the Disease or Feaver be the object of their designs yet As all wise men consider by what means the ends they propose to themselves may be effected so do they deliberate how they shall effect their designs and that is by removing the Cause of the Malâ—dy But as in other designs it frequently happens so here they often meet with impediments which must be removed before they can prosecute their intentions by direct means Upon this account they are forced upon maâ—◠〈◊〉 which they confess are not immediately 〈…〉 of a Feaver which yet they purâ—â—â— because without doing so the indisposition either could not be cured or not with such safety as becomes prudent persons Few of them ever bleed that I know of meerly for refrigeration and the extirpation of the formal heâ—t without regard to the material cause of it which is to be concocted and ejected by Nature Though Phlebotomy be but one operation yet it produceth sundry effects in the body and in order to each of them is both indicated and practised For it evacuateth that redundancy of blood which frequently occasioneth diseases alwayes is apt to degenerate into a vitious morbifick matter during the Feaver and by an indirect and exorbitant motion to afflict some or other principal parts to the great danger if not destruction of the Patient upon this account we do use Phlebotomy in Feavers sometimes to diminish the Plethora and so to prevent the violence of the succeeding disease and dangerous symptomes that may insue and then the veins are too much distended to facilitate and secure the operation of subsequent Medicines that are used to evacuate the Antecedent Cause and to maturate and expedite the continent morbifick cause Besides it promotes transpiration incredibly gives a new motion to those humours which together with the blood oppress and indanger the internal and principal parts it diverts them from the head and draws them from the heart lungs stomach and bowels into the habit of the body whereby Nature being alleviated prosecutes her recovery by maturation and expulsion of the peccant depraved matter deducing to its proper state that which is semi-putrid and not irrecoverably vitiated and separating first then exterminating what is incorrigible So the Patient recovers Nor is there any thing more true than this which every Practitioner may daily observe in his practise that Of all the Medicaments which are vsed by Physitians there is not any may compare for its efficacy and utility with Phlebotomy so expedite so facile and so universal is it The universality of its use appears herein that it evacuates the redundant it alters the exorbitant Fluxes of the peccant or deviating humours and blood It retaxeth the vessels and pores of the body and refrigerates the habit thereof And therefore is so absolutely necessary in putrid Feavers that though I do not say they are incurable without it yet I pity the languishing condition of such as omit it the violence of the symptomes being increased thereby and the cure procrastinated to the great trouble and hazard of the sick and his great detriment afterwards for you shall ordinarily meet with a slow convalescence and the blood be so depraved by so long and violent an effervescence that it becomes remediless and degenerates into an evil habit of body Scorbute Dropsie c. This being premised which is more clearly proved by Experience than Reason I answer to his Argument that we do not go about only to refrigerate the Patient but to concoct and eject the morbifick matter that we take the most befitting course to exterminate that spinous offensive cause and as upon the prick of a Thorn if part stick in the wound and be buried therein we proceed to maturate and bring to a paculency the vitiated blood and humours inherent in the part affected and with the suppâ—â—â—â—â—d mâ—tter drâ—â— out the fragment of the Thorn so we do in Feavâ—â—s where the depraved humours are not so easily sepâ—â—â—ted and extirpated as in the prick of a Thorn maturate the eject the morbifick câ—â—se and thereby atchieve the Cure And I do profess my self to concurre with the Ancients in their Opinion that there is a great Analogy betwixt the generation of the Hypostasis in the Vrine after a Feaver and the production of purulent matter in an Apostimation and that Feavers are but a kind of Abscesse in the mass of blood for the proof whereof I do remit my Reader to Ballonius de Hypostasi Vrinarum Amongst the Ancients I find two wayes commonly practised to extinguish this Febrile Heat by a course corresponding with the usual wayes of extinguishing a fire which are 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by substracting the fewel from it thus they did Phlebotomise at once till the Patient did swoone the other 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by quenching it thus they gave them cold Water to drink largely until the sick grew pale and fell into a shivering this last was not practised till there were manifest signs of concoction But 't is observable that upon either of these Medicaments they did expect that happy issue that Nature thereupon should presently discharge it self by sundry evacuations of the morbifick matter so that they did not thereby intend bare resignation but the extermination of the concocted febrile matter And thus much may suffice in answer to this Objection The last Objection he makes is this as I shall form it The great Indications of the Galenists for Phlebotomy are either Evacuation of the redundant blood in a Plethora or the Revulsion and direct pulling back of what is in flux or flowed into any part already But neither of these Indications are valid and oblige them to that practise Therefore the practise of Phlebotomy is not to be continued As to Phlebotomy in a Plethorick body he thus explodes that If by plenitude be meant an excess of pure blood I absolutely deny there is any such 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or indication for Phlebotomy for during the goodness of this juyce there must needs be perfect Sanity arising from integrity of all the actions of the body so that it may justly be reputed madness to go about to broach this Balsome of life weakning Nature thereby as long as there is health with abundance of strength Imprimis notandum saith Van Helmont in cap. de febr p. 8. ut nunquam vires peccare possint abundantia ne quidam in Methusalem ita nec bonis sanguis peccat minuitate eo quod vires vitales sanguis sint correlativa i. e. We are to take special notice that too much strength can never be offensive to any yea not to Methusalem no more can any one have too much blood for as much as vital strength and blood are correlatives Well then it is plain that whatsoever sickness seems to indicate Phlebotomy upon the account of an 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 sanguineous superpletion must needs come from an apostate juyce generated by vitious digestions
