XIIII. Of Meat and Drink
XV. Of Motion and Rest.
XVI. Of Sleepe and Watching.
XVII. Of Repletion, and Imanition, or Emptiness.
XVIII. Of the Perturbations, or Passions of the mind
XIX. Of things against Nature, and first of the Cause of a Disease
XX. Of a Disease
XXI. Of a Symptome.
XXII. Of Indications.
XXIII. Of Certaine wonderfull and extravagant wayes of Curing diseases.
XXIIII. Of Certaine jugling and deceiptfull wayes of Curing.
To know the nature of Humors is not only necessary for physicians, but also for surgeons, because there is no disease which arises not from some mixture of humors. Hippocrates wrote that every creature is either sick or well according to the condition of the Humors in the body.
All putrid fevers proceed from the putrefaction of humors. Neither do any acknowledge any other origin or distinction of the differences of Abscesses or Tumors: neither do ulcerated, broke or otherwise wounded members hope for the restoration of continuity, from other than from the sweet falling down of humors to the wounded part. Which is the cause that often in the cure of these effects, the Physicians are necessarily busied in tempering the Blood, that is, bringing to a mediocrity the 4 humors composing the mass of blood, if they at any time offend to quantity, or quality. For whether if any thing abound, or digress from the wonted temper in any excess of heat, cold, viscosity; grossness (thickness), thinness, or any such like quality, none of the accustomed functions will be well performed. For which cause those chief helps to preserve and restore health have been divinely invented; Phlebotomy, or bloodletting which amends the quantity of too much blood; and purging which corrects and draws away the vicious quality. But now let us begin to speak of the Humors, taking our beginning from the definition.
A Humor is Liquid and flowing in the body of living creatures endued with blood, & that is either natural, or against nature. The natural is so called because it is fit to defend, preserve and sustain the life of a creature. Quite different is the nature & reason of that which is against nature. Again the former is either Alimentary, or Excrementitious; The Alimentary which is fit to nourish the body, is that Humor which is contained in the veins and arteries of a man which is temperate & perfectly well; & which is understood by the general name of blood which is let out at the opening of a vein.
Blood otherwise taken is a Humor of a certain kind, distinguished by heat from the other Humors comprehended together with it, in the whole mass of the blood. All things which we eat or drink are the materials of blood, which things drawn into the bottom of the ventricle by its attractive force, and there detained, are turned by the force of concoction implanted in it, into a substance like Almond Butter. Although it appears one and like itself, it consists of parts of a different nature, which not only the variety of meats, but one & the same meat yields of itself. We term this Chylus (when it is perfectly concocted in the stomach). But the Gate-veine receives it driven from thence into the small guts, and sucked in by the Meseraicke veins, and now having gotten a little rudiment of change in the way, carries it to the liver, where by the blood-making faculty which is proper and natural to this part, it acquires the absolute and perfect form of blood. But with that blood at one end and the same time and action all the humors are made whether Alimentary or excrementitious. Therefore the blood that it may perform its office, that is, the faculty of nutrition, must necessarily be purged and cleansed from the two excrementitious humors. Of which the bladder of Gall draws one which we call Yellow Choler, and the Spleen the other which we term Melancholy.
These two humors are natural, but not Alimentary, or nourishing, but of another use in the body, as afterwards we will show more at large. The blood freed from these 2 kinds of excrements is sent by the veins and arteries into all parts of the body for their nourishment. Which although then it seem to be of one simple nature, yet notwithstanding it is truly such, that four different and unlike substances may be observed in it, as blood properly so named, Phlegme, Choler and Melancholy, not only distinct in colour, but also in taste, effects, and qualities. For as Galen notes in his book De Natura humana, Melancholy is acid or sour, choler bitter, Blood sweet, Phlegme unsavory. But you may know the variety of their effects, both by the different temper of the nourished parts, as also by the various conditions of the diseases springing from thence. For therefore such substances ought to be tempered and mixed amongst themselves in a certain proportion, which remaining, health remains, but violated, diseases follow. For all acknowledge that an oedema is caused by Phlegmatick, a Scirrhus by Melancholike, an Erysipelas by Cholericke, and a Phlegmone by pure and laudable blood. Galen teaches by a familiar example of new wine presently taken from the press, that these 4 substances are contained in that one mass, and mixture of the blood. In which everyone observes 4 distinct essences.
