The workes of that famous chirurgion Ambrose Parey translated out of Latin and compared with the French. by Tho: Johnson. Whereunto are added three tractates our of Adrianus Spigelius of the veines, arteries, & nerves, with large figures. Also a table of the bookes and chapters.

CHAP. VII. The signs of a Leprosie, breeding, present, and already confirmed.

THe disposition of the body and humors to a Leprosie is shewed by the change of the na∣tive and fresh colour of the face, by that affect of the face, which is commonly called Gutta rosacea, red and blackish suffusions and pustles, the falling away of the hairs, and a great thirst, and a driness of the mouth, both by night and day, a stinking breath, little ulcers in the mouth, the change of the voice to hoariness, a desire of venery above nature and custom. Now there are four times of this disease,* 1.1 the beginning, increase, state and declension. The beginning is, when as the malignity hath not gon further then the inner parts and bowels, whereupon the strength must needs be more languid. The increase is, when as the virulency comes forth, and the signs and symptoms are every day increased in number and strength. The state is, when as the mem∣bers are exulcerated. The declension is, when as the aspect of the face is horrid, the extreme parts fall away by the profundity and malignity of the ulcers, so that none, no not of the common sort of people, can doubt of this disease. According to the doctrine of the Antients, we must in search∣ing out of the signs of this disease being present, have chief regard to the head. For the signs of di∣seases more properly and truly shew themselves in the face, by reason of the softness and rarity of the substance thereof, and the tenuity of the skin that covers it; wherefore a black and adust humor diffused thereunder, easily shews it self, and that not only by the mutation of the colour, but also of the character, and bulk, and oftimes by manifest hurting it. Wherefore you must observe in the head, whether it have scales, and whether in the place of those hairs that are fallen away, others more tender, short and rare grow up, which is likely to happen through defect of fit nourishment to preserve and generate hairs, through corruption of the hairy scalp that should be stored with such nourishment, and of the habit it self, and through the unfitness thereof to contain hairs: lastly, by the acrimony of the vapors sent up from the adust humors and entrails, fretting asunder the roots of the hairs.* 1.2 But if not only the hair, but also some portion of the skin and flesh about the roots of the hair, come away by pulling, it is an argument of perfect corruption: let this therefore be the first sign of a Leprosie. A second and very certain sign is, a numerous and manifest circumscrip∣tion [unspec II] of round and hard pushes or pustles under the ey-brows, and behinde the ears, and in several places of the face, resembling round and hard kernels, occasioned by the default of the assimula∣ting faculty. The cause of this default is the grosness of the flowing nourishment, by which means it being impact, and stopping in the straitness of the way, it grows round, as it were compassed a∣bout in the place whereas it sticks, and by the means of the crudity, for that it is not assimulated, [unspec III] and by delay, it is further hardned. The third sign is, the more contract and exact roundness of the ears, their grossness, and as it were grainy spissitude or densness; the cause of their roundness is the consumption of the flaps and fleshie part through want of nourishment, and excess of heat; but the occasion of their grainy spissitude is the grossness of the earthy nourishment flowing thither. [unspec IV] The fourth sign is a Lion-like wrinkling of the fore-head, which is the reason that some te••m this disease morbus Leoninus;* 1.3 the cause hereof is the great driness of the habit of the body, which also is the reason that the bark of an old oak is rough and wrinkled. The fifth is, the exact roundress of [unspec V] the eies, and their fixt and immovable steddiness; verily the eies are naturally almost round, yet they appear obtuse, and somewhat broad on the foreside, but end in a Conus on the hind part, by reason of the concourse and figure of the muscles and fat investing them. Therefore these being consumed either through defect of laudable nourishment, or else by the acrimony of the flowing humor, they are restored to their proper figure and roundness Now the muscles which moved the eies being consumed, and the fat which facilitated their motion wasted, it comes to pass that they stand stiff and unmoveable, being destitute of the parts yielding motion, and the facility thereof. [unspec VI] The sixth sign is, the nostrils flat outwardly, but inwardly straight and contracted, that is, an earthy and gross humor forced from within outwards, which swels the sides or edges of the nostrils▪ whence it is, that the passages of the nose appear as it were obstructed by the thickness of this hu∣mor; but they are depressed and flatted by reason of the rest of the face and all the neighboring parts swoln more then their wont; add hereto that the partition is consumed by the acrimony of [unspec VII] the corroding and ulcerating humor. The seventh is, the lifting up, thickness and swelling of the lips, the filthiness, stench and corrosion of the gums by acrid vapors riseing to the mouth; but the

