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.

THE SECOND BOOK. PART. II. Of the Causes of DISEASES.

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.

CHAP. II. Of things which are the Causes of a Disease, and first of Non-naturals.

MOreover the efficient causes of Diseases considered absolutly, or as they are such; all things are the causes of Diseases, which can hurt the natural constitution, and turn it into a preternatural: and such things are either without the body, or within it.

Things that are without our bodies, are either necessary, * 1.12 and to be suffered by all, and none can avoid them; or not necessa∣ry, but may be avoided. Of the first sort are those things cal∣led non-naturals, and are in number six, Air, Meat and Drink, * 1.13 Sleeping and Waking, Exercise and Rest, Repletion and Inani∣nation, and the Passions of the Mind; whereof the four latter are rather to be called evident then external. Things befalling us not necessary, are those that wound us, knock us, or in such like manner hurt our bodies, which befall us by chance, which are not included within a certain number.

But both those, as well necessary as unnecessary, * 1.14 may be re∣duced to four heads; those things which are taken in, those which are carried; those that are put out and retained; and lastly, those that befal us externally.

Under the notion of those things which are taken, are com∣prehended Air by breathing, Meat and Drink, and Medicine in∣wardly taken.

By those things that are carried about, we comprehend all the motions of the body and mind, of what kind soever; such as the perturbations of the minde, anger, griefe, joy, sleep, wa∣king, rubbing the body, navigation, the course of our lives, and such like.

By Excretion and Retention is understood whatever is thrown out of the body; such are the Ordure, Urine, * 1.15 all sorts of Hu∣mors, Seed, Menstruis; for these as those that are emitted, alter the constitution of the body, belong to those which are called Excretions; and the same when they are deteined, are referred to Retentions.

Moreover those things that externally happen to us, * 1.16 compre∣hend them that encompasse us, as the Air, Baths, and those things that are applyed to our bodies; as Garments and Cove∣rings, Oyls, Unctions, and such like. Lastly, those things that by force and impulsion befal us, as Wounds, Contusions, and

such like; but since there is no certain number of them, we will onely speak of non-naturals, as they are the causes of Disea∣ses.

First from the air is made a great alteration, * 1.17 as being that wher∣in we continually live, and without which we cannot live a mo∣ment; for it alters us in a twofold manner; namely, as we draw it in by breathing, and as it encompasseth us, and by the Pores penetrates us, and communicates that distemper which it hath to our bodies; * 1.18 for the hot Air heats our bodies, dissolv•• humours, melts, attenuates, increaseth choler, and whets, in∣flames the spirits, so begets hot Diseases; for by calling forth and dissipating the natural heat, it weakens the concoction. The cold Air, * 1.19 on the contrary, cooleth, condenseth, closeth the Pores, thickens the humours. The moist moistens the body, hapeth up superfluous humours, drives out the natural heat, generates crude distillations, especially joyned with cold. But if joyned with heat, * 1.20 it is the greatest cause of putrefaction. Dry Air dries our bodies, and being joyned with heat, burns them.

First the constitution of the Air depends upon the season of the year, * 1.21 whereof the Spring is temperate, the Summer hot and dry, Autumn cold and dry, Winter cold and moist; and hence several Diseases happen at the several seasons of the year; of which Hypocrates in the third of his Aphorismes, 4, 5, 6.7, 8, 9.10, 11, 12, 13, 14, 15, 16, 20, 21, 22, 23. The winds also conduce to the alteration of Air; so do Countries and Situati∣ons, of which Hypocrates 3. Aphorisme, 15, 17. And in his Book of Air, Water, and Places; and it doth not onely affect our bodies with primary qualities, but impresseth in us a ma∣lignant and pestilent disposition (if it be infected therewith) and can communicate to us those effects which it hath, and so ex∣cite malignant and epidemical Diseases in us; of which is spo∣ken in the doctrine of malignant and pestilent Fevers.

Secondly, [unspec 2] * 1.22 Meat and Drink, if either it be taken in too great measure, or be unwholsome, or if any fault be committed in the taking of it, may be the occasion of many diseases. Dyet then offendeth in quantity, manner of taking it, and quality; for if too great a quantity of meat stuff the stomach, it cannot be well concocted, but sendeth aboundance of vapours to the braine, which offend it, and is the cause of divers fluxes of Rhumes; and when the error of the first concoction is not cor∣rected in the second, that Crudity is the occasion of many Dis∣eases which arise afterwards in the whole body; and as an im∣moderate

quantity of meat and drink, is the occasion of many Diseases. So the want of them is hurtful; for thereby the good humours of the body are wasted, and the body dryed, 1. Aphor. 14. In an impure body it stirs up ill humours, * 1.23 whence divers parts are ill affected; for it is hurtful to eat meat whilest any is unconcocted in the stomach: variety of meats is also hurt∣ful.

