A treatise of the rickets being a diseas common to children. Wherin (among many other things) is shewed, 1. The essence 2. The causes 3. The signs 4. The remedies of the diseas. Published in Latin by Francis Glisson, George Bate, and Ahasuerus Regemorter; doctors in physick, and fellows of the Colledg of Physitians at London. Translated into English by Phil. Armin.

CHAP. XV. The Causes of the Rachites. And first those things which concern the Parents. (Book 15)

WE have largely explained above both the Pri∣mary and Secondary Essence of this Disease. And indeed we have sufficiently demonstra∣ted in the same place, the dependance of the secondary upon the Primary Essence. It may not ther∣fore be here expected, that we should again purposely and in particular discuss the causes of the secondary Es∣sence, which we have handled before. It may suffice that we have found out the causes of the secondary Essence. Yet if any cause do occur which at once▪ hath an influx as wel into the primary or secondary Essence of the Di∣seas, we shal not refuse to take notice of it, by the way as we proceed.

But omitting al diligent search into the several kinds of causes, we purpose to contract this our discours chief∣ly to two heads. The former containeth the Infirmities and the diseased dispositions of the Parents, which per∣haps have so great an influence upon the Children, that they suppeditate, at least a proness to this affect, and in∣fer an aptitude to fal into it, if they have not actually fallen into it from their very birth. The latter compre∣hendeth the accessary causes of this Diseas; namly, those which happen to children after their birth.

Concerning the causes of the first kind we meet with a Question at the first entrance: How and whether this Diseas may be said to be hereditary? That we may the more succesfully proceed in the determination of

this question, an hereditary Diseas must be distinguish∣ed into that properly, and that improperly so called. And indeed an hereditary Diseas properly so called, is ever supposed to be preexistent in both or one of the Parents, and from thence to be derived to the Progeny. But an hereditary Diseas improperly so called, is not supposed to be preexistent in the same kind, either in both or one of the Parents; yet the same fault must always necessarily precede (perhaps altogether of a different kind) at least in one of them, by vertu wherof a certain disposedness is imprinted in the children, wherby they are made obno∣xious to fal into this improperly hereditary Diseas.

Moreover, An hereditary Diseas properly so called, is twofold; either in the conformation, as when a lame Person begets a lame; a deaf Father, a deaf Son, or a blind a blind; or in the similary Constitution: as when a Gowty Father begets a Gowty Child. It is to be no∣ted, that in the first kind, ther is an hereditary fault in∣herent in the first affected parts of the Conformation. But in the latter, there is no necessity that a Diseas of the same kind with the Diseas of the Parents, should be actually inherent in the Embryon, from the first forma∣tion. But such a disposition imprinted by one or both of the Parents is sufficient, which as the life is lengthe∣ned may be actuated into the same, by the concours of other intervening causes. Again, an hereditary Diseas improperly so called, may be likewise twofold; namely, either in the Conformation, or in the similary Consti∣tution. In the formation, as when neither of the Pa∣rents is blind, pore-blind, lame, &c. yet have begotten a Son blind, pore-blind, or lame, by the very fault of the formation. For in these cases, that very fault which is sensible and conspicuous in the Issu, flowed from som fault in the Parents, although perhaps of a different

kind, and so it may be called, though improperly an he∣reditary Diseas. In like manner in the similary Con∣stitution of the Issu, there may reside an hereditary Di∣seas improperly so called, as when a Melancholy, seden∣tary, or an intemperate Parent, begetteth a Child subject to the gowt, or the Cachexia, although perhaps the Pa∣rent was never troubled either with the one or the o∣ther.

These things being thus premised, we approach neer∣er to the resolving of the Question. And first, we affirm that this Diseas is not comprehended under the former species of an hereditary Diseas, properly so called. For that consisteth in the formation: but this Diseas accor∣ding to its primary Essence, is a similary Diseas, as we have before demonstrated, and very rarely bewrayeth it self from the very Birth, much less from the very con∣ception and formation. And for the same Reasons, we also affirm this Diseas belongeth not to the former kind of herditary Diseases improperly so called. Which after a like manner consist in the formation of the parts, and are begun presently after the first formation.

Secondly, We say, that so it may com to pass, that this Diseas may fall under the second species ptopounded, of an hereditary Disease properly so called; namely, that which consisteth in the similary Constitution. Yet we cannot affirm this as certain and undubitable, becaus the Children which we have hitherto known to be afflicted with this Diseas, have not lived to such maturity of years as to beget Children: and therefore we cannot o∣therwise suppose, then by probable conjecture, whether or no their progeny should be infected with this affect, as it were by right of inheritance.

