very much commended. And indeed in Country bodies, or robust, this Cathartick may seem convenient. Take of Epithimum half an ounce, of Agarick, Lapis Lazuli, each three drams, Scammony one dram, Cloves thirty; make a Powder: the Dose is from half a dram to a dram.

Take of the Powder Diasenna, of Diaturbith with Rhubarb, each half a dram; make a Powder: let it be taken in a draught of Posset-drink, in a Decoction of Epithimum simple four or five scruples.

Take of the best Senna two ounces,* 1.545 of the Roots of Polypodia of the Oak two ounces, of Epithimum one ounce and a half, of yellow Citrons half an ounce, of Tamarinds one ounce, of Coriander seeds six drams, boil them in Barnet water four pints, till half be consumed,

strain it, and let it be evaporated in a warm Bath, to the consistence of a Syrup, adding towards the end, of pure Manna, and of white Sugar, each four ounces; make a Syrup: the Dose is two spoonfuls or three, in three ounces of some convenient distilled water, or in any other liquor. Or,

Take of the same liquor evaporated to the consistence of Honey six ounces, of fresh Cassie four ounces, of the jelly of Currans two ounces, of Cream of Tartar, of the Salt of Wormwood, each one dram and a half; of the Powder of Diasen. two drams, of yellow Sanders powder'd two drams; mix them and make an Electuary: Dose three drams to half an ounce.

* 1.546Purging is not to be used continually, nor too frequently, yea it suffices that it be administred within six or seven days space, and at other times, let the belly be taken down by Clysters, if it be bound. As to other Medicines, which are not evacuators, though the Ancients relied not much upon them, we put our greatest confidence of Cure in them. For they (to whom also many moderns consent) thought there was no∣thing more to be done for the curing of Melancholy, than to Purge forth the Melan∣cholick humor; wherefore, making Purges their chiefest business, they instituted the other Medicines called Preparatory, only for the sake of this, to wit, making it their scope, that as soon as the humor being reduced to a fit consistency, by altering Medi∣cines, and that the ways for its excretion were open enough, then that it should be carried forth of doors by Purgers.* 1.547 Which kind of Hypothesis seems not agreeable, neither to reason, nor to Medical experience; because Melancholick people rather receive hurt than help by often Purging, how methodically soever it be instituted. Therefore, we, placing the cause of this Disease in the Dyscrasie of the Blood and Spirits, and in the weakness or evil conformation of the Viscera and the Brain, esteem altering and cor∣roborating Medicines to be in the first rank for Remedies, and for the sake of these, that Purgers may be used sometimes between whiles. Therefore Purging being rightly prescribed at due intervals, for the removing impediments, as to the rest you may pro∣ceed according to these forms.

* 1.548Take of the Conserves of the flowers of Gilliflowers, and of Brage, each two ounces and a half; of the rinds of Myrobalans preserved six drams, of Coral prepared, and of Pearl, each one dram and a half; of Ivory, and Crabs Eyes, each one dram; of Confection de Hyacintho two drams, of the Syrup of Coral and red Poppy what will suffice; make an Electuary: take two drams Morning and Evening, drinking after it three ounces of the following Iulep, or the distilled Water.

* 1.549Take of the water of the Flowers of Cowslips, and of black Cherries, each six ounces; of Balm four ounces, of Dr. Stephens his Water two ounces, of Sugar six drams; min∣gle it and make a Iulep.

* 1.550Take of the leaves of Balm, Borrage, Bugloss, Fumitory, Water-Cresses, and Brooklime, each four handfuls; of the flowers of Pinks, Marigolds, Borrage, and Cowslips, each three handfuls; the outer rinds of six Oranges and six Lemons, being all cut and bruised, pour to them Whey made of Cyder eight pints; distil it in a common Still, and mix all the liquor together.

* 1.551Take of the Powder of Pearl, of Ivory, of Coral prepared, each two drams; of the Species Laetificant (or making merry) of Diarrhod. Abbatis, each one dram; of the Oyl of the rind of Citrons half a scruple, of white Sugar, dissolved and boiled to the consistence of Lozenges, in what will suffice of Balm Water, six ounces; make Lozenges according to art, weigh∣ing a dram: take two or three at nine of the Clock in the Morning, and at five in the Afternoon, drinking after it a draught of the distilled Water or of Tea. Or,

* 1.552Take of the Roots of Chervil, of Polypodium of the Oak, each one ounce and a half; of the leaves of Harts Tongue, Ceterach, Scolopendria, Germander, each one handul; of Tamarisk half a handful, of the bark of the same half an ounce, of Raisins of the Sun stoned two ounces, one Apple cut; let them be cut and bruised, and boiled in four pints of Spring-water, to the consumption of a third part; about the end add of the leaves of Water Cresses one handful, let it be strained and clarified: take of it six ounces twice or thrice in a day; sweteen it with Syrup of Fu••itory.

* 1.553Spaw-Waters coming from Iron, are wont oftentimes to give great benefit for the Curing of Melancholicks, to wit, because they being plentifully drunk, wash out salino∣sulphureous Tincture of the Blood, and destroy its evil ferment. Moreover, they wipe clean the silthiness of the Viscera, unlock obstructions, and what is of great benefit, they corroborate, by their astriction, both the weak and too loose Viscera, and also shut up the little mouths of the gaping Vessels of the Brain, by which a passage lay open

into it for the extraneous matter, together with the nervous juice. And for this rea∣son, to wit, by corroborating the Viscera, and by locking up the passages of the Head, Vitriolick•• prepared of Iron are wont to be given profitably in Melancholy, and al∣so in the Vertigo.

Take of our Steel prepared three drams,* 1.554 put it into a quart of the Water above described, take of it three or four ounces twice in a day, by it self, or with any other solid Me∣dicine.

Take of the filings of Iron one ounce,* 1.555 put it into a glass with the juice of Oranges two ounces; let it stand for a day, shaking it sometimes, then pour to it of the Water of Pipins, and of White Wine, each one pint; or of the more thin and sweet Cyder one quart: take of it three ounces, twice in a day, after the same manner.

Take of the Vitriol of Steel, of the Cream of Tartar, of Crabs Eyes, each one dram; mix them; make a Powder, and let it be divided into nine parts: Take one part every Morn∣ing in a draught of the distilled Water, or the Decoction, or in a proper Broth.

Take of the Syrup of Steel four ounces: take of it one spoonful twice in a day, in a pro∣per Vehicle.

Take of the Extract of Steel, of our Steel prepared with a proper Decoction three drams, of the Powder of Ivory, of yellow Saunders, of Lignum Aloes, each half a dram; of the Salt of Tartar two scruples, of Ammoniacum dissolved in the Water of Worms what will suffice to make a mass; let it be made into small Pills; let three or four be taken every Evening, drinking after it three ounces of the water of Apples, or of Cowslip flowers.

Whey,* 1.556 if it agrees with the stomach, being drunk very plentifully, for many days, for the same reason as Spaw-waters, viz. by washing out the Salt, and Sulphureous particles of the Melancholick blood, is often given with success. Whey with Epithimum infused in it, or boiled in it, is highly praised by some.

Let Broths be made of a boiled Pullet,* 1.557 with the roots of Polypodium, Chervil, Fenil, But∣chers Broom, and the leaves of Ceterach, Harts Tongue, Scolopendria, &c. take a draught of it in the Morning, and at five of the Clock in the Afternoon, in which dissolve of the Vitriol of Steel six grains, to ten of the Salt of Wormwood, and of the Cream of Tartar, each a scruple.

The Iuices of Herbs and their expressions bring sometimes notable* 1.558 help to the taking away the Discras••e of the Blood. Take of the leaves of Borage, of Water-Cresses, each six hand∣fuls; two Apples pared, the Pulp of two Oranges, and of white Sugar one ounce; let them be all bruised together, and pour to them of the best Cyder a pint and an half; make an ex∣pression very strongly, and let it be kept in a glass. The Dose is four ounces twice or thrice in a day.

In the summer time,* 1.559 a Bath of sweet water, for that it wipes away the filth im∣pacted in the Pores of the skin, and moves transpiration insensibly, is very profitable to some.

Because Melancholick persons sleep but badly,* 1.560 and from long and frequent waking become worse, therefore Anodynes, and sometimes the more gentle Hypnoticks (when there is need) may be prescribed to be taken late at night, for this end are convenient, a Decoction of Cowslip flowers, or of the leaves of Lettice, or the water of red Poppies, or the Syrup of the same: Further, Emulsions of the Seeds of the white Poppy, of the Syrup de Meconio, and others that are only agreeable and cherishing of the Spirits.

As there is an infinite Company of Melancholicks, as well as of Fools, therefore we shall illustrate our Hypothesis with two Examples only, in one of which the Disease be∣gins from the sensitive part of the Soul, or the Animal Spirits; and the other from its Vital part, to wit, from the Blood.

Sometime since,* 1.561 a noted person about forty years of Age, of a florid countenance, chearful, and nimble about any business, being afflicted in his mind, by reason of a cer∣tain affair, and very much dejected, he became thereupon very sad, Melancholick, and with a dark and cast down countenance. When I went first to visit him, he complain∣ed of a manifold hurry and distraction of thoughts, which were so many, that he was bus••ed in his Phantasie almost night and day continually, he lived without any sleep: Nor were these cares concerning the commonweal,* 1.562 or the proper business of his Fami∣ly; nor about the health of his Soul, or of his Body, was he at all solicitous; but was rather troubled perpetually about small matters, and of no moment. He was so fear∣ful of all things, that he presaged loss or death immediately to happen to him, upon every small accident. And lastly, he was so sad, as if he would contend in wee•••••••• with Heraclitus. Further, he laboured with such a straitness of Heart, and so g•••••••• a constriction, that he seemed to feel all his Praecordia to be drawn together like a Purse,

and he thought that there still lay there an immense burthen, and mighty weight, under which he imagined he could not go, unless stopping towards the Earth. Whilst he talked, and discoursed with his Friends, this constriction of the Praecordia, and the weight did somewhat remit; but then again, they were wont to be repeated more ve∣hemently, shaking for fear at any unaccustomed object: Nor did he labour only in his Praecordia, but with a certain constriction in his whole Body besides, and as if a certain burthen lay on the region of his Loins, and also on his shoulders and arms.

* 1.563The reasons of these Symptoms are clear enough from our Hyphothesis. As to the Cure, after various Medicines being given, without any success, I at last perswaded, because it was then Summer time, that she should drink of our Artificial Spaw Waters, for a fortnight: Therefore, first two quarts of Spring-water being poured upon half a dram of our prepared Steel, for a night, and afterwards as much in four quarts of water; the sick man every morning drunk the clear liquor, and within four or five hours he rendered the greatest part of it by Urine: He took besides, going to sleep and early in the morning, a Dose of an appropriate Electuary, (such as is above descri∣bed) with a Cephalick Iulep; within two months he became much better, and after∣wards by degrees returned to himself.

* 1.564Whilst I was writing these, a young Noble man, being lately returned from his Tra∣vels beyond Sea, and becoming unhealthy, put himself upon our care. This person being formerly indued with a Sanguine and chearful temperament, splendid in his ap∣pearance, as also with an acute wit, and of a ready ingenuity, whilst he travelled in the Countries abroad; but one Summer living in Spain, he felt a great alteration in him∣self, from the great heats in that place: for first of all, from the frequent heatings of his Blood, he became obnoxious to an heat arising in the palms of his hands, and in the bottoms of his feet, with prickings over all his body, which in a short time vanish∣ed. Then he found him self very bad as to his Appetite and Sleep; moreover being dull and sad, he began not to mind, yea sometimes to avoid any pleasant business, or the converse of his Friends. At length his indisposition daily increasing, without any evi∣dent cause, or real trouble of mind, he became Melancholick, so that being ever thoughtful, fearful, and sad, nothing could delight him; for his studies, exercises, travelling, conversation with learned men, or any other thing which he before delighted in, now became to him a trouble and a terror. After this manner being distemper'd for two years, he was so changed from himself, as if he were another Man. For his Cure he had consulted the most skilful Physicians in Spain, France, and Holland, and lastly in England, and had tryed several methods of healing almost without any be∣nefit. The Melancholick distemper of his blood, at first contracted by the intempera∣ture of the Air, still remaining, and afforded to the Animal regiment, Spirits as it were acetous, that is such as we but now described. To this Noble man, at the begin∣ning, we thought good to recommend these following Remedies.

* 1.565Take of the Decoction of Senna Gerionis (with Tamarinds half an ounce) four ounces, of the Syrup of purging Apples one ounce, of Aqua Mirabilis two drams; mix them, and take it with government, repeating it within nine days. After Purging let Blood be taken away with Leeches, about four ounces.

Take of our Syrup of Steel six drams, take a spoonful in the morning, and at five of the Clock in the Afternoon, in the following liquor three ounces, walking after it for an hour or two.

Take of the leaves of Balm, Borrage, Bugloss, Pimpernel, Elm-tree, Harts Tongue, Wa∣ter-Cresses, each four handfuls; of the Roots of Borrage half a pound, of Pinks and Ma∣rigold flowers, each three handfuls; the outer peels of eight Oranges and four Lemons, of Mace half an ounce; these being cut and bruised, pour to them of Whey made of Cyder eight pints; let them be distilled in common Stills.

Take of the Conserves of Gilliflowers, Betony, Borrage, each one ounce and a half; of Pearl powdered two drams, of red Coral prepared one dram and a half, of the Species Con∣fect. de Hyacintho two drams, of the Syrup of Coral, and red Poppies, each, what will suffice: make an Opiate to be taken going to sleep every night, the quantity of a Chesnut, drinking after it of Cowslip flower water two or three ounces.

After sixteen or twenty days, changing the method of altering Medicines, the fol∣lowing things were used in their places.

Take of the Powder of Ivory, Pearls, red Coral prepared, each two drams; of male Poeony roots one dram and a half, of the Wood-Aloes half a dram, Lozenges made out of Oranges four ounces, of the solution of Tragacanth made of Balm Water, what will suffice: make Troches weighing half a dram: let him eat four in the Morning, and at five in the Afternoon, drinking after them a draught of Tea.

Take of the same Powder without the Lozenges half an ounce, of the flowers of Sal Ar∣moniack, and of Salt of Coral, each one dram; with Turpentine of Chio six drams, make a Mass: take half a dram Evening and Morning, drinking after it of the di∣stilled water three ounces.

His food was only good and easily digested meats: he drank small Ale, with the leaves of Harts-tongue infused in it. He tasted sometimes a little Water and Wine, or Cyder, and he was almost continually employed, sometimes in some easie affairs, sometimes in moderate exercises, or in several sorts of recreations.

Thus much concerning universal Melancholy,* 1.566 by which the sick are affected almost indifferently by any object, so that they are intangled in every place, and by any acci∣dents and circumstances, with a multitude of thoughts continually, with raving, fear, and sadness.* 1.567 We have largely enough handled the symptoms of this Disease being ma∣nifold, and the reasons of them, partly in this Chapter, and partly in another Tract.

It is called special Melancholy, when the sick respect a certain particular thing, or some kinds of things, of which they think almost without ceasing; and by reason all the powers and affections of the soul being continually imployed about this one thing, they live still careful and sad; moreover, they have absurd and incongruous notions, not only about that object, but also concerning many other accidents and subjects. In this Distemper, the Corporeal Soul, bending from its proper kind, assumes a certain new one, but not being conformable, either to the Rational Soul, or to the Body, or to it self, it enters into a certain Metamorphosis.

This kind of Distemper,* 1.568 is produced by many ways, and on various occasions; for vehement passions, desire, fear, anger, pleasure, yea all other passions both of the con∣cupiscible and irascible Appetite, being long continued, and carried forth to the height, are wont to excite the same. But there are two general occasions, from which speci∣al Melancholy chiefly and most frequently doth arise; to wit, first, when there lyes a most heavy pressure on the mind of some present evil, or an evil just at hand, whether it be true or imaginary: or secondly, if the loss or privation of some good before ob∣tained, or desparing of something wished for or desired, happen. In these opposite cases, the Corporeal Soul being either drawn forth outwardly, omits all domestick care, either of it self, or of the Body, or of the Rational Soul: or being pressed in∣wardly, it relinquishes or perverts the offices of Reason, and of both the Vital and Animal Functions. It would be an huge work to enumerate the various cases in ei∣ther kind, and their ways of affecting; out of the great plenty, which being of the greatest moment, seem to require the care of a Physician, are chiefly furious Love, Iealousie, Superstition, despair of Eternal Salvation, and lastly the imaginary Metamorpho∣sis of the Body or its parts; and the good and evil phantasticks of fortune; of these, severally, we shall speak briefly.

Concerning the power of Love,* 1.569 saying nothing here of some most noble Lord, or Heroick actions, (which appear chiefly on the stage of the Theatre, and on that of hu∣mane life) it is a most common observation, that if any one being taken with the aspect and conversation of any Woman, begins to desire her and to grow mad for her inward∣ly, and for his most devoted affection has nothing but loss and contempt allotted him, unless he be very much supported by a firm reason, or is averted as it were by other cross affections, there is great danger lest he falls into Melancholy, Stupidity, or Love-Madness; with which passion, if by chance he be distemper'd, he forth with seems trans∣formed from himself, as it were into an animated statue, he thinks on, nor speaks of any thing but his Love; he endeavours to get into her favour, with the danger of both the loss of his Life and Fortune; in the mean time, he not only neglects the care of his houshold affairs, or of the publick, yea his own health, but becoming desperate of his desires, he oftentimes lays violent hands of himself: But if he be content to live, yet growing lean, or withering away both in Soul and Body, he almost puts off man; for the right use of reason being lost, omitting food and sleep, and the necessary offices of Nature, he sets himself wholly to sighing and groaning, and gets a mournful habit and carri∣age of body.

If we should inquire into the reason of this Distemper,* 1.570 it easily appears, that the Corporeal Soul of Man being obnoxious to violent affections, when it is wholly car∣ried into the object most dear unto it self, viz. the beloved Woman, and cannot ob∣tain and embrace her, there is nothing besides that can quiet or delight it; yea be∣ing refractory, it grows wholly deaf to the Rational Soul, and hears not its dictates, but carrying only tragical notions to the Imagination, darkens the sight of the intel∣lect. Further, forasmuch as the Praecordia (the more plentiful afflux of the Spirits be∣ing

denyed to them) do slacken of their motions, the blood heaped up in the bo∣soms of the heart, and apt to stand still, stirs up a great weight and oppression, and for that reason, sighs and groans; in the mean time the face, and the outward members grow pale and languish, for that the affluence of the Blood and Spirits is with∣drawn: Hence in our Idiom or Speech, the Heart of despairing Lovers is said to be bro∣ken, to wit, because this Muscle is not lively enough actuated by the Animal Spirit, and so is shaken weakly and slowly, and doth not amply enough cast forward the blood with vigor, into all parts. Indeed in Love, the Corporeal Soul intimately em∣bracing the Idea of its most grateful object, endeavours all it can to be joyned, and fully united to the same; emitting toward her, the roots of the affections, with which it is most strictly enfolded, seems from thence to draw its chiefest life and growth; so that the body being neglected, when as it inclines it self wholly towards the thing beloved, if by chance being broken off from this union, it suffer a divorce, like a plant taken out of its natural soil, for that it does not receive any more, or as∣similate food convenient for it self, it soon withers: Hence the Animal Spirits leaving their accustomed offices, and wonted tracts of expansion, do not actuate or irradiate either the Brain or the Praecordia, nor the nervous Appendix, after their due manner: wherefore, not only for the present an untrimmed, and a delirous disposition of mind, with a mournful habit of body, are excited; but from thence the vitiated Blood, and the Spirits, having gotten an acetous nature, an habitual Melancholy is intro∣duced.

* 1.571Such an inordination of the Animal Function as Mad-Love hath, about the acquisi∣tion of its object, the same or very like hath Iealousie, about the retention of the same, being gotten; so always (as well in the fruition as in the desire) Res est solliciti plena timoris Amor: Love is ever full of careful fear. This Soul, if it be not secure of its most dear prey, it presently grows hot, and pours forth darkness and clouds upon its own serenity: Then afterwards being infected by a Cholerick tincture, it receives every object, as if it were imbued with a yellow colour: for indeed, as the ferment of the stomach being too much indued with a sourness, perverts all things that is put in∣to it, into its nature; so Iealousie being once arisen, changes all accidents and cir∣cumstances, into the food of its poison; and when the sensitive Soul, being as it were bowed inward in this passion, becomes not conform to its Body, for that reason the Oe∣conomy of the Functions both Animal, Vital, and vegetative being depraved, Iealousie makes one rave, and to wither away.

* 1.572Superstition, and a despair of Eternal Salvation, are wont to impress on the sensitive Soul, the Blood, and the Body, almost the like Distempers of Melancholy, as Love and Iealousie; but their way of affecting is somewhat different: for in those the object, whose acquisition or loss is indanger'd, is wholly immaterial, and its affection being at first conceived by the Rational Soul, is impressed on the other Corporeal: In the pro∣secution of which, if ••he easily obtains her desires, then no perturbation of the humane mind arises; but if (as it often is wont to happen) the Corporeal Soul being oppugned or refused, it will not stand to the monitions of the Rational, but presently growing hot, moves inordinately the Blood and Spirits, opposes the Corporeal goods and blandishments to the spiritual objects, from the intellect, and endeavours to draw the man to its side; and so whenas there is a continual skirmish between the two Souls, and that sometimes the superior Will, and sometimes the sensitive Appetite pre∣vails; at length the judgment seat of the Conscience is erected by the mind, where every several action is scrupulously examined.* 1.573 By reason of this more frequent strife of the Souls, the Animal Spirits being too much and almost perpetually exercised, and often commanded, and as it were drawn hither and thither into contraries, at length they depart something from their vigor and their nature, and at length being made more fixed and Melancholick, for that they are detained from their wonted expansion, cut unaccustomed and by-tracts in the Brain, and so induce a Delirium or idle raving, with mighty fear and sadness. In this sort of Distempers, the Cor∣poreal soul being snatched as it were violently, departs both from it self, and from the Body, and according to the characters of the impressed Idea being modified, it is wont to assume a new image, either Angelical or Diabolical; in the mean time, the Intellect, because the Imagination furnishes it only with undecent and monstrous no∣tions, is wholly perverted from the use of right reason.

* 1.574By the like means of affecting, it happens that some Melancholick persons under∣go imaginary Metamorphoses, as to their fortunes, or as to their bodies, viz. whilst one imagines himself, and plays the part of a Prince, and another a Beggar; ano∣ther believes that he has a Body of Glass, and another that he is a Dog, or a Wolf,

or some other Monster; for after the Corporeal Soul's being distemper'd with a long Melancholy and the mind blinded, it wholly departs both from it self, and also from the Body, and affects, and as much as in it lyes, truly assumes a new image or con∣dition.

CHAP. XII.

Of Madness.

AFter Melancho••y,* 1.575 Madness is next to be treated of, both which are so much akin, that these Distempers often change, and pass from one into the other; for the Melancholick disposition growing worse, brings on Fury; and Fury or Madness growing less hot. oftentimes ends in a Melancholick disposition. These two, like smoke and flame, mutually receive and give place one to another. And indeed, if in Melancholy the Brain and Animal Spirits are said to be darkned with fume, and a thick obscurity; In Madness, they seem to be all as it were of an open burning or flame. But indeed, for that as we have already shewn, that the Animal Spirits being inkindled or inflamed do excite a Phrensie with a Feavour, which is wanting in Madness, their affection will be better illustrated in this Disease, as well as in Melancholy, by the Analogy of Chy∣mical Liquors.

Whenever therefore Madness without a Feavour being excited,* 1.576 with a remarkable hurt of the animal Function, is wont to be permanent, and continue long, its next and immediate subject are the Animal Spirits; which acting not by consent, nor from any force from another, but of themselves, are habitually distemper'd, and depart from their proper and genuine nature,* 1.577 to wit, a Spiritual saline, into a Sulphureous-saline dispo∣sition, like to Stygian-Water, as we have shewed above; therefore they perform only in∣ordinate acts, and so persist a long while to act amiss or evilly. To this vice of theirs, perhaps the Brain, or the Blood, or other parts may contribute somewhat, but the Spi∣rits themselves are first and chiefly in fault.

It is observed in Mad men,* 1.578 that these three things are almost common to all: viz. First, That their Phantasies or Imaginations are perpetually busied with a storm of im∣petuous thoughts, so that night and day they are muttering to themselves various things, or declare them by crying out, or by bauling out aloud. Secondly, That their notions or conceptions are either incongruous, or represented to them under a false or erroneous image. Thirdly, To their Delirium is most often joyned Audaciousness and Fury, con∣trary to Melancholicks,* 1.579 who are always infected with Fear and Sadness. These primary symptoms of Madness in the Animal Spirits, indued with the nature of Stygian-Water, may be thence most aptly deduced as appears clearly by what follows.

For first,1 1.580 the Particles of Stygian-Water are highly active and unquiet, and in per∣petual motion; hence the Effluvia's falling from them continually strike the Nostrils, and the Liquor being poured forth from the Vessel, meeting with some other bodies grows very hot, and penetrates their Pores and Passages; the reason of which is, be∣cause the Saline Particles being conjoyned with the Sulphureous, shake one another, and will not cohere with any of another kind. In like manner we may suppose that the Animal Spirits being stilled forth from the Blood; filled as it were with a Nitrous sulphur, are indued with a notable mobility or unquietness;* 1.581 which, for that reason, being stretched forth from the middle of the Brain on every side, both in its compass and in the nervous System, and being from thence perpetually reflected, produce unbridled Phantasies, and almost never interrupted, and also great and perpetual inordinations, both of the sensitive and loco-motive function.

Secondly,2 1.582 the Effluvia's exhaling from Nitrous or Stygian Spirits, do not so much evaporate from open spaces, but being very penetrating, cut every where new ones, almost in every subject, where they are able to break thorow; yea most bodies con∣taining these kind of Spirits, or the things laid upon the mouths of the Vessels, are so bored thorow by them, that they are presently rendred friable or brittle, and fall into small bits. In like manner we believe, that the Animal Spirits in the Di∣stemper of Madness, becoming very moveable, and very much sharpned, out of their morbid nature, do so likewise leave their former tracts of going and returning to and fro, and do cut for themselves, every where in the Brain, new little spaces or walks,

and plain••y ••••vious; in which, whilst they slow, they produce unaccustomed notions, and very absurd, whence there is a necessity, that the distemper'd do speak, and imagine for the most part incongruous and discomposed things; at once confounding things past with things present, or to come; and contrary or opposite things.

3 1.583Thirdly, it is observed, that the vaporous little bodies falling away from the Nitro∣su••phureous Spirits of Minerals, do not only subsist in the neighbourhood, (as the breath exhaling from acetous Liquors) but are diffused very far, and on every side into remote places. I have often seen, when the Spirit of Nitre has been mixed with the Butter of Antimony, that the whole Chamber has been filled with a black smoke ascending from those Stygian Liquors: When Aqua fortis or the Spirit of Nitre being poured from the Alembick, or drawn forth by a gentle heat, a most sharp vapor has pierced the Nostrils and Lungs of those standing afar off; which certainly happens by reason of joyning to∣gether of the fluid Salt, and the rag••ng Sulphur; the little bodies of either of which mutually incite one another, and so being combined together, are carried farther. In∣deed,* 1.584 after the same manner it seems to be concerning the Animal Spirits in Mad-men, which, for that they are of the same nature as Stygian Water, quickly passing thorow both the frame of the Brain and its Appendix, cause the distemper'd not only to be furious, but as it were Demoniacks or possessed with the Devil; so that being free from any fear or languishing, they enter upon any thing boldly, and expose them∣selves fearless to sword or fire; also by reason of the prodigious putting forth of their Spirits, with a mighty strength, they often break asunder bonds and chains, and over∣throw at once many strong men, resisting and going about to restrain them.

* 1.585The comparing of the Animal Spirits with Stygian Water, or the Nitro sulphureous Spirit, clearly shews what is the conjunct or immediate cause of Madness; to wit, which seems to consist, not so much in an adult bile or humor, or black and sharp vapour, being suddenly suffused into the Brain, and inciting the Spirits inhabiting it into rage and fury; (for such a vapour or humor either exhales of its own accord, or may be soon removed by the help of Remedies; and so the madness thence excited, would pass away as quickly and as easily as the Fury or Delirium produced by the eating of wild Parsnips) but rather raging Mad-men are habitually so made, because their Ani∣mal Spirits degenerate from a gentle and benigne nature, as also a subtil and very active disposition, to wit, a Spirituous-saline, into another more sharp, to wit, parta∣king of a fluid Salt, an Arsenical Sulphur.

