Platerus golden practice of physick: fully and plainly discovering, I. All the kinds. II. The several causes of every disease. III. Their most proper cures, in respect to the kinds, and several causes, from whence they come. After a new, easie, and plain method; of knowing, foretelling, preventing, and curing, all diseases incident to the body of man. Full of proper observations and remedies: both of ancient and modern physitians. In three books, and five tomes, or parts. Being the fruits of one and thirty years travel: and fifty years practice of physick. By Felix Plater, chief physitian and professor in ordinary at Basil. Abdiah Cole, doctor of physick, and the liberal arts. Nich. Culpeper, gent. student in physick, and astrology.

The Causes.

Every Cause of the kinds of voluntary motions hurt, both of the stronger and weaker (which we call impotencies) is either in the Organ sending, or com∣municating the power of moving not in the principal the brain; for then also the internal senses should cease together with motion, as hath been said in their hurts, which comes not to pass here, but 'tis in a Nerve or the Instrument which moveth, a Muscle, or in the part which is moved, as we shal now explain.

The Nerves (under which name we comprehend both the Spinal marrow and Nerves) seeing they are portions of the brain, * 1.1 every where ful of animal spirit, which by conferring their proper substance on the parts with the spirit, do communicate the power of moving & feeling; if they be so hurt, that they can no more do that, than one or more Muscles into which they are inserted, loosing that power of moving, and no more attracting the member which it ought to move, there follows a resolution of it, or Pal∣sie, that is, it becomes languid and unfit for motion, the sound part then, as they say drawing the sick: and if the hurt be vehement the sense of Feeling also is taken away too, not only in the Muscle, but in the Skin drawn over it, which receives sensory Nerves from the same Nerve that is hurt. Or if the hurt be not so great, because greater force is required to exercise Motion, then to confer the sense of Feeling, this sense may sub∣sist either whol, or impaired, yet the Motion being taken away: as also if another cause moreover be joy∣ned there may also be felt a pain or trouble too, in the part (although it be immoveable or hardly moved) as we shall now describe, both what Nerve, and by what Disease affected, doth produce the diverse Species of Palsies.

This hurt of the spinal marrow often happens, see∣ing it is very much exposed to external injuries, and because it lies under the Brain, fit to receive its ex∣crements; which if it be affected in the beginning of its passage made by the Brain through the Back-bone, next to the Brain, by depriving all the Nerves, which spring from that, of the Animal spirit, it makes a ge∣neral Palsie, in which all Voluntary Motions cease, as well the stronger of the Body, as the weaker of the parts of the Face. And besides these, Breathing, the Voice, and Speech, Swallowing also, and some Mo∣tions of Excretions do suffer some hurt, as hath been said, if the hurt be neer to the Brain and great: because the Conjugations of the Nerves do issue forth there from the beginning of the spinal Marrow, and then also are hurt, as shall be said by and by; but if in the rest of the progress of it, there happen any such hurt to the Back, then by taking away that faculty from those Nerves only, which are under it, it makes those Mem∣bers Palsied, into which they are inserted; by whose hurts it is easily known, where the cause lurkes in the spinal Marrow; which in what place soever it is, if the hurt be in both sides, the cause is in both, if only in one (as the spinal Marrow is perceived to be truely distin∣guisht) the Cause only in that side, makes a Palsie, and by so much the more general, by how much that is af∣fected more towards the Original.

If paires of Nerves proceeding from the Spinal mar∣row be hurt, then according as a general Nerve com∣municating Nerves to many parts, or a special one communicating to some only, is seazed with the Dis∣ease, more, or one part suffers a resolution; by which also we shall easily find out, what Nerves are affected, if we know which are communicated to every part: and hence many Particular resolutions may be made in the Members, which have received Nerves from the paires of the spinal marrow, yet not in all, because the Mus∣cles moving the Breast especially the Midrife, and those of the Belly also being compeld by a necessity of brea∣thing, especially seeing breathing is caused also by the help of natural Motion do nevertheless perform their office in the palsied, in respiration and casting forth of Excrements; hither also makes somwhat, that the Midrif doth receive Nerves not only from the spinal marrow, but also from the conjugations of Nerves as shall be said, as we shall declare things further in the defect of Respiration; besides which parts, the rest which are moved by the Muscles, may suffer a resolu∣tion.

The Contractions of Nerves derived from the Brain that do communicate Motion, if they suffer a Disease, then that part is hurt, to which the Nerve hurt is pecu∣liar, and by the Palsie of the part, the Nerve affected is known; as if that called the second Conjugation of Nerves derived to the Muscles of the Eye be affected, there is a Palsie of the Eye, the which nevertheless can

scarce be done in this Nerve unless the neighbouring Brain be hurt, as it comes to pass in an Apoplexy, but as more commonly the Conjugation of Nerves carried to the Face, Lips, Ey-lids and temporal Muscle, being affected, there is a resolution of the Lips and Ey-lids, but seldom of the lower Jaw; seeing the Temporal Muscle doth receive more Nerves: and if the Nerve of the Tongue, called the third Conjugation doth suffer, the Tongue being Palsied, the Speech suffers a blemish and then commonly by reason of its communication with the Auditory Nerve, if the hurt be so great that they become wholly mute, they are Deaf also: The same may happen in that conjugation of Nerves, which they call the sixth and seventh, which falling from the Brain, and joyned into one descending Nerve, and communicating the sense of Feeling to many Interiour parts, and giving also Motion to the Muscles of the Laryux, Tongue, Jaws, Midrife; also to the Muscles of the Bladder, Fundament, if it be hurt about the original or somwhere also in its Progress, it breeds Palsies of the parts into which it is inserted, if they be moveable, in others a certain sense of Stupidity, and hence if the re∣current Nerve be affected, there is a defect of the Voice and Speech, if the Nerves which go to the Muscles of the Jaws be hurt, seeing swollowing is caused by them, and not by the Fibres of the Oesophagus, as they have thought, there follows a difficulty of swallowing, and also there comes some Impediment in Breathing, if the Nerves which go to the Midrife be hurt, and that espe∣cially in violent sending forth the Breath, when they would utter a great Voice, or are compeld to Cough, for then not being able to express it, they come into some danger of Suffocation; because otherwise for the perfecting of moderate breathing, the Midrife which causes it, seeing it doth receive also from the Spinal marrow, as hath been said, it can nevertheless in some sort perform its office, although these Nerves be hurt; in which hurts of Motions, an offence of the sense of Feeling being joyned, that sense of heat and tingling doth so much molest the sick about the Stomach, espe∣cially where the Nerves are greater, and about other internal parts, as hath been said; but if there be a cer∣tain general hurt of the same Conjugation; because then both the Sphincters of the bladder and Anus, and the rest of its Muscles are Palsied, an involuntary Pis∣sing moreover, and a relaxation of the Fundament, is coupled with the other Species of a Palsie, as we shall explain all these more at large in the defect of brea∣thing, and of Excretions, and in the difficulty of swal∣lowing.

