concretus It is the more crude impure part of the bloud the purer part of the chyle being digested into a saline juyce is carried into the milky vessels and veins and mingling at last with that ruddy liquor is called Cruor and at last becomes perfect bloud It undergoes manifold guises and is often the subject matter of a multitude of diseases being sometimes changed into an Ichor Tabum or Sanies The third part is properly called Sanguis or Bloud 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 it is a most pure sweet Homogeneous Balsamie Vital juyce for the most part of a bright Red or Reddish colour made by the Archaeus by virtue of ferments implanted in the ventricles of the heart lungs veins and arteries causing a formal transmutation of the Ckyme or milky substance into this sanguineous liquor ordained to be the seat of Life and and the principal matter for sense motion nutrition accretion and generation It is for good reason called Balsamum seu Condimentum totius corporis forasmuch as it hath a sanative power sweetly uniting all the parts of the body for the conspiration of the good of the whole It is a great preservative against putrefaction as long as it remains in its integrity for consisting of many saline particles it seasoneth whatsoever it toucheth with a pleasing sapour It is the proper habitation of the vital spirit the immediate instrument of the soul in which it shines displaying its radiant beams every way that sensation motion nutrition and all other functions may be exquisitely performed God and Nature never intended other then that the bloud should be Homogeneous pure plain symbolical with that single principle of the Vniverse Now these Peripatetick Philosophers deliver to the world that the contexture of this vital juyce is made up of Choler Phlegm Melancholy and Blood which united produce this compounded body which we call Sanguis How grosly erroneous and dangerous this Tenet is most Learned Helmont hath made evident Wherefore we conclude with that noble Philosopher that Bloud is an Vnivocal substance divisible only by some external accidental means as the Air or Fire which cause a various texture and different position of its Atomes whereby it seems to consist of parts which are not really inherent in it as is manifest in its degeneration from its native colour sapour consistence and goodness which it had before it became corrupt in the pottinger or underwent the torture of fire Both of which do strangely larvate and disguise the puniceous Balsome giving occasion to the Galenists to frame their four fictitious humours no where really existent This being the foundation of all his declamations against Phlebotomy before I proceed any farther it may seem requisite that I should make some Animadversions thereon I might take much notice of and display his errours as to what he sayes that the Latex is by the Greeks called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 this is the first time I ever read it called so the usual terms being 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The notion whatever Helmont say is not new at all an hundred Galenists have mentioned and treated of it as the vehicle of the bloud and nourishment But that cruor should come from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 crudus concretus is an opinion singular to the Baconical Philosopher That 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 doth signifie cold I know well and that cruor properly signifies the the bloud of dead people or the mortified bloud issuing from putrefied wounds I no less understand though Authors frequently confound it with Sanguis But that his Latex and the Lympha so called by moderns are the same is news for it is not held that the Lympha in its peculiar form was pre-existent in the Arteries and as such did accompany the Blood through the Maeandrous pipes but is generated as it is discharged into the Lymphaeducts and from them is re-mixed with the bloud And if it were yet would not the definition of this Latex agree with it for the Lympha is no inseparable companâ—on of the bloud as appears by its peculiar vessels it is seldome a diaphanous clear liquor being commonly tinged with several colours oftentimes whitish sometimes yellow or as it were stained with bloud And whereas this Latex is devoid of all sensible qualities those who have experimented the Lympha do not find any such thing but a variety of tasts Nor is it true that the Serum which accompanies the Bloud is such a Latex as our Helmontian describes it being never to my taste free from a salsuginous sapour though it retain that with a great Latitude nor devoid of colour so as to be clear and diaphanous and 't is very seldome seen that the said Serum will not coagulate unless preternaturally upon a gentle fire so that it is no more to be termed a Latex than the whites of eggs beaten to the like fluidity In like manner that in the Lymphaeducts will coagulate as Bartholin observes and others As for the Cruor that there are graduations of the Bloud as to its crudity and impurity is no doubt amongst the Galenists and that it may oftentimes transcend the state of due maturation and so become degenerate is as easily granted as that it should come short of its desired perfection and when this Blood degenerates any way into a Tabum or sanious matter I must tell him that Aristâ—â—le and his followers acquainted us therewith before that Helmont was ever heard of whose Cruor bred in the Liver and distinct from the Bloud impregnated with vitality is such a piece of non-sense as ought not to be mentioned in this Age but to Baconical Philosophers who not only connive at but applaud any Hypothesis Concerning the Blood when I read the Elogies he bestowes upon it as the Seat of the Soul by which sensation motion nutrition generation are performed I thought â—pon the opinion of Aristotle and his zealous sectators â—mongst the Physicians who have denied all Animal spiâ—its fixed the principality of the Members in the Heart and from thence derived even the nerves If G. T. will defend the generality of his Assertion I assure him that Hofman Van der Linden and Harvey will be more serviceable to him than Van Helmont But this consideration hath little influence upon the present Controversie that which follows hath nothing of Truth in it that the Bloud is an Homogeneous pure body for nothing homogeneous can ferment But it is most evident that the bloud is in a perpetual fermentation and that it is such a liquor as is constantly generating constantly depurating and constantly expending it self so that nought but Imagination can represent unto us such a thing as pure bloud and I hope the specious pretences of a Real Philosophy will not terminate in Speculation and Phansie When the bloud either naturally issues forth or upon incision of a vein it representeth unto
dependance of our Life thereon is not so great or intimate as that upon the effusion of a little no nor of a great deal of the bloud Death or any debility extraordinary and durable should ensue unavoidably and if it happen but sometimes 't is apparent thereby that 't is but accidental and not a proper consequence of that effect 'T is manifest that the operations of the Soul are not restrained to one determinate proportion of bloud in every body nor to the same in any albeit that there seem requisite in all Animals that there be some bloud or what is equipollent thereunto 'T is also manifest that this Bloud for which some are so sollicitous doth continually expend and waste it self in nutrition and that even the nourished parts are in a continual exhaustion so that without supply it would degenerate â—nto choler except in those miraculous fasts and diminish to little or nothing as appears upon great fastings and several diseases 'T is no less manifest that upon great evacutions of bloud by wounds or otherwise when the Bloud hath been so exhausted that very little can be imagined to remain yet in a few dayes the veins and arteries do fill again and nature is so replenished and vigorated that this lost bloud seems not only as good in order to the functions of life but better in order to health and strength since the production of this last in the end of diseases is accompanied with convalescence whereas the precedent did not hinder the indisposition Out of what hath been said the Answer to this Objection is facile viz. The Blood is not so the seat and residence of the Soul nor so absolutely necessary to Life granting all that can be desired of us as that some of it may not be let out without present danger or irreparable detriment so that if the motives for Phlebotomy be cogent or so probable as to render the Action prudential no difficulty can arise from this scruple It is written in Deut. 24.6 No man shall take the upper or nether milstone to pledge for he taketh a man's life or soul to pledge Here the milstone is called the life or soul of a man as much and as properly as ever the Blood is any where else But though there be a prohibition for a man to deprive his poor neighbour thereof as of the support of his Life yet undoubtedly none was ever interdicted by virtue of this precept to help the distressed Miller to pick and dress his Milstones His third Argument is this Moreover one would think it should put a stop to their prodigal profuse bleeding if they did but consider with what difficulty Nature brings this Solar Liquor to perfection how many hazards of becoming spurious and abortive it passes through how easily it is stained by an extraneous tincture how often intermixed with something allogeneous and hostile to it how many elaborate circulations digestions and refinings it undergoes before it be throughly animated and made fit for the right use of the immortal Soul One would imagine by this Objection that the Generation of the Bloud were as difficult a work and required as much of sollicitude as the Philosophers stone and that the least errour would disappoint the process and eject the poor soul out of its tenement and mansion But there is not any such thing he that considers the perpetual supply of Chyle by the Ductus Thoracicus and with how much ease it is transformed a great part into Blood by the similar action of that which pre-existed in the veins together with the concurring aid of the Heart and sanguiferous emunctory vessels and the previous alterations in the stomach and intestines will imagine neither the production of Bloud nor the reparation of it to be so tedious and hard a matter Nor is it true that the Bloud is so easily stained with hostile tinctures since it is a liquor that is in perpetual depuration and hath the convenience of so many out-lets to discharge it self by Neither will every crudity in the immature Chyle or bloud render the blood unfit for the use of the immortal soul there is extraordinary and unimaginable difference betwixt the bloud of one person and another as appears upon distillation burning and mixing it with other liquors yet are all these within the latitude of Health and with equal perfection exercise the operations of Life Nor doth every allogeneous mixture vitiate or deprave the bloud for the Chyle Bloud and Flesh retain some particles of the original food taken into the stomach hence it is that sheep fed with pease-straw though as fat as others yield a flesh differently tasted from other mutton the like is to be observed in the feeding of other Animals generally Nor is this more evident in other Animals than 't is in Men for not to mention those Medicaments which by the alteration they make in the Vrine do demonstrate they have passed along and been once mixed with the bloud as Cassia Rhubarb Annise-seeds c. In fonticulis observavi quod si praecedente die aliquis allium aut cepam comederit pus quod in fonticulo est odorem allii aut cepae obtinebat sanguis autem qui per fonticulum expurgatur non nifi per venaâ— expurgari potest unde possumus dicere quod sanguis acutum odorem detinere possit The like phaenomenon is to be observed in wounds and ulcers which feel detriment according to the various food and drink of the patient Nay in pleurisies and other wounds it hath been taken notice of that the purulent matter hath discharged it self by the veins re-mixing with the bloud into the intestines and by urine The Bloud of some persons in perfect health hath been observed to stink worse than rotten eggs even as it was issuing from the arm upon Phlebotomy yet when it was cold it did not stink nor seemed to differ from the best bloud except that it was of a more beautiful red than is usual I conclude therefore that in this Argument many falsities are contained and there is nothing of such force as to deterr a prudent Physician who understands the rules of his Art and those cautions which are suggested to us in Phlebotomy to let his Patient bloud and emit some of this solar Liquor His fourth Argument They should never attempt yea rather abhorr to enervate in the least by the Lancet the strength with its correlative bloud and spirits without which there is no hopes of attaining a desired Cure For it is a most established verity taught by Hippocrates that Naturae sunt morborum medicatrices the most assured means of sanation is to keep up the vital pillars without which all falls to ruine So that Van Helmont is without controversie in the right when he sayes utcunque rem verteris ignorantiae plenum est procurata debilitatu sanare velle i. e. make the best you can thereof It savours of gross ignorance
by the History of Generation that no Parenchymatous part hath any operation in the first production of the blood all their Parenchymas being post-nate thereunto And if the blood be thus generated at first it is but rational for us to imagine that it is alwayes so generated during life For as it is true that the same cause acting in the same manner will alwayes produce the same effect So in this case to argue from the identity of the effect to the identity of the cause is allowable Est enim causarum identitas quae facit ut effectus sit idem quippe effectus supponitur non esse donec a causis existentiam suam indeptus fuerit dum existentiam illam largiuntur oportet ipsius quoque identitatem impertiant qua sine effectus ipsemet nequaquam fuerit That the Spermatic vessels in which the blood moves do contribute to sanguification much seems apparent from hence that the blood is seen in them before it is in the heart And because it is observed that the fluidity of the blood seems to depend much on them and therefore in the dead it doth not coagulate except praeternaturally in the veins though it do commonly in the Heart or wheresoever it is extravasated Manat praeterea aliquid a venis nobis incognitum quod dumearum ambitu sanguis concipitur prohibet ejus concretionem etiam post mortem in cadaveribus jam perfrigidis nequis hoc colori acceptum ferat quod vero coralliorum instar aliquando repertus est concretus in venis ipsis hoc merito Fernelius ascribit morbo occulto And not only the fluidity but motion of the blood seems to depend much thereon for if by a ligature the impulse and succession of blood be prevented yet will the blood in the veins continue its course and not stagnate Exempto e corpore corde motus tamen sanguinis isque satis celer in sanis videntur Et si vena ulla etiam lactea duobus locis ligetur laxata ea sola ligatura quae cordi propinquior est dum partes adhuc calent semper Chylus ad hepar sanguis ad cor cum movebitur qui nec a corde per Arterias nec ab intestinis per lacteas objecto potuit obice propelli nec stuiditate sua potius sursum quam deorsum movetur The truth hereof seeming undeniable to Pecquet he makes use of a new Hypothesis to solve this motion of the blood as if it arose from compression of other parts or contraction in the vein it self But the Phaenomenon will appear in such cases as admit not this pretence From these reasons it is that the blood doth not need so much as any pulse in the veins and arteries as appears in the first faetus but as soon as it comes to the Heart it does to prevent coagulation the punctum saliens being endowed with no such quality practiseth its systole and diastole when yet no such motion is observable in the Arteries at that time Whence the colour of the blood ariseth is a secret unto me I know that digestion reduceth some Juyces to a redness in some Fruits the fire doth the like in some the mixture of acid Liquors begets a Vermilion But here I conceive none of these causes produce the effect the generation of the blood is manifestly an Animal Action and as such unsearchable Whatever I attribute to the veins it is not to be expected that supposing they should instrumentally sanguifie the blood should turn blew from them any more than that water put into new vessels of Oak should turn white whereas it becomes reddish Thus the Plastic form produceth blood at first and whilest there is no first concoction in the stomack supplieth that defect by that albuiginous Colliquament which is of the same nature with the Chyle we digest our meat into and convey by the Lacteous Thoraciducts into the Heart That it is of the same nature appears hence that it resembles it and that it is extracted from the Blood of the Mother and produceth in the Embryo the like excrements of Choler and Vrine and Macosities nay it hath been observed by Riolanus to have been tinged yellow How much more may be concluded hence in favour of the Galenical alimentary humours supposed to constitute the Blood I leave those to judge who consider the variety of female constitutions and their condition during their being with child perhaps the Hypothesis of a proportionate mixture of the five Chymical Principles will not seem more colourable Having thus related how Sanguification is performed in the Faetus at first I come to give an account how it is performed afterwards and even here it seems an Action perfectly Animal for even Concoction in the Stomach is not the bare effect of Heat elixating the meat nor of acid or saline Ferments dissolving it nor of any other kind of imaginary Fermentation But 't is the effect of an Animal power operating upon the Meat in the stomachs of sundry Men and Animals by several wayes This appears most evidently herein that the same meat eaten by several Persons or different Animals produceth different Blood and different Excrements therefore Chylification is an Animal operation and is modulated by the specifick and individual constitutions Having thus determined of things that the Soul in all these actions is the Efficient we may consider that the meat being masticated in the mouth and commixed with the salival juyce or spittle is prepared in order to Chylification then it descends into the stomach and is there sometimes in a longer sometimes in a shorter space reduced into a cremor which is so far from being acid as Helmont saith that it is generally rather saline as are also the recrements of it that remain in the empty stomach It is true that according to the stomachs of Individuals and the meat they eat it happeneth so that this Cremor hath no certain taste nor colour Undoubtedly it must have been bitter in that Marriner and such as he of whom Vesalius writes that the Gall did naturally discharge it self into his stomach yet did he digest very well and never was apt to vomit or to be so much as sea-sick From the stomach the Cremor descends into the Intestines not all at once but as it is digested and there undergoes a second digestion receiving into its mixture the Gall and Pancreatick juyce I shall not speak of the variety that hath been observed in those two liquors nor trouble my self about the manner how they operate on the Chyle It is manifest that upon that mixture the Chyle suffers a great alteration if not some effervescence and some parts are coagulated and as it were precipitated and by a succession of changes the several particles are so blended and refracted in their qualities that the excrements at last are neither acid nor bitter but in dogs both sapors are extinguished In the mean time during