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 whol◠〈◊〉 by a natural coherence and dependance is not only eâ—â—cuated but altered in its minute texture and conformation It is most evident that the Blood in the Veins and Arteries 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 Arâ—eries 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 Pipes 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 Phlâ—botomy Thus upon Scariâ—ication 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 arbitrantur After this He explains the doctrine of Revulsion in this manner Quae postea de revulsionibus dicuntur nullum nobis facessunt negotium Tantundem 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 crure 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 morbiâ—ick 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
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 digestion by virtue of a ferment there residing It is the inseperable companion of the Bloud and closely pâ—rambulates 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 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 â—orasmuch 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 dislay 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 piteâ— 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 companion 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 Lympâ—aeducts 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
bled him in the open field the bloud fell on the ground to the quantity as he guessed of a quart when a Lipothimy approached he put him to bed and giving him a Cordial he fell into a sweat and was recovered perfectly in very few dayes There is no doubt but the practice was justifiable in men of a convenient habit of body to bear it and where neither the climate which oâ—tentimes is particularly repugnant to large Phlebotomy nor idiosyncrasie which sometimes happens or evil diet preceeding or the particular malignity of the venenate disease nor the prejudicate opinion of the people do contraindicate It hath authority from Hippocrates Galen Avicenna and many others Nature doth seem to direct us thereunto by her own excessive evacuations in that kind by which diseases are frequently acted and no evacuation is to be accounted immoderate which is beneficial By this and expurgation even to Lipothymy in the first beginning of several diseases men were cured presently nor did the maladies proceed to those times which in the usual method they make their progress through In my Exercitations against Dr. Sydenham as yet unfinished I have entreated largely of the several methods of curing which I shall not now transcribe As for that way of bleeding which is now generally in use though practised with a great latitude in several Countries and by several Physicians in the same Countrey it is most manifest that if due circumstances be regarded and all other medicaments dexterously 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 Dureâ—us Rondeletius Massarius Septalius Claudinusâ— Crato or Rulandus If Experience be our Guide leâ— 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 â— 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 expurgâ—tur 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 morbisick 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 oâ— 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 â— 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 Phlâ—botomy 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 Lawâ—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 practicas 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 necessariâ— 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 disâ—empers 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 puâ—ting 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 Phleâ—otomy 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 cathartiâ—s 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 the Phlebotomy makes a great alteration therein But I proceed to his other Argument This is taken out of Van Helmont whose
introduced and since we disturb Nature with our vomits and minoratives in the beginning and neither bleed dyet or otherwise Physick our Patients according to the ancient prescriptions do we wonder to see another face and issue of maladies than was heretofore Or doth not he rather deserve to be wonder'd at that should expect in so different circumstances for resembling effects I believe our Helmontian with his Emeto-cathartis and exquisite Arcana so far transcending all the shop-medicaments or received Chymical preparations doth see as few Crises as any Phlebotomist and may not I then retort upon him that he by his practise wholly disappoints a Crisis Nay doth not he tell us that in his way there will be no need to stand gaping for a crisis sith that may be anticipated and all secured before that time if there be a regular procession And may not the present Galenists justifie themselves in the same manner since they can better warrant their process and Medicaments by a longer succession of Experiments happily made by judicious men then this ignorant Helmontian Innovator Another Argument of his is this If it be so that striking a vein often in a long tedious disease is a preparatory for a sharp Feaver as Doctor Willis and I both herein jump right in our observation then 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 who after sharp conflicts fall either into relapses or Agues Scorbute Dropsies Consumptions Atrophy Jaundise Asthmaes c. which might be easily prevented if a mature regular course were taken to give convenient Emeto-cathartics Analeptics Diaphoretics which safely and speedily cleanse the Stomach keep up the strength and breath that we need not fear any mischief from this late invention Redundance of Sulphur or Salt in the blood no more than choler phlegm and melancholy in the Ancients The observation of Doctor Willis is this de febr p. 75. Prae caeteris vero observatione constat quod crebra sanguinis missio Homines febri aptiore reddat i. e. Now above all it is certainly known according to observation that often bleeding makes men more apt to fall into a Feaver Again he follows it close Hinc â—it ut qui crebro mittunt sanguinem non tantum in febres proclives sint verum etiam pinguescere soleant propter cruorem succo Sulphureo plus impregnatum i. e. Hence it comes to pass that they who often breath a vein are not only prone to fall into Feavers but also are wont to grow fat by reason the blood is full of Sulphur In another place to this purpose he drives it home Qui sanguinem habent sole volatilisato bene saturatum ij sunt minus febribus obnoxii hinc etiam qui saepius sanguinem emittunt ad febres aptiores sunt They whose blood abounds with volatile Salt are not subject unto Feavers for this cause they that use Phlebotomy often are more liable to Feavers From hence G. T. forms this Epilogisme Well then the Doctor and I agree thus far in the main that frequent bleeding procures Feavours which is sufficient to back my Assertion that Phlebotomy is no good method of healing sith it is plainly a procatarctick cause of Feavers For whatsoever means exhausting the strength as I can demonstrate this course doth more or less sensibly or insensibly inviting or making way for Feavers instead of preventing of them is not to be approved of or allowed in curing the Scurvey or other diseases unless we do act like Tinkers some whereof are reported to amend one hole and make another for how can it possibly consist with the honour and credit of a Physician quem creavit Altissimus to go about to correct the blood by often letting it out in a Chronick disease and likewise withall to usher in or as it