But the Disease with which the spinal Marrow or Nerve is possest, * 1.2 is that, which deprives it of the Animal spirit, which it hath need of to exercise its Function; for being so affected, it can neither any more communicate to a Muscle the power of moving, nor to the sensible parts the power of Feeling, if the Nerve be wholly destitute of that, and the remaining part of it from the place af∣fected even to the part, into which it is inserted, be∣comes unprofitable. As it comes to pass, if its conti∣nuity with the part be broken, for then this passage is interrupted: or if the Nerves be so straiten'd, that the Animal spirit, which requires a free passage through them, can no longer pass through them, or fil them up, or not sufficiently; seeing, though it be most thin and subtile, and doth Illustrate the Nerves like the rayes of the Sun, yet nevertheless it may be hinderd, as the Sun Beams also may: as this happens if it be so prest in any part of it, that its substance doth wholly sink down, or if its substance be so condensed that also by this means the passage for the spirit is intercepted. And also the same may fal out, if some part of the Nerve do so labor of a distemper, that it can no waies perform its Functi∣on; as how these Diseases, viz. A Solution of Conti∣nuity, a Straitness of the Nerves, a Condensation and simple distemper, or with an Afflux of Humor, and Repletion, or with a preternatural Tumor, or some fault of the Organ do proceed from Internal or Exter∣nal Causes, to wit a Flegmatick humor, or Bloody. or from a distemper, or some hurt by Compression, Ligatures, of from a wound, or some other blow, we will now expain.

As it hath been explained in the Causes of an Apo∣plexy, that an Apoplexy which is a Palsie of the whol Body, is generated from Flegm or a Watery, Serous, Cold, moist Excrement of the Brain, bedewing the brain or pressing the original of all the Nerves, so if this happen in the Nerves a Palsie is generated; for such a humor, heaped up plentifully in the Head, for the causes there assigned, and cast off from the Brain in an Apo∣plexy which it hath first produced, or without that, fal∣ling down from the Head, not though the substance of the Spinal Marrow, or Nerves, but either discending through the Cavity of the Vertebraes of the Back, which doth contain the Spinal Marrow, and there stopping about the beginning or progress of it, or sliding down further through the passages, which the paires of Nerves proceeding from the Spinal Marrow do every where run through in the Body without any Connexion, or falling from the Head and following the like passages of the Conjugations or pares of Nerves and somwhere sticking about the Nerves, in what place soever this happen, whether about the Spinal Marrow, or about the paires or Conjugations of Nerves, by compressing or bedewing them, as if this come to pass in the Brain it procreates an Apoplexy, so if it happen in the foresaid places it produceth a Palsie, of more or fewer parts, according as a general or particular Nerve is affected: whenas if plenty of Humor flow thither, in those nar∣row places compressing the Nerves with its weight, it may also intercept the passage of the Animal spirit, as hath been said formerly, and by so much the longer, if being detained there by a long stop, it become thicker and Mucous; but principally because by its moisture it continually bedewing, filling, and cooling the sub∣stance of the Nerves, it destroies their proper temper in that place, and hinders that they cannot be filled with the Animal spirit, nor enjoy it: whence also by reason of the interposition of this unprofitable part of the Nerve affected, the other part of the Nerve which is carried to the parts, being also made unsit to exercise its Function, there must needs follow, if the hurt be great, a perfect resolution of the parts unto which these Nerves are communicated, and that by so much the more lasting and pertinatious, by how much the hurt of the Nerve is greater, which we have found by disse∣ction to be the true cause of a Flegmatick Palsie, the spinal Marrow being swelled up with a watry Humor, that there is no need to phansie here any obstruction in the Nerves which are solid, or made up of Filaments; nor any Cavity which may admit that thick humor, as some do write. Or if indeed they do grant this moist∣ning of the Nerves: yet to assert that that comes to pass by this means, because the Nerves being made longer an slacker, they become unfit for motion; be∣cause as hath been formerly said, the Nerves do no waies attract the part; and far less to contend, that a Palsie is from the same Flegm as obstructing the Nerves, for filling of them, so it must needs be that Convulsions

do ensue, which we call Contractions, and for that cause to assign the same Cure to them both.

But also such an excrementiti∣ous humor from elsewhere than from the Brain, * 1.3 being carried to the Nerves of certain parts, or heaped up there, doth induce a Palsie proper to certain parts; which oftentimes also mixt with other acrid and chole∣rick humors, or otherwise putrifying, not only by be∣dewing but also by irritating the Nerves doth cause pains offering themselves with the resolution of the part and sometimes ending in Convulsions as this hath been said in Convulsions; such a kind of Palsie as hath be en explained in the kinds, as is wont also to happen in Colick pains, with torments of the Limbs, Heat, Tingling, and other troubles.