* 1.586As to what belongs to the more remote or antecedent causes of Madness, viz. by rea∣son of which the Animal Spirits acquire a most sharp disposition; before we come to these, we ought to shew how, and by what reason or means, a certain Corrosive Latex or water (such as we suppose the Animal Spirits with its Vehicle to be) is begotten, and is able to subsist in the humane body.

* 1.587Truly, that most sharp humors are sometimes begotten in our bodies, plainly ap∣pears by many observations. We have elsewhere made mention of a Noble Man, grievously obnoxious to distempers of the Brain and Nerves, whose sweat (when he was in a fit) presently eat thorow his shirt, or made it so crumbling or friable, as if it had been dipt in Aqua fortis. It is an usual thing for some to render by Vomit oftentimes as it were a Vitriolick water, corroding the coats of the Oesophagus and the Pa∣lat. Further, Cancrous, Scrophulous, and Pestilential Ulcers, shew a most sharp humor, by which the flesh and Membranes are eaten, as it were with Aqua fortis, with a blackness poured on them. Further it is observed, that Corrosive Stagmas, not chiefly brought forth in the Blood, are affixed to the musculous flesh, or to the Parenchyma of the Viscera; but more frequently being procreated in the nervous liquor, being laid up with its Latex in the nervous parts, or their Emunctories, do produce Aposthums, and Pockey, Septick, and other foul and filthy Ulcers. For these are most often excited in the Glandulas, or near the Tendons, or Membranes; and when as the humor falling away from them is first thin and watry, and afterwards becomes black very stinking, and corrosive; it is a sign indeed, that the nervous Liquor it self is changed into that sort of putrefaction.

* 1.588It easily occurs, if the reason of these be inquired into, that the Latex watering the Brain and nervous Appendix, doth contain in it self, together with a subtil Spirit, great plenty of volatile Salt. Therefore, when this is so depraved, that the Spirit being de∣pressed, the Saline Particles degenerate into a flux, and acquire to themselves little Sulphureous bodies, it becomes plainly Corrosive and Stygian. Wherefore, malig∣nant humors and Ulcers chiefly happen in the nervous parts, and their Emuncto∣ries, and there are excited upon any light occasion (as when a small hurt happens to the Breast of a Woman, a Cancer follows) because, indeed, the nervous humor being hindred somewhere in its passage, doth there stagnate, presently the Spirit being

depressed, or flying away, the Saline Particles degenerating from a volatile to a four nature, get to themselves soon after strange companions, and snatching either Eart••y or Sulphureous little bodies, or of some other kind, begin to congeal into S••••••hous, Strumous,* 1.589 or Cancrous Tumors. And when after this manner, by the stagnating of the nervous Liquor, and by its getting an heterogeneous concretion, the Mine of a Tumor is blown up in some part, and the supplements of the same liquor are conti∣nually perverted into the like nature of viciousness; to which also happen, the Melan¦chol••ck impurities, poured forth from the Blood, and other humors, which with their joined forces encrease the rage (even as when diverse Salts and Sulphurs are destilled together) and constitute in the distemper'd part, a Septick matter, and like to the Escharotick or crusting up of Stygian Water. According to this reasoning or Aeti∣ology, the irregularities of these kind of Tumors, as also the appearance of the Kings-Evil, are most aptly unfolded. If that the nervous Liquor so corrosive, and made de∣generate, doth not grow into Tumors, flowing into the nervous Fibres, it is wont to cause here and there most cruel Pains and Cramps.

But as this Liquor of the Nerves,* 1.590 being depraved after this manner, stirs up the afore∣faid▪ Distempers in the nervous parts; so it is not difficult to conceive, that the same water, for that it is for a Vehicle of the Animal Spirits, flowing in the Brain, doth ac∣quire, together with those Spirits, a Corrosive and as it were a Stygian nature, and for that reason excites Madness.* 1.591 The depravation of the Animal Spirits, together with the juice watering the Brain, or the disposition of Madness, is wont to arise after va∣rious ways and for diverse causes; but truly, for the most part this Distemper (as we have observed of Melancholy) begins either from the Spirits themselves, or else from the Blood.

First,* 1.592 Madness beginning from the Spirits, arises sometimes from an evident solitary cause, as a violent Passion; sometimes also it proceeds from a foregoing cause lying in the Brain, as when it comes upon Melancholy or a Phrensie. We shall a little weigh the reasons of either case, and the various manner of their being made.

1. As to the former,1 1.593 when a vehement affection puts any one besides himself, that happens to be made thus; either because the Animal Spirits are too much overthrown, and hurried into confusion; or because they are elevated above measure, and endeavour to stretch themselves forth beyond their sphere.

First,* 1.594 The Spirits are wont to be cast down by a violent and terrible Passion; so it often happens, that some being struck with a panick fear, by seeing a true or an ima∣ginary Spectre or Ghost, afterwards fall into a perpetual Madness. Further, some by reason of some notable disgrace or repulse, others by reason of their hopes of obtain∣ing their Love being suddenly and unthought of frustrated, and others by reason of a rash breaking their oaths or vows, and violated Conscience, being first highly troubled in mind, anon become Mad. The reason of which is, because the Animal Spirits being driven beyond their orders and wonted passages, and put into confusion, do make for themselves new and devious ways, which entring into, immediately they bring forth delirious Phantasms; in the mean time, the Saline Particles of the nervous juice, the spirituous being depressed, depart from their volatileness; and suffering a flux, assume to them∣selves the Sulphureous little bodies poured forth from the Blood, into the then weak and open Brain; From whence this Liquor, being most sharp like Stygian Water, and the Animal Spirits becoming fierce and very much incited, become furious.

Secondly,* 1.595 Sometimes the Animal Spirits, whilst they are too much elevated, almost after the same manner induce both to themselves, and the nervous juice, the mad disposition. Hence Ambition, Pride, and Emulation, have made some mad; the rea∣son of which is, because whilst the Corporeal Soul swelling up with an opinion and pride of its own excellency, lifts up it self, and endeavours on every side to expand or stretch it self forth most amply, beyond the border or sphere of its body, the Ani∣mal Spirits being tumultuarily called into the Head, will not be contained within their wonted bounds, but being there broken and diversly reflected, by reason of their too much excretion, are compelled into new and plainly devious tracts; wherefore, both they being thrust forth from the course of their proper emanation▪ and also the nervous Liquor, do quickly acquire a sharp and incitative Disposition, as was said but now, for that reason Madness follows.

Thus much concerning Madness,2 1.596 excited by reason of a solitary evident cause; but this Disease doth also arise from a Procatartick cause, preexisting in the Brain, and chiefly from Melancholy or the Phrensie going before; in that the Animal Spirits with the nervous juice being a little more exalted, and in this a little more depressed, acquire the disposition of Madness. As to the former, it is a vulgar observation, that sudden and great Melan¦choly is for the most part next to Madness: the reason of which is, because, when the

Animal Spirits, together with the nervous liquor, degenerate into a sourness, are per∣verted, there only wants the accession of Sulphur, by which they afterwards getting a Stygian nature;1 1.597 may induce Madness; (as when an acid Liquor distilled out of Vitriol or Salt, by the addition of Sal Nitrosus, becomes Aqua fortis) but indeed, in a great passion of Melancholy, because the Spirits being disturbed, the passages of the Brain are too open, the Sulphureous Particles carried from the Bilous and Rancid Blood, find an easie entrance, and so the former sour or acid disposition, turns into a Stygian or Maddish. Hence it is observed, if any one of a more hot temperament, falls into a Me∣lancholick Delirium, with fear and sadness, forasmuch as the Sulphureous Particles in its humors, are joyned to the Salts being depressed into a flux, that sadness and thinking at the beginning,2 1.598 very readily a short time after becomes madness. Secondly, for that also a Phrensie often ends in Madness, the reason is almost the same with the former, but inverted; to wit, because in a Phrensie the Spirits and the nervous Liquor becom∣ing Sulphureous, and too much inflamed, afterwards burning forth, get to themselves Sa∣line Particles, and so in like matter get a most sharp and as it were a Stygian nature; wherefore the Feavour then ceasing, the Fury becomes fixed and continual.

2 1.5992. The disposition of Madness, hath no less frequently its roots in the bloody Mass, and is at length produced into act, to wit, when as the Blood being depraved, and becomes Nitro-sulphureous, it either perverts the nervous Liquor, as also the Animal Spirits, or supplies them but evilly. Which kind of taint of the Blood is either here∣ditary or acquired.

1 1.600First, It is a common observation, that men born of Parents that use sometimes to be mad, are obnoxious to the same disease, and though they have lived above thirty or forty years prudent and sober; yet afterwards without any occasion or evident cause, they have fallen into Madness. The reason of which is, for that the Blood at that time bending from its due temper, by degrees into a Nitro sulphureous, affords to the Head Animal Spirits,* 1.601 and also the nervous juice, participating (as hath been said) of a most sharp nature. We have formerly shewn, that in our Complexion, Elemen∣tary Particles do persist during life, apart from the secondary, afforded by nutri∣tion, and have their times of crudity, maturity, and defection; wherefore we sup∣pose, the morbid seeds do ripen into fruit, according to the periods of Ages. Further, we take notice, that oftentimes the fruits of Diseases of this kind, do remain ripen∣ing for a long time, or perpetually as long as life; yet sometimes falling off as it were of their own accord, do wither away; then sometimes in another tract of time, from the infection being left, new fruits do spring up, and by little and little rise up to their height. Wherefore, Hereditary Madness is sometimes continual, and sometimes inter∣mitting; Its fits are wont sometimes to come again after a shorter time, and sometimes after a longer interval.

2 1.602Secondly, As the foregoing Cause of Madness sticking in the Blood, is oftentimes innate or original, so sometimes the same is by degrees begotten, either by an evil manner of diet, or by the suppression of usual evacuations, or by reason of a Feavour going be∣fore, or for some other causes, and at length being brought to maturity, breaks forth into Madness.* 1.603 It is an usual thing in great want of sustenance, that some poor people, being constrained to feed only on very disagreeing meats, and of ill digestion, become at first sad, with an horrid aspect, louring and dark, and a little after Mad. The Hae∣morrhoids, and the after flowings of Women in Child-bed, being restrained in their flux, or some evil and foul running Ulcers being suppressed, dispose some towards this Dis∣ease. Further, those who originally, or by acquisition, are indued with a more sharp temper, and with fierce manners, and threatning countenance, by reason of the dispositi∣tion of their Blood, being nigh to a Nitro-sulphur, are in danger to fall into Madness, from some strong evident cause.

* 1.604Thirdly, Venomous Ferments being insinuated to the Blood and nervous juice, as first of all from the biting of mad Animals, or by the taking of some poisons, are wont to stir up Madness. Concerning the reasons of the former, we have proposed our con∣jectures in another place.* 1.605 Of late a very Noble Lady, and to be credited, told me from her own knowledge, that a certain Gentleman, having eaten at dinner time the tender leaves of Wolfs-bane, in a Sallad with other herbs, in the Evening found himself ill, and complaining of a great unquietness and agitation of his Blood and Spi∣rits, he desired his Friends to send for a Chirurgeon to let him blood, or that otherwise he should grow Mad; which indeed, as he said, came to pass; for be∣fore he could be let blood, he fell into Madness, and dyed in a nights space: This kind of deadly Distemper so suddenly happened, for that this poison had not only perverted the Blood and Animal Spirits, as to their temper, but had slain or beat them down immediately, with its malignant Ferment.

Thus much for the formal Reason, and Causes of Madness.* 1.606 The primary Symptoms of it, we have mentioned to be a Delirium and a Fi••ry; the reasons of which appear clear enough from what has been already said. To these we may moreover add Boldness, Strength, and that they are still unwearied with any labours, and suffer pains unhurt, of which we will speak briefly.

Mad-men are not as Melancholicks,1 1.607 sad and fearful, but audacious and very confi∣dent, so that they shun almost no dangers, and attempt all the most difficult things that are. The reason of which is, because the Animal Spirits being very fierce and provoked, both fortifie the Imagination, that no object may seem greater or bigger than it is wont to be, and actuate also the Praecordia with vigor, so that they cast forth the Blood strongly and swiftly, and drive it forwards lively to the utmost borders of the Body. In this Distemper the Soul endeavours to be carried forth, and to l••ap beyond the compass or sphere of the Body, and so striving on every side, against the incursions of any exterior things, bears it self without fear.

Secondly,2 1.608 Mad-men are still strong and robust to a prodigy, so that they can break cords and chains, break down doors or walls, one easily overthrows many endeavour∣ing to hold him. The certain cause of which is, because in the Blood and nervous juice of Mad people, are contained Particles as it were Nitro sulphureous, or otherways most sharp, and as it were Stygian; from whence the Animal Spirits are indued, or are strong with an Elastick or Explosive force, stupendous, great, and far beyond what's natural.

Thirdly it is observed,3 1.609 that Mad men are almost never tired; for although by play∣ing mad pranks, and striving many days and nights they strongly exercise their mem∣bers, and live in the mean time without sleep or eating, yet they scarce languish at all, nor desist from their agonies for want of strength. Which without doubt comes to pass, for that the Animal Spirits, though very moveable and Elastick, are not how∣ever volatile and easily dissipable, but by reason of the Saline Particles being depressed from their volatileness into a flux, being joined with the Sulphureous, become firm and more fixed; and therefore continue longer in their activity. In like manner as we have observed in Aqua fortis, which though it be contained in a vessel that's open, per∣petually sends forth very many Effluvia's, and yet still retains its substance unwasted, and its corrosive force, otherwise than the spirit of Wine or Blood, the virtue of which soon evaporates.

In the fourth place, almost for the same reason,4 1.610 Mad-men, what ever they bear or suf∣fer are not hurt; but they bear cold, heat, watching, fasting, strokes, and wounds, without any sensible hurt; to wit, because the spirits being strong and fixed, are nei∣ther daunted nor fly away. Further, the blood having gotten a Nitro sulphureous Dys∣crasie, is incapable of any other sudden mutation; wherefore, although insensible tran∣spiration be hindred, and other usual evacuations suppressed, or the supplies of the nou∣rishing juice degenerated, yet neither a Catarrh, nor Feavour, nor Atrophy, or evil di∣gestion easily comes upon Madness. For in this Distemper, although the Particles of the Blood do greatly swell up, yet by reason of the abundance of Salt they do not conceive a Feavourish burning. Even as also Aqua fortis, though it grows very hot and burns other subjects, yet it self is not at all inflamed, but rather resists burn∣ing.

The differences of this Disease are easily gathered from what hath been before said;* 1.611 for first as to its beginning,1 1.612 it is either occasional, which sometimes quickly ceases, the evident cause being taken away presently; or habitual, depending upon a foregoing cause lying in the Blood, and that either hereditary, or acquired.

Secondly,2 1.613 by reason of the magnitude, Madness is either highly furious, that the distemper'd ought to be bound or lock'd up, lest they should attempt any mischief to themselves or others; or else it is more gentle, in which the sick, being conversant with others,3 1.614 abstain from any malice or hurt. Thirdly, In respect of time, Madness is wont to be long or short, continual or intermitting. Fourthly, As to the various kinds of Deliriums, the shapes or types of this Disease are almost innumerable; all which to run thorow, is neither possible, nor worth the while; but most commonly, the distemper'd are mad alike in all things, or else chiefly as to one particular thing, having their judgment concerning other matters for the most part right.

As to the Prognostick of Madness,* 1.615 if the distemper'd be not obnoxious to a Feavour, nor any other Diseases besides, nor easily hurt by external accidents the Disease is not mortal of it self; yet the Cure is very difficult, because there is made a great alte∣ration in the Blood and Spirits, and the sick resist every method of healing, and are enemies to Physicians and to themselves.

If Madness be inveterate or hereditary, or is caused by the biting of a Mad-Dog, it

is hardly or not at all to be cured. What is excited upon some occasion, or from a so∣litary evident cause, or succeeds a Feavour, also upon which comes a Manginess, Whelks, the Haemorrhoids, or spots in the skin, is easily cured.

Those who are obnoxious to this Disease at intervals, about Midsummer, or when the Dog Star arises, are in greatest danger; also those who are altered according to the changes of the Air, or when long cold and foul weather are opposite in the constitution of the Heaven.

* 1.616As there are two kinds of Madness, to wit, Continual, and Intermitting; so the means of healing ought to be twofold.

* 1.6171. The Curatory method to be administer'd, as to continual Madness, suggests the commonly noted three primary Indications, viz. The first Curatory, which respecting the Disease it self, endeavours to correct or allay the furies and exorbitances of the Animal Spirits. Secondly, Preservatory, which being levelled against the causes of the Disease, endeavours to take away or amend the sharp and Nitro-sulphureous Dyscrasies of the nervous Juice and the Blood, as also the Stygian disposition of the Spirits. Thirdly, Vital, which directs such a means of dyet and restraint, which is only fit in this Dis∣ease, for the nutritive and vital function to have and be sustained with.

1 1.618The first Indication, viz. Curatory, requires threatnings, bonds, or strokes, as well as Physick For the Mad-man being placed in a House convenient for the business, must be so handled both by the Physician,* 1.619 and also by the Servants that are prudent, that he may be in some manner kept in, either by warnings, chiding, or punishments in∣flicted on him, to his duty, or his behaviour, or manners. And indeed for the curing of Mad people, there is nothing more effectual or necessary than their reverence or stand∣ing in awe of such as they think their Tormentors. For by this means, the Corporeal Soul being in some measure depressed and restrained, is compell'd to remit its pride and fierceness; and so afterwards by degrees grows more mild, and returns in order: Wherefore, Furious Mad-men are sooner, and more certainly cured by punishments, and hard usage, in a strait room, than by Physick or Medicines.

* 1.620But yet a course of Physick ought to be instituted besides, which may suppress or cast down the Elation of the Corporeal Soul. Wherefore in this Disease, Blood-letting, Vomits, or very strong Purges, and boldly and rashly given, are most often con∣venient; which indeed appears manifest, because Empericks only with this kind of Physick, together with a more severe government and discipline do not seldom most happily cure Mad folks. But indeed, this more sharp handling is not convenient for all Mad people, but to the most furious. Others more remissly Mad, are healed often with Flatteries, and with more gentle Physick.

* 1.621In most Mad folks the taking away of Blood copiously ought to be in the begin∣ning of the Disease, as it is the common practice and vogue of the people. And in∣deed, while there is strength, the opening a vein ought to be repeated, sometimes in the Arm, sometimes in the Neck Vein, Forehead, or Foot; and sometimes it is ex∣pedient for the Hemorrhoidal Vessels to be opened by Leeches; for these evacuations be∣ing timely made, both the raging of the Spirits and the lifting up of the Soul, are best of all suppressed; then besides the Dyscrasies or evil habits of the Blood (for that what was sharp and Corrosive in it being drawn forth, a new and gentler comes in its place) are amended.

* 1.622That Vomiting Medicines are highly profitable for the curing of Mad people, it is almost a Proverb, so that the most part of Hellebore, yea almost all Anticyra is allotted to them. By what means Emeticks do often help in Cephalick Diseases, we have shown already. Quack-salvers in this case, give with success many times, though rashly and with danger, a large Dose of Stibium: But Chymical things are here more convenient, both because they move more strongly, and because also the sick may be more easily de∣ceived by them.

Take of the Sulphur of Antimony eight grains to ten, of the Cream of Tartar half a scru∣ples; mix them together by pounding them; make a Powder: let it be given in a spoonful of grewel; or if it be to be given deceitfully, to one not knowing of it, let it be put in∣to a bit of white Bread, and so let it be taken in Milk or Broth. Let this Vomiting Me∣dicine be often repeated, to wit, once in four days.

Take six or seven grains of Mercurius Vitae; let a Powder be made, and given after the same manner. The Emetick Tartar of Mynsicht, and of Hercules Bovius, and other va∣rious preparations of Mercury may be given after the same manner. Aurum vitae or the Solar Precipitate, also the Lunar Precipitate, are esteemed by Chymists for specifick Remedies against madness; and indeed, Mercurial Medicines, for that they operate not only by Vomit and Stool, but oftentimes by Sweat, Urine, or Salivation, do notably help. A long and plentiful spitting or flux at the mouth hath perfectly cured some Mad people.

3. The more strong Purging Medicines,* 1.623 (where strength and the constitution may bear them) because they depress the raging of the Spirits, and of the Blood, and very much evacuate the Emunctories, that are for the receiving the recrements of the Blood, and nervous Juice, do often bring help in this Disease. For this use preparations of black Hellebore, as chiefly its extract, and Wine of the Infusion of its strings, or the pulp of an Apple with the roots of it boiled together are much praised.

Take of the Extract of black Hellebore, of Calamelanos of each one scruple: make a Bolus.

Take Calamelanos one scruple, of Diagridium from twelve to fifteen grains; make a Pow∣der.

Take of Confectio Hamech, or of the Electuary of the juice of Roses half an ounce to six drams: let it be given in broth.

Take of the Decoction of Senna Gereonis, or of Epithimum (with the roots of black Hellebore two drams) six ounces; make a draught.

Take of the Powder of Diasennae two drams: let it be taken in Posset-drink.

In the mean time,* 1.624 whilst these things are doing, let the Preservatory Indication re∣spect the cause of this Disease. Wherefore, with these frequent purgings and letting of Blood, between whiles let altering Medicines or Remedies be used, which may attem∣per the Blood and nervous juice, and reduce them to their due temper; if that the sick be tractable and orderly enough, they will not refuse to take such things methodically.

Take of Crystal Mineral, or of the best purified Nitre two ounces, of Pearls powdered two drams, of Sugar Candy two drams and a half, of Camphor half a scruple; let them be all beaten together to a moist fine Powder: let two drams of this be put into a glass vessel that will hold two quarts of Spring-water, or of clear small Ale, or Beer and ••••ld; let it be given for ordinary drink at pleasure.

Put to Whey being made hot the flowers of Violets or Water-Lilies,* 1.625 and after they have infused for two hours, let them drink it plentifully; also the Spaw Waters are conveni∣ent for Mad people to drink orderly, and plentifully.

Take of the tops of green and the tenderest Borrage, and Bugloss,* 1.626 each four handfuls; three Apples pared, of Sal Prunella two drams, of Sugar half an ounce; let them be bruised together, and pour to them of Spring-water three pints; make a strong Expression: take half a pint thrice in a day or oftner.

Take of the Conserves of Borrage flowers,* 1.627 and of Violets, each three drams; Confectio de Hyacintho, of Alchermis, each two drams; of Coral prepared a dram and an half, of the Powder of Pearls one dram, of the Salt of Coral one dram, of the Syrup of red Pop∣pies what will suffice; make an Electuary, of which take two drams twice or thrice in a day, drinking after it of the following liquor four ounces.

Take of the waters of the flowers of the Water-Lilie,* 1.628 Borrage, Bugloss, and of black Cher∣ries, each four ounces; of red Poppies six ounces, of red Rose-water two ounces, of Cam∣phor tyed in a rag and hang'd in the glass half a dram, of the Syrup of Coral one ounce and a half; mix them and make a Iulep.

Take of the yellow flowers of the Willow-tree what will suffice,* 1.629 let them be distilled in a common Still, and let the Distillation be repeated, by putting to it fresh flowers for three times: Give of it four ounces twice or thrice in a day, sweetning it with the Syrup of Water-Lilies.

Take of the leaves of the Willow, Meadowsweet, Pimpernel, Borrage, Balm, each six handfuls; of the flowers of the Water-Lilie, of the tops of St. Iohns-wort, each four handfuls; of Camphor powdered three drams, all being bruised together, pour to them eight pints of new Milk; let them be distilled in common Stills.

Let the brains of Weathers be distilled with Milk, and give of the water three or four ounces thrice in a day.

Further there are to be used Specifick Remedies,* 1.630 so called, of which is famous, a Decoction of Pimpernel with the purple flower, also the tops of Hypericon or St. Iohns∣wort, and other Decoctions, Opiates, and Powders of Antilyss•• are frequently noted a∣mong all the famous Empericks.

Concerning the cure of Madness,* 1.631 excited from the biting of venomous or mad Ani∣mals, for that it is almost only Emperical, and commonly known, we shall not discourse of it in this place, and since we have elsewhere proposed our conjectures concerning it. But a Decoction or an Infusion of Apples, either raw or boil'd in Spring-water, the li∣quor

of Tea, Emulsions, with many other things, whose forms we have shewn in the Cure of Melancholy, are convenient in this case.

* 1.632Moreover, from Chirurgical Remedies, besides opening of a Vein, many other helps are wont to be had for the curing of this Disease. Cupping-glasses with Scarificati∣on, often help. Blisterings, Cauteries both actual and potential are praised of many. Others commend cutting an Artery, others Trepaning, or opening the Skull, others Salivation. But these kind of administrations, besides that their effects are uncertain, can hardly be performed, or not at all safely, by reason of the intractability of the sick; wherefore, it were here superfluous to inquire into the reasons of help or cure to be ex∣pected from them. The hair being shaven off, sometimes it is expedient to apply to the forepart of the Head the hot Lungs of a Lamb or Weather, and other Fomentati∣ons, and so to change them. But these sorts of Remedies also are hardly to be ap∣plied and repeated methodically, because of the reluctancy of the sick, and so often afford more hurt than help.

3 1.6333. The vital Indication institutes how mad people ought to be handled, concerning their government, dyet, and sleep. In this Disease there is no need of keeping up the flesh, as in most other Diseases: For the spirits ought not to be refreshed with Cordials, nor strength to be restored with Medicines; but on the contrary, both being too raging of themselves, things are to be administer'd as it were for the suppression or extinction of a flame raging above measure. Therefore let the diet be slender and not delicate, their cloathing course, their beds hard, and their handling severe and rigid. But sleep, for that it is very necessary, ought to be caused sometimes by A∣nodynes; for which end, Hypnotick Remedies or Medicines above prescribed for Melan∣choly, are also convenient in this Disease. In inveterate and habitual Madness, the sick seldom submit to any Medical Cure; but such being placed in Bedlam, or an Ho∣spital for Mad people, by the ordinary discipline of the place, either at length return to themselves, or else they are there kept from doing hurt, either to themselves or to others.

* 1.634There is no need to illustrate the nature of this Disease with Histories and Ex∣amples, or to describe the manifold Types of it; but rather let them go to the Hospi∣tals of Mad people, where they may behold, not without a wonderful spectacle, as it were a new and monstrous nation of men, contrary to rational people, and as it were our Antipodes; all which, if they were gathered together in one place, and that all, Madmen and Fools were joyned to them; I know not whether this world would not be equally divided between them and the sober and prudent.

* 1.635Thus much concerning the cure of continual Madness. The intermitting, either has perfect lucid intervals, in which the sick return to themselves, or the fury only ceases, the Delirium being still lest, insomuch that the distemper'd become gentle and tractable, yet still they continue amiss, as to their imagination and judgment, and speak and do many absurd or incongruous things, and afterwards sometimes again become fu∣rious.

* 1.636The Cure of either of these Distempers, as to the Curatory Indication, is the same, as in continual Madness, so that there is no need to shew here any other Medicines, or method. But as to what respects the Prophylaxis or Preservatory Indication, by which the means of healing is instituted out of the fits, cautions and threatnings are to be given them; in whom only the Fury intermits, the Delirium remaining, the very same Remedies of Medicine, which we have prescribed for the taking away the foregoing cause of Melancholy are convenient.

* 1.637In Madness which perfectly intermits, as to all its Symptoms, at the chiefest conve∣nient times, to wit, Spring and Fall, they ought to enter into a solemn course of Phy∣sick; and besides, there is a continual need of looking to, or governing the sick, both as to diet and to their manner of living, that they may be always preserved in an equal and a moderate temper; and also, that as soon as the signs of the approaching fit ap∣pear, its coming may be hindred by Blood-letting, and by administring of Medicines.