As for the qualities of meats, * 1.24 those which have in them cer∣tain qualities, by which they can alter our bodies, are called medicamental, and they are changed into humours of a like qua∣lities with them, and in a sound body cause a like distemper; and in a sick body may introduce an unlike and contrary di∣stemper; to wit, if they are contrary to the preternatural di∣stemper, but if they agree with it, they encrease it. Meats dif∣fer not onely in the first qualities, but also in others, nay in the whole substance; some thick, others thin; some much, others little; some cause good Asiment, some bad; of which Galen in his books of the faculties of the Aliments, and in his book of good and evil Juice treateth; and we shall speak more in our fourth Book.

Thirdly, sleeping and waking moderately preserve health, [unspec 3] * 1.25 im∣moderately destroy it, 2. Aphor. 3. For too much sleep hindreth the natural evacuations and excrements, and dulls the heat of the body, and so is the occasion of cold diseases, and principally of Distillations. On the other side, too much waking dissi∣pates the Spirits, dryes the body, and whilest the humours are kindled and become adust, they are of themselves the causes of hot distempers; and whilest they dissipate the Spirits, the na∣tive heat is weakned, and the radical moisture is consumed, and by accident are the causes of cold diseases.

Fourthly, there is the same reason of exercise and rest; [unspec 4] * 1.26 for idlenesse and too much rest fills the body with Excrements, dulls the native heat, and renders the body slow and feeble; on the other side, too much exercise dissipates the Spirits, consumes the body, and by consequence cooles the whole body, hinders concoction; the veins and vessels often break, stirs up untimely humours, heats them, and causeth fevers; and especially if the body be full of vitious humours, they being stirred are carried through the whole body, and stir up fevers and other distem∣pers and symptomes.

Fifthly, [unspec 5] * 1.27 the affections of the mind make great alterations in the body; in anger the Blood and Spirits become extream hot, and are hurried to the external parts from the internal, whence

they inflame the whole body, and often kindle Fevers, and raise other Symptomes. Too much joy may so dissipate the Spirits, that it is observed one may die therewith; in fear and trembling the Spirits and heat desert the exteriour parts, and fly to the heart, and suffocate the heart; sorrow by degrees dissolveth the Spirits, cooleth the Body, dryes, spoils concoction, causes watch∣ings, and begets melancholly diseases.

Lastly, * 1.28 those things that are reteined in, and sent out of our bodies, are the causes of Diseases; for if the profitable humors be untimely sent out, it debilitates the body, and consumes it; but if the excrements are retained, diseases are bred that are like unto them.

CHAP. III. Of the internal causes of Diseases, and first of fulnesse of Blood.

INternal things which are the causes of diseases, * 1.29 either are gene∣rated in the body according to nature, or are found in the be∣dy contrary to nature; those which are generated according to nature, are those three of Hypocrates, conteining, conteined, and doing violence; or as others would have it solid, humid, and spirituous; those are called preternatural humours, which are found in the body contrary to nature; as stones, gravel, wormes, and all things that are generated in the body differing from natural; whereunto belongeth those things that are sent into the body, and there stick and remain, as darts, bullets of lead, and such like.

But these things are made to be the causes of diseases, * 1.30 either as they are in their whole kind, contrary to nature; or as they of∣fend in qùantity, quality, motion, or place.

The fault of humours in Specie is divided into Plethorick and Cacochimick; * 1.31 for humours are either apt to nourish the be∣dy, or not fit: plenty of the one ••s called Plethorick, of the o∣ther Cacochimick; for Plethory is when blood and humours profitable for the nourishment of the body abound, * 1.32 and are be∣yond mediocrity. This plenitude is twofold, either as to the vessels when blood so abounds, as that the vessels wherein it is contained are stretched beyond their ordinary bigness; the other as to the strength, when there is more blood then the strength can bear; to which Horatius Augenius adds this mixt of them both, to wit, when there is so great plenty of blood as stretcheth and extendeth the veins, and so great pains, that the strength cannot bear it,

Chacochimy is an excesse of other humours besides blood, * 1.33 namely, when natural excrementious humours offend in plenty, or preternatural excrementious humours abound, and whilest either these or those putrifie, and bring in a strange nature. * 1.34

The seat of Plethory is only in the veins; but Chacochimy is not onely in the veins, but also out of them, and in the whole body, or some parts, especially the bowels.