The same might come to pass from Blood out of the Vessels falling into these Cavities of the Nerves and retained there a long time; but seeing that doth pre∣sently putrifie it doth sooner breed an Inflammation, as also if it insinuate it self into the substance of the Nerves, whence other accidents do follow rather than those of a Palsie: but in the Veins if from a fulness, or non-natural situation of a Member (as if the Arm be held a long while lift up on high) the blood be carried into one place more plentifully, because then in some sort it presseth a neighboring Nerve, seeing the Nerves are alwaies wont to follow the course of the Veins, it rather causeth a light Numness or Tingling, than any Disease or long continued Palsie; the blood easily go∣ing back again, and not so stopping, but as in the brain it is abundantly powred forth into its ventricles, it may may cause an Apoplexy as hath been said there.

Also a streightening may be caus∣ed from a hard Tumor of a Nerve, * 1.4 as from a Callus or a Skar after a Wound, or bruise growing in the Nerve, or from a bunching out ari∣sing from the proper clammy Nutriment of a Nerve which doth stop its animal spirit; but from an Oede∣ma, which also they hold to be the cause of it, that can∣not be done, unless some one would call it Irrigation and swellings of the Nerves, as hath been formerly said, an Oedema; the same also may happen from the Tumors of other parts pressing a Neighbooring Nerve.

By the fault of conformation or shaping from the birth, * 1.5 the Nerves being not rightly formed or other∣wise carried, the same also may come to pass, which often happens in the Nerve of the Tongue as we shal by and by explain in the defect of Speech, that they are born Dumb and Deaf, as hath been said in the hurt of Hearing.

From a Cold Distemper, or too much cooling (as we shall by and by explain in the Muscles) if not only the Muscles but also the Nerves themselves with the Muscle into which they are inserted, * 1.6 or without that, in their course out of the Muscle, seeing Cold is a very great enemy to them, be so affected, that they are either bound up and condensed by Cold, whence the animal spirit hath no longer a free passage, or be so hurt, that their function perisheth, then also there follows a Palsie of those parts whose Nerves are affected.

Trallian teacheth that there is a Palsie caused from driness and heat, * 1.7 which certainly must needs sall out so, if it be such as may harden the Nerve that the spirit can pass through it; as the same may come to pass from the Causes to be explained in the exiccation of the Muscles.

A vehement and lasting pressi∣on of a Member, * 1.8 caused by a hea∣vy burden, or some other force, especially in that place where the Nerves are greater or lie bare un∣der the skin, first of all the spirits being repulsed, hin∣dred, and running up and down, induceth the sense of Tingling in a stupidity, by and by an abolition of mo∣tion, and at length a perfect stupidity in the part, into which the compressed Nerve is inserted; this often comes to pass when at rest, especially in the time of sleep one part lying long upon another, as the body on the Arm, one Foot on the other, and pressing the same it renders the part immoveable and insensible and as they call it asleep: but if that this compression be sud∣denly caused with a strong blow of a Nerve, then there is only felt some stupidity yet mixt with pain and a sense of Tingling; as this is often wont to fall out by chance in the stricking of the Elbow there where the Nerve lies almost bare; and in the Ring-finger and little finger.

In vehement Ligatures of the Members, chiefly if a Nerve be contained in the bandage, the motion and sense of Feeling of the part do cease, as also the recur∣rent Nerves being bound we shal shew that the Voice doth perish, by and by in the defect of Speech.

The Vertebraes being luxated and the Bones of o∣ther Joynts, if the neighboring Nerves be there prest, a Palsie followeth; the which yet can scarce be done, because they easily give way, as also other discommodi∣ties do ensue, as in the luxations of the Vertebrae of the Neck, Impediments of Breathing and Swallowing, as we shal explain in their hurts; but in the other Verte∣brae of the back, unless there be so great a luxation as doth vehemently press the spinal Marrow, there is no Palsie caused; as we see some Gibbus in whom many Vertebrae luxated do cause a crookedness of the Back, which the marrow that is within it doth follow with∣out a compression, that they are yet no waies Palsied; unless by chance one or two Vertebrae being vehe∣mently forced forth, making an acute Angle in the Back, do press it, the which scarce can be, by reason of the firmness of the Back.

A Nerve being cut off by a Wound; * 1.9 because then this continuation with the part is wholly taken away, the Member becomes Palsied and Insensible also, unless it receive sense from other Nerves that are yet unhurt; the which also a Contusi∣on of it doth often cause, the Nerve being so hurt and filled with blood, that it becomes unprofitable; whence the spinal Marrow being so affected by a fall there of∣tentimes follows a general Palsie, but at other times the Nerves being Contused elswhere, a particular Re∣solution, oftentimes also after a Contusion, a Callus being left being left behind it, that happens as hath been said.

Also from the Nerves affected, Convulsions, * 1.10 or particular Cramp∣ings of the Members may be caused, not being filled with flegm (as they would have it, and have written that from the same humor sliding into the Nerves divers Diseases may be produced, and that both a Palsie and Spasm may be caused) but being irritated and molest∣ed from the same causes as hath been explained in an Epilepsie, yet not being so grievosly hurt, as to draw

the Brain into consent, for a general Convulsion or E∣pilepsie would be caused, as this somtimes follows this particular Spasm, especially if the greater Nerves be affected, and the hurt be grievous: in which particu∣lar Spasm also, as in a Palsie according as more general or private Nerves are affected, as there happens a Palsie so here a Convulsion of more or fewer parts; and the parts of the Back being affected, it manifests its self here in the inordinate Motions of the Back, Arms and Hands; which doth either very much Convel and Attract these Members, in that called a true Spasm of them, or only lightly draweth the Fingers, Hands, Armes, or other Members and relaxeth them again, in a Convulsive Palpitation, therefore so called because it threatens true Convulsions. Also the Conjugations or pares of Nerves being molested, it often causeth that diseased crookedness and distorsion of the Mouth which they call a Dog-like Spasm, or also that light Species of a Spasm, which happens unvoluntarily to those that Cry and Laugh, and that from a too great affection of the Mind, the Spirits being poured forth thither with the Tears and forcing the Nerves; as how this comes to pass, and that from this cause, only more grievous Convulsions do arise, hath been explained in the cau∣ses of an Epilepsie, and Catalepsie; although these also generated from other things do produce not only that Spasm raised in the Mouth by the affections of the Mind, and ceasing by and by, as they remit, but also a lasting and dangerous one; such as that Sardonius Laughter was, described by Cicero, that killed folkes; the which also being Supervenient in a general Con∣vulsion together with other things, is accounted for the worst sign, and oftentimes when the Paroxysm is off, it remaines stil, by reason of an Alienation of the Mind as was said in an Epilepsie: and also this Particular Convulsion presents it self not only in the foremen∣tion'd hurts of Motions, but also in others, and in the Motions of Breathing and Excrements, if the Nerves destined for them, be affected; amongst which that difficulty of swallowing which the Chyrurgions cal the Stomach Spasm, and which they so much fear in woun∣ded People, is wont to be very frequent: as these shal be explained more rightly in their proper places.