Thirdly, We say, that in many Children this Diseas doth directly fal under the second species of an heredita∣ry

Diseas improperly so called. For according to the primary Essence of it is a similary Diseas, and although it hath not yet been so long and sufficiently discovered unto us, that we can determin the effects of it, how they wil operate in the Progeny, yet frequently in the present progeny we have observed certain Rudiments of this af∣fect to have been derived to many from one or both of the Parents. So that although neither of the Parents were in their infancy or child-hood afflicted with this Diseas, yet som proness and disposedness to this Diseas hath presently appeared in their little Infants, especially in those whose Parents before coition were predisposed by som vitiosity of body, or error of life, to transmit this pollution to their Issu; but those defilements of the Parents which dispose them to propagate Children ob∣noxious to this affect, we shal by and by reckon up, in their order; from whence also a higher confirmation of this assertion may be deduced.

Fourthly, We say, although the affects of the Parents do frequently imprint a certain propension in the Issue, to fal into this Diseas, so that this Diseas may be there∣fore reputed in the second acception of an hereditary di∣seas, improperly so called; yet it very rarely happneth that this Diseas doth actually break out before the birth of the child. One amongst us attesteth, that once, and only but once, he saw a Child new born invaded with this Diseas. And in this Child the Back-bone, and the neck were so weak, that they could not sustain the weight and greatness of the Head, within three months after it was born, the Child dyed. Wherby it is apparent that he was grievously affected. It seemeth conspicuous by what hath been said, that Infants, however they may fre∣quently borrow from their Parents a disposedness to this affect, are most rarely and seldom troubled with it

before they are born, but if at any time they are so pre∣maturely afflicted, that then the affect is most vehement and grievous. Now a reason of the event of both these may be demanded. To the former therefore we say, that this Diseas doth partly consist in a cold distemper of the first affected parts, and indeed an unequal one, as namly, being very cold in the said parts, respect being had to the temper of the Head, and the Bowels: and that here∣upon that unequal coldness of those parts, is of great mo∣ment in this Diseas, and that also in respect of the very inequallity. For this contributeth much to that unequal and deficient distribution of the Vital Blood to the parts first affected. Seing therfore at such time when the Em∣bryon is carried in the womb, this inequallity of the temperament of the first affected parts may be much cor∣rected and averted by an equal heat, wherby the womb may on every side embrace, and cherish the body of the Embryon, it followeth that the gestation doth very much drive away this Diseas, at least retard the invasion of it. For the body of the Womb being all about equally war∣med with an even heat, and equally embracing and che∣rishing al the parts of the Embryon, doth not easily per∣mit one part to wax colder then the rest, and by that means to be cherished with a defective and sparing afflux of the Vital Blood. Wherfore seing that that very in∣equallity of heat and comfort, are Essential parts of this Diseas, and without which this Diseas cannot consist, it is no wonder that the womb strongly resisting these parts of the Diseas, and the invasion therof, doth for the most part protract it, at least during the impregnation.

As for the latter part of the question propounded, nam∣ly, Why Infants, who before their birth were infested with this Diseas, are more grievously and dangerously affli∣cted? We say, according to that Aphorism of Hippo∣crates,

that a Diseas which holdeth the least congruity with the condition of the Diseased, is more dangerous then the contrary; as a Feaver threatneth more danger to an old man, than to a yong, and in the winter, then the summer. For a Diseas that hath som correspondence & conformity with the condition of the Diseased, requi∣reth a slighter caus for its introduction: but that which is contrary therunto argueth the magnitude of the caus, which notwithstanding resistance, and opposition, will produce his effects. In the present Diseas therfore if the equal and impartial heat of the womb cannot restrain the propensity of the Embryon to this affect, but it wil fal into it, som vehement cause must needs be imprinted by the Parents, and the seminal Principals extreamly weak∣ned. Therfore there is little hope when the Embryon laboring with this Diseas is born, neither wil a prudent Physitian attempt the cure without som Prognostick of imminent danger. Moreover, instead of a Corallary, we substitute another Rule, having som affinity with the former, although perhaps it be not yet certain and ap∣proved; namly, that Children by how much the sooner after their birth they are invaded with this Diseas, so much the more difficulty (caeteris paribus) are they de∣livered from it. And let these things suffice concerning the Question propounded.

We wil now apply our selvs to the division and recko∣ning up of those causes which on the Parents parts may produce this Diseas. Som of these faults in the Parents relate to the Generation of the seed, wherof the Embry∣on consisteth, others have reference to the Embryon now conceived, and yet born about in the Womb. The faults of the Generation of the seed proceed either from the man or the woman, or from the whole Body, or from those parts onely which are dedicated

by nature to Generation. The faults of the Pa∣rents depending upon the whole Body have the strongest influence into the Child, because it transmitteth such matter to the Generation of the Seed, as is unapt for those parts dedicated to that office. We purpose not here to particularize the several faults of the matter of the Seed, but to instance in those alone, which conspire to entitle the Progeny to this Diseas. These we reduce to four Classes.