Therefore, in the times of the Aequinoxes, let Blood be taken out of the Arm, and seven or eight days after out of the Hemorrhoidal Veins by Leeches. Let Purges and Vomits be given twice or thrice at due intervals. Moreover, between whiles, let them take in order altering Remedies, at Physical hours. The Formulas or Recipes of these are set down both in this Chapter and in the former for the cure of Melancholy. Let the dyet be slender and of good digestion; as concerning exercise or motion, sleep, and other non-naturals, let them be all moderate. When the approach of Madness is seen to be at hand, and constantly before the Summer Solstice, let Phlebotomy be celebra∣ted, with Vomiting, and a more slender or sparing diet.

CHAP. XIII.

Of Stupidity, or Foolishness.

STupidity, or Morosis, or Foolishness, although it most chiefly belongs to the Rati∣onal Soul, and signifies a defect of the Intellect and Judgment, yet it is not im∣properly reckoned among the Diseases of the Head or Brain; forasmuch as this Eclipse of the superior soul, proceeds from the Imagination and the Memory being hurt, and the failing of these depends upon the faults of the Animal Spirits, and the Brain it self.

We have before clearly shewed,* 1.638 that the Rational Soul doth subsist in a sensitive or corporeal Soul, and that its principal seat is the Imagination: Further from this, and the Memory, either the notions themselves, or their occasions of all things are supplied, which the Mind beholds; wherefore, when it happens that these Corporeal Functions are defective or hindred, forthwith the eye of the Intellect, as if covered with a vail, is wont to be very much dulled, or wholly darkned. Therefore, that the reason of Foolishness and Stupidity may be rightly delivered, first we ought to inquire by what means, and from what causes, the Imagination and the Memory are often defective or fore-hindred.

That we may proceed methodically,* 1.639 concerning these, hither ought to be referred, what we have discoursed before concerning the Functions of the Corporeal Soul, and their subjects and instruments. we have at large declared that the Callous Bodies, or the middle of the Brain is the seat of the Imagination; and the Cortical Marrows of the Brain, the seat of the Memory; and further, that the Animal Spirits are the im∣mediate organs of either. Wherefore, because their powers being hindred (which are the first or chief movers of any other Function, both rational and sensitive) the Imbe∣cillity and dulness of the mind, the slowness of the ingenuity, stupidity and madness at length do often arise; the fault is either in the Brain it self, or the Animal Spirits, or both together, and at first now these, now that.

1. As to the Animal Spirits, we have largely enough declared, of what sort they ought to be, of their proper and genuine nature, and what they are by reason of their preter∣natural disposition, in the Phrensie, Melancholy, and Madness. But besides (which we before mentioned) it may be suspected, that these Spirits being sometimes almost desti∣tute of active Particles, become as it were liveless or vapid; to wit, when the spiritu∣ous Particles ought to excel, and to get to themselves volatile Salts; in Stupidity, both these, together with the Sulphureous, being too much depressed, they are almost drowned and overwhelmed with the watery and terrestrial. For indeed, Fools are not so dull or of such thick understanding, as their soul seems to be indued with, and their Animal Spirits are rather formed of clay than their Heart. There are many oc∣casions or evident causes, by which the Animal Spirits acquire so deadish a texture, the chief of which we shall touch on by and by.

2. But it doth not frequently come to pass, that Stupidity is excited by the mere so∣litary fault of the Spirits, or of the Corporeal Soul it self, but more or rather the Brain it self is found to be first in fault: For as there are many things requisite, by which this exact subject or machine of the Animal Function is constituted, if by chance any thing of them be deficient or depraved, it easily follows, that such so distemper'd have little wit.

First,1 1.640 It is a vulgar observation, That the wit and ingenuity doth depend somewhat on the magnitude and figure of the Head, and consequently of its Brain; for as to its bulk, it is a Proverb, that it argues little of Brain or too much Foolishness. And al∣though this does not always happen, yet it does for the most part. The reason of which is, because in a little Brain but a few Spirits are begotten and exercised; but in a grea∣ter, consisting for the most part of a vile or base texture or frame, it is less fitted for the quickness or sharpness of the mind.

Secondly,2 1.641 The genuine and best figure of the Brain ought to be globous; to wit, for the end that the Spirits may be poured forth with an equal efflux on every side, from its middle part to the whole compass, and may be from thence retorted every where by equal angles of reflections. But those who have a flat head, or too sharp, or other∣ways improportionate, are affected for the most part with some noted fault of the Animal Function; for these kind of Brains, like distorted Looking-Glasses, do not

rightly collect the Images of things, nor truly object them to the Rational Soul.

3 1.642Thirdly, The substance of the Brain should be well temper'd, and of a laudable frame; not only as to the qualities of heat and cold, of driness and moisture, but its Systasis or Constitution consisting of plenty of a volatile Salt and Spirit, with a moderate pro∣portion of the rest should be thin and airy, that the Spirits may pass thorow the whole, and cut out to themselves paths; also it should be moderately firm and compacted, that the tracts and passages being made, may remain, and not be presently blotted out again, by the sinking of the too so••t parts. But in Stupidity, it is to be suspected, that there is in the Brain an excess of some manifest quality, as of moisture or coldness, for which reason, Children and old people are wont to be affected with a dulness of their senses; or some∣times, the Texture is too thick, and Earthy; so that the spirits do not easily irradiate it, or cut tracts for themselves; to wit, they cannot penetrate an opacous or thick bo∣dy, no more than rays of light. To this kind of deadish Texture of the Brain, those that are born of Plowmen and Rusticks, as if they were formed of a worser clay, are obnoxious; hence in some Families, reckoning many descents backward, there is scarce one witty or wise man found. In some places, the influences of the Heaven and Air incline, as it is thought, the Inhabitants to Stupidity; so, to be born in Batavia, is proverbially, as much as to say, a Fool.

4 1.643Fourthly, Besides these vices of the Brain, which are for the most part original and born with it, sometimes its evil conformation, as to its Pores and Passages, by reason of some acquired inordinations, is a cause that the Animal Function is not rightly per∣formed. For first of all, as to what appertains to the smaller Passages and Pores of the Brain (which the spirits themselves frame every where thorow its whole substance, and perpetual flow into them for the exercise of the Animal Functions) it sometimes hap∣pens that these are either defective or perverted, and so bring on a dulness of mind, or Foolishness. These little spaces are defective, because the consistency of the Brain being either too obdurate or too fluid, it will not indure to be cut thorow after a due manner, or to remain or continue so bored thorow. But we suspect those Passages to be perverted, either because they are too loose or too strait, or else, for that their making is unequal. Too strait Pores do not sufficiently admit store of matter for a good plenty of Spirits: Those loose above measure, receive together with that mat∣ter, Heterogeneous Particles, and infesting the Animal Regiment. They seem to be unequally formed, where they are more open in one part of the Brain, and more strait in another. For this cause we think it to be, that some understand, or know things well enough, but still judge evilly; for that their notions and conceptions, like the visible Images, passing thorow a diverse Medium, become distorted. Further, perhaps for this reason it comes to pass, that some excel, or are strong in Imagination and Phantasie, yet are very deficient in Memory, and others on the contrary.

3 1.6443. It sometimes happens, that both these conjunct causes do concur together to Fool∣ishness, to wit, because both the Animal Spirits are dull and to••pid, and also the Brain evilly conformed. And in truth, which part soever is first in fault, it quickly will make the other in like manner guilty. Because when the Spirits being blunt and sluggish do not freely pass thorow the Brain, the Pores and Passages in it are not either sufficiently cut thorow, or else they close again; and the Spirits if they cannot expand themselves, by reason of the evil texture of the Brain as they should do, they at length becoming sloth∣ful and idle, grow heavy, and acquir•• a vicious disposition.

* 1.645Thus much concerning the Conjunct Causes of Foolishness, as to its Procatartick and Evident, there belong more occasions, by reason of which the aforesaid evils are wont to be brought to the Brain, or the Spirits, or to both together.

1 1.646For in the first place, Stupidity (as we but now observed) is sometimes original or born with one, and so it is either hereditary, as when Fools beget Fools, the reason of which is clear enough, to wit, the same weak Particles flowing for the constituting the Ani∣mal Organs in the Son, which were in the Father•• or Stupidity being born with one, is as it were accidental, to wit, it frequently happens, that wise men and highly ingeni∣ous,* 1.647 do beget Fools and Changelings, or heavy witted: which we suppose so to come to pass sometimes for this cause, for that the Parents being too much given to study, reading, and meditation, the Animal Spirits that inhabit the Brain, are so much wast∣ed, that for the supply of them, the most generous Particles of the Blood are still car∣ried to the Head, and but few only, and small, are permitted to descend to the Sper∣matick Bodies.* 1.648 When the rational Soul becomes greatly solicitous in bringing forth its child (which are the works of the Intellect) then the Corporeal Soul (the Spirits being called away to wait on the other) becomes not at all, or very weakly prolifick.

* 1.649Besides this reason, there is another frequently to be met with, wherefore the first implanted sagacity of men, as well as of Brutes, is not often propagated from the

Parents to the Children: For when as we presume certainly, the Colt of a generous Horse, or of a delicate strain, or the Chickens of a Game-Cock, that they will patris∣sare, or be like their Sires, so that they are sold at a great rate, and the virtues of these, if not broken by inordinate and preternatural feeding or bringing up, descend by a long series to their young from age to age: This often happens otherwise to men, to wit, because the Parents do so enervate and weaken their bodies by intemperance, luxury, and evil manners, that they beget only languishing and unhealthy Children. Hence it is, that for the most part, those who are born of Parents broken with old age, or of such as are not yet ripe or too young, or of drunkards, soft, and effeminate men, want a great and liberal ingenuity or wit. Nor does there happen a less detriment to them of the Animal Faculty, whose sires are obnoxious to evil affections of the Brain, as the Palsie, Epilepsie, Carus, Convulsions, and the like; so that to be born of Parents who have a sound mind in a sound body, is far beyond a large patrimony.

Secondly,2 1.650 There are more evident causes, by which Stupidity is wont to be induced, to some originally whole. Some at first crafty and ingenious, become by degrees dull, and at length foolish, by the mere declining of age, without any great errors in li∣ving; to wit, because the nervous liquor, and the blood, (whose evil dispositions the Animal Spirits partake of) like some Wines, and other fermented liquors, depart from their vigor after a perfect Fermentation; and by little and little degenerate into a dead and pallid substance. For it is observed, the wits of some people do receive a various increase and decrease, according to the periods of their Ages. I have known many in their childhood very sagacious, and extreamly docil or apt to learn, that by their litera∣ture and discourse have caused admiration, who afterwards becoming young men, were dull and heavy: and those who at first were very beautiful, were afterwards not at all handsome, or beautiful in their aspect. In like manner, it often happens on the con∣trary, that many at first indocil or unapt to learn, and wholly unfit for literature, and seeming of an ill favour'd countenance, when they have become young men, or have put off their childhood, have had both an excellent wit, and become beautiful. The reason of the former is, that some ripe wit, or ingenuity, like garden fruit, does not remain long in the same condition, but soon declining, quickly withers. For in every mixture or concretion rightly made, there is required, that a progression from crudity to maturity be made gently and by little and little, that is, the active elements do not at first arise above the rest, and shew themselves above measure, but being involved with the others, rise up and put forth themselves by little and little; for otherwise, being too free in the beginning, and made loose, they easily fly away, leaving their subject al∣most dead or taste less. Wherefore, Boys who are seen to be dull in their first Age, may be hoped afterwards, when the temper of the Brain (the superfluous moisture being evaporated) is come to maturity, to become ingenious enough.

Thirdly,3 1.651 Sometimes great strokes or bruising of the Head, especially such as happen from a fall from some high place, do bring hurt or debility to the Animal faculties. I have known some very learned, and men of great wit and judgment, who outliving some of these falls by chance, afterwards were of a heavy and dull ingenuity. It is commonly said of such so distemper'd, that their Brain is turned; and indeed a vehement Convulsion or shaking of the Brain, greatly perverts, and not seldom presses together, or shuts up the accustomed tracts and paths of the Spirits, so that they perform the acts of the Me∣mory and the Imagination for ever after, hardly, and amiss; so as some by some great wound inflicted on the Head, have become sottish, and afterwards mad.

Fourthly,4 1.652 Frequent Drunkenness and Surfeiting, especially if they sleep in their Cups, and lie as it were buried in Wine and Sleep, do very much decay the wits of some, and make infirm the use of their Reason; to wit, because by them, Heterogeneous little Bo∣dies, and infesting very much the Animal Regiment, are introduced. Almost for the same reason, the frequent use of Opiates very much troubles the sharpness of the mind.

Fiftly,5 1.653 Violent and sudden passions, as in the first place, an unexpected and very great affright, or terror or vehement sadness, have caused Sottishness or Foolishness in some, so that they have been scarce able to express the sense of their mind in words, or to perform the familiar actions of life. Which certainly comes to pass, forasmuch as the spirits inhabiting the Brain upon such an occasion, are very much dissipated and drawn asunder one from another, and afterwards, are not able to repeat the the for∣mer footsteps of their motions; in like manner as Souldiers, being put to flight by a sudden and violent attack of the enemy,6 1.654 recover not easily their orders and stations.

Sixthly, It is observed, that some men have contracted also Foolishness, by reason of cruel Diseases of the Head. This frequently happens in a great and long Epilepsie, for that this Distemper, possessing the middle part of the Brain, perverts, and so fills and

stuffs up with feculencies, all the Pores and passages, the Spirits being thereby frequently and vehemently thrust forth, that the tracts of the Spirits being shut up; the acts of the internal Senses and Motions are hindred. I knew a young maid, at first of an acute wit, and lively ingenuity, who after she had long laboured with the Falling-sickness, became sottish and foolish, like a changeling. Further, I have taken notice in many, that Stu∣pidity hath accompanied the Palsie, or has gone before it (as we mentioned in the Chap∣ter of the Palsie) to wit, the same matter which brings a resolution or loosning, being in the Streaked Body, being heaped up in the Callous, causes often, if not an Appoplexy, or Carus, a Foolishness.

* 1.655Many differences of this Disease are to be met with; and first, there is commonly wont to be a distinction between Stupidity and Foolishness, for those affected with this latter, apprehend simple things well enough, dextrously and swiftly, and retain them firm in their memory, but by reason of a defect of judgment, they compose or divide their notions evilly, and very badly inferr one thing from another; moreover, by their folly, and acting sinistrously and ridiculously, they move laughter in the by-standers. On the contary,* 1.656 those who are Stupid, by reason of the defect of the Imagination and Memory, as well as of the Judgment, do neither apprehend well, or quickly, nor argue well; besides they behave themselves not as the others by toying and gesticulation, but sottishly, foolishly, or like a dull Ass; so that the simplicity of these is the more mise∣rable, who shew so the Disease in their countenance and behaviour. In Foolishness, it seems, that the Animal Spirits being somewhat active, though less firm, do pass thorow only more short and oblique tracts, and do not beam thorow the Brain, with an equal and constant irradiation, but leaping forth, or running out desultorily or after a leaping manner, sometimes here sometimes there perform the acts of the Animal Fun∣ctions, perfunctorily only, or ridiculously. But in Stupidity, the Spirits being obtuse and dull of their own proper nature, and flowing, very little pervious in the more thick Brain, cannot exercise themselves rightly, for the performing the offices of the Animal Regiment.

* 1.657Stupidity (whose Pathology we here chiefly deliver) hath many degrees; for some are accounted unfit or incapable, as to all things, and others as to some things only. Some being wholly fools in the learning of letters, or the liberal Sciences, are yet able e∣nough for Mechanical Arts. Others of either of these incapable, yet easily comprehend Agriculture, or Husbandry and Country business. Others unfit almost for all affairs, are only able to learn what belongs to eating or the common means of living: Others merely Dolts or drivling Fools, scarce understand any thing at all, or do any thing knowingly.

* 1.658As to what belongs to the Prognostick, Stupidity being contracted from the birth or hereditary, or happening from unknown causes, if it still persists to ripe age, it is almost never healed: but when it happens that Children being at first dull and almost insensible, by reason of the complexions of both their Brain and Spirits being ripened, they are made ingenious and docil enough.

* 1.659This Disease excited from an evident solitary cause, as from an hurt of the Head, or a violent passion, also coming upon an inveterate Epilepsie, if it continues for some time, it is afterwards incurable.

* 1.660What succeeds a Lethargy, and any other sleepy Diseases, depends chiefly on the hurt of the Memory, and sometimes vanishes of its own accord, those Distempers being cured. Therefore, when in these cases the cure of Stupidity is instituted, here are con∣venient almost the same method of healing and Remedies, which we have prescribed in the Preservatory Indication of the Lethargy; the chief intentions of which are, that the Animal Spirits being freed from any torpor or benummedness, cut forth or frame Pores and passages within the translucid Brain, and may be expanded truly in them.

* 1.661Sometimes a Feavour has cured some Fools, and stupid, and render'd them more acute. Huartus tells of a certain man that was a Fool in the Court of Corduba, that be∣ing distemper'd with a malignant Feavour, came so much to himself in the midst of the Disease, and with that judgment and discretion, that the whole Court stood in admi∣ration; and so remained his whole life afterwards, one of the most prudent men of his time. We our selves have known a certain man of a very blunt, Boeotick or dull wit, who talking idly in a Feavour, most suddenly brought forth most acute speeches, and sea∣soned with a great deal of salt or ingenious wit. Further, we before spoke of a generous old Gentleman, who having lost his memory, and so the use of discourse, received great help by the distemper of a Feavour happening afterwards; the reason of which seems to be, because the feavourish burning sometimes rarefies and dispels the darkness cover∣ing the Brain.

As to what respects the cure of this Disease,* 1.662 Stupidity, whether innate or acquired (if it be not plainly Madness or Stolidity, uncapable of all learning) though it may not be cured, yet is often wont to be amended. Wherefore it must be the work both of a Physician and a Teacher, that the wit of such that are so affected, may be somewhat trimmed, and they being at least brought to the use of reason in a little measure, may be accounted out of the number of Brutes.

For this end,* 1.663 because dull or senseless Beetles, or the more dull Loggerheads or Block∣heads, do not readily learn the common notions of things, no more than Children the first elements of letters, therefore they are to be instituted in all things, by the frequent care of a Master, and the same things are again and again to be inculcated to them. For by this means, the Spirits, though slow and torpid, are a little sharpened by perpe∣tual exercise, and they being continually excited in the Brain, how rude and crasse so∣ever they be, do cut forth at length for their expansion, some tracts or passages, though more imperfect.* 1.664 But that this may the more happily and easily succeed, medical Re¦medies ought to be administred, which may purifie and volatize the Blood and nervous Liquor, together with the Animal Spirits; and also, that may clarifie the Brain, and ren¦der it as it were Diaphanous.

For the purifying the Blood,* 1.665 let there be sometimes administer'd a gentle Purge, and Phlebotomy in a small quantity, if there be strength, several times; for that end also Issues are convenient, in the Arm or Leg, or both, for the driving the filthiness from the Brain:1 1.666 In fat folks, and such as are indowed with a moist Head, let them some∣times be made between the shoulders. Further, some in this case cry up with wonder∣ful praises a Trepaning, by which the Brain may more freely breath forth, and evapo∣rate. Let their diet be light and attenuating; their dwelling in a free air, and dry; their sleep moderate.

After these have for some time been administred,2 1.667 in the ordinary and usual manner, if that in the left part of the breast there is no beating of the heart in the Arcadian youth, or if there be no sign of hopes, it will be in vain to spend labour and pains, and Medicines any further on them: but if by the use of these, any signs of help, or any hopes appear, sometimes it will be to the purpose to add to these, altering Remedies, to be daily ta∣ken at medical hours, for a long time. The Recipes or Formula's of these are already delivered in our Pharmaceutice for the taking away the foregoing causes of most Cepha∣lick Diseases; and thence may be taken: moreover what do besides respect this particu∣lar case, we think here good to add, being some magisterial Receipts.

Take of the Spirits of Armoniacum,* 1.668 succinated, or with Amber six drams; let it be given from fifteen to twenty drops Evening and Morning, in three spoonfuls of the following di∣stilled water; drinking after it seven spoonfuls of the same.

Take of the fresh leaves of Misletoe of the Apple tree six handfuls;* 1.669 of the lesser Sage, Rose∣mary, Savory, the greater Rocket, Mother of Thyme, Calaminths, Penyroyal, Marjoram, each four handfuls; of the roots of Angelica, of Imperatoria, each six ounces; of Zedo∣ary, the lesser Galingal, of the Aromatick Reed, of Winterans Bark, each two ounces; of Cloves, Nutmegs, Mace, Cinnamon, Ginger, each one ounce; of Cubebs, Cardamums, Grains of Paradise, each six drams; all of these being cut and bruised small together, pour to them twelve pints of the best Canary; let them be digested cold, and close shut in a vessel for three days, then distilled according to art: let the whole liquor be mixed together, and sweetned with Sugar when it is taken: The Dose is two or three ounces.

After the use of the Spirits of Armoniack for fifteen or twenty days,* 1.670 other Medicines about that time may have their turns, such as Spirits of Harts-horn, of Sut, Humane Skull; Tinctures of Coral, Antimony, Castor, Amber; the Elixir Vitae Quercitani, Elixir Proprietatis, Spirits of Lavender. &c.

Or Take of the Conserves of the flowers of the Lilie of the valley six ounces,* 1.671 of the roots of Acori veri preserved six drams, of Ginger preserved in India, of preserved Nutmeg, each half an ounce; of Species Diambrae two drams, of Lignum Aloes, yellow Saunders, the pickt roots of Zedoary, of Cubebs, of Iamaica Pepper, each one dram and a half; of Coral prepared two drams, of the Syrup of Candied Ginger what will suffice; make an Electuary. The Dose two drams Morning and Evening, drinking after it of the distil∣led Water three ounces.

For those whose Brain is too abounding with moisture,* 1.672 let them drink every Morn∣ing a draught of Coffee, with Sage leaves boiled in it: For those who have their Animal Spirits too poor and liveless;* 1.673 let them take Chocolate, as we have described it above,

which seems most profitable. For ordinary drink let small Ale or Beer be prepared in a vessel containing three or four Gallons, and after it has work'd, put into it in a little bag,* 1.674 these following things. Take of the leaves of Sage, the sharp leaved and dryed, four handfuls; of Cubebs one ounce, of Cloves and of Nutmegs bruised, &c. Mix them ac∣cording to art.

* 1.675Outward Applications have also a place here; such are a quilted Cap, Plasters, and Liniments: and sometimes let these, sometimes those or others be administer'd.

* 1.676Take of the flowers of the Lily of the valley, Rosemary flowers, Stoechadoes, each one handful; of Celtick Spike two drams, of the roots of Cypress, the lesser Galingal, the Flo∣rentine Iris, each three drams; of Labdanum, Benzoin, of Toluvian Balsam, of Amber, each two drams; of Nutmegs, Cloves, Mace, Cinamon, each one dram and a half: make of them all a fine powder, quilting it in a Cap with silk between.

* 1.677Take of the Plaster of Floris unguent▪ so called, two ounces, of Tachamahac, of Carranae, of the Balsom of Tolu, each three drams; of the Powder of Amber, Myrrh, each two drams; of Cloves, Nutmeg, Mace, each one dram; being all liquefied or melted together, let them be made into a mass, of which make a Plaster, spread it on leather, and the head being shaved, put it to it.

* 1.678Take of the Oyl of Palms half an ounce, of Capive Balsom three drams, of the Balsom of Peru one dram, of the Oyl of Nutmeg, by expression two drams, Oyl of Amber half a dram; make an Ointment for the Head.

I might here add many other Medicines, and ways of Administrations, but in this almost desperate case, where oftentimes no Remedies are wont to help, and the Cure never perfected, these may suffice.

CHAP. XIV.

Of the Gout.

AMong the Diseases of the Head and the nervous stock, we may refer hither some Distempers that are chiefly wont to infest the Feet and the Belly,* 1.679 to wit, the Gout and the Colick. That the seat of either is in the nervous parts, we may ve∣ry well conclude from the primary Symptom, to wit, pain. The cause of this latter, Charles Piso has affirmed to exist within the Head, and Fernelius affims the same of the other. Wherefore we shall endeavour to deliver the Pathologie of either, together with the apposite means of healing them; and first we shall speak of the Gout.

* 1.680The name of the Gout denotes plainly its subject; because that it is almost only Ar∣ticulate, or is in the space where the heads of two or more Bones meet together. This Disease is wont to be excited more frequently about the Internodia or knittings of the Bones of the Feet; because this part being greatly declining, and remote from the Prae∣cordia, and the fountain of Heat, receives readily the Morbisick matter, and does not easily overcome it, or quickly put it off. Yet the Gout often happens in the jointings of the Hip or huckle bone, the knee, the bending of the arm, the shoulder, the wrist, the ancle, and of other parts.

* 1.681The fits of this Disease (which are almost ever intermitting) invade either wandringly, or periodically; which being finished, sometimes sooner, sometime more slowly, the in∣tervals happen lucid or quiet enough; presently after the first assault of it, for the most part pains arise without any tumor; though afterwards, about the height of the Disease, the distemper'd part often swells up; the pains in the beginning yield to no Remedies, but are made more cruel by Catharticks, and are not presently put to flight by Topicks, or wont to be allayed. The Fit most often falls upon one without any previous distem∣per, but suddenly; yet sometimes there will be an heat of the blood, or a little feavour∣ish distemper going before. The disposition to this Disease is sometimes hereditary, and sometimes acquired, by reason of an evil manner of living. The occasions or causes, which being wont to move this disposition, stir up the Gouty pains, are all violent alte∣rations or passions, inflicted on the humors or spirits. Hence Surfeiting immoderate drinking, especially of sharp and thin Wines, transpiration being hindred, wrath or in∣dignation, immoderate Venus or Lust, sadness, also the changes of the air, and of the year, and any great mutations ordinarily induce fits of this Disease. Those obnoxious

to this disease, are sometimes in danger to be distemper'd also with the Stone, or Gravel in the Reins; and so on the contrary, those obnoxious to the Stone, are wont to be troubled with the Gout. Yea the Gout growing grievous, it every where heaps up about its nests, to wit, in the joynts, a calculous or stony matter, and there excites a stony or hard bulk.

The distemper'd parts,* 1.682 whose pains are stirred up in the hauled Fibres, for the most part are the Periostea, or the heads clothing the Membrane of the Bones, and perhaps the Tendons and Ligaments there planted about. But sometimes the pain in these parts, wholly depends upon a breach of the unity, and this proceeds from a certain matter be∣ing impacted in those Bodies, or lying upon them; first of all we shall inquire, what sort of morbific matter this is; secondly, from whence it comes; and thirdly, by what means it so stirs up periodical Gouty Fits, by breaking the unity in them.

As to the Morbifick Matter it seems,* 1.683 first that it is not the Blood or nervous juice of it self; nor is it one only simple humor laid up a part from the others. We deserved∣ly excuse the Blood from this censure, because these pains only infest Bodies for the most part without Blood; yea, and almost them only. For although in the neigh∣bouring parts, by reason of the course of the Blood being hindred, sometimes a tu∣mor happens with an inflammation; yet this is not the Disease, but a Symptom, and for the most part comes upon the Gout. Further it appears, that the nervous juice (how ever sharp, or biteing, or pricking, or pulling it is supposed to be) does not excite of it self the pains of the Gout; because then the Distemper would cause pains also, or as much in some other passages of the nervous parts, and also in the Internodia or knittings of the Bones.

It is improbable,* 1.684 for the same reason, that any singular, excrementitious, or super∣fluous Humor or Matter deposited from the Blood or nervous juice, to cause the pains of the Gout. For if such were only carried thorow the Nerves, it would excite pains by order, and a continual tract, not first in the feet or extream joints, but by irritating the nervous Stock in its whole journey. If that according to the opinions of Hollerius, Sennertus, and other Moderns, it be affirmed, that some impurities falling off from the heated Blood, and received by the joints, is the material cause of the Goutish pain; then it should follow, that all who are greatly obnoxious to the Goutish Distempers, are also most prone to Feavourish burnings or heats; and that a Feavourish heat should pre∣cede every assault of this Disease; neither of which to be true, common observation doth witness. For those troubled with the Gout, as it were with a privilege (to wit, by reason of the Saline dispositions of the Humors) are free from a Feavourish Distemper. Further, the Fits of the Gout most often arise of a sudden, without any great swelling up or ebullition of the Blood, and presently at the beginning become very cruel; which also argues, that the Morbific Matter is not by degrees laid up in the distemper'd part, as in a Mine, and then to excite pains by its fulness. For if it were so, the beginnings and the increase of the Disease, being always made gradatim, they would be longer and more durable; not doth the distemper (as it often is wont) being presently vehe∣ment, by and by change its seat, and quickly vanishing in one place, anon arise up in another.