A Muscle, seeing it is the instru∣ment of voluntary Motion, * 1.11 which moves the Member, if it be so affect∣ed, that it can no more attract the Member, then there is a resolution or Palsie or if its Disease be such, that the Member be drawn against our will, then there follows not a Convulsion of it properly called, which we have said was only caused by reason of the Nerves, but ei∣ther a Convulsion improperly called, viz. a Flatulent Cramp, or that called by us a lasting and strong con∣traction of the Member, which certainly a Nerve, so smal a chord, if it be compared with so heavy a Mem∣ber, cannot effect, but so may a Tendon of a Muscle that is so strong. But after this manner the Muscles almost proper to every part are hurt, whence also only Particular resolutions or contractions of those parts do ensue, or of one part only, if its Particular Muscle be hurt, or of more, if one Muscle send Tendons to many parts, yet somtimes also many Muscles being affected together, also these more general hurts of the parts which they move, do follow; the which may come to pass by reason of the neerness of the Muscles, and be∣cause many being collected together, in certain places they are as it were included in one Membrane, as shall be said; which hurts, whether of one or more Muscles they depend on these causes; to wit, if they be possest with a Humor or Wind, or suffer a Preternatural Tu∣mor, or are wasted being dried up, or suffer a cold distemper, or are hurt some other way, or have con∣tracted an Organical fault.

From a Humor filling up the Muscles, or Besmearing them, * 1.12 or Insinuating it self into their spaces, a Palsie is seldom ingendred, as it is frequently if it possess the Ner∣ves, as hath been said formerly. For if a Flegmatick, serous, or Excrementitious Humor flow down to the Bodies of the Muscles, or be heaped up there, then it breeds pains, and for that causeth that the Member can scearcely be moved, rather then a languishing or insensibility of it, as we shall explain in pains arising from Desluxions; the which also if Blood be there poured out of the Vessels, happens together with an Inflammation of the part; yet somtimes it comes to pass, that a watry humor, a long time washing and bedewing the Tendons of the Muscles, they being too much relaxt, and lengthend, there followes a Palsie of that part, which they ought to attract. Which for the most part happens only in those places, where many Tendons are carried in a fleshless and narrow place, about the bending of the Joynts, being bound and joy∣ned together with Ligaments as it were with Rings, as in the Region of the Wrist and instep, where somtimes a Humor retained by reason of the narrowness of the place, and many spaces of many smal bones, combi∣ned together in the Wrist and afterwrist, Ankle and In∣step, and moisting and relaxing the Tendons it causeth that the Hands or Feet do continue Palsied in some all their life time: and it ceasing in other parts, only a Pal∣sie is left in these, even when the Humor is wasted, the Tendons remaining longer then is fit; whence all their life time, they carry their Hands and Feet hanging, and when they endeavour to lift up, or lay holdon any thing because nevertheless they can move their Fingers or go, yet because they cannot do that by benefit of the Muscles, they are wont to cast them up on high, by the inpulse of the Arm or Thigh; in whom also for the most part appears an eminency as it were a certain Tu∣mor in the superficies of the Wrist, arising by reason of Extenuation which is wont to be its companion, the bones bunching forth there, or by reason of a Callus or Node, which often grows here, for the causes after∣wards to be mentioned; the which our Germans call Contracted, when notwithstanding they are Palsied; and that perhaps because, as hath been said formerly, with a Resolution of them caused about the Wrist, there is somtimes also joyned a Contraction of the Fingers: which comes to pass, because in the Hands laboring also of an Atrophy by reason of the compression of the Veins, which about the streits of the Wrist are prest by a Tumor, and are cooled in those bloodless parts, so that for those causes there is not sufficient passage for the Blood the Ligaments and Tendons also being wasted and dried do cause, that those Joynts of the Fingers be at length stopt, but not the Joynts by which the Hand is moved, which were already Palsied before: and thus in the same seat are found, parts Palsied, Con∣tracted, and wasted.

From the same Flegmatick or Watry, or Excremen∣titious Humor, so filling up the Body of the Muscle or Tendons, that being distended and made shorter, it attracts the part into which it is inserted, it seems that a Contraction also may be caused. But when an Humor fallen down to the Muscles possesses their spaces, by which they are joyned together; a pain rather doth follow, and upon that account that difficulty of mo∣ving

the Member than Contraction of the part, and if it bedew the Tendons or Nerves, a Palfie rather en∣fues.

After the same manner from Wind breathing in, * 1.13 not into the bodies of the Muscles, but those Spaces which the Muscles make being joyned together, or knit to∣gether by neighboring parts, and by its plenty distending one Muscle or more, so that being made shorter, they attract the part for a while, violently to themselves, doth that Cramp which there∣fore they call Flatulent, arise; as many have delivered which most strong extension of the member yet can scarce be caused from Wind only, as we shal shew that called a Flatulent Palpitation doth frequently arise from thence, unless some other cause over and above be joyned, of which we shal speak by and by in the too great attraction of the Muscles which as it happens of∣tentimes in divers parts of the body, so most common∣ly in the Toes of the Feet, the fleshy Muscles of the Calfe being then affected with the highest pain by reason of their distention, and protuberancy.

