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.
Glisson, Francis, 1597-1677., Bate, George, 1608-1669., Regemorter, Assuerus, 1614-1650.

CHAP. II. Anotomical Observations collected from the Dis∣section and Inspection of Bodies subdued and killed by this Disease.

BEfore we attempt an enquiry into the Na∣ture and Causes of this Disease, we hold it convenient to premise some few certain and undoubted things, as being obvious to the Senses, which both demonstrate the real exi∣stence of this Disease, and may also be cast for a foundation, whereon to build the Superstructure of our judgment & opinion concerning this new Dis∣ease. For we would not have any man to imagine that we here treat of some Fictitious & Imaginary Evil, much less to expect that our Opinion should be credulously embraced without examination. But this we rather aim at, That the matter of our Dis∣course to all possibility may be known and precon∣ceived in the very entrance, that we may confirm those things which we shall propose, by those things that are obvious to the Senses, as occasion shall re∣quire; and that the Reader being instructed in these, may become a competent judge of our Reasons, and with the more facility be able to interpose his judg∣ment concerning each of them. We attest therfore Page  9 that many of us have been present at several Disse∣ctions of Bodies which have been separated by this Disease, and that we will in this Chapter briefly and faithfully declare those things which we have hi∣therto Observed by long experience and frequent Dissections, namely, Those things which we have seen with our eyes, and have handled with our hands.

In the mean time Two things are here to be pre∣monished: The former is, That the Reader carry in his memory, That the dead Bodies which we o∣pened were most vehemently afflicted with this dis∣ease whilest they were animated, for they are sup∣posed for the most part to have yeelded to the very magnitude of the Disease, and therefore he must not expect that magnitude of the Affect or Symptoms which we here describe, in other Bodies yet living or newly besieged. For every Disease is moved to a Consistence, and then also Nature being op∣pressed and unable to maintain the conflict groweth worse and worse. The latter is that the Reader take notice, That almost all Diseases in processe of time, do unite unto themselves other affects of a different kind, and therefore that chronical Diseases are for the most part complicated before death: Let him not therfore imagine that every preternatural thing that is found in dead Bodies, though destroyed by this affect, must of necessity belong to this evil; for perhaps it may rather have reference to some other Diseae supervenient upon this before death, then to this very Malady: And the truth is, Anatomists through inadvertency, and want of due regard to this Caution, have fouly ered in their Observations, whilest they ascribe those things which concern a∣nother Page  10 Disease, to another wherewith it was com∣plicated before the dissolution. The best preventi∣on therefore or rectification of this error is, Not to make a rash judgment from the inspection of one or two bodies, but first by a reiterated and sedulous ex∣periment, to be able to distinguish what things per∣petually occur, what for the most part, what fre∣quently, and what but seldome, in the dissected bo∣dies that have perished of the same Disease: for you must know, That whatsoever is not perpetual∣ly conspicuous in the opened Bodies dissolved by the same Disease, cannot appertain to the intimate and chief Essence of it: for neither the Disease it self can have an existence being separated from its Essence, nor the Essence being separated from the Disease. But enough of these things; let us now proceed to the Observations themselves.

These our Anatomical Observations are distin∣guished into those which do extrinsecally occur, the Body being not yet opened, and those which pre∣sent themselves only upon the Dissection of the Body.