were to be a Pander to the introduction of an Acute feaver which in a short space dissipates that strength which this Phlebotomical harbinger hath in part worsted In this Argument there are so many defaults which are obvious to be seen that I must recommend again to these Baconical Philosophers a Caution I have more than once given them which is to omit in all their discourses those vexatious coujunctions Causals and Illatives 'T is meer pedantry for them to be tyed up by such particles the idle foppery of Grammarians and Logicians and men of common sense The Reason if reduced to form runs thus That which inclines unto a Feaver is not a proper remedy in a Feaver But frequent blood-letting inclines to Feavers Ergo. The Major is false every way whether it be supposed that Phlebotomy produce such an effect per se and directly or by accident and only in some persons in some circumstances For were it true that Phlebotomy did directly and wheresoever it is used introduce a Feaver yet it may so happen that a Feaver may be expedient to some Patients for the prevention of greater evils and sometiems for the curing of them and in these cases 't is as much prudence in a Physician to acquiesce in or run the fortuitous hazard of a lesser or less dangerous evil as 't is for States-men in the Body politick Nature doth often cure one disease by introducing another and commuting the more dangerous into another of lesser hazard as any intelligent Physician knows who understands the Metaptosis and Metastasis of diseases I am not obliged to read to these Disciples of my Lord Bacon a course of Medicine There is an Aphorisme of Hippocrates to this purpose Quia convulsione ant distentione nervorum tenetur febre superveniente liberatur Upon which words Hieremias Thriverius doth thus comment Alio modo febris convulsionem tollit ex plenitudine alio rursum modo distentionem convulsionem enim curat quia plenitudinem discutit distentionem vero quia insigniter universum corpus incalefacit forte etiam distentio convulsionis genus nescit Quicquid autem sit utrique febris confert ac potissimum diaria imo putrida minus periculi affert quam ipsa distentio Frustra ergo conflictantur in ea questione Neoterici an putridam febrem convenit excitare in convulsione ex plenitudine aut flatulento tumoâ—e Which that it may be lawfully and prudentially done but not by every fool is a judged case amongst us and were it not lawful the Argument would by a parity of reason extend to several operations in Chirurgery It is the judgment of Celsus long ago with which I conclude Sed est circumspecti quoque hominis novare interdum augere morbum febres accendere quia curationem ubi id quod est
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 thâ—t 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 seasonablenâ—ss and season of the years Nor shall I exclude the passâ—onately angry or melancholick or phlegmatick from a latitude yet doth their blood exceedingâ—y vary in the porrengerâ— 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 â— but the assent of this Ichorous blood through the more black and fibrous mass I have some grounds for this suggestion but I never could see any pellicle or thin concretion upon the turned blood and to the defect thereof I have been willing to attribute the Phaenomenon 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 Bâ—rtholin 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 si purus rubicundus inculpatus educatur venenositatem 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 apparâ—bat aliis
to be very serous and that of a livid and citrine colour and in Hydropics that have bled at the nose there was not any serum in the blood at all In the Febris alba virginea which I here contradistinguish from the Chlorosis I extracted four hours after dinner out of the Saphena of such blood as that the Crassament was laudable for colour and consistence but the serum was so white as not to be distinguished from milk the lacteous serum did coagulate but retained no smell whereas it usually resembles a roasted egg it was saltish to taste At the same time I blooded two more in the foot neither of which had any such lacteous serum but a citrine serum Hers which was a young Lady and in health burned very well and crackled the other being aged sixty years was excellently and equally coloured from top to the bottom and the serum inclining to citrine but would not burn at all only crackled much and puffed with wind She had no indisposition on her only was troubled with a flushing in her face swelling of the nose and an inward hear such as is commonly attributed to an hot liver I do not attribute that lactescense in the first Ladies blood to the mixture of new Chyle which Doctor Lower saith he hath observed in Men and other Animals being phlebotomised a while after meat to create a lacteous ferum for I never in all my life was so happy as to see that though 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 Sâ—rum which I have tasted I never found any to be bitter though I extracted some once that seemed so bilious that being put into an 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 â— 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 Observation 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 diffected 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 storidus 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 Rooâ—s 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 paâ—â— 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 excrementitious 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
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 â—vident 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 there are 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 ramificationes quasdum excurrere quae postea venas evadunt Rivuli isti in unum punctum colâ—untes in eum locum conveniunt qui postea punctum saliens cor appelâ—â—tur Idque fieri videtur diu antequam sanguinis aliquod vestigium compareat Herewith agree the most exquisite Observations of Doctor Highmore Most certain it is by the History of Generation that no Parenchymatous part hath any operation in the first production of the blood all their â—arenchymas 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 effâ—ct to the identity of the cause is allowable Est enim causarum identitas quae faâ—it ut effectus sit idem quippe effectus supponitur non esse donec a causis existentiam suam indeptus â—uerit 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 â—anguification 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 dum earum ambitu sanguis concipitur prohibet â—jus 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 â—â—uidity but motion of the blood seems to depend much thereon for if by a lâ—gature 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 câ—ler 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 â—ire doth the like in some the mixture of acid Liquors begets a Vermilion But here I conceive none of these causes produce the effectâ— 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 thâ—re 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 Mucosities nay it hath been observed by Riolanus to have been tinged yellow How much more may be concluded hence in favour of the Galenical alimentâ—ry humours supposed to constiâ—ute 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 â—ffect 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 speciâ—ick 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
