Articella (The Little Art of Medicine)

as with superfluous flesh excessive growth and scabies. The widening of the pores also happens in four ways: either from intense motion pushing the faculty the vital force; or from the weakness of the retaining faculty; or from an abundance of heat and humors; or from opening medicines. Lightness occurs in two ways: namely, wind, and externally but originating internally from dissolved viscous humor; externally, however, from wax melted with ointment. Roughness, however, is produced in two ways: from within and from without. From within, indeed, from a superfluous and sharp humor; from without, however, from smoke and dust.

Concerning the superfluity of members in number.

Superfluity of members in number happens in two ways. For if the superfluity is natural, it will be from a superfluous, natural, and good humor, as from an abundance of the formative faculty; which, if it is outside the natural course, will be from a non-natural and inconvenient humor, or from an abundance or weakness of the faculty.

Concerning the diminution of members.

Diminution of members in number likewise happens in two ways: either internally or externally. Internally, due to a diminution of humors; externally, from the burning of fire, or from cold, or putrefaction, or incision. Putrefaction, however, happens either from a killing power or a putrefying agent, or from the constriction and retention of that humor which is being dissolved.

Concerning the size of members.

Greatness of members happens in three ways: either from a multitude of humors, or from an abundance of the faculty, or from a mixture of both. Smallness happens in three ways likewise: either from the weakness of the faculty, or from the reduction of humor, or from an external infirmity, such as from an incision or the burning of fire or the cold of snow.

Concerning the movement of a member.

The movement of a member from its place happens in two ways: either from voluntary motion, or from a humor near to equality, dissolving the member and making it slippery. A member or bone exits from its joint and changes likewise in two ways: either from a joint in which separation is not fitting, or from a separation where a joint is not fitting. If this is from union without separation, it will be either from an acute humor affecting it, or from an accidental wound, or from a spasm. If, however, it is from a separation where union is not fitting, it is either from a gross humor, or an accidental wound, or from a spasm.

Concerning the separation of a joint.

The separation of joints happens in two ways: either intrinsically or extrinsically. It happens intrinsically either from an acute and incising humor, or from a fatty wind distending or dissipating. It happens extrinsically either with a tear or fracture, or excessive exercise, or the cut of a sword, or what distends like a rope, or what bruises like a stone.

Concerning the modes and number of significations.

There are three genera of significations. For some signify health, others infirmity, others the neutral; and each genus of these significations is divided into two. For there are those that signify concerning official members organs with specific functions, and there are those that signify concerning similar members homogeneous tissues like bone or fat. There are two modes of significations of similar parts. For some are substantial, others accidental. Substantial ones are like heat, coldness, dryness, and moistening. Accidental ones, however, are signified either by touch, such as hard or soft; some by sight, such as colored; some by the perfection of the faculties, such as full and perfect operations.

Concerning signs of official members.

There are likewise two modes of significations of the infirmity of official members: substantial and accidental. Substantial significations are all four: art, mode, number, and position. Accidental significations are likewise four: good, bad, perfect, and imperfect.

The genera of significations perfecting their genus are three. Some are those that signify a past thing that has already departed, and this is called cognitive or recognitive; for example, those seeing a moist body recognize that sweat has proceeded. Others signify the present, and are recognized through significations, just as when a large and fast pulse is found, we understand that it signifies overcoming heat. There are also others that signify the future and antecedent recognition; as when we see the lower lip twitching, we perceive that vomiting is about to happen, which, after it has happened, is called a significatory progression. But there is a difference between significations and accidents, since there is a division with augmentation between them, which, if you wish to examine each of these divisions, they have one relationship; but for the sick, these are accidents, while for the physician, they are significations.

Concerning the signs of accidents and their number.

Accidents, therefore, that are significatory are three. For one is the operative faculty changed, such as indigestion; another is the quality of the body changed, such as jaundice; another is that which issues from the body, such as black urine. The operative faculty changed is threefold: it is either total, as in indigestion; or partial, as in the obscuration of the eyes or slow digestion; or from quality into quality, such as from good into smoky, like an acid, as if flies or wood appear to the eyes; or, finally, an obscuration of part of the vision.

Concerning the modes of change of quality.

The signification of the changed quality of the body happens in four ways: either by sight, such as jaundice or leprosy in the medieval sense of skin patches and blackness of the tongue and the like; or by smell, such as fetid breath, or sweat, or a polypus, or goat-like odor and the like; or by taste, as false bitter or acid; or by touch, such as soft and hard. That which issues from the body, the signification is bipartite: one with sound, the other without sound. With sound: such as burping of the mouth, or rumbling of the intestines, or wind through the anus. That which is without an unnatural sound is held in three ways: another by quantity, such as lientery diarrhea with undigested food; another by quality, such as black urine; another by both, such as the flow of blood.

Concerning the change of members.

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The signification of changed members is divided twofold: namely, intrinsically and extrinsically. There are six intrinsic modes. For some come from the change of the operative faculty in the member; others from those issuing from the body; others from pain in a neighboring member; others from its own place; others from an unnatural removal from its place; others from the judgment of the patient. It happens extrinsically in three ways: either by sight, such as white or black; or by touch, such as hard and soft, hot and cold; or by both, such as large or small, more or less.

Concerning the occasions of infirmities.

The occasions of infirmities are three: the change of nature, the inconvenient habit of an official member, and the separation of a joint.

Concerning the operation of medicine.

The operation of medicine has a triple effect. For it either guards health according to its own likeness, or it makes health from infirmity, or it does the contrary. There is a triple mode of regulating the healthy: those suffering illness, those beginning to be infirm, and the defective. We regulate those suffering infirmity of the aforementioned things through competent moderation. For those beginning to be infirm, we apply a double care: either we draw off the superabundance of the chyme humoral fluid, or we repair the defect of nature by applying those things that are necessary. Of the defective, some are infants, others elderly, others convalescing from infirmity.

Every medicine is either universal or particular. Universal is through the correct ordering of the aforementioned. Particular is done through the contrary and is threefold: for one is in similar members, another in official members, another in the separation of joints. We restore the changed assimilative members to their likeness, and by binding them, we complete their remaining in their quality. If the hollows have been dilated beyond measure