But sometimes Plethory and Chacochimy are mixed, whence both are divided into spurious and legitimate; pure Plethory is, when there is too great plenty of pure blood and humours, with∣out any vitious ones. Pure Chacochimy is, when there is too great plenty of ill humours, and no good blood with them; but when good juyce aboundeth, and ill humours are mixed there∣with, it is called a spurious Plethory, or Chacochimy, accor∣ding as blood and ill humours do more or lesse abound.

There are many causes of Plethory, as plenty of Dyet sup∣plies matter to cause it; nourishment of good juyce, and great plenty of such nourishment: the Efficient causes are Constitu∣tion of the Body, and principally of the Heart and Liver, hot and moist, and youthful age, which may be occasioned in the Spring time, and a temperate constitution of the Air, idlenesse, moderate sleep, a life without care and paines, suppression of ac∣customary evacuations of blood,

Chacochimy according to the variety of excrementitious hu∣mours is manifold; * 1.35 for sometimes phlegm, sometimes choller, sometimes melancholly, and adust melancholly, and sometimes serous humours abound; of which humorsthere are again various differences.

CHAP. IV. Of Phlegm.

THere are divers kinds of Phlegm which are commonly di∣vided into natural and preternatural. * 1.36 Natural is a cold and moist juyce, or blood not perfectly concocted; but if we rightly observe the matter, this humour is not properly to be reckoned amongst the excrementitious humours, because the blood is crude, and may be turned into the aliment of the parts.

Of the preternatural Phlegm there are four kinds, unsavory, * 1.37 sharp, vitreous, salt.

Unsavory Phlegm peculiarly and principally may be called a Crude Humour, which for want of concoction hath not ac∣quired that perfection which it ought in the stomach; and

therefore can no where in mans body be turned into good sub∣stance.

Acride Phlegm is also crude and called so from the taste it re∣lishes of to them that void it, * 1.38 and proceeds from the defect of heat.

These two kinds proceed from the same causes, which accor∣ding to greater or lesser power they have of introducing coldness and crudity; so sometimes this, sometimes that kind is genera∣ted: such are cold meates, hard to be digested; too great plenty of meat and drink, and taken at unseasonable times, a cold constitution of the stomach, and the adjacent intrails which way soever occasioned.

Salt Phlegm, * 1.39 so called from the savour, and is occasioned by the mixture of a serous humidity, and a salt with Phlegm: whence it is not simply cold, but mixed with heat and drinesse; and as there is more or lesse of the salt humour mixed, so is it more or lesse hot.

Lastly, * 1.40 Phlegm is vitreous, so called by Praxagorus, because in substance and colour it somewhat doth resemble melted glasse; this is exceeding cold, clammy, and thick.

CHAP. V. Of Choller.

CHoller is threefold, * 1.41 Alimentary, Natural, and Contrary to Nature; but the first is not an Excrement, but the hot∣ter and dryer part of the Masse of Blood, of a different na∣ture, from that which is in the bladder of the Gall. Excremen∣tious Choller is twofold, Natural, and Contrary to Nature.

Natural is yellow, * 1.42 and is generated by Nature; and that onely is properly called Choller: it is an Excrement of the second con∣coction, and generated in the Liver, and collected into the Bladder of the Gall; it is generated out of the hotter and dryer parts of nutriment.

Preternatural is that which is not generated in our bodies ac∣cording to the law of Nature, * 1.43 whereof for the most part we ac∣count four kinds, Vitelline, Leekeblade colour, Verdegrease co∣lour, and Woad colour, or a blewish green.

The Vitelline is so called from the yolk of an Egge; * 1.44 it is yel∣low, hotter and thicker; it is generated of yellow and burnt Choller, whence it is sometimes called rosted Choller: And there is another kind of Vitelline Choller, but not so properly so called, which is neither so hot nor so yellow, which is com∣pounded of Phlegm and yellow Choller.

Leekgreen Choller, so called, * 1.45 because it represents their green∣nesse, which is often voided with the Excrements of children by the panch, and is often generated in the stomach by corrupt nu∣triment, and sometimes also in the Veins, and about the Liver, out of the Vitelline, from the great heat of the Liver, and 'tis of a venemous nature, and it is hot and very biting, the likest to Verdegrease.

The Aeruginous which comes neer to the colour of rusty gree∣nish Brasse, is generated out of corrupt aliment, * 1.46 when the heat is more vehement in the Stomach, in the Liver and Veins from the inflamation of the Liver, and the too great heat of the Veins.

