The Perturbations are commonly called the accidents of the mind, because, as bodily accidents from the body, so may these be present and absent from the mind, without the corruption of the subject. The knowledge of these must not be lightly passed over by the surgeon; for they stir up great troubles in the bodies, and yield occasion of many & great diseases; of which things, joy, hope and love, may give a apparent testimony. For by these motions the heat and spirits are sometimes gently, sometimes violently, diffused over all the body, for the enjoying of the present, or hoped for good. For then the heart is dilated, as to embrace the thing beloved, and the face is dyed with a rosy and lively colour. For it is likely, that the faculty itself is stirred by the object, by whose power the heart itself is moved.

For it is first necessary, before we be moved by any passions, that the senses in their proper seats, in which they are seldom deceived, apprehend the objects, and straight as messengers carry them to the common sense, which sends their conceived forms to all the faculties. And then, that each faculty, as a judge, may freshly examine the whole matter, how it is, and conceive in the presented objects some show of good, or ill, to be desired, or shunned. For what man that was well in his wits, did ever fall into a laughter, unless he formerly knew, or saw somewhat said or done, which might yield occasion of laughter? Therefore joy proceeds from the heart, for the thing causing mirth or joy, being conceived, the faculty moves the heart, which shaken and moved by the faculty which has dominion over it, is dilated and opened, as ready to embrace the exhilarating object. But in the meantime, by the force of that dilatation, it sends forth much heat, and spirits together with the blood into all the body. A great part of which coming to the face, dilates it, the forehead is smooth and plain, the eyes look bright, the cheeks become red, as dyed with Vermilion, the lips and mouth are drawn together, and made plain and smooth; some have their cheeks dented with two little pits (which from the effects are called laughing cheeks) because of the contraction or curling, which the muscles suffer by reason of their fulness of blood and spirits, all which to be brief is nothing but to laugh.

Joy recreates and quickens all the faculties, stirs up the spirits, helps concoction, makes the body to be better liking, and fattens it, the heat, blood, and spirits flowing thither, and the nourishing dew or moisture, watering and refreshing all the members; from whence it is, that of all the passions of the mind, this only is profitable, so that it exceed not measure; for immoderate and unaccustomed joy, carries so violently the blood and spirits from the heart, into the habit of the body,that sudden death ensues, by a speedy decay of the strength, the lasting fountain of the vital humour being exhausted. Which thing principally happens to those who are less hearty, as women and old men. Anger causes the same effusion of heat in us, but far speedier than joy; therefore the spirits and humors are so inflamed by it, that it often causes putrid feavers, especially if the body abounds with an ill humor. Sorrow, or grief dries the body by a way quite contrary to that of anger, because by this the heart is so straitened, the heat being almost extinct, that the accustomed generation of spirits cannot be performed; and if any be generated, they cannot freely pass into the members with the blood; wherefore the vital faculty is weakened, the lively colour of the face withers and decays, and the body wastes away with a lingering consumption. Fear, in like sort, draws in and calls back the spirits, and not by little and little as in sorrow, but suddenly and violently; hereupon the face grows suddenly pale, the extreme parts cold, all the body trembles or shakes, the belly in some is loosed, the voice as it were stays in the jaws, the heart beat with a violent pulsation, because it is almost oppressed by the heat, strangled by the plentio of blood, and spirits abundantly rushing thither; the hair also stands upright, because the heat and blood are retired to the inner parts, and the utmost parts are more cold and dry than stone; by reason whereof the utmost skin and the pores, in which the roots of the hairs are fastened, are drawn together.

Shame is a certain affection mixed, as it were, of Anger and Fear; therefore if, in that conflict of, as it were, contending passions, Fear prevail over Anger, the face waxeth pale, (the blood flying back to the heart) and these or these Symptomes rise, according to the vehemency of the contracted and abated heat. But if on the contrary, Anger get the dominion over Fear, the blood runs violently to the face, the eyes look red, and sometimes they even foam at the mouth. There is another kind of shame, in which there is a certaine flux, and reflux of the heat, and bloud first recoiling to the heart; then presently rebounding from thence againe. But that motion is so gentle, that the heart thereby suffers no oppression, nor defect of spirits; wherefore no accidents worthy to be spoken of, arise from hence: this affect is familiar to young maides and boyes; who if they blush for a fault committed unawares, or through carelesnesse, it is thought an argument of a vertuous and good disposition. But an  agony, which is a mixt passion of a strong feare, and vehement anger, involves the heart in the danger of both motions; wherefore by this passion, the vitall facultie is brought into very great danger. To these sixe passions of the minde, all other may be revoked, as hatred and discord to anger: mirth and boasting, to joy; terrors, frights and swoundings, to feare; envy, despaire and mourning, to sorrow. By these it is evident, how much the passions of the minde can prevaile, to alter and overthrow the state of the body; and that by no other meanes, than that by the compression and dilatation of the heart, they diffuse and contract the spirits bloud, and heate; from whence happens the dissipation, or oppressions of these spirits.

The signes of these symptomes quickly shew themselves in the face; the heart, by reason of the thinnesse of the skinne in that part, as it were painting forth the notes of its affections. And certainely the face is a part so fit to disclose all the affections of the inward parts, that by it you may manifestly know an old man from a young, a woman from a man, a temperate person from an untemperate, an Ethiopian from an Indian, a Frenchman from a Spaniard, a sad man from a merry, a sound from a  sick, a living from a dead. Wherefore many affirm that the manners, and those things which we keep secret and hid in our hearts, may be understood by the face and countenance. Now we have declared what commodity and discommodity may redound to man from these forementioned passions, and have shown that anger is profitable to none, unless by chance to some dull by reason of idlenesse, or oppressed with some cold, clammy and phlegmatic humor; and fear convenient for none, unless peradventure for such as are brought into manifest and extreme danger of their life by some extraordinary sweat, immoderate bleeding, or the like unbridled evacuation, wherefore it behoves a wise surgeon to have a care, lest he inconsiderately put any patient committed to his charge into any of these passions, unless there be some necessity thereof, by reason of any of the forementioned occasions.