revulsion when the â—lood 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 â— 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 Gout 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 require expurgation Here they accumulate a multitude of Arguments and undoubtedly since so great men are of that side it must needs be that they have cured those diseases without Phlebotomy But the contrary practise hath so many abettors whose credit equalleth or exceeds that of the others and Experience in a multitude of cases hath shewed the great efficacy of Blood-letting in a Cachochymy or meer impurity of the Mass of Blood and so prodigious is the efficacy thereof in promoting transpiration and opening all the emunctory passages of the body in preventing of putrefaction and expediting of the concoction and in refrigerating the whole habit that Hippocrates and Galen did resolve it in general That whensoever any great Disease did seise upon any Person if he were of Strength and Age to bear it he ought to be let blood The Arabians dissented from this practise but Massarias after Iacchinus and the Florentine Academy did prudently revive it and solidly defend the Tenâ—t and the happy Cures did so convince the World of the truth of their Assertions that all Italy in a manner was presently reduced under them and France and Spain so that though they did and do still in Spain and Italy retain Avicen to be read in their Vniversities as well as Hippocrates yet herein they have abandoned the Arabians` and they which do adhear to that old Maxime of purging out the evil humours when they abound do also comply with the Hippocratical practise and by new excuses accommodate it to their principles So that as to most diseases 't is agreed though upon different grounds what may or must be done Few now are so timorous in bleeding as heretofore and where that apprehension is still continued the Physicians rather comply with the prejudicate conceits of the people then act out of Reason He that can doubt the strange effects of bleeding notwithstanding the concurrent judgment of Physicians let him either read over Prosper Alpinus concerning the Physick practised in Aegypt amongst the Turks where Phlebotomy is the principal and frequently the sole remedy or advise with any Fâ—rrier and he will be satisfied that in a Cachochymy nothing is more beneficial though it be particularly said of Beasts that the Life or Soul is in their Blood For my part I am sufficiently convinced of the solidity of their judgment who do much use Phlebotomy and I have frequently observed that the best Medicaments have been ineffectual till after Phlebotomy and then they have operated to the recovery of those Patients who found no benefit by them before so that to begin the cure of most diseases therewith is the most ready and certain way of curing them and to make that previous to purging is the direct course to purge with utility 'T was most Oracularly spoke by Vallesius Facile concesserim venae-sectionem esse optimum omnium auxiliorum quibus Medici utuntur Est enim valentissimum maxime presentaneum multiplex Dico autem multiplex quia vacuans revellens refrigerans venas relaxans omnem transpiratum augens quam ob causam est a Galeno valde celebratum in nullo magno morbo non est opportunum si vires ferunt puerilis aetas non obstat When I considered the strange efficacy of blood-letting in several diseases and that the discovery of the Circulation of Blood had rendered most of the Reasons which were formerly used to be more insignificant or false I was not a little surprised I observed that the effects were such as did exactly correspond with their Hypothesis and that the practise was not faulty or vain though the principles were neither ought any man to quarrel with or laugh at such Arguments as 't is certain will guide a man rightly to his utmost ends 'T is a kind of impertinency that swayes this Age for 't is not so much a Physicians business to talk but to heal It was most judiciously said long ago Ac nihil istas cogitationes ad Medicinam pertinere eo quoque sensudisci quod qui diversa de his senserint ad eundem tamen sanitatem homines perduxerint Itaque ingenium facundiam vincere morbos autem non eloquentia sed remediis curari Quae siquis elinguis usu discreta benenorit hunc aliquanto majorem Medium futurum quam si sine usu linguam suam excoluerit Neither did Hippocrates place any great value upon Philosophical curiosities and Natural discourses but esteemed it very well in Physicians if they could demonstrate by their success the solidity of their judgment 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 I resolved with my self that if the Circulation of blood and other modern discoveries taught us but the same practise we already followed it was useless If it contradicted it it must be false I observed that it was the great work of the wiser Novellists to accommodate the new Theories to an old and true way of practise and perceiving that the effects of Phlebotomy were such as the Ancients insisted on I perplexed my self in considering what there might be therein to produce so different effects I abstracted from all common Principles and called to mind the Opinion of the Methodists who were a judicious sort of Physicians and the most prevalent at Rome in Galen's dayes They held that Diseases did not arise from peccant humours since many lived and lived long with Cachochymical bodies and in diseases if in the beginning a multitude of humours and such as
premised or used it subsequently as I saw cause thus Rulandus Cent. 5. cur 36 64. for which procedure you may see his Reasons added Cent. 7. cur 20. And the practise of Gabelchoverus Cent. 1. cur 11 Cent. 2. cur 23. But Gabelchoverus in his Scholium here doth not allow of so strong purges as Rulandus sometimes makes use of and defends by the Authority of Hippocrates who did use Peplium and Hellebore in such Pleurisies as the pain descended to the Hypochondria and did not ascend to the Omoplate But Rulandus doth not regard that distinction nor Gabelchover nor many others The case of the Wife of Ludovicus Paniza doth deserve to be set down here Ludovicus Paniza Mantuanus in Apologia Commentarii de parca evacuatione in gravium morborum principiis a materia multa mala non furiosa pedetentim facienda cap. 6. fol. 59. col 1. Praeterea quid sensui respondebimus quod anno 1554. mea conjuge pleuritide correpta ea suum annum 72. agente imbecillis naturae melancholicae temperaturae sanguine carne exuta dolore ad spatulam ascendente Eam secundo mobi die non cum Phlebotomia sed cum Pharmaco purgavimus quod summa cum tranquillitate subduxit deinde subtili cum diaeta coquentibus sputum facilitantibus ut par est in hujusmodi morbis usque ad septimam sic procedentes qua traâ—sacta de Phlebotomia memores sanguinis carnis privatione aetate aegra reluctante eam dimissimus atque ad id faelicissimum purgatorium Medicamentum rursus devenimus a quo post xiv diem salvata fuit It is further to be taken notice of that sometimes Pleurisies have been cured without Phlebotomy purging or vomiting or bleeding by Liniments and