lips of leprous persons are more swoln by the internal heat burning and incrassating the hu∣mors, as the outward heat of the Sun doth in the Moors. The eighth sign is, the swelling and [unspec VIII] blackness of the tongue, and as it were varicous veins lying under it; because the tongue, being by nature spongeous and rare, is easily stored with excrementitious humors, sent from the inner parts unto the habit of the body: which same is the cause why the glandules placed about the tongue above and below, are swoln hard and round, no otherwise then scrophulous or meazled swine. Lastly, all their face riseth in red bunches or pushes, and is over-spread with a dusky and ob∣scure redness; the eies are fiery, fierce and fixed, by a melancholick chachectick disposition of the whole body, manifest signs whereof appear in the face, by reason of the fore-mentioned causes, yet some leprous persons have their faces tinctured with a yellowish, others with a whitish color, ac∣cording to the condition of the humor, which serves for a basis to the leprous malignity. For hence Physicians affirm that there are three sorts of Leprosies; one of a reddish black colour, con∣sisting in a melancholick humor; another of a yellowish green, in a cholerick humor; another in [unspec IX] a whitish yellow, grounded upon adust phlegm. The ninth sign is a stinking of the breath, as also of all the excrement s proceeding from leprous bodies, by reason of the malignity conceived in the humors. The tenth is, a horsness, a shaking, harsh and obscure voice, as it were [unspec X] comming out of the nose, by reason of the lungs, recurrent nerves, and muscles of the throttle tain∣ted with the grosness of a virulent and adust humor; the forementioned constriction and obstru∣ction of the inner passage of the nose; and lastly, the asperity and inequality of the Weazon by immoderate driness, as it happens to such as have drunk plentifully of strong wines without any mixture. This immoderate driness of the muscles serving for respiration makes them to be trou∣bled with a difficulty of breathing. The eleventh sign is very observable, which is a morphew or [unspec XI] defedation of all the skin, with a dry roughness and grainy inequality, such as appears in the skins of plucked geese, with many tetters on every side, a filthy scab, and ulcers not casting off only a bran-like scurf, but also scales and crusts. The cause of this dry scab is the heat of the burning bowels and humors unequally contracting and wrinkling the skin, no otherwise then as leather is wrinkled by the heat of the sun or fire. The cause of the filthy scab and serpiginous ulcers, is the eating and corroding condition of the melancholick humor, and the venenate corruption, it also being the author of corruption, so that it may be no marvel, if the digestive faculty of the liver be∣ing spoiled, the assimilative of a malign and unfit matter sent into the habit of the body, cannot well nor fitly perform that which may be for the bodies good. The twelfth is, the sense of a cer∣tain [unspec XII] pricking, as it were of Goads or needles over all the skin, caused by an acrid vapor hindred from passing forth, and intercepted by the thickness of the skin. The thirteenth is a consumpti∣on [unspec XIII] and emaciation of the muscles which are between the thumb and fore-finger, not only by rea∣son that the nourishing and assimilating faculties want fit matter wherewith they may repair the loss of these parts, for that is common to these with the rest of the body; but because these muscles naturally rise up unto a certain mountainous tumor, therefore their depression is the more mani∣fest. And this is the cause that the shoulders of leprous persons stand out like wings; to wit, the e∣maciation of the inward part of the muscle Trapozites. The fourteenth sign is, the diminution of [unspec XIV] sense, or a numness over all the body by reason that the nerves are obstructed by the thickness of the melancholick humor hindring the free passage of the animal spirit, that it cannot come to the parts that should receive sense, these in the interim remaining free which are sent into the muscles for motions sake, and by this note I chiefly make trial of leprous persons, thrusting a somewhat long and thick needle some-what deep into the great tendon endued with most exquisite sense, which runs to the heel, which, if they do not well feel, I conclude, that they are certainly leprous. Now, for that they thus lose their sense, their motion remaining entire; the cause hereof is, that the nerves which are disseminated to the skin are more affected, and those that run into the muscles are not so much; and therefore when as you prick them somewhat deep, they feel the prick, which they do nor in the surface of the skin. The fifteenth is, the corruption of the extreme parts posses∣sed [unspec XV] by putrefaction and a gangrene, by reason of the corruption of the humors sent thither by the strength of the bowels, infecting with the like tainture the parts wherein they remain: add hereto that the animal sensitive faculty is there decaied, and as often as any faculty hath forsaken any part, the rest presently after a manner neglect it. The sixteenth is, they are troubled with terrible dreams; [unspec XVI] for they seem in their sleep to see divels, serpents, dungeons, graves, dead bodies, and the like, by reas n of the black vapors of the melancholick humor troubling the phantasie with black and dis∣mal visions, by which reason also such as are bitten of a mad dog fear the water. The seventeenth [unspec XVII] is, that at the beginning and increase of the disease, they are subtill, crafty and furious, by reason of the heat of the humors and blood; but at length in the state and declension, by reason of the heat of the humors and blood and entrails decaying by little and little; therefore then fearing all things whereof there is no cause, and distrusting of their own strength, they endeavor by craft maliciously to circumvent those with whom they deal, for that they perceive their powers to fail them. The eighteenth is a desire of venery above their nature, both for that they are inwardly burned with a [unspec XVIII] strange heat; as also by the mixture of slatulencies therewith (for whose generation the melancho∣lick humor is most fit) which are agitated, and violently carried through the veins and genital parts by the preternatural heat; but at length, when this heat is cooled, and that they are fallen in∣to an hot and dry distemper, they mightily abhor venery, which then would be very hurtful to them as it also is at the beginning of the disease, because they have small store of spirits and native heat, both which are dissipated by venery. The nineteenth is, the so great thickness of their gross and [unspec XIX]