The first Classis containeth a cold and moist distem∣per of the matter, wherof the Seed is Generated. This chiefly resulteth from a cold and moist distemper of the Parents, unto which we also refer a predominancy of il juice, especially that which is Phlegmatick and waterish also a Cachexia, and Dropsy, and perhaps the Green-Sickness, which som cal the white Feaver, not sufficient∣ly subdued before conception; al which affects manifest∣ly help to constitute a waterish matter, both cold and moist in the Genital Parts, which is not only in gene∣ral less apt for the Generation of the Seed, but it parti∣cularly inclineth to a condition of this Diseas; a part of whose primary Essence consisteth in that very cold and moist distemper, as we have already proved. More∣over, we may perhaps hither reduce the Scurvy, the French Pox, & the Jaundice, in which affects the Blood also is polluted with filthy excrementitious humors, and corrupt exulcerations, which cannot easily be changed into laudable and fruitful Seed.

The second Classis containeth containeth the penu∣ry of Natural Spirits, wherby the good Seed should be Generated. For a Spirituous Seed cannot flow from such a kind of matter. The causes which suppeditate that impure matter to the Parts of Generation are the dried and extenuated Bodies of the Parents, wasted either by

long abstinence, or by som vehement evacuation, as by vomits, lasks, Lienteries, Dysenteries, Hepatical Flur∣es of long continuance; by an excessive Hemorrhage from any part, by violent sweatings, or any Chronical Diseases, which wasteth the strength and is not repair∣ed before Coition especially, a Consumption, a He∣ctick Feaver, an indigestion from any kind of Caus. Lastly, from a defective and imperfect Concoction of the last aliment, or the fault of any part. For in such cases the matter which is separated to the parts subservi∣ent to Generation, is destitute of a competent plenty of Natural Spirits, wherupon the Parts preparing and con∣cocting the Seed cannot perfectly correct this defect, and ejaculate such Seed as is sufficiently abounding with Spirits. Seing therfore that a considerable part of this Diseas consisteth in the paucity of Natural Spirits, it cannot otherwise be, but that the issue propagated by such a crude and almost Spiritless Seed, should be tain∣ted with a certain Natural Propension to this affect, even in their first rudiments, which afterwards upon the concurrence or other causes, is easily deduced into Act.

The third Classis containeth the benummedness or stupour of the matter transmitted to the Generative Parts, wherof the Seed is produced. For not only the solid parts, but also the whol Mass of Blood, and the hu∣mors therin contained are obnoxious to that same stu∣pour. And from hence it is that Physitians being to ren∣der the causes of Diseases, do use to say, that the humors and also the Blood are too fluid and moveable and un∣duly vehement; somtimes on the contrary that they are unapt for motion, less fluxible, and unactive beneath a Mediocrity, & in respect of this thing also a certain Mene is most wholsom: but more things relating hither may be seen above. We will here only prosecute those faults

of the Parents from whence this defect of vigor and a∣ctivity in the matter of the Seed doth arise. These therfore are first the fost, loos, and effeminate Constitu∣tion of either or both the Parents, indisposed to strong and Masculine exercises. Secondly, an overmoist and full diet and epicurison, obnoxious to frequent crudities. Thirdly, A delicate kind of life abandoned to eas and voluptuousness, slothful, and rarely accustomed to la∣bor, danger, and care. Hither you may also refer a to∣tal defect of manly Exercise immoderate sleep, especial∣ly soon after mate, and any kind of sleepings whatsoe∣ver, a sedentary, speculative life, intent upon soft and queint Arts and Sciences, as Poetry, Musick, and the like, to these may be further added a dayly frequenting of Comedies and other Plays, an assiduous reading of Fables, and Romances, and instead of manly and lau∣dable Recreations, a loos expence of time in Carding and Dicing. Hither also belong the neverfailing fruits of a lasting peace and plenty, such as security, indiligence and the like. All these enumerated faults do manifestly contribute a share to introduce a laziness and Effemi∣nateness in the parts. Seing therfore that the Blood, together with the humors contained in it, doth in its circulation wash all those stupified parts, it cannot o∣therwise be, but that as it glideth along it must partici∣pate some such alteration; and seing that some porti∣on of the transient Blood affected with this stupefacti∣on, is transmitted to the Generative Parts, with the ve∣ry matter wherof the Seed is Generated, it is easie to in∣fer that that Child which springeth from such princi∣pals must inwardly contract at least some propension conformable to the sluggishness, and stupour of its Na∣tive matter, and that that propension, after-Birth when the preservation is taken away by the equal cherishings

of the Womb, is by divers causes without difficulty de∣duced into act, wherfore seing that such a dulness is a part of the Primary Essence of this Diseas, it followeth that in such vitiated principals there lurketh a propensity to this affect, derived from one or both of the Pa∣rents.