Lastly, Woad colour, * 1.47 or a blewish green Choller is more deep in sense then the Leek colour, and is caused by more adust Aeru∣ginous Choller.

Aliment hot and dry, * 1.48 affords matter fit for all the kinds of Choller, and especially sweet and fat things. A constitution hot and dry, hath regard to the Efficient cause, and those things that adde to it are youth full age, Ait that is hot and dry, watch∣ing, anger, too much exercise of the body.

CHAP. VI. Of Melancholly.

THe third is the Melancholly humour, * 1.49 which commonly is distinguished into Alimentary and Excrementitious; but Alimentary is nothing else then the colder and dryer part of the Masse of Blood.

The Excrementious is twofold, Natural and Preternatural; * 1.50 Natural is that thick and feculent Excrement, which in sangui∣fication which is made in the Spleen, as is abovesaid, is collected and separated for the generation, whereof much meat conduceth, 'Tis of a terrestrious and thick juyce of every sort, especially be∣ing hardned with salt and fuliginous vapours, old Cheese, Cab∣bage, all sorts of pulse, as Pease, &c. a cold and dry constitution of air, cares, fear, sorrow.

The black Melancholly which is generated contrary to nature, * 1.51 although it be sometimes also called by the name of melancholly; yet Physitians for the most part call that Excrement which is na∣turally generated, black Juyce, not black Melancholly; but that which proceeds from adustion is called black Melancholly; and that Excrement is naturally cold and dry; but this Preternatural hot and dry, the worst of all humours.

But adust Melancholly is commonly accounted threefold, * 1.52 One is that which is occasioned by adust blood, and is coun∣ted the least; the second is that which is generated of Melan∣cholly humours if they are burnt. The third is that which pro∣ceeds from adust colour, which is of all the worst. Hence it is manifest, that although all which can generate Melancholly hu∣mours, or yellow Choller, conduce to the generation of black Choller: yet the generation of black Choller, principally de∣pends upon the too great heat burning the humours.

CHAP. VII. Of the Serous Humour, and of Wind.

AMongst the humours that are the causes of diseases, * 1.53 we are not to slight Serous Humours and Wind; by Serous Humours we sometimes understand all thin humours and watery: sometimes peculiarly we mean not those onely which are watery, but have a saltnesse joyned therewith, which Galen calls A salt serous moisture: the greatest part of this serous humour turns to Urine, and is ejected by it; yet some part thereof is mingled with the Blood to clarifie it, and make it more easie to be distributed: and lastly, through the Pores of the skin, or insensible transpiration, or sweat is emitted. Of this serous humour there is found but small quantity in the Veins in sound bodies; yet sometimes for some causes Preter∣natural, there is found greater quantity. The matter that breeds it, are Meats that contein much Whey in, and watery juyce in them, * 1.54 much Drink, Obstructions and Distempers of the Bow∣els, by reason whereof this serous matteris not rightly separated, it is deteined and gathered together, because the reins do not draw enough, and by reason of the weaknesse of the expulsive fa∣culty, and the suppression of its passages by Sweat and Urine. Of humours oftentimes are generated Vapours and Wind, * 1.55 which are the causes of many evils; windy meats afford matter for wind; so doth much drink, especially when yellow and black Choller is spread over the stomach. Also wind is generated from debility of heat, which rusheth out of the abundance of matter, that it cannot overcome it all; and that is such, either simply and in its own nature, or in respect of the matter, from the plen∣ty whereof, although it be otherwise strong enough, it breaks out.

CHAP. VIII. Of humours according to the opinion of latter Physitians, and of Chymists.

ALthough some Chymists plainly reject these things that have hitherto been said, * 1.56 according to the opinion of the Galenists; and having rejected them, they have in their stead and place put the names of Salt, Sulpher, and Mercury; yet they have no reason for it; for as Galen in his first Book of Places affected, and second Chapter writeth, That that which put, we are diseased; and which taken away, we are freed; 'Tis taken for granted by all to be the cause of a disease; but we see the hu∣mours being present we are diseased; and being taken away, we are freed; therefore humours are the causes of diseases. Yet this we grant, that humours are not confined to the first quali∣ties, but that they have in them secondary qualities; such are, bitter, acide, salt, sharp, which may offend and hurt the body no lesse then the primary, as Hypocrates of anci∣ent Physick teacheth, which he calleth the Powers and Efficacies; also the force and strength of humours. Whence Galen also, and o∣ther Physitians, call them Salt, Nitrous, Aluminent Humors, which plainly manifest themselves in many diseases, as the Gout, Scurvy, Cankers and others. * 1.57 And so such humours are not to be rejected, but to be explained by the principles of Chymists; and such things as have affinity with themselves: and hence ve∣nenate humours bred of poyson and poysonous matter, do not seem so properly to be referred to Choller, Phlegm, Melancholly; although in colour it seems to have some affinity with some of these, yet their nature is far different, and therefore are to be described by their Powers Hyppocratically. * 1.58

Lastly, of the Melancholly and black humour. It is to be noted, that by it selfe it is thick, earthy, feculent, or salt, and for the most part 'tis so much moystened by many serous and wate∣ry humours, that it becomes like unto Lee, which consist of wa∣tery adust, and salt parts; and therefore it is called by some Water.

