THE _Causes_ of the _Spirits_[64] moving inordinately, are either _External_ or _Internal_. The _Externals_ are the _Sun_, _Hot Baths_, _Frictions_, and _Concussions of the_ HEAD; or a _Fall_, _Blow_, _Contusion_, and all inordinate and immoderate _Motions_ of the whole Body: such as _Running_, _Leaping_, _Riding_, _Dancing_, too much _Venery_, or hard _Drinking_; as also the Use of _Acids_, or acrimonious Things, and all Things replenishing or stuffing the HEAD; such as _Garlick_, _Mustard_, _Anise_, _Parsley_, _Leeks_, _Onions_, _Radish_, strong _Snuffs_, _Drinks_, &c. THE _internal immediate Causes_ are the _Imagination_ of the PATIENT, _Vapours_ of the whole Body, frigid _Flatulencies_, and[65]a sudden _Fluxion_ of the _vital Spirits_ into the HEAD. THE _mediate Causes_ are _Material_; and this _Matter_[66] (almost all _Physicians_ agree) is _frigid_. From hence it is certain, that the _Distemper_ proceeds from _Crudities_, and _Victuals_ of a crude Juice; such as _Pulses_, _Cheese_, _Tarts_, _Fish_, and all _other Sorts_ of the like frigid and humid _Qualities_: But _these_ are only to be reckon’d _concurring_, not _efficient Causes_. THE most common _material Cause_ is, according to _Galen_[67], the BILE; which, seeking for Vent at the _Mouth of the Stomach_, is the _Cause_ of these _Symptoms_, and is[68]properly to be educed or evacuated by a due _Vomit_. BUT in Case of VAPOURS, _Heat_ is always the _efficient Cause_, elevating them from the peccant _Matter_; since a _Cold_, or a refrigerated _Body_, can never engender VAPOURS or _Wind_ from any Material Cause. I shall not now enter upon the particular _Diagnosticks_ of this _Distemper_, because they are as _Various_, as the _Causes_, and affected _Places_ are different. Let me observe only, that the _simple_ VERTIGO is easily known by the _Imagination_ of the _Circular Motion_ of the _Patient’s_ HEAD, or That of _external Objects_, or by vitiated _Seeing_ and _Hearing_. BUT the SCOTOMIA differs from the VERTIGO, in that besides the _Imagination_ of the _circular Motion_, the PATIENT often loses his _Sight_, staggers, tumbles, or falls to the Ground. And yet the _same_ is distinguished from the _Epilepsy_, in that the PATIENT retains his principal _Functions_, and neither _Foams_ at Mouth, nor is _Convulsive_. HOWEVER, as to the _Distinction_ of Causes, if the _internal Cause_ proceeds from _Calidity_, it is known by the _hot Temperament_ of the whole Body, as well as by a _Swelling_ and _Pulsation_ of the ARTERIES about the _Throat_: Besides that this VERTIGO easily _accedes_ and _recedes_, it is always attended with _Calidity_ and _Redness_ of Face and Eyes; with _Watchings_, _Deliriums_, &c: And it commonly follows _Fevers_, _Watchings_, _Anger_, the _Use of Calids_, hot Things, _&c._ In which _Cases_, it is always to be helped by the _Use of Frigids_, or Coolers.