expectorating Medicoments as in Gabelchoverus Cent. 1. cur 3. Cent. 2. cur 93 98 99. But to oppose G. T. directly sometimes Pleurisies have been cured by Phlebotomy alone and pectoral Medicaments as in Rulandus Cent. 7. cur 13 14. Cent. 10. cur 49. Gabelchoverus Cent. 3. cur 7. Sometimes by Phlebotomy and sweating as in Rulandus Cent. 6. cur 60. I have hitherto made use of these Authors because they were most eminent Practitioners and particularly famed for their Cures in that disease and it is manifest hereby that Physicians are not bound up to one method therein Neither indeed can they be in any disease for in some years and in some ages and persons and in some circumstances they are forced to recede from their usual courses and sometimes the mildness of a distemper is such that it requires not all their address those Methods which are set down in our praxes I now come to give an account of the most common and received Method of curing Pleurisies amongst Physicians and to shew with how much reason they practise Phlebotomy therein There is not any disease whereof Hippocrates did take so particular care in relating its Diagnostics Prognostics and Cure as a Pleurisie as is evident by what he hath written in his Books De victu in morbis acutis and De morbis besides what he hath set down occasionally in his other Works It is an Acute Feaver finishing its course in seven nine eleven or fourteen dayes though it hath happened as in the case of Anaxion that it extends its period to thirty four dayes It is attended alwayes with troublesome oftentimes with dangerous symptomes A violent Cough difficulty of breathing pricking pains and Stitches in the sides these are the Pathognomonical signs of this Feaver Though the part affected seem principally to be the Pleura or costall membrane yet are the Lungs attacqued by this disease and frequently it hath been found that the seat of the Pleurisie is rather in them than in the Pleura as the followers of Petronius do demonstrate and their fabrick is so tender that it is in great danger to be putrified or corroded in this distemper by the sharpness or other evil qualities of the sputaminous matter Besides it is a very fallacious disease and frequently after hopes of a recovery by a benign Anacatharsis after that the stitches have abated oftentimes the disease becomes crude and exasperated again to the detriment or death of the Patient as appears by the case of Anaxion in Hippocrates and that other related by Franciscus Rubeus as also by Mercatus If it be not happily cured the danger is no less than that it should change into a Phrenitis or Peripneumony or terminate in an Apostemation of the Lungs or an Empyema in the Thorax Where the disease is so full of dangerous as well as vexatious symptomes it is not to be wondered that Physicians have diligently looked into the disease and recommended unto our practise a great many things which they who either perfunctorily look upon matters or superciliously despise dangers or out of ignorance cannot apprehend them may contemn That the Blood in that disease should acquire a congealing or coagulating quality seems unimaginable both because that oftentimes the procatarctic cause is sudden in its operation as when a plethoric person any way doth over-heat himself or drink cold drink c. and also that the congelation in the Pleura when it is there is no other than what is seen in the spots of the spotted Feaver or Plague which seem not to be congelations of the Blood Besides How comes it to pass that this aptitude to congeal if it be in the whole mass of blood doth not discover it self any where else but in the Pleura And if such a Diathesis ad acescendum in the blood produce a Pleurisie How is it true that Hippocrates saith Acidum qui eructant non sunt pleuritidi obnoxii Why also are splenetic persons in whom we may best suppose such a Diathesis not inclined to Pleurisies except the spurious and statulent ones Is it not moreover known that Vinegar dissolves congealed Blood and is therefore given in bruises As also Oxymel and syrup of Vinegar in Pleurisies But 't is evident that it is a Feaver accompanied with a Catarrh upon the Thorax and Lungs and that it admits of a great diversification according as the Galenical humours do operate in it and in the Cure a different regard is to be had to a bilious or pituitous Pleurisie from what there is in one that is sanguine as any man knows that understands Physick or hath so much as read Salius Diversus upon Hippocrates de Morbis lib. 2. Or Forrestus's Observations lib. 16. It was the advice of Hippocrates at first to try to discuss it by fomentations if they succeeded not then in case the stitches seemed to diffuse themselves upwards towards the shoulders to phlebotomise the Patient and let him to bleed largely until the colour changed from corrupt to red or from pure and red to blackish But in case the pains descended below the Diaphragme then to purge with black Hellebore or Peplium The reason upon which he
fuerit nulla insalubris aeris anomalia quae febri occasionem submiâ— nistraret Nihilominus etiam hujusmodi homines praecedente insigni aliqua aeris vel victus caeterarumque rerum non-naturalium ut vocant mutatione identidem febre corripiuntur propterea quod eorum sanguis novum statum conditionem adipisci gestit qualem ejusmodi aer aut victus postulaverint minime vero quod particularum vitiosarum in sanguine stabulantium irritatio febrim procreet 'T is true he did not pen it in Latine but another Mr. G. H. for him and perhaps his skill in that tongue may not be such as to know when his thoughts are rightly worded But it seems strange and irrational to attribute such an understanding to the Blood and to transmute a natural Agent into one that is spontaneous and which is more having represented it as such to make it so capricious as not to know when it is well but to run phantastically upon such dangerous changes as occur in putrid Feavers and the Small Pox for even in this last ariseth from a desire the Blood hath to change its state Since natural Agents demean themselves uniformly and of them 't is most true Idem quatenus idem semper facit idem I was surprised to see these new principles and to see effects of this nature arise without any cause It doth not seem possible for him ever to demonstrate that there is no Plethora or Cacochymy or obstipation of the pores of the body antecedent to a Feaver nay the contrary seems evident to all Physicians nor ever was there any whereunto they did not attribute some procatarctick cause Besides he doth not alledge any Reasons or Experiments to shew that there is any alteration in the blood before and after the Small Pox or a Feaver or any difference betwixt the Blood of such as have had those diseases and of those which have not had them So great a supposition ought not to be made without ground And since it is natural and Nature is constant why is not the Disease more ancient and universal than it appears to be For if there be any grounds to think the Small Pox to be of long continuance 't is certain 't is but seldom spoken of by any old Writer perhaps once by Hippocrates yet so as never to be understood by any that hath not seen the indisposition and never by Galen It may be imagined to have come from Aegypt by contagion and might have been