IN the last Sheet (Practice of Physick duly Regulated) having there shewed, the Safety and Great Prudence of the Professors, in the management of the Anci­ent Practice; being guarded by the Physicians personal labour in, and custody of Medicines: Thereby, not only securing the Art: from Invasion by Aliens; and Patients, from Casualties; but also Enriching the Professors, with such a stock of most requisite Knowledge in Pharmaceutic Preparations; as enables them to design and provide the most hopeful curing Medicines, that Art and Experi­ence can acquire.

Also I there set forth the vanity and hazards: attending the genteel new Mode of prescribing to the Shops; (a late Invention) this Practice appearing ignorant and de­linquent in many respects, as proved by nine distinct Arguments; differently pointing at several great failings; and convicting the folly of that unreasonable Innovation; which draws a long Tail of unavoidable Injuries, the chiefest remora to the Progress and per­formance of this Art.

Having thus determined upon the two Modes of Practice, Ancient and Modern; and also upon our tripple division of Medicines relating thereto; respecting Latitude and Adaptation: I proceed forwards to the matter of Practice; and as the basis thereof, I shall first Examine the Catalogue of Diseases, appearing to me over-grown, and out of due form.

'Tis worth remarking, from whence, or how this Register of Diseases did increase so greatly; when as their number (much better and truer) might have been cast up with fewer figures; and the Practice of Physick, more easie and intelligible; for, the number of Diseases, unnecessarily multiplied, and falsly denominated, must needs pro­duce diversity of ill Methods, and great variety of injurious Medicines; which renders this Art so perplext and difficult, as scarcely to be comprehended by Humane Under­standing, and the attempts of Healing so often frustraneous: For this great List of Diseases being hundreds, must require a vast number of Medicines; thousands to answer the Practice thereof, as you manage the Matter: For Indications being various and diffe­rent in every Sick Man's Case; therefore all of them (you say) requiring different Medicines adapt to those cases by Appropriate new mixtures: thus the number of Medi­cines [Page 2]are become numberless, and the Practice of Physick incomprehensible; and no man is able to be Master of this Art (in your way) if he were to live a 1000 years, but must alwaies be devising, ghessing ex tempore, and venturing at uncertain unproved Medicines: thus practising fortuitously, with doubt and hazard all the days of his life.

The Number of Diseases must needs be unnecessarily and falsly multiplied; when Symptoms, Causes and Products, bear the names of Diseases, which ought otherwise to be distinguished by their proper names; then failure in curing may reasonably be ex­pected, when the Physician aims at the wrong mark, not rightly discerning one from the other: But if Diseases were reduced to their true number in Scheme; they would sooner be found out in Practice, and their Cures more safely and frequently per­formed: But as they stand regimented with other preternatural effects (erroneously sup­posed to be Diseases, and prosecuted as such) Hereby Diseases truly denominated are much obscured, often overseen, and something else aimed at; tyring the Patient with improper and frustraneous means. To illustrate and prove these Assertions, I shall give you some eminent Examples, in their due place.

After various Opinions, controverted by the Learned of this Faculty, in determining upon Diseases; as to the Notion, Denomination, Number, and Division of them: I find the result thereof, by the Majority and better Judgments of the Galenists, to rest in this Establishment following; received and approved by the Professors of this present time: The which I shall now lay before you; and then make my Exceptions.

The General Catalogue of Diseases, is set forth and comprised under these three Di­visions, thus distinguished: Similar, Organical, and Common.

Morbus Similaris est morbus ex inconvenienti qualitatum contemporatione resultans. Similar Diseases are such as arise from the inconvenient contemporation or disproportion of qua­lities; First, Second, or Occult. The first qualities, are four: Hot, Cold, Moist, Dry: either of these in Excess, make a Disease Simple: and any two of these qualities exceeding, make a Disease Compound: so that there are four Similar Simple; and four Similar Compound Diseases. Both these, Simple and Compound, admit of another division: In temperature with Matter, and without Matter: and each of these divisions, (cum & sine materia;) make four Diseases more distinct from the former. There is yet another subdivision; equal and unequal. Intemperies qualibet, sive simplex fuerit, sive composita; materiamque conjunctam habuerit, sive non; duplex est: aequalis vel inaequalis; the words of one of your best Authors. From these Qualities were Temperaments denominated, and distinguished; as also Diseases called Distempers. The second qualities being Ob­jects of the five External Senses, are these: Odours, Colours, Sounds, Sapors, Tactils; when Preternatural, these also are Similar Diseases, and they are accounted many. Occult qualities inconveniently mixed, make Similar Diseases likewise; called also Morbi totius substantiae. These qualities when preternatural to make a Disease; they will have them to be seated in the Similar parts of the Body, (therefore called Similar Diseases) as Bone, Ligament, Tendon, Nerve, Veine, Artery, &c. contradistinct to Organical Diseases, that affect Organical and Dissimilar Parts: as Heart, Ventricle, Muscle, Eyes, Ears, Nose, &c. Here are Similar Diseases set forth very speciously, amply and nicely: much pains bestowed to little purpose; all this will come to nothing in the sequel of our Discourse.