When therefore any singular humor (of which sort soever it be supposed) seems not efficacious enough,* 1.685 for the provision of the Fits of the Gout; we may affirm, That in the nest or mine of this Disease, (whether it be one or many), that many fermentative juices, and those not easily to be mixed, do meet together; then from the strife and growing hot of these, the painful Vel••ications or pullings of the nervous Fibres do a∣rise.

Formerly discoursing of the wandring Scorbutick Gout,* 1.686 and the Rheumatism, we plain∣ly shewed what was also the cause of this Gout, of which we now treat; viz. forasmuch as it appears by a very vulgar experiment, that salts being put in a diverse state, to wit, some of them being fixed or Alchalizate, and others having gotten a flux, or sharp, or acetosous things, being put together, do very much boil up and grow hot, and their humidity causing a white and hardish Coagulum or curdling; as for instance well known, when the spirit of Vitrial is poured to oyl of Tartar, it manifestly appears; and why may we not think, that in the fits of the Gout, there is something like it? to wit, that from the fighting and mutual conflict of the Liquors, which are of a diverse Saline na∣ture, the nervous Fibers are pricked and provoked, and at length, from the various Coagulations of either juice, that there is sometimes heaped together in the distemper'd places, a Calculous or stony matter.

That we may shew the genuine matter of the Gout,* 1.687 we ought to referr hither, what we have elsewhere said, concerning the nourishment of the solid parts. For indeed, we have shewed, that to that office both the Blood, and the nervous Liquor do bring

their tributes; to wit, when the nourishing juice is carried from the Blood, thorow the Arteries, to all the parts of the whole body, another liquor being deposited from the Brain, thorow the Nerves, and their dependences, doth actuate that former, as it were with an inspired spirit, so that it is made full and fertil, and so more easily insinuates into the Pores and passages of the part that is to be nourished, and is assimilated into its susbtance. There will be no need to repeat here what we have formerly discoursed at large; as to what respects the present matter, we shall take notice, that the nutritious humor, distributed from the blood, consists of a little Spirit, but of more plenty of Wa∣ter, Earth, and Sulphur, and moderately of Salt, somewhat volatile; further, whilst the nutritious humor is distributed, for that its Particles, which are for the cherishing or nourishment of any part, ought to be proportionate, and to remain like it self; there∣fore, whilst the spirituous are destinated to the Brain, and the sulphureous to the flesh, the inwards and the fat, it is behoveful, that the most Saline and more fixed, should be laid up about the jointings of the Bones, and then growing full with the nervous liquor, to be assimilated with them.

* 1.688But if by reason of the vitious Dyscrasie of the Blood, it happens that Particles saltish above measure, and fixed, should be laid up in the joints, and by reason of their incon∣gruity are not presently assimilated; they soon after grow together into an heap, or a certain Morbific mine. But the Fit of the Gout is not wont for that reason to be ex∣cited, but an heaviness only and languishing of the distemper'd member,1 1.689 which is of∣tentimes taken away by abstinence, or exercise, or Physick; the strange Particles be∣ing discussed, or supped back again into the Blood.

But if the Particles of the nervous liquor degenerate from a volatileness into an acetous Flux,2 1.690 a flowing arising from thence, they ••all down in too great plenty into the little joints, and because they there grow hot, with the Saline or Lixivial Mine, there before laid up, they stir up the Fits of the Gout.

The Saline or Tartarous Matter therefore being laid up from the Arterous Blood, about the jointings together of the Bones,* 1.691 is as it were the feminine seed of this Dis∣ease; which notwithstanding, though there be heaped together a great plenty of it, is of it self wholly unfruitful, like an Egg without a Cock; until the nervous liquor grow∣ing turgent, sends its acetosous Recrements falling from it, into the nest of the former; which immediately,* 1.692 as it were the masculine seed, renders the other prolifick. For inasmuch as those two Particles which are of a different state and original, do meet to∣gether, and mutually concur, they pull or haul the Fibres of the Membranes and Ten∣dons, and so stir up the fit of the Gout; the allaying of which, wholly depends upon the mutual subaction or bringing under, and the difflation or blowing away of the most sharp Particles of either kind.

These things concerning the formal reason, and the conjunct cause of the Gout, being thus laid down,* 1.693 we will proceed to the further unfolding its Procatartick or foregoing causes: And we say, that these are a Saline matter, laid up from the Blood in the joints, and acetous or sharp Recrements, sent into the same nest, from the swelling up of the nervous liquor.

First therefore, that this sort of Saline Mine is laid up about the jointings or knitting of the Bones together,1 1.694 is plainly argued by the sudden and unlook'd for assault of this Disease, and from its difficult cure; for the matter doth not flow into the distemper'd part altogether, and at once, in such abundance, that it should excite a fit so grievous and tedious; besides, for that the pains are repeated still within the accustomed nest, it seems that their fetation or hatching doth most certainly depend upon the Egg some∣where laid up before hand. But that this matter is not merely Excrementitious, but a portion of the nourishing juice,* 1.695 degenerate towards a fixed Salt, being destinated to the same bony parts, we may lawfully conjecture, because an humor merely Excremen∣titious, would cause in the distemper'd place, a continual trouble and tumor; more∣over, this plainly convinces, from the cure of the Gout, by torture or cutting of the part: For Authors worthy to be believed, have told us in their writings, that the Mem∣ber being cut off, in which the sickness uses to be, or greatly wounded, that the Dis∣ease has ceased without any relapse; in like manner as a most grievous Tooth-ack, and continual, is most often cured by pulling out the distemper'd Tooth.

If that the Goutish humor were (as it is commonly said) a Cholerick, or a Phlegmatick humour,* 1.696 or any other merely Excrementitious, it flowing afterwards to some other member, after the former distemper'd were cut off, would there excite a new Morbific Mine; but this happens only in some accustomed joints, for that this or that part is become more weak, and so admits into it self the more easily, all other filthy portions; and neither assimilating nor sending them away, suffers them to increase into a Morbi∣fic Mine. Further, the Recrements also of the nervous juice, that are sharp and acetous, fall down more readily into the same part by reason of its debility.

But to the Saline Procatarxis,* 1.697 or foregoing cause of this Disease, lying in the Joints; not only the weakness of the distemper'd member, but much more and first of all, the evil disposition of the Blood doth help. We shall weigh a little the reasons, and the man∣ner how it is done, of either.

1. And in the first place, the fault of the Blood is, that its elementary Particles, and chiefly the Saline, are not in a fit state or condition. For they ought to be within the mass of the Blood, in the middle betwixt a fixed and a volatile constitution: they are called fixed, so long as the Sulphur and Earth being combined, do pertinaciously adhere to them; as it is observed in fresh and raw Urine, from which you shall not easily draw by distillation, either Salt or Spirit: But the saline Particles are votatilised, when leaving the Sulphur and Earth, they adhere to the spirituous, and with them fly away; as it is seen in the spirit of Urine, being distilled after a long digestion. Then there is a mid∣dle constitution between these, when the Saline Particles are so loosned and dislocated from the Sulphureous and Earthy Particles, that upon occasion they may be easily laid hold on by the Spirituous, and ascend together with them; as it is in Urine putrefied by digestion, from which with a very little heat, you may force out Spirit and Salt. In like manner the Saline Particles in a living body, seem first of all to be in a degree of fixity, within the Chyle; from which, notwithstanding, through Concoction in the Bowels, being rightly made, they begin to come forth a little. Secondly, these are made volatile in the nervous juice: And, Thirdly, they are of a middle constitution in the bloody mass; to wit, which are exalted by a continual circulation or digestion, so that they are in some manner volatile, that being associated, partly with spirituous particles, and distilled forth with them into the Brain, they go into Animal Spirits; and partly going into the nutritious juice, together with the sulphureous and others, they in∣crease in their nourishing the solid parts.

But sometimes it happens,* 1.698 that the saline Particles (at least not all) are not rightly ex∣alted within the bloody mass, but remaining in a state of fixity, give a beginning or cherishing to many Diseases. That we may say nothing of the Scurvy, Dropsie, and ma∣ny others, we only say for the present, it may be suspected, that the first seeds of the Goutish distemper depend upon this cause;* 1.699 for when the nervous juice, being destina∣ted to the heads of the bones (where it is chiefly received) ought to consist of very much Salt, there is a necessity, that its Particles, because they are too fixed and thick, cannot be admitted presently into the Pores and passages, should increase into a Morbific Mine. Besides, that more easily and more often happens, if the weak or broken Fibres of the bodies, planted near, cannot by wrinkling themselves, shake off what is troublesome or superfluous.

As to the secret leading or evident causes,* 1.700 from which the nutritious liquor being brought from the blood to the joints, is imbued too much with a fixed Salt, and by rea∣son of which, these parts become too prompt and easie for the receiving what is impro∣portionate to them, the chief of these, for that they are various and manifold, we will briefly touch upon.

1. And first of all,1 1.701 an hereditary disposition is wont to produce either evil. For those troubled with the Gout, for the most part beget Gouty Children, and this Disease descend∣ing from the Parents to the Children, is wont not only to have the like fruits in both, and also to ripen about the periods of the same age; but for the most part, it hath its first roots in the same members, and observes every where the like progresses: concern∣ing the reason of which, I think, we have already said enough, being the same as other Diseases propagated ex traduce, or from the Parent.

2. But indeed,2 1.702 the Gouty disposition is brought in oftentimes without any original fault, by reason of an evil manner of living, and errors in the six non-naturals. For those who are given to Surfeiting and drinking much, and indulge their appetites by an inor∣dinate eating and drinking, and especially if they feed on salt and spiced meats, and guzle down great plenty of Wine, easily contract this Disease. For by this means, the Chyle is indigested, and indued with very unfit and untameable Particles, and so ill pre∣pared in the Bowels; and then from a more liberal drinking of Wine, saltish settlements and heterogeneous feculences or dregs, which subsist somewhere in the first passages, being too much exalted, are carried into the Blood: to which enormities of living▪ if a sedentary life, idleness, or sleeping at noon be added, so that the superfluities neither exhale, nor the Saline impurities are dissipated by exercise, but left to settle about the jonts, certainly too much of this Alchalisate seed is sowed for a plentiful harvest of this Disease of the Gout.

3. The debility of the little Joints,* 1.703 and Goutish disposition is not only hereditary, but excited frequently by reason of various occasions. The falling down of the Morbific matter often induces this: for if by chance it happens, that at first, the fit of the Gout

comes in this or that part, afterwards the peccant humor more easily falls down into the same member; and quickly constitutes, as it were, a nest, where the Eggs may be con∣tinually laid up. Besides, a solution or breach of continuity also, or some hurt inflict∣ed on any joint, by wet, or cold, by a blow, or putting out of joint, oftentimes stirrs up the Goutish disposition.

2 1.704Secondly, But indeed, as the Blood brings a Saline Mine for the Morbid seed, and the Joints receive and hide it readily; yet this provision, without the coming of the other seeds, is like an addle Egg, wholly barren and unfruitful; because, for the con∣stituting of this Disease into act, it is required, that the nervous liquor, by chance swel∣ling up or growing turgid, pours forth Saline impurities of another condition, to wit, acetous, falling away with a certain effervescency, or heat, and as it were a firing of the other Mine. Wherefore, we think good to set down this other foreleading cause of the Gouty Disease in the nervous humor, and its acetous or sharp affluxions, or flowing to the parts.

* 1.705And indeed, that the Saline Particles of this Liquor degenerating from a volatiliza∣tion to a flux, do become acid, we have shewed by very many instances and reasons; both formerly, and also in this Tract. But for the provision of this Disease, it is not requisite that the whole Mass of the nervous juice should be acetous; but it is sufficient, that some portions of it in the Brain, or elsewhere in the nervous stock, being depra∣ved, or that its Recrements laid up here and there, had contracted this kind of Nature, from which afterwards growing turgid, when as the acid Particles run together to the Saline Mine laid up in the Joints, they stir up the Gouty fit after the manner aforesaid.

* 1.706But truly, it manifestly appears, that acetous fluxions being brought from the nervous humor, do frequently happen; by a notable instance or experiment, often cited by me; viz. I have often observed, That those obnoxious to the passions or pains of the Nerves, have suffered or felt a light rigor or stiffness in their whole Body (which is a corrugation or wrinkling of almost all the nervous parts) and then presently, the Convulsive Distem∣per would follow; at which time the Urine was rendred very copiously and clear, which being without any lixivial or nitrous savour (which otherwise it always has) was very sharp, like mere Vinegar: indeed by this most clear sign it appears, that the humor be∣ing risen up to a fulness in the nervous parts, and moved by its swelling up, doth bring in the Convulsive Distempers; and when a portion of the same sweating or dropping forth, is laid up in the Glandulas, immediately being reduced thence into the Blood, by the passage of the Veins and Lymphaeducts, it did excite the flood of the sharp Urine: Indeed in like manner, from the same humor swelling up in a lesser measure, and still remaining within the nervous passages, and setling in the Joints, we think the Gouty fits do arise.

* 1.707Indeed it is an argument, that part of the Goutish matter doth proceed from the Brain and Nerves, because for the most part, those obnoxious to this Disease, do complain a little before the fit, of an heaviness of the head, and of a dulness, with a Vertigo, and sleepiness; but as soon as they begin to suffer the pains of the Gout, as if the Clouds were blown away from the Brain, they enjoy a more free understanding, with a great and un∣wonted sharpness of wit. Besides, when as there are sometimes many Saline Mines of this inveterate Disease, deposited in diverse Members, it is observed, that the pains do very much invade, first the superior places, and then by degrees descend to the rest; wherefore, when perhaps at first the Vertebrae of the neck were troubled, a little while after the shoulders, or other members of the Arm were possessed, then the Dis∣ease reached to the Loins, or the Hips, and lastly the joints of the Legs, and so to the lowest joints, sometimes these, and sometimes those.

* 1.708The Evident Causes, which in respect of the nervous liquor stir up the Gouty Fits, do either pervert the Particles and portions into an Acetousness, or else stir them up before degenerated into Fluxions.

1 1.7091. Acid liquors, as thin Wines, Cyder, stale Beer (experience being mistress) are to be shunned by Gouty persons, more than a Mad-Dog, or a Snake. For these kind of Drinks do not only bring into act the cause of this Disease, but contribute more Ace∣tous Particles, (by carrying them to the Brain, and nervous Fibres) to its nest, and in∣crease the Morbific matter.

2 1.7102. Immoderate or unseasonable exercises of the Body, violent passions, immoderate Venus, and a disorderly feeding, and whatsoever besides greatly disturbs the spirits and humors or shakes them, and by that means stir up the fluxions of the nervous juice or its recrements, induce the pains of the Gout.

3 1.7113. Usual evacuations being suppressed, also taking of cold and wet, for that by this means the blood, and by consequence the nervous liquor, conceive effervescencies and fluxions, do bring on the fits of this Disease.

4. For the same reason,4 1.712 the changes of the Heaven and of the Air, as also the Tro¦picks of the year, are wont to bring on the pains of the Gout; so that it is become a Pro∣verb, That Gouty persons carry their Almanack in their joints; and deduce most certain Prognosticks of the weather, from their pains: For as often as the humid constitution of the year, or the blowing of the Southern, or the Northern Winds, or Snow, are at hand, they are wont to predict these from the coming of their pains. Further, every Quarter of the Year, especially Spring and Fall, they are more grievously tormented. Where∣fore the Aequinoxes are always religiously observed by them. The reason of these con∣sists partly in this, forasmuch as insensible perspiration is variously altered, by reason of the mutations of the Air and Year; therefore the Effluvia's which are wont to tran∣spire, being restrained, do ferment the Blood and the nervous Humor, and easily stir them up into Goutish Fluxions. Besides, the humors of our Bodies, even as the Sap of Vegetables, and other natural and artificial Liquors do diversly grow hot, about the changing of times, and enter various states or conditions of either fixation, or some∣times of volatileness, or of a flux.

The chief differences of this Disease,* 1.713 are taken from the distemper'd places, and so there are ordained as it were distinct species of the same, to wit, the Chiragra or Hand Gout,1 1.714 the Ischia or Hip Gout, the Gonagra or Knee Gout, and the Podagra the Foot or Toe Gout; in the mean time, pains are wont to be excited in some other members, and are noted by the common name of the Gout. Whether the pains of the Teeth, or of the Loins, and pains of other parts ought to be referred hither, we have not now lea∣sure to inquire.

This Distemper,2 1.715 as to its original, is said to be hereditary, or acquired; as to the temperament of the sick, it is Hot or Cold, or Sanguine, Cholerick, or Phlegmatick, to wit, because the Blood being hindred in its circuit, about the distemper'd places, some∣times an Inflammation, or a watry swelling come upon the pains.

As to the relation of other Diseases,1 1.716 the Distemper of the Gout is either singular, or else complicated with other Diseases, and chiefly with the Scurvey, or the Stone. Of which kind of combinations, because they are intimate and frequent (as if they were of kin to this Disease) it will seem to the purpose, for us to inquire into the reasons.

A long Gout oftentimes gets to it the Scurvey,* 1.717 and some Scorbutick Distempers are so like the Gout, that they are not easily distinguished. The reason of the former is, both the like Dyscrasie of the Blood in either Distemper, depending upon a fixed Salt, as also for that Gouty people, being for a long time fixed either to their Bed or Chair, the Scor∣butick disposition easily comes upon them. Secondly, The Scorbutick Distempers which imitate the Gout are the Rheumatism, and the wandring Scorbutick Gout; the reasons and causes of which, and how they may be discerned from the Gout, we need not re∣peat here, having already delivered them in our tract of the Scurvey.

The Gout hath so near a relation to the Stone,2 1.718 or Gravel in the Reins, that either di∣stemper, as if they had the same original, most often meet together; for scarce any is sick of the Gout, but is found to be also obnoxious to the other Disease. Further, an inveterate Gout, is wont to excite stony Concretions in the Joints, such as the Stone doth in the Reins.* 1.719 Hence I think it is most likely, that the Stone or Gravel in the Reins, doth arise from a like, if not wholly the same cause, that we assigned for the Gout, to wit, the Saline fixed matter, being deposited from the Blood, in the Reins, doth grow hot with the acid humor, being there poured forth thorow the nervous passages, and by that means doth frequently induce Nephritick pains, or of the Reins; then, from either matter being coagulated, after growing hot, doth form the Stone. For the illustrating this Pathology farther, (here being no place for it) it shall be deferred to ano∣ther time.

Every Body is wont to give a Prognostick of the Gout,* 1.720 to wit, that it is safe enough, but most hard to be Cured. 1. As to the former, this Distemper is not only free of it self from danger, but on the contrary, preventeth most other Diseases. For Gouty peo∣ple, by reason of the Saline fixed Dyscrasie of the Blood, are little obnoxious to Feavours; but for the most part live free from a Consumption, and other more grievous Distempers of the Bowels or Head; because the Recrements of the Blood and nervous Juice are continually laid up in the Joints. 2. But as to the latter, the so great difficulty of Cure, the reason is, that for the taking away the foregoing cause of this Disease, there is re∣quired a most perfect amendment, of a double Humor, viz. of the Blood and nervous Juice; to wit, that they may beget no Saline fixed or plainly acid Particles; and more∣over, a restitution of the weakned Joints; neither of which can ever be easily obtain∣ed. And besides this, it happens, that the Conjunct Cause of this Disease subsists in places greatly at a distance, so that the virtues of no Medicine are able to reach them.

* 1.721Sometimes it happens, by reason of the Fluxions of the Gouty Matter, being suppres∣sed or beat back, that sometimes torments of the Ventricle, of the Bowels, and of the Belly, sometimes a straitness of breathing, an Asthma, or other Distempers of the Breast, and sometimes also an Ap••plexy, and other sleepy, or Convulsive Diseases are excited; which being observed, it may be objected, that the Mine of the Gout is not the same as we but now described: because its Saline part, if it were the same which is destinated for the nourishing of the Joints, would not be from thence expelled or deferred, or laid up elsewhere; then as to the other part, to wit, the laying up of the acid seeds in the accustomed place, it seems that it should not be easily repercussed, or of it self suppres∣sed in its way, or any where else translated, to be very hurtful to any part. But in∣deed, it is easie to reply to this, that an acetous portion of the Gouty Matter, may be repelled or suppressed, flowing thorow the nervous passages, and so it being poured in to other parts,* 1.722 doth oftentimes excite most grievous evils. Indeed the nervous Liquor and its Recrements, for that they consist of very subtil and active Particles, upon every light stop or repulse, are driven into diverse deflections and flowings; moreover, when these grow turgid, or meet with the Particles of humors of another kind, and grow hot with them, they stir up various Distempers, or such as are painful and Convulsive; and not rarely, because the dissimilar Particles are mutually coagulated, sometimes Strumons, sometimes Cancrous, or otherways malignant Tumors arise. Instances very remarkable of these kind of effects, we have shewn in our Treatise of Convulsive Dis∣eases; But especially concerning a Maid, who by reason of the Inguinal Glandulas, or the Kirnels about the Groin,* 1.723 being hardly pressed and hurt with a Truss for a Rupture, fell into a Vertigo, and Convulsive Distempers, and shortly after had great Scropul••'s or running Sores, growing on the same side, in the Neck. After the same manner, by reason of the Goutish Mine being restrained from its wonted place, and suppressed with∣in the nervous Passages, or otherways translated sometimes most wicked Distempers arise.

* 1.724Whilst I was writing these, I was sent for to a Noble Matron, who sometimes past being obnoxious to the Gout, and that very much, after about three months last past, she had laboured almost continually with a languishing of the Ventricle, with a queasiness, ••auscousness, and vomiting; at length, I know not upon what occasion, falling into frequent swoonings or loss of spirits, a little after she was troubled with a Vertigo, with a loss of memory, and sometimes with a light Delirium; and when she had continued thus for some days, and free in the mean time from the Gout, and growing well in her stomach, she eat with an appetite broth twice or thrice in a day, and once a day flesh meat, and digested it without any trouble: by this manifest sign indeed it appears, that the Recrements of the nervous humor, which were wont before to fall down by the Spi∣nal Nerves into the Feet, to the Mine of the Gout, afterwards being deposited in the Ventricle, thorow the Nerves of the wandring pair, and the Intercostals, did stir up the continual troubles in it; which at last partly restagnating in the Brain, and being partly translated into the Cardiack Nerves, (or those going to the Heart) those last Distempers of Swooning, of the Vertigo, and the Delirium succeeded.

* 1.725The Curatory method suggests three primary Indications, the first of them Curatory, to be administer'd only in the Fits, for the allaying the pains, and for the sooner ending of them. Secondly, Preservatory, being destinated for the intervals of the fits, endea∣vours the taking away of the foregoing cause of the Disease,* 1.726 that the fits of the pains may more rarely, or less, or not at all be repeated. Thirdly, Vital, which institutes, by what kind of food, and by what Remedies, strength may be sustained in the cruel Torments, and life be prolonged, and also refreshed or cherished, notwithstanding the frequent and almost continual troubles of the Disease.

1 1.7271. The first Indication, to wit, the allaying of the pains, contains these two chief in∣tentions, to wit, that the breach of the unity be taken away; and in the mean time, that the irritation, or the growing hot of the Fibres, or of the Spirits flowing in them, may be quieted or appeased.

1 1.7281. For the taking away of the breach of the unity in the distemper'd places, both the flowings of the humors, which are apt to tend thither, ought to be hindred, and the Mine already impacted to be dissipated, and shaken off, and its Particles suppressed, from their mutual effervescencies or growing hot. For these ends are destinated, evacua∣ting and altering Remedies, and of either both internal and external. We shall here add some forms of these, and the more select ways of administration, in their or∣der.

* 1.729Phlebotomy or letting of Blood, in a fresh Gout, or not very inveterate, and especially in a more hot constitution, being used about the beginning of the Disease, doth often bring help; but in an habitual Disease, and in a frigid temperament, and old age, it

is wont to be more hurtful than profitable; because it depresses the vigor of the Blood, and of the Spirits, not too much raging, without a lessening of the Morbific matter.

The business is very much controverted concerning Purging about the beginning of the Disease,* 1.730 whilst some Physicians most strictly abstain from all Purging, before the de∣clination or end of the fit; others on the contrary, constantly give strong Purges about the beginning of the Disease, and oftentimes with good success. The reason of the dif∣ference seems to be placed chiefly in this, to wit, because some Gouty persons are yet firm in the constitution and tone of the humors, and the Vessels containing them, and being not yet weakned in their joints, as often as the Blood and nervous Liquor are disturbed by Medicines, their superfluities and recrements are not presently precipitated into the Mine of this Disease, yea these being provoked by the Medicine, and also obeying the incitement, are drawn forth by the mo••ths of the Arteries, into the cavities of the Intestines; and in the mean time, the Vessels being emptied, they draw or sup back a certain part of the Morbific Matter. But it is otherwise in tender and weak Constitu∣tions, for from the least commotion of the Medicine, the purgings of either humor fall down into the Gouty place. Therefore to whom Purging is convenient, it ought to be instituted with the more strong Medicines,* 1.731 and Elaterium. For this matter, these are of known use. The Electuary Caryacostinum. The Purging Syrup de Ramno. Pills of Hermod••ctyls. The Compounded Pill ex Duobus. The Pill of Rhasis; which if we may believe the Author, will quickly make the sick to walk. Take of the best Aloes half an ounce, of red Roses two scruples, of Hermod••ctils barkt one dram and a half, of Diagridium one dram, of Honey of Roses what will suffice; make a Pill. Roderick of Fonseca, wonder∣fully crys up the root of black Hellebore, and among other things, an Apple with its small strings put into it, to about half a dram, roasted under the ashes, and so eaten.

Take of Calowel••nos one scruple, of the Resine of Ialap three grains, or of Scammony three grains, of the Oyl of Cloves one grain, of the Ba••som of Peru what will suffice; make th••re or four Pills, for one Dose.

In the time of Purging, it will be of some moment, perhaps, as Solenander advises, to restrain the falling down of the humors into those places, by a Plaster, or other defen∣sive Medicine, laid upon the distemper'd places.

Vomiting,* 1.732 to whom it is wont to be safe and easie, may be also convenient in this Disease; for which end, the Emetick Tartar of Mynsicht, the Sulphur of Antimony, or its Flowers, Mercurious Vitae, Vinum Emeticum, Gambogia, may be administer'd.

But in the Goutish fit,* 1.733 the Powders of Stones, Bones, and Shells, as also of sharp Ve∣getables, do help; which being called the Alexiteria of this Disease, subjugate all the Particles, and by growing hot with them, do as it were mortifie them, and at last they being overcome, they carry them forth either by Urine or Sweat.

Take of the Powder of Crabs claws compounded two drams,* 1.734 of Ivory, of the Root of Cre∣tick Dittany, of the Root of male Poeony, each one dram; of the Wood of Aloes, of yel∣low Saunders, each half a dram; make a Powder, let it be taken half a dram or a dram, either by it self, in a spoonful of red Poppy Water, drinking after it six spoonfuls of the same, or let it be reduced into a Bolus, or Pills, with Andromach Treacle, or Venice Turpentine what will suffice: the Dose one dram twice a day, drinking after it of the distalled Water afterwards described two or three ounces.

Or Take of the same Powder six drams,* 1.735 of the Conserves of Gilliflowers, and of Betony, each one ounce and a half; of Diascordium one dram, of the Syrup of Poppies what will suffice; make an Electuary: the Dose one dram to two, Evening and Morning.

In the mean time, while these things are doing, besides, altering Medicines, and al∣laying, have their turns, for the calling away to some other place, the flowing of the Morbific matter into the places distemper'd, or for the carrying it forth; such as may allay the swelling up of the Blood, and the nervous Juice, and stop the Fluxions of the Recrements falling from them; for this end a slender diet, and spoon meat (if it be con∣venien••) being ordered; let Emulsions, Iulep••, and Apozems made of gentle things, and Anodynes, be prescribed.