But this Flatulent Spasm is caused by plenty of Winds, the Largeness of the passages, or foresaid Spa∣ces betwixt the Muscles especially helping, being fit for the receiving of Wind; which happens to some either by Nature, the which also are more obnoxious to this evil. Or if it falls out from a vehement motion of the Muscles, for so, being as it were pulled from one ano∣ther and from the neighboring parts, the Spaces which come between them, by degrees become wider, especi∣ally if such motions be often repeated, into which af∣terwards Wind doth easily slide in and for a light cause, especially whenas the Muscles being very much con∣tracted in motion, doth make way for it, as shall be said by and by; as in Hides Excoriated we easily know that such like Wind doth lie betwixt the Mem∣branes and the Flesh by the Bubbles appearing there.

A hard preternatural Tumor growing in a Muscle as some∣times it causeth that they keep the Members attracted to it, * 1.14 so sometimes bound up: as a Schirrus or Node gendred from the excrements in the Muscles, and especially about the Tendons where many meet in the Region of the Joynts, as hath been said formerly of the Wrist, and I have seen somtimes come to pass in the Knee, the Foot being then so drawn upwards, that the Heel was next to the Tail. Also a Callus in a Muscle or a Tendon being left after a Wound, by which they were wound∣ed yet not wholly cut in two, and contracting the Lips of the Wound, because then it shortens the body or tail of the Muscle, it causeth that part into which it is in∣serted, is more or less bound up; the which also I have seen come to pass in a hurt of the temporal Muscle, and the Mouth then was so drawn up, that it would scarce admit the most liquid meats.

The Muscles or their Tendons being dryed, * 1.15 and with them som∣times the Nerves inserted into them being so far wrinkled and bound up, they are become as it were Hardned and Callus, that they cannot be extended or bent; then in what situation they remain firm, in the same also they keep the Member which they are implanted, fixt and immoveable, and more or less Contracted; as of∣times we see by reason of Old Age or of too much and long continued labour, some parts to become Stiff and diversly crooked, and those especially which have been much and long exercised with too much working: and that they go with a Crooked Back, and cannot raise themselves up streight, who have a long while carried heavy Burdens, and that they have Crooked Fingers and Hands, who have too much used their Help, or that Old Folks do labour of a Tetanus, or other species of Contractions: the which may come to pass not alwaies by reason of the Joynts as shal be said afterwards, but also from the foresaid Exiccation of the Muscles, their Humor being then Wasted by the forementioned causes, so that being consumed by Leanness (the which appears manifestly in the Mus∣cles of their Limbs, especially in the greater even out∣wardly) their bodies and Tendons seem to consist ra∣ther of Fibres than Flesh, and to represent dry Cords, not soft Nerves: which Driness is helpt by the defect of Fat, which is wont first of all to be wasted by the said causes, whenas it growing both Extrinsecally to their Membranes, and being Intrinsecally inbred with the Fibres of certain greater Muscles especially, anoyn∣ting them that they may the easier be extended and contracted in motion, but if they be deprived of it rendring them unfit for motion, also the Consumption of the Glue with which the Tendons upon the same account are wont to be smeared, from the same causes, for which the Humor and Fat do fail; which Exicca∣tion we have demonstrated doth depend on an Atro∣phy, formerly in a pituitous humor possessing the Ten∣dons of the Wrist: the which also may happen from a vehement Heat from without, through great Heats if either they persevere long, or are so powerful, that they burn almost, the Tendons and Muscles rather the more membranous than fleshy being then bound up from thence: But there can scarce be such an Exiccation of the Muscles from internal heat even in the most burn∣ing Feavers, seeing in Hectick Feavers, the body being otherwise almost reduced to a wasting, the members do not appear contracted by reason of that, unless by chance this happen in the Midriff and in the Tongue, the which being dried, as shal by and by be said, its Function also is weakened, as we shal speak of in the Breathing hurt: for that the Convulsions also which follow these Feavers, which we have said do very much differ from Contraction, do not proceed from the Exiccation of the Nerves as they would have it, but from their Irritation, hath been explained in an E∣pilepsie.

The Muscles being very much Cooled by an external cause, * 1.16 so that the native heat being laid a∣sleep, their Function is weakened, then either they cannot rightly move the member, or scarcely, as it oftentimes hap∣pens in the Hands and Feet, parts more exposed to in∣juries by reason of the Air, Wind, Water, Cold, that then they cannot rightly lay hold on things with their Fingers, they being either numed together, or affected with a great pain, manifesting it self about the roots of the Nails, as hath been said elsewhere, but also they think that Spasm is caused by cold which is wont to betide those that swim in very cold Water, by binding up the Muscles and Tendons, the causes of which ne∣vertheless we have expounded to be other, the which notwithstanding this may help.

The Muscles or their Tendons being Cut, * 1.17 or only Wounded a little way transversly there fol∣lows a Languishing or Palsie of

that Member which they ought to draw, which as it happens in divers places of the body, it doth bre••d ma∣ny sorts of Palsies; so if it come to pass in the tem∣poral Muscle, the lower Jaw is Palsied.

Moreover the Tendons of a Muscle being too much Extended by a violent motion, * 1.18 so that being as it were drawn asunder they be∣come longer than is meet, it comes to pass that afterwards they cannot sufficiently elevate the Member, and because then they hardly recollect them∣selves again, the Evil becomes lasting, which somtimes happens in the Hands by lifting up heavy burdens, in that strong streining: as also I have seen it happen in the Joynt of the Knee, being so forced by violence, that the many Tendons which meet there, being dissevered by that violent and sudden motion, and become long∣er, or freed from their connexion with their Liga∣ments, they could no more afterwards rightly bend that part, and the Patients have afterwards remained Limping.

