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. XXIII. The Prognostical Signs in the Diseas of the Rachites. (Book 23)

THis Diseas in its kind is not mortal, yea som∣times it is so light and gentle, as the Chil∣dren affected therwith have been restored to health by the sole benefit of Age, the Vital heat being encreased and summoned forth to the exter∣nal parts by the force of frequent Exercises. Yet it som∣times so vehemently prevaileth, that the iminent danger of life can scarce, yea somtimes cannot be prevented by the best and most prudent applications. Wherfore it is very necessary that a Physitian should first diligently contemplat the Prognostical signs of a diseas, that hemay be the better instructed to forsee the several events of it. But in general those things which abet the Diseas, that is, all such things as war against Nature, require a con∣trary consideration, and as thes are the stronger and they the weaker, so much the more grievous and pernitious is the Diseas. But becaus it is not obvious to every one to give an accurate Judgment of Particulars from this General Admonition, it will not be impertinent or un∣profitable to insert som particular and special Rules and Observations hitherto belonging.

First, This Diseas properly Natural, or that which in∣vadeth before the birth, is the most dangerous, and sel∣dom, if ever, end in health. For it argueth a deprivation

of the Seminary principles, and by consequence that the Spirits are very infirm; besides it insinuateth a ve∣hemency in the causes.

Secondly, The more early the invasion is after the Birth, the more dangerous (caeteris paribus) the Di∣seas is: for the Spirits are so much the weaker. In like manner, The Elder Children, and such as go up and down, are more easily cured then yong Infants that can∣not use their legs.

Thirdly, A Diseas improperly so called; nam∣ly, that which in part dependeth upon the Natu∣ral Inclination, is more dangerous than that Which is contracted by the meer error of the Nurse or Mo∣ther.

Fourthly, This Diseas proceeding from som other fore-going Affects, is more dangerous than that which is introduced by an erroneous Regiment of health; For it implyeth a precedent dejection of the Spirits.

Fifthly, Som have observed, That Infants who have had red Haird women to their Nurses, have been most obnoxious to this Affect. Yet we indeed suspect this rule of som fallability.

Sixthly, Some affirm, That Girls are more fre∣quently infested with this Diseas than Boys, and more easily cured. The truth is, we have not yet had a∣ny unsuspected experience of this. Yet we grant that Girls are of a more cold and moist tempera∣ment, which holdeth the greatest correspondency with this Diseas, and for that reason probable it is that the Female Sex may be affected with the ligh∣ter causes, and for the same reason also be the sooner re∣stored.

Seventhly, This Diseas doth chiefly invade the Cra∣dles

of the Gentry, especially, of those who live at eas, and fare deliciously; then of the poorer sort, by rea∣son of the manifold and various errors which necessity introduceth as wel in the diet of the Parents, as the Re∣giment of their Children; but it findeth the most diffi∣cult access unto those who are priviledged from such as∣saults by a mediocrity of fortune, and accustomed to un∣dergo some pains-taking and labor, and are not desti∣tute of necessary means to sustain life and a healthful competency to prevent indisposition.

Eighthly, By how much the more the first affected parts are extenuated, so much the more difficult caeteris paribus is the cure of the Diseas.

Ninthly, The greater the Head is, the longer and the harder is the Cure. When therfore the Bone of the Forehead sticks much out forwards, it portendeth at least a long continuance of the Diseas; the same also do the other irregular stickings out of the other Bones of the Head.

Tenthly, The weaker the Back-bone, the greater and more dangerous is the Affect. Wherfore they which are unwilling to sit upright, much more they which are not able to sit upright, but most of all they whose feeble Necks cannot underprop the burden of the Head, are in hazard of their lives. Moreover, by the Diuturnal weakness and bending of the Back-bone, Children become Crook-back'd, or some other waies incuruated, and the trunk of the Body is afterwards scarce reducible to its Native Figure.

Eleventhly, Great Swellings in the Bones of the Wrests and the ends of the Ribs presage the continuance of the Diseas. Moreover, The crookedness of the Shank-bone, Shoulder-bone, or the Bone in the Arm, prognosticate no less. Again, The greater that the inflexion of the Joints

is, the more difficult and retarded will the restauration be.