For the flower of the wine working up swims at the top, the dregs fall down to the bottom, but the crude and watery moisture mixed together with the sweet and vinous liquor, is everywhere diffused through the body of the wine, the flower of the wine represents Choler, which bubbling up on the superficies of blood, as it concretes and grows cold, shines with a golden colour; the dregs Melancholy, which by reason of its heaviness ever sinks downward, as it were the Mudd of the blood; the crude and watery portion Phlegme: for as that crude humor, except it be rebellious in quantity, or stubborn by its quality, there is hope it may be changed into wine, by the natural heat of the wine; so phlegm which is blood half concocted, may be the force of native heat be changed into good and laudable blood. Which is the cause that nature decreed, or ordained no peculiar place, as to the other 2. humors, whereby it might be severed from the blood; but the true and perfect liquor of the wine represents the pure blood, which is the more laudable and perfect portion of both the humors of the confused mass. It may easily appear by the following scheme, of what kind they all are, and also what the distinction of these four humors may be
Humor | Nature | Consistency | Color | Taste | Use |
|---|---|---|---|---|---|
Blood | Air: hot and moist | Of smooth consistency, neither too thick nor too thin | Red, rosy, crimson | sweet | It chiefly serves for the nourishment of the fleshy parts and carries heat to the whole body |
Phlegme | Water: cold and moist | liquid | white | Sweet, rather unsavory, for we commend that water which is unsavory | Nourishes the brain and all the other cold and moist parts, to temper the heat of the blood, and by its slipperyness helps the motion of the joints |
Choler | Fire: hot and dry | thin | yellow; pale | bitter | It provokes the expulsive faculty of the guts, attenuates the phlegme cleaving to them, but the alimentary is fit to nourish the parts of like temper with it |
Melancholy | Earth: cold and dry | thick and muddy | blackish | acidic, sour, biting | stirs up the appetite, nourishes the spleen and all the parts of like temper to it, as the bones |
Blood hath its nearest matter from the better portion of the Chylus: and being begun to be labored in the veins, at length gets form and perfection in the liver. But it has its remote matter from meats of good digestion and quality, seasonably eaten after moderate exercise; but for that, one age is better than another, and one time of the year more convenient than another. For blood is made more copiously in the Spring, because that season of the year comes nearest to the temper of the blood, by reason of which the blood is rather to be thought temperate, than hot and moist, for that Galen makes the Spring temperate, and besides, at that time blood letting is performed with the best success: youth is an age very fit for the generation of blood; or by Galen’s opinion, rather that part of life, that continues from the 25 to the 35 year of our age. Those in whom this humor hath the dominion, are beautified with a fresh and rosie color, gentle and well natured, pleasant, merry, and facetious.
The generation of Phlegme is not by the imbecility of heat, as some of the ancients thought; who were persuaded that choler was caused by a raging, blood by a moderate, and phlegme and melancholy, by a remiss heate. But that opinion is full of manifest error: for if it be true that the Chylus is labored and made into blood in the same part, and by the same fire, that is, the liver; from whence in the same moment of time should proceed that strong and weak heat, seeing the whole mass of the blood different in its four essential parts, is perfected and made at the same time, and by the same equal temper of the same part, action, and blood-making faculty; therefore from whence have we this variety of humors? From hence, for that those meats by which we are nourished, enjoy the like condition that our bodies do, from the four Elements, and the four first qualities; for it is certain, and we may often observe in what kind soever they be united or joined together, they retain a certain hot portion imitating the Fire, another cold, the water, another dry, the earth, and lastly, another moist like to the Air. Neither can you name any kind of nourishment, how cold soever it be, not Lettuce itself, in which there is not some fiery force of heat. Therefore it is no marvel, if one and the same heat working upon the same matter of Chylus, varying with so great dissimilitude of substances, do by its power produce so unlike humors, as from the hot, Choler; from the cold, Phlegme; and of the others, such as their affinity of temper will permit.
