Nine books of physick and chirurgery written by that great and learned physitian, Dr Sennertus. The first five being his Institutions of the whole body of physick: the other four of fevers and agues: with their differences, signs, and cures.

CHAP. I. Of the Causes of Diseases.

SEeing that nothing can perfectly be known unless the causes thereof are known whither can diseases be avoided unless the causes are shun'd; neither can the same be taken away, unless the causes if they are present, be first taken away: We will now treat of the cau∣ses of Diseases.

Although by the Philosophers there are rightly constituted four kinds of causes, * 1.1 the Materiall, Formall, Finall, and Efficient; yet here we are to speak onely of the Efficient causes of diseases; for the form, such as accidents have, is already explained. Diseases have not matter unless it be the subject wherein they are inherent; * 1.2 the end also is not since they arise from the want of perfection, and therefore Physitians when they handle the cause of diseases under∣stand the efficient cause onely.

But Efficient causes of Diseases are considered either in respect had to a disease and a body, or absolutely, and as they are things which can take upon them the nature of mortifique causes. If cau∣ses as they are referred to a disease, or its effects, they are considered thus; first, one cause is proximate and immediate, another remote. The proximate is that cause betwixt which and the disease nothing intercedes. The remote is that betwixt which and the disease there comes another neerer cause. The proximate (since nothing

can come to pass without a cause) is in all diseases; but the 〈◊〉〈◊〉 is not so.

Secondly, since that of those causes which conduce to the gene∣ration of a disease, and indeed such as some matter doth exeite, * 1.3 some are neerer, others more remote, and oftentimes there is a long rank of them: Physicians call some causes containing, others antecedent, others primitive.

A cause containing, which is also named consummative, [unspec 2] * 1.4 is that which proximately adheres to a disease in a body, and cherisheth it, and which being put the disease is, being taken away, the disease is taken away: so a stone is the cause containing of ob∣struction of the bladder. A humour in a turnour is the cause of increasing of Magnitude, but a cause containing and immediate, is not absolutely the same, for as much as all diseases have a proxi∣mate cause, since nothing can be done without a cause, but they have not all the cause containing; namely, thes•• oke of a sword is the proximate cause of a wound, but not the cause containing. And those diseases only have a cause containing, which are joyned with matter, and are cherished by it as tumours, obstructions, pu∣trid Feavers. Yet you are here to be admonished that these things which are here spoken of a cause containing, as also of the differences of other causes, are all spoken of in respect of a disease, defined by Galen, per dispositionem, or casually as they say; for in respect or this, not all but some diseases only have a cause containing. But if a disease be defined formally and through impotency, all diseases whatsoever have a cause containing, namely some vitious disp••si∣tion of body. * 1.5

The antecedent causes are certain dispositions lying hid in the body which go before a disease, and out of which a disease may arise. For although that be most properly called a cause which doth now act; yet Physitians call those things causes which as yet pro∣duce not any disease, so that they may produce them. Antecedent causes are defined not by the act, but by the power of effecting, so some vitious humour which lyeth lurking in the body, produ∣ceth not a disease as yet; yet it may gonerate one, * 1.6 that is called the antecedent cause thereof.

The primitive causes which anciently they called Prophasis, are such as move the antecedent in a body, and give occasion that they may become proximate causes; such are watchings, cares, ange, too much exercise, and motion, and such like. But primitive causes and evident are not the same, for every Pro••atarcktick is evident or manifest, but every evident and manifest is not a Primitive, as a sword is the evident cause of a wound, but not the primary; for an

evident or manifest cause is whatsoever produceth a disease in a ma∣nifest manner, whether it be immediate or remote, but the primi∣tive can never be the proximate, but alwayes requires preceding preparation of the body, and a neerer cause in the body which it may move.

Nor is the primitive cause the same with the external; for ex∣ternall is only in respect of the body, and every thing which is with∣out the body, after what manner soever, it produceth a disease, it is called an externall cause, but Primitive is spoken in respect to other causes, and is that which stirreth up and moveth the hidden causes of the body, either within the body or out of the body; whence Sleep, Watchings, Passions of the mind, and other causes which are in the body, are named primitive, not externall.

Thirdly, [unspec 3] * 1.7 some causes are evident, others hidden, and obscure: evident and manifest are such as are obvious to the senses, neither is there need of any other signes to know them by. Occult and hid∣den are such as lurk in the body, and require signes to be known by.

Fourthly, [unspec 4] * 1.8 some causes are internall, others externall; internall are such as are within the body, externall are such as are without the body.

Fifthly, [unspec 5] * 1.9 some causes are by themselves, others by accident. Causes by themselves are such as produce dieases by their own proper force and violence, and not by the assistance of other causes; so fire heateth, water cooleth. A cause by accident is when it per∣forms ought by the intervening of another cause, and not by its own force; so cold water by accident is the cause of heat, whilst by its binding, and closing the pores of the skin, the hot exhalati∣ons are detained within, which otherwise would evaporate by in∣sensible transpiration.

Also some causes are common, * 1.10 as Air, Meat and drink, when many use them in one place; others are proper which are peculiar to certain men.

Lastly, some causes are positive, others privative; positive are such as by their presence produce an effect like themselves, * 1.11 after which sort water cooleth. Privative are such as by their absence pro∣duce an effect like themselves; so heat returning to the internall parts, and leaving the externall, is the cause of refrigeration of the outward parts.

Notes

• * 1.1

  The sorts of causes.
• * 1.2

  The Phy∣sitian treats of efficient cause. The causes of diseases are four∣fold. The prox∣imate. The remote
• * 1.3

  Contain∣ing.
• * 1.4

  Contain∣ing.
• * 1.5

  The ante∣dent.
• * 1.6

  The pri∣mitive. How cau∣ses differ. The mani∣fest evi∣dent. The mani∣fest exter∣nall.
• * 1.7

  Evident causes. Occult.
• * 1.8

  Internall. Externall.
• * 1.9

  Perse By acci∣dent.
• * 1.10

  Common. Proper. Positive.
• * 1.11

  Privative.