called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Quia urbi Bubasti Aegyptiae familiaris hic morbus It infesteth some places more than others In Graecia non adeo frequens Ideo antiquiores Medici vix ejus meminerunt In the West-Indies it was not heard of till the Spaniards came thither and they as also the English there seldome have it I believe the Disease to be novel and of no longer date than the Sarracenical revolution I could instance in the nature of such great altâ—rations that they have ever been preceded and accompanied with many peâ—ty changes in other things and if ever I have so much vacant time aâ— to make political reflexions upon the rise of Mahomâ—â— I may declare much to this purpose This is that invidiâ—us subject about which Eâ—â—bolius Glanvili makâ—â— so â—uch noise as if to avow that Mahomet â—ere a Gentleman of noble extraction marrieâ— to one who â—â—r birth riches and beâ—uty might hâ—ve bâ—en a Princâ—ss and accomplished with that sober Uertue Wit â—lâ—quence and Education by much travâ—l â—or he travelled all over Aegypt Africk and â—pain aâ— to â—â—nder himself one of the most considerable of his Age or to say that the Christians were so ignorant and debauched and perfidious and addicted to Legends more than to the sound Doctrine of the Gospel at â—hat time that most of the Fables in the Alcoran were accommodated to the honour of the times more than to truth â—nd so Mahamet told them or to say He pretended to revive Ancient Christianity were to be an Apologist for the Mahometans and an abettor of the Alcoran Whereas none but the Illiterate can deny these things and the Age our Virtuoso speaketh of is the Age of Apostacy according to the Doctrine of our Church Oh Heavens to what an height is Impudence and Ignorance arrived Or what can be safe if so prudential and generous a design as I had must be calumniated by such a R in this manner Bnt to resume my discourse in the behalf of my opinion concerning the novelty of this disease besides what the learned Mercurialis hath said I shall conclude with the words of Rodericus a Fonseca which are these Si ex nativitate esset ab initio mundi fuisset aut saltem ita frequenter tunc ut nunc solet esse et licet antiqui aliquam de his pustulis mentionem fecisse visi sint ea certe exigua est dubia ut câ—rtum sit vix illis temporibus fuisse talem morbum negligentissimi certe habendi essent si tam ingens commune frequens malum illotis manibus silentio involuissent cum morbus sit puerilis Hippocrates eas numerasset inter aetates 3. Aphor. ubi diligentissime puerorum morbos connumerat tamen nullam hujus mali fecitmentionem sed illud satis demonstrat hunc morbum novum esse quod in multis mundi partibus nunquam visus fuit ubi nunquam apparavit nisi postquam Hispani eo pervenere siquidem per contagium Aethiopis cujusdam illuc delati magnam Indorum partem sustulit I might here insist upon the Hypothesis of Doctor Sydenham concerning the Inclination of the Blood to change its state I cannot believe but that the Physicians understood themselves as well before he writ when it was said that there was in every one that was born something of impurity in the body which was naturally to be purged out by an ebullition in the blood and such an effervescence as terminated in those Abscessus called the Small Pox. Quandoque accidit in sanguine ebullitio secundum semitam putredinis cujusdam de genere ebullitionum quae accidunt succis talia quidem accidentia fiunt per eam ita ut partes eorum ab invicem discernantur Et de hoc est cujus causa est res quasi naturalis faciens ebullitionem sanguines ut expellatur ab eo illud quod ad miscetur ei de reliquis nutrimenti sui menstrualis quod erat in hora impraegnationis aut generatur in eo post illud ex cibis faeculentis malis de illis quae rarificant substantiam ejus faciant eam ebullire donec fiat substantia recta fortior prima magis apparens sicut illud quod natura efficit in succo uvae ita quod rectificat ipsum faciendo vinum similis substantiae jam expulsa est ab eo spuma aerea faex terrena He that can English this
protests he writes nothing in order to its Cure but what six and forty years 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 deiractione 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 sâ—nguinis copia adeo parva quod exquisitiori victus institutione securius rem possis agere quam aliis praesidiis quae licet aliquo modo possint convenire non subinde sunt ita secura certa quod eis prorsus fidendum sit i. e. Concerning Blood-letting no man ever did doubt thereof or if he did he did it without any reason except the Patient were so weak that he could not endure it without greater hazards or that the disease were so mild and benign that it seemed better to leave all to the strength of Nature without debilitating any way the sick person or the redundance of blood and peccant humours so inconsiderable that the Cure might be wrought by a diligent attendance and well-ordered diet without employing any of those Remedies which how convenient or safe soever yet according to that fate which disposeth of all humane affairs may sometimes have an evil issue and are not therefore needlesly to be presumed upon In Portugal I find Rodericus a Fonseca to approve of Phlebotomy in this disease As also Stephanus Rodericus Castrensis avoweth its utility upon his own Experience I might add others but that this is the general practise of Spain is so indisputable that I should but abuse the patience of my Reader I now come to Germany and Denmark where the most learned and the most eminent Physicians that we hear of have admitted of this Remedy The beneficialness thereof was experimented by that famed Practitioner Forrestus Solet enim mirifice prodesse in hoc affectu hoc auxilii genus modo tamen fiat in principio antequam morbilli aut variolae egrediantur i. e. It is usually of marvellous benefit to the Patient if he bleed before the Small Pox or Measils do come forth Whereupon he did ordinarily begin his Cures therewith and saith that undeniably it ought to be so if all requisite circumstances concurre Felix Platerus a man of principal esteem in Switzerland and Germany recommends it to our practise Sanguinis detractio per venae sectionem in brachio facta ab initio si Synochi hae sunt febres â—u juscunque generis ad sanguinis accensi vel simul puiridi vel maligni etiam portionem educendam causamque sic minuendam in adulâ—is plurimnm competet Quae infantibus majoribus cum in minoribus naâ—u non liceat non inutiliter administraretur Quae tamen si jam maculae pustulae eruperint ne naturae motus impediatur omittenda erit i. e. Bleeding in the Arm when it is practised in the beginning if the Feaver be any kind of Synochus arising from the inflammation of the mass of blood or its being putrefied or vitiated by any malignity will be of great benefit to those that are of Age to lessen the morbific matter and abate the violence of the cause of the distemper It might also be done to Children of some bigness not to little ones may be profitably But if the Pox be coming forth it is to be forborn least it cause them to retire in Neither is it a common Elogy for this practise that Gregorius Horstius commends and justiâ—ies it And his learned Son Io. Daniel Horstius asserts the the judgment of his Father As cautelous as Sennertus would