is conveyed as it were in conduit-pipes the Heart being the great Elastic Engine which drives it being fed by the vena Cava and disburthening it self by the Aorta though even the motion of the Heart depend upon a Superiour influence by its Nerves which wherein it consists and how derived from the Brain and Soul is a thing to us incomprehensible I do suppose that the Circulation is continued and carried on principally by Anastomoses betwixt the Capillary veins and Arteries many whereof having been discovered by Spigelius Veslingius and others the rest may well be supposed and perhaps in the coats of the Veins and Arteries there may be a certain texture requisite whereby the transpiration is managed in order to the safe continuance of the digestive fermentation in the Blood and the nutrition of the body The impulse of the Heart together with the pulsation is sufficient to convey the blood to the lesser capillary Arteries and there though the pulse be lost which yet a little inflammation in the extremities of the body will make sensible and in some Ladies as also in Children the least preternatural heat yet it is impelled by the subsequent blood still into the veins and having acquired by the common miscele in the Heart and the digestive fermentation which naturally ariseth in such heterogenious liquors an inclination to expand it self the compression in the Capillary vessels adds to its celerity of motion when the larger veins give liberty for it the Aiery corpuscles of several kinds which are easie to be discovered upon burning by their expansion and contraction adding much thereunto Thus in Water-engines the narrowness of the â—ipes do add to the impetus with which the Water issues forth And I do conceive by the Phaenomena which daily appears in practise that the Animal heat in the Blood actuating that heterogeneous miscele and according to the diversity of its parts producing therein with the help of its fermentation a rarefaction of what is aiery and according to the room there is a liberty or inclination to expand and evaporate themselves this is the principal cause of the continuance of the motion of the blood in the veins and of its saliency upon Phlebotomy Thus upon Scarification there is no salience or spurting out of the blood there being no room for such an expansion or for the Aiery halituous parts in which there is as great a difference as in those exhaling from the terraqueous Globe to rush forward out of the continued Arteries and together with themselves to protrude the blood Upon this account the Methodists and old Physicians as also the Aegyptians where the tender bodies and constitutions of Children and Women or Men admit not of or requireth that great relaxation of the pores and texture of the body which a more robust and firm habit wherein as the natural resistance in health is greater so the recess from it in a bad estate is much greater would be cured by they use these Scarifications and prefer them most judiciously to Phlebotomy This constitution of the Body doth evince the great utility of Phlebotomy and best as I suppose explicates the effects thereof which we daily experiment From hence not only is manifest how the Body is evacuated in a Plethora but in case of Revulsion and Derivation It is manifest in Aqueducts and Siphons that the liquors though much differing in nature from the Blood nor so inclined to evaporate does accelerate their motion and issue out so rapidly upon an incision or fracture in one of the Pipes that a lesser in such a case will deplete the greater notwithstanding its free passage in its own entire Canale Thus the most learned and considerate Physician Sir George Ent having observed first thus much Videmus aquam per siphones delatam si vel minima rimula hiscat foras cum impetu prorumpere And Sanguis per aortam ingressus fluit porro quocunque permittitur peraeque sursum ac deorsum quia motus continuus est quemadmodum in canalibus aquam deferentibus contingit in quibus quocunque feruntur aqua continuo pergit moveri Quare nugantur strenue qui protrusionem hujusmodinon nisi in recta linea fieri posse arbitrâ—ntur After this He explains the doctrine of Revulsion in this manner Quae postea de revulsionibus dicuntur nullum nobis facessunt negotium â—antundem enim sanguinis a pedibus ascendit per venas quantum ad eosdam delabitur per Arterias Facto itaque vulnere in pectore aut capite revulsio instituitur si modo tam longinqua instituenda sit in â—rure Quia sanguis alias quoquoversum ruens facto nunc in pede egressu copiosius per descendentem ramum procul a vulnere delabitur Non enim arbitramur sanguinem aeque celeriter sua sponte per arteriam aut venam fluere atque is secta earum aliquo effluit Nec sanguis ad laesum pectus aut caput per venam cavam impetu affluit quia fluxus ille aperta inferius vena intercipitur I do acknowledge that the reading of these passages did first create in me the thoughts I now impart unto you And hereby it is evident how the Ancients with their large Phlebotomies might derive even the morbifick matter or revell it though impacted Our minute Phlebotomies do seldom produce such an effect for since it is not otherwise done but by a successive depletion out of the Arteries it would seem necessary to extract three or four pounds of Blood to effect such a matter Neither indeed is it necessary albeit that I believe the most speedy cures but great judgment is requisite in such operations were atchieved thereby for though we do not retract the Humour or Blood unto the place where we Phlebotomise we do revell it from the place whither it was flowing and the course of the Blood and Humours being diverted the Arteries leading to the part affected or depleted and the Flux of Humors which was by them is abated their tenseness there which appears by their pulsation there where they did not beat before is relaxed and so becomes less opportune to extravasate either the Blood or other Humours whereupon Nature it self alone or with a little help of the Physician doth digest and dissipate the impacted matter Whereupon if we add the motion of restitution in the parts affected which is hereby facilitated the great change in the digestive fermentation of the Blood which is manifest by the melioration of the Blood which is seen in repeated Phlebotomies and the relaxation of the whole body in order to the transpiration and other depuration of the Blood by its several Glandules the Kidneys Liver Guts the reason of those prodigious benefits which Patients have had of old and now under our practise is manifest nor do we want a justification for reiterating Phlebotomy or exercising it in different veins and divers manners I designed long ago to set aside some spare
AN EPISTOLARY DISCOURSE CONCERNING Phlebotomy In Opposition to G. Thomson Pseudo-Chymist a pretended Disciple of the Lord VERVLAM Wherein the Nature of the Blood and the effects of Blood-letting are enquired into and the practice thereof EXPERIMENTALLY justified according as it is used by Iudicious Physicians In the Pest and Pestilential diseases In the Small Pox In the Scurvey In Pleurisies And in several other diseases By HENRY STVBBE Physician in Warwick Hippocrat l. 1. Aph. 2. VASORVM inanitio si talis fiat qualis fieri debet confert bene tolerant sin minus contra Inspicere itaque oportet regionem tempus aetatem morbos in quibus conveniat aut non Printed in the Year MDCLXXI SIR IN obedience to your Commands I have read over the Treatise of Thomson concerning Blood-letting I never underwent a more difficult task in my life And had the Virtuosi imagined with what reluctancy and constraint I should undertake such a work they would have abandoned all their other stratagems and imposed on me this pennance as the most severe I profess I am not so understanding in the Greek Latine or English Tongues as to comprehend his Language yet I think I am not so much in default therein as He who according to the peculiar fate of the modern Baconists hath either out-lived his Learning or never was endued with any That He should pretend to read or understand Hippocrates is a vanity equal to that with which Ecebolius professeth himself to be versed in the writings of Aristotle and when he blames the Method which the Galenists have used above this sixteen hundred years would not one imagine that the birth and flourishing renown of Galen had preceded those Centuries whereas you must place him in the second Century during the Reign of Marcus Aurelius Commodus Pertinax and Severus or you will contradict the account which Galen gives of himself and the relations of other Historians and at such time as he arose the world was prepossessed with Methodists and Empiricks But I wish his greatest errours lay in his ignorance of these things Alas he understands not any thing of the Rudiments of Physick and to inform him one must write an entire Body of Physick Were it not for a few hard words borrowed from Van Helmont such as Enormon Archaeus Daumvirate c. and his extravagancies about fortifying the vitâ—l spirits ejecting the venome or spina in diseases and that by a diaephoresis generally by the means of certain Arcana more famous for the death than recovery of his patients the man would have nothing to say And do we wonder at the unfortunate cures for which he is blamed or that more than one at White-chappel should suffer by his ill-advised Pepper-drops 'T were strange should one that neither understands humane nature nor the types times motions and terminations of diseases should ever except by accident do any good not that He should frequently do harm But a fool may commit more faults than a wiser man than I and of more leisure can discover I shall confine my present address to the point of Phlebotomy wherein he so traduceth the Hippocratical Physicians as so many murtherers and particularly declaimeth against the most judicious Assembly of our Faculty that Europe ever beheld and who if they be culpable are mis-led by the practice and precepts of that Author Hippocrates whom he himself often cites and to less purpose than I might in this controversie alledge him Some years since I designed to write an enquiry into the original and nature of the Blood and the usefulness of Phlebotomy in several diseases in which abstracting from the single opinions of Writers I purposed to illustrate each point by practical principles and ample Histories out of intelligent and creditable Physicians concerning the bad or good success with which Blood hath been let in diseases according to the several Ages of the disâ—ased and the nature of their maladies whether Epidemical Sporadical or of a less general constitution But the Controversies I have been involved in have so incumbred me that I have not been able to pursue thâ—se intentions nor have I any preparations almost in order thereunto as yet digested into writing But this Antagonist requires not all my strength a less powerful Assault will suffice to overthrow Him 'T is not any kindness to him but indulgence to my self that I do not pursue all his errours even in the generation of blood or go about to convince him of the several mistakes which he is fallen into for want of reading more modern Writers and their discoveries Beyond Helmont or in contradiction to him the man neither does nor will understand any thing And even in that Author he seems so little conversant that he sometimes mistakes him and generally represents things with more obscurity and intricacy then they are expressed in the originals of Van Helmont or Grembs Of those that have opposed Phlebotomy these are not the first which this Century hath produced long ago Galen complained of Erasistratus the sisters son of Aristotle that he was 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 fearful to let his Patients blood before him Chrysippus Cnidius Medius and Aristogenes did reject the usage Also Apaemantes together with Strato are recorded to have contradicted the practice of Phlebotomy by Arguments The strength of that faction in Physick was such at Rome in those times that Galen spent several books against the followers of Erasistratus upon this subject But above all that ever intermedled I will give this character to Thomson that never did any presume more upon so weak grounds Nor ever was Confidence so poorly mounted and so pittifully be-jaded After much trouble and enquiry the sum of all he sayes in this case amounts to this The promiscuous mass of Bloud which flows in the Veins and Arteries he divides into three parts the one is called by him the Latex the second Cruor the third Sanguis or most properly Blood The Latex so called by Helmont by some Lympha by the Greeks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 is a diaphanous clear liquor 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 fabricated in the second digestioâ— by virtue of a ferment there residing It is the inseperable companion of the Bloud and closely perambulates with it through all the wandring Maeandrous pipes in this Microcosme It is the matter of Vrine and Sweat Spittle c. and renders several other considerable services to the body The goodness or pravity of the Latex depends much upon the bloud as it is constituted for albeit it is no essential part thereof yet is it altered for better or worse according to the channels it passeth through the lodging it taketh up and the condition of its associate notwithstanding that it may be sometimes impaired in its due excellency and the bloud withall remain very pure and sincere The second part is called Cruor from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 i. e. Crudus
Medicinam inculpate exercere contra facies quanto enim magis sanguinem videbis à propria natura discedere tanto minorem quantitatem vacuabis aliquando nisi copia urgeat cacochymiae permista à venaesectione prorsus abstineto Nor is this the judgment of a single writer hundreds are of the same opinion the Learned L. Septalius Animadv Medic. l. 4. sect 2. is of the same judgment In sanguine detrahendo cavendum maxime ne quanto putriorem deterioris conditionis sanguinem è vena profluere viderimus tanto majorem quantitatem effluere sinamus quod plurimos facere observamus tali enim existente sanguine pauciores subesse spiritus constat vires facillime solent collabascere Even Galen and Avicen are alledged for it And it ought with less reason to be objected in England because our Physicians generally as likewise are the Germans seem not so prodigal of the bloud of their Patients as to make a Cacochymie much less a 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or total corruption of the sanguineous mass to be the proper indication for bleeding nay most that hold Blood-letting in great diseases arising from Cacochymie to be a necessary remedy not indicated by the depravation of the bloud but violence of the disease they are cautious in the quantity which they take away because in such an habit of body the strength of the patient is seldom great enough to bear much Out of which it is manifest that what he sayes about the impurity of the bloud in the porringer that 't is an excuse or imposture used by the Galenists in defence of Phlebotomy it is a fiction of his own not made use of directly by any but the followers of Botallus the rest will give him other reasons for their practice than a Cacochymie alone or total corruption of the mass of bloud A farther mistake it is in him that he represents the Galenists as such pittiful fellows that should not know but that each corruption of the bloud is incorrigible and therefore let it out It is true that we do hold that it is possible for the bloud to be so vitiated as to be incorrigible and that one may assoon hope to see the regress from a total privation as it restored This hath been observed in pestilential diseases sometimes and in sphacelated parts and perhaps I may be allowed to reckon as such the bloud of that person in Fernelius which was universally coagulated in the veins so as to be taken out as 't were branches of coral And that Woman 's in the observations of Pachequus whose bloud in a continual fever did issue out upon Phlebotomy as cold as Ice or Snow the like to which in the spotted fever is taken notice of as a fatal prognostick by Petrus à Castro If Plempius give me leave I would reckon in putrid fevers that bloud to be incorrigibly depraved which doth not coagulate and is destitute of its fibres since Fernelius and others esteem of such as an evident testimony of the highest putrefaction It is also true that we do hold that where diseases are ordinarily or frequently curable yet by accident from the idio-syncrasie of the patient or some other intervening cause the bloud may be continued in such a vitiated estate as to be incorrigibly corrupted and yet its essential form not lost as in case of Cancers Hypochondriacal and Scorbutical distempers Scirrhosities of the Liver Spleen and Mesentery Leprosies knotted Gout calculous indispositions c. I might mention other cases but they relate not to the present controversie and I have already said enough to shew the ignorance of this Baconist To come nearer to the main matter It is true that we do hold that in many distempers as in the Scurvey putrid Fever and some others the mass of bloud is so putrified and corrupted that even that which is termed more stricktly Blood is depraved sundry wayes for if the vessels that generate and convey the Chyle and the Chyle it self be corrupted 't is impossible but that which is produced and supplied daily out of the Chyle should participate of it pravity and so much the more in that they flow intimately commixed in the same Arteries and Veins But that in such cases we hold the Blood to be so depraved as to have lost its formal essence totally and irrecoverably is most notoriously false and any man may see hence that this Ignoramus understands not the Galenical way but deserted it before he had acquainted himself therewith We do hold that the blood and associated humours may come to a partial putrefaction and yet be recovered again and 't is this recovery and redintegration that we design by our practice and if we cannot effect it totally yet that we aim at is to concoct the several humours so that what there is of them that is alimentary and agreeable to nature may be mitified and retained and the rest so digested as that it may be with ease and safety ejected the body and so the Mass of bloud regain its former lustre and amicableness This being the grand intention of the received Method of Physick 't is one thing to debate whether blood-letting practiced according to Art for we are not otherwise concerned in the Quarrel be a suitable proper means to atchieve our purposes And another to say that we pierce poor mans skin and rashly throw away the support of life out of a vain apprehension that it is totally corrupt and depraved of its former being and no wise capable of being retrograde This cannot be said without an apparent injury unto us We know the variety and fallaciousness of colours and by our rules can well conjecture how far the Humours are vitiated what may be concocted in order to the nutriment and benefit of nature and what maturated to a convenient ejectment And we do utterly deny the consequence of this Argument though we grant the Assumption Viz. If the bloud be of such a nature that it may be recovered to its pristine colour and vigour without Phlebotomy then ought not men to use Phlebotomy But the Bloud like Mercury may be polymorphised and changed into divers shapes and at length be reduced to the same state and condition as when it was in its primitive essence Ergo. The Assumption I can grant but not where such a practitioner as G. T. is made use of I doubt not but the followers of Erasistratus could effect it by their Fastings Frictions Bathes and other remedies used by such judicious men I grant that robust nature doth daily produce such rectifications of the bloud in many that make no use of a Physician But as willing as I am to gratifie my Adversary I should not yield thus much to Helmont or such as practice with Arcana and commanding Medicaments To the sequele of the Major I reply that albeit that Nature may oftentimes do miracles yet are not miracles to be presumed upon It is