As to what belongs to the other intentions of healing,2 1.736 viz. the Discussion of the im∣pacted Mine, and for the ••llaying the burning or growing hot of the Fibres and the Spi∣rits; this latter must be endeavoured, without which, being performed, the other in∣tention will not satisfie: for this end therefore it is expedient, to give both external Medicines, viz. Topicks of a various kind; as also internal, viz. Hypnoticks.

For that there are an immense company of Topicks,1 1.737 these are only Anodynes, which re∣spect

only the pain by it self, or are such as aim at this together, and the tumor; or they are repelling, or resolving, and discussing: There are various Formula's of every one of these, and ways of administrations: But the chief in use are Fomentations, Pultesses, and Plasters; of these we shall shew the most celebrious; and first of all, Anodyne Appli∣cations, which please the Fibres with a certain delight. For this use the most common practice with the vulgar are,* 1.738 〈◊〉〈◊〉 or Pultesses of Milk and 〈◊〉〈◊〉 of Bread, or of those with a Muccage, or jelly of the leaves and of the roots of Mallows, and Marsh∣mallowes, and such like.

Others praise a Pultesse of the fresh dung of a Cow applied warm.

* 1.739Take of the Water of Nightshade, and of the Sperm of Frogs, each six ounces; mingle them: Lint being dipt in this, let it be applied warm.

Take of red Lead three ounces, of distilled Vinegar one quart; let them digest for several days; and use this liquor by it self, or else the water drawn of by distillation.

Also a Water distilled, made of a Tincture of Verdigriese, distilled in Vinegar, often times allays the pains.

I had from a Gentleman, oftentimes heavily obnoxious to the Gout, that he in the most cruel torments of this Disease, had always present ease, from a Fomentation, of the water distilled from the contents in the stomach of an Ox fresh killed.

* 1.740For the extream torments of the Gout, outward Narcoticks ought sometimes to be ap∣plied. Take of the leaves of Henbane, and of Hemlock, each three handfuls; let them be put into boiling water, and as soon as they grow tender let them be taken out: These being bruis∣ed, add to them, of the Powder of Chamomel flowers about two drams, and the yoalk of one Egg; make a Poultesse.

Or take of the Tincture of Saffron, made in the Spirit of Wine four ounces, of Camphor, of Opium, each one dram; let them digest close shut and warm, till they are dissolved; anoint the pained part with this liquor. There are to be found other innumerable Medicines of this sort in Medical Books, and are every where ordinary, and wont to be prescribed almost by every vulgar person; which also suffices for the fulfilling of the other Intenti∣on, to wit, the repercussion of the Humors, when it is seen necessary.

* 1.741As to what respects Resolving and Discussing Topicks, they are not required to be of the same kind, which open only the Pores, and evaporate the Serum, and make the Blood circulate, as in an Inflammation, or a white hard swelling; but whose Saline Par∣ticles, being destinated for the opposing those Salts of the Goutish Mine, may either by embracing them carry them sorth of doors, or by precipitating them may suppress them from their painful heats. Wherefore in this Disease, when Fomentations or Pul∣tesses of Cha••••mel, Mallows, Marsh-mallows, Line and Fenegreek seeds, bring little or no help; yea by loosning the nervous parts, do oftentimes much hurt; the Salt of Armoniack or Sea Salt, or Nitre, or of Vitriol, quick Lime, and dissolutions of the like, or di∣stilled Liquors, always troublesome to other humors or pains, are wont to give the greatest help.

* 1.742These kind of Liquors in the Goutish Fits, to be applied to the grieved part, are vari∣ously prescribed, by Quercitan, Crollius, Hartman, and other Chymists; and as other famous Physicians have often ••ound them by experience good, and approved of them, we may conclude that they are helpful for the aforesaid reason.

There will be no need here to repeat the forms of these, though I could easily set down many other preparations of this sort; yet I shall here give you one or two of them only.

Take of Sal Tartari, and Armoniac powdered, each two ounces; put them into rain or spring water two quarts, and with a linnen cloth dipt in it warm, apply it.

Take of the Spirits of Vitriol not rectified one pint, of Sea Salt calcined and powdered one pound; distil them in a Glass retort in sand; a very pure Spirit of Salt will come forth, which being expulsed from its lodging by a Vitriolick Stagma, leaving the possession▪ easly ascends: To the dead head pour two pints of the Spirit of Wine, digest it close and warm, adding of Camphor two drams; let it be applied warm to the grieved part with linnen rags.

Take of the Filings of Iron, of the Flowers of Sal Armoniack, each six ounces; mingle them well by pounding them together; let it be distilled in a Glass retort till the Flowers are sublimated; to the Caput Mortuum being pounded, pour the Spirits of Wine, digest it, and keep it for use.

I have heard of some that for the allaying of the pains of the Gout, have inclosed the distempered foot in a little Bay, filled with Sea Salt calcined and powdered; from which they have still expected a certain and sudden help.

In the declination of the Fit,* 1.743 for the strengthening the part, and for the shaking off the relignes of the Morbific matter, Plasters are profitably applied; which however are not all convenient to all, but for some more, for others less hot; But the most effica∣cious to most people are those in which are Red Lead, Ceruse, and Soap, boiled with Oyl. Or Take of the Plaster of Red Lead two parts, of Paracelsus one part, wax them, and spread them upon Leather.

2. Internal Remedies for the pains of the Gout,* 1.744 that are made use of, are only Narco∣ticks, or such as stupefie, which ought to be administer'd in cruel and long torments. Of these we shall chiefly commend Preparations of Opium, with Salt of Tartar or its Tincture. Further, for this use, the Laudanum of Paracelsus, or that of London, Pills of Styrax, and Cynogloss, or Dogs Tongue, Syrup de Maeconie, or of Poppies, Treacle An∣dromach, and Diascordium, are wont to be helpful or give ease.

The Indication Preservatory,2 1.745 or so called, respects the taking away of the foregoing causes of the Gout; wherefore, that the fits of pains may more rarely, or less or not at all infest them: For this end, Evacuating, Altering, and Corroborating Remedies, toge∣ther with an exact dyet, are prescribed to be given out of the Fits.

1. Gouty people therefore ought constantly to be purged Spring and Fall;* 1.746 and then al∣so it will be expedient to Vomit, if nothing gainsays it; and sometimes afterwards at in∣tervals, to repeat them. Let those who are indued with a more strong stomach and Praecordia, take Emetick Minerals prepared out of Antimony or Mercury. Those who are of a more tender constitution, may take after the eating of slippery meats, Wine of Squills, or the Salt of Vitriol with Posset drink; and then the stomach being filled with warm water, or simple Posset-drink, or with the leaves of Carduus boiled in it, let Vomiting be twice or thrice or oftner provoked. For Purging to be often cele∣brated also at convenient times, between, the forms of purging Medicines already pre∣scribed are convenient enough. Or Take of the strings of black Hellebore cleansed one ounce, of Lignum Aloes and of Cloves, each two drams, bruise them, and pour to them of the Spirits of Wine, not rectified, one quart; let them digest warm and close shut, for several days. The Dose two or three spoonfuls in the morning, twice or thrice in a week; and let Vomiting and Purging be always begun before the Aequinoxes, lest perhaps the Fit being first be∣gun should pervert the course of the Medicine.

Letting of Blood,* 1.747 or the opening of the Hemorrhoidal Vessels, are sometimes conveni∣ent Spring or Fall, in an hot temperament, and for such as are indued with a more sharp Blood. Cauteries, made in the Arms, and between the shoulders, are profitable to every one almost obnoxious to this Disease.

But besides,* 1.748 altering Medicines, Antidotes so called by the Ancients, against the Gout, are of known use; and in a long time, together with an exact method or Government concerning the fix non-naturals, often bring great help; in this rank the chief are Medi∣dicines indued with a Volatile Salt, and Balsamick Sulphur, forasmuch as these exalt the fixed Salt, and reduce what is Acetous; besides, bitter and astringent things, as these Herbs, Chamaepitys, Centaury, Germander, the Roots of Gentian, and Aristolochia, or Birthwort, &c. (as by experience has been approved of in this Disease) for this reason seem to be profitable; because they help the offices of Concoction, and Chylification, or ma∣king of Chyle; and restrain the Saline fixed feculencies or dregs, that they may not be car∣ried into the Blood. We shall here set down some forms of each of them.

Take of the Powder of Chamaepitys six drams,* 1.749 of Crabs Eyes two drams, of Venice Turpentine what will suffice, make small Pills, take three or four Morning and Evening, for thirty or forty days, drinking after them of the following distilled water two or three ounces.

Take of the leaves of Cypress Tree,* 1.750 of the Ash, and of Misleto of the Apple tree, each six handfuls; of the roots of sweet smelling Avens, Burdock, each one pound, the outer rinds of ten Oranges, and of six Lemons, of Nutmegs, and Mace, each one ounce; let them be all cut and bruised, and pour to them seven pints of new Milk and of Malaga one pint; let them be distilled according to art, and the whole liquor mixed together.

Or let there be a simple Water prepared of the leaves of Burdock by pouring it twice or thrice upon fresh leaves.

Take of the Powder of the Seeds of Burdock six drams, of Crabs Eyes two drams, of Nut∣meg half a dram, of Capive Balsom what will suffice to make a Mass, which form into small Pills: let four be taken Evening and Morning for many days.

Take of the Tincture of Antimony one ounce;* 1.751 the Dose twenty drops to twenty five, Evening and Morning, with three ounces of the water but now described.

* 1.752For poor people I was wont to prescribe after this manner. Take of the Powder of the leaves of Sage half a pound, of Crabs Eyes, and of the Sugar of Crystal, each two ounces; mix them; let it be kept in a Glass, and take one spoonful twice in a day, with a draught of a Decoction of the leaves of Sage, or of the roots of the Burdock.

Or of the Powder of Dorncrellius prescribed to be taken after the same manner.

Take of the Powder of the leaves of Germander, of Gout Ivy, of the lesser Centaury, of Marjoram, of Sage, of Betony, of the roots of Gentian, and of round Birthwort, each one ounce; of Sugar one pound; mix them and make a Powder.

Or of the Powder of John Anglicus, called by himself Saracenick.

Take of the Powder of the leaves of Chamaepitys, one ounce, the bones of a Mans foot burnt two drams, of Liquorish three drams, mix them.

* 1.753For ordinary drink, let there be prepared a Bochet of Sarsaparilla, of Saunders, wood of Rhodium, shavings of Ivory, Harts-horn, &c. or let there be prepared small Ale, in a Vessel holding about four gallons, instead of Hops let their be boiled the leaves of Ger∣mander and Chamaepitys, and after it has work'd, put into it of the leaves of dry Sage four handfuls, of Sassaphras two ounces, of the roots of sweet smelling Avens eight ounces.

* 1.754Among Altering Medicines a Milk dyet has not the last place, that the Patient should use for three or four Months, no other food: let him drink Morning and Evening new Milk from the Cow; about noon, and at other times, let him eat white Bread boiled in Barly, or Water-gruel of Oatmeal: I have known some by this kind of dyet to have received notable help; but others, to have received much hurt or to grow worse, by the use of Milk, and the Gout being nothing cured, to have contracted great obstructions of the Viscera, and a Cachochimical disposition or fulness of evil humors. Therefore this method is not rashly to be entered upon, without the counsel of a pru∣dent Physician, and by a sedulous observation, whether it be convenient or not.

* 1.755Of late it has been a common custom, for people having the Gout, to drink every Morning their own Urine; which I know has been beneficial to some. The reason of which help seems to be, because the Saline Latex of the Vrine, passing thorow the Blood, doth carry with it to the Reins, the Saline fixed Particles that were before wont to be carried into the joints. Wherefore, this method, when it is helpful to the distemper of the Gout, for the most part encreases the Stone: which I think sufficiently appears from the following History.

* 1.756A very Learned and Pious Man of this Nation, and also the glory of Learned Men Dr. H. H. after he had lived for many years, grievously obnoxious to freqent fits of pains, of Vomiting, and a making of bloody Urine, at length by the constant use of the fol∣lowing Remedies, he lived above seven years almost free from the Stone, and without any grievous Fit. The method of Cure which had been taught him by a certain Gen∣tleman, was after this manner, without any Physick or medicine, abstaining from Wine and Cyder, he drank for his ordinary drink small Ale, made of Oaten Malt; further, once in a week in the Morning, he took a draught of the same Ale, to about a pint, with the Powder of small old rotten Bones three spoonfuls dissolved in it: By the use of these, within a few months he seemed to be in health, and freed from the Stone, but shortly after he began to be sick of the Gout, and was infested with most grievous Fits of it, all the time he was free from the Stone; and at length upon every light occa∣sion, was become so obnoxious to them, that presently after feeding, if he exercised either his body or mind, by walking or study, he most certainly expected the Fits of his pains. The reason of which was, because the Blood being filled to a plenitude with Saline fixed Particles, and the nervous Liquor still with Acetous, when being incited, and also poured forth on the fresh nutritious juice, they grew turgid, presently they deposed their superfluities, viz. the Morbific matter of either kind, into the very weak Joints.

This venerable person therefore, being tyred out with so frequent and almost continu∣al torture, by the counsel of a certain Friend, drank every morning of his own Urine, by the use of which, within a month or two, he was less tormented with the goutish Fits, but with an evil turn, the Distemper of the Stone began to grow again upon him, for he was from thence troubled with a pain about his Loins, with Vomiting, and a pain in making water, and a little after a total suppression of Urine followed, which being not to be helped by any Remedies, in about a fortnights time this Reverend Gen∣tleman dyed.

* 1.757The Carcase being opened, all the Viscera, except the Reins appeared most sound and firm, but the right Kidney was almost consumed, a small heap of the Gland••la's being only left, all the Vessels and the Vreter being joined together, and wholly shut up,

so that no Urine at all had passed there of a long time: The left Kidney being large enough, contained within the cavity and its passages, a great heap of Sand or Gravel, and little Stones; besides there was a round hard and whitish stone fallen into the Vre∣ter, three inches deep, and there fixed, and had wholly shut out the passage of the wa∣ter; the Membrane of the Vreter, where the Stone stuck, was become so thick and cal∣lous, and so free from pain, that here it could by no means be moved either upwards or downwards.

It seems in this case, that when the coagulated Particles of the Blood and nervous juice, to wit, the Saline fixed and the Acetous, meeting together at first in the Reins, did stir up for a while the Distemper of the Stone; afterwards, by the use of the above∣said Powder, the saline Particles being still thrust forward into the habit of the Body, and not easily rendred, heaped together the Goutish seed plot in the Joints, the Reins being in the mean time free. But at length, when by the drinking of his own Urine, the saline Mine was brought back into the Reins, the Disease of the Gout was changed into the mortal Disease of the Stone.

CHAP. XV.

Of the Colick Passion.

IT has been mentioned in the former Chapter,* 1.758 by what right we have referred this Disease among the Distempers of the Brain and nervous Stock, to wit, both in re∣spect of the Symptoms urging, which are pain, and Convulsive motions, as also from the reason of the cause, by Charles Piso placed in the head, and truly not impro∣bably.

Concerning the word Colick, from the Intestine called the Colon, we shall not strive, for that it is supposed,* 1.759 though wrongfully, to be chiefly affected in this Disease. The Distem∣per may be described, That it is an hauling or notable pulling of some parts of the Ab∣domen or the Belly;* 1.760 from whence a very acute pain arises, and with it for the most part, a Vomiting, as also Convulsions, and Contractions almost of the whole Viscera of the Belly, are wont to be joined. And for that the Navil, and its neighbouring parts, are sometimes as it were with a Perforation, or boring thorow, drawn inwards, and sometimes swell out, with an inflation or blowing up, and as it were with a great leap∣ing forth; the Intestines, by an inverse motion of the Fibres, are oftentimes pulled toge∣ther upwards: wherefore the Belly being extreamly bound together, renders little or nothing; yea although it be often provoked by Clysters, it doth not easily part with its contents: It appears clearly, that the Ventricle, with the Duodenum, and the blad∣der of Gall, are in like manner pulled, by Vomiting, and by the casting forth of great plenty of yellow or green Choler: Sometimes the Vreters, and the bladder of the Urine, are so contracted, that in all the fit, the Urine is wholly suppressed, or but very sparing∣ly rendered: Besides, a Vertiginous Distemper of the Head, frequently preceeds, or fol∣lows the fits of this Disease: yea, the Colick growing worse, and inveterate, oftentimes causes pains in the outward members, and at length ends in the Palsie: Therefore, for∣asmuch as very many parts are wont to labour in this Disease, we shall inquire, which is primarily affected, and by what means the other suffer; then what is the conjunct cause of the Disease, in what place it subsists, and from whence it draws its original.

As to the part primarily or first of all distemper'd,* 1.761 though the Disease being urgent, the whole region of the Belly is wont to be disturbed, yet its primary seat ought to be placed, where the pain chiefly infests, and pertinaciously sticks: But this, by the con∣sent of very many Physicians, is said to be some where in the Gut Colon. Wherefore Celsus saith, That the Colick is a Distemper of the greater Intestine; which also reason seems to perswade, something; for whether the Morbific Matter is supposed to be heaped up in the Cavities of the Intestines, or to be wholly fixed in their Membranes, certainly there are extant deep little Cells in the folds of the Colon, for its receptacles, and thick coats of this Intestine,* 1.762 in which the peccant humor may be deeply fastned. But indeed this opinion (to which we cannot easily assent) as also the denomination of the Distemper, seems to have grown in credit in the Schools of the Physicians, from this only, because we ordinarily observe, that the Intestines enter into pains and torments, being irritated by wind, medicines, Choler, and perhaps other humors, contained within their cavities;

hence, as it is obvious, may be inferred, that the Colick pains do arise from the sharp and provocative contents of the Intestines, and especially of the Colon. But if it were so, without doubt, those things which loosen the Belly, and draw forth plentifully the wind, and the dregs or Faces, should give certain ease; the contrary of which often happens, to wit, by some more violent, or often Purging, the Disease has grown worse.

* 1.763Wherefore, that the seat of this Disease, and the nature of it may be truly known, we ought first of all to distinguish here, concerning the torments of the Belly, or pains commonly esteemed for Colicks: to wit, these are either meerly occasional, arising from a solitary evident cause, and ordinarily happen without any previous disposition to some men, and especially to those who being of a tender constitution, have very sensible Fi∣bres, and Spirits quickly dissipated;* 1.764 after this manner, disagreeable or unwonted eating or drinking, also medicines, taking of cold, and many other alterations about the six non-naturals, oftentimes excite great perturbations, with pains in the Viscera of the lower part of the Belly: which kind of Distemper, ought to be esteemed, not the Disease, but only Symptoms excited from a manifest cause.

* 1.765But besides, the Colick properly so called, happens to some, not only produced by an accidental cause, but falling upon some men predisposed by a peculiar right, depends wholly upon a foregoing cause ripened by degrees. The more grievous fits of this Dis∣ease, for the most part, have their periods, and observe the changes of the Air and Year; further, being excited, they do not easily give place to any Remedies, nor quickly pass over; but notwithstanding the use of Fomentations, and though the Belly be taken down very much by Clysters, or Purging, they oftentimes continue with great fierceness for many days, and sometimes weeks. The pains in every fit still repeat the same part, and are fol∣lowed with a concourse, for the most part, of other the like Symptoms: But the pains of the Colick, though they have not the same se•••• in all, but sometimes exercise their cruelties under the Ventricle, sometimes about the Navel, or the Hypochondria, and sometimes in the lower part of the Belly, or about the Loins; yet as often as they are repeated in the same sick person, they mostly observe the same nest.

* 1.766For the unfolding the Aetiology of this Disease, it is not enough to affirm, that the Intestines are pulled, either by their sharp contents, or irritated by the Blood, and other humors poured into them, and breaking the continuity. For as to the former, it is ex∣treamly improbable, that the Bile, or Choler, or Phlegm, or the Pancreatick Juice, or any other simple humor, or growing hot or fermenting with others, should be able to excite such fixed, cruel, and long continuing pains: Besides, because the Intestines being besmeared with their own dung, cannot be easily pricked by the Contents, though sharp; nor are they wont to be exasperated by them; insomuch that the sharpest stools, which oftentimes fetch off the skin at the Fundament, very little trouble, or not at all, the passages of the Guts; further, these being grievously provoked, whatever is trouble∣some, contained in their cavity, is easily shaken forth, and either by driving it forward, upwards, or downwards, is quickly thrust forth; as is plainly perceived in the Disease of the Choler, and other Dysentrick Distempers; nor indeed is there almost any loading of these provoking the Membranes, and stirring up pains, which may not be exterminated or carried forth of doors by one purge or other.* 1.767 Then, secondly, as to what respects the suffusions of the Blood, or Serum, within the coats of the Intestines, by which an Inflam∣mation or painful Tumors are excited; Indeed we grant, that sometimes it may so come to pass, yea I have known it by ocular inspection; but from thence we have observed, not the Colick but the Iliack passion to have been excited. For when I have opened se∣veral dying of the Iliack passion, I found almost in all, that the cause of the Disease, and of their Death, was an Inflammation or Ulcer of some Intestine; neither is this any wonder, because a Solution of the continuity, in a very tender and highly sensible Membrance, doth stir up Convulsions, and painful Corrugations or wrinklings together, and so continual and cruel; that therefore the Peristaltick motion of the distempered Intestine, whereby the dung or dregs of the Belly are carried forward toward the Anum or Arse-Gut, should be hindred and wholly inverted.

* 1.768Therefore, that we may thorowly inquire out both the Matter and Mine, as also the seats, and the ways of flowing to them, of this Disease of the Colick, by some o∣ther means; it may deservedly be suspected, that it is the nervous Juice, and its Recre∣ments; and that the rather, because this passion hath so intimate an agreement or con∣sent with the other Distempers of the Brain and the nervous Stock, as we have al∣ready shewed. Charles Piso hath affirmed, That as most distempers of the whole Bo∣dy, so also the pains of the Colick, are excited by a Serous heap or deluge gathered to∣gether in the head; and he contends, that the seat of this Disease, is neither in the coats nor cavities of the Intestines, but in the Peritonaum or inner rim of the Belly, and

that the cause sticks wholly in the Brain, near the original of the Nerves. To wit, he supposes,* 1.769 (which he saith he hath found by Anatomical observation)

The serosities laid up in the hinder region of the Brain, to beset the little heads of the Nerves of the wandring pair, and so some of the utmost branches and shoots of them inserted in∣to the Peritonaeum or inner rim of the Belly by the Caul, to move into Convulsions; and from the contraction or drawing together of this, most cruel pains, both in it, and in the underlying Viscera, as it were breaking them to pieces, to be excited.

For the proof of this opinion, he brings an example of a certain man dissected, being dead of a most grievous fit of the Colick, in whom the hinder region of the head near the Cere∣bel, was so much drowned with a clear water, as also the nervous original of the wandring pair, that the marrowy substance appeared very much moistened, like wet Paper, Sect. 4. Chap. 2.

But indeed,* 1.770 though we should grant, that the Colick should arise from the humor of the Brain, and from the default of that watering the nervous parts; yet we think that this painful passion is excited, not after that manner as this Author has laid down. Be∣cause we think neither the seat of this Disease to subsist in the Peritonaeum, nor its primary cause to be within the head. For as to this, although the Morbifick matter being heaped up in the head, near the origine of the Nerves, doth sometimes produce in the parts at a great distance, Numnesses, Cramps, and Convulsive motions, as we have elsewhere shewn, by many instances, with the reasons of the Distemper; yet it is much otherwise in a very cruel pain, such as the Colick is wont to be: For as to this being excited, which always proceeds from a breach of the continuity, it is required, that the dolorifick cause or improporti∣onate object, should be fixed in the distemper'd member itself, or at least a certain part or portion of it: Neither is it sufficient to say, that the Convulsion proceeds from a remote cause,* 1.771 and so the pain from the Convulsions: For although pain oftentimes doth pro∣duce Convulsive motions, yet these do not produce pain of themselves, at least great and continuing long. Wherefore in the pain of the Colick, the matter drawing asun∣der the sensitive Fibres, and pulling them one from another, and so provoking them into painful Corrugations or wrinklings, doth not still stay in the Brain; but descending from thence, thorow the nervous passages, towards the Intestines, seems to be heaped up somewhere in their neighbourhood, nigh to the pained parts, and there either growing turgid or swelling up, by reason of their fulness, or growing hot with some other humor, do bring in the fits of this Disease.

We indeed reject the Mine of the Colick,* 1.772 from the Peritonaeum; because this Mem∣brane being very thin, and gifted but with very few and only small Vessels, is neither capable of any great affluxions of Humors, neither can it self, though pulled together, be able to urge the Viscera lying under it, into pains, by compressing or drawing them together. But the Morbific matter being slid down from the Head, by the Nerves, into the Belly, finds very convenient nests in the Mesentery; in which very many and great Nerves have there their noted infoldings and distributions: Wherefore, as this part is very sensible, and very much obnoxious to the flowings in of the humors of the nervous Stock, it may be deservedly affirmed to be the seat of this Disease of the Colick.

We have shewn formerly,* 1.773 the causes of some Convulsive motions in the Abdomen, which are commonly called Hysterical, to lye hid in the Mesenterick Infoldings; more∣over, in the same places, we did then assert, That the Colick pains had sometimes their nests, and confirmed it sufficiently by Anatomical observation. But the matter is some∣thing diverse, and not the same, that is wont to excite the so different Distempers of either, under the same roof. In the Passions called Hysterical, we have largely declared in a former Treatise, That the Animal Spirits being burthened with an Elastick Copula, are let off, or as it were exploded one from another, and so the containing bodies are unwillingly forced into irregular or preternatural Motions. But in the pains of the Co∣lick, the same Spirits, by reason of the matter troublesome to them, and improporti∣onate, being provoked, and so pulled and distracted one from another, do put the sen∣sible Fibres into very troublesome Corrugations, or wrinkling themselves together: By what means this comes to pass in the pains of the Colick, also what are the conjunct, and the foregoing causes of this Disease, and the reasons of the Symptoms, we shall a little further explain.

Therefore we shall suppose,* 1.774 that for a Seed-plot or Mine of the Colick Distemper, some Recrements of the nervous humor being fallen from the Brain, thorow the Nerves, and slid down into the Mesentery, and other infoldings of the Abdomen, are there heap∣ed up; which if they be thick, and very viscous, so that they cannot be received by the Lymphaeducts or water-carriers, and so sent away, or that they cannot sweat forth by the small shoots of the Vessels into the cavities of the Intestines, stagnating in those parts, and being by degrees heaped together, do arise at length to a provocative

fullness; then this matter growing more degenerate by standing, and becoming more infestous, grows turgid occasionally, or of its own accord, or perhaps grows hot or ferments with a Saline fixed humor, poured forth thither, from the Blood, torments the shoots of the Nerves, and the nervous Fibres (of which the Mesentery hath an infinite number) with very troublesome and painful Corrugations; which kind of Distemper of these, doth not plainly cease, till the hot or Fermentative matter being shaken off, or pressed forth into the cavities of the Intestines, is at length overcome.

* 1.775Further, forasmuch as from the Mesentery and its Infoldings, nervous shoots and Fi∣bres are most thickly put forth into the bottom of the Ventricle, the bladder of the Gall, the Choledoch passages, all the Intestines, and on every side almost into all the Vis∣cera of the whole Abdomen; therefore whilst the Colick matter grows hot or ferments in its Mines, it there stirs up torments, and oftentimes most cruel pains; and together with them in many other Membranous parts Cramps, and Convulsive or painful Con∣tractions, are every where excited. Hence, by reason of the Mesentery being primarily distemper'd, a most sharp pain under the Navil shews it self, like as if a stake were dri∣ven thorow it, or a wimble a boring it; then round about almost in the whole Abdo∣men or lower region of the Belly, by reason of the Intestines being variously drawn down, or backwards, in diverse places together, wandring pains run about hither and thither; and by reason of the motions of the Fibres being disturbed or inverted, both in these, and also in the urinary Vessels, the Belly is almost always bound up, and sometimes a suppression of the Urine, or a rendring but a very little succeeds: yea also the Duodenum, the Gall-Bladder, with its passages, and the bottom of the Ventricle, being distem∣per'd with a Spasm or Cramp, and their Fibres drawn upwards, from thence frequent Vomiting, with a copious casting forth of yellow or green Choler, doth infest during the fit.