CHAP. IX. Of the generation of Stones and Worms.

BEsides Wormes there are other things found and generated in the body, * 1.59 which are the causes of diseases: as stones and worms; that Stones for the most part are generated in all bodies; experience and the observations of Physitians do ma∣nifest.

They are generated of feculent matter, earthy, slimy, muddy, and of moisture apt to putrifie; which when the passages are straiter and narrower in the body, sticks, and of its own accord tends to coagulation and concretion.

Wormes also may be generated in most parts of the body, * 1.60 out of corrupt and putred matter, containing in it Seed, or some proportionable principle to Seed, namely, some vital principle.

CHAP. X. Of the causes of Diseases, of Intemperature without Matter.

HItherto we have explained the causes of Diseases general, * 1.61 now we will handle them severally. And First, for Dis∣eases of Intemperature: Galen accounts five sorts of Diseases of distemperature by heat; [unspec 1] Motion of the body and mind, * 1.62 which causes heat by too much stirring of the humours and spirits. [unspec 2] Putrefaction which is the cause of heat, because in putrefaction the internal heat, * 1.63 is called forth by the external, and being outward, [unspec 3] is more sensibly hot. Hot things touching our body, * 1.64 and impressing their qualities on our bodies. Co∣stivenesse of body, and Retention of the hot steeme which should passe through our Pores. Lastly, mixture with some hot thing, or hot things taken into our bodies, as Air, Meat, Drink, hot Medicines. [unspec 4] Galen in his fourth Book of the Causes of Diseases of Distemperature by cold, * 1.65 reckons these. The presence of cold things, [unspec 5] the quantity and quality of meats and drinks condense∣ing & rarifying, * 1.66 idleness and immoderate exercise: all which, and if there be any other, may conveniently be reduced into four ranks. For, whatsoever brings a cold distemper to the body, do it either by altering, and by its proper force cooling the bo∣dy; such are cold things, whether outwardly applyed to the body, or taken inwardly, or suffocating the innate heat; such are those things that prohibit the ventilation and blowing of the

fuliginous vapours; [unspec 3] or extinguish the heat by their too great a∣boundance, * 1.67 or dissipate the same by overmuch exercise of the body or mind, a hot constitution of Air, and such like, or through want of food, which poverty may occasion, or by let∣ting too much blood.

Hence it is manifest, [unspec 4] that the causes of hot Distempers when they are in excesse, become the causes of cold Distempers, * 1.68 by dis∣sipating, extinguishing, or suffocating the innate heat.

The causes of overmoist Distempers, may be reduced unto two, the proximity to moist things, or those things that hinder transpitation, and so retain the cold steem of the body.

Dry distemper is occasioned by the contrary causes, to wit, * 1.69 by alteration of drying things, and want of aliment.

Compound distempers are from compound causes; * 1.70 and if the causes of simple distempers are joyned together, there ariseth a compound distemper: yet complication of causes is not always necessary for production of compound distempers; since there are many causes which have in them double qualities, which therefore, if they have equal strength and force, cause a com∣pound distemper; so that the body be so disposed, as it be fit to receive the actions of them both alike.

CHAP. XI. Of the causes of distemper with matter.

SInce every humour hath its peculiar Temperature, * 1.71 and com∣municates it, and impresseth the part which it adheres to, The blood which is hot and moist, heats and moistens; yellow Choller which is hot and dry, heats and dryes; Phlegm which is cold and moist, causeth a cold and moist distemper; Melancholly which is cold and dry, causeth a cold and dry di∣stemper.

The matter which is the cause of distemper in the affected, * 1.72 either is collected by degrees, or else falls on it on a suddain; 'Tis collected either through the error of the Aliment, or default of the part; through the fault of the part it is collected, when ei∣ther the faculty of concoction is weak, and doth not rightly ela∣borate the Aliment, and from thence causes excrements, which either the expulsive faculty can expel, or the weaknesse of expul∣sion is such, that it cannot expel; that too great quantity, or some disease of conformation, and straitnesse of the passages, suf∣fers not the Excrements to be cost forth; But by default of the Aliment the matter is collected, when that is not good, but

such, by reason whereof great store of excrements are generated, or slimy and viscious humours are produced, that the expulsive faculty cannot expel them.

