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. III. Certain Suppositions are proposed for the easier finding out of the Essence of the Disease. First of the Essence of Health. Secondly of the Essence of a Disease. Thirdly of a threefold Division of Health and Diseases. The Explication of the third Division, and the Ʋse of the same. The Description of a natural Constitution, and the exaltation of it. The Fourth Supposition of the Combination of three Constitutions in the same parts. (Book 3)

THat we may proceed the more distinctly and clearly in the finding out of the Es∣sense of this Disease, we judged it very ad∣vantagious to premise these subsequent Suppositions:

I That the Essence of Health doth consist in some Con∣stitution of the Body according to Nature. But seing this is twofold in the kind, one Essential and necessary, re∣specting the tò esse simply, which during life conti∣nueth immoveable and immutable under various affections, and is indivisible: The other Accidental, having reference to the tò bene esse, which in respect of the whole Animal, is both moveable and mu∣table▪

and hath a great latitude, and can be present or absent without the dissolution of the whole. Health consists not in the former, but in the latter Constitution.

II. That the Essence of a Disease in like manner con∣sisteth not in the Essential Constitution: For so the dis∣solution of the whole would by and by follow: But in the Accidental Constitution, namely such an one, as in respect of the whole can be present or absent without its dissolution. We have said (and not without reason) that this Constitution wherein Health and Sicknesse are founded, is moveable and accidental in respect of the whole; for even this al∣so in respect of some part may be essential: as for example, a finger being cut off, a Disease ariseth in the defective number of the parts, which in respect of the whole, is founded upon an accidental Con∣stitution; for that finger may be present or absent without the dissolution of the whole; but in respect of the lost member it is founded upon an Essential Constitution, for this Disease being supposed, the Essence of that finger perisheth.

III. That the Constitution wherein the Essence both of Health and Sickness consisteth, admits a threefold man∣ner of division or distinction in the method of Discipline. The first is somewhat thick, and is resolved into parts altogether Concrete, namely, It proceedeth Kata topous, according to the division of the parts from head to heel. The second is purely abstracted, and searcheth out all the Elements of the moveable Constitution, from whence cometh the division of Diseases into similar, organical, and common; and then again those various subdivisions into distem∣pers, faults of figure, superficies, cavities and pas∣sages,

of magnitude, number, site and continuity. The third is as it were a middle manner, and al∣though it hath been hitherto neglected, yet we dare avouch, That it may have its use, and that no con∣temptible one, in the handling of Diseases, and the finding out of the causes of the Disease; and it is divided into a Constitution Natural, Vital, and Ani∣mal.

The first is proper to, and inherent in every part, abso∣lutely competible to it, and without any dependance upon the other parts according to the Essence of it simply: This remaineth a while after death, till it be resol∣ved by Putrefaction, Ambustion, simple Exiccati∣on, Mummification, Petrification, and the like vio∣lent Causes. This Constitution in respect of its simple Essence, doth not depend upon those Mem∣bers which minister an Influx, but it dependeth up∣on them both in respect of its Conservation, and likewise of its Operation. For the vital influx cea∣sing after death (which is as it were the salt and con∣diment of it) quickly perisheth, and as long as the creature liveth, this is variously affected by the in∣fluxes, and thereupon the actions are either promo∣ved or interupted.

The Second is the Vital Constitution, which is produced by that continual influx from the heart thorow the arteries into the parts of the whole Body. This also it admit∣teth degrees, and is often subject to variations more or lesse, and sometimes also seemeth to suffer a kind of eclips, as in a swouning, a syncope, &c. yet it per∣severeth from the beginning to the last period of life (at least in its fountain, and in some other parts.