* 1.776But some do contend that this Bile or Choler (which is sometimes cast forth as green as a Leek) is the material Cause of the Disease; and that abundance of it dropping or distilling forth into the Viscera, doth excite the Colick pains in the Intestines. I say, that this humor about the beginning of the fit, is contained without any offence in the Blad∣der or bag of the Gall; but afterwards by reason of the Convulsions of the Viscera, being from thence pressed forth, and as it were drawn or stroked out into the Stomach, it is carried from the distemper'd Ventricle by Vomit; but there perhaps meeting with some other acid humor, it acquires a greenish colour, yea sometimes a blackish (as we have sometimes found by Anatomical observation.) And indeed, it appears clear from this, because those who are of a more cold temperament, and beget little Choler, when they are sick of the Colick, cast forth by Vomit little or nothing of the yellow or green Bile; and yet they are wont to be vexed with as cruel and sharp pains as others.

* 1.777In the fit of the Colick, to the pains of the Belly, most cruel pains, raging about the Loins, in the bottom of the back, are very often joined; which certainly cannot arise from the irritation of any Intestine. But it may be easily conceived, that these are exci∣ted from the Morbific cause implanted in the Mesentery; forasmuch as some most noted Nerves, belonging to the Loins, enter into the greatest nervous infolding of the Mesentery; hence not only painful Convulsions are delivered by consent from one part to another; but besides, it is probable, that some Recrements of the Back and Loins, are derived by this passage into the Mesentery; and in some measure, for this reason Scorbutical people are so very obnoxious to pains of the Belly, and to a Flux.

* 1.778Thus much concerning the nature and seat of the Colick, as also of its conjunct cause, and of the Symptoms of the same coming into act: As to what belongs to the foregoing cause, it consists chiefly in these two things, to wit, first of all for that many Recrements are heaped together in the nervous Liquor; and secondly, because they being chiefly re∣ceived from the Nerves, destinated to the Viscera of the lower Belly, and brought into the Mesentery,1 1.779 constitute the Morbid Mines there: 1. The former of these happens for the most part, from the fault and vice of the Brain; to wit, because this admits together with the nervous liquor, Heterogeneous Particles, and infestous to the Animal Regiment within its borders; besides also, for that it doth not send away presently these and other ordinary Recrements by convenient sinks: Wherefore, the incongruous matter, when it cannot be otherways carried from the Brain, it most easily rushes into the most open Nerves of the wandring pair. And for this Reason it is, that Women from every in∣ordination of the Brain,2 1.780 frequently contract the disposition called Hysterical; to wit, because the Recrements of the nervous Liquor, whether they are Spasmodick or Con∣vulsive, and Elastick or letting off, or painful, or provocative only, being more apt to be deposed into the wandring pair, so ordinarily excite Convulsive Symptoms, like to the Colick. 2. Because this matter running into the pair of the wandring Nerves, is laid up in the Mesentery, or in other Infoldings within the Abdomen; the reason is, that in

these nervous Infoldings, many and large Nerves of the same conjugation are at last ter∣minated: wherefore, if the Recrements of the nervous humor, subsiding here as it were upon its bottom, neither can be drawn back by any of the Vessels, nor pass into the cavi∣ties of the Intestines, there is a necessity that it must erect in this part its morbid nests.

The evident causes are of a double kind,* 1.781 to wit, first, those that do injury to the Brain and nervous stock, by causing a greater provision of the Morbific matter: or, se∣condly, those which by agitating or shaking the Blood and humors, stir up the Mines ga∣thered together, and before quiet, and provoke them into painful heats or fermentings. It would be tedious here to examine the manifold, and diverse occasions, by which the Colick pains are brought upon those predisposed; for these often are caused by great in∣ordinations in the six non naturals, and the mutations of the Air, and the Year; and moreover (by what help should be expected) by the untimely administring Medicines themselves.

From what has been said,* 1.782 the differences of this Disease may be easily known. For, first, by means of the causes, we have shewn the Colick to be either accidental, which is caused by reason of the Intestines being provoked by sharp contents, such as we but now described it. Secondly, By reason of the place affected, the Colick is sometimes supe∣rior, sometimes inferior, sometimes lateral or of the side, as the Morbific matter is fixed, either sometimes in this part, sometimes in that part of the Mesentery, or in other infoldings of the Abdomen. Thirdly, By reason of the sickly condition and tempera∣ment of the sick, it is called a Bilous, or Cholerick, a Phlegmatick, or a Melancholick Co∣lick; also either simple, or Scorbutick; not that these imaginary humors excite of them∣selves the Colick, but according to the dispositions of the Body distemper'd, various Symptoms are made, or caused to vary.

As to its Prognostick,* 1.783 it is commonly known, that the accidental Colick, to wit, ex∣cited from a solitary evident cause, is most often safe, and with an easie matter cured; but the habitual, as to its disposition, it is very difficult to be rooted out, so that the fits may no more return; and its fits sometimes are pertinacious, notwithstanding Re∣medies, and sometimes continue many days, yea weeks, and months.

2. The Colick disposition frequently succeeds long intermitting Feavours, and conti∣nual, being evilly handled; for that the nervous Liquor being highly vitiated, gathers together many Recrements, which are deeply deposed into the Infoldings of the Abdo∣men, as it were the more open receptacles. Further, for this reason, an Epidemical Fea∣vour rages some years, to which the Colick is joined, as its Pathognomonick or peculiar Symptom: hence in like manner, a long and grievous Scurvy causes also the Colick, be∣cause it perverts the nervous liquor.

3. After the Colick pains have raged for sometime in the Belly, they fall oftentimes into the Loins, and then the Disease increasing or growng worse, they enter upon the members, and the muscles almost all in the whole Body, and at length oftentimes end in the Palsie; which certainly is a manifest sign, that the Morbific matter is not carried by the Arteries, but by the Nerves; and that its subject or seat, is not the cavities or the coats of the Intestines, but the nervous Infoldings of the Mesentery: For because the Lumbary pains, or those of the side, do come upon the torments of the Belly, besides that the Nerves of either place communicate, the cause is further, for that the Mor∣bific matter being much increased in the Head, slides down, not only into the wandring pair, but also into the spinal Marrow; and entring into it, and setling in its bottom, causes pains to arise in the Loins, and afterwards in many other Nerves, which proceed from the Spine or Back-bone, and in other Members and Muscles distemper'd; lastly, it brings in the Palsie by the passages of the Nerves being stuffed by the Morbific Matter heap∣ed up to a plentitude in them.

4. The more cruel Colick, and very much raging, whose cause is an Inflammation, or an Imposthum of some Intestine, for the most part induces the mortal Iliack Pas∣sion.

The Curatory method in the Colick,* 1.784 as in most intermitting Diseases, suggests three primary Indications: The first of which Curatory, to be administer'd in the fit, respects the allaying of the pains, and for the sooner and more easie taking away the coming of the Disease. Secondly, Preservatory, which shews the taking away the cause of the Dis∣ease without the fit, that the fits may not be often repeated, or more grievously infest. Thirdly, Vital, which supplies Remedies for the preserving of strength in the torments, and most cruel Cruciations, and for the cherishing of the Spirits. Concerning these we shall speak a little more sully in order.

1. We almost only respect the Curatory Indication in the accidental Colick;1 1.785 for the evident cause, which is an irritation of the Intestines by sharp contents, being removed, the pains for the most part cease of their own accord, nor do they return without the

like occasion. Wherefore, for the quick curing of this Disease, the practice is well e∣nough known to every common person, among the vulgar, to wit, presently to admi∣nister softning Clysters, Topick Anodynes, and Narcoticks; to which, if a Feavour be join∣ed or feared, letting of blood is often used with success. We shall set down forms of these, and the order of using them in the Cure of the habitual Colick.

* 1.786Therefore, for the healing of this Distemper, in the fit, there are two chief Intentions; to wit, both to take away the painful breach or solution of the unity, and to allay the burning or growing hot of the Fibres, and the Spirits in them. For the former, you must endeavour, both that the matter impacted in one or more Mines, may be shaken off or subdued; and also, that a flowing in of new matter may be hindred. The second Intention, which ought chiefly and continually to be insisted upon, is performed by Ano∣dynes chiefly, and Narcoticks: After what manner, and by what Remedies, every one of these are methodically to be done, we shall now shew you.

* 1.787Most often, the Cure of the pain of the Colick, and that rightly, is begun with a Clyster. Let this at first be gentle, and only emollient, by which the Corrugations or the wrinklings of the Fibres may be allayed, and the burning Spirits flattered or pleased. For this end, warm Milk with Sugar, or Molossus, or Syrup of Violets, is convenient; as also Emollient Decoctions of Mallows, Marsh-mallows, Mercury, with the Flowers of Melilot,* 1.788 and Elder, with the Oyl of Almonds, or of Olives; also a Decoction of a Sheeps-head, or Calves-feet: sometimes a Clyster of mere Oyl of Olives, or of Linseed Oyl, is wont to help before any others.

But if the more gentle Clysters do not loosen the Belly, nor are easily ejected, there must be given such as will more provoke, and press, or as it were stroke forth the hu∣mors, by the little mouths of the Arteries: For which end, let there be prepared Car∣minative Decoctions, or such as expel wind, or bitter Decoctions; in which are dissolved Electuary Diacatholicon, Diaphoenicon, or of Laurel berries, or Species Hierae: Also to these Liquors it is usual to add the Infusion of Crocus Metallorum three or four ounces, or of the Emollient Decoction one pint: add of Venice Treacle dissolved with the yolk of an Egg one ounce or an ounce and a half; or Take of sound Vrine one pint, of Venice Turpentine dissolved one ounce and a half, of Molossus one ounce, mix them, and make a Clyster. I have known this oftentimes to bring great help; the reason of which seems to be, for that the Balsamick Particles of the Turpentine comfort the Intestines; and besides, being received by the Blood in the Veins, and with it circulated thorow the whole Body, moves the Urine, so that by such a Clyster, plenty of water follows, and always is rendred with a smell like Violets. Perhaps also, the Particles of the Turpentine being every where diffused, either move the stagnating Morbific matter, or incline the acetous, or otherways degenerate, to a better disposition.

* 1.789Whilst the Intestines are thus washed with Clysters, and are cherished within, Fomenta∣tions are likewise to be applied to the outer parts of the Belly. Take of the leaves of both the Mallows, of Mercury, of Pellitory, each four handfuls; of the Flowers of Elder, Chamo∣mil, and Melilot, each two handfuls: the head of a Sheep cut in pieces. Let them be boiled in as much Spring-water as will suffice; strain it, and use it for a Fomentation, with hot linnen stuphes dipt in it, and wrung forth, and shifting them apply them by turns. Re∣peating them as often as the more strong pains do come upon them: In the intervals, Pultesses or Oyntments may be administer'd.

* 1.790Make a Pultess of bruised Herbs, adding to it of oaten meal what will suffice; which may be laid to the belly, covering it with little square bags made for that purpose. Let one of these at a time be made hot in a pan set over hot coals, with the Oyl of Earth-worms, or of Frogs; lay them on warm, shifting them as soon as one grows cold.

* 1.791Or Take of the Oyl of Earth-worms or of Frogs what will suffice; and anoint the pained part, after the Fomentation, and lay upon it a thin sheet of fine brown paper dipt in it.

The Caul of a Lamb, or the Lungs, or the Inwards of any other Beast, being laid warm to the Belly, and so shifted, sometimes wonderfully eases the pain.

* 1.792I have observed in some Constitutions and temperaments, that Fomentations or Bathings made of hot things, and applied hot, have rather made the pains worse than eased them: wherefore in these cases, it will seem good to prescribe Fomentations of the so∣lutions of Nitre, or of Sal Armoniack, or other Chymical Liquors, as in the pains of the Gout, and sometimes (as Septalius says) of pure cold water.

But if the torments of the Belly do not remit by the use of these, Hypnoticks must be used; which being given in a just Dose, oftentimes give great truces: In the mean time, that the tired Spirits may be refreshed, and strength preserved, there must be yet insti∣tuted a farther provision against the Disease.

Take of liquid Landanum Tartarisated,* 1.793 from sixteen drops to twenty, let it be given going to sleep, in a spoonful of the water of Chamomil flowers, drinking after it six spoonfuls of the same water: Let it be repeated every other, or every third night, if the pains be very great.

In a more hot Constitution, Take of the water of Chamomil flowers three ounces, of the Syrup of Poppies half an ounce, of Aqua mirabilis two drams; make a draught, to be taken at the hour of Sleep.

In the mean time,* 1.794 whilst these things are doing, for the allaying the pains, evacu∣ating Remedies have their turns, for the discussing, or at least for the loosning the mat∣ter impacted in the morbid nests; to wit, that both the Colick Mine may be wholly extirpated; and also that the supplements or its cherishment be cut off, that they may not more increase.* 1.795 For these ends a Vomit (where it is convenient) and a gentle purg∣ing, ought to be ordered; and also in an hot temperament, where there is a Feavour, or where it is feared. letting of Blood.

Take of the Sulphur of Antimony, from five grains to seven or eight, of the Conserves of Borrage one Dram; let it be given in the Morning with government. In this case may be given, according to the judgment of the Physician present, either an Infusion of Crocus Metallorum, or of Mercurius Vitae: The Emerick Tartar of Mynsicht, the expression of the leaves of Asarum: and in more tender Constitutions, Salt of Vitriol, and Wine and Oxymel of Squills.

Purges must be given only in a small Dose,* 1.796 and such as are choice, lest they move a nauseousness in the stomach of the sick.

Take of the Resine of Ialap, of Scammony, each five grains, of the Cream of Tartar one scruple, of Cinnamon powdered four grains; make a Powder, or let it be reduced into Pills, or into a Bolus, with the Conserves of the Flowers of Borrage, or Damask Roses.

Take of Scammony sulphurated half a scruple, of the Cream of Tartar fifteen grains, of Diaphoretick Antimony one scruple; make a Powder, and let it be given after the same manner.

If there be not a Feavour, a Dose of Stomach Pills cum Gummi may be given, or of Amber by it self, or with the Resine of Ialap.

Take of Pill. Rudii twenty five Grains, or half a dram, of Laudamon one grain; make four Pills, let them be taken at the hour of rest: These at first cause sleep, and Purge in the morning.* 1.797 Or, Take of Calomelanos one scruple, of the Resine of Ialap six grains, of Scammony four grains, of Ammoniacum what will suffice; make four Pills to be taken go∣ing to rest.

In a long and tedious Colick, when all other Remedies help little or nothing, I have often known this Medicine, being once or twice given, to have moved Salivation, with the greatest ease to the sick. For when the morbific matter, being heaped together, and thorowly impacted in the nervous Infoldings, and other places about the Abdomen, could not be moved by any other Medicines; the Mercurial Particles every way unfold∣ing themselves, easily dissolve it, and divide it into small bits, and drive it up and down hither and thither, and at length wholly dissipate it. Wherefore in a long and pertinacious Colick a gentle Salivation sometimes may be very happily administer'd.

Baths,* 1.798 and Sweating Medicines, are ordinarily wont to be prescribed in the pains of the Colick; but as to our observation, very rarely with success: For that these, by sha∣king the Blood and nervous humor, cause them to lay up still more matter into the Colick Mine, yea and that matter there deposited, to grow more hot and raging, and very rare∣ly wholly shake it off.

Diureticks are wont much more profitably to be given,* 1.799 by which when the Blood is poured forth, and its serosities plentifully precipitated, the nourishment of the Disease is cut off, and the bloody Mass being emptied, receives part of the Morbific matter, so that its reliques are more easily shaken off. For this end,

Take of the best Spirit of Tartar rectified half an ounce; let half a dram be given twice or thrice in a day, in a spoonful or two of the following Iulep, drinking after it five spoonfuls of the same.

Take of the Water of the leaves of Burdock, or of Aron, or of Arsmart, one pint; of the Water of the flowers of Elder and of Chamomil, each four ounces; of the compound water of Gentian, of the compound Water of Raddishes, each two ounces, of Sugar six drams; mix them together.

After the same manner as the Spirit of Tartar, may be given in a just Dose, sometimes the Tincture of the Salt of Tartar, sometimes the simple mixture, or the Spirit of Sal Armoniack succinated, or impregnated with Amber.

Take of Millepedes prepared two drams, of the flowers of Sal Armoniack Tartarized one dram, of the Oyl of Nutmegs half a scruple, of Turpentine what will suffice; make a Mass, and let it be made into Pil••s; take three or four once or twice in a day, drinking after it a Dose of the Iulep, or of the following distilled water five or six spoonfuls.

Take of fresh Millepedes or Hog-Lice cleansed one pint and a half, the outer rind of six Oranges, and of four Lemons, six Nutmegs; let them be cut small, and add to them one pound of the crumbs of stale white Bread: all being bruised together and well mixed, pour to them four pints of new Milk, and of Sack one quart; let them be distilled according to art, and the whole liquor mixed together; you may sweeten it with Sugar, or the Syrup of Violets as you please.

* 1.800In a long and pertinacious Colick, to those who are of a more cold temperament and Viscera, Purging Spaw Waters, or Whey with the Syrup of Violets, are wont to be given oftentimes with great help; for both liquors, where they are agreeable, being plenti∣fully drunk, refrigerate the stomach and the hot Intestines, and presently loosen and help them in their painful Cramps and wrinklings, or from the Convulsive winds or blasts that extend them; besides, they chiefly help (as I suppose) for that they tame and subdue the Saline Particles of another nature, insinuating themselves into the Morbific Mine, and other Saline and irritative Particles inhabiting it, and oftentimes carry them forth by Purging.

In this Disease, as all things are not convenient for all men, yea neither the same thing always for the same person, there is dayly need of the careful observation of a pru∣dent Physician, that by the co-indications from things taken, that hurt or help, a right method of healing may be instituted, and varied as occasion serves.

2 1.8012. The Vital Indication ought to be joyned to the Curatory, and that between whiles. For when the sick, being afflicted with torture, watching, Vomiting, and abstinence almost continual, often fall into languishment, and sometimes in danger of their lives; Remedies which sustain strength, refresh the Spirits, and procure some truces against the fierceness of the Disease, to wit, Cardiacks or Cordials, and Hypnoticks or such as cause rest, have here their turns.

* 1.802Take of the Water of the flowers of Chamomil, and of Elder, each four ounces; of Barlyed Cinnamon, and of the whole Citron, each two ounces; of Pearl powdered one dram, of Su∣gar three drams; make a Iulep, take of it five or six spoonfuls.

Take of the Powder of Pearl, and of Crabs Eyes, each one dram; let it be divided into four parts; let one part be given twice or thrice in a day, with the Iulep, or with a De∣coction of the roots of Contrayerva.

Take of the Conserve of Clove-Gilliflowers one ounce, of the Confection de Hyacintho, of Alchermes, each two drams; of Pearl powdered half a dram, of the Syrup of the juice of Citrons what will suffice; make a Confection, give of it the quantity of a Nutmeg, three or four times in a day with the Iulep.

In less hot Constitutions, Spirits of Harts-horn, of Sut, of Sal Armoniack impregna∣ted with Amber, also the Tincture of Antimony, or of Coral, do oftentimes give nota∣ble help.

* 1.803Opiates are of necessary use in the Disease of the Colick, without which, the sick cannot live, nor the Physicians, nor those who attend them be at quiet, or have any leasure time. Take of the water of Cowslip flowers three ounces, of the Syrup of Poppies half an ounce, of Aqua Mirabilis two drams; mix them and make a draught to be given going to sleep.

If the pains be very strong, and yield to no such Remedy, prepared Opium and its compositions ought to be given. The Laudanum of Paracelsus, or the London Lauda∣num, Pills of Styrax, or of Hounds-tongue are convenient; a Solution of Tartarisated Opium from sixteen to twenty grains is much used by me. Which Medicine indeed I have given with very good success, to some, that for a long time have been miserably vexed with this Disease, sometimes a great while every night or every other night.

3 1.8043. The Preservatory Indication hath only place in the intervals of the fits, and endea∣vours the taking away the present foregoing cause of the Disease, and hindring it for the future, so that the fits of the pains may seldom or never afterwards return: For which end, the Blood and the nervous liquor ought to be purified, le••t they should beget the morbific matter; and conserved in its due temper, and the Brain and the nervous In∣foldings

of the Abdomen corroborated, le••t they should too readily receive it. For these ends, a strict dyet being ordered, let them enter into a course of Physick Spring and Fall; such as we prescribed for the prevention of the Gout.

Vomiting in this case is never to be omitted,* 1.805 if it be agreeable, to wit, by which the Emunctories of the Viscera being emptied, the Recrements of the Blood, and the ner∣vous Liquor, which otherwise would augment the morbific matter, may be received more plentifully; besides the nervous Infoldings, and all the parts are so shaken, that nothing of that which is about to go into the Mine of the Disease, is suffered to stagnate or to be heaped up there.

Let Purging for three or four times,* 1.806 with due intervals, and also in a hot Constitution, Phlebotomy be celebrated; moreover, let altering Remedies, and especially Chalybeats, or such as are made out of Steel, when they do not Purge, be daily taken at medical hours.

But before all other Remedies whatsoever,* 1.807 the drinking of Mineral Waters, such as come from Iron, for a month, in the Summer time, is wont to give the greatest help: But when these are drunk, you must take heed, that they be rendred well and quickly by Urine or Stool, lest if they should chance to stay long in the body, by running into the Head or Feet, (as they often do) they should cause a Vertigo or the Gout.

Take of our Tincture of Steel one ounce, and let fifteen to twenty drops be taken twice in a day in seven spoonfuls of the following Iulep.

Take of the Waters of the leaves of Aron, and of Burdock, each half a pound; of the Magisterial of Earth Worms, of Gentian compound, of Poeony compound, each two ounces; of Sugar half an ounce; mix them.

After the same manner, here deservedly have place the Tincture of Antimony, and of Amber, yea and many other altering Remedies above prescribed for the Distem∣pers of the Head, may also be used for the preservation from the Colick, whose fore∣going cause proceeds from the Brain.

As to Charles Piso's Observation,* 1.808 by which he endeavours to prove, that the cause of the pain of the Colick remains wholly in the Brain, because he had found a Serous de∣luge in the Head of a certain person dead of that Disease: I say, that this Serum being heaped up in the head, was the remote and antecedent cause of this Disease, and not the conjunct cause. But indeed it is probable, that from this first spring a certain por∣tion of this superfluous and sharp Serum did descend, by the nervous passage, into the nervous Infoldings of the Abdomen, and there constitute the Mines of the Colick Distem∣per. Further, although the Morbific matter there sliden down, because of the tenuity of the parts, and the smallness of the nests, can rarely be seen with the eyes, yet I have plainly seen and handled such a Mine of this Disease become inveterate and very cruel, not long since, in the Mesentery, opening the dead body of a certain Gentlewoman, of whom I have elsewhere made mention.

Being sometimes since consulted with,* 1.809 concerning the curing of a Reverend old Man, grievously obnoxious for many years to the Disease of the Colick; I administer'd to him the same method of healing, and the Remedies I but now described; by the use of which, he found himself much better after a month or two, and within half a year he seem'd to be perfectly well, so that he lived afterwards wholly freed from any fits of the pains: But the Colick disposition had not long ceased, and he had omitted the usual course of Medicine, but he suffer'd about his throat a resolution or loosning in the Mus∣cles serving for swallowing, which troubled him oftentimes, so that he was in danger to be choaked by Food, and chiefly by liquid things sticking in that place. Against this evil receiving help by Antiparalytick Remedies, he continued from thence six or seven years in moderate health; at last, being taken, the first time in the midst of a jour∣ney with an Apoplexy,* 1.810 he dyed. It is obvious enough in this case, that the Recre∣ments of the nervous liquor, that were wont to be deposed about the nervous Infold∣ings of the Abdomen, did at first stir up the Distemper of the Colick; then the same being shut forth from that part, getting another nest for themselves about the Ganglio∣form nervous Infoldings of the Throat, brought in the resolution or short Palsie of the Oesophagus; and lastly, by reason of the same matter restagnating in too great a plen∣ty in the middle part of the Brain, that deadly senslesness followed.

A certain cunning and crafty little Lawyer,* 1.811 about fifty years of Age, was wont to be troubled for many years with a periodical Headach, and with a stupor or numness of his Senses, and a great weight of his head; about the middle of Summer labouring very much with the aforesaid Distempers, he perceived a sudden ease from the apply∣ing of Topical Remedies; but a little after, he was taken with a very cruel Colick, then

being the first time; whose fit fell upon him with so much cruelty, that his strength suddenly failing, he fell into frequent swooning fits, with a cold sweat, which fit not∣withstanding by leasure vanished within twenty four hours, without any breaking of wind, or going to Stool. But after that, he suffer'd frequent fits, and became obnoxi∣ous to the Disease; all which (as I was carefully informed) for the most part were usher'd in with a pain of the Head, with a Vertigo, and amazedness, or stupidity, and from hence he was wont to presage the pains of the Colick would very suddenly follow. In a certain fit, which lasted for twelve days with great cruelty, the sick person himself ob∣served, and told me, that whilst the distemper troubled him in his Belly, he felt no trou∣ble in his head, but the Colick pains remitting, presently the Vertigo returned, with the Headach:* 1.812 from which reciprocal translation of these Symptoms, from the Head into the Belly, and so on the contrary from the Belly to the Head, we may lawfully argue, that the same Morbific matter, flowing in the nervous Passages, falling down sometimes be∣low, brought in the Colick Passion, and sometimes above; and restagnating, caused those distempers of the Head. Hither may be referred, what Charles Piso hath accurately observed concerning himself, being wont to be affected with Cepha••ick distempers, and the Colick pains by turns, and with a mutual dependency, Sect. 4. C. 2. p. 355.

* 1.813Not long since, a certain studious young Gentleman, and living a sedentary life, be∣gan to complain of a great stupidity of his senses, and a dulness, as also of a great weight of his Head, and almost continual sleepiness; further, his Ventricle or Stomach was become so slothful and stupid, that he wanted all manner of Appetite, whilst a Cure was instituted against this evil disposition, by Remedies which roused up the Spirits, and shook off their burthens, this Gentleman fell into a most cruel Colick Passion (which he was never obnoxious to before) from which a most cruel pain, like the boreing of an Auger, possessed the middle of the Abdomen, his Navil being drawn inwards, and notwith∣standing the daily use of all kind of Remedies, it continued for three weeks, with great cruelty; that in the time he could take no rest, but what he received from Narcoticks, nor could he receive any ease from his pains,* 1.814 unless by an hot fomentation. Certainly in this case it is plain enough to every one, that the impurities of the nervous liquor being gathered to a certain fullness, was the immediate or conjunct cause of the whole sickness; which matter subsisting first in the Head, brought in the notable stupidity of the Brain and the oppression of the Animal Function; then being fallen down, by the passage of the Nerves, into the nervous Infoldings of the Abdomen, caused that cruel and daily Colick.

FINIS.

Notes

• * 1.1

  The Pain of the Head the chief∣est and most common affecti∣on among Dis∣eases.
• * 1.2

  The Causes of it manifold, and very diverse, that they 〈…〉〈…〉 be metho∣dically recited.

  Hence it is, that its Cure is often instituted E••∣pirically.
• * 1.3

  What things be∣long to its Pa∣thology.
• * 1.4

  The Subject of this Disease.
• * 1.5

  The formal Rea∣son of it.
• * 1.6

  The differences and kinds.
• * 1.7

  Pain is either without, or within the Skull;
• * 1.8

  Or universal, or particular.
• * 1.9

  This either be∣fore, behind, or on the side.
• * 1.10

  Many other dif∣ferences of it no∣ted;
• * 1.11

  Of which the chiefest is, that it is either oc∣casional, or ha∣bitual.
• * 1.12

  The reason of the former un∣folded.
• * 1.13

  The habitual Pain of the Head hath al∣ways a more re∣mote Cause, be∣sides the evident Cause.

  The evils, or the weak Constitu∣tion of the affe∣cted part, and the easie flowing in of the morbi∣fic matter, con∣cur to this more remote cause.

  The Parts of the Head predispo∣sed, and their vices, viz. an evil or weak conformation are noted.
• * 1.14

  The former often times is innate and hereditary;
• * 1.15

  But more often is contracted a∣new:
• * 1.16

  And chiefly from Cold,
• * 1.17

  Also by reason of the inordinati∣ons in the six non naturals.
• * 1.18

  By accident.
• * 1.19

  From internal Corrections.
• 2 1.20

  The debility of the distem∣per'd part is al∣so a more remote cause of the Headach; which outward accidents and errors in feed∣ing and other Distempers, are wont to produce. The other part of the more remote Cause, secondary and moveable, consi••ting in the flowing i•• of the morcific mat∣ter.