't is very unlikely a plenitude should be of any duration Is it not then greater prudence in a Physician to minorate what is superfluous by safe profitable wayes of secretion and excretion still advancing the principal Agent then for that end to give vent indiscreetly to what comes next without any election incommodating if not hazarding the loss of the vital principles For believe it whosoever hath any great quantity of blood taken from him either rues it for the present or hereafter Let him that is heterodox prate what he will alledging examples of those sturdy lusty bodies which have hereby received immediate succour I can make good by practise and challenge any one to come to that otherwise let him forbear his Garrulity whosoever is cured by a Lancet in this sort is either prone to relapses or to live more crazy in his younger or elder years although for some short time he may not by reason of a robust ingrafted constitution be sensible of these inconveniences As for Phlebotomy in order to Revulsion he thus explodes it Another pretended way for sanguâ—â—â—ission is Revulsion by which they say a violent slâ—â—x of morbifick lâ—quâ—r into any noble parts is intercepted for this end they use the Lancet in a Pleuriâ—ie Peripâ—eumony or any inward inflâ—mmation But how far they erre herein is well known to the best Practitioners for although I confess they do sometimes in the beginning suppress and as it were crush the aforesaid diseases yet is it done accidentally very uncertainly rather by way of distraction of the Nature for the loss of its substantial treasure than from any true Revulsion or direct pulling back of what is in flux or already stowed in 'T is true where the vessels are depleted a repletion is forthwith made ob fugam vacui to avoid a vacuity but the supply is from what comes next for as intro as well as intro for as However there is no streight immediate Revulsion intended from the part affected to the Orifice It seems strange to me that any man should pretend thus long to have diligently attended on the practise of Physick and yet never have seen or have the impudence to deny that there can be any such thing as a surcharge of Blood which is that which Physicians call a Plethora or Plenitude But the continuance of these Baconical Philosophers will in time free us from any admiration of this kind In Greece when the Athletae or Wrastlers were publickly maintained the observation indeed was more facile than now but every Countrey almost yields frequent cases of such an indisposition particularly 't is easily to be remarqued in strong healthy and plethorick Children whose sudden death â—s it often ariseth from no other cause so it astonisheth the vulgar and usually raiseth in them suspicions of Witchcraft Hippocrates and Galen having taken notice of the evil consequences attending this habit of body do advise the owner to attempt the change of it though it be accompanied with the most perfect health and vigour imaginable 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 And this habit of body and fulness of blood which he saith would do Methusalem no harm is observed by those who had daily opportunity to see the sad experience of it to abbreviate the life and occasion many diseases as Apoplexies Cardiacal Syncopes and Ruptures of veins in the Lungs Squinancies Pleurisies c. So that Hippocrates condemns that habit of body again in his book De Alimento and Celsus concurs with him therein Ea corpora quae more corum Athletarum repleta sunt celerrime senescunt aegrâ—tant i. e. Those bodies which are dieted and brought up to an Athletick habit do soonest of all decline into sickness and premature old age I never read of any Physician who in his directions for health recommended unto his Patient that course of life wherein the Athletae were bred up thereby to acquire such a Plethoric habit and whatever the present sanity were which they injoyed as to strength of body their intellectuals were very dull and the most understanding persons would have thought it prudential in such a case to broach some of the Balsome of life and weaken Nature thereby rather than to live in a perpetual danger of such perillous diseases as that Euexy subjecteth men unto But our Helmontian doth think otherwise If such an habit of body be thus perillous during perfect health how ought a Physician to apprehend it upon the first approaches of sickness Doth not then Nature add to the redundance of blood by a defective transpiration whereas the veins are so full as not to be able to contain more Is not the pulse weak slow and oppressed and the Heart so debilitated as not to be able to discharge it self of the Blood which flows into it and in danger to stagnate in the Lungs or coagulate in the Ventricles Can there seem any thing more agreeable to common reason in this case than to practise Phlebotomy whereby Nature is at present alleviated the surcharge of blood abated and the imminent dangers prevented Is it not prudential were a little blood so precious a thing and the loss thereof attended with some small irrepairable debility Is it not I say a part of prudence to submit to lesser though certain inconveniences then to run an almost inevitable hazard of the greatest imaginable I read not that the famous Milo arrived to the years of Methusalem nor yet to those of Hippocrates though I am apt to think he was so solicitous for to preserve his strength in its vigour as not to have been much Phlebotomized At the Olympic Games being Victor and going to receive the Garland from the judges he fell down dead suddenly and was thence carried to his Grave It is to be supposed according to our Helmontian that in that Euexy of body something so virulent or odious put the Archaeus into such a fury that it ran mad and destroyed him whereas had it been sublimate or Arsenic it would not have been half so exasperated or hasty 'T is a most humoursome and sensless Kitchin boy that no man knows how to please Suppose that the Brain might be in him a little oppressed with a Vertigo or some petty disorder must this capricious Duumvirate immediately produce the Idaea of no gentler a disease than an Apoplexy or Epilepsy But to pass from these phantastic causes the allegation whereof least becomes an Experimental Philosopher I shall instance in the effects of Bleeding in a Plethora Anton. Benivenius Medicinal observat c. 69. Men commonly attribute much to the Pulse in the discovery of diseases If that be weak low and small they frequently presage death or mortal dangers if it be full and strong they give hopes or assurance of recovery Yet we meet with one Philip a drunken and corpulent fellow who lying sick in his bed I found his Pulse so weak that it was scarce perceivable and I should have
I have some groundâ— for this suggestion but I never could 〈◊〉 any 〈◊〉 or thin concretion upon the turned blood and to 〈…〉 fect thereof I have been willing to attribute the â—â—â—â—nomenon when the turned blood hath not equalled in floridness the first superficies Some have attributed that florid colour to the concretion and shooting of some volatile Salts in the surface of the Blood and think that Kiâ—cher mistook those saline striae for Worms in his Microscope Besides this difference in the Mass of Blood as to several Individuals it may not be amiss to consider the difference that is betwixt the Blood in sundry vessels and parts of the body It is the most common tenet amongst Anatomists that the Blood of the Arteries differs very much from that of the Veins Though Harvey seems to deny it with much confidence and appeals to Experience for the proof of his Opinion yet the Generality as Doctor Ent Walaeus and Lower grant there is a great difference in the colour of them and that the Arterious blood is the most florid the venous is of a darker red Besides this difference in colour there is a greater which ariseth from the quantity of serum which abounds in the Arterious blood more than in the venous Comprobavimus in accepto per nos ex crebris Arteriotomiis cruorum duplem ferme compertam ichoris portionem qua fit fortassis ut crediderit Auctor lib de util respir. Sanguinem Arterialem non concrescere velut venalem quanquam nos eum concrescere non semel observavimus So Aurelius Severinus with whom Bartholin agrees And Doctor Ent sayes it is more dilated than the venovs Besides this there is a discrepancy in the venous blood it self for in the Lungs the Blood acquires by the mixture of the Air a tenuity of parts and florid colour exceeding any other venous Blood this Columbus first observed and gave this reason for the colour and great change which is made in the Blood by passing the Lungs proceeding to an imagination that the vital spirits in the Arterious blood might be the result of this intermixture of Air with the Blood in the Lights Most of whose opinion is taken up by Doctor Willis of late and Doctor Lower Besides this there is a discrepancy betwixt the Blood of the Vena porta commonly and that of the Vena Cava which is not barely supposed by Riolanus but yielded by Bartholin Sanguinem in cava prope cor puriorem esse illa qui in vena portae continetur omnibus in confesso est qui circulum norunt Upon this account it is that by the Emerods there is often discharged a black faeculent blood to the great benefit of the Patient but whensoever it is florid the effusion thereof brings a great debility sometimes very lasting unto many persons May I be allowed here to take notice of the Observation of Spigelius concerning the Saluatella that the Blood which issues thereat is more florid and Arterious than any can be drawn from the greater veins this he attributes to the frequent Anastomoses that are betwixt the Arteries and Veins in the remote parts of the body wherein he was defended by Veslingius and Van der Linden Doctor Harvey observed in the most healthy and robust persons a certain muccaginous humour to jelly upon the surface of their Blood which he esteemed to be the most spiritous part thereof others take it to be not an excrementitious Phlegm but indigested Chyle concerning this Maebius doth profess he never observed any of it in the blood drawn or issuing from the veins in the head but frequently in that let out of the arms and most of all in that which hath been taken by Phlebotomy in the feet It hath been observed that the Blood which hath issued from the head at the nose hath been of a laudable colour and consistence when that which hath been let out at the same time by Phlebotomy hath seemed impure And the like difference hath been taken notice of betwixt the Menstruous evacuations of Women and the blood taken from their armes This variety in the blood of several persons oftentimes is a cause of that discrepancy which is to be in the blood of Men that are sick in so much that when sundry men are afflicted with the same Malady yet may it happen so that there be little or no resemblance found in their blood Oftentimes it is observed that in â—utrid feavers the blood that is let out by Phlebotomy is seemingly good Saepe ad speciem visum purus est qui aliqui 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 malus est Vt contra impurus cernitur â— specie qui non ita 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 malus The blood often seems to be good when it is essentially corrupted and noxious and it seems often to be bad when as yet it is incorrupt and alimental In malignant and pestilential Feavers the blood is sometimes good to see to whilest yet the sick languish under most violent symptomes and commonly such blood is of an evil prognostick Pessimum signum est timoris plenum cum sanguis vena scissa extrahitur â—i purus rubicundus inculpâ—tus educatur veneno siâ—atem superare indicum est aut putredinem in penitioribus cordis latitare In me ipso olim observatum nam ter per hanc febrem misso per venam sanguine nulla prorsus putredinis nota apparebat aliis signis immani ferocitate saevientibus In like manner doth Simon Paulli observe such outward goodness of blood to be a sign of malignity in a Feaver and to be of an ill presage which he illustrates with the case oâ— an ancient man fifty six years old who being sick of a Feaver which the Doctor concludes to have been pestilential was let blood that which issued out was so florid that it transcended what any pencil could paint or pen describe now out of any Artery or the Lungs ever surpassed it after it had stood twenty four hours the mass was all coagulated and no serum to be seen the Patient died suddenly and without any pangs of death a little after With this doth that Observation somewhat correspond Coyttarus doth make though he take it for no ill presage that in Epidemical pestilential Feavers at the beginning if they be phlebotomised the blood of the Patient will seem very good and sound but in the progress it will come out putrilaginous Circa morborum Epidemialium principia sanguis si educatur ruber sano similis apparet quoties iterum tertio mittitur corruptior quam prius elicitur This he illustrates with Instances and makes this Hypothesis most judiciously the foundation of his Method to cure such Feavers by letting the sick blood in the progress not beginning of the Disease And undoubtedly if then the blood do not seem corrupted but florid it must be from some venenate or
fluid and bloâ—kish underneath nay I have out of healthful blood in the Spring I am almost convinced that the blood varieth with each quarter of the year cast it up to the surface in just such a mass as covers the top of the blood in those distempers by putting some spirit of Hartshorn into the Porringer before the party bled into it I place the choler in the serum not but that I know that it hath not the taste or consistence of the excrementitious Bile but because it hath frequently the colour of it and the Vrine and Pancreatick juyce not to mention the Lymphaeducts are tinged with it and oftentimes have the Sapor of it I am sure that herein I have the suffrage of Pecquetus thus far that the choler which is separated in the Liver and which tingeth the Vrine is extracted out of the serum of the blood where it circulates first along with it and is percolated out of it in the place aforesaid Et vero nullibi per universas animalium species absque hilis mixtura sanguinem reperius flavescens id serum salsumque testatur nisi forsitan aliquot in suppositis quibus dulcem mitior natura sanguinem concoxit sicut in aliis quibus acciditatis expertem infudit aut nullo prorsus liene instruxit aut sane perexiguo I cite him the more willingly because that If the Galenists seem infatuated for saying the Gall is a constitutive part of the mass of blood whereas they cannot demonstrate signs thereof by its bitterness a great part of the scorn may fall upon Pecquet Backius and Sylvius de le boe and other Neoterics who hold it is incorporated in the Mass of blood But these Controversies can be no better decided than by an Enquiry into the Generation of Blood how that it is at first begun and afterwards continued the knowledge whereof will conduce much not only to the decision of that Question Whether there be in Nature any foundation for those Galenical Humours that they are constitutive parts of the Mass of Alimental Blood But also to the main debate in hand Concerning Phlebotomy There is not anything more mysterious and wonderful in the Vniverse I think then the production of Creatures In so much that Longinus a Paynim doth hereupon take occasion to celebrate the judgment of Moses in that He represented the Creation by a Divine FIAT and God said let there be and it was so The Mechanical production of Animals from so small and tender rudiments out of a resembling substance in all that variety which we see by a necessary result of determinate Matter and Motion is so incomprehensible and impossible that were not this Age full of monstrous Opinions the consequent of Ignorance and Inconsiderateness one would have thought no rational Men much less Christians would have indulged themselves in the promoting and propagating such Tenets 'T is an effect of that Soveraign command that every thing hath its being and faculties Quin nil aliud est Natura quam jussus ille Dei per quem res omnes hoc sunt quod sunt hoc agunt quod agere jussae sunt Hic inquam non aliud quicquam cuique rei suam dedit speciem formam Per hunc non agunt modo pro sua natura hoc est prout preceptum est ipsis res creatae omnes sed per eundem reguntur conservantur propagantur Et nunc etiam quasi creantur This is that which gives a beginning to the Faetus particularly and by unknown wayes contrives the seminal vertue its receptacle or Egg and that colliquament out of which the Body is formed Because the first rudiments of conception are tender and minute such a provision is made in order thereunto that the albuginous substance of ordinary Eggs is no other than what is derived into the female womb And if we may continue the comparison it will seem most rational to imagine that the parts of the whole are contrived at one time though they neither appear all at the same nor in a proportionate bulk for in some their minuteness in others their whiteness and pellucidity conceals them from the Observer But that even then â—â—re are exerted the preludes of those vital operations which are so visible after in Nutrition I doubt not and that as in the Coates of our eyes the minute veins and arteries convey their enclosed liquors though undisernable except in Eyes that are blood-shotten and as in the brain there hath been discovered veins by some drops of blood issuing in dissection though no Eye can see most of the capillary vessels and as even the veins and arteries themselves are thought to be nourished by other arteries and veins rendring them that service which they do to the more visible parts even so it is in the first formation wherein after some progress the vessels begin to appear and blood first discovers it self in the Chorion and thence continues its progress to the punctum saliens or heat and undoubtedly proceeds in its Circle though the smalness of the vessels as in other cases conceal the discovery So that we may imagine that the Plastick form or whatever else men please to call it doth produce the blood out of that albuginous liquor which seems as dissimilar as the blood out of which it is derived though the parts be providentially more subtilised and refined by its own power as it doth the rest through the assistance of warmth and concurrence of the contemporary fabrick for the first blood can neither give a beginning to its self nor is it comprehensible how the weak impulse thereof should shape out all the veins and Arteries in the body according as they are scituated Out of which it is evident that the Soul or Plastick form doth at first reside and principally animate in the Spermatic parts so called not that they are delineated out of the Sperme but out of the Colliquament which is Analogous to it and that they are her first work the blood is but the secundary and generated out of the Colliquament for other Materials there are none by the Plastic form which is the proper efficient thereof and besides the Auxilary Heat theâ—â—â—re no other instrumental aids but the spermatick vessels wherein the Colliquament at first flows to the punctum album which when blood is generated do become the Heart and sanguiferous Channels This is avowed by Doctor Glissen himself Liquor hic vitalis antequam sanguinis ruborem induit sese a reliquis ovi partibus quibus promiscue commiscetur segregare incipit in rivulos seu'rdmificationes quasdum excurrere quae postea venas evadunt Rivuli isti in unum punctum coleuntes in eum locum conveniunt qui postea punctum saliens cor appellatur Idque fieri videtur diu antequam sanguinis aliquod vestigium compareat Herewith agree the most exquisite Observations of Doctor Highmore Most certain it is
