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. IV. Of an equall and unequall Pulse.

REspectively or Relatively, * 1.1 for either respect is had to the equality and inequality, or to order, or to proportion or number; equal∣lity and inequality of the Pulse is nothing else but a con∣gruity or difference of one thing in pulses when compared with another.

Equality and inequality is either simply and absolutely such; or Secundum quid, * 1.2 and which is at least in a certaine kinde such.

Absolutely and simply, a Pulse is said to be equall which neither changed in magnitude nor in swiftness, nor in fre∣quency nor in vehemency, nor in swiftness, and if equali∣ty be observed in neither of these, it is called a Pulse abso∣lutely and simply unequall; but if a Pulse keeps not equal∣lity in all these, neither is made unequall in all these; it is said according to something, and in some respect to be un∣equall, the denomination is to be taken from that wherein it observes not equality.

Moreover these unequalities againe are divided into sy∣stematicall or collective, * 1.3 which is observed in more stroaks, and singular, which is in one stroake; collective, againe is double, unequality equally, and unequality un∣equally; unequall Pulses are equally when the first is so to the second, as the second is to the third, the third to the fourth, and so forward, unequall; unequall unequally are those which are not alike in their change, neither is the first so to the second as the second is to the third.

We call an unequal Pulse equally Myouron, * 1.4 from the simi∣litude of the tayle of a Mouse, which as the taile of a Mouse from some thickness by little and little and equally tends to sharpness, so these Pulses in magnitude are lessened by de∣grees and equally, and the following stroake is alwayes less then the former, which some call maimed Pulses.

These againe are either deficient Myourn which perpetu∣ally are lessoned till at length they plainly cease to strike a∣ny more; or such as at length cease to be lesned, * 1.5 and do not plainly give off and rest; and both of them againe are vari∣ous, for some keepe that pravity to which they are come

others do not persevere therein; but returne againe to mag∣nitude, * 1.6 which the Greekes call maimed Pulses running a∣gain, reciprocall shortned, or running Pulses, and these again either return to their former magnitude, or to lesser, or to a greater.

Unequally, unequall Pulses also are various according to all the simple differences of Pulses, but the chief, and those which the Ancients gave names unto, are the intermittent, deficient, the intercedent, or intercurrent.

The name of intermittent is attributed to that in∣equality which is in pravity and rarity, * 1.7 or only rarity, namely when the arterie is so hindered in cessation, that one pulsation seems to have two or three, between two which seeme to be deficient, and after one or more stroakes, * 1.8 the intermittent begins to beat againe.

Intercurrent, or such as go between, are opposite to inter∣mittent, and amongst them after certain stroakes, one or more stroakes intervene, which causeth inequality of fre∣quency.

A deficient Pulse is when an artery after it hath made un∣equall stroakes, * 1.9 plainly seemes to be defective in motion and to cease; which if it returne to its former motion, it is called a reciprocall deficiency, * 1.10 and this is the difference between an intermitting and deficient Pulse, that a deficient reci∣procall after a long space between, whereby the man seemes to be destitute of a Pulse, returnes, but an intermit∣ting at the highest returns after intermission of five Pulses.

A singular inequality is either in one part of an artery, * 1.11 or under one finger, or more, or all; inequality under one finger is, when in dilatation and contraction a certaine diversity in celerity is observed, so that one part of one motion is swif∣ter, another part is found slower, and this inequallity Authors divide into three parts, namely an intermitting Pulse, an uneven Pulse, and a hasty Pulse, or striking double.

Intermitting in one Pulse is when the dilatation of the artery before it can come to its terme and externall rest, * 1.12 is interrupted in the middle of its motion, and is refreshed in its rest, yet so that it cannot remaine in rest but performes motion, and comes to its accustomed terme and Externall rest.