There is no cause that anyone should think that variety of humors to be caused in us, rather by the diversity of the active heat, than wax and a flint placed at the same time, and in the same situation of climate and soil, this to melt by the heat of the Sun, and that scarce to wax warm. Therefore that diversity of effects is not to be attributed to the force of the efficient cause, that is, of heat, which is one and of one kind in all of us, but rather to the material cause, seeing it is composed of the conflux, or meeting together of various substances, gives the heat leave to work, as it were out of its store, which may make and produce from the hotter part thereof Choler, and of the colder, and more rebellious Phlegme. Yet I will not deny but that more Phlegme, or Choler may be bred in one and the same body, according to the quicker, or slower provocation of the heat; yet nevertheless it is not consequent, that the original of Choler should be from a more acrid, and of Phlegme from a more dull heat in the same man. Every one of us naturally have a simple heat, and of one kind, which is the work of diverse operations, not of itself, seeing it is always the same, and like itself, but by the different fitness, pliableness, or resistance of the matter on which it works. Wherefore Phlegm is generated in the same moment of time, in the fire of the same part, by the efficiency of the same heat, with the rest of the blood, of the more cold, liquid, crude, and watery portion of the Chylus. Whereby it comes to pass, that it shows an express figure of a certain rude or imperfect blood, for which occasion nature has made it no peculiar receptacle, but would have it to run friendly with the blood in the same passages of the veins, that any necessity happening by famine, or indigency, and in defect of better nourishment, it may be a perfecter elaboration quickly assume the form of blood. Cold & rude nourishment make this humor to abound principally in winter, and in those which incline to old age, by reason of the similitude which phlegm has with that season and age. It make a man drowsy, dull, fat, and swollen up, and hastens gray hairs.
Choler is as it were a certain heat and fury of humors, which generated in the liver, together with the blood is carried by the veins and arteries through the whole body. That of it which abounds, is sent, partly into the guts, and partly into the bladder of the gall; or is consumed by transpiration, or sweats; it is somewhat probable that the arterial blood is made more thin, hot, quick and pallid, than the blood of the veins, by the commixture of this alimentary choler. This humor is chiefly bred and expelled in youth, and acrid and bitter meats give matter to it: but great labours of body and mind give the occasion. It makes a man nimble, quick, ready for all performance, lean, and quick to anger, and also to concoct meats.
The Melancholicke humor, or Melancholy, being the grosser portion of the blood, is partly sent from the liver to the spleen to nourish it, and partly carried by the vessels into the rest of the body, and spent in the nourishment of the parts endued with an earthly dryness; it is made of meats of grosse juice, and by the perturbations of the mind, turned to fear and sadness. It is augmented in Autumne, and in the first and crude old age; it makes men sad, harsh, constant, froward, envious, and fearful. All men ought to think, that such humors are wont to move at set hours of the day, as by a certain peculiar motion or tide. Therefore the blood flows from the ninth hour of the night, to the third hour of the day; then Choler to the ninth of the day; then Melancholy to the third of the night, the rest of the night that remains, is under the dominion of Phlegm.
Manifest examples hereof appear in the French-Poxe. From the elaborate and absolute mass of the blood (as we said before) two kinds of humors, as excrements of the second concoction, are commonly and naturally separated, the one more grosse, the other more thin. This is called either absolutely choler, or with an adjunct, yellow choler. That is called Melancholy; which drawn by the Spleen in a thinner portion, and elaborate by the heat of the Arteries, which in that part are both many and large, becomes nourishment to the part; the remnant thereof is carried by the veiny vessel into the orifice of the ventricle, whereby it may not cause, but whet the appetite, and by its astriction strengthen the actions thereof.
But yellow choler drawn into the bladder of the gall, remains there so long, till being troublesome, either in quantity or quality, it is excluded into the guts, whereby it may cast forth the excrements residing in them; the expulsive faculty being provoked by its acrimony, and by its bitterness kills the worms that are bred there. This same humor is accustomed to dye the urine of a yellow colour. There is another serous humor, which truly is not fit to nourish, but profitable for many other things, which is not an excrement of the second, but of the first concoction. Therefore nature would that mixed with the Chylus, it should come to the Liver, and not be voided with the excrements, whereby it might alay the thickness of the blood, and serve it for a vehicle; for otherwise the blood could scarce pass through the capillary veins of the liver, and passing the simous and gibbous parts thereof, come to the hollow vein. Part of this serous humor separated together with the blood which serves for the nourishment of the Reines, and straight carried into the bladder, is turned into that urine which we daily make; the other part therefore carried through all the body together with the blood, performing the like duty of transportation, is excluded by sweats into which it degenerates.
Besides the forenamed, the Arabians have mentioned four other humors, which they term Alimentary and secondary, as being the next matter of nourishment, as those four the blood contains, the remote. They have given no name to the first kind, but imagine it to be that humor, which hangs ready to fall like to little drops in the utmost orifices of the veins. They call the second kind Dew; being that humor, which entered already into the substance of the pass, doth moisten it. The third they call by the Barbarous name Cambium, which already put to the part to be nourished, is there fastened. The fourth named Gluten, or Glew, is only the proper and substance-making humidity of the similar parts, not their substance. The distinction of the degrees of nutrition recited by Galen in his Books of Natural faculties, answer in proportion to this distinction of humors. The first is, that the blood flow to the part that requires nourishment; then that being there arrived, it may be agglutinated; then lastly, that having lost its former form of nourishment, it may be assimilated.