his Patient to alleviate the disease in its course by preventing all troublesome and mitigating all dangerous symptomes and to facilitate as well as hasten his recovery It is not questioned but Patients have been and may be recovered of Feavers with little or no blood-letting yet when I consider the great hazard they run in that course the vexatious and perillous symptomes which they languish under longer and with more violence than others I cannot approve of the practise nor think the Physician dischargeth his duty and a good conscience in so doing Extrema necessitas in moralibus ut certum est vocatur quando est probabile periculum and the Patient doth offend against himself if he refuse to take a befitting course against dangers that probably are impending and the Physician doth trespass against his neighbour if he do not propose and practise such a course I cannot to use the words of the incomparable Riolanus I cannot without pity to the sick and some resentment against the Physician read in Platerus's Observations how sundry of his Patients were broyled and torrefied with burning Feavers whom he never let blood He doth relate of himself how he was sick of a most burning Feaver yet did he never so much as let himself blood therein albeit that it were requisite in those cases Such are not obliged to their Doctors but peculiarly to the Divine Providence for their recovery It was the mature consideration of that tenderness w ch is requisite in Physicians towards their Patients which advanc'd the present course of Physick to its glory above all other Methods it being endeared to our esteem by all those regards that represent it as prudential It was not introduced by chance or the subtlety of some persons but the choice of all and so established by the Magistracy that to transgress against the traditions of this Art was criminal in a Physician even by our Laws It may in some cases seem to be troublesome and unpleasant yet SAFETY requires it It may seem tedious sometimes by multiplication of Medicines yet Prudence obligeth by all those means to preserve and secure life and if the omission thereof be criminal in a Physician in case of any sinister accident why is not the practise laudable Would Men but seriously consider How much danger they run and How much more they suffer upon the negligence or indulgence of a Physician who leaves all to Nature and adviseth them to wear out a distemper they would rather hate than love such a Man and the apprehension they should have for the unnecessary jeopardy he put them on would extenuate his credit very much The most rash and brutish counsels may succeed well but yet the most prudent are to be preferred Amonst Physitians I do not reckon the Helmontian as any there is no doubt but a Plethorick indisposition requires Phlebotomy Nature being surcharged with blood forceth us thereunto least some vein should break in the Lungs or the Patient be strangled with that excess this is called Plethora quoad vasa when the vessels are so full of blood that there is danger of their breaking or that the blood should stagnate in the Heart Lungs or Head there wanting room for its motion or take some inordinate course and so strangle the Patient There is another redundancy of Blood which is called Plethora quoad vires or such a plenitude of blood as brings along with it no apparent hazard of breaking the vessels yet doth it oppress Nature so as thereby to become redundant It is more than she can bear in the present juncture 't is more than she can rule and it will suddenly fall into an exorbitant motion to the detriment of some principal part in case timely prevention be not used In both these cases in which the blood is not supposed to be much depraved from its natural estate all do allow of Phlebotomy and if it be timely put in execution it may hinder the progress however it expedites the cure of the disease In these cases we consider not only the present plenitude but also the future what may be in a few dayes to the great exasperation of the disease and peril of the Patient For it is possible that in the first beginnings of a disease there may be neither of these plenitudes but they may ensue a little after For when the insensible transpiration shall have been a while abated as inquietude pain and watching will abate it the Blood degenerates and no longer continuing its usual depuration those excrementitious particles which were lodged in the habit of the body and pores do remix with the sanguine mass and become like so many fermentative corpuscles agitating and attenuating the blood so that whereas before there was no plenitude now there is that the excrementitious particles do contract a fermenting heterogeneous quality different from what they had in the Blood appears hence that those which sweat much as the new-comers in the Indies their sweat is less noysome and bilious by far than it is in those that sweat more seldome Thus Soot is a different body from any thing that is burned Hence it is that those particles being reimbibed into the blood are so offensive to the nervous parts and introduce a lassitude as if the body were surcharged with a plenitude Besides these two cases in which Phlebotomy seems to be directly indicated by a Plethora or surcharge of blood It is practised in other cases by way of revulsion when the Blood and intermixed Humours flow into any determinate part or are fixed there as in Apoplexies Squinancies and Pleurisies for as upon dissection it is manifest that in such diseases there is a greater efflux of Blood than upon other occasions so it is evident by long experience that Phlebotomy doth alter its course and draw back the blood so as that sometimes after that the first blood hath run more pure and defaecated the subsequent hath been purulent as if the conjunct cause of the Pleurisie or Squinancy had been evacuated thereby In reference to such fluxes of the blood to determinate parts we usually consider what in all probability may happen as well as what is at present urging and therefore for prevention thereof we let blood upon great contusions and wounds It is also practised by way of derivation when we let blood near to the affected part thereby to evacuate part of the imparted matter Thus Van der Heyden did frequently let his Patients blood in the same foot for the Gont Thus in a Squinancy to open the Iugulars it is a derivative Phlebotomy In all these cases all Physicians agree to the received practise but in case that the disease be not meerly sanguine but seem to arise rather from a Cachochymy or redundance of evil humours than any plenitude or exorbitant motion of the Blood here many Physicians cry up that Rule That Plethorick Diseases require Phlebotomy but those that arise from a Cachochymy
body from streightness to laxiiy the most powerful were Phlebotomy and Purging and that their principal effects were not meerly to evacuate such or such peccant Humours but in doing so to create a new Texture and configuration of Corpuscles in the whole Body and therefore they held them to be General Medicaments and of use in most great diseases since such distempers were rather occasioned by a streightness than laxity of the pores and even such as were laxe one way as Dysenteries and Diarrhaeas might be accompanied with a streightness in the habit of the body This Hypothesis for the further explication whereof I remit you unto Prosper Alpinus having been of great renoxa and more accommodated to the course of life by which the Romans and since the Turks and others that follow not our Physick did preserve their Health and recover their Maladies did merit my regards and I observed the truth of that part of their Opinion which avows that purging and bleeding have further effects than meerly the evacuation of Blood and other Humours that they had such an influence upon the whole body as to restore and promote all the natural evacuations of the body by its several emunctories and pores and that Phlebotomy did particularly incline to sweat promote urine and sometimes instantly allay its sharpness and make the body soluble so that upon Phlebotomy there needs no antecedent Glyster Neither is it convenient in a great Cacochymy to purge before bleeding not so much for fear of irritating the Humours but that the purge operating so as to attenuate and alter the whole mass of blood and promote secondarily all natural evacuations without preceding Phlebotomy it is scarce safe not secure to purge except in bodies the laxity of whose texture is easily restored or with gentle Medicaments for the Humours being powerfully wrought upon by the strong purges and inclined to be expurged by their several emunctories and those being either defective or the veins and arteries too full to admit a greater rarefaction in the mass of blood which is requisite to their separation and transpiration hereunpon there happens a dangerour Orgasmus or turgency of humours in the sick which Phlebotomy doth prevent And 't is I conceive in reference to this alteration of texture that Hippocrates saith 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 I observed a great congruity betwixt the Static observations and those of the Methodists and that Sanctorius hath a multitude of Aphorismes which agree with them viz. That such bodies as transpire well in the hottest weather they are lighter and not troubled with any vexatious heat That nothing prevents putrefaction like to a large transpiration In fine I did observe that it was the general sense of Physicians that Phlebotomy did draw the Humours from the Centre to the Circumference and I had taken notice of it alwayes in my self even in the Colick bilious when I was tired out with pains vomiting and want to sleep when I took no Laudanum and reduced to extream debility and emaciation I determined in that forlorn case having used all other means for several weeks to bleed so long yet partitely as that I might be freed from a most troublesome pulsation of the descending Artery below the reins I bled eight ounces at first and found a vextious heat in the whole habit of my body I repeated the Phlebotomy in the afternoon and was very hot all night thus I continued to bleed twice each day for three dayes loosing above sixty ounces and then fell into sweats was eased totally in my back and afterwards recovered with a more facile Paresis in my Armes and no contracture then that disease commonly terminates in there These considerations made me think that there was some more important effect in Phlebotomy than the evacuation derivation and revulsion of the Blood and other Humours and that it must consist in promoting that Statical transpiration and I conceived that the Blood was in perpetual motion and though Motion doth hinder Fermentation yet I had observed that in Pipes at Owburne Abby where the drink runs from the Brâ—w-house to the Cellar to be tunned up the Fermentation continues so especially in the stronger drink that the Pipes frequently break therewith as rapid as the motion is I did not imagine that the nature of the Blood was such as to be exalted into one Vniform liquor resembling Wine for such a liquor would not be liable to such sudden changes and alterations from one extream to another but that it was a miscellary of heterogeneous liquors in a perpetual digestive fermentation and depuration by halituous particles arising from it as in more gross by the emunctories which if the conformation of the pores and passages be such as to give it due vent all continues well if they be obstructed or vitiated then several maladies ensue except timely prevention be used I conceived that in Phlebotomy as the Blood issueth from the vein so as in the pouring out of other liquors the Air comes in by the orifice and mingling with the Blood produceth as great or greater effects than in the Lungs when it mixeth there with the Blood invigorating it in an unexpressible way whence we commonly see that the pulse grows stronger and stronger during the bleeding and upon this account I think it may happen that bleeding with Leeches though equal quantity be taken away oftentimes does harm never alleviates so much as Phlebotomy and such persons as by reason of their tender habit of body cannot bear a violent transpiration swoon not by bleeding in water though otherwise they do by reason that the great effects of the Air upon the Blood are impeded by the ambient water the like happens in Scarification with Cupping-glasses and in bleeding with Leeches I did suppose that oftentimes in a Plethora quoad vires transpiration being hindered by the change of the texture of the Body the not-exhaling particles remix with the Blood and there also happens a subsidence of the vessels and change of the porosities so that the Fermentation is is not only clogged with morbose particles of several sorts but so hindered by the subsidence or compression of the vessels and alteration of the pores as not to be able to ferment for freedom of room is necessary to Fermentation nor transpire nor continue its due course nor by reason of the charge of porosities confer aliment aright so that a Plethora ariseth hereupon But as soon as the vein is breathed and the Blood as in your common water-pipes when a Pipe is cut acquires a more free passage that way it presently becomes more rapid and its motion also is accelerated by the fuliginous exhalations hastening to the vent together with the natural Fermentation resuscitated and so the whole boâ—y by a natural coherence and dependance is not only evacuated but altered in its minute texture and conformation It is most evident that the Blood in the Veins and Arteries
procured by a legitimate form of Physick either live crasie fall into secondary calamities or recidivate divate into a Languour of the like Idaea This is that irrefragable Argument drawn from past Experiments which is the Sum of all Proofs and must satisfie all that are capable which it is possible it may do if there be persons in the World that are capable of being resolved hereby But impossible Suppositions are equipollent to Negations Assuredly either this Age affords no such Men or they are a Company of Fools Who else will give credit to the bare assertions of G. T. He should have done like his Brother Odowde printed an account of Cures though they had been all false and fictitious but as the case is he neither cites so much as Van Helmont and the Peasant that cured Pleurisies with stoned-horse-duaeg but is himself Author and Witness Thus he bristles most Porcupine like Se jaculo sese pharetra sese utitur arcu This is all I reply to his Authority and Experiments His pretences to Reason are no less gain He sayes That when we bleed any Pleuritick there is no streight immediate Revulsion intended from the part affected to the orifice which is a most TRUE and Bacon-like Aphorisme for we never thought that the Revulsion could be streight whereas the line in which 't is made is crooked If we Phlebotomise in the Arm whether it be on the same side or on the contrary or in the foot none was ever so besotted as to avow the Revulsion to be streight though he held not the Circulation of the Blood But such as hold that the Revulsion is made thus in that the Veins draw from the Arteries and so as in Siphons divert the stream they cannot hold any thing like it nor that the Blood impacted or flowing was immediately revelled and drawn back But I am apt to think that some upon large and repeated Phlebotomies may have drawn some of the purulent and degenerate blood out of the veins of the Arm in which there is no more of impossibility than that it should be carried by the emulgent Arteries into the Kidneys and disharged by urine which last is avowed to have been done I do not know that such large Phlebotomies in a Pleurisie are practised by the English Physicians though I think there is not so much of Reason as vulgar prejudice to oppose the thing when the Doctor is an understanding Man For why may not we in England bear that which they do in Holland there Heurnius took away above four pounds of blood from one Plethorical Pleuritic at one time in a dangerous Pleurisie and recovered him when all others gave him up for dead I believe there may be some amongst us that repeat Phlebotomy too often but I am confident the generality erre in taking away too little at one time in the beginning of Pleurisies and Feavers His next Argument is that the Cure by Phlebotomy is accidental only and uncertain sometimes in the beginning they do thereby suppress the disease and as it were crush it but it is a contingent not at all Rhizotomous Cure which ought to be performed by those things which are 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 dulcifying the acid Latex carrying it off through all its emunctories rectifying the stomach and mortifying the malignity That all Pleuritics shall be cured by Phlebotomy is a thing no wise man will undertake for As little will any man promise to cure a Pleurisie by sole Phlebotomy without giving the Patient any Expectorating or Sudorifick Medicaments or other Potions besides the Powders of Pikes-jaws Boares-teeth Crabs-eyes c. which correct the acidity of the Latex if there be any such thing But to shew the folly and impertinence of this G. T. There are several sorts of Pleurisies in many whereof no Galenical Practitioner is obliged to Phlebotomy at all though in some such cases it be left to their discretion either to use it or omit it as in Bastard Pleurisies Of those which have the Character of true Pleurisies some are occasioned by the Wormes in which G. T. cannot imagine that any man would rely on Phlebotomy There are also Pestilential Pleurisies wherein the effects of Phlebotomy are as uncertain as in the Pest it self Gesner in his Epistles somewhere speaks of such a one in which all died that were blooded So doth Bartoletus and Wierus There was also an Epidemical Disease in Friuli which Vincentius Baronius first named a Pleuripneumony in which the Pleura and Lungs were both affected where the seat of a Pleurisie is is doubtful amongst Physicians but yet so that though they had all the signs of a common Pleurisie at the beginning yet did they never come to suppuration but were cured by Phlebotomy immediately upon the administration whereof they were relieved and with the help of accessional Medicaments expectorated bilious and pituitous spittle and so recovered As to those which are confessed to be Pleurisies it is to be observed that neither can all persons nor all places bear Phlebotomy therein and in such cases no wise Physician will administer it the qualities of the Climate and individual constitutions or debilities are circumstances he will alwayes regard It is granted that some Pleurisies are so mild and attended with such favourable symptomes of so good a prognostick that they do not need Phlebotomy In moderata pleuritide in qua videlicet parum urgent respiratio tussis dolor febris Phlebotomia inutilis est aut certe non necessaria Aliis enim levioribus anxiliis curari potest quomodo is a Galeno percuratus qui in levi pleuritide sanguinem expâ—ebat plurimi visi sunt a nobis aliis medicis citra ejusmodi aâ—xilium convaluisse But although I am ready to grant that in such cases Phlebotomy may be omitted and yet the Patient escape yet I can hardly commend the prudence of such Physicians as do omit it For since a Pleurisie is alwayes an acute Disease in such our Prognosticks are not certain and the parts affected such as are of greatest importance and equal tenderness since the disease is frequently so fallacious that amidst the most hopeful signes and when we may justly expect its happy termination even then most direful symptomes break out and render the case deplorable Nam aliquando ubi antea signa omnia salutem praenuntiauerint crisâ—â— tempore quae fere fit ad septimum aut alium diemcriticum vehementer Pleuritis exacerbatur symptomata omnia increscunt tum nibil movendum est sed omnia naturae committenda sunt Since the Patients condition is such I do not see how any Physician can answer it well to his Conscience or the Rules of Art I am sure 't is criminal in Italy if he forbear to take some Blood albeit not so much as otherwise he would away from him the damage is inconsiderable but the hazard otherwise so great that no prudence can well