Now Gentlemen of this Robe; I must direct some of my discourse to you; who know this to be a short and true account of the first division of the general Triplicity: and before I go farther, I must remark upon what hath been said, shewing the Incongruities, Errors, and Contradictions thereof. When I was a Prescriber to the [Page 3] Shops, (many years ago) I was a zealous observer of this Doctrine, because I knew no better, being led by Books: and probably I was guilty of doing hurt thereby: but I did it through ignorance (as many do now following that Road) which mitigates the guilt à tanto. But 30 years Practice since, in another thinking and working way, and proving of Medicines; hath informed me better things.

I perceive now, and am well satisfied; that Writers too much follow the general cur­rent of Opinions; who take them up, and set them down again for truth, without a strict and serious perpension: and I doubt Practisers are drawn into the like snare, by being too credulous of Authors; when the greatest safety in Practice, does depend upon the security and certainty of Medicines of their own design, Manufacture, Melioration, and Probation.

The design of this Art, being to find out and subdue Diseases; if they stand not right in the general Catalogue, there to be found, and truly distinguished; inquiries after them, and means intended against them will be disappointed. Setting forth Dis­eases in their due Classes, is the Basis of Practice: if the first general divisions be false; the subdivisions contained under them must needs be wrong; and such Errors runs through, and perverts the whole Practice of this Art: as will appear when we examine the Diseases of the several Regions of the Body; and in them the Diseases of particular Parts: Nor is it barely an Error of denomination; but a fundamental Error; making that a Disease which is not; and the whole Prosecution Erroneous.

Morbus Similaris! there is no such thing in Nature; nor praeter naturam: This first division therefore of the General Catalogue, containing Similar Difeases, I must strike quite out: as not being capable to stand amongst the number of Diseases, being not of that Tribe; but appertaining elsewhere, and otherwise denominated more truly: and thus one third of Diseases have injuriously been added. But to sentence the Judgments and Approbations of former Ages, and the concurrence of the Learned of this present time, without sufficient Reasons and good Proof, would incur a censure.

Res praeter naturam sunt tres: Morbus, morbi causa, & Symptoma. There are three things, preternatural, most considerable and rightly to be distinguished; else great Errors in Practice will arise from thence, viz. The Morbific Cause, the Disease, and the Symptom. The Morbific Cause generates a Disease; the Disease beg ets Symptoms. All Preternaturals are comprised under these three Heads, or reduceable thereto: Then Qualities Preternatural, must fall into one of these Classes; but to which of them they belong to is the question in hand.

If Qualities preternatural do affurge from Morbific Causes and Diseases, as the Ef­fects thereof; then Qualities cannot be Diseases: But Qualities preternatural are so pro­duced, ergo: the Major Proposition needs no Proof; the Minor appears plainly thus. Quali­ties being Accidents, have no existence of themselves separately; but are dependant upon Substantial Causes, both in their Natural and Preternatural State: So that Qualities act not but by the vertue and power of their Substances on which they depend, and issue from; Therefore when they are unduely exalted preternaturally, they are instrumental, subse­quent, and attendant upon Diseases and Morbific Causes as the product thereof.

Secondly, That which is but a Symptom of a Disease, is no Disease: But Qualities preternatural are Symptoms; Ergo: the Minor Proposition I prove from the definition of a Symptom. Symptoma est Accidens praeternaturam Morbum sequens, velut umbra Corpus. In this definition are qualities preternatural comprised (Cui convenit definitio, ei con­venit definitum) as properly belonging to the Tribe of Symptoms; and that they are so, I shall single out one of your Principal Similar Diseases (Intemperies calida) a hot Distem­per; and shew you that this Quality in excess is plainly a Symptom assurging from, and depending upon a Substantial cause.

