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SECT. II. CHAP. IV. Of a Tympanie.
ATypany vulgarly, although not properly, is esteemed a kind of Dropsie, from which rank, Prosper Martianus alleading the testimony of Hippocra∣tes, rejects as well this Disease, as an Anasarca. But the former infessting the region of the Abdomen, and raising it up into a bulk, now comes under conside∣ration next after an Ascites, (to which it is something a-kin): where first of all it is obvious, that this Disease as it is most difficult to cure, so also to be known; for although its outward form, viz. a somewhat hard swelling of the belly, very stiffe and yielding a sound like a Drum, upon touching it, is evidently perceived by many senses together; notwithstanding what may be the morbifick matter inducing that Tumour, or after what manner it is generated in the belly, or from what place it comes thither, is altogether unknown: therefore those who have a Tympanie, as though they were big with winde, are ignorant both of the manner and time of its conception. Truly I therefore judge the nature and causes of this disease to lye concealed, because whereas its first beginnings are not observed, it suddenly aug∣ments prodigiously; so that they who are affected, do scarce sooner perceive them∣selves to be sick, than that they are become almost incurable. Moreover, a Tympa∣nie, its station being accomplished, degenerating into an Ascites, or rather procuring it to its self, seems to lose its own nature; and truly after death Anatomical inspecti∣on scarce discovers any thing more in bodies dying with a Tympany, than with an Ascites. But that many Physical Authors do readily declare this Distemper to be raised by wind enclosed within the cavity of the abdomen, doth not at all satisfie a mind desirous of the truth; because it seems altogether improbable that winds should be produced so suddenly, and in so great plenty in that place; or admit they were, that so hard, unmovable and constant a tumour should be raised.
Moreover they do not easily agree concerning the seat of the disease, where the wind is supposed to be included; for some affirm that this place is determinate in the concave of the Peritonaeum, and by the convex superficies of the Intestines, and other bowels of the lower part of the belly; but affer what manner such a heap of winds can be therein collected, in my opinion it cannot be manifested by any reason, exam∣ple, or parallel instance. Besides, if the case were such, it might be more easily cured by pricking, than an Ascites by a Paracentesis; which yet I never heard accomplisni∣ed. Helmont reports a stinking wind was vented by a Paracentesis, in one esteemed Hydropick; that suddenly his abdomen sunk, and the man dyed immediately. But Platerius and Smetius, no less worthy of credit, do affirm, They discovered in some who wore thought to have the Tympaine, and dissected after death, that no wind broke forth out of the hollow of the belly, neither that it fell, but that especially the smaller guts being distended, and strutting with winde, burst out so, that they could not be put up again into the same belly.
But truly neither is this observation an argument to me, that the cause of the disease (of which we treat) remains within the Cavities of the guts, and that the winds ac∣cumulated in that place, do often or most of all raise a Tympanitick swelling of the belly. For besides that, a disease taking rese from such an occasion, would not be of im∣movable, and frequently incurable; moreover, I am induced to think, that the In∣testines are not so greatly dilated by winds shut up in them, but that they often of their own accord swelling out, give occasion to those winds consequently and secon∣darily to be produced, by which the spaces enlarged might be filled, as we shall by and by more clearly demonstrate.
But what is asserted by others, that the windes which are the cause of a Tympany, are engendered among the Coats of the Mesentery, and Guts, seems yet much more improbable; because when there is no cavity in that place preexistent, after what manner can the winds so tear those parts and separate them froom one and another so that from such formed Denns, the whole region of the Belly should grow into so vast a bulk by accumulated windes there laid up? Certainly so many and so great divulsions could not be made without continual torment and most sharp pains.