us different Phoenomena oftentimes in several porringers and in the same porringer different substances sometimes a supernatant gelatine and mucus a coagulated mass consisting of thinner and a less fibrous crimson and a grosser and more blackish-red body enterwoven with fibres both which may be washed away from the fibrous part and a serous fluid liquor sometimes limpid sometimes of a bilious or other colour in which the concreted mass of bloud doth float All these with other Phoenomena in a great variety are to be seen in the aforesaid cases and even the Bloud of the same body as it issues from several veins furnisheth us with matter for different observations Now in a liquor so pure and Homogeneous as our Disciple of the Lord Bacon imagineth the Bloud to be though we should suppose the Air to corrupt it as it issues into and settles in the pottinger yet would the corruption thereof be uniform which seeing it is not I take it for demonstrated that it is Heterogeneous And that being granted it matters not whether the four humours so frequently mentioned by Physicians be actually or potentially in the blood Whether they be the constitutive parts thereof or whether it be one entire Liquor made up of Heterogeneous parts which in the bodies of sundry individuals produceth such Phaenomena as if it did consist of such Alimentary Humours and degenerates occâ—â—â—onally into those others that are Excrementitious In order to our practice 't is all one for it to be so and to appear so and our documents are nevertheless useful though they seem not rigorously true The Galenical Physicians are not herein agreed nor is any man confined in his sentiments about this subject 'T is malapertness in this Bacon-faced generation to dispute these points since the phaenomena of diseases and the operation of Medicaments doth correspond with this Hypothesis and are as adequate thereunto as humane nature which is not capable of an exact knowledge and ought to acquiesce in what is useful can adjust them Nor is it any more of disparagement to Physick that should be built upon so tottering a foundation then that the Temple of Diana one of the wonders of the world should be situated upon a bogg Hitherto I have examined his preliminary discourse of the Bloud and its concomitant Latex and have made it evident that this person understands not what he asserts nor what he rejects and indeed such is his ignorance that after so much study having rolled every stone and searched out everâ— scruple to be informed concerning the truth of the Galenick and Helmontian way he understands neither Nature nor the Galenists nor Van Helmont I now come to examine his Arguments against Phlebotomy which if they be so weak and inconsiderable as not to justifie so extraordinary an impudence let him blame himself not me who do not intend if possible in such a confused obscure Treatise to injure him in the recital His first Argument against Phlebotomy Had they but considered how this vital moysture the Blood ebbs and flows in goodness and pravity upon slight accidental occasions of any exorbitant passions as fear sorrow anger c. the manifold impressions of the ambient Air ill Diet immoderate exercise divers excessive evacuatioâ— and long retention of any excrement did they rightly understand how bloud like Mercury may be polymorphised and changed into different shapes and at length be retroduced to the same state and condition as when it was in its primitive essence certainly then these Dogmatists would never be so forward to pierce poor man's skin rashly let out and throw away that substantial support of life foolishly and falsely apprehending that to be totally corrupt and deprived of what it was in its former being and in no wise capable to be retrograde and return to it self again because it seems to their eyes when it appears abroad discoloured invested with a contemptible apparel as yellow green white blue c. supposing it to be corrupt and so unfitting to be retained within the verge of life It is no such matter I can maintain for this superficial alteration proceeds from the Air spoiling it of its pristine goodness not that it was really corrupted in the vein For the demonstration of this I will undertake upon forfeiture of a great penalty to open the vein of a Cacochymic body emitting about two or three ounces of the visible aforesaid degenerate matter then stopping the Orifice make use of proper remedies to this Individual whose habit I doubt not so to alter in the space of about a fortnight that no such putrid matter as they improperly call it shall be found in any vein whatsoever opened which may fully satisfie any sober enquirer after truth that the corruption was never really existent in that whilst it was in the vein which in so short a time is thus redintegrated for Corruption being an absolute privation of that formal essence of the thing and sith there is no retrogradation in this kind that an Ens losing its form by dissolution should assume it again Nam à privatione ad habitum non datur regressus it infallibly follows that this juyce thus restored Technicâ—s by Art was never truly corrupted as they would have it Hence it follows that the fair pretence of the Galenists that the juyce drawn out of the Patient forasmuch as it is corrupt in the porringer is happily discharged appears a mere imposture contrived on purpose to stop the mouth of those who scruple and question Phlebotomy This is the principal Argument which he hath against Phlebotomy yet doth he so handle it as that the onely evidence it carries with it is that the Author is a most illiterate person It is very ignorantly done of him to make as if the Galenists in general did let their Patients bloud merely for a Cacochymy or depravation of the bloud as if it were a Rule amongst them that Whensoever the blood is depraved vitiated and corrupted it ought to be emitted by Phlebotomy Whereas there is not any tenet amongst them more general then that Cacochymical bodies require purging the Plethorick or such as are in danger to be surcharged with excels of blood require Phlebotomy nor do they recede from this resolution but in urgent cases and with deliberation and many are so cautious herein that if the bloud appear in the porringer to be of an evil colour and very corrupt they enjoyn us to stop the vein presently and not continue or repeat the evacuation I shall set down the words of Horatius Augenius Hic vulgarium Medicorum error detegendus est Putant quo sanguis impurior fuerit à sua natura magis alienus eo plus detrahendum in hoc mirifice sibi placent in vulgusque proponant admodum utilem factam fuisse vacuationem quod corruptissimum pessimumque sanguinem vacuaverint Tu vero cui in animo est humano generi prodesse
administred it is so far from debilitating Nature that it adds to its strength mitigateth the present symptomes prevents the violence of the future and concocteth the disease apparently I will not undertake to justifie the demeanour of each particular Physician any more than I will answer for their intellectuals and skill in Physick It is not the reading of Sennertus and Riverius with a little knowledge of the new discoveries in Anatomy and a few Canting terms about Fermentation texture of bodies or such like knick-knacks and Conundrums of the novel Philosophers which accomplish a man for practice These men will never come to be ranked with Vallesius Mercatus Fernelius Duretus Rondeletius Massarius Septalius Claudinus Crato or Rulandus If Experience be our Guide let us inform our selves by the Histories of such as they have given us of Epidemical and pestilential diseases and of particular cases as also the cures and following them let us come to practise and not deserting our own reason let us be cautioned by them These others for want of judgment to consider each circumstance cannot make an Experiment or relate it whilest they extenuate the credit of the ancient and modern Physicians that are not Innovators though more observing and experimental than themselves they do it only to excuse their ignorance in that kind of Learning and whatever they have of the Lord Bacon they have this of the Russe in them that they neither believe any thing that another man speaketh nor speak any thing themselves worthy to be believed For such as these or any else that do not practise Phlebotomy according to the rules of Art I cannot make any Apology nor do I think that their errours ought to extend so far as to disparage all Physicians who demean themselves prudently and discretely Notwithstanding all our care some Patients will dye no Physician can secure all men from what their frail condition hath subjected them unto If our Method and Medicaments be such as the general rules of Medicine and an Experience generally happy do warrant 't is as much as can be expected from us and the Imperial Laws allow of this defence though they punish the immethodical and novel Experimentators and the Ignorant Sicut Medico imputari eventus mortalitatis non debet ita quod per imperitiam commisit imputari ei debet pretextu enim humanae fragilitatis delictum decipientis in periculo hominis innoxium esse non debet To conclude this Argument I say that although it often happens that diseases are cured by sole Phlebotomy Evenit ut saepius missio sanguinis sola curationem perficiat Misso sanguine saepe sponte naturae expurgatur corpus alui profluvio vomitu aut sudore succedente Yet no wise Artist will rely upon that alone but with the addition of other auxiliary medicaments Herein Spain and France are pretty well agreed And as no wise man will undertake to cure by bleeding alone so it is most foolishly done of our Helmontian to demand or expect it as he doth here I come now to his fifth Argument The means to let out bad blood without removing the efficient cause thereof is no direct method of healing Now Phlebotomy lets out bad blood without removing the efficient cause thereof Ergo Phlebotomy is no direct Method of healing The Major is proved thus Whatsoever suffers the cause to remain can never remove the effect For manente causa manet effectus Now Phlebotomy suffers the cause to remain Ergo it can never remove the effect The Minor is made good by frequent experience If the cause of bad blood were cut off the Feaver or Scorbute depending according to Dr. Willis upon the degeneration Sal and Sulph therein would quickly cease but we plainly see the contrary for after the veins are much depleted the disease becomes more truculent and oftentimes mortal which could never be if this depraved blood were any other than a product or an effect of an essential morbifick cause The same agent which in sanity sanguifies regularly without any considerable defection in sickness becomes exorbitant sending out a vitious juyce into all parts be it good or bad it still springs from a root which continually feeds the branches so that it cannot be other than great folly and wrong to the Patient to let out that juyce though it seem never so corrupt when another of the like condition must needs enter into its place derived from the shop the duumvirate where it first receives a previous rudiment which ought in all reason rather to be reformed than to give vent to those easily evanid particles inseparably joyned with this ruddy liquor how ill soever represented If all contained in the reins supposed to be corrupt were discharged yet as long as the ferments principally of the first and sixth digestion deviate from their right scope there would in a short space be a succedaneous repletion of a matter equally contemptible yea worse in respect of an enervation of strength than before This Argument though our Helmontian rely so much upon it is a pure Paralogisme First He supposeth that we use Phlebotomy in all diseases as a direct method of healing which is not true except in some maladies as Apoplexies Squinancies Haemorraghies or great eruptions of blood some Atrophies and sometimes in Feavers in which 't is frequent with us to rely solely or principally upon Phlebotomy yet even here we would think it very improper to admit of our Phlebotomy to be stiled our direct Method of curing because it is but a part of our Method which will include if not some other prescriptions yet at least dyet In many cases we use Phlebotomy as one part of our Method but not as the principal as when we use it antecedently to other remedies Pharmaceutical and dietetical to prepare way for or facilitate their happy operation I am not now to write Institutions in Physick for the documentising of this Disciple of my Lord Bacon 't is enough that he may learn any where almost as in Vallesius Mercatus Claudinus and Plempius that we propose more than one scope to our selves in Blood-letting neither is it ever except in diseases arising from a partial or total Plethora our direct method of healing If it be but a part and necessary or useful part thereof we are sufficiently justified Thus his Major is enervated for if he would have opposed the modern practise he ought to have urged it thus The means used to let out bad blood without removing the efficient cause thereof is no direct Method of healing nor an useful or necessary part thereof This is manifestly false as I shall shew anon As to his Minor That Phlebotomy lets out bad bloud without removing the efficient cause thereof This would the Ancients deny who bled their Patients in many cases until they swooned or fainted with great success and we must say it is not absolutely true there being no Practitioner I believe
but hath seen some cases in which sole Phlebotomy hath effected the cure he may see many Instances of this in Botallus and that in diseases where the body was undoubtedly cacochymical I have seen Agues tertian and anomalous perfectly cured with once bleeding in women with child and in children I have seen some Atrophies so cured that the principal cause of their recovery was to be attributed to their Bleeding the like I have observed in several Chronical diseases even in inveterate quartanes as also others have done nor is there any thing more common almost in our Cases than the relation of several diseases absolutely cured by single Phlebotomy which I shall not transcribe here but in my large discourse of Phlebotomy in Latine I intend to represent all such cases at large with their circumstances and the History of Phlebotomy with all that variety of success which judicious Practitioners relate of it in several diseases and persons I add now that No man can be an accomplished practitioner who is not versed in the History of Diseases and particular cures for the general rules and directions make no more a Physician than such a knowledge in Law would do a Lawyer the res judicatae import more with us than they do in Law-cases and as Reports of the Iudges in special cases must be known by a compleat Lawyer so must our Book-cases be our presidents and regulate our practise Duobus enim tanquam cruribus innititur Medicina neque solis theoreticis rationibus contenta insuper etiam practicaes experientias particularium requirit indefessam ad singulos casus intentionem Thus is his Minor false as was his other Proposition and it should have run thus But Phlebotomy lets out the bad blood without removing the efficient cause thereof or conducing thereunto But he proceeds to defend the Minor thus If the Cause of bad blood were removed then would the effect cease but oftentimes we see that notwithstanding such a depletion the disease continues and if it be not mortal yet it becomes more truculent Here he commits the same errour that before expecting a greater effect from Phlebotomy than we propose generally to our selves in it we do it sometimes for revulsion of the matter flowing to any part as in some Pleurisies Squinancies the Colick Bilious and Rheumatismes c. wherein we never rely solely upon bleeding and though oftentimes the effect transcend our expectation yet do we not presume upon it Sometimes we let blood for prevention of future diseases as in great contusions and wounds Sometimes we let blood only to prepare way for future Pharmacy Ita plerumque in febribus mittitur sanguis qui non superat naturalem mensuram neque simpliciter neque in hoc homine sed quia nisi mittatur ob febrilem calorem qui adest succorum putrescentium mistionem corrumperetur ac fortasse malignè cutis rarefactioni ventilationi vasorum relaxationi ad futuram expurgationem necessariae impedimento esset Itaque mittitur non quia multa subest copia sed quia ea quae subest tunc est inutilis noxia ac proinde facultate ferente deponenda etsi causa morbi non inclinet ad ideam sanguinis modo non ab ea plurimum evariet i. e. Thus in feavers we usually let blood not that the blood abounds above its due proportion either in general or in reference to this or that individual but because the blood which flows in the veins is infected with a feavourish heat and would be corrupted thereupon and by reason of the intermixed humours now inclined to putrefaction and that perhaps joyned with malignity for the prevention thereof and least that plenitude and depravation of the Blood should hinder that transpiration in the habit of the body ventilation of the blood and laxity in the vessels which is requisite for the subsequent purge do we use Phlebotomy not imagining that there is any superfluous abundance of blood but that there is then in the body some that may well be spared and which if the Patient hath strength to bear it may with prudence be let out to prevent so great dangers as are imminent and to secure unto us the good effect of the subsequent Physick And if the disease do sometimes encrease upon Phlebotomy it behoveth wise persons to distinguish whether those symptomes happen by reason of bleeding or only succeed it in course the disease being in its increment for this makes a great difference in the case as also whether amidst those symptomes which are in due course most violent in the progress and state of the disease whereas we bleed usually in the beginning only there be not some that yield signs of concoction and melioration which if they do as we may justly attribute those hopeful consequences in part to Phlebotomy so we need not be amazed at the present truculency of the disease which affrights none but the ignorant If notwithstanding all our care and due administration of Medicaments according to Art the Patient do dye yet is neither Phlebotomy nor the other Physick to be blamed but we ought rather to reflect upon Physick that 't is a conjectural skill in the most knowing men and that we are not as Gods to inspect into the bowels and secret causes of diseases that besides the special judgment of God upon particular persons all diseases are not curable in all individuals either by reason of the variety of distempers complicated which interfere with and contra-indicate one to the other or for some unknown idiosyncrasy or other intervening cause which defeats our Methods as well as it disappoints the Arcanum of Pepper-drops I must here take an occasion to remind this Helmontian that he doth ill to disparage Phlebotomy by reason that after it there may follow some truculent Symptomes and yet to reject that imputation where his Dietetical rules are in dispute When he gives his vinous and spirituous liquors in Feavers a practise not peculiar to the Helmontians but allowed with regard to due circumstances by Hippocrates not only in diaries but acute-feavers so Galen would have told this Ignoramus if any seemingly frightful Symptomes appear as extraordinary heat an inquietude a little raving a swerving from right reason the Patient must not be startled in a vulgar manner but be satisfied that these are but the effects or fruits of an Hormetick motion in the Spirits excited and increased by good liquors easily united with them for the routing and putting to flight every way whatsoever doth disturb its vital government Though Hippocrates say it is good in all diseases that the Patient retain his senses though he reckon inquietude and restlessness in the sick amongst evil signs yet our Helmontian dissents from him whatever time of the disease it be and whatsoever other circumstances attend thereon For oftentimes madness deviation from the right understanding a Lethargical or sleepy disposition suddenly break forth Nihil
est quod tam magnifice prodest quod non aliquo ex modo obest What matters it if the heat be magnified besides the main purpose to some small trouble if ten times greater benefit accrue to the sick It is impossible any Physician should perform his duty as he ought if he boggle at the foppery of heat and cold meerly momentany and transient often deluding our senses Surely he that is thus negligent of the Animal faculty in its principal operations may bear with a pitiful Galenist for not regarding much the loco-motive strength whilst he is as sollicitous as any Helmontian to support the vitals and let any one judge which is most likely to impair the vital faculty a little blood-letting duly administred or such an increase of the feavourish heat restlessness deliriums phrensies lethargies as our Author here despiseth I must not yet dismiss him not that I intend to laugh at his six-fold digestion he might as well make a dosen of digestions but it is necessary that I tell him that the production of good or evil blood doth alwayes depend upon one root that feeds the branches for 't is possible that the stomack and pancreatick or bilious mixtures in the guts may not be faultless and yet the blood of the Patient either not vitiated the errors of the first concoction being amended by the primigenial sanguifying Blood for 't is the Blood in the vessels which principally sanguifies or if it be depraved yet not so as to generate any disease or abbreviate the life for cacochymical persons with a little can live more long and more free from diseases than those of a purer and more generous blood Nor is it less true that oftentimes it happens that the blood is infected with recrementitious heterogeneous and noxious mixtures from obstruction of the pores or other occasional causes wherein the stomach and vitals otherwise sound and vegete are only oppressed and distempered by accident some of those impure humours being discharged upon them and in these cases repeated Phlebotomy alone may cure If the credit of Botallus will not satisfie him herein let him believe his beloved Hippocrates a man who did extraordinarily practise blood-letting so as that the French do impatronise him to their Phlebotomy he tells us this story A certain man amongst the Oeniada was sick when he was fasting he felt as it were a great suction in his stomach and a violent pain and after he had eaten any meat as it digested his pains returned He grew very tabid and wasted away in his body his food yielding him no sustenance but what he took came away in ill-concocted and adust stools But when he had newly taken any sustenance at that instant he felt none of that vexatious pain and suction He took for it all manner of Physick both emeretics and cathartics but without any alleviation But being let blood alternately in each arm or hand till he had none left in his body that was vitious he amended upon it and was perfectly cured Read but that case you that are so timorous with the Comment of Van der Linden in his Selecta Medica c. xiii and tell me if upon Phlebotomy as ill blood alwayes succeed as is let out I could add more parallel stories But to demonstrate unto this