And also an Attraction with vi∣olence oftentimes befals the Mus∣cles and their Tendons, * 1.19 that they being too much bound up, be∣yond their term, or otherwise di∣storted or bowed, or somwhat de∣clining from their natural situati∣on, so that they cannot be relaxt again presently, they draw the Member beyond a mean figure, and that Spasm is caused which so often seazeth on men for a time, when they extend their Members violently or with an inordinate motion: as it more commonly happens in the Feet when they put on their Shoes with pain, or Swimming in the Water, they stir them after an unusual manner, in which Spasm a Prominency of the Muscle appearing, and vehement pain, doth suffi∣ciently shew that it is wound up by contraction, and too much streightened in it self, Wind then also break∣ing into that Space, which it causeth by its elevation, as hath been said formerly, and helping its distension; and that so long til the Muscle being relaxt again, the Spasm doth cease again: which is the sooner perform∣ed by the opposite Muscle drawing the part which the Muscle fastened to it doth follow; the which never∣theless, if the part be disposed as hath been said former∣ly in Wind, and there is plenty of Wind, it is wont sooner and the easier to return, and somtimes to molest men not only in some one place, but in many places; which every one, if he rightly consider the business, may know to be the true cause of the Cramp that doth so violently and with pain extend the members: see∣ing the true Spasm which is caused by reason of the Nerves sometimes in these or other parts, cannot ex∣tend the members so violently, or cause so great pain, as when it ariseth by reason of the Muscles.

But also if this Organical Disease from inbred causes be∣fall the Muscles or their Ten∣dons from the Birth, * 1.20 that in more or fewer places, they are longer or shorter, there follows ei∣ther a Languishing, or Astriction of those Members: as we have seen some Born with a Rigid or Bowed back, or contracted in other parts, or also palsied.

The parts which are moved in voluntary motions, are the external Members strengthened with Bones, which do perform strong motions, as hath been said; in which if the cause of immobility consist, it is for the most part in their Bones or Ligaments and Cartilages, and the parts of the Face that exetcise the weaker mo∣tions, as the Lips, Eyelids, the Eye; whose faults which are prjudicial to their motions, now we wil ex∣plain in particular.

If the Bones be so affected, * 1.21 that they cannot be moved out of their place, then neither can the part which is composed of them and strengthened by them, fol∣low; which comes to pass from an emi∣nent hurt of them, they being broken or cut off, or Contused, or otherwise prest by some weight; or if they be dislocated in the Joynts, in which they are joy∣ned together for the exercising of motion.

The Bones then of the movea∣ble parts being broken or cut off, * 1.22 or contused, or prest (for concer∣ning other hurts of them we shall treat elswhere) it comes to pass, that first of all if they be broken and wholly broke off, then though part of the broken Bone, into which the Muscles and Tendons are implanted, be attracted (the which can∣not be, by reason of the pain which is present, and is encreased by the least motion of it) seeing the part broken off doth not follow, the part can no waies be rightly moved: the which soonest comes to pass in the long and round bones of the parts which are mo∣ved, the which are the easier broken, if they consist on∣ly of one bone, and then if the Fracture be so great, that the ends of the bones broken off do part from one another, that portion of the Bone which grows to the Tendons, which are alwaies retcht, being drawn up∣wards, seeing nothing doth resist, there follows an ab∣breviation of the part, as it often comes to pass in the Bones of the Thigh, Arm, and Fingers, but in those parts which are strengthened with two Bones, that this may come to pass, they must both be broken and diffe∣vered after this manner, whenas if one only be broke, the other doth yet sustain the part, and therefore there follows no shortness of it, neither would the motion of it then be taken away, unless pain did hinder it; as in the two Bones of the Leg and Elbow this somtimes happens; and in the distinct broad Bones of the lower Jaw, it may fall out on both sides, or only on one side: but if the part be compounded of many long Bones, as in the Instep and Afterwrist, seeing all of them are scarce broken together, pain (as long as it lasts) ra∣ther than an Organical fault, wil then hinder the moti∣on: also if short and thick bones be broken, then also by reason of pain, the motion is so long hindred; as when the Vertebrae of the Back have been broke off, as I have once observed it, seeing the bodies of them can scarce be throughly broken, as neither no other small Bones. Yet the Ankle being broken (which I have seen by chance wholly pul'd in two in the middle) the motion also is taken away of it self, and not only by reason of the pain: and if this come to pass in the Knee-bone, which in some I have oftentimes noted to be broken into two parts very much separated and distant, then seeing the Knee doth no way constitute the Joynt, but because the Knee-pan only doth retain the wandring Tendons, that they turn not aside, the motion of the Joynt suffers an Imperfection.

All which forementioned Bones both long and short cut asunder in like manner by a Wound do produce the like Impotency in Motion for the same rea∣son.

As from a Contusion of them, as long as the Pain molests, the motion is hindred by reason of that rather

than any thing else, unless there be a Fracture, the which is wont somtimes to happen in the Vertebrae of the Back, and in the lesser bones of the Wrist and other smal ones of the Feet.

All which, as well Fractures, as Wounds and Con∣tusions, do befal them from a violent cause comming from without, as from a blow or fall: also from cor∣ruption of the Bones, by a Sphacel, not only of the lesser, but also of the greater. We have seen some parts of them so eaten and corrupted, that the bones have fallen, as if they were broken, and have been rendred unfit for Motion, and that both by reason of the French Pox, and other causes; as also we have observed from the Cancer of the Gums, that part of the lower Jaw toge∣ther with the Teeth, hath been taken out on one side, and the Maiden which suffered this, could nevertheless chew her Meat.

And also the bones being burthened by a weight, Flesh, or Fat, they follow more slowly to move.