  This matter is ei∣ther the Blood, or its 〈◊〉〈◊〉, or the nutritio••s, or nervous 〈◊〉〈◊〉. Which some∣times alone, sometimes ••••••∣ing together, 〈◊〉〈◊〉 the 〈…〉〈…〉.
• * 1.21

  How the Blood excites the Headach.
• 2 1.22

  How the Serum.
• 3 1.23

  How the nu∣tritious Iuice.
• 4 1.24

  How the ner∣vous Liquor is a cause of this Disease.
• * 1.25

  The Headach a∣rising from the fault of the ner∣vous Liquor in∣fests chiefly in the Morning.
• 5 1.26

  How many humors meeting together, and mutually grow∣ing hot, stir up Headaches.
• * 1.27

  The habitual Headach de∣pends chiefly up∣on the fault of the nervous ha∣mor.
• * 1.28

  The fault of the nervous liquor is either univer∣sal, or particu∣lar, proper to the place distemper∣ed.
• * 1.29

  The more remote or evident Cau∣ses of the Head∣ach are noted.
• * 1.30

  Of which sort are, first, those which move the morbific matter flowing from a∣nother place, to wit, either the Blood, or Serum, or nourishing juice, and stir it up within the places affected of the Head.
• * 1.31

  The Blood and its contents, in Headaches are sometimes the means of the Conjunct, some∣times of the E∣vident Cause.
• * 1.32

  For what Cau∣ses the Blood is wont to be mo∣ved, and to bring 〈◊〉〈◊〉 to the distempered Head.
• * 1.33

  The Blood deli∣vers to the head the morbific matter received from any other part.

  A Flux of the Serum sometimes from meer full∣ness.
• * 1.34

  Sometimes from other Causes.
• * 1.35

  Sometimes the watry humor suffering a flux offends the Head.
• * 1.36

  Hence in those that have the Headach, as in Convulsive Dis∣eases, there is of∣ten a clear and copious Vrine. The recrements of other parts, often carried violently to the head with the Serum.
• * 1.37

  The evacuation of the Serum thorow its right ways, being suppressed, brings its flux to the Head.
• 3 1.38

  The nutriti∣ous juice some∣times the cause of the Headach, either,
• 1 1.39

  Because it is carried with the Blood into the Head.
• 2 1.40

  Because not being agreeable to the blood, it stirs up its ef∣fervescency.
• * 1.41

  Sometimes the evident causes of the Headach are Convulsions somewhere be∣gun and conti∣nued by the pas∣sage of the nerves, into the Head.
• * 1.42

  Convulsions be∣ginning after off, are some∣times signs of an Headach short∣ly to follow.
• * 1.43

  Sometimes also the cause of it.
• * 1.44

  Co••vni••••••e Headaches seem to arise so from the Vi••••era, not from Vapours.
• * 1.45

  But this sympa∣thetick Distem∣per per••••ps pro∣ceeds el••ewhere, by reason of an evil ferment, communicated to the blood.
• * 1.46

  So sometimes it seems to be cau∣sed from the Ven∣tricle.
• * 1.47

  The Head and the Stomach in∣timately con∣spire, and mu∣tually affect one another.
• 2 1.48

  How the Head-ach seems to arise from the Spleen.
• * 1.49

  The like reason is for this Dis∣ease, arising from the Liver, Mesentery, or Womb.
• * 1.50

  The kinds of ha∣bitual Headach are noted. It is either,
• * 1.51

  Continual,
• * 1.52

  •• Intermitting.
• * 1.53

  The Fits of the intermitting, either periodi∣cal, or certain;
• * 1.54

  •••• i••certain, and wandring.
• * 1.55

  The prognostick of the 〈…〉〈…〉 is ••asie or diffi••••lt to se¦cured; also,
• * 1.56

  the 〈◊〉〈◊〉 of the Disease safe or dangerous.
• * 1.57

  By what signs we may pro∣nounce it safe, and easie to be cured.
• * 1.58

  By what diffi∣cult.
• * 1.59

  By what scarce possi••le.
• * 1.60

  By what, dange∣rous.
• * 1.61

  Accidental Headach easily cured.
• * 1.62

  The habitual af∣fords more indi∣cations.
• * 1.63

  Two chief scopes of Cure.
• 1 1.64

  To cut in two the Bed •••• Root of the Dis∣ease.
• 2 1.65

  To root out the Conjunct Cause.
• * 1.66

  The ••••st or Tin∣der of the Dis∣ease, the blood, serum, nourish∣ing juice, ner∣vous Liquor, and the Recre∣ments caried thorow the Blood.
• * 1.67

  How the inordi∣nations of the Blood may be ta∣ken away and prevented.
• * 1.68

  The pain of the Head from the serous heap, ••ow to be cured.
• * 1.69

  Phlebotomy.
• * 1.70

  Purges.
• * 1.71

  Pills.
• * 1.72

  Purging Pow∣ders.
• * 1.73

  An emetick Powder.
• * 1.74

  An Apozem.
• * 1.75

  A decoction of woods.
• * 1.76

  A Cephalick Decoction im∣preg••ated with the Tincture of Coffee.

  T••e Headach from other ba∣rious mixt with the serum, how to be cu∣red.
• * 1.77

  The Headach a∣rising from any Inward, how to be cured.
• * 1.78

  Rais'd up from the fault of the nourishing Iuice, how to he handled.
• * 1.79

  Frequently fol∣lows the Small Pox and Mea∣sles.
• * 1.80

  Easily cured.
• * 1.81

  An Electuary.
• * 1.82

  A Iulep.
• * 1.83

  Antiscorbutick Remedies good for it.
• * 1.84

  The Headach raised up from the vice of the nervous humour, how to be cured.
• * 1.85

  Its fault either private or par∣ticular,
• * 1.86

  Or universal; and then letting of blood, or stronger Purges, are not conve∣nient.
• * 1.87

  Remedies called Cephalicks pro∣per here.
• * 1.88

  Of which sort are these,
• * 1.89

  which are con∣venient in Dis∣••ases of the Brain, and in these kind of Headaches.
• * 1.90

  A great many of these every where to be found in Physi∣cal Books.
• * 1.91

  An Electuary.
• * 1.92

  Iulep.
• * 1.93

  A distilled Wa∣ter.
• * 1.94

  Tablets.
• * 1.95

  Tinctures.
• * 1.96

  Spirits.
• * 1.97

  The use of mille∣pedes notably helps.

  The other part of the conjunct Cause, consisting in the weakness or evil confor∣mation of the distempered part, how to be handled.

  We are not to de∣spair of the Cure.
• * 1.98

  Here those Me∣dicines are only profitable, that cut off the in∣kindling or root of the Dis∣ease.

  Chyrurgical Re∣medies chiefly help here; of which are, 1. Plasters.
• * 1.99

  Medicines rai∣sing Whelks and Blisters.
• * 1.100

  Liniments, Fo∣mentations and Bathings, help not.
• * 1.101

  An Embrocati∣on, or a dip∣ping of the head in cold water, oftentimes helps.
• * 1.102

  Issues.
• * 1.103

  Issues made upon or near the di∣stempered place, help little.
• * 1.104

  The opening of the Skull cry'd up by many, but rarely or never attempted.
• * 1.105

  Whether saliva∣tion in invete∣rate Headaches, without any sus∣picion of the Venereal Dis∣ease, ought to be administred.
• * 1.106

  The means and manner of sali∣vation by Mer∣cury, unfolded.
• * 1.107

  Salivation not always safe, wherefore to be suspected in Headaches.
• * 1.108

  What the cutting of the Artery may profit in this Disease.
• * 1.109

  Nevertheless in this Distemper it is often help∣ful, and by what means, is shown.
• * 1.110

  Farriers use the like practice.
• * 1.111

  And perhaps it may be conveni∣ent for the cu∣ring of strumous or running hu∣mours, such as the Kings Evil.
• * 1.112

  The History of a continual and a deadly Head∣ach.
• * 1.113

  A continual and inveterate Headach passing into a Lethargy.
• * 1.114

  A second Histo∣ry of an incu∣rable Headach, in a most noble Lady labouring with it for twenty years.
• * 1.115

  Remedies of e∣very kind for the curing this Headach, try'd in vain.
• * 1.116

  Conjectures con∣cerning the rea∣son of this cruel Disease.
• * 1.117

  A third History of a deadly con∣tinual Headach.
• * 1.118

  A conjecture concerning the reason of the Disease.
• * 1.119

  A fourth Histo∣ry of an Head∣ach, excited from a fiery Swelling, or an Inflammation of the Meninges.
• * 1.120

  An History of an Headach raised up from an Impost••ume in the Menin∣ges.
• * 1.121

  A continual Headach, we always to be accounted in∣curable.
• * 1.122

  An intermit∣ting Headach, whose Fits are uncertain, are so frequent that we need shew no instances of it.
• * 1.123

  The sixth Histo∣ry of a periodi∣cal intermit∣ting Headach.
• * 1.124

  The Cure of the same.
• * 1.125

  The reason of this Case un∣folded.
• * 1.126

  The seventh Hi∣story of the same Distemper, ex∣cited by the de∣fault of the nervous Liquor.
• * 1.127

  The Cure of it.
• * 1.128

  The reason of the Case unfolded.
• * 1.129

  An Instance of an intermitting Headach, which seem'd to be ex∣cited from the womb.
• * 1.130

  The eighth Hi∣story of an in∣termitting Headach, seem∣ing to a••ise from the Sto∣mach.
• * 1.131

  A reason of this Case delivered.
• * 1.132

  The like reason is for other Headaches, seeming to arise from the Spleen, Liver, Mesen∣tery, &c.
• * 1.133

  The Seat of the Lethargy is the same with that of Sleep and Memory; to wit, about the Shell of the Brain.
• * 1.134

  By this name both the Fits of the Lethargy are called,
• * 1.135

  And also the so∣poriferous dispo∣sition, or Slee∣piness;
• * 1.136

  Of which there are various kinds:

  The continual Sleepiness, the Coma, &c.

  In every Lethar∣gick Distemper there is an ex∣cess of Sleep, and a defect of Memory.
• * 1.137

  The essence and causes of natural and non-natural Sleep, rehearsed.
• * 1.138

  The causes of preternatural Sleep are,
• * 1.139

  An infartion or obstruction of the outward part of the Brain, and a recess of the Spirits from thence:

  Sometimes this, sometimes that, is the cause.

  The Lethargy of∣tentimes from the serous heap overflowing the outward part of the Brain:

  And sometimes from a Dropsi•• of the whole Brain.
• * 1.140

  Not only a plenty of humour, but the malignity, often causes this Disease.
• * 1.141

  The pro••atar∣ctick causes of the Lethargy.

  In what respect they are in fault;
• * 1.142

  Both the Blood begetting evil humours, and sending them to the Brain;
• * 1.143

  and the Brain too easily recei∣ving them.
• * 1.144

  Vpon what oc∣casions the Brain is prone to the Lethargy.
• * 1.145

  The evident cau∣ses of this Dis∣ease.
• * 1.146

  Another con∣junct cause of the Lethargy consists in the af∣flicting the Spi∣rits with some narcotick.
• * 1.147

  How opiates causes Sleep.
• * 1.148

  How they ope∣rate in the Ven∣tricle, 〈…〉〈…〉 what mea•••• in the Brain.
• * 1.149

  The History of one presently kill'd by taking too large a Dose of Opium.
• * 1.150

  Sometimes a Lethargy arises from Narcotick Particles begot∣ten in the Body;
• * 1.151

  Even as Con∣vulsions from a nitro-sulphure∣ous, or explo∣sive matter.
• * 1.152

  What things be∣long to the The∣ory of the Le∣thargy.
• * 1.153

  Its symptoms.
• * 1.154

  The chief of which are, a sleepiness, and oblivion.
• * 1.155

  By what means the other facul∣ties of the Soul, to wit, the knowing, de∣siring and loco∣motive, are af∣fected.
• * 1.156

  The evil of the Disease reaches also to the Cere∣bel.
• * 1.157

  Hence breathing is often hurt, or altered.
• * 1.158

  This proceeds not from the Inflammation of the Midriff. From whence the Lethargick Feaver.
• * 1.159

  Not from Phlegm putrify∣ing in the Brain.
• * 1.160

  Nor is the for∣mer always the cause of it in the Lethargy. Lib. de Morb. Convuls. Cap. viij. p. 96.
• * 1.161

  More often the effect of this Disease
• * 1.162

  proceeds from the Organical Circulation of the Blood, be∣ing hindred or altered.
• * 1.163

  How none dyes without a Fea∣ver.
• * 1.164

  The Prognostick of the Lethar∣gy.
• * 1.165

  When the Dis∣ease is desperate.
• * 1.166

  When it is only so.
• * 1.167

  When some hope may be concei∣ved.
• * 1.168

  From whence more hope may be had.
• * 1.169

  Whence more of hope than of fear.
• * 1.170

  A red Swelling coming upon a Lethargy some∣times cures it.
• * 1.171

  Lib. 9. of Con∣vulsive Diseases.
• * 1.172

  The Cure of the Lethargy.
• * 1.173

  Phlebotomy al∣most always ne∣cessary.
• * 1.174

  Outward Ad∣ministrations.
• * 1.175

  Internal Reme∣medies.
• * 1.176

  Iulep.
• * 1.177

  Spirits.
• * 1.178

  A Powder.
• * 1.179

  A Vomit or Purge.
• * 1.180

  How they are indicated.
• * 1.181

  When to be a∣voided.
• * 1.182

  Starification.
• * 1.183

  Catharticks.
• * 1.184

  Erthines, Snee∣zing Powders, and Apophleg∣matisms, &c.
• * 1.185

  A Blistering applyed to the Forepart of the Head very much helps.
• * 1.186

  The first History.
• * 1.187

  The reason of this.
• * 1.188

  A second Histo∣ry.
• * 1.189

  The third Hi∣story.
• * 1.190

  The Cure descri∣bed.
• * 1.191

  Sleepy Diseases do not arise by reason of the Ventricles of the Brain being filled with wa∣ter.
• * 1.192

  The ends or li∣mits of the Li∣thargy, as to the places distem∣pered, are con∣stituted.

  Some sleepy Di∣stempers lesser than that, viz. Sleepiness, and the Coma: The Caros is greater than it.
• * 1.193

  Continual Slee∣piness described.
• * 1.194

  Its Seat assign∣ed.
• * 1.195

  In what respect it differs both from the Le∣thargy and the Coma.
• * 1.196

  The conjunct cause of Slee∣piness.
• * 1.197

  What the deluge or Anasarca of the Cortical part of the Brain is.
• * 1.198

  To which hap∣pen an heaping up, or as it were a stagna∣tion of the Blood, about the compass of the Brain.
• * 1.199

  Also a Torpor or Sleepiness of the Spirits.
• * 1.200

  The Cure of Somnolency.
• * 1.201

  An History.
• * 1.202

  The 〈…〉〈…〉 Sick 〈◊〉〈◊〉
• * 1.203

  The sleepy Coma.
• * 1.204

  The reason of it.
• * 1.205

  The Coma is ei∣ther a primary Disease, or it comes after o∣ther Distempers.
• * 1.206

  The Cure of it when it is a Disease of it self.
• * 1.207

  The Cure of the Coma as it is the symptom of another Disease.
• * 1.208

  In Lib. Of Con∣vulsive Diseases Chap. viij.
• 3 1.209

  Of the Ca∣ros.
• * 1.210

  How it differs from the Lethar∣gy and the Apo∣plexy.
• * 1.211

  The Seat of the Caros is a little deeper in the Brain than that of the Lethargy.
• * 1.212

  Its Conjunct Cause.
• * 1.213

  The Caros is ei∣ther a primary Disease, or it cometh upon o∣ther Distempers.
• * 1.214

  The Prognostick of the Carus.
• * 1.215

  The event of this Disease is vari∣ous, sometimes it passes into an Apoplexy:
• * 1.216

  Sometimes into the Palsie.
• * 1.217

  Its Care is the same with the Lethargy and the Apoplexy.
• * 1.218

  The first History.
• * 1.219

  Another History.
• * 1.220

  Long Waking is either the symp∣tom of other Dis∣eases, or else is a Disease of it self.
• * 1.221

  The cause of na∣tural Waking consists in the restlessness of the Spirits, and the openness of the Cortical part of the Brain.
• * 1.222

  In like man∣ner also preter∣natural Watch∣ing depends up∣on one or both.
• * 1.223

  The former means descri∣bed, by shewing how many ways the unquiet or elastick Spirits stir up long wa∣king.
• * 1.224

  First, Because being recalled for Sleep into the middle part of the Brain, they grow tu∣multuous.

  Secondly, Be∣cause being cal∣led back into the nervous Stock, they im∣petuously leap forth.
• * 1.225

  And so, either into the in∣terior Nerves, serving the Prae∣cordia and Vis∣cera;

  Or, into the Spinal Marrow, and the exterior Nerves.
• * 1.226

  The causes of the aforesaid Di∣stempers assign∣ed.
• * 1.227

  The Cure of them declared.
• * 1.228

  The second sort of thorow or long waking, ari∣sing both from the too much o∣penness of the Brain, and from the unqui∣etness of the Spi∣rits;
• * 1.229

  its foreleading Cause.
• * 1.230

  Which also cau∣ses waking in Melancholick People.
• * 1.231

  For the same reason Coffee causes waking.
• * 1.232

  An History shewing an ex∣ample of this Disease.
• * 1.233

  A description of the waking Co∣ma.
• * 1.234

  The cause of this Distemper shewn.
• * 1.235

  It is more often a symptom of o∣ther Distempers than a Disease of it self.
• * 1.236

  The Seat of the Incubus is in the Cerebel.
• * 1.237

  A Description of it.
• * 1.238

  It most often proceeds from natural causes.
• * 1.239

  The Seat of this is falsly placed in the Brain.
• * 1.240

  The Praecordia truly labour.
• * 1.241

  The cause doth not stick partly in the Brain, and partly in the Breast.
• * 1.242

  The next cause of this is, the hin∣drance of the in∣flowing of the Spirits to the Praecordia.
• * 1.243

  This not in the Parts affected;
• * 1.244

  Nor in the Nerves them∣selves:
• * 1.245

  But happens in the Cerebel, where the first Spring of the Spirits is.
• * 1.246

  From whence the sense of the Weight proceeds.
• * 1.247

  Whence loss of motion proceeds.
• * 1.248

  Wherefore the fit being so grie∣vous, is so soon ended, without leaving any e∣vil.
• * 1.249

  Whence after the Fit, the trem∣blings of the Heart and the Praecordia.
• * 1.250

  The Incubus of it self rarely dan∣gerous.
• * 1.251

  The Prognostick of the Incubus.
• * 1.252

  The Event of it is shewn.
• * 1.253

  Its Cure.
• * 1.254

  Infants and Boys obnoxious to this Disease, how they ought to be handled.
• * 1.255

  The Stat of the Vertigo.
• * 1.256

  A Description of it.
• * 1.257

  The Causes and the Manner of the non-natural Vertigo.
• * 1.258

  The Reasons of them shewn.
• * 1.259

  Why looking down from on high, and pas∣sing over Brid∣ges, cause a turning round in the Head.
• * 1.260

  How Drunken∣ness.
• * 1.261

  A perturbation of the Spirits in the Brain, and a revocation of them from their flowing into the Nerves, depend mutually on one another.
• * 1.262

  From what cau∣ses the preterna∣tural Vertigo is wont to be excited.
• * 1.263

  Sometimes the Vertigo is a symptom of other Cephalick Dis∣eases.
• * 1.264

  Sometimes it is excited by rea∣son of the Di∣stemper of other distant parts, viz. from the stomach, spleen, &c. and so by two means:

  1. Either by rea∣son of the Flood of the Blood be∣ing kept back.
• 2 1.265

  Or by reason of an inordi∣nate recourse, or flowing back of the Spirits to∣wards the Brain.
• * 1.266

  Not by reason of vapours, eleva∣ted from these parts is it ex∣cited.
• * 1.267

  The immediate Subject of the Vertigo is the Animal Spirits.
• * 1.268

  The mediate the Callous Body.
• * 1.269

  Its formal rea∣son.
• * 1.270

  Its Conjunct Cause.
• 1 1.271

  From the per∣turbation of the Spirits.
• 2 1.272

  From their ways or passages being obstructed.
• * 1.273

  This is seen by things helpful and hurtful.
• * 1.274

  The more remote foregoing cause of the Vertigo consists both in the vice of the Bloud, and of the Brain.
• * 1.275

  The Reason of the former explain∣ed.
• * 1.276

  The vices of the Brain noted.
• * 1.277

  The differences of this Disease.
• * 1.278

  Its Prognostick
• * 1.279

  The Cure of the Vertigo.
• * 1.280

  There are three chief intentions of healing;
• 1 1.281

  To take a∣way the root or feeding of the Disease.
• 2 1.282

  To remove the procatartick causes.
• 3 1.283

  To take a∣way the Con∣junct Cause.
• * 1.284

  The Curatory Method as shewn.
• * 1.285

  Why vomiting Medicines are so much noted in this, and other Diseases of the Head.
• * 1.286

  What is to be done out of the Fit, for preven∣tion sake.
• * 1.287

  Electuary.
• * 1.288

  A distilled Wa∣ter.
• * 1.289

  Tablets.
• * 1.290

  Chalybeats or Steel-Medicines
• * 1.291

  Spirits.
• * 1.292

  Powders.
• * 1.293

  Cases and Ex∣amples of the Sick.
• * 1.294

  The first History.
• * 1.295

  The second Hi∣story.
• * 1.296

  The Reason of the Case described.
• * 1.297

  The third Hi∣story.
• * 1.298

  The Seat of the Apoplexy.
• * 1.299

  A Description of the Disease.
• * 1.300

  Its Subject.
• * 1.301

  The spontaneous Functions only deficient in the Apoplexy.
• * 1.302

  The opinions of others concern∣ing this Disease.
• * 1.303

  The Theory of this Disease is best shewn by the famous Dr. Webfer.
• * 1.304

  Another Reason given by the Author.
• * 1.305

  The Exclusion of the Blood from the Brain does not easily hap∣pen;
• * 1.306

  Because all the Arteries com∣municate one with another, and some of them supply the defects of the o∣thers.
• * 1.307

  A total Exclu∣sion of the blood from the Brain sometimes hap∣ning, causes a terrible Syncopy.
• * 1.308

  This depends of∣tenest on the motion of the heart, being hindred, and so either because of the Cardiack Nerves being bound together;
• * 1.309

  Or, By reason of the Spirits in the Cerebel, be∣ing hindred from their flow∣ing into the Nerves.
• * 1.310

  Hence there is a twofold Apo∣plexy, one in the Brain, the other proper to the Cerebel.
• * 1.311

  The Theory of the former deli∣vered.

  This Disease ei∣ther accidental, or habitual.
• * 1.312

  The cause of the former is, either a great breach of the unity in or near the mid∣dle of the Brain;
• * 1.313

  Or a sudden stu∣pefaction or ex∣tinction of the Spirits.
• 1 1.314

  A Solution of the unity, ei∣ther from blood let forth of the Vessels; Or,
• 2 1.315

  From an Im∣posthume, or the breaking of an Vlcer; Or,
• 3 1.316

  From a De∣luge of the Se∣rum.
• * 1.317

  An extinction of the Spirits from Opiates, or from immode∣rate Drinking of hot Waters.
• * 1.318

  The operation of Opiates, as it is assigned by the famous Webfer.
• * 1.319

  The formal rea∣son of the habi∣tual Apoplexy.
• 1 1.320

  What its Conjunct Cause is.
• * 1.321

  It consists in the Pores of the cal∣lous Body, be∣ing suddenly stop'd, and the Spirits being driven away, by the contact of malignant mat∣ter.
• * 1.322

  What the nature or disposition of the morbifick matter is.
• * 1.323

  The procatarctic Cause of the ha∣bitual Apoplexy.
• * 1.324

  The differences of this Disease.
• * 1.325

  Its Prognosticks
• * 1.326

  The Curatory Method.
• * 1.327

  What is to be done in the Fit.
• * 1.328

  In what position the Sick ought to be kept.
• * 1.329

  Phlebotomy.
• * 1.330

  Other ways of Administration noted.
• * 1.331

  Vomiting Me∣dicines.
• * 1.332

  Comforters.
• * 1.333

  Cupping-glasses.
• * 1.334

  Hot or glowing Iron.
• * 1.335

  The preservatory Method.
• * 1.336

  Purging and Bleeding Spring and Fall.
• * 1.337

  Cephalick Re∣medies.
• * 1.338

  An Electuary.
• * 1.339

  A distilled Wa∣ter.
• * 1.340

  Lozenges.
• * 1.341

  Spirits and Tin∣ctures.
• * 1.342

  Tea, Coffee, and Chocolate prepared, how
• * 1.343

  to be made and taken.
• * 1.344

  A Powder.
• * 1.345

  Medical A••.
• * 1.346

  Examples.
• * 1.347

  A very rare Hi∣story.
• * 1.348

  An Anatomical Observation.
• * 1.349

  The middle of the Brain, which is the Seat of the A∣poplexy is also the Seat of the Epilepsy.
• * 1.350

  The streaked Bodies, the Me∣dullar Trunks, and the Nerves, are the Seat of the Palsy.
• * 1.351

  what the Palsie is.
• * 1.352

  Its Conjunct Causes are, Ob∣struction of the passages, and the Impotency of the Spirits.
• * 1.353

  In the Palsie ei∣ther motion, or sense only, or both together, is hurt.
• * 1.354

  Spontaneous motion is abo∣lished by rea∣son of the ways being obstruct∣ed, either in their begin∣nings, or the middle passages, or about the ends.
• * 1.355

  The ways are obstructed by Impletion, or Compression, or by a breaking of the Vnity.
• * 1.356

  An obstruction in the streaked Bodies causes the Vniversal Pal∣sie, or the Palsie of one side.
• * 1.357

  Why sense is not hindred as well as motion in e∣very Palsie.
• * 1.358

  In an universal Palsie why all the Muscles of the Eyes and Face are not loos••ed.
• * 1.359

  A Compression of the streaked Body sometimes stirs up the Pal∣sie.
• * 1.360

  A Paralytick obstruction doth sometimes hap∣pen in the Ob∣long and Spi∣nal Marrow.
• * 1.361

  A Palsie often succeeds stupi∣dity, or becom∣ing foolish.
• * 1.362

  A Palsie some∣times from the pressing together of the Marrowy Cord.
• * 1.363

  Sometimes from the unity being broke.
• * 1.364

  The Seat of the Palsie sometimes in the Nerves themselves, which are ei∣ther obstructed, or compressed, or the unity bro∣ken.
• 1 1.365

  An Obstru∣ction.