[Page 4] Natural Heat is a signal of humane Life; and quite cold is one sign of a dead Body: So that Heat appears, and disappears, as the Life is present, or absent; and shewing the State thereof. If that be temperate, the vital Principle (which is the Life) is pla­cid and quiet; but when intemperate Heat appears, the vital governing Principle, is disturb'd in its oeconomy, aestuates and grows hot, as offended by some Morbous cause: So that Heat riseth and falls, with the state and condition of the vital Principle; and is a Symptom and effect thereof, signally declaring. Intemperies calida, this hot Intem­perature, is not; cannot be called a Disease; but is the Symptom dependant upon, and the Effect of a Disease, or Morbific Cause, irritating the vital Principle which is the Fountain of Heat; for, so soon as the life is extinct, the Heat vanisheth totally.

'Tis daily obvious to those who are conversant with the Sick, that most Diseases have Preternatural Heat attending them; and this as a Symptom, giving notice that the Governour (Spiritus impetum faciens) and the oeconomy or government is disordered and disturbed by some Morbous cause, requiring the Physicians help: which heat, not to be re­garded otherwise than as signal; but the Morbific cause to be inquired after, and the Disease planted thereby; and to them Medicines must level at: So that Heat and Cold, Moist, and Dry, these Symptomatical Qualities are cured of course, when the Diseases are cured, on which they depend: But if you begin with curing these qualities, ab­stractly from their dependencies; you begin at the wrong end; and such ways of curing are like to have no end; at least not by such your endeavours. If this be not allowed for truth; the Doctrine of Symptoms is destroyed; which is rational and useful in Practice; and the preternatural triplicity (Morbus, morbi causa, & Symptoma) is made void and fictitious.

To spare farther arguments in this matter; if I prove qualities preternatural to be Symptoms, by the same Authors that before made them Similar Diseases; then I need no farther Proof but their own contradiction: and I find it so in that part of Patho­logia called Symptomatica; where Symptoms are generally divided into these three parts. Actio laesa, excretorum & retentorum vitium, & qualitates mutatae. In this third Branch of the Division, I find Qualities preternatural, and in their due place: But why Authors that made them leading the Van amongst Similar Diseases; should now make them bring up the Reer of Symptoms; how comes this about? Qualities are not of that Protean na­ture, to appear Diseases in one place, and Symptoms in another; that cannot be; e­specially without respect to some particular and extraordinary case.

I wonder this false Doctrine of Similar Diseases, should pass through so many Cen­turies of years; and through the Hands and Heads of so many Learned Writers with­out a reform: and why the intemperature of Qualities should be so confined to the Si­milar Parts only, to make Diseases there (and thereby denominated) and not in Dissi­milar Parts also, I know no reason, and they can give none: but on the contrary I know, that such intemperate preternatural Qualities does spread and affect Dissimilar Or­ganical Parts also; both the first and second Qualities; which latter are peculiar to the Organs of Sense.

You see plainly that Similar Diseases are improperly so denominated, and to be expunged out of the number of Diseases: and thus the first division of the Cata­logue is set aside, as injuriously put forth; which mischiefs more evidently will ap­pear in Practice, when I come to treat of particular Diseases, and Symptomatical affects. As for the Occult Qualities; (also accounted Similar Diseases) if I knew where to find them; I shou'd put them into their right place: But since we know not what they are, nor where they are; let them pass at this time, until you give me a better account of them.

I must remark from hence; that whereas this first Division of the Catalogue, con­taining [Page 5]many supposed Diseases (which are but Symptoms) appearing more frequently in Practice, than all the rest; we may reasonanbly conclude, that erroneous and false prosecutions, have engrossed the Major part of the business in this Art: And then, if contrary Methods, and improper adapted Medicines will kill; How many Thousands do you think have been sent into the other World, by such Proceed­ings? I'le leave the number to your thoughts; this Account is too great for my A­rithmetick: But when I come to examine the false Doctrine of Fevers, and the Practice thereupon; you may better compute the total of the Slain.

I am amazed to think, and sorry to declare; that the Art of curing should so frequently be the occasion of Killing: But much of this ariseth from want of true knowledge, in distinguishing Diseases from other preternaturals: for let us look back and see what Pra­ctisers have been doing; I find they have been very busie in curing of Symptoms, when they should endeavour the eradicating of Diseases; they catcht at the shadow, but could not see the Body: Symptoma sequitur Morbum, ut umbra Corpus.