The Third is the Animal Constitution, which is derived

from the Brain thorow the Nerves into the Organs of Sense and Motion. This is many times totally wan∣ting in many parts, the life notwithstanding remain∣ing; yea it might for a long time together be de∣fective in several parts, or all the parts, did not respi∣ration, which is absolute necessary unto life, depend upon it. These Constitutions therefore keep such a connexion between themselves, that the second doth eternally and continually presuppose the exi∣stence of the former, and the third of the second; but there is not back again so absolute a dependance between them, because (as we have even now said) the former can for some time subsist without the se∣cond, and the second commonly altogether without the third: And these three Constitutions may in most bodies be manifestly perceived, yet we affirm not that they may be found in all. The Natural in∣deed and the Vital are wanting to no part: but the Animal is defective in the Bones (though the teeth will admit some doubt) gristles, perhaps ligaments, and some substances as of the Liver, Spleen, &c. we assert therefore this threefold Constitution to be in all those parts, to whom the Natural, Vital, and Animal Faculty is communicated. For although these Faculties as to the first act may be said to de∣pend upon the Soul (which relation hath indeed no relation to the Medicinal art) yet in respect of the second act they are necessarily rooted in some mate∣rial Constitution of the parts to which they belong. For whereas some say that the Vital Faculty is deri∣ved from the Heart, and the Animal from the Brain unto the other parts, that must not so be understood, as if the Faculties themselves in a wandring manner were transient from part to part (for the passing of

an accident from subject to subject cannot be con∣ceived by any understanding) but that the Vital Fa∣culty is derived with, and in the vital Spirit from the Heart unto the parts, or at least is excited by some motion of the Heart and Arteries in the parts them∣selves, and in like manner the Animal Faculty doth descend in and with the Animal Spirit by the Ner∣ves, or is produced in the parts by some motion of the Nerves in the Brain. Which way soever it comes to passe, we must needs confesse that some alterati∣on is imprinted in the part it self receiving it either from the said Spirits, or from their motions. Which alteration as it is here granted to be the root of the Faculty, either Vital, or Animal in the respective parts, so is it a moveable Constitution, because it can be variously changed, remitted, and intended without the dissolution of the whole; and it is the Constitution wherein either Health or Sicknesse may consist, seeing that whensoever alteration is de∣ficient unto the parts wherein it ought to be, or any other wayes administred then is requisite, the action will thereupon be unavoidably depraved; but if it be rightly performed, then sound and perfect health is said to be present from the part of that Constitu∣tion. Considering therefore that there are two kind of Alterations besides the natural and inherent Con∣stitution, one from the influx of the Heart, another from the influx of the Brain in most parts; and see∣ing the said alterations, as they themselves are more perfect or more imperfect, do render the Faculties in the respective parts (at least as to the second act) more perfect or imperfect, and that the actions are thereupon depraved or sound, it is necessary that this threefold Constitution reside in most of the parts,

and that the said kind of alterations be medical con∣stitutions whereon Health and Sicknesse may be grounded.

That this Division or Distinction is not frivolous or altogether unprofitable, appeareth from hence, because the practical Physitians in their Methods do rightly admonish, that in obscure Diseases the Faculties must be accurately observed, when their actions are seen to be depraved, which diligence may serve as it were for a Manuduction to guide us to the Origine of the affect; now if it be a conside∣ration of so just importance to note the interupted Faculties in Diseases, certainly it will be an exercise of no lesse moment to take cognizance of the Con∣stitutions themselves, upon which those Faculties have an immediate and strict dependance.

Now least any man should conceive that there is almost a coincidence between this third Division and the second, he may observe, if he will diligent∣ly weigh the matter, That every member of this di∣vision doth in some manner include al the members of the next precedent, namely that the natural Con∣stitution doth comprehend primarily indeed the si∣milar Constitution, but that secondarily and in or∣der to the whole creature, it containeth in a sort the conformation and continuity; in like manner that the Vital and Animal Constitution do in their way so clearly participate of all the Members of the said Division, that to offer proofs of it were an unneces∣sary undertaking: Only we desire the Reader to take notice (which also we even now intimated) That the natural Constitution primarily and princi∣pally hath respect unto the temperament, the com∣mon qualities, the plenty of the Spirits, and the pe∣culiar

disposition of them (which by some are re∣fered to the form and the whole substance) but that it hath respect unto the manner of the Organe and the continuity as it were secondarily, and in order to the whole creature, and that it can scarce be other∣wise hurt or vitiated by them. Yet we must not de∣ny but that the natural Constitution is sometimes vitiated as it is meerly Organical, for thus it falleth out in the obstructions of the natural passages; as for example, when a stone is impacted or grown to hardnesse in the passage of the Meter or the yard, and in the like cases: but this happeneth unto it e∣specially in as much as the passage is ordained for the use and conservation of the whole; but for the most part the Organical vices in the natural Consti∣tution are of lesse note and consideration then the si∣milar.