Two Bones being Dislocated which mutually joyned and bound together with Ligaments, * 1.23 do form a Joynt for Motion: if this happen in the Joynts which are moved by an apparent Motion by a Diarthrosis, then this Immobility will be more manifest, and more prejudicial, especially if the Luxation be great; which comes to pass, if the Head of the Bone do wholly fal, forth of its socket, and then they call it an Exarthrema for jf it be only carried to the Brow of it, then the Lux∣tion is lighter, and tis called a Parathrema, which some call only a Separation, both which if they happen in the joynts, joyned by an Enarthrosis as of the Thigh with the Hip, and the Head falling out of its receiver and thrust to the upper parts do stop there, retained by a Lax Ligment, the Thigh also is shorted, and there is an apparent prominency in that part; the which also happens if it be carried to the hinder or utter parts; for if it be led to the inner or fore parts, because it subsists about the brows then the Foot rather becomes longer. And if this come to pass in the Joynt of the Arme with the Shoulder, as it may the sooner be by reason of its plain socket, the Arm for the most part fals down to the lower parts under the Shoulder, and then the eminency of the top of the Shoulder is lost, and in the place of it a hollowness doth manifest it self; and if the Jaw be Luxated after this manner, it makes that mouth open, fixt, and crooked, if the Luxation be only in one side: the same may happen in the Joynts, composed by a Gynglymus, their Heads and Sockets going a part, to to this or that side, as in the Leg with the Thigh and Feet, in the Luxations of the Elbow with the Shoulder and lower part, and of the Joynts of the bones of the Fingers, for which reason also the Knee-bone if it fall out of its Socket, it doth prejudice Motion by diver∣ting the Tendons, as hath been said in the Fracture of it, and upon no other account. But in the Trochoidal species of Articulation, by which the Head is moved up∣on the Vertebrae, seeing that hinge, which the first Verte∣brae makes with the second, can scarce be lift up so high, that it should fal out of its Socket, & tis so firmly bound up with Ligaments it can scarce come to pass, that the Head should loose its Motion, by reason of a Luxation. But if a Luxation happen in the Joynts which are moved by an obscure Motion, by a Synarthrosis, and this be in that Species, which we have called the moveable Joy∣ning, or Coalessency, by which the Vertebrae of the Back are joyned together, then the Cartilage which doth also Conglutinate the Verbebrae together being relaxt, it slacking somwhat in many Spaces of them, espacially a∣bout the middle part of the Back, and the upper part of the loins, seeing it is found there more plentiful, it comes to pass, that many Vertebrae (because one alone can scearce be carried so outwardly, and the Cartilage with which it is knitted be so Relaxt) more or less parting from one another, do produce a crookedness in the Back, and when it cannot erect it self, also a short∣ness of it, and with that of the whol Body, in those cal∣led Gibbous, and then the Prominency arising from thence bunches forth to the outer parts, rather then to the inner, because the bones of the Vertebrae do not suffer them to be so wrested thither, and according to the various manner of severing the Vertebrae it causeth somtimes an Acute, somtimes an Obtuse bunch, and greater or less. Somtimes the Vertebrae bowed towards the sides, do fram the Body wreathed and short after another manner: and in all those crookednesses of the Back, because the Ribs annext to the Back do follow, the breast also appears either lift up or deprest, or other∣wise deformed; whence follows difficulty of breathing if the structure of the Breast be very much vitiated; or also danger of Suffocation if the Vertebrae of the Neck be Luxated, the which notwithstanding cannot be un∣less by great violence, because there intercedes a little Cartilage, but as somtimes the first Vertebra which is loosely joyned by an Arthrody, if it be Luxated, it caus∣eth the sixth species of a quinsie so called by Hippocrates.

But in the other Structures of smal bones mutually joyned, as of the bones of the Wrist, Foot, Instep, this seldom comes to pass, because they are strongly bound together; and if it do happen, because all of them are moved very obscurely, they cannot bring any great impediment in Motion.

But this great perversion of the natural Scituation of the Joynts, that the joynts looseth its moveableness, and that hinge, as is said cannot be turned, proceeds from divers causes; somtimes from a violence offered to the bones and deviding these Conjuctions of the bones, as if either bone which frames the joynt, be forced or thrust by a blow, or fal from its Conjunction with the other, which as we see in many joynts, so in that of the Shoulder, otherwise naturally prominent there, it easely and often happens by a fall; the same also may come to pass from the Attraction of a bone made beyond measure, or to a place, whether it ought in no wise to be drawn, as in Yawning the mouth being too much or crookedly distended, a Luxation of the Jaw, or a Contorsion of other bones by Gestures or seriously by a rack. But also this happens by degrees, if a moveable part be often inclined to the same part, and be kept a long while in that Scituation, whence at length by continuall use the joynts being relaxt, they are drawn asunder, and because they cannot be redu∣ced to their natural Scituation, they cause an Immo∣bility of the Member, whose Figure, also they corrupt, for which reason a bunch is wont to grow in the Verte∣bra of the Back of Maides, because by custom they sit crooked a spinning, and of Infants, because they lie in an uncomly posture of Body; by which means also they increase the beginning of the crookedness of the Back, whether caused from the birth or by chance by inclining themselves that way, both in their going and lying down, and not resisting by a contrary Motion. A Luxation also may happen of its own accord, not by the fault of a bone, but of the Ligaments as we shall now explain.

By reason of the Ligaments that do inclose and retain the Joynt, * 1.24 the Joynt may be Luxated, and so its Motion may cease, or otherwise it may be stopt and hindred without a Luxation.

By reason of the continuity of the Ligaments dislolved, * 1.25 which ought to retain both bones in the Joynt, that they should not be dislocated; a Luxation of them also, or at least wise an Elongation of the Member, so called by some, may be caused, the which yet can scarce happen from the breaking of them, seeing these are most strong bound, unless this befal the round Ligament, which knits the Head of the Thigh to the receiver, being broken off from the bones by violence: But the same may come to pass from a wound penetrating to the Membranous Ligaments which do outwardly compass the joynt, and cutting them in two, but this seldom comes to pass, because these lie in hidden places. The Ligaments also may be eaten through by matter Sup∣puration being made there, the which is wont somtimes to fal out in the joynt of the Thigh with the Hip by reason of Sinuous Ulcers, which arising there about the Membranous parts, do continually pour forth a white Viscous matter, by the Buttocks and Hip, and Intrin∣secally corrupt these Ligaments; of which sort we have seen many so affected, with a Luxated and shortend Thigh to have remained perpetually lame, or at least∣wise that not being Luxated, to have limped with one Foot longer then was meet. Somtimes also the Liga∣ments that compass the joynts, being too much drawn asunder and as it were torne in part from the bones, to which they grow, by some violent forcing of the joynt on the rack, or by some chance, the Motion of the Joynt is left somewhat hindred, with a pain at first, of∣tentimes a long while troublesome: as I have som∣times observed, hath happend in the joynt of the Knee, and Shoulder and in others; and Casparus Wolphius, an eminent Physitian, my true friend, hath told me, that by violent drawing on of Bootes, when they were put on, his Hip joynt hath been thus hurt.