Pyrotechnist that single Phlebotomy will amend and inrich the mass of Blood I propose this case An ancient Gentlewoman of a very strong and corpulent habit of body but frequently troubled with hysterical and hypochondriacal vapours was taken with a violent catarrh upon her stomach together with great pains in her right and left hypochondria as if the liver and spleen had been tumified sometimes she complained of an insupportable acidity in her stomach and sometimes a saline humour molested her Sometimes she fell into cold clammy sweats sometimes her sweats were so hot that she complained as if her skin were burnt and even when her stomach felt any alleviation she complained of a burning fire as it were in her bowels near and in the region of her liver a perpetual sputation did follow her I being sent for after several Medicaments prescribed methodically but with little or no alleviation I proposed earnestly that she should be let blood notwithstanding she were above sixty years old I took away eight ounces or more She found immediate alleviation there seeming no default in the blood or serum I burned the blood in an arched fire it came to ignition but flamed not at all but crackled like Bay-salt and after some while a sudden eruption of ventosity made such a noise as equalled the cracking of a Chesnut in the fire She took a stomack-powder of Ivory Pearl Crabs-eyes c. and was pretty well for three or four dayes but upon a small fright relapsed I bled her again as before and in that short time in which she had taken very little sustenance but behold this blood which looked no better than the other did burn with a vivid and lasting flame as well as any I ever tryed in my life and without any sign of flatulency She recovered presently after with some further Medicaments but not so as to be perfectly well at stomach of a long time I doubt not but if others would try that way of burning blood they would soon be convinced that Phlebotomy makes a great alteration therein But I proceed to his other Argument This is taken out of Van Helmont whose Latine words I shall not transcribe now but only the English Let them make it appear if this do not imply a contradiction that a Feaver hath the property to pollute the blood and that this property can be taken away a posteriori by a posterous manner to wit by withdrawing what is putrified For if first the fouler blood be let out they open a vein again all this while they overthrow and confound the strength and so thereby wholly disappoint a Crisis But suppose sometimes a fresh ruddy blood run out they presently cry as cock-sure that a whole troop of diseases is cut off at the first dash as if the resting place of the Feaver did only extend from the heart to the bending of the arm and the good blood did take up its abode about the liver This Argument proceeds upon a most gross falshood in that part of it where we are supposed to place such a value upon the colour of the blood as by the goodness or ruddiness thereof we should esteem our selves as cock-sure that a whole troop of diseases is cut off at the first dash whereas no intelligent Physician ever thought so for we do say that the blood of all men is not alike neither as to colour nor consistence naturally and therefore in diseases we do not expect to see such nor intend to make any alteration to such a degree as transcends the natural estate of the body for 't is our business to preserve each man his natural habit be
yet the Serum was insipid it is not properly sanguine but pituitous But to resume the discourse I expected to have seen the Minor proved by our Helmontian but although I find that he saith his observation did jump with that of Doctor Willis that Phlebotomy did incline to Feavers Yet my Reader may see that in the first part of the Argument as I have urged it in his own words he reckons amongst the evil consequences of bleeding none that proceed from an opulent and sulphureous blood transcending the dominion of the spirit that remains after Phlebotomy but such as argue an impoverishing of the blood or a cold indisposition I will repeat it again to shew how justly I censure his Logick and so dismiss the Argument If it be so that striking a vein often in a long and tedious disease is a preparatory for a sharp Feaver as we both herein jump right in our observation when am I certain that Phlebotomy repeated in an acute Sickness is a door set open and an in-let for a long infirmity so that this mode of defalcating the vigour of the spirits doth for the most part as I have strictly heeded many years disarm and plunder Nature in such sort that it cannot resist the assaults of every petty infirmity witness those multitudes of relapses or Agues Scorbute Dropsies Consumptions Atrophy Iaundise Asthmaes c. The proof of the Minor here is not only defective but the mischief is that Doctor Willis who judiciously useth Phlebotomy commends it in Feavers both in the beginning and augment of those that are putrid and also in Diaries as the principal remedy inprimis conducit and speaks in the place cited by our Helmontian only of a customary letting blood in time of health Whereas this Bacon-faced Pyrotechnist saith that their Wits jump in this that often striking a vein in a long and tedious disease is a preparatory for a sharp Feaver Let any man read the place and see how he abuseth that excellent Practitioner whose words are Prae caeteris vero observatione constat quod crebra sanguinis missio homines febri aptiores reddat quare dicitur vulgo quibus sanguis semel detrahitur eos nise quotannis idem faciant in febrem proclives esse I am sorry he should seem to give a reason for a vulgar error for once or twice bleeding doth no more create a Custom or dispose Nature to an anniversary commotion in the blood than one Swallow makes a Summer But certain it is I speak of our cold Climates not of those hotter where sweat and transpiration often prevent those determinate motions of nature that such here as are very much accustomed to bleeding keep certain times for it their bodies will require it at that time and if they refrain it they will feel an oppression and dulness or lassitude and may fall into a Feaver but Aches Rheumatisme Gout are more likely except other accidents concur to produce a Feaver if the ebullition be no greater than to produce a Lassitude 't is possible in some bodies that the Scurvy Cacochymy Cachexy Dropsie Asthmaes Cephalalgyes may ensue for the morbifique ferment like the scum boyled into the broth may mix inseparably with the blood and vitiate for ever that great sanguifier with an unexpressible pravity But he that thinks 't will be so in diseases when the Patient is phlebotomised neither understands the motions of nature nor the effects of a sound recovery Instead of Doctor Willis this illiterate Baconist who professeth to be so well versed in the way called Galenical should have as he argues made his recourse to Avicen and his followers who are in many cases fearful of Phlebotomy least it should produce an ebullition yf choler or crudity which two inconveniencies may produce all that G. T. talks of Thus sometimes Tertians have been doubled nay turned into irrecoverable continual Feavers But all the cases relating thereunto concern not an intelligent Physician who understands what is past present and to come and knows when to presume when to fear But I intend not to teach these fellows it were better for the Nation and them too that they were Coblers or day-labourers than Practitioners in Physick a Doctoral Diploma though purchased will not sufficiently qualifie them for the profession and as little doth the title of Experimental Philosophers and Verulamians avail them The next Argument of his that I come unto and which is more than once inculcated as if he thought it a Demonstration is this as I may form it If it be not fitting nor useful to bleed in the Pest which is a Feaver 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 it is not fitting nor useful to bleed in any ill-conditioned Feaver whatsoever But it is not fitting nor useful to bleed in the Pest. Ergo. The Consequence of the Major is thus proved It is no less criminal to suffer the Blood to spin out in any ill-conditioned Feaver whatsoever then in that which is so 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 And Albeit our Phlebotomists do extenuate the matter setting a fair gloss upon it pretending that in malignant Feavers of the inferiour clast Plethorick or Cacochymical indications do manifestly require their utmost assistance before that inconsiderable venome lying occult I must by their favour be bold to tell them they will never solidly and speedily make a sanation of any great Feaver or any other disease till they handle it in some manner like the Plague for there is quiddam deleterium a certain venenosity in most maladies as I can prove ex facto The Minor is thus proved For whosoever at any time upon what pretence soever of caution attempts Phlebotomy for the cure of the Plague takes a course rashly to jugulate the Patient unless some extraordinary redemption happen Certainly here Doctor Willis who allows to persons accustomed to bleeding and in plethorick bodies the humours being very turgent though seldome and with great caution to bleed speaks by rote for had he Anatomised the Pest investigated the nature of that atrocious stroke as I have feeling the smart of it three several times he would as soon allow of piercing a vein in him who hath taken an intoxicated draught as at any time in this case where the Stomach alone is the place from whence the poyson is to be exulated 'T is no wonder if the Galenists strait injoyn bleeding where they find a seeming soulness in the less malignant Feavers when they dare be tampering with it in the greatest The only noted Sluce through which the poysonous matter of all malignant Feavers passes away is the universal Membrane the Skin on which the Stomach hath no small influence governing this Catholick coat at its pleasure in so much that no successful sweat or eruption can be expected as long as the Duumvirate lies prostrate under any insulting calamity Wherefore the Arch-design of the Physician is to cherish corroborate and remove all impediments of this eminent part that
thereupon to take that Analeptick Physick in order to a perfect convalescence whatever ensues is neither the default of the Doctor nor the evil consequence of Phlebotomy The same I may say in case either the sick party be not tractable or those about him malapert or negligent or some extraordinary casualty do fall out For where many concurrent causes are requisite to the producing of an effect if it succeed not we are not to blame what did operate but what failed As to Revulsion that which he saith is very weak G. T averrs that the best Practitioners take it for an Errour 'T is no great vanity to pretend to know more than a Baconical Philosopher I do say that no experienced Physician ever denied the operation though since the tenet of the Circulation of the Blood the manner how such an effect doth succeed admits of some dispute and is obscure We the silly followers of Galen and the Ancients do think it an imbecillity of judgment for any to desert an experimented practise because he doth not comprehend in what manner it is effected In eruptions of blood and Catarrhs every one sees the thing is done and that the Fuga vacui is not the occasion of the subsequent blood flowing to the orifice of the vein I believe those to whom he dedicated his Book will assure him How perfect our Cures are continual tryals demonstrate How little confidence there is to be placed in the Brags of G. T. after his ten years practise any man may determine by taking a due estimate of his Ignorance Having thus examined all his Arguments against Phlebotomy I come now to give our Reasons for it But before I proceed to them it is necessary that I give my Reader some account of The quantity of Blood in Humane bodies The several Qualities of the aforeâ—aid Blood The manner of its Generation As to the Quantity of Blood that is to be found in Humane bodies Gassendus holds that the utmost thereof exceeds not five pounds but he is justly reproved for that errour and for intermedling with Medicinal debates by Riolanus who avows that in suffocating diseases he had taken away much more than that within the space of twelve hours without indangering the Patients life To relinquish therefore these impertinent Naturalists whose discourses in Physick have done more hurt than good being accommodated generally to some prejudicate Hypothesis they take up or founded upon a narrow experience let us see what Artists teach us Avicenna and several of the Arabians do hold that there are ordinarily in a man twenty five pounds of blood and that a man may bleed at the nose twenty pounds and not dye but if the flux exceed that after the loss of twenty five pounds he dies inevitably Moebius doth allow of twenty four pounds to be the usual quantity Homo staturae decentis ad libras xxiv sanguinis in corpore habet Riolanus imagines there may be in such a person fifteen or sixteen pound at most but twenty in a French-man though in a German he sayes Plempius supposed there might be thirty In an healthy sanguine person being in the prime of his years Marquardus Slegelius doth so calculate the matter that he concludes there cannot be above twenty or eighteen pounds and that the generality of men contain but fifteen Doctor Lower in his excellent Treatise Of the Heart doubts whether any man hath twenty five pounds of blood in his body and sayes that according to Anatomists the quantity seldome exceeds twenty four pounds or is less than fifteen Perhaps the consideration of such fluxes of blood as spontaneously happen may give some light unto the controversie and contribute most to the decision of the grand one concerning the prejudice that may arise from the loss of Blood by Phlebotomy It is recorded by Matth. de Gradi that he had under his cure a lean slender and seemingly Phlegmatic Nun which by the Nose Mouth and Vrine did void at least eighteen pound of blood and yet there remained so much in her that upon the application of Cupping-glasses they were instantly filled with Blood and he recovered her notwithstanding that loss of blood Brassavolus relates how he had in cure one Diana a Lady of the House of Este which bled so much at the Nose that he saved and weighed eighteen pounds besides what was lost in the clothes applied to her so that the whole quantity might amount to twenty two pounds He recovered her by the use of several Remedies one whereof was Phlebotomy Marcellus Donatus doth avow that he weighed eighteen pounds of blood which issued from the Nose of a certain Cook of the Cardinal Gonzaga's who was recovered to as perfect health and as good an habit of body as he ever enjoyed before Amatus Lusitanus gives an account of one in a Quartane which bled at the Nose within five dayes twenty pounds and of another who bled in like manner within the space of six dayes forty pounds whom yet he cured by Phlebotomy Montanus saith he cured one of the Emeroids which bled every day for forty five dayes two pounds of blood and more Arculanus doth tell of one Woman that avoided by the Womb in three dayes twenty five pounds of blood and yet recovered Almericus Blondelus cured in a very short space a Souldier who was wounded under the right Arm-pit unto the Lungs after the man had lain without sense or motion many hours on a sudden there issued an incredible quantity of blood out of his mouth The like incredible fluxes of blood in men and women he professeth to have observed many times Forrestus relates how a Gentleman that was his Patient did bleed at the nose in three dayes time about twelve pounds of blood and was recovered as well as ever And when William Prince of Orange was wounded in the throat by an Assassine he bled at the Iugulars before the flux could be stopped which was not done in several dayes twelve pounds of blood and was perfectly recovered to his strength again He also tells of another Gentleman that having drunk Wine-must fell into such an Haemorrhagy at the nose that he bled without intermission six pounds and was cured by Phlebotomy and other befitting Medicaments Massarias did see a young Lady of twelve year old which avoided at the nose about twelve pounds of blood but fell afterwards into a Cachexy To conclude in the words of Io. Riolanus Imo decem vel duodecim libras per nares vel haemorroidas per uterum in mulieribus effundi intrâ— sex octove horas sine vitae detrimento quotidie observamus As to the Quality of the Blood it is observable that there is a great variety in the colour and consistence thereof even in men of perfect health many upon Phlebotomy convince us that their blood is seemingly bad whereas they are not molested with any distemper at all
but enjoy as entire a sanity and are as free from diseases as those whose blood is to appearance better I have elsewhere given an account of several Phaenomena to be remarked upon the burning of Blood which Observations are the â—ore considerable in that I. I. Becherus hath published a great mistake about it viz. Siccum sangninem in ignent lardum â—â—grare absumi non minori celeritate quam ipsum olium vini spiritus in hoc quidem balsamino spiritu igne totius sanguinis vis bonitas consistit quoque corrupto aut alterato totius ejus crasis alteratur But I say that it is not requisite the blood of every healthy person should burn so and 't is evident by those Experiments of mine that there is a very great diversity betwixt the blood of several persons as to inflammability and I know a most fair Lady whose blood will not burn at all only crackles that enjoyes a constant health beyond most of the Sex excepting a pain at her stomach and I have observed that to be an usual consequent to such blood I shall not illustrate this matter at present by demonstrating the great discrepancies of the blood in several healthy persons by mixing it with sundry liquors wherein the diversity of Phaenomena doth manifest the great variety thereof It is observed by many Practitioners that in healthy persons such blood doth often appear upon Phlebotomy as to the Eye seems bad I have seen many saith Blondelus who being casually hurt in the Eye by a tennis-ball or by some other accident wounded and bruised have been let blood and the blood which issued out seemed corrupt yet have not these persons had any thing of a Feaver on them nor been some of them sick of twenty years before And Ballonius observed in several Ladies that out of humour rather than any indisposition were let blood in May and six or seven poringers taken from them that their blood was very putrid And he avows that in the most fair Ladies there generally is found such blood as looks impure and evil yet that such persons enjoy a greater or at least as perfect an health and live as long as any that have a better-coloured blood It is granted by Slegelius that oftentimes upon Phlebotomy the blood which issueth forth may seem impure and yet the Patient be healthy Nonnunquam satis insignis impuritas inest sanguini ex cava educto nullis gravioribus symptomatis homini molestis ex quo patet non tantum semper periculum imminere si nonnullae sordes sanguini admisceantur I shall repeat here again the strange blood which Simon Pauli observed in an healthy person In the year 1654. a Citizen of Coppenhagen aged almost sixty years being accustomed to be let blood every year in May for prevention of the diseases incident in Summer would needs be Phlebotomized in the presence of Me and his Wife and Children the Chirurgeon having prick'd the Mediane vein the blood as it issued out had a peculiar but most noysome smell transcending any rotten Egg or stinking Vlcer c. which was so offensive to all in the room that we were forced to remedy it by burning some perfumes As soon as the Blood was cold in the porrenger the stench ceased and the blood seemed to be of a very good consistence and of so radiant a Scarlet that it equalled or rather exceeded the best red that is to be seen in the most beautiful Flowers it contained but little serum This passage of his recalls to my mind the serum of the blood of a Maid of a sanguine colour and perfect health excepting a pain in her stomach the blood which I caused to be taken from her seemed laudable and burned very vividly but the serum being set to coagulate seemed in consistence like to tallow and smelt like thereunto In another Child that died of an Hydrops thoracis I observed the serum as it heated to sent extreamly ill and with a penetrancy as if it had been Vitriol burning it would not coagulate though I boyled it but afterwards when it had stood to be cold it did jelly I know a Gentlewoman of extraordinary beauty troubled with nothing but Morphew or Vitiligo alba on her Armes in some places being let blood it appeared to be all serum almost and very little of any crimson mâ—ss was in it and that not so tenacious or fibrous as is usual though it were as well coloured as any is I boyl'd away all the serum which made up about six ounces or more and it would never inspissate or coagulate The variety of Blood is further illustrated by the case of Henry van Bueren a Brewers man who in perfect health had his Blood such that though it came out of the vein with a ruddy colour yet as it cooled all the serum did turn lacteous and resembled Milk though the sanguineous Mass retained its due colour and this was constant to him whether he bled by Phlebotomy or any other way A case like unto this is related by Bartholin from Ioh. Bapt. Caballaria Concerning the variety of blood in healthy persons it is further observable that not only in some small wounds admit of no cure or a difficult one whilest others heal with more facility in the same persons when they are young wounds will be easily cured even by the first intention and conjoyning of the lips thereof And afterwards as they grow more in years every superficial wound gives them much trouble but when they become old every scratch degenerates into a foul Vlcer notwithstanding that the Patient all this while commits not any errour in his diet nor is sensible otherwise or any alteration in his body or blood In fine diligent observation will assure any man that not only the Quantity of blood doth vary in sundry persons but even the Quality according to the age temperament and diet of the parties nay even according unto the seasonableness and season of the years Nor shall I exclude the passionately-angry or melancholick or phlegmatick from a latitude yet doth their blood exceedingly vary in the porrenger and consequently in the veins I have oftentimes seen and so hath Van der-Linden that in some healthy persons the blood hath been of a redness equally florid from the top to the bottome in some there hath appeared only some blackish spots at the bottome which no conversion to the open Air would rectifie into a florid crimson and perhaps some Observations may inform a man that the florid colour in the surface of the blood ariseth from a thinner sort of blood of a peculiar kind which radiates through a subtle pellicle on the top and when the blood is turned topsie-turvey 't is not the impressions of the Air that restores the decayed colour in the more black blood but the assent of this Ichorouâ— blâ—â—d through the more black and fibrous mass