  Sometimes in the beginning of the Nerves.
• 2 1.366

  Sometimes in the middle.
• 3 1.367

  Or in their utmost processes. The other con∣junct cause of the Palsie, to wit, the impo∣tency of the Spirits;
• * 1.368

  Often arises from narcotick or vitriolick Particles, by which the Spi∣rits are put to flight.
• * 1.369

  In every Palsie the matter is not so thick or cold, as it is vitriolick or o∣ther ways infe∣stous to the Spirits.
• * 1.370

  The blasting or withering in Trees like the Palsie.
• * 1.371

  The more re∣mote foregoing causes of the Palsy, which are two:
• 1 1.372

  More remote, to wit, a vici∣ous Blood, and for that reason pouring forth a deadly matter upon the head.
• 2 1.373

  Nearer, to wit, a weak and loose Brain, admiting the evil Particles. The Palsy is ei∣ther a primary Distemper, and a Disease of it self;
• * 1.374

  Or secondarily, viz. Coming up∣on or succeeding other Diseases▪
• * 1.375

  Wherefore the Palsie often suc∣ceeds Convul∣sive Diseases.
• * 1.376

  Wherefore the Distemper of the Colick.
• 3 1.377

  Wherefore the Gout.
• * 1.378

  The evident Causes of the ha∣bitual Palsie.
• * 1.379

  Want or pa••city of Spirits of∣tentimes the Cause of the Spurious or Ba∣stard Palsy.
• * 1.380

  For this Reason Old Men are obnoxious to this Disease.
• 2 1.381

  Also Scorbu∣tical Persons, and such as are full of ill hu∣mours.
• 3 1.382

  Also others long sick.
• * 1.383

  Hence some dare not venture on local motion.
• * 1.384

  Others endea∣vouring, cannot bear them long.
• * 1.385

  The Impotency of the Spirits pro∣ceeds in some measure from the default of the explosive Copula.
• 2 1.386

  The kind of Palsy, in which Motion and Sense are hurt at ones.
• 3 1.387

  Kind, in which sense on∣ly is affected.
• * 1.388

  Wherefore feel∣ing is sometimes lost, and moti∣on safe.
• * 1.389

  What is the pro∣per Organ of feeling.
• * 1.390

  The Prognostick of the Palsy.
• * 1.391

  Its Cure.
• * 1.392

  Three means of healing, accor∣ding to which this Disease is, 1. Either acci∣dental; 2. The off-spring of a∣nother Disease; 3. Habitual.
• 1 1.393

  The Cure of the former.
• * 1.394

  A Powder for a Fall.
• * 1.395

  Topicks to be, applyed to the Distempered part.
• 2 1.396

  How the Palsie coming upon another Disease is to be cured.
• * 1.397

  The Cure of the habitual Palsie.
• * 1.398

  Whilst it is In fieri, or doing.
• * 1.399

  The Intentions of healing re∣spect the Blood and the Brain.
• * 1.400

  Bloodletting.
• * 1.401

  A Purge.
• * 1.402

  Cephalick Re∣medies.
• 2 1.403

  How the Disease in ha∣bit is to be cu∣red.
• * 1.404

  Bloodletting and Purging cautiously and rarely to be ad∣mitted.
• * 1.405

  Altering Me∣dicines ought to be given with choice.
• * 1.406

  How the Palsy is to be healed in a cold tem∣perament.
• * 1.407

  Electuary.
• * 1.408

  Coffee.
• * 1.409

  A Decoction.
• * 1.410

  Spirits.
• * 1.411

  A Distilled Wa∣ter.
• * 1.412

  Tinctures and Elixirs.
• * 1.413

  Powders.
• * 1.414

  Lozenges.
• * 1.415

  Pills.
• * 1.416

  How the Chole∣rick or hot Pal∣sie is to be cured.
• * 1.417

  An Electuary.
• * 1.418

  A Distilled Wa∣ter.
• * 1.419

  Chalybeats or Steeled Medi∣cines.
• * 1.420

  A Decoction.
• * 1.421

  The juice and expressions of Herbs.
• * 1.422

  Pills.
• * 1.423

  Topick and par∣ticular Reme∣dies.
• * 1.424

  Vniversal Re∣medies.
• 1 1.425

  Diaphore∣ticks.
• * 1.426

  They are not to be administred indifferently to all.
• * 1.427

  They often hurt the Cholerick.
• * 1.428

  Sweating Me∣dicines.
• * 1.429

  Stoves, Baths, Natural Baths.
• * 1.430

  When the use of Baths is hurt∣ful in the Palsie.
• * 1.431

  Salivation.
• * 1.432

  Vomitories.
• * 1.433

  Histories and Examples of Paralyticks.
• * 1.434

  The Example of the Palsie habi∣tual▪ excited of it self. The first History.
• * 1.435

  The Reason of it.
• * 1.436

  The second Hi∣story more rare and notable.
• * 1.437

  An Anatomic•• Observation, •• which the Ca•• is explained.••
• * 1.438

  The third Hi∣story.
• * 1.439

  The Reason of this.
• * 1.440

  The fourth Hi∣story.
• * 1.441

  The C••rt expo∣posed.
• * 1.442

  The Reason of it.
• * 1.443

  The fifth Histo∣ry, sh••wing when the Baths are hurtful.
• * 1.444

  An example of the Palsie from a Lethargy.
• * 1.445

  The Distempers of the Brain follow, in which Reason is hurt as well as the other Animal Functions.
• * 1.446

  Who are said to be Foolish, or to talk idly.
• * 1.447

  This is either shorter, as the Delirium; or longer, and with a Feavour, & called Phren∣sie; or without a Feavour, as melancholy, madness, stupi∣dity.
• * 1.448

  What the Deli∣rium is.
• * 1.449

  Its formal Rea∣son.
• * 1.450

  The Causes of the Delirium.
• 1 1.451

  Either from the Blood: Or
• 2 1.452

  From exte∣rior Spirits planted in the nervous Stock.
• * 1.453

  By what, and how many ways the Delirium is caused by the Blood:
• 1 1.454

  By reason of its too great heat.
• 2 1.455

  By reason of untameable Par∣ticles carried from it into the Brain.
• 3 1.456

  By reason of malignant Par∣ticles suffused from it.
• 4 1.457

  By reason of Effluvias, or venomous Par∣ticles, obtru∣ded also on the Brain.
• 5 1.458

  By reason of its afflux being denied to the Brain.
• * 1.459

  How a Deliri∣um proceeds from the irre∣gularities of the exterior Spi∣rits.
• * 1.460

  The Prognostick of a Delirium.
• * 1.461

  Its Cure▪
• * 1.462

  Of the Phrensie, what it is.
• * 1.463

  The Paraphrene∣sis.
• * 1.464

  Their Conjunct Causes.
• * 1.465

  The Phrensie not from the In∣flammation of the Meninges.
• * 1.466

  The Paraphre∣nesis not from the Inflammati∣on of the Dia∣phragma.
• * 1.467

  Wherefore brea∣thing is hurt in this Disease.
• * 1.468

  The formal Rea∣son of the Phren∣sie.
• * 1.469

  This Disease proceeds from the burning of the Animal Spirits.

  The Inflamma∣tion of the Me∣ninges stirs up rather the in∣veterate Head∣ach, or the Le∣thargy, than the Phrensie.

  Prosper Marti∣anus also asserts this.
• * 1.470

  Chymical Spi∣rits in their distilling are sometimes in∣flamed.
• * 1.471

  So the Animal Spirits.
• * 1.472

  What the Indis∣position of the Brain is to the Phrensy.
• * 1.473

  The Procatar∣tick Causes of the Phrensy,
• * 1.474

  which are partly in the Blood, and
• * 1.475

  Partly in the Brain.
• * 1.476

  The evident causes of the Phrensie.
• * 1.477

  The differences of it.
• * 1.478

  The Prognostick.
• * 1.479

  The Cure of the Phrensie.
• * 1.480

  Phlebotomy.
• * 1.481

  Clyster••.
• * 1.482

  A Iulep.
• * 1.483

  An Apozem.
• * 1.484

  A Drink.
• * 1.485

  Hypnoticks.
• * 1.486

  External Medi∣cines causing Sleep.
• * 1.487

  Epithems.
• * 1.488

  The means for the preserving of strength.
• * 1.489

  Cordials.
• * 1.490

  The Histories of sick persons in Hippocrates Lib. Epidem.
• * 1.491

  A notable Hi∣story.
• * 1.492

  The Distemper of the Animal Spirits, being after a 〈◊〉〈◊〉 manner, as it is the cause of the Phrensie, so it is of Melan∣choly, Madness, and Stupidity.

  The definition of Melancholy. That it is a Di∣stemper of the Brain and Heart.

  Its Examples or Types various, and almost infinite.
• * 1.493

  Melancholy is ••ither, 1. V∣niversal, or
• 2 1.494

  Particular.
• * 1.495

  The primary Phaenomena of a Melancholick D••••••rium.
• * 1.496

  From what dis∣position of the Spirits they pro∣ceed.
• * 1.497

  As they are compared to Light, they are called opacous, or full of darkness.
• * 1.498

  These kind of Spirits in Me∣lancholy compa∣red to those in Chymical Liquors.
• 1 1.499

  They are not like the Spirit of Blood, as they should be.
• 2 1.500

  Nor like the Spirit of Wine: Such rather in the Phrensie.
• 3 1.501

  But these are like acid Spi∣rits, distilled out of Salt, Vi∣negar, Box, and such like.
• 4 1.502

  Stygian Wa∣ters are like the Nature of the Animal Spi∣rits in Madness.
• * 1.503

  The formal Rea∣son of Melan∣choly aptly re∣presented by a∣cetous Chymical Liquors.
• * 1.504

  There are three chief affections of these, which agree with the Animal Spirits in Melancholy.
• 1 1.505

  Effluvias falling away from these Li∣quors are perpe∣tually in mo∣tion.
• * 1.506

  In like manner also the Spirits in the Phanta∣sie of a Melan∣cholick person.
• 2 1.507

  Effluvias from acetous Chymical Li∣quors do not proceed far.
• * 1.508

  In like manner the imaginati∣on of a Melan∣cholick Person, though always employ'd, com∣prehends only a few things.
• * 1.509

  And therefore every thing is conceived with a greater Image than it should be.
• 3 1.510

  Effluvias from acetous Li∣quors do not e∣vaporate so much from open Pores, as they make new.
• * 1.511

  And in like manner the A∣nimal Spirits, whilst they form in the Brain new Tracts, pro∣duce unwonted and incongruous Notions.
• * 1.512

  In Melancholy, after the Ani∣mal Spirits be∣ing for some time vitiated, the Conforma∣tion of the Brain is also hurt.
• * 1.513

  The Affection of the Praecordia in this Disease, as to fear and sadness, is delivered.
• * 1.514

  After what manner the Corporeal Soul is affected in these two passions.
• * 1.515

  The cause of ei∣ther depends partly on the blood;
• * 1.516

  and partly on the Animal Action of the Heart.
• * 1.517

  The procatartick Causes of Me∣lancholy are,
• * 1.518

  Partly the ace∣tous Nature of the Spirits, and partly the Melancholy Dys∣crasie of the Blood: The Di∣stemper begins sometimes from this, sometimes from that.

  How it begins from the Spirits and the Animal Government.
• * 1.519

  By what means this Disease ari∣ses from the Blood.
• * 1.520

  Melancholy doth not arise from an atrabilary humour heaped up in some place or mine.
• * 1.521

  By what means according to the Antients, it is said to arise from the Head.
• * 1.522

  How from the Womb.
• * 1.523

  How from the Spleen.
• * 1.524

  How from the whole Body.
• * 1.525

  The Differences of the Disease.
• 1 1.526

  In respect of its first Subject.
• 2 1.527

  By reason of Temperament of the Sick.
• * 1.528

  In respect of the next Cause, as it is singular, or conjunct.
• * 1.529

  In respect of the Imagination diversly hurt.
• * 1.530

  The Prognostick of this Disease.
• * 1.531

  The Cure of the Disease.
• * 1.532

  The evident Cause first to be removed.
• * 1.533

  Three primary Indications.
• 1 1.534

  Curatory.
• * 1.535

  The healing of the Spirits, is best performed by admonitions and artificial inventions, concerning the business of Life.
• * 1.536

  Yet oftentimes there is need of Medicine besides.
• * 1.537

  The Preservatory indication, concerning the Procatartick Causes of the Disease.
• * 1.538

  Phlebotomy.
• * 1.539

  Purging.
• * 1.540

  Vomiting.
• * 1.541

  Vomitories.
• * 1.542

  Purgers.
• * 1.543

  Pills.
• * 1.544

  Powders.
• * 1.545

  Syrups.
• * 1.546

  Altering Medi∣cines are of the greatest mo∣ment;
• * 1.547

  and not pargi••g Medicines, as the Antients thought.
• * 1.548

  An Electuary.
• * 1.549

  A Iulep.
• * 1.550

  A Distilled Wa∣ter.
• * 1.551

  Lozeng••s.
• * 1.552

  An Apozem▪
• * 1.553

  Spaw-Waters.
• * 1.554

  Chalyb••ates.
• * 1.555

  Steeled Medi∣cines.
• * 1.556

  Whey.
• * 1.557

  Broths.
• * 1.558

  Iuices of Herbs.
• * 1.559

  A Bath.
• * 1.560

  Hypnoticks.
• * 1.561

  The first Histo∣ry.
• * 1.562

  An Example of Melancholy be∣ginning from the Spirits.
• * 1.563

  The Cure.
• * 1.564

  The second Hi∣story.

  An Example of Melancholy ari∣sing from the Blood.
• * 1.565

  The Curatory Method propo∣sed.
• * 1.566

  Vniversal Me∣lancholy.
• * 1.567

  De Morbis Convulsivis, Cap. 2. Particular Me∣lancholy,
• * 1.568

  is excited by reason of two sorts of Affecti∣ons concerning Good or Evil.
• * 1.569

  Love-Madness.
• * 1.570

  The Reasons of Symptoms in mad Love.
• * 1.571

  Iealousie.
• * 1.572

  Superstition and Desperati∣on.
• * 1.573

  The reason of the Symptoms.
• * 1.574

  The imaginary Metamorphosis of Melancholick Persons.
• * 1.575

  Madness and Melancholy are akin.
• * 1.576

  The Subject of Madness are the Animal Spirits.
• * 1.577

  The disposition•• of which are like to Stygian Water.
• * 1.578

  Three chief Ac∣cidents in Mad∣ness.
• * 1.579

  Which are also to be found in Stygian Wa∣ter.
• 1 1.580

  The Parti∣cles of this are always in mo∣tion.
• * 1.581

  And in like manner the A∣nimal Spirits in Mad-men.
• 2 1.582

  The Effluvi∣a's of Stygian Water, every where make new Pores and Passages. In like manner also the Animal Spirits in Mad men.
• 3 1.583

  The Effluvi∣a's of Stygian Water are diffu∣sed far.
• * 1.584

  In like manner as the Animal Spirits in Mad-men.
• * 1.585

  What the Con∣junct Cause of Madness is.
• * 1.586

  How the Ani∣mal Spirits ac∣quire a disposi∣tion like to Stygian Water.
• * 1.587

  It is shewed in the first place that corrosive and as it were Stygian Par∣ticles, are be∣got in the hu∣mane Body.
• * 1.588

  Wherefore the Nervous Liquor oftentimes be∣comes corrosive. Because the vo∣latile Salt most easily degene∣rates into an a∣cid and most sharp, with the acquired Sul∣phur.
• * 1.589

  Hence the Rea∣sons of Tumours and Vlcers in the Kings Evil and the Cancer, are given.
• * 1.590

  Hence also the Madness of the distempered Spi∣rits.
• * 1.591

  The Original of Madness either from the Spi∣rits themselves, or from the Blood.
• * 1.592

  It begins for two occasions from the Spi∣rits.
• 1 1.593

  By Reason of a violent Passi∣on, by which
• * 1.594

  They are either too much cast down,
• * 1.595

  Or elevated a∣bove measure.
• 2 1.596

  Madness be∣ginning from the Spirits suc∣ceeds Melancho∣ly, or the Phren∣sie.
• 1 1.597

  By what means it comes upon Melancho∣ly.
• 2 1.598

  How upon a Phrensie.
• 2 1.599

  The Original of Madness sometimes from the Blood.
• 1 1.600

  It is either Hereditary.
• * 1.601

  The Reason of which is shewn.
• 2 1.602

  Or acquired, and so either,
• * 1.603

  By reason of er∣rours in the six Non-naturals;
• * 1.604

  Or by reason of Poysons.
• * 1.605

  An History of a Mortal Mad∣ness, from eat∣ing the leaves of Wolfs Bane.
• * 1.606

  The Reasons of the symptoms of Madness ex∣plained.
• 1 1.607

  Wherefore Mad-men are audacious.
• 2 1.608

  From whence their immense strength.
• 3 1.609

  Wherefore they are never tired.
• 4 1.610

  Wherefore they are not ea∣sily hurt.
• * 1.611

  The Differences,
• 1 1.612

  In respect of the Original.
• 2 1.613

  By reason of the Magnitude.
• 3 1.614

  In respect of Time.
• * 1.615

  The Prognostick.
• * 1.616

  The Cure.
• * 1.617

  What the indi∣cations are of continual Mad∣ness.
• 1 1.618

  The Curatory Indication.
• * 1.619

  As to Discipline.
• * 1.620

  As to Medicine.
• * 1.621

  Phlebotomy.
• * 1.622

  Vomiting Me∣dicines.
• * 1.623

  Purging Medi∣cines.
• * 1.624

  The preservatory Indication. Altering Medi∣cines.
• * 1.625

  Whey.
• * 1.626

  An Expressions.
• * 1.627

  An Electuary.
• * 1.628

  A Iulep.
• * 1.629

  Distilled Wa∣ters.
• * 1.630

  Specificks.
• * 1.631

  A Decoction and Infusion of Apples.
• * 1.632

  Other Chirurgi∣cal Remedies.
• 3 1.633

  The vital In∣dication.
• * 1.634

  Histories and Examples of mad people are to be sought in Bedlam, or Hos∣pitals for mad people.
• * 1.635

  The Cure of In∣termitting Mad∣ness.
• * 1.636

  The Curatory Indication.
• * 1.637

  Preservatory.
• * 1.638

  Stupidity arises chiefly from the failing of the I∣magination and Memory.
• * 1.639

  Wherefore the Organs of these Faculties la∣bour in this Dis∣ease.
• 1 1.640

  As to Mag∣nitude.
• 2 1.641

  By Reason of the Figure.
• 3 1.642

  As to its Sub∣stance or Tex∣ture.
• 4 1.643

  The evil con∣formation of the Brain, as to its pores and passages.
• 3 1.644

  Stupidity sometimes pro∣ceeds from both of them being in fault together.
• * 1.645

  What the Ante∣cedent Causes of Foolishness, are,
• 1 1.646

  An Heredi∣tary Disposition.
• * 1.647

  Why strong or wise men are not always begot∣ten of strong and wise Man.
• * 1.648

  The first Reason.
• * 1.649

  A Second Rea∣son.
• 2 1.650

  Ripeness and the Declination of Age dispose some to Foolish∣ness.
• 3 1.651

  Great hurts of the Head sometimes cause Doting, or want of Inge∣nuity.
• 4 1.652

  Frequent Drunkenness.
• 5 1.653

  Vehement Affections.
• 6 1.654

  The more grievous Disea∣ses of the Head, oftentimes ex∣cite Foolish∣ness.
• * 1.655

  The Differences of this Disease.
• * 1.656

  How foolishness and stupidity differ.
• * 1.657

  Degrees of stu∣pidity.
• * 1.658

  The Prognostick of the Disease.
• * 1.659

  Evil if from an hurt of the Head.
• * 1.660

  What is excited from a Lethargy admits a Curt.
• * 1.661

  Sometimes it is cured by a Fea∣vour.
• * 1.662

  The Cure re∣quires both a Master and a Physician.
• * 1.663

  What the labour of the former ought to be.
• * 1.664

  What the Medi∣cal intentions art.
• * 1.665

  What kind of Remedies are shewn.
• 1 1.666

  Evacuating Remedies.
• 2 1.667

  Altering Medicines.
• * 1.668

  Spirits.
• * 1.669

  A Distilled Wa∣ter.
• * 1.670

  Tinctures, E∣lixirs.
• * 1.671

  An Electuary.
• * 1.672

  Coffee.
• * 1.673

  Chocalate.
• * 1.674

  Physical Beer.
• * 1.675

  Outward Ap∣plications.
• * 1.676

  A Cap or quilt∣ed thing for the Head.
• * 1.677

  A Plaster.
• * 1.678

  A Liniment.
• * 1.679

  The Distempers of the Gout and Colick are Distempers of the nervous Stock.
• * 1.680

  The Subject of the Gout.
• * 1.681

  Its appearances rehearsed.
• * 1.682

  The parts affect∣ed.
• * 1.683

  The Morbifick Matter.
• * 1.684

  It is not any simple or singu∣lar Humour sug∣gested from any of them.
• * 1.685

  In the Mine of this Disease two humours concur, and mutually grow hot.
• * 1.686

  In like manner, as when the Spirits of Vi∣triol are pour∣ed upon Oyl of Tartar.
• * 1.687

  A Vitriolick Matter partly supplied from the Nervous Liquor.
• * 1.688

  Either Matter, growing dege∣nerate or depra∣ved, turns to the Gout.
• 1 1.689

  From the Blood, for that it becomes full of a fixed Salt.
• 2 1.690

  From the nervous Liquor, for that it is a∣cetosous or sharp.
• * 1.691

  The former is, as it were, the feminine Seed of the Gout;
• * 1.692

  The other mas∣culine.
• * 1.693

  The Procatar∣tick, or fore∣going Causes of the Gout.
• 1 1.694

  A Mine of fixed Salt laid up about the In∣ternodia, or Knitting toge∣gether of the Bones.
• * 1.695

  This Matter is not meerly Ex∣crementitious,
• * 1.696

  nor a Bilous or Phlegmatick Humour.
• * 1.697

  To this previous procatarxis, to wit, a fixed Salt, the Dis∣crasie of the bloud, and the debility of the Distemper'd Member doth help.

  What the Saline Particles of the bloud ought to be, to wit, in a middle state, between fixati∣on and volati∣lisation.
• * 1.698

  When, being too fixed, they become Morbi∣fick.
• * 1.699

  And so they bring forth the Scurvy, Drop∣sie, and other Diseases, and especially the Gout.
• * 1.700

  The Saline fix∣ed, or Arthri∣tical Dispositi∣on of the Blood, proceeds from various Causes.
• 1 1.701

  Sometimes it is Hereditary.
• 2 1.702

  Oftentimes acquired, by reason of an e∣vil manner of living.
• * 1.703

  From what Causes the de∣bility of the Ioynts is exci∣ted.
• 2 1.704

  The other foregoing Cause of the Gout, from the acetous part of the ner∣vous humour.
• * 1.705

  Such an acetous disposition does not come upon the whole Mass of the nervous humour, but on∣ly some portions or recrements of it.
• * 1.706

  It is shewn that acetous fluxions do proceed from the nervous hu∣mour.
• * 1.707

  And so part of the Gouty Mixt is sent from the Brain and Nerves.
• * 1.708

  The evident Causes of the Goutish Fit.
• 1 1.709

  The drink∣ing of sharp Liquors.
• 2 1.710

  Immoderate Exercise.
• 3 1.711

  Evacuati∣ons being sup∣pressed.
• 4 1.712

  The Circula∣tions of the Hea∣ven, Air and Year.
• * 1.713

  The differences of the Gout.
• 1 1.714

  As to the places affected.
• 2 1.715

  As to its O∣riginal.
• 1 1.716

  In respect of other Diseases.
• * 1.717

  It is wont to be complicated with the Scur∣vy.
• 2 1.718

  With the Stone.
• * 1.719

  The Reason of this is shewed.
• * 1.720

  The Prognostick of this Disease.
• * 1.721

  The Gouty Mat∣ter being re∣strained, or any other way tran∣slated, often∣times excites dangerous Di∣stempers.
• * 1.722

  The acetous re∣crements of the nervous Liquor do chiefly effect this.
• * 1.723

  The first Instance of such a•• Ef∣fect.
• * 1.724

  A second In∣stance.
• * 1.725

  The Cure.
• * 1.726

  Three primary Indications.
• 1 1.727

  Curatory, for the allaying the pains in the Fits.
• 1 1.728

  For the ta∣king away of the Breach of the Continuity.
• * 1.729

  Phlebotomy.
• * 1.730

  Purging.
• * 1.731

  Forms of Pur∣ges.
• * 1.732

  Vomiting.
• * 1.733

  Altering Medi∣cines, or such as preserve from the Gout.
• * 1.734

  Pills.
• * 1.735

  An Electuary.
• 2 1.736

  The Spirits ought to be al∣layed, or qui∣et••d.
• 1 1.737

  By Topick Remedies.
• * 1.738

  Pultesses.
• * 1.739

  A Fomentation.
• * 1.740

  Outward Nar∣coticks.
• * 1.741

  Resolving To∣picks consisting chiefly of Saline Particles, even analogic, or cor∣respondent to the Morbific Mine.
• * 1.742

  Forms of these.
• * 1.743

  Plasters in the declination of the Fit.
• * 1.744

  Opiates.
• 2 1.745

  The preserva∣tory Indication, out of the Fit.
• * 1.746

  Usual Purging and Vomiting.
• * 1.747

  Phlebotomy.
• * 1.748

  Altering Medi∣cines called An∣tidotes of the Gout.
• * 1.749

  Pills.
• * 1.750

  A Distilled Wa∣ter.
• * 1.751

  Tinctures.
• * 1.752

  Powders.
• * 1.753

  Medicated Beer.
• * 1.754

  A Milk Diet.
• * 1.755

  Drinking of ones own V∣rine.
• * 1.756

  A notable Hi∣story of the Stone convert∣ed into the Gout, and on the contrary of the Gout into the Stone.
• * 1.757

  The reason of this shewed by Anatomical Ob∣servation.
• * 1.758

  Why the Colick is counted a∣mong the Di∣stempers of the Brain, and the nervous Stock.
• * 1.759

  From whence the denomination.
• * 1.760

  A description of the Disease.
• * 1.761

  The seat of the Disease is not always, or of∣ten in the In∣testine, or Gut Colon.
• * 1.762

  viz. neither in its Cavity or Coats.
• * 1.763

  Pains common∣ly taken for Co∣licks.
• * 1.764

  These are merely accidental or habitual.
• * 1.765

  These latter are properly the Dis∣ease.
• * 1.766

  The conjunct cause of the Dis∣ease are not the Contents of the Intestines.
• * 1.767

  Not the humors impacted in the Membranes.
• * 1.768

  The nervous Li∣quor seems most of all to contri∣bute to the cause of this Disease.
• * 1.769

  Charles Piso's Opinion cited,
• * 1.770

  and examined.
• * 1.771

  The seat of the Morbi••ick Mat∣ter not in the Brain.
• * 1.772

  The part pri∣marily affected in the Abdo∣men, not in the Peritonaeum. But more right∣ly it seems to be the Mesentery.
• * 1.773

  Where the seat of the Distempers called Hysteri∣cal, often lyes hid.
• * 1.774

  The Colick-mine is affirmed to be within the ner∣vous, and other mesenterick in∣foldings of the Abdomen.
• * 1.775

  From which, planted therea∣bouts, the Co∣lick Symptoms are excited.
• * 1.776

  The yellow or green Bile or Choler, that is cast forth by vo∣miting, in the Colick-Fits, is not the material cause of this Disease.
• * 1.777

  Wherefore pains of the Loins of∣ten come upon the Colick pains.
• * 1.778

  In what the foregoing cause of this Disease consists.
• 1 1.779

  The nervous Liquor is in fault, because the Morbifick Matter is ga∣thered together in it.
• 2 1.780

  The nerves of the wan∣dring pair, and their mesente∣rick Infoldings, because they re∣ceive into them∣selves this mat∣ter.
• * 1.781

  The evident causes of this Disease.
• * 1.782

  The differences of this Disease.
• * 1.783

  Its Prognostick.
• * 1.784

  The Cure.
• 1 1.785

  The first In∣dication Cura∣tory.
• * 1.786

  What the chief Medical inten∣tions are in the Fit.
• * 1.787

  For the most part Clysters are to be begun with,
• * 1.788

  Which are at first to be gen∣tle; afterwards more sharp Cly∣sters.
• * 1.789

  Fomentations.
• * 1.790

  Pultesses.
• * 1.791

  An Oyntment.
• * 1.792

  Cold Fomenta∣tions.
• * 1.793

  Opiates.
• * 1.794

  Evacuating Medicines.
• * 1.795

  Vomiting Me∣dicines.
• * 1.796

  Purges.
• * 1.797

  Salivation.
• * 1.798

  Baths.
• * 1.799

  Diureticks.
• * 1.800

  Mineral Pur∣ging Waters.
• 2 1.801

  The Vital Indication sug∣gests Remedies.
• * 1.802

  Cardiack.
• * 1.803

  Hypnoticks.
• 3 1.804

  The Preser∣vatory Indica∣tion, by which are indicated,
• * 1.805

  Vomiting.
• * 1.806

  Purging.
• * 1.807

  Altering Reme∣dies.
• * 1.808

  The Objection of Charles Piso solved.
• * 1.809

  The first History.
• * 1.810

  The Reason of it.
• * 1.811

  The second Hi∣story.
• * 1.812

  The Reason of it.
• * 1.813

  The third Histo∣ry.
• * 1.814

  The Reason of it shew'd.