But also by reason of a slackness of these Ligaments, * 1.26 as in the joynts which are moved by a manifest Mo∣tion, this naturally befals them, that they are more Lax, neither do they hinder the joynt, which ought to be moved freely, by strict binding it, it comes to pass that these joynts are more easily dislocated then others, so also if these which are more Lax then others, and others also if they be broad, be yet more amplified, and those which are round, be lengthned, then the Member stands forth, further then is meet, and gives a helping cause, that a Luxation be the easier made, and from a less force. Which things befal some from their birth, whence they can both bend and extend their limbs, somwhat beyond their natural bounds; or they have one limb longer then another, or as some would have it, they presently grow with dislocated Members; or it hap∣pens by reason of the Age, because of the softness of the Ligaments, and appendixes of the Bones, that from the joynt which remain for some time Cartilaginous; and most have thought that might come to pass from a watry, Flegmatick, Serous humors so bedewing these parts, the which yet is not very likely, as appers from hence, because in the Leucophlegmatia and other Species of the Gout, the Humor staying there a long time, yet there follows no Luxation of the part.

The Ligaments also being dried, and hardend, * 1.27 and being bound up and Callous, or hindred with knobs in the Gout, or with Nodes, the Motion of those joynts remains sixt and immoveable, or otherwise they are hardly moved, and somtimes they make a noise and crackling, as if they were broken, if they be urged with geater force. The cause of which sound also is, if it be driven by force further then the joynt ought to be mo∣ved by a moderate Motion; but such an Exication of the Ligaments, somtimes proceeds from old age, and a most acute feaver drying up also the Bones and Nails, as hath been said elsewhere: or from some other hurt, whence a Callus or Node grows there, or from a Hu∣mor turned into a knob about the joynts, as shall be explained in its place.

The Cartilage, * 1.28 which crusts over the Heads of the moveable bones, if it loose its slipperiness, and clammi∣ness, and be dried up, or Exaspera∣ted from the said causes; it doth also hinder Motion, as a hinge tainted with rust.

By Reason of an affect of the Lips opening the Mouth it happens, * 1.29 that their Motion is weakend, and the largeness of the Mouth depraved; if they be so cut off, or dissected, that they cannot follow Motion, or otherwise, as we have seen it fall out in the French Pox, if they be eaten with Ulcers and corrupted; but their other faults do preju∣dice rather by pain, as we shall shew in their places.

It scarce happens that by fault of the Ey-lide the Eye cannot be shut, * 1.30 unless a Tumor or some excrescence growing there do hinder it; but it fals out that the Eye cannot be opend, only the up∣per Ey-lide being cut in two, and scarce for any other causes.

By Reason of a Disease of the Eye, its Motion scarce fails, unless this proceed from a Tumor of it, that it cannot be rowled about freely, pain then chiefly hind∣ring the Motion; but a squinting though it be from the Birth, doth rather arise by reason of the Muscles of the Eye, as hath been said, and if this comes to pass, the Eye being wounded or digd out, the Eye doth not on∣ly loose it Motion; but also becomes unprofitable.

Notes

• * 1.1

  The cause of a Palsie in the Nerves.
• * 1.2

  The Diseases of the Nerves, from whence a Palsie is.
• * 1.3

  Other humors pos∣sessing the Nerves are the cause of a P••lsie and Spasm.
• * 1.4

  A Tumor of a Nerve is the cause of a Palsie.
• * 1.5

  The fault of con∣formation in a Nerve is the cause of a Palsie.
• * 1.6

  A cold distemper of a Nerve is the cause of a Palsie.
• * 1.7

  The Driness of a Nerve the cause of a Palsie.
• * 1.8

  The Compression of a Nerve is the cause of a Palsie.
• * 1.9

  The hurt of a Nerve is the cause of a Palsie.
• * 1.10

  The cause of a particular Spasm is in the Nerves.
• * 1.11

  In the Muscles or their Tendons, is the cause of a Palsie, a windy Spasm and other Species of Immo∣bility.
• * 1.12

  A Flegmatick hu∣mor possessing the Tendons, is the cause of a Palsie.
• * 1.13

  Wind in the spaces the Muscles is the cause of a flatulent Spasm.
• * 1.14

  A Tumor in a Muscle or Tendon is the cause of the said contraction of the Member.
• * 1.15

  An Exiccation of the Muscles on their Tendons is the cause of the Contraction of the Members.
• * 1.16

  A cooling of the Muscles is the cause of Impotency of mo∣tion.
• * 1.17

  The solution of Con∣tinuity in the Mus∣cles or Tendons is the cause of a Palsie.
• * 1.18

  The too much leng∣thening of the Ten∣dons is the cause of Impotency of Moti∣on.
• * 1.19

  Too great attraction of the Muscles and their Tendons is the cause of a Flatulent Spasm.
• * 1.20

  An Organical fault of the Muscle is the cause of the Impo∣tency of motion.
• * 1.21

  The Cause of Impotency of motion in the Bones.
• * 1.22

  A Fracture of a bone is the cause of Impo∣tency of motion or some other hurt of them.
• * 1.23

  A Dislocation of the Bones of the joynts, is the cause of Immobility.
• * 1.24

  In the Ligaments of the Bones of the joynts, is the cause of the Impotency of Motion.
• * 1.25

  The Continuity of the Ligaments dis∣solved, is the cause of Immobility.
• * 1.26

  A slackness of the Ligaments, is the cause of the impo∣tency of Motion.
• * 1.27

  A driness of the Ligaments, is the cause of the im∣potency of Moti∣on.
• * 1.28

  In the Cartilages of the Bones of the joynts, is the cause of immobility.
• * 1.29

  In the Lips, is the cause of their immobi∣lity.
• * 1.30

  In the Ey-lids, is the cause of their immobi∣lity.