A flux is either when humours are drawn to a part, * 1.73 or sent to a part. Attraction is principally through heat and pain; not because they draw, but because they afford occasion for humours to flow to the part, to which you may adde, for the supply of vacuity.

But humours flow to the parts affected, * 1.74 though they are not drawn for two reasons; first because the humours collected in the vessels, by their own violence begin to flow into some part, ac∣cording to its situation, and its respect to the vessels. Secondly, because the parts which have strong expulsive power, tire, or de∣cay in their strength, or quality, or being burthened with plen∣ty of humours; unlade themselves, and lend that which is trou∣blesome to another part; either the whole body sends forth venc∣mous humours, or else some parts.

Yet that there be made a flux, there is required not onely the part flowing, but the part receiving, which is either weak, or apt and disposed to receive fluxions.

CHAP. XII. Of the causes of Diseases of the whole substance.

DIseases of the whole Body, * 1.75 or of Occult qualities which are in the similar parts, besides diseases of intemperature, are all produced from causes of the whole substance, or acting in a hidden manner; such are all venomous, malignant things, and such as act in a hidden manner: Of such causes some are produced in the Body, some happen to it from without.

Those which are in the body are humours and excrements, * 1.76 if they contein in them malignant and venomous qualities; as pu∣trified Blood, Seed, and other corrupt humours.

As for external causes, * 1.77 First venomous and malignant Aire. Secondly, Virulent and contagious Diseases. Thirdly, Poyson drunk, or after what manner soever taken into the Body. Fourthly, Poysons which come by the smitings, or bitings of venomous creatures, or some other way communicated to the body externally.

Venom is either generated in the Air, or else the Air receives it from some other thing; * 1.78 It receives it from some other thing by malignant exhalations and vapours, from Cattel, Marish grounds, dead Carkasses, and other such like exhalations. Poyson is

generated in the Aire, by reason of its hot and moist constituti∣on, or the occult influences of stars.

Contagion is a Granary, or if you please, * 1.79 an Affect contrary to nature, which is communicated to another body, from a body affected likewise contrary to nature. This Infection is twofold, either by touch, when the body which is infected tou∣cheth that body which is next to it; or at distance, when a bo∣dy far distant from another, by that which it emits, it infects the distant body.

Poysons taken into the body, are either Plants, * 1.80 or living Crea∣tures, or Minerals, or poysonous Metals.

Poysons which happen externally to the body, are the biting of venomous Creatures, Stroakes, Exhalations, or venomous Unguents and Powders.

CHAP. XII. Of the causes of Organick Diseases.

NOw for the causes of Organick Diseases, and first the figure of Conformation is vitiated either by it selfe, or by acci∣dent.

By it selfe it is vitiated first in the womb, * 1.81 through some error of the formative faculty. Secondly, out of the womb through vi∣olent motion, either of those things that happen externally, or those which are with us, or in us, or by the errors of our Mid∣wives, Nurses, or Chyrurgions. Thirdly, by too great repletion and encrease, and on the contrary, by Inanition, or Defect of Aliment, and lesning the due magnitude, or in default in num∣ber. By accident the figure is hurt, when any parts grow not, as they ought, but another way, through loosening of Nerves, Convulsion, Inflammation, or swelling, a Scyrrhus or hard bunch on the Liver, the cutting of a Nerve or Tendon, or by some hard skin growing in them.

Moreover to what belongs to Diseases in the Channels of the Body. Diseases in the Channel, are either in excesse or defect; * 1.82 in excesse the passages are too much dilated by something, filling them contrary to nature, and stretching them sometimes too much; But straitness of the passages is either from our first forma∣tion when our stomachs are narrower then they ought, or by re∣pletion, or when in an Empyema, an Impostumation or Ulcer is generated in the brest, and there broken, and flowes, and makes it narrower; or whilest a stone groweth in some hollow part; or by compressure, when from what cause soever a hollow member

lying under its Cavity is pressed too close, or by the closing of its outsides, or by constriction, when by too much use of binding things the stomach is contracted.