I have blooded my self on purpose two hours after dinner to make the tryal and have an hundred times examined the blood of others who have been blooded at such times as we might expect to see that Phaenomenon of his Yet hath the reality of his observation been confirmed unto me by other credible witnesses so that I question not but he may have seen it though I could not in these Ladies who all dined together about one of the clock and had done bleeding by four Neither may I pass by this Observation that of all the Serum which I have tasted I never found any to be bitter though I extracted some once that seemed so bilious that being put into aâ— Vrinal none could know it from urine highly tinged as soon as I set it on the fire it coagulated with a less heat than I imagine it to have had in the veins and it exchanged its hue for the usual white smelling like a roasted Egg. Yet doth Van der Linden say that some have tasted the blood of Icterical persons and found it bitter Actu nihil naturaliter in sanguine amarum est Sed nec esse potest redderet enim sanguinem ineptum suo muneri ceu observare est in Ictericis In his enim sanguinem amaricare accepimus ab iis qui ipsum vena emissum urinam ejus gustarunt Asclepiadio more And Vesalius gives us an account of one Prosper Martellus a Florentine Gentleman much inclined to and troubled with the Iaundise whose Liver was scirrhous but Spleen sound and his Stomach turgid with choler and wheresoever he opened any of his veins they were full of thick choler and the fluid liquor which was in the Arteries did tinge his hands as if it were choler I find the like Oservation in Th. Kerckringius that an Icterical Woman brought forth a dead Child in the eighth moneth which was so yellow all over that it rather seemed a Statue of such wax than an humane Abortion being dissected By him instead of blood in the veins there was nothing but choler and all the bones were tinged with such a yellow that one would have thought them painted The Scholiast upon Ballonius observed that however the blood is naturally sweet even such as upon obstructions from the Menstrua hath regurgitated and discharged it self at the Gums of women as they have told me yet in one that was troubled with the Green-sickness the blood though florid was salt Potest esse floridus color in se esse acrior biliosior unde quaedam mulier 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 ejusmodi praedita temperamento mihi affirmavit siquando vel ex dentibus sanguis affluit vel e capite eum sibi gustum sentiri salsum molestum When I was at Barbadoes we carried off several poor English thence to Iamaica where many of them falling sick and some being well were let blood I observed that in those poor people which live upon nothing almost but Roots and drink Mobby a liquor made of Potatoes boyl'd and steep'd in water and so fermented that their blood did stream out yellow and in the Porringer did scarce retain any shew of red in the coagulated mass yet are they well and strong but look pale and freckled such persons which are frequent in Barbadoes are called Mobby-faces It were infinite at least beyond my present leisure to relate all that variety of morbid blood which hath been observed in sundry diseases and in several persons languishing under the same distemper as in Pleurisies the Scurvey French-pox Hypochondriacal Melancholy and the like wherein if it be true as it is that oftentimes diseases vary in individuals 't is no less certain that the blood doth also vary in them so that oftentimes ignorant Physicians do imagine a greater corruption in the blood and a greater recess from what is natural to the person and a greater danger in the disease or in the practise of Phlebotomy than they need yet in Epidemical or some Sporadical diseases if the Phaenomena be as general as the disease 't is certain then that the resemblance of the blood argues a resembling cause which prevails over the idiosyncrasy of particulars I know it will be expected that I should say something about the Controversie whether the Blood be one Homogeneous liquor the recrements whereof make up the four Galenical Humours which are no otherwise parts thereof than the Lees and Mothers of Wine are constitutive parts thereof Or whether the four Galenical Humours viz. that which is properly Blood Melancholy Choler and Phlegm are the constitutive parts of the Blood in its natural consistence and Crasis I shall say therefore about this point as much as may be requisite to my present purpose First I observe that the Galenists are at a difference whether the Mass of blood contain those Humours actually or only potentially so that one may hold according to them that the blood is as homogeneous a liquor as any Neoteric doth hold it to be though it arise by the mixture of their five principles Amongst others Erastus hath a disputation in which he amply asserts that all those Humours when they are actually in the blood they become excremenâ—itious and are no longer parts thereof but such as the ejectment thereof depurates and perfects the other remaining blood which he confesâ—eth to consist of several parts constituting one body to which they are as essential as the serous caseous and butyrous part are to Milk which if they be deficient 't is no longer Milk Nam ut non potest lac bubulum intelligi sanum perfectum sine tribus suis partibus sero caseo butyro ita non potest sanguis probus animo concipi definiri absque partium illa varietate Fernelius doth compare the generation of Blood to that of Wine wherein the Chyle is supposed to resemble Must which by fermentation separates and throws out such parts as are not actually in that liquor but arise upon fermentation and are ejected several wayes the more crude parts are by time digested and then the noble wine brought to perfection so he supposeth it to be in the blood and thus though all the humours be at once as it were produced in the Chyle yet are they no more parts of the blood than the Tartar and Mothers are parts of Wine Both these Similitudes of Milk and Wine to Blood were first I think introduced by Galen I am sure he made mention of them and so did his Successours to Mercatus Fernelius Platerus Palleriaca then Carolus Piso began to carry the comparison further in his discourse of Feavers and after him Quercetan and since that our learned and judicious Countrey-man Doctor Willis Others held that the blood as it flows in the veins and is designed by Nature for the Aliment and other uses in man is not to be understood as one liquor consisting of some variety of parts yet united
frequently the most rational and best Methods of curing Quaedam ejus sunt conditionis ut effectum praestare debeant quibusdam pro effectu est omnia attentasse ut proficerent Si omnia fecit ut sanaret peregit Medicus partes suas etiam damnato reo Oratori constat eloquentia officium si omni arte usus sit 3. If it be true that there is so great a variety and discrepancy in the Blood then is there no secure judgment to be made of the Blood issuing out of the vein either to the continuing or stopping its Flux But the Physician is to proceed according to the Rules of Art and accordingly as they direct him may he promote stop or repeat the evacuation A seeming Cacochymy in the Blood doth not impede venae-section nor call for purging and rectifying Nothing is evil that is natural to a man but real Cachochymy or redundance of Humours offending Nature this doth call for our assistance and requires sometimes Phlebotomy and sometimes other Medicaments 4. If it be true that Sanguification is an Animal Action if it be true that the Plastick form is in being before the Blood and produceth it and the whole Fabrick and subsequent operations and that the motion of the Heart is proved by Doctor Lower to depend upon the Nerves during life then is there no such strict connexion betwixt the Soul Life and Blood as G. T. doth fancy 5. If it be true that the Blood doth continually waste and spend it self in Nutriment and Excrements then is it manifest not only that the loss of a little Blood partitely taken away is not the loss of life or prejudicial thereunto Neither doth it follow that the loss of Blood in a moderate quantity is any imminution of the vital Nectar it is neither the chief residence or seat of the Soul nor in a determinate quantity requisite to the continuance of Life but comes under a great latitude It abounds more in some seasons of the year and times than at others and why may not Artists imitate Nature in diminishing its redundance upon occasion as she does As long as he proceeds not to exhaust all or too much The loss is easily repaired upon convalescence and the qnantity is more than can be governed by Nature in sickness 't is but the observation of a Geometrical proportion in such a Phlebotomist The same Agent will produce the same effects if Nature be corroborated and the vitiated tonus of the concocting and distributing vessels be amended there is no fear of wanting a new supply proportionate to the exigence of the Patient The Blood we take away is no other than what would be expended or exhausted naturally within a few hours or dayes as the Staticks shew and it must needs be considering the quantity of Chyle which flows into the veins upon eating and drinking 6. If it be true not only that Nature doth thus expend in transpiration and Excrements as well as Nourishment much of the Blood and repairs her defests by a new supply whereby Life is continued not impaired so as that the melioration of the following Blood is rather evident in his first years by his growth vigour strength and intellectuals But also that She doth of her self make men and women apt to bleed at some times ages and seasons which is known to all then is not the effusion of this solar liquor so unnatural a thing nor so homicidial an Act as 't is represented 'T would seem a strange Law that should punish every Boy that breaks the Head or Nose of another as a Bronchotomist or Cut-throat If it be true that Nature doth oftentimes alleviate even in the beginning and in the end cure Diseases by spontaneous evacuations of Blood at the Nose and Vterus by vomiting and stool then a Physician whose business it is to imitate Nature in her beneficial Operations is sufficiently authorised and impowered to practise due Phlebotomy by the best of Presidents Hâ—ving premised these Conclusions which are all either proved in the foregoing discourse or evident in themselves to all understanding men I shall proceed to give an account of the Reasons why Physicians do so frequently and in so many Diseases practise Blood-letting and those deduced from its variety of effects in Humane bodies For it is not a single Remedy subservient unto one Indication or End but conducing to many and therefore made use of upon several occasions to different intentions Vtile est id remedium ad quamplurima vix-potest in ullo magno morbo non esse aliquid cujus gratia utile sit Before I come to particulars it is necessary I tell you that in the cure of all diseases Physicians propose unto themselves sundry considerations they regard the disease the antecedent causes and the symptomes which attend or will ensue thereupon either generally or in such an individual constitution they employ their cares to prevent some inconveniences as well as to redress others Some remedies they make use of because they are necessary of some because they are beneficial yet may the disease 't is granted be cured oâ—herwise in case the Patient have a reluctancy thereto or for some private reasons the Physicians esteem it fitting to alter their course Upon this account 't is assented unto that many distempers may be cured without Phlebotomy which yet are ordinarily cured with it or may be so And herein the disagreement of Physicians or different procedures are all according to their Art nor is it denied but that All of them may atchieve their ends by their several Methods So that it is a gross paralogisme for any one to conclude this or that Physician is mistaken or takes a wrong course because another takes or prescribes a different one All the Physicians in Spain France and Italy do not bleed with equal profuseness In Germany and England some do practise more frequent Phlebotomies than others do and neither of the parties do erre in case the other remaining Method be inviolately observed It is in humane bodies as it is in the body Politick where there is a Method of ruling though it be carried on by several wayes and means and whilst each States-man doth prudentially sway the Government procuring peace and plenty to the subject his conduct though it vary from that of his Predecessour is not to be blamed It is not to be doubted but that many grievous distempers are cured by Nature without the use of any remedies at all Yet will no wise man adventure his life on such incertainties 't is not to be denied but some are cured with fewer Remedies than others are But yet 't is not prudence to put Nature upon too great a stress or to account all means unnecessary which are not absolutely requisite or without which the effect may though with more difficulty and hazard be brought to pass It lyeth upon the Physician therefore to pursue all those means which may secure the life of
Physicians usually seem to require Phlebotomy he doth allow the practise thereof in the Small Pox before they come out be it on the fourth day or later that they discover themselves After they do appear he alloweth not except there be a manifest plenitude and â—urcharge of morbific humours then he alloweth only a minute letting of blood and not what is too copious and adds that in this disease 't is most convenient to let blood and if the Patient be not blooded in a Plethoric constitution and that by a repeated phlebotomy according to the exigency of the case that is compleatly there is danger least the party suffer the corruption or loss of some of his limbs by a Gangrene or other evil accident for when the redundance of the expelled matter is such that it cannot duly maturate and transpire in the pustules it frequently corrodes the ligaments and tendons and otherwise vitiates the remoter parts of the body even Worms have been bred in a pestilential Small Pox all under the pustules as at Stralesund in 1574. sometimes the matter not finding room to disburthen it self in the circumference turns its course into the bowels and begets mortal Diarrhaeas and Dysenteries Of the same opinion is Rhases as appears by what is extant amongst the Scriptores de febribus viz. Si antequam apparere incipiant medicus aegrum inveniat minuere eum faciat aut cum ventosis sanguis extrahatur Minuatur equidem sanguinis multitudo It is true that there he prohibites Phlebotomy after the Pox come forth but I find him cited by others 〈◊〉 concurring with Avicenna as to bleeding even at the nose as extreamly beneficial and to approve of phlebotomy after they come forth in case the Patient find no alleviation thereupon but there continue signs of a plenitude or redundancy of ill humours a great Feaver and difficulty of breathing But there is another piece entitled unto Rhases wherein how indulgent he is to Phlebotomy you may learn from Augenius Rhases libro suo de peste capite sexto mittendum esse sanguinâ—m vult pro quantitate plenitudinis si enim maxima fuerit non veritur vacuare usque ad animi deliquium si mediocris mediocriter educit si parva fuerit paulum sanguinem educit verba ejus sic habent Tu venam incidito quam multum sanguinis effundito scil ad sanguinis defectionem usque Supra vero syndromen attulit maximae plenitudinis paucis interpositis inquit Cum vero haec signa admodum evidentia non erunt veruntamen vehementia quidem parum sanguinis fundito Sin minime minimum haec ille How successful so large bleeding may be though Augenius and Ranâ—hinus and others condemn it we may judge by the practise of Botallus To these I add the authority of Serapion which runs thus Si haec febris fuerit propter causam variolarum virtus aetas consentit tunc non aliquid magis juvativum quam phlebotomia venae Et si aliquid prohibet phlebotomiam tunc oportet ut administrentur ventosae Out of which it is evident that the generality of the Arabians were of a different sentiment from what Doctor Whitaker ascribes unto them and Claudinus is less mistaken when he as do many others avoweth that The Arabians universally agree to let Blood in the Small Pox upon occasion Nor is there more of truth in that which follows in our Doctor viz. that Their followers have not determined this doubt For though two or three may seem refractory still in the World yet it is not amongst Physicians but amongst them that are not Physicians that the doubt is indetermined I shall take some pains to undeceive this Age as to the present point Gordonius's words are these Inprimis si corpus est Plethoricum aut si sanguis dominatur aut virtus est sortis fiat Phlebotomia de mediana postea de summitate nasi i. e. In the first place if the body be plethoric or if the Disease be such as is attended with abundance of blood or if the Patient be strong let him bleed first in the middle vein and afterwards at the Nose Petrus Bayrus having repeated the signs of the Small Pox when they are violent adds His apparentibus statim fac Phlebotomiam copiosam prius scilicet quam variolae ad extra appareant licet possit fieri etiam ipsis incipientibus apparere stante multa repletione non tamen tunc fiat ita copiosa sicut ipsis non apparentibus dicente Avicenna in casu Extrahatur sanguis quantitate quae exiret hoc est minoret i. e. when the Small Pox begin with such a vehemence of symptomes presently take from the Patient a large quantity of Blood before the Small Pox begin to come forth yet may he also be let blood after they begin to appear if there be a great repletion but yet not in so large a manner as otherwise for so Avicenna directs in the case and let the Patient bleed in such a quantity as may dry the habit of his body that is you may lessen the quantity of the morbisick matter so to bring them forth to a kind maturation but not so as to divert Nature from her work I shall not trouble my self to repeat the words of others at large but refer my Reader to the places cited Horatius Augenius one of our best Writers upon the Small Pox and who protests he writes nâ—thing in order to its Cure but what six and forty 〈◊〉 Experience had convinced him of to be good doth allow in difficult cases and when the Disease is somewhat pestilential that the Patient bleed first at the Arm and then at the Nose by irritating it with Yarrow or Horse tayl With him agrees the cautilous and learned Practitioner Iuleus Caesar Claudinus who doth debate and determine this doubt as also doth Dilectus Lusitanus in his Treatise of Venae-sectione and Epiphanius Ferdinandus and Aemilius Campolongus Neither is it to be questioned but that this is the common practise of all Italy so that I shall cite no more of that Nation In Spain 't is approved of by Christophorus a Vega whose words are these Si vero lactae fuerint variolae ab humore fiant crassiore ab initio sanguinem mittere si febris adfuerit sine ipsa vero minime And the best of Writers Ludovicus Mercatus is thus peremptory in his Resolution De sanguinis detractione nullus usquam dubitavit aut id sine ratione fecit nisi aut vires sint adeo dejectae quod neque minimam citra majus damnum ferre possint aut affectus adeo levis aut benignus existat quod satius sit naturae committere quam ipsam infirmare sanguine misso vel sanguinis copia adeo parva quod exquisitiori victus institutione securius rem possis agere quam aliis praesidiis