seem he only doubts concerning Phlebotomy in Children not in others Si tamen in aetate quae venae sectionem perferre possit sanguinis abundantia venae sectionem postulet mox in principio ante quartum diem aut sane prius quam variolae erumpant dum vires adhuc constant sanguinis tanta copia ad ambitum corporis confluxit vena aperienda ut natura oneris parte levata quod reliquuum est facilius vincere possit Post quartum autem diâ—m ubi meculae erumpere incipiunt abstinendum a venae sectione inprimis si jam aeger melius habere incipiat ne materia ad ambitum corporis tendens ad interiora revocetur i. e. But if the Age of the Patient be such as to be able to endure Phlebotomy and the redundance of blood be such as to make that Remedy necessary a Uein must be opened before the fourth day and whilest yet the Small Pox are not come forth the strength not being yet impaired and the blood so immoderately discharging it self upon the exteriour parts of the body that hereby Nature being disburthened of a part of what molested her may the more easily concoct and subdue the rest But after the fourth day and when they begin to come forth Phlebotomy is not to be used especially if the Patient seem alleviated least thereupon the matter be drawn back which was hastening unto and fixed in the habit of the body To these may be added Baldasser Timaeus Physician to the Elector of Brandenburgh who after thirty six years of practise approved this course and I. Petrus Lotichus as also the younger Sebizius â— now Professour at Iena and I. Christianus Frommanus a Physician in Saxony and Franciscus Ioel In Denmark I find Bartholinus to be resolute for it before the Small Pox do come out and if they do not come forth kindly but that symptomes of an evil presage multiply upon the Patient he allows a minute bleeding then and sayes many have been happily recovered by these means And so much for Germany In England the paucity of our Wâ—iters upon this subject gives me no opportunity to defend Doctor Willis by the citation of any Book 't is enough that since the original and first records of the Disease no other Method than what he pursues hath been commonly
in the Disease And now the Physicians quarrelled one with another one blamed the Clyster which impeded the course of Nature and retracted the humours inwards whose tendency was to the habit of the body Others censured the Fomentation which though anodyne might close the Pores and give occasion to the bloody urine by repercussion of the pustulary matter Thus one Physician inveighed against the errors of the rest whilest indeed all of them ought privately to confâ—ss that their great failour was in omitting Phlebotomy and that this was the cause of her death Thus Physicians oftentimes occasion the death of their Patients by not doing what they should and not only by over-acting this last is the default of those who attend on the sick and first try their own pretended Experiments then have recourse to the receipts of the populace or prescriptions of some practising Ladies and thus by doing what they ought not they most officiously kill the sick and prevent the seasonable advise of wise Physicians who ought to have been consulted at first These kind of persons are in as much default as those timorous and cautelous Doctors who dare not administer those Remedies which are necessary in acute diseases but by neglecting their Patients suffer the Disease to prevail over the vital faculties and kill the infirm Thus far the Helmontian but to give him his due judicious Practitioner and I recommend this case to the Abettors of Doctor Whitaker and Doctor Sydenham since there appears upon dissection that the Small Pox had not fixed themselves within but that a meer surcharge of the mass of blood either natural or contracted from the attenuation of the ebullient blood was the cause of her decease I forgot in the conclusion of what I writ of the Small Pox to speak about Bathing of the hands in the Small Pox the practise whereof Doctor Whitaker represents as having been fatal to the Princess Royal. His words are I observe Riverius above all other Authors to ordain the bathings of the hands and feet by reason of the density of those parts in some more dense than others as in Smiths Carpenters and Foot-posts whose hands and feet are harder than persons of a more tender and sedentary Trade or Profession I cannot but acknowledge that humectation and attenuation to mollifie those parts is properly indicated but the mode of this application is observable because upon the opening of the porosities by bathing the ambient air may obtain the advantage of repelling the morbifical matter from those ignoble and extream parts to the more noble by the ambient air in the course of sanguineous circulation and hath proved fatal in such as have rare and tender skins as is proved by the bathing the Illustrious Princess Royal. Concerning that Princess how she was ordered and at what time of the Disease bathed thus I know not but 't is an equitable presumption that in so important a case so understanding Physicians as she employed did nothing rashly or without reason I find in the relation of her being dissected causes enough of her death without imputing it to this usage her Omentum was putrified and much inflamed towards the Spleen-side her Spleen was flaccid and semi-putrid her Stomach was inflamed and on the inside beset with Aphthae her Liver spotted and inflamed even to a Gangrene almost her Lungs in a manner rotten and replenished with black blood spotted and pustulated in the superficies the Parenchyma of her heart was much consumed But had not these things been nothing is more certain than that of Petronius Quod non expectas ex transver so fit et super nos negotium Fortuna curat But that Riverius doth prescribe this Bathing above all Authors is a manifest falsity His words are only these Ac primum in eruptione Variolarum aut dum maturescere incipiunt ingens dolor vel pruritus interdum aegrotantes affligit praesertim vero in plantis mannum et pedum eo quod densior in iis partibus cutis eruptionem prohibeat Cui symptomati medeberis si partes illas decocto emolliente diutius foveas vel in aqua calida detineas I shall compare herewith the directions of Horatius Augenius whose character I have already given He having prohibited the bathing of the whole body doth add Sed non est eadem ratio in particulari balneo cum scilicet partes aliquaspiam extremas lavacro calido fovemus ut ex illis duntaxat citius facilius variolae exeant doloremque mitigemus ut plurimum satis insignem hoc quidem praetermitti non debet Nam plerumque accidit ut ex volis manuum plantis pedum varioloe non erumpant nisi cum maxima difficultate et dolore propterea expedit fovere eas partes aqua calida aliquando simplici et aliquando simul decoquendo flores Camomillae aut Altheae aut violarum vel aliud ejusdem generis quod fuerit ad manus Haecque antiqua extitit Arabum consuetudo nam Rhases ita scriptum reliquit lib de Pestilentia c. 8. Quod si in volis manuum expullulet tu hasce ex oleo tepente quo gossypia imbuta sint multum refricato in calida aqua foveto Verum si dolor non sedetur nec pestis facile expellatur tu sesamum perpurgatum ubi contuderis in lacte maceraveris illico illinito in linteo per totam noctem alligato dehincubi amoveris calente aqua