Twelfthly, They whose Thigh and Shank-bones are much encreased, rather according to latitude and thick∣ness, then according to longitude, for the most part be∣com dwarfs.

13^ly. They who draw their Knees upwards and un∣willingly, suffer them to be extended, recover not with∣out som difficulty.

14^ly. When the Teeth wax black or fal out by pieces, there is som danger, and so much the more, the later they com again, that is, others in their room.

15^ly. Al they who attain to the consistence of the Di∣seas, escape the danger of it, being carefully lookt unto, unless perhaps som other Diseas be conjoyned with it, or do accidentally com after, and disturb the Patient with a higher encreas. In like manner the declination of the Symptoms doth assuredly promise a restitution of health.

16^ly. If an Hydrocephalus be complicated with the Rachites it ever importeth great danger. But if it prevail far, as that the Sutures of the Brain pan do gape, and that som water gotten into the middle Spaces doth swell the Dura mater into a waterish and soft Tumor, it is mortal.

17^ly. A painful and laborious breeding of Teeth coms somtimes accompanied with most vehement Symptoms, and even threatneth death. But commonly it is violent and ceaseth in a short time; however, so long as it is conjoyned, it much accelerates the motion of the Diseas. But the Dog-Teeth com forth with more vexation, than the rest and portend more danger.

18^ly. An Asthma (especially the Orthopny, when the Patient cannot draw breath, but with an erected

neck, and that difficulty of breathing when he cannot ly on either side) is very dangerous. For that prompteth to a suspition of som Tumor, Imposthum, Pleurisie, or In∣flamation of the Lungs, or som growing too of the Lungs with the Pleura, all which affects want not their danger.

19^ly. If the Ptisick be complicated with this Affect, it is for the most part mortal, especially if one and the same ulcer of the Lungs continu above forty days.

20. We affirm that if this Diseas be of any long con∣tinuance it easily changeth into the Ptysick, or a Consump∣tion, or at least commonly brings a Consumption to the destruction of the Sick, unless som other affect per adven∣ture, or grievous symptom do intervene, and prevent the Consumption by hastning death; as a Convulsion, the loud Cough, the swelling of the Lungs, (vulgarly called, THE RISING OF THE LIGHTS) a continual Feaver, a Pleurisie, &c.

In the next place, We assert, That if a Dropsy of the Lungs, or an Ascites be complicated with the Rachites, it portends a desperate and deplorable condition.

Again, An Hectick, slow, putrid, and especially a continual Feaver, consuming the first affected parts doth vehemently hasten the motion of this Diseas, and render it the more dangerous.

Also, If the Venereous Pox be consociated with the Rachites, b e it hereditary or contracted by infection, it is almost uncapable of remedy.

The Scurvy likewise conjoyned doth very much retard the cure, thoug h less than the Pox.

In like manner Strumatical tumors either internal or external do not very much suspend the hopes of cure, though otherwise of themselves they are not easily subdued in this tender age. For the external

parts are exulcerated, or inflamed with insuppor∣table pain, and do vehemently irritate Nature, and wast the Spirits, but the internal much more, especially, if they invade the more noble parts, or bring molestation to the adjacent members with their weight and bulk.

Moreover, Whosoever are not perfectly cured before the first five years of their age be spun out out, they after∣wards for the most part live miserable and sickly, and being either Astematical or Cachectical or P••ysical they dy before they arrive to the consistence of their age, or else they grow deformed, crooked, and dwarfish.

If Scabs, wheals, pimples, or the itch com after this Affect, it doth hopefully expedite the cure.

Finally, They which easily endure any kind of agita∣tion of the Body, caeteris paribus, are cured without dif∣ficulty.

Thus at length we have finished the History of the three kinds of Signs, according to the best faith of our observations hitherto. In the next place we shal pro∣ceed to the Method of practice, which comprehendeth the prevention and cure of this Diseas.