The Fourth Classis containeth the vicious Disposi∣tions (if any such occur) of the Parents, who in their Childhood were infected with this Diseas. For these would transmit into the Children a continuation of an hereditary Diseas properly so called. But because, as we have said, it is not yet manifest whether the Pa∣rent afflicted with this Diseas in their infancy shall be∣get children therewith affected; besides, becaus the faults of the Parents may be conveniently referred to a∣ny one of these Classes aforesaid, or to many, or indeed to all of them, it will be fruitless to insist longer upon them. Therfore having reckoned up the faults of the Parents which depend upon the whol Body, in the next place we proceed to their faults which peculiarly reside in the Genital Parts.

These faults are somtimes a cold distemper, somtimes a moist, when by reason of too much humidity they are loosned or weakned, wherupon they ejaculate either an unfruitful deed or such as is propense to this Diseas, somtimes those parts are infested with a virulent, vici∣ous or waterish Gonorrhea, and they excern a Seed not sufficiently elaborated; the same must be said of the white and red Fluxes of Women. Again, some things outwardly applied to those parts have reference hither; as Ointments of Hemlock and other Narcotical things, especially if they be often anointed with them, in like manner Oyntments that are incorporated with white or red Lead, Chalk of Lead, Litharge, Sugar of Saturn

and the like, dayly and for a long time adhibited to those parts. For such as these blunt the activity of the inherent Spirits in those Parts, and introduce a certain dulness in them, which being communicated to the Seed prepared in them disposeth the progeny to this af∣fect.

At length we have finished our intended enumerati∣on, if not of all, yet at least of all the most principal causes which happen before Conception about the Ge∣neration of the prolificative Seed, and have any concur∣rence to produce this Diseas, or to dispose to the produ∣ction therof. Now follow the faults and errors of the Mother in the time she beareth the Embryon in her Womb, which also must be reputed among the causes of this Diseas before the Birth.

First, There hapneth a cold and moist distemper of the Womb it self, which (as were we silent is easily ma∣nifest to every one) may most readily be communicated to the Embryon by the perpetual contact of the Womb.

In the Second place, All those things offer themselves which suppeditate to the Embryon crude and impure Juyces converted by excrementions and corrupt humors instead of laudable aliment. Hitherto principally be∣longeth the unwholsom and preposterous diet of Wo∣men with Child, especially inclining to moisture, cold∣ness and the heaping together of crudities. The same things also happen by the imperfection and defect of the first or second Concoction, especially when they are not excerned by vomit or some other evacuation of the Crudities from thence proceeding, but are at length transmitted with the Mothers Blood for the aliment of the Embryon. Besides, if a moist and cold Diseas, as a cold and moist distemper with the matter, an ill di∣gestion,

a Cachexia or Dropsy, &c. do invade a woman with Child after Conception, it may thereupon easily happen, that the impure aliment also, which nourisheth and cherisheth the Seeds of this Diseas, be dispensed to the Embryon.

In the third place are to be reckoned al those things that defraud the Embryon of du aliment, as any exces∣sive evacuation, especially a lashing flux of Blood in a∣ny part; also a rash opening of a Vein, or Phlebotomy that exceeds in quantity. The suckling of another child may also divert the afflux of sufficient aliment from the Womb towards the Breasts. Hitherto likewise belongeth inordinate fasting, or any indigestion in the Mother, a∣ny inappetency after meat, or defect of concoction. Moreover, an acute Feaver hapning to a woman with Child, besides other inconveniences, may also defraud the Child of du aliment; so also an Hectick Feaver. All these things do not only infer to the Embryon, a dejecti∣on of Vital Spirits, and a defective nourishment, but also they cause a want of natural Spirits. For the Naturall Spirits are wasted and dissipated without due nourish∣ment, and are also destitute and disappointed of necessa∣ry reparation. Seing therfore that a part of the Essence of this Diseas consisteth in the defect of Natural Spi∣rits, som disposition to this affect must need be be∣queathed to the off-spring from the causes aforesaid.

4^ly. & lastly, excessive sleepines of women with child, slothfulness, eas, any vehement labor and exercise after Conception, do also contribute their share. For although violent motions and actions of any kind are forbidden to women in such causes; yet moderate labors, watch∣ings and exercises which offer no violence to the womb, or provoke to abortiveness, do not only conduce to the health of the Mother, but in som degree they drive a∣way

that dulness from the Embryon, and augment the heat, vigor and activity of it. And thus we put an end to the first Chapter of the causes of this Diseas before the Birth. Those which happen after the birth shall be the subject of our next examination.