I. These of the former kind are they which are out∣wardly visible upon the first appearance of the naked dead Body.
  • 1 An irregularity, or disproportion of the parts; namely, The Head bigger then ordinary, and the Face fat and in good constitution in respect of the o∣ther parts. And this indeed hath appeared in al those whom hitherto we have beheld to perish by this af∣fect, Page  11 one only excepted, who together with this Disease had suppurated Lungs, and was pined and disfugured with the Physick. Yet he also through∣out the whole progresse of the Disease, was full fa∣ced, and had his head somewhat big; but for about fourteen dayes before he Deceased, on a sudden all the fleshy parts about his head consumed away, and his face was like the picture of Hippocrates, not with∣out the just wonder of all those who beheld so sud∣den a change.
  • 2 The external members, and the muscles of the whole Body were slender and extenuated, as if they had been wasted with an Atrophy, or a Consumpti∣on. This (for so much as we know) is perpetually observed in those that die of this Disease.
  • 3 The whole Skin, both the true, and also the fleshy and fattish Membrane, appeareth lank and hanging, and loose like a Glove, so that you would think it would contain a far greater quantity of flesh.
  • 4 About the joynts, especially in the wrests and ankles certain swellings are conspicuous, which if they be opened, not in the fleshy or mem∣branous parts, but in the very ends of the bones, you may perceave them to be rooted in their ap∣pendances; and if you will file away those promi∣nencies of the bones, you will easily perceive them to be of the same similary substance with the other parts of the bones.
  • 5 The articles or joynts, and the habits of all the external parts are less firm and rigid, and more flex∣ible then at another time they are observed to be in dead bodies; and in particular the Neck after death is scarce stiffe with cold, at least much less then in o∣ther Carkasses.
  • Page  12 6 The Brest is outwardly lean, and very narrow, especially under the arms, and seemeth on the sides to be as it were compressed, the Stern also is somwhat pointed, like the Keel of a Ship, or the breast of a Hen.
  • 7 The top of the ribs to which the stern is con∣joyned with gristles, are knotty, like unto the joynts of the Wrest and Ankles, as we have already said.
  • 8 The Abdomen indeed outwardly in respect of the parts continent is lean, but inwardly in respect of the parts contained it is somwhat sticking out, and seemeth to be sweld, and extended. And these have been our Observations before the opening of the bellies.
II. The Abdomen being opened, we have Noted these things:
  • 1 The Liver, in all that we have dissected, hath exceeded in bignesse, but was well coloured, and not much hardned, nor contaminated by any other remarkable vice. We desire som bodies should here be excepted, in which other Diseases before death were complicated with this, as in a Dropsie & an extream Consumption we remember to have hap∣ned.
  • 2 The Spleen (namely so far as hitherto it hath been lawful for us to observe) for the most part is not to be contemned, whether you consider the magnitude, the colour, or the substance of it; not∣withstanding we do not deny but it may otherwise happen in regard of a complication with other Dis∣eases.
  • Page  13 3 We have sometimes espied a wheyish water to have glided into the cavity of the Abdomen, but indeed not often, nor in any great plenty.
  • 4 The Stomach and Guts are somewhat more infected with flatulent humors, then sound bodies usually are, which partly may be the cause of that extension of the hypochondriacal parts above men∣tioned.
  • 5 The Mesentery is sometimes faultlesse, and sometimes affected with glandulous excrescences bigger then ordinary, if not with swelling bunches: But concerning the sweet-breadwe declare nothing for a certainty; only we suspect that obstructions, if not a schirrhus, may sometimes invade that part. But thus we delegate, to the enquiry of o∣thers.
  • 6 The Kidneys, Ureters, and Bladder, unlesse there be a concomitancy of some other Disease, are laudably sound. We observe in general of all the Bowels contained in this Belly, that although the parts containing them, as we have noted above, are very much extenuated and emaciated, yet are they as large and as full, if not larger and fuller, then those seen in sound bodies, as hath been said of the Liver.
III. The Sterne being with-drawn, these things have presented themselves in the breast.
  • 1 A certain adherence or growing to of the Lungs with the Pleura which hath been more or lesse discernable in all the Bodies which hitherto Page  14 we have cut up. Yet we suppose that this affect may happen without any such nourishment, although in the advancement of the Disease for the most part it cometh before the Patient die.
  • 2 The stopings or stuffings of the lungs are no less frequent, especially in those coadhering parts. Hard humours also engendered by a thick, viscous, and blackish bloud, sometimes in one, sometimes in many of the strings of the Lungs, yet are not these alwayes conspicuous, many times also Imposthums and Ulcers.
  • 3 One amongst us doth attest, That he once saw glandulous knobs and bunches, so numerous, That they seemed to equallize, if not exceed the magni∣tude of the Lungs themselves▪ They were scitua∣ted on both sides between the Lungs and the Me∣diastinum (that is the Membrane that divides the middle belly) and were extended from the Canel∣bone to the Diaphragma.
  • 4 In the cavity of the Breast we have sometimes seen a collection of wheyish waters, & indeed more frequently then in the cavity of the Abdomen, but not in all.
  • 5 One amongst us hath likewise seen this affect complicated with a great Impostume, and with the Ptysick: the Stern being removed, all the Lungs on the left side were infected with an Impostume, and on every side growing to the Pleura, and the humour being lightly crushed, a copious, thick and stinking Matter of a yellowish colour, flowed out thorow the sharp artery into the very mouth: The outward Membrane of the Lungs whereby they firmly adhered to the Pleura, appeared thicker then ordinary, and by the mediation of it, the strings on Page  15 that side did so grow together, that you could scarce distinguish them or such: the same Mem∣brane also, involved both the Lungs and also the Impostume it self▪ which being opened the magni∣tude of the Imposthume was discernable, which by the estimation of those that were present, contained at the least two pound of water.
  • 6 The kernel in the Canel-bone in Childhood is alwayes observed to be great, and perhaps grea∣ter yet in those who have died of this Disease.
IV. The Skull being sawed thorow in a circular Fi∣gure, and the little cover being removed, we have observed these things:
  • 1 The Dura Mater hath been more firme, and adhered to the Skul in more places then is usual in men of ripe years: perhaps the same may be obser∣ved in other Children not affected with this evil, al∣though, as we suppose, not in so great a manner: for certain it is, That in new born Infants there are ma∣ny and straight connexions between the Pericranian and the Dura Mater which are afterwards broken off and are scarce discernable.
  • 2 In some Bodies that we have dissected, be∣tween the Dura and the Pia mater, and in the very ventricles of the Brain, we have found wheyish and waterish humours; from whence it is manifest, That this affect is complicated with the Hydro∣cephalus.
  • 3 We have found the Brain in others that we have opened, to be firm and inculpable, and not o∣verflowed with any waterish congestions.
  • 4 Lastly, We have observed in some Bodies late∣ly Page  16 opened, That the Carotides have exceeded their just proportion, and so also have the jugulary Veins; but the Arteries and the Veins which are delated to the outward parts, were of an unusual slender∣nesse.

    But whether or no this be perpetual in this affect we cannot yet witnesse by an occular testimony; yet we conjecture, That it happeneth so perpetually, but it came not sooner into our minds to examine it, since the beginning of our Anatomical enquiries into this subject.

These things being premised, our next Disqui∣sition shall be to find out the Essence of the Dis∣ease.