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. IX. Of the causes of Pulses in generall.

THe causes of pulses are divided by Physitians, * 1.1 into cau∣ses of generation, or immediate and proximate; and causes of mutation or remote; or into primary or secundary; those they call primary which make the pulse, and which being put there is a pulse, and being taken away there is none; * 1.2 those which do not make a pulse but alter and change it are three, the faculty, or use or end; these are many, whereof some belong tonaturall things, as tempera∣ments, sex, age, habite of body; others to things not natu∣rall, as aire, meate and drinke, exercise, rest, sleeping, weaking, excretions, retentions, passions of the minde; others to preter-naturall namely, diseases, causes of diseases, and symptomes.

The causes of pulses containing, each of them have two differences, * 1.3 for the faculty is either strong or weake, the use is increased or diminished, the instruments are soft or hard, hence some pulses do perpetually arise of one cause onely, which Gallen calls the necessary consequent, others call proper, and unseparable; and such like pulses only follow the faculty and iustruments, but not the use, and of necessitie a strong pulse necessary followes a strong faculty, a weake pulse, a weak faculty; hard arteries, make a hard pulse, soft arteries make a soft pulse, some although they are made more from one cause containing then another, yet they do not arise from that only, * 1.4 but tis necessary that others concur also, which they call familiar; the familiar pulses of a strong facultie, are great, swift, thin, weake small, slow, frequent; the use increased, great, swift, frequent; diminished, little, slow, thin; a soft arte∣ry, great, swift, thin; hard artery, little, slow, thick.

Compound causes make compound differences, and some∣times

two, sometimes three causes, are complicate; first, * 1.5 a strong faculty, and the use increased; the instruments obtaining a naturall constitution make pulses, great, swift, frequent, and moreover vrhement, a strong faculty and the use lessened brings forth pulses, moderate in mag∣nitude, slower, thinness, yet vohement; from an infirme faculty and the use moderately increased comes a pulse moderate in magnitude and celerity, frequent, languishing; but if the force be very weake, the pulse is little, slow, very frequent, weake; from a faculty weakned and use dimi∣shed ariseth small pulses, flow, thick, fainty; and if there be very great debility, the very least intermittent and defi∣rent pulses arise.

Secondly, if the use and instrument be joyned together, * 1.6 the use increased with a soft instrument, makes great pulses, swift, moderate in frequency; or if there shall be great excess, frequent, and soft; the use increased, and in∣struments hard, bring forth lesser pulses, swifter, more fre∣quent; if hardness abound; but if use, greater; if indiffe∣rent, there is excess of them both; if moderate in magni∣tude, they are swift, frequent; the use diminished with a soft instrument, causeth moderate pulses, in magnitude, slow, thin, soft; the use diminished with a hard instru∣ment renders the pulses less, slow, hard: and the instru∣ment exceeding in hardness inclines the pulse to smalness, rather then to slowness, contrariwise it happens when re∣frigeration exceeds.

Thirdly, if the faculty and instrument be complicate, * 1.7 and the faculty be strong, the instrument soft, the pulses are manifestly made greater, somewhat duller, thinner, and softer; a strong faculty, and hatd instruments bring forth small pulses, frequent, and for the most part swif∣ter, namely if hardness abound, but in an equall recess of them both, the pulses are moderate in all, yet harder; a weake faculty with soft instruments makes for the most part pulses in magnitude, and swiftness moderate and soft, but in an immoderate recess, they shall be little, slow, frequent. And if the faculty be very infirme, the pulses be come small, dull, and frequent; Lastly, if the faculty be infirme with the instrument hard, pulses that are little, slow, thicke, and hard do arise.

But sometimes all these three are complicate, * 1.8 and indeed, first the faculty strong, the use increased, the instruments soft make great Pulses; swift, moderate, in frequency, ve∣hement, soft.

Secondly, if these should be complicate, a strong fa∣culty, the use increased, and the instruments hard; and that hardness be little, but the use very much increased, the pulses are made greater then is fit, swifter, and more frequent; but if the hardness be not great nor the use much increa∣sed, the pulses are moderate in magnitude, and become more swift and frequent.

Thirdly, if the faculty be more strong, the use diminished and the instrument soft, the pulses are moderate in magni∣tude, slower, thinner, vehement and soft, and if the use be much diminished, are plainly less, slow and thin.

Fourthly, If the faculty be strong, the use diminished, and instruments hard, the pulses are lesser, In celerity and frequency moderate, or also if the use be great, and that there be a recess of the instrument from mediocrity, the pulses are slower and thinner, but the hardness of the instrument abounding, there is a great recess of the use from Nature, and the pulses are small, slow, and more frequent.

Fifthly, If the faculty be weake, the use increased, and in∣struments soft, the pulses are become moderate in magni∣tude and celerity, yet more frequent, but if the power be ex∣ceedingly weakned, it makes a small pulse, slow and most frequent.

Sixthly, If the faculty be weake, the use increased, and the instruments hard, the pulses are made little, slow, and frequent.

Seventhly, If the faculty be weake, the use diminished, and the instrument soft, the pulses are lesser, moderate in frequency, or rather thin.

Lastly, if the faculty be weake, the use diminished, and the instruments hard, pulses are made small, slow, frequent, but yet not alwayes of the same smallness, slowness and fre∣quency, but according to the excess of the causes are, lesser, slower, or more frequent.

But here it is to be noted, first, that the force and power of causes are more to be valued then nuthe mber, fince one more potent cause can do more in changing pulses then many weaker; secondly, the hardness of the Artery alwayes

doth resist the magnitude of the pulse, but not the celerity and frequency; thirdly, there is no more efficacious cause of small pnlses then weakness of strength and vertue.

Notes

• * 1.1

  Causes of pulses of generation.
• * 1.2

  Of commu∣tation.
• * 1.3

  Proper and unsepera∣rable pul∣ses.
• * 1.4

  Familiar.
• * 1.5

  The sacul∣ty with the use chan∣ged; what pulses it makes.
• * 1.6

  The use changed and instru∣ment.
• * 1.7

  Faculty and influ∣ment.
• * 1.8

  Faculties, instruments and use.