'Tis commonly and well said; a Disease found out is half the cure: but if the noti­on of a Disease in general be not truly stated, and rightly understood; we cannot easi­ly imagine that the knowledge of particular Diseases can be attained, but by this ne­cessary introduction: For if you mistake in the general conception and notion of a Dis­ease, you err fundamentally, and then cures will be performed but accidentally: and that there is a failure in the general notion; does appear from the definition of a Disease in general, by consent of Authors thus defined. Morbus est affectus corporis viventis praeter na­turam, a quo functio laeditur primum. The general definition should give light into the knowledge of particular Diseases; but this is a dark Lanthorn. I should be loth to ven­ture my life upon the mean knowledge contained in this definition.

Morbus est affectus] that's ignotum per aeque ignotum. The first part of this definition, di­stinguisheth not a Disease from a Symptom; for, Symptoma est affectus corporis viventis praeter naturam: The latter part; à quo functio laeditur primum; this distinguisheth not the Disease from the morbific Cause: for, causae morbificae, sunt res omnes aptae corpora nostra quomodo cunque alterando immutare, & a salubri statu deturbare. Here is something of a disease described (a posteriori) in it's effects; but we should have it (a priori) in its causes. This definition setting forth and stating the notion, and ratio formalis of a Disease in general; is the Standard whereby we are to take our measures of all Diseases in particular: and this ought to be clear from all ambiguities; to stand distinct and separate from all other Preternaturals. Scire est per causas cognoscere: This definition ought to shew what a Disease is, in its essential causes (non per genus & differentiam) efficient and material: but upon this neglect and oversight supposed Diseases have been foisted into the general Catalogue; which ought not to stand there, but belongs to another Tribe of Preternaturals.

The misapprehension of a Disease in the notion of it; must needs make a false Cata­logue; and a false Catalogue must necessarily beget male practice; your definition of a Disease not being true (Consequenter) then your knowledge of a Disease is not true also: the mischiefs from thence in the designs of curing may easily be imagined. But to pull down and not to build up, is but half the work incumbent upon me: it remains therefore I should set forth the nature of a Disease, in terms more intelligible and useful in Practice.

A Disease in the true notion of it, is best known by comparing it with Health; that being a deviation from this. Sanity or Health is a perfect state of the invisible life, or vital governing Principle; acting in a visible organized Body, and duly constituted to perform vital Actions: Econtra; Disease (generatim) is the pravity, deviation or [Page 6]Defection of the vital Principle in it self; or impedited by unfitness of the Body to act vi­tal functions.

From hence you may take notice, that man being composed of two parts; the one Active, governing by vital irradiating power: The other Passive, governed by reception of that influx: So that hereby there are Diseases arising from the imbecility, enormi­ty and defection of the vital Agent; as also from the fragility, decay and ineptitude of the Passive Body: And that some Diseases do arise from the Spirit of Life (Spiritus im­petum faciens) and others by the frailty and indisposition of the Body. But Phisicians wrongfully have charged all the declensions and Morbous alterations, upon bodily imbeci­lity and decay ( witness the Catalogue of Diseases) they being unacquainted with, and not discerning the Diseases of male administration; arising meerly from the instability, per­turbation, defections and irregularities of the vital governing Power: So that in the esta­blished Catalogue, I find many Diseases more than should be; and some left out, that ought to be in.

Our learned men have taken great pains to search the Frame and fabrick of man's Body; to anatomise and view the visible Parts: but the governing ruling power which moves all in this Machine; that hath been slighted over, and overlook'd; as if not concern'd in Bodily Diseases; when as this commonly bears the chiefest part, in all Mor­bous alterations. Does any part suffer as diseased, but the Spirit of Life is concern'd? ei­ther as the first irregular mover, or else is drawn into consent, and complies to the con­tinuance and fixing of the Disease, by enormity thereof. Quicquid in sanis edit actiones sanas; id ipsum in Morbis edit actiones vitiatas.

Having noted the errors and defects of the old Catalogue of Diseases, and cashered the first general division thereof; I shall now draw out a new Scheme; and turn that general Triplicity (of Simliar, Organical, and Common) into a duality. Comprising all under these two Heads. Diseases are either Spirital, or Corporal. But by this general division, I do not mean such a perfect separation in forming Diseases, as if the one did make a Dis­ease so distinct from the other, as not to participate, and be unconcern'd in partnership: but to shew that one side is more eminently concern'd to bear the Character of Disease, and to have the Denomination; and where the stress of the Cure does chiefly lye, and to be aimed at.