Diseases of the passages since they are in excess or in defect; * 1.83 An Anastomasis is caused first by the too great quantity, or the quality of humours initating the expulsive faculty, or the mouth, of the vessels opening themselves; moreover sometimes by Medicines, and other things which have power to relax and loosen the mouths of the vessels. A Devision is made by some gnawing or cutting cause, such may be sharp humours, or fretting Medicines, either stretching them too much, as too great store of humours, * 1.84 or else breaking them, as violent motion, clamours, heavy burthens, knocking. An opening the Tunicles of the ves∣sels is by moistning and rarefying things. * 1.85

The causes of the defect of passages, or of narrownesse of them are five; Obstruction, Constipation, Cealescence, Compres∣sure, Subsidence. The cause of obstruction is, first, that which is conteined in a passage, and is not generated, for such are thick or viscide humours, clots of blood, quitture, hard dung, stones, worms, and too great abouncance of humours.

The cause of Constipation is hard flesh; as when there is a Tumour, the flesh growes in the passage; Coalescence is cau∣sed when after a wound the walls of the passages grow toge∣ther.

Compression is made by things externally hapning, which have power by weight and violence, or otherwise, to p••esse the passages, and have strength to force them inward, as divers tumours and bones out of joynt, are amongst the internal causes; amongst the external, Bones, Con••usions, Stroakes, and such like; * 1.86 Subsidence is when the outsides of the passages, by too much moisture are made looser then they ought: to which some adde Constriction, by cooling and astringent things.

The causes of Diseases on the outside, * 1.87 or extremities of the body, are such as make it rough or smooth; rugged things make it rough, so does gnawing things, and such as dry overmuch, as sharp humours, and medicines endued with such qualities, sharp vapours, Wind, Smoak; sharp Meates, things endued with contrary qualities make the body smooth. Moist••ning things make the body soft, contrary to nature; drying things make it harder, the mixture of black humours, and such as give a tincture, spoyles the clearnesse of comple∣xion.

The cause of Diseases of defect, * 1.88 in number are either from a mans birth; namely defect of matter, or imbecillity of the facul∣ty, drawing matter, being not able to retain and elaborate the same, or error of formation: Or else after one is born, by out∣ting, burning, gnawing, putrefying, and too much cooling; either natural things abound contrary to nature, and that from our beginning, the cause whereof is either too great plenty of profitable matter, and the strength and error of the formative faculty; or after our birth, as is a Membrane, a Tubercle, the cause whereof is plenty of good matter, and by it occasion is gi∣ven of breeding an Ulcer; or somewhat contrary to nature a∣boundeth, as Warts, Stones, and such like; the cause whereof is peccant matter.

Magnitude is encreased contrary to nature, * 1.89 either accor∣ding to some dimensions only, or according to all. First, it is encreased by things contrary to nature; as by wind, as in a Timpany, and a windy Tumour; or by water, as in a Dropsie; or by the falling of one part into another, as when one is bur∣sten. Augmentation is made according to all the dimensions, by the spreading of humours over all the substance of the body, which comes to passe either by reason of profitable humours, which happens to fat people, and in the encrease of certain parts; or from an unprofitable and Excrementitious, which happens in divers kinds of tumours.

Magnitude is lessened by weakness of virtue, * 1.90 and want of suste∣nance, or by cutting, burning, gnawing, putrefaction, refrige∣ration.

Lastly, parts change their places by reason of the loosenesse, * 1.91 or solution of unity of those parts wherein they are conteined, or contraction of ligaments, or when they are violently put out of their places.

The vicinity and connexion for the most part is hurt by the same means; namely, * 1.92 if the parts by whose intervening they are knit together, are loosened, broken, or wounded.

CHAP. XIIII. Of the causes of Diseases of Solution of Unity.

THe causes of Diseases of Solution of Unity, * 1.93 although they are very many, yet all may be reduced into five ranks; for all things that dissolve the continuity of any part, either cut, or gnaw, or knock, or bend and break, or burn: those that cut are all sharp bodies, which whether edglings, or wound with the

point, as all kinds of weapons and darts, thorns, the biting of living Creatures, and such like. All sharp things erode, as hu∣mours, * 1.94 and all sharp, eroding, putrifying, burning medicines. Those that are heavy, and great, and blunt, knock, as stones, woods, * 1.95 dashing the body against hard things; which if they happen to a part that can give way to it, they bruise it; if they happen to a hard part which cannot yeild, they break it; they knock and break those things that fill the part, as plenty of hu∣mours, and store of wind, or they powerfully dry or violently di∣late the part, as dancing, and all loud singing, and heavy bur∣then oppressing, to which belong immoderate cold. Lastly, hot Irons burnt, * 1.96 and other mettals, and hot and fiery things.

The end of the Second Part of the Second Book.