Of this kind some Authors make many differences, * 1.13 a∣mongst which the cheife is an uneven Pulse, when in the Diostile as it were in the middle of its rest tis interrupted, yet so that after rest the faculty ariseth higher and perfects motion, whence in an uneven Pulse in one dilatation there is as were a double stroke, and indeed the latter swister then the former. * 1.14

An even hasty Pulse is when the motion is continuall and interrupted by no rest, * 1.15 but the part of the distending one is slower, another swifter, as if the motion of distention begins slowly and afterwards ends swiftly, or the contrary. * 1.16

Dicrotus or a double striking Pulse is when the Artery be∣gins to be moved, but before it perfects its motion it goes back and a small contraction being made it riseth againe to perfect its motion, and strikes the second time, so that a double Pulsation seemes to be made, which neverthelesse consists of one distention or dilatation.

In equality in one Pulse, but under more parts of the Ar∣tery happens, when in one dilatation the Pulse strikes two, three, or foure fingers, but those unequally, so that in one finger the Pulse is otherwise perceived then in another, and that in a twofold manner, for either the motion is interrup∣ted, so that some fingers perceive motion, others not, or it is a continued motion, when the Artery is otherwise moved un∣der other fingers; * 1.17 and indeed those which are made unequall in magnitude in one Pulse are called Myourus, namely when the Pulse under the fore finger is greater, lesse under the second, lesse then that under the third, but if the Pulse under the middle fingers be greater, under both extreame fingers lesse, they are called prominent Pulses or Myouroy, changing about unto every part.

Out of these simple differences of inequality other com∣pound do arise, * 1.18 for either a Systematicall inequality is com∣plicat with a simple, or a Systematicall with a Systematicall, or a singular with a singular; out of which compound differ∣ences the cheife are first, a rugged or uneven, second full of surges, third when it bears as if a worme did creep under ones finger, foure that feeles as if it were a Pismire, five a serrate Pulse, six a hectick, seaven a trembling.

In an uneven Pulse whereof we have spoken before in e∣quality is twofold in swiftnesse and violence, * 1.19 for one part of the motion is swifter the other, more vehement then the for∣mer.

In a Pulse full of waves there are two inequalities, * 1.20 in magnitude and frequeney, namely when the Artery is moved, the motion not interrupted, but unequall, so that magnitude may appeare first under the fore finger, afterunder the second, then under the third, hence under the fourth; according to the manner of the waves.

The Pulses like the moving of a Worme or Pismire, * 1.21 differ from a surging Pulse only in magnitude, for there is the same inequality in that Vermicular as in the waving, but the Ar∣tery is lesse and slower lifted up, and it renders the Artery as it were into the forme of a creeping worme.

This Vermicular Pulse being lesse and slower, * 1.22 but very fre∣quent is a Formicant motion, so called from the creeping of a Pismire, which indeed makes quick steps, but goes lesse way in longer time.

A Serrat Pulse is when one part of the Artery is more lif∣ted up and strikes the fingers more, * 1.23 the other is lesse lifted up, and strikes the fingers lesse.

A Hectick Pulse is so called from the similitude of a Hectick-Feaver, * 1.24 it alwayes persists in the same in equality what ever the inequality be.

Lastly a trembling or fainting Pulse hath inequality in many Pulses, * 1.25 in magnitude, frequency, and vehemency, in the same manner, as you may observe in the panting of the heart,

Notes

• * 1.1

  Respective differences of pulses, e∣quality and inequali∣ty.
• * 1.2

  How ma∣nifold e∣quall. Absolutely equall. Absolutely unequall.
• * 1.3

  Systemati∣que ine∣quality. An une∣quall pulse equally. unequall.
• * 1.4

  Myoures.
• * 1.5

  Deficient Myouroi.
• * 1.6

  Maimed reciprocall.
• * 1.7

  Intermit∣ting.
• * 1.8

  Intercur∣rent.
• * 1.9

  Deficient.
• * 1.10

  Reciprocall defictent.
• * 1.11

  A singular nequallity.
• * 1.12

  Intermit∣ting in one Pulse.
• * 1.13

  Caprisons.
• * 1.14

  Ʋneven.
• * 1.15

  stirred up.
• * 1.16

  Dicrotus.
• * 1.17

  Myourus on Pulse.
• * 1.18

  Prominent.
• * 1.19

  Caprisons.
• * 1.20

  A surging pulse.
• * 1.21

  Virmicall.
• * 1.22

  Formicant.
• * 1.23

  A serrate.
• * 1.24

  A hectick
• * 1.25

  A trem∣bling.