the time of the Disease or contraindicated by any number of dayes but by other motives and that whensoever it is necessary upon any urgency nothing but want of strength doth repugne thereunto It may perhaps be demanded Whether upon the declination of the Small Pox if there be any danger of an Asthma or Consumption to be contracted it be safe to let blood or in order to better convalescency I profess it may safely and prudently be done for Revulsion before the humours be more radicated and setled there and the Disease become incurable for this is an infallible sign that the Disease is not well terminated and then those Rules which oblige us not to intermeddle with any perfect Crisis or indication are infirm conclude us not Oftentimes we see Rheumatismes and Botches to ensue and they shew that all the morbifick matter is not ejected Besides in order to a better convalescence if Phlebotomy have been omitted in the beginning and that the recovery is likely to be slow I think and 't is said to be the judgment of Avicenna that it may be done and I have seen it practised with a much more happy success than ever I saw Purge given in that time But in this last case I referre it to every mans judgment to act as he please and request only that they would not condemn others of a different practise from what they follow After all this discourse of bleeding in the Small Pox I must conclude with this intimation that in sundry cases and some habits of body 't is possible that Phlebotomy may be supplied by Cupping-glasses and Scarification and I profess that were the Scarification of the Aegyptians mentioned by Prosper Alpinus and frequently used amongst the Ancients admitted into our practise I should frequently prefer them before any Phlebotomy Being in Iamaica I observed that the Spanish Negroes there did much use them and during my sickness of the Colick bilious I had the curiosity to have them tryed upon me in the beginning I observed that they were as indolent as Prosper Alpinus and Mannus do relate them to be but no blood almost ensued thereupon whence they presaged to me a long and violent sickness saying that all the water of my blood was translated out of the veins into my bowels yet I have seen them to extract one from another a pound or more as they pleased But I find my self wearied with the prosecution of this Letter and the sickliness of the season permits me not leisure to carry on the debate unto the Scurvey But whosoever examines attentively that disease will be easily satisfied that it may be beneficial and oftentimes absolutely necessary to the cure thereof In those Countries where it is most frequent and where the Climate bears a great correspondence with ours this is the practise as you may see in Forrestus I add the Authority of Claudinus Ioel who prescribes the repeating of Phlebotomy at least three times Rembertus Dodonaeus Severinus Eugalenus Balthasar Brunerus Henricus Brucaeus Baldassar Timaeus who also reiterates bleeding several times Platerus Sennertus Baldwinus Ronsseus Io. Wierus Salomon Albertus Matth. Martinus Gregor Horstius Valentinus Andreas Mollenbroccius and the Colledge of Physicians at Coppenhagen in their advice for the Scurvey published by Bartholinus I might add others to this Catalogue but that 't were needless 'T is true that in the Scurvey many do not bear well large Phlebotomy but that is not the Question 't is enough that they minute venae-section and that reiterated doth agree well with them and is oftentimes so necessary to the cure that the omission thereof doth frustrate the most efficacious Medicaments The Disease generally ariseth from an obstipation of the Pores and such an alteration in the texture of the body as the Methodists would bring under Adstriction and therefore it seldome occurreth in hot Countries except the wind suddenly change into a cold quarter and a multitude of Cures are recorded wherein Phlebotomy hath been the leading Remedy The sick do frequently bleed at the Nose and Emrods c. and since in distempers of the Spleen I find Phlebotomy commended 't is not to be denied in this case without some special contra-indicant which I am not yet acquainted with I think I have in the precedent discourse enervated all that M. N. hath maliciously and ignorantly suggested against Phlebotomy neither do I know one passage in him that can raise any scruple in the breast of a judicious person but I must particularly caution him not to give too much credit to the dotages of Thonerus a man of little note in his own Countrey nor to go about to delude the World with Fables as if the Northâ—rn Climates did not suit well with Phlebotomy whereas it is notorius that no Nations do bleed more largely nor more frequently that they I will not insist on what they do in their natural or artificial Bathes with Cupping-glasses and Scarifications whereby they extract many ounces frequently every year they applying ten or fifteen Cupping-glasses with Scarifications which sometimes they repeat twice in one hour As to Phlebotomy in Denmark nothing is more common than whensoever the Almanack recommends bleeding for every man almost to step into the Barbers-shop and having bled to go about his business which custom though Bartholinus condemn yet doth it evince the general use thereof in time of health and who can doubt but that they who bear it so well whilest free from any Disease but a tincture of the Scurvey might endure it in sickness did not a puerile fear in the Patient or ignorance in the Physician hinder them Adultiores alii in venarum apertione nimis sunt profusi vel audaces quippe visa fascia rubente ante aedes Chirurgorum appensa ex Calendariorum signis dependentium statim sine alia corporum praeparatione in sella officinae considentes brachium sine delectu pertundendum offerunt peracta operatione vel itineri se committant aliisque negotiis conficiendis vel vini modium ebibunt cumulati errores acri censura digni sunt sed verba perdere nolo quia Aethiopem me lavare scio Monendum tamen duxi scorbutica nostra corpora maxima indigere praeparatione antequam generoso isti remedio subjiciantur If letting of blood were so pernicious in the Scurvey 't were impossible in so general a practise but the inconvenience would be discovered and the people reclaimed from that inveterate vulgar custom of Switzerland is he that blameth it doth thus describe Solent nostrates Ruricolae inprimis ter quaterve in anno venaesectiones usurpare quolibet vice duas quandoque tres non raro quatuor venas pertundendas curant emittunt soepe binas sangninis libras Nulla cura est vel temperamenti vel sexus vel aetatis Vindentur quandoque gravidae quae his terve gestationis tempore sanguinem vena secta effundunt nec etiam partui vicinae a venaesectione sibi
Vossius de Philos. c. 12. sect 19 Suidas in 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Let D. M. take notice here that there private Arcana such as the Quacks pretend unto concealing the Medicaments and others by that name published in Print in Crollius Schroder and others In his Preface to the Reader he sayes He doubts not the time will come yea is not far off that a Phlebotomist as he hath characterized him will be looked upon as little better than a Broachotomist a Cut-throat Galen de Sangu miss c. 2. G. Th. of the Blood p. 19 20. Ibid. p. 22. Ibid. p. 1 2 and 34. Ibid. p. 2. Some peoples flesh will not heal upon the least cut notwithstanding this Sanative quality in the Blood Yet are several glandules sweeter to taste than the sanguineous fleshy parts of Animals What becomes of the duumvirate then And may I not ask if the Spirits be nâ—t the immediate Instruments of the Soul Ibid. p. 5. If God and Nature intended the blood for so pure and homogeneous a liquor why did they produce man with such a fabrick that the chyle several ways tinged should mix with it in the sub-clavian veins Ibid. p. 6. C. Hofmann de Ichor sect 12 13.9 Th. Scheuck de sero sangu c. 1. Gâ—isson de hepate c. 45. Charleton Occoâ— Anim. exercit 9. sect 7. a Glisson Anat hepat c. 45. Quippe tota haec Lympha uti experientium compertum est densior minusque pellucens interdum lactis instar albescens aliquanâ—s sufflava non nunquam loturae carâ—is similis Vide Charlton ubi supra b Centies facto experimento vadi semper serum ipsum non modo leviter incrassari sed agglutinari fieriqne membraneum H. Barbat diss de sangu sero pag. 16. c Th. Bartholin Spicileg p. 71. M. Bogdan apolog adv O. Rudbek sect 116. Vide Hofman de Ichoribus sect 71 c. Dr. Willis de â—erment c. 6. Kerger de fermentat sect 1. c. 11. E venis capitis nunquam talem muccaginem affluentem vidimus crebrius è venis brachii è pedum autem venis creberrimè in majori copia Moebius fundam medic de usu Cordâ—â— p 259 p. 87. p. 6 7. p. 18. Vallesius method medend l. 2. c. 4. Horat. Augen de miss sangu l. 9. c. 24. Petrus Castel de abusu Phlebot pag. 73. Alex. Massaria Apolog. l. 11. disp 11. c. 14. Fernel Physiolog l. 6. c. 7. River obs communicatae à Pachequo obs 46. Petr. à Castro de febre malign pag. 90. Fernel Therapent Univ. l. 2. c. 17. Sennert de febr l. 2. c. 1. This be might have learned from Galen in his Comment upon Aphor. 17. l. 2. Hippocr Epid. sect 1. l. 2. Fienus de signis medicis par 2. c. 1. sect 8. Francisc. Rubeus Nocturn exercit in Histor Medic. exerc 6. p. 98 99 100. Prosper Alpin de praesag vita morte l. 7. c. 2. p. 52. Scaliger de subtil exercit 102. sect 5. Fernel Phisiolog l. 5. c. 16. Valles sacr philos c. 5. p. 102. Fernel Physiolog l. 2. c. 1. Plempius sundam medic l. â— c. 1. Botallus de sangu 〈◊〉 c. 34. Id ibid. c. 33 sect 7 8. c. 35. p. 7. Domin de Marchettis Anatom c. 9. Domin de Marchettis Anatom c. 10. Paraus chirurg l. 16. c. 49. Simon Pauli de febr malignis sect 11. p. 89 90. (a) 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Arist. Ethic. l. 10. c. 9. Io. Franc. Ripa tract de peste c. 7. sect 17. Arist. l. 8. Phys. c. 3. t. 22. 1 de ort inter c. 3. t. 59. Steph. Roderic Castrens quae ex quib l. 4. c. 7 8. Iodoc. Lommius de curand febr contin c. 3. With this opinion of J. Lommius doth Citesius agree de usu Phlebotom c. 4. Galen de sang miss c. 14. a Citesius de usu Phlebotom c. 5. Rolfinc meth medic spec c. 4. sect 2. c. 11. b Rolfinc ubi supra Dilect Lusitan de venae sectione cap. 14. Artic. 1. G. Fletcher's History of Russâ—â— c. 28. p. 279. P. Zacchias Qu. Medico legal l. 9. consil 40. Vide I. Franc. Ripia tract de peste c. 7. §. 64 65 78 104. â—â—lles Meth. Med. l. 2. c. 3. Vide Riolan de circulat Sanguin c. xx Vallis meth medend l. 4. c. 2. Pag. 105.106 He should rather have regarded the â—econd then sixth digestion Brune Seidelius de morb incurabit p. 57. Valles meth medend l. 2. c. 3. P. 168 169 Valles in Hippocr de victu in morb anot l. 3. p. 169. Ballonius Epidem ephemerid l. 1. p. 101. Vide Riolâ—n de circulat sang c. xx Hippocrat Epidem l. 5. c. 11. 6. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 See Antâ—n Bâ—nivenius his medicinal observat c. 44. p. 107 108. Ballonius Epidem l. 2. p. 191 Fallonius Epidem l. 2. p 192 Ballon Epid. l. 2. p. 167. Petrus a Castro de febre malig puncticul p 90. Simon Pauli digress de febr malign §. 12.14 Valles meth medend l. 4. c. 2 Castellus de abusu venaesection p. 60. Forrest de febre l. 12. in Scholio Novae Acad. Florentinae opuscula adv Aviceâ—n p 43 p. â—3 Ibid. p. 99. P. Castellus de abusu Phlebotom p 6 7. p. 101. p. 110. p. 108. p. 109. G. T. understands not what a procatarctick cause is it is here a causa 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Vide Steph. Roder. Castren Ouae ex quibus Valles in Epidem l. 4. p 448. in historia Alcippi ibid. p. 401. in hist. â—omulae emptitiae Hieremias Thriverius Brachelius in lib. 4. Aphor. 57. Valles controvers Medic. l. 8. c. x. Hieron Rubeus in C. Celsum l. 5. sect 4 C. Celsuâ— de Medicina l. 3. c. 9. p. 169. Novâ— Acad. Floâ—ent opuscul p. 21. Io. Riolan in resp ad dubia Anatomica Barthâ—lâ— p. 75. Ar. Rhet. l. 2. c. 4 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Claudinus proposeth frequent Phlebotomy as a remedy for fatness Venae sectio omnino convenit imo fâ—nt qui nihil râ—agis ad detrahendam corporis molem valere existimant quem erebram sectionem venae Empiric rational l. 1. §. 1. c. 4. Io. Fuchsius Compend abus p. 2. c. 7. Primros de vulgi error l. 4. c. 50. Prosper Alpinus de med Egyptiorum l. 3. c. 15 16. Dr. Willis de â—ebr p. 197. Dr. Willis de febr p. 166. edit 1662 Hor. Augen de miss sangu l. 4. c. 19. p. 82. p. 99. p. 81. p. 99. Maebius fundam med de usu ventriculi p. 178. Kerger de fer met §. 3. c. 2. G. T. of the Pest. c. 1. p. 8. Isbrand a Diemerbrook de pest l. 1. c. 7. §. 1. p. 18. edit 1665. Amsterdami Zacchias Qu. medico legal l. 3. tit 3. Qu 1. §. 13 14. G T. of the Pest. c. 3. p. 42. Isbr. a Diemerb de Peste l. 1. c. xii So Van der Mye during the siege of Breda relateâ— causes of such as had
de circul sang sect 137. â—â—laeus de moru sang epist. 2. Pecquet dissertat Anat. de circulat sang c. x. Riolanus Anthopogr l. 6. câ—lt p. 411. Concerning Concoction in the stomach see the excellent discourse of Maebiâ—â— de usu ventriculi fuâ—doâ— Medic. c. x where he resolves it is done by an Animal bear or Spiritâ—â— vitalis vegetâ— colote praeditus Vide Maebium ubi supra Karger de ferment sect 3. c. 2. p. 200 201. Vesalius de fabric hum corp l. 5. c. 8. Reusuerâ—â— de urinis c. 3. p. 42. Dr. Needham deformat faet p. 101 102. Dr. Lower de corde c 5. Platerus Quaest. Physiolog 17. Maebius fundam Medic. c. 14. p 339. Mâ—bius ubi supra p. 338. Fonseca de Exâ—rement c. de Vrinâ—â— Vesolius Examin obs Pallop p. 191. Regner de Graeff de succo pancreatit §. 65. Seneca de benit l. â— Botallus de venae sect c. 15. Hippocrat sect 3. Aphor. 27.20 Valles Meth. med l. 4. c. 2. Riolanus de circulat fang c. xx Anthopograph p. 585. Platerus Observat l. 2. Sanctor Med. Static sect 1. aphor 41 49. sect 4. aphor 7 8. Sanctor Med. Static sect 4. aphor 10 11. Van der Heyden Synopsis discurs disc 2. de potu frigida So Blondelus could not with all his Skill cure the Marquess of Cauvre till he did bleed him in a chronical terrible dysentery which he confesseth though he writes against Phlebotomy in Epidemical dysenteries Valles meth med l. 4. c. 2. C. Celsâ—â— Medicin in pref Hippocrat de Aâ—te c. 23. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Cassius in problem 71. They seldome used purging imagining it not fit till the body was prepar'd and humours concocted but they made much use of vomits Valles method medend l. 4. c. 2. Gregor Horstius Instit. Med. diâ—p 18. Coron dâ—venae sect qu. xi Any man that is conversant in Physick knows that such purges as operate on the blood promote urine and sweat and transpiration even during the working for those very qualmes the Patients feel are an effect of Diaphoresis Lipothymia juvet quia sudorem validam perspirationem facit Sanctor Med. Stat sect 1. Aph. 98. Hippocrat § 2. aphor x. Sanctor sect 1. aphor 104. Id ibid. sect 2. aphor 28. §. 1. aph 120 I did herein follow Galen and those that represent Phleâ—otomy as a great Anodyne and particularly Citâ—sius concerning the Colick in Poictâ—ers Kergerus de ferment sect 1 c. 9. sect 2. c 8. Williss de ferment c. 6 This is agreeable to the Hypothesis of the Methodists Apolog. pro circul sangu sect 23. p. 62. Id. ibid. p. 107 108. Id. ibid. p. 179.180 The alteration of the teâ—ture of the body is no less evident out of Dietetical observations of which I have made many and did intend once to prosecute for these inquiries as also the discovery thereof in dead bodies I intend some time this Summer to write a discourse concerning the Vnlawfulness of Divines to proctise Physick Vide Meiboâ—ium in sur Hippocrat c. 5. Io Laurent dissert de Aesculapio 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Hippocr lege c. 2. Aristot. Metap lib. 1. c. 1. Ethicor. l. x. c. 9. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Hippocr de veter medicin c. 17. p. 126. p. 126. See Schenckius obs l. 2. de pleurit Prosper Alpin Medic. meth l. 7. c. xi I. Heurnius apud Schenckius lib. 2. de pleurit p. 126. I would willingly know of this Holmontion whether it be a Rhizotomous cure when Nature doth put a period to a disease by an eruption of blood at the nose Here is no dulcification of the acid Latex no rectification of the stomach and no other mortification of the malignity Quercetan Redivicus â— 3. p. 10â— Baptist. Cadronch de morb vulgaâ— c. xii and Bartoletus de diffic respir. l. 5. c. 4. Bartoletus de difficil respir. l. 5 c. 4. Wierus obser l. 1. de Epid. pleuritide Vincent Baronius de pleuripneumon l. 1. c. 1. Castellus de abusu Phlebotom p. 87. Gobelchoveruâ— centur 2. cur 92 in Scholio Hollerius apud facetium in Coac l. 7. sect 2. sect 18. vide etium Iacoâ— in Coac l. 5. sect 2. §. 26. Galenâ—â— comment 3 in l. 6. Epidem But Riolanus doth blame Galen as violating his own Rules hereby De circulaâ— sang c. xx Hippocrat l. 2. Aphor. 19. Holler de morb intern l. 1. c. 26. De pleuritide Zacchias Qu. Medico-legal l. 9. consil 40. sect 4. Alexius Pedemont de secr l. 1. p. 51 49. River cent 4. obs 88. Quercetan Redivivâ—â— â— 3. p. 103. Fr. Volleriole obs Medic. l. 4 obs 1. Lazarus Messonnierius doctr nov sebr Exerc. 3. p. 41 42. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Hippocrot de victu in acut l. 1. sect 8. Valles in Hippocrat de victa in morb acut l. 4. p. 197 Hartman praxis chym 〈◊〉 pleurit p. 1 33. edit Genevens Hippocrat aphor 8. § 4 cum notis Vallesit Hippocrat Epidem §. 3. l. 3. p. 309 310 311 312. cum notis Vallesiâ— Hippocr Coac Praenot l. 5. sect 2. sect 27. cum notis Iacotii Ballonius Epidem l. 1. p. 20. Franc. Rubeus nocturn exercitat xii Lud. Mercatus consult xi Hippocr Coac Praenot lib. 5. sect 2. sect 72 cum notis Iacotii 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Hippocr de victu acut l. 1. sect 35. Librand â— Diemerbrook de pest c. 14. sect 7. Hippoc. aphor 33. sect 6. Hippocrat de victu in morb alcuct l. 2. cum notiâ— Vollesit p. 42. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Hippoc. aphor 16. l. 6. Valles in Hippocrat Epid. l. 6. p 456. Van der Linden select Medic. c. xii Hippocr Coac praenot l 5. sect 2. sect 25. Vesalius saith that all the quarrels about the different Phlebotomies in a Pleurisie were Rixa de lana caprina Vesal exam obs Fallopii p. 129. yet this is evident that Nature delights to evacuate diseases of the liver by an Haemorragy of the right nostril of the spleen by the right And that there is as it were a seam in the body is apparent in the Palsie So that 't is wisdome for us to imagine that 't is not indifferent what side we bleed â—n Valles Meth. med l. 4. c. 2. Riolanus de circular sangu c. xx Forrest Obs. l. xvi Obs. 33. in Scholio Tulpius Obs. l. 2. c. 1 2 3. Almaricus Blondelus de venae sectione p. 50. Platerus prax t. 2. c. x. Iâ— Riolan de circulat sang c. 20. Botallus de venae sect c. 3. C. Celsus Medic l 2. c. 10. I have seen Ladies with child to be let blood when they were continually swooning and fainting and extream weak and that judicioâ—sly for they having large veins and otherwise a firm and imperspirable habit of body we did not regard the Animal Imbecillity nor the irregularity of a pulse altered by vapours but proceeded to cure them by Phlebotomy and it prospered Baldass Timaeus respons Medic. 58. Petrus Salius Diversus de affect particular c.