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.
• * 1.12

  External Causes.
• * 1.13

  Necessary. Unnecessa∣ry. Non-natu∣ral things.
• * 1.14

  Four ranks of things non-natu∣ral. Those which are taken. Which are carried.
• * 1.15

  Which are retained and reje∣cted.
• * 1.16

  Those which hap∣pen out∣wardly.
• * 1.17

  Air.
• * 1.18

  The effect of hot Air.
• * 1.19

  Of Cold. Of moist.
• * 1.20

  Of dry.
• * 1.21

  The con∣stitution of the Sea∣sons of the year. Of Wind and of Si∣tuation. Pestilent Air.
• * 1.22

  Meat and Drink. It offends in quanti∣ty.
• * 1.23

  Manner of using.
• * 1.24

  Quality.
• * 1.25

  Sleeping and wa∣king.
• * 1.26

  Exercise
• * 1.27

  Passions of the mind,
• * 1.28

  Excreti∣ons and retentions.
• * 1.29

  Internal things, the causes of diseases.
• * 1.30

  How many wayes.
• * 1.31

  The fault of humors twofold. Plethorie.
• * 1.32

  Plethorie towfold. To the vessels. To the strength.
• * 1.33

  Chachochi∣my.
• * 1.34

  The seat of Plethory and Chaco∣chimy. Both pure and spuri∣ous. Pure Ple∣thory. Pure Cha∣cochimy. Spurious. The causes of Pletho∣ry.
• * 1.35

  The kinds of Chaco∣chimy.
• * 1.36

  The kinds of Phlegm Natural Phlegm.
• * 1.37

  The kinds of preter∣natural Plegm. Unsavory.
• * 1.38

  Acride.
• * 1.39

  Salt.
• * 1.40

  Vitreous.
• * 1.41

  The kinds of Choller.
• * 1.42

  Yellow Choller.
• * 1.43

  Preterna∣tural.
• * 1.44

  Vitelline.
• * 1.45

  Leekgreen
• * 1.46

  Aerugi∣nous.
• * 1.47

  Blewish green.
• * 1.48

  Causes of Choller.
• * 1.49

  Melan∣cholly.
• * 1.50

  Twofold. Natural.
• * 1.51

  Preterna∣tural.
• * 1.52

  Its kinds.
• * 1.53

  Serous what.
• * 1.54

  Its cause.
• * 1.55

  Wind.
• * 1.56

  The opini∣on of Chy∣mists about humours.
• * 1.57

  Venemous humours.
• * 1.58

  The Me∣lancholly humour explained.
• * 1.59

  Stones.
• * 1.60

  Worms.
• * 1.61

  The eauses of hot di∣stemoen.
• * 1.62

  Exercise.
• * 1.63

  Putrefa∣ction.
• * 1.64

  The proxi∣mity of a hot thing.
• * 1.65

  Costive∣ness.
• * 1.66

  Mixtures of a hot thing. Causes of a cold di∣stemper.
• * 1.67

  Dissipation
• * 1.68

  Drawing away food. Moist.
• * 1.69

  Dry,
• * 1.70

  Of com∣pound di∣stempers.
• * 1.71

  The causes of distem∣per, with matter.
• * 1.72

  A collecti∣on of mat∣ter.
• * 1.73

  A flux made by drawing.
• * 1.74

  Transmis∣mission.
• * 1.75

  Causes of diseases of the whole substance.
• * 1.76

  Internal.
• * 1.77

  External.
• * 1.78

  Aire.
• * 1.79

  Contagion
• * 1.80

  Poysons taken. Poysons from with∣out.
• * 1.81

  The causes of the fi∣gure viti∣ated,
• * 1.82

  Diseases of the pas∣sages.
• * 1.83

  The causes of Diseases of passages Anastoma∣sis. Diaresis.
• * 1.84

  Diapedesis.
• * 1.85

  The causes of defect and strait∣nesse of passages. Obstructi∣on. Constipa∣tion. Coales∣cence. Compres∣sion.
• * 1.86

  Subsidence.
• * 1.87

  The causes of Disea∣ses in the Superfici∣es.
• * 1.88

  Causes of Diseases in number.
• * 1.89

  Of Mag∣nitude en∣creased.
• * 1.90

  Diminish∣ed.
• * 1.91

  Of chan∣ging place.
• * 1.92

  Of Con∣nexion.
• * 1.93

  Causes of Diseases of Solution of Unity. Of cutting
• * 1.94

  Eroding.
• * 1.95

  Knocking and break∣ing. Eating.
• * 1.96

  Burning.