Those humors are against nature, which being corrupted, infect the body and the parts in which they are contained by the contagion of the corruption, retaining the names and titles of the humors, from whose perfection and nature they have revolted, they all grow hot by putrifaction, although they were formerly by their own nature cold. And they are corrupted, either in the veins only, or within and without the veins; in the veins Blood and Melancholy; but both without and within the veins, Choler and Phlegm. When the blood is corrupted in its thinner portion, it turns into choler, when in its thicker, into Melancholy; for the blood becomes faulty two manner of ways, either by the corruption of its proper substance by putrefaction or by admixtion of another substance by infection. The Melancholy humor which is corrupted in the veins, is of three sorts: the 1 is of a Melancholy juice putrefying, and by the force of a strange heat, turned as it were into ashes, by which it becomes adust, acrid and biting. The other arises from that Choler which resembles the yolks of eggs, which by adustion becomes leeke-coloured, then aeruginous, or of a bluish green, then red, and lastly black, which is the very worst kind of Melancholy, hot, maligne, eating and exulcertaing, and which is never seen or voided with safety.
The third comes from Phlegm putrefying in the veins, which first degenerates into false Phlegm, but straight by the strength of extraneous heat degenerates into Melancholy.
Phlegme not natural is bred, either in the veins or without the veins.
In the veins, is either:
Phlegme not natural bred without the veins is of 4 sorts, either:
without the veins:
Choler not natural is bred, either
Choler not natural is bred, either
The kinds of such choler, are often cast forth by vomit in diseases, the strength of the disease being past, being troublesome to the parts through which they are evacuated, by their bitterness, acrimony and biting.
I think it manifest, because the matter and generation of flesh is principally from blood, that a man of a fleshy, dense, and solid habit of body, and full of sweet and vaporous juice, is of a sanguine complexion. And the same party hats a flourishing and rosie colour in his face, tempered as with an equal mixture of white and red; of white, by reason of the skin lying utmost; of red, because of the blood spread underneath the skin; for always such as the humor is, such is the colour in the face. In manners he is courteous, gentle, easier to be spoken to, not altogether estranged from the love of women, of a lovely countenance and smooth forehead, seldom angry, but taking all things in good part; for as the inclination of humors is, but the strong heat of the inward parts makes him eat and drink freely. Their dreams are pleasant, they are troubled with diseases arising from blood, as frequent Phlegmons, and many Sanguine pustules breaking through the skin, much bleeding,and menstruous fluxes. Wherefore they can well endure blood-letting, and delight in the moderate use of cold and dry things; and lastly, are offended by hot and moist things. They have a great and strong Pulse, and much urine in quantity, but mild of quality, of an indifferent colour and substance.
Choleric men are of a pale or yellowish color, of a lean, slender and rough habit of body, with fair veins and large Arteries, and a strong and quick pulse: their skin being touched, feels hot, dry, hard, rough and harsh, with a pricking and acrid exhalation which breathes forth of their whole body. They cast forth much choler by stool, vomit and urine. They are of a quick and nimble wit, stout, hardy and sharp vindicators of received injuries, liberal even to prodigality, and somewhat too desirous of glory. Their sleep is light, and from which they are quickly waked; their dreams are fiery, burning, quick and full of fury; they are delighted with meats and drinks which are somewhat more cold and moist, and are subject to Tertian and burning fevers, the frenzy, Jaundice, Inflammations, and other cholericke pustules, the Laske, Bloody fluxe, and bitterness of the mouth.
Those in whom Phlegm hath the dominion, are of a whitish coloured face, and sometimes livid and swollen, with their body fat, soft and cold to touch.
They are molested with Phlegmatic diseases, as oedematous tumors, the Dropsie, Quotidians fevers, falling away of the hairs, and catarrhes falling down upon the Lungs, and the Aspera Arteria, or Weason; they are of a slow capacity, dull, sloth-full, drowsy, they do dream of rains, snows, floods, swimming, and such like, that they often imagine themselves overwhelmed with waters; they vomit up much watery and Phlegmatic matter, or otherwise spit and evacuate it, and have a soft and moist tongue.
And they are troubled with a dog-like hunger, if it at any time should happen that their insipide Phlegm become acidic; and they are slow of digestion, by reason of which they have great store of cold and Phlegmatic humors, which if they be carried down into the windings of the cholicke-gut, they cause murmuring and noise, and sometimes the cholicke.