livid blood, that if you wash it, you may finde a sandy matter therein, as some have found by ex∣perience, [unspec XX] by reason of the great adustion and assation thereof. The twentieth is, the languidness and weakness of the pulse (by reason of the oppression of the vitall and pulsifick faculty by a cloud of gross vapors.) Herewith also their mine sometimes is thick and troubled, like the urine of carriage-beasts, if the urinary vessels be permeable and free, otherwise it is thin, if there be ob∣struction, which only suffers that which is thin to flow forth by the urinary passages; now the urine is oftentimes of a pale ash-colour, and oftimes it smells like as the other excrements do in this di∣sease. Verily there are many other signs of the Leprosie, as the slowness of the belly by reason of the heat of the liver, often belchings by reason that the stomach is troubled by the reflux of a me∣lancholick humor, frequent sneezing by reason of the fulness of the brain; to these, this may be added most frequently,* 1.4 that the face and all the skin is unctuous or greasie, so that water poured thereon, will not in any place adhere thereto: I conceive it is by the internal heat dissolving the fat that lies under the skin, which therefore alwaies looks as if it were greased or anointed there∣with in leprous persons. Now of these forementioned signs, some are univocal, that is, which truly and necessarily shew the Leprosie: other-some are equivocal or common, that is, which con∣duce as well to the knowledge of other diseases as this. To conclude, that assuredly is a Leprosie which is accompanied with all, or certainly the most part of these fore-mentioned signs.

Notes

• * 1.1

  The beginning of a Leprosie. The increase. The state. The declension
• * 1.2

  The first sign of the Lepro∣sie.
• * 1.3

  Why it is cal∣led Morbas leo∣ninus.
• * 1.4

  Why their fa∣ces seem to be greasie.