Spirital Diseases are distinguished by their causes, from whence they arise and are procured, and such Causes are twofold: External and Internal. Spirital Diseases that are raised or produced (ab extra) from outward Causes, are commonly called Passions; as Anger, Grief, Fear, Melancholy, Despair, Love, Jealousie, Madness, Extasie, &c. and these I consider, not in relation to Divinity or Morality, but as aberrations and deviations from the rectitude and steddiness of Government in Humane Bodies: And thus in a Natural Sense, these Passions are evil, and are Diseases of the Vital governing Spirit; and produce bad effects, and pre­ternatural alterations proportionate, as these Passions are in degree more or less turbulent, violent and du­rable: And that these you call Passions, are Diseases, as truly and properly, as Corporal Diseases; I might prove from their Causes preternatural, by their Diagnostic Signs declaring them so; and by the Symptoms that attend and follow, as the Products thereof: but I must not enlarge now upon them.

Spirital Diseases (ab intra) are occasioned by morbific Causes, generated within the Body; and from hence the vital Spirit suffers, is put by and forced out of its sedateness and regularity of Government; or else spontaneously makes a defection and deviation in Government, by Natural debility and proneness to swerve, from lapsed Nature; the Vital Principle (Spiritus impetum faciens) not being so strong, vigorous, and stable, in some Persons, as in others; naturally so from their Progenitors; or by their different (vitae genus) Education and Manner of Living.

Spirital Diseases thus caused, are such as these: Debility, Ebriety, Aestuation, Lassati­on, Perturbation, Syncope, Epilepsy, Apoplexy, Palsy, Rigor, Sopor, Algor, Agues, Procellae spiritus impetum facientis; Pains (à causa quacunque) complaints of the Vital Principle grieved; Hysteric Fits, Hypochondriac Melancholy, &c.

[Page 7] But some may say; what hath a Physician to do with Passions, since there is no Physick to cure a diseased mind? I answer; there is advice to be given for avoiding them; and the Physician ought to know if his Patient labours and suffers under, or by them; and there is Physick against the Impressions and Effects wrought from thence: For what causes soever, alienates the Vital Principle from rectitude in Government, and makes an alterati­on in the Body; a Physician ought to take cognizance of them, and his measures thereby, in the design of Curing, especially if such Causes continue in being. The Vital Spirit also la­bours and suffers under the like Passions, from Molesting, Irritating, and Seducing morbific Causes, generated within the Body, as it doth by external provoking and procuring Causes; so that the Passions are much what the same, and produce the same ill effects, be the Causes outward or inward. Hence we may learn and know, what it is that acts the chiefest part, in these preternatural morbous alterations; and what is to be aimed at, for reduction to a natu­ral good State, Ʋt sanitas consist it in vita integra, ita Morbus, in ipsamet vita oblaesa. Helmont.

Corporal Diseases are such as result from preternatural undue Conformation and Constitution of the visible Corporeal Parts. Such Diseases are either in Magnitude, in Figure, in Number, in Scituation, in Conjunction, or Disjunction, in Discontinuity. And these being general Heads, admit of various Subdivisions, which I must pass by at this time: The urgency and importance of the following Postscript, forceth me to cease pro­secution at present, expecting opportunity hereafter to proceed, and explain what now seems dubious, and difficult to admit of.

The Vital Spirit being thus variously provoked and afflicted; begets or forms various Diseases, from the diversity of Organs used, and Functions to be performed thereby. We may hence learn, that Diseases in their multiplicity, and variation by denomination, from Parts affected, and Functions impedited; do not lye so wide asunder, and differing, as the world does imagine; since the chief moving Principle, or obstructed in motion; is one and the same in all the Faculties, but irritated to disorder, or impedited in Vital Government: Ab unitate Animae, defluunt variae dotes ad organa singula.

I have shewed you herein some part of the Learning in this Faculty, the World hath much confided in, and ventured their Lives with; which Learning I well know, and can stand it; and do understand it so well, that I have declined much of it, many years ago, as unserviceable in the true Methods of Curing. I have not troubled my self about bare empty Notions impracticable and unprofitable, but what are necessary and advantageous in Practice: that you may see the Life in Rectitude, Vigour and Sedateness, as also in Declen­sion, Enormity, and Perturbation; that knowing how Diseases are formed, what contributes to their Gene­ration, Efficiently and Materially; what is Active and Passive in Morbous Alterations; we may the better level at them, with more Security and Certainty.

I should now proceed, to give you a farther Prospect, and clearer light into this Novel Doctrine, and re­solve some Questions and Doubts therein: but at this time I am prevented by the following Matter.

LONDON, Old Southampton Buildings, over against Grays-Inn, 1691.