These things may suffice to be spoken in a gene∣ral way of this triple Constitution. We will now in particular speak a few things of them in few words.

The Natural Constitution which is proper unto and inherent in every part, may be known by this discri∣ption, That it is the manner of the natural Being, setled in the parts, competible to them, in as much as they are aptly constituted by their temperament, and common quallities, by their sufficient portion and convenient disposition of ingenerated Spirits, and by their just conformation and continuity, to a perfect performance of natural actions, together with the concurrence of the Vital (and perhaps the Animal) influx. Therefore when there is in any part a just temperament, convenient common qua∣lities, an exquisite proportion, and harmonious dis∣position

of inherent Spirits. Finally, when there is a laudable conformation and unity, and yet notwith∣standing all this, the natural action is depraved, we may well conclude that it is not vitiated by the na∣tural Constitution, but by reason of the concurrent cause, namely the vital or natural influx, or of both together; for the natural actions in creatures in re∣gard of the union and wedlock of life, are exalted to a more eminent condition then otherwis they would attain unto by the natural Constitution alone. And from hence it comes to passe, That although the na∣tural Constitution in slain Creatures remaineth af∣ter death undepraved for a while, yet the attractive and retentive Faculty, the concoction of the ali∣ment, and the expulsion of the exctement do alto∣gether cease: And in Diseases also many times the natural Constitution is at first untoucht, yet the na∣tural action is vitiated meerly by the defect of the due concurrence of the vital influx: after the same manner somttimes the natural and vital Constituti∣on being sound and healthful, yet some natural acti∣on is depraved by reason of the defect of some ani∣mal influx and concurence: but this for the most part happeneth only in the Nervous, Fibrous, and Membranous parts, especially where they make a hollownesse, but seldom or not at all in the sub∣stance of the parts: As in the Palsy the excrements are many times unduly retained, by reason only of the astonishment and insensiblnesse of the guts, the other constitutions being sound. Therefore in these cases, when some natural action is hurt, we must not presently conclude that the natural Constitution is first vitiated, but we must with dilligence enquire out that Constitution which is first vitiated, for that

is to be looked upon as the root and first essence of the evil; in like manner if some vital action be de∣praved, we must not presently infer that the vital Constitution is primarily vitiated; because some∣times the first Origin is more rightly deduced from the natural, or perhaps the animal Constitution: as for example, Through the intensivenesse of cold, a finger is mortified by inflamation: in this case it is true that the influx of the vital bloud is plainly inter∣cepted; yet the beginning of that interception must be sought out in the natural Constitution of that ve∣ry part so benumned: So also in a Convulsion the circulation of the bloud is perhaps something di∣sturbed and interupted; but the first depravation must be ascribed to the animal, not to the vital Con∣stitution. On the contrary, in a Feaver the Head is invaded, but the source of the evil will peradventure be found out in the vital Constitution: so perhaps the Flesh is wasted, and al the natural Spirits are de∣cayed; yet the root of the evil wil be found out in the vital, not in the natural Constitution: So that any Constitution of the three before named may be in several Diseases, sometimes the first, sometimes the second, and sometimes the third cause of vitiated actions.

Not only many other parts of the body (yea sim∣ply al the sensible) which exhibit not an influx, nei∣ther are subservient as delatory parts, do naturally admit this threefold Constitution, but besides also even the Heart it self, and all the arteries, and the Brain and al the nerves, so that the Brain (excepting the fault in its natural Constitution) may be cheri∣shed and helped by the vital Spirit which is trans∣mitted thorow the veins and the arteries, being wel

affected, or vitiated and hurt if that be ill affected: And after the same manner also may the Heart by the animal Spirit which hath an influx thorow the recurent nerve of the sixth pair, the arteries also by the animal influx thorow the nerves by a way per∣haps not yet found out: And Finally, The Nerves also by the vital Spirit deduced thorow the Arte∣ries.