foveris rursus illinito Verum si velis palmulus ubi contuderis in butyro maceraveris vel in sesami faece illinito Siquidem haec similia cutem remolliunt faciunt que ut pestis facile excernatur dolores cedant Haec Rhases Quae omnia judicantur mihi saluberrima in praesenti casu nisi quod abstinerem ab oleo quia facit ulcus ipsum sordidissimum ac sanatu difficile Ego autem nullum inveni praestantius remedium quam fovere partes extremas manuum pedum aqua tepida vel decoctione florum camomillae Altheae Quod si emollire adhuc magis voluerimus decoquo simul semina faenugraeci This Bathing is no less recommended unto our practise by the diligent and learned Forrestus who speaking of an ancient Woman of fifty years old which was sick of a Malignant pestilential Feaver accompanied with the Measils that came out on the sixth day concludes the Observation thus Huic tamen quod fere jam omiseram ingens pruritus punctio in plantis pedum ac volis manuum aderant pro quo symptomate mitigando quum maxime eo intolâ—rabiliter affligeretur ut se potius mori velle diceret quam illum pruritum punctionem ferre jussi ut pedes manus continuo teneret in aqua calida Quo consilio pruritus tum puncto cessarunt et melius per cutem in volis manuum et pedum morbilli emergebant Hujus rei experimentum notatu dignum ab ipso
P. Neucranâ—zius de purpura c. 6. p. 69 70. Filindererus de pest c. 6. Isbr. a Diemb. l. 1. c. 1. Schenckius obs l. 6. Hieron Râ—â—era in C. Cels. l. 3. c 7. p. 143. Riverius prox l. 17. sect 3. c. 1. â—â—br a Diemb. l. 1 c 12. §. 4. P. Zacchias though he do hold that the Pest is most commonly contagious yet he proves it is not necessary it should be alwayes sâ— Quest. Medico legal l â— tit Qu. 2 sâ—ct 21 22. Io Crato assert lib de â—ebr pestilent p. 18 Id. ibid. p. 20. A Pâ—raeus Chirurg l. 21. c. 12. P. Pâ—â—w tract de Pest. c. 2. Sennertus de febr l. 4. c. 1. (a) Coyâ—tarus de purpurat febr c. 12 13. Pâ—tâ—uâ— a Castro de â—ebr puncticular sect 6. in dedicatoriâ— epist. Dilect Lisnan de venae sect c. 9. art 4. p 1â—9 Septal. de Pest. l. 5. c. 17. p. 217. (b) Bartholin de Angina puer exercit 5. â—everin de abscess p. 449. Menâ—tâ—s consult â—4 (c) Cobelchoâ—er cent 5. cut x. in Scholio Râ—land de â—ebr Vngoric p 270. alibi Botallus de venâ— sectione c 7. Massarias de Pest. l. 1. Rodericâ— a Fonseca in append ad Iacchin de febr p. 354 Septal. de pestâ— l. 5. c. 14. Forrestus Obs. l. 6. obs 17. C. Hofmann Anti Fernel lemm 64. Prosper Alpin de medic Aegyptior l. 2. c. 7. p. 54. Prosper Alpin medic meth l. 5. c. 9. In lib. 7. c. 20. Th. Brastus epist. 25. Citantur ab Isbrando a Diemerbrook de pest l. 3. c. 3. §. 1. C. Cels. Medicin l. 3 c 7. Caeterum in contrariam sententiam abeunt complures alii iidemque doctissimi Medici docentes omnino secandâ—m esse venam nec minores paucioresve adducunt felices successus Hieron Rubeuâ— in C. Celsum l. 3. c 7. p. 140. Massarias de Pest. l. 2. inter opera p. 531. F. Platerus de â—ebr inter opera p. 161. C. Celsus in preâ— Medicinae Mindererus de pest c. 3. Sennert de febr l. 4. c. 1. Anton Benivenius obs Medicin c. 54. H. Florentius in notis ad â— Pâ—â—re de pest p. 154 155. Sennertus de febr l. 4. c. 6. Erastus ep 25. p. 90. N. Ellain de pest apud Guibert Med. Offic. p. 533. With him agrees Gerardus Columbs de â—ebr pestil c. 24. p. 253â— Mindererus de pest c. 3. Scire enim quid fiâ—ri Oportâ—at magna res non est sed quibus rationibus illud efficias id vero arduum Galen 6. m. m c. 2. P. Zacchias Qu. Medico-legal l. 6. â—it 1. qu. 7. §. 2. id ibid. §. 7 8 (a) Erastuâ— epist 25 p 97. c. 2. Thâ—vâ—râ— in Schol. ad Ballâ—n Epidâ—mâ— l. 50 51. â—châ—â—kiuâ— ex Paraeo l. 6. p. 770. (b) Hippocr sect 4. Aphor. 36 37 42. Eâ—ast â—p 25. p. 99. (c) Erast. epist. 25. p. 9â— c. 2. (d) â—d ibid. p. 98. Erast. ubi supra p. â—9 Isbr. a Diem brook de pest l. 3 c. 2. §. 1.6 l. 2. c. 6. §. 14. C. Celsuâ— l. 3. c. 7. Erast. ep 25. p. 97. Hippocrat Epidem l. 6. sect 7. cum notis Vallesiâ— p. 7â—8 739. C. Celsus medicin l. 3. c. 7. de febr pest Id ibid. c. â— De febr p. 235 Ioseph Mâ—neâ—sus de sec. venae cubiti in febr putr malig p. 141 142â— C. Tacit. Annal l. 4. l. xii W. C. may learn what Medicus circumâ—oraneus is out of Menagius's Amâ—â—fuâ—at jur civil c. 3â— Lindenbrogius Codex legum Antiq. inter constitut Siculaâ— Stâ—t Colleg. Lâ—â—din Miss in biblioth 〈◊〉 Cannot an Accident be the product of a fore-going cause Besides whoever defined a Feaver so as to make its Genus to be An Accident Valles meth med l. 3 〈◊〉 Valles Mâ—th med l. 4. c. 2. Id autem ita esse aperte intelliges considerans quae partibus in quibus suppurationem molimur contingunt Ea enim alteratio similliâ—ae est concoctioni quam in materia putridarum febrium expectamus nisi omnino est eadem Valles Method med l. 4. c. 2. Galen â—eth medend l. 9. p. 122. p. 123. I would willingly know how this Archaus doth frame the Idaea of a disease and what this Idaea of a Feaver is to return G. T. his own words Is it a Substance or an accident Material or Immaterial That it specificateth the disease must be granted But the notion is incomprehensible and this Scurvy Idea is more ridiculous than the Scurvy Qualities The Analysis Synthesis of inâ—nimate bodies doth not teach the Operatour convincingly what may be done in those that are Animate p. 124. How much blood doth he account to be a great Quantity I do not know of any Physician that takes away such great Quantities as to create these dangers Can you make good by practise that Phlebotomy is the cause of these subsequent evils p. 126. Hippocr sect 1. eph 3. â—lato de repub l. 3. Galen in exhortat ad bonaâ— artes discend C. Celsus Medicin l. 1. c. 1. Aeâ—im var. Histor. l. 9. c. 31. Aristot. polit l. 3. c. 2. Gâ—len adv â—rasisâ—ratum â—â— 4. C. Celsus Medicin l. 3 c. 9. 〈◊〉 was 〈…〉 fiâ—st prâ—â—essâ—d to 〈…〉 jâ—câ—ndâ— C. Cels. l. 3. c. 4. 〈◊〉 quos 〈◊〉 non restiâ—uiâ— temeritas adjuvat C. Celsus Med c. l 3. c. 9. Forreâ—t obs l. 1. obs 3. in Scholio Siâ— omnia membra vehementer resoluta sunt 〈◊〉 apoplexia sanguinis detractio veloccidit vel liberat Aliud curationis genus vix unquam sanitatem restituit sepe mortem tantum differt C. Celsus Medicin l 3. c. 27. Itaque mittitur non quia multa subest copia sed quia ea quae subest tunc est inutilis noxia Valleâ— Method medâ— l. 2 c 3. Potestautem id dum solum est non movere qued junctum aliiâ— maxime movet C. Celsus l. 1. in praef I. Riola opusâ— Anat. nova iâ— rot adv Gâ—ssend p. 174. Alex. Massarioâ— de febr c. â—9 Io. Riolâ—h Enchirid Anatom l. 2. c. 27. Mâ—bius fundâ— med c. 12. sect 18. Riolan de circulat sangâ— in Antropograph c. 15. p. 585. M. â—legelius de sangu motu c. 13. p. â—04 Dr. Lower de Corde c. 3. p. 115 116. â—â—â—â—nck Obs. med l. 1 p. 172 Art Musâ— Brassavoluâ— câ—mment ad Aphor. 23. l. 5. Marcell Donatus de vario liâ— c 23. Amat Lusit curâ—t 100. câ—nt 2. cur 60. cent 7. Schâ—nâ—k obs med l 3. p. 312 Shâ—â—ck Obs. Medic l. 4. p. 614. Almâ—r Blondelus de venae â—ectione c. 2. p. 30. Forrest Obs. Medic. l 1â— Obs. 14. cum Scholio Id. ibid. Obs. 12. Alex. Massarias de febr c. 29. I. Riolan inter opusc nova Anat. adv Gassendum p. 108. I. I. Becherus Physic. â—ubterrâ—n l. 1. sect 5 c. 1. p. 5â— Almericus Blondelus de venae sectioâ—e c. 1. p. 8. Ballonius Epidem l. 1. p. 101â— 102. Id. ibid. l. 2. p. 192. M. Slâ—gel de sanguinis motu c 9.