For much wind is easily caused of such like Phlegmatic excrements wrought upon by a small and weak heat, such as Phlegmatic persons have, which by its natural lightness is diversely carried through the turnings of the guts, and distends and swells them up, and while it strives for passage out, it causes murmurings and noises in the belly, like wind breaking through narrow passages.
The face of a Melancholy person is swart, their countenance cloudy and often cruell, their aspect is sad and froward; frequent Scirrhous, or hard swellings, tumors of the spleen, Hemorrhoids, Varices (or swollen veins) Quartaine fevers, whether continual or intermittent, Quintaine, Sextaine, and Septimane fevers; and to conclude, all such wandering fevers or agues set upon them. But when it happens the Melancholy humor is sharpened, either by adustion, or commixture of Choler, then Tetters, the black Morphew, the Cancer simple and ulcerated, the Leprous and filthy scab, sending forth certain scaly and branlike excrescences, (being vulgarly called Saint Manis his evil) and the Leprosy itself invades them: they have small veins and arteries, because coldness hath dominion over them, whose property is to straighten, as the quality of heat is to dilate. But if at any time their veins seem big, that largenesse is not by reason of the laudable blood contained in them, but from much windinesse; by occasion whereof it is somewhat difficult to let them blood; not only because that when the vein is opened, the blood flows slowly forth, by reason of the cold slowness of the humors; but much the rather, for that the vein doth not receive the impression of the Lancet, sliding this way and that way, by reason of the windinesse contained in it, and because that the harsh dryness of the upper skin, resists the edge of the instrument. Their bodies seem cold and hard to the touch, and they are troubled with terrible dreams, for they are observed to seem to see in the night Devils, Serpents, dark dens and caves, sepulchers, dead corpses, and many other such things full of horror, by reason of a black vapor, cleverly moving and disturbing the brain, which also wee see happens to those, who fear the water, by reason of the biting of a mad dog. You shall find them froward, fraudulent, parsimonious, and covetous, even to baseness, slow speakers, fearful, sad, complainers, careful, ingenious, lovers of solitariness, man-haters, obstinate maintainers of opinions once conceived, slow to anger, but anger not be pacified. But when melancholy hath exceeded natures and its own bounds, then by reason of putrefaction and inflammation all things appear full of extreme fury and madness, so that they often cast themselves headlong down from some high place, or are otherwise guilty of their own death, with fear of which they are terrified.
But we must note that changes of the native temperament do often happen in the course of a man’s life, so that he which a while ago was Sanguine, may now be Cholericke, Melancholic, or Phlegmatic, not truly by the changing of the blood into such humors, but by the mutation of diet, and the course or vocation of life. For none of a Sanguine complexion but will prove Choleric if he eat hot and dry meats, (as all like things are cherished and preserved by the use of their like, and contraries are destroyed by their contraries) and weary his body by violent exercises, and continual labors; and if there by a suppression of Choleric excrements, which before did freely flow, either by nature, or art. But whosoever feeds upon meats generating thick blood, as Beef, Venison, hare, old Cheese, and all salt meats, he without all doubt sliding from his nature, will fall into a Melancholy temper; especially if to that manner of diet, he shall have a vocation full of cares, turmoils, miseries, strong and much study, careful thoughts and fears; and also if he sit much, wanting exercise, for so the inward heat as it were defrauded of its nourishment, faints, and grows dull, whereupon thick and drossie humors abound in the body. To this also the cold and dry condition of the place, in which we live, doth conduce, and the suppression of the Melancholy humor accustomed to be evacuated by the Haemorrhoids, courses, and stools.
But he acquires a Phlegmatic temper whosoever uses cold & moist nourishment, much feeding, who before the former meat is gone out of the belly, shall stuff his paunch with more, who presently after meat runs into violent exercises, who inhabit cold and moist places, who lead their life at ease in all idleness; and lastly, who suffer a suppression of the Phlegmatic humour accustomely evacuated by vomit, cough, or blowing the nose, or any other way either by nature or art. Certainly it is very convenient to know these things, that we may discern if any at the present by Phlegmatic, Melancholic or of any other temper, whether he be such by nature, or necessity. Having declared those things which concern the nature of Temperaments, and deferred the description of the parts of the body to our Anatomy, we will begin to speak of the faculties governing this our life, when first we shall have shown by a practical demonstration of examples, the use and certainty of the aforesaid rules of Temperaments.