but hath seen some cases in which sole Phlebotomy hath effected the cure he may see many Instances of this in Botallus and that in diseases where the body was undoubtedly cacochymical I have seen Agues tertian and anomalous perfectly cured with once bleeding in women with child and in children I have seen some Atrophies so cured that the principal cause of their recovery was to be attributed to their Bleeding the like I have observed in several Chronical diseases even in inveterate quartanes as also others have done nor is there any thing more common almost in our Cases than the relation of several diseases absolutely cured by single Phlebotomy which I shall not transcribe here but in my large discourse of Phlebotomy in Latine I intend to represent all such cases at large with their circumstances and the History of Phlebotomy with all that variety of success which judicious Practitioners relate of it in several diseases and persons I add now that No man can be an accomplished practitioner who is not versed in the History of Diseases and particular cures for the general rules and directions make no more a Physician than such a knowledge in Law would do a Lawyer the res judicatae import more with us than they do in Law-cases and as Reports of the Iudges in special cases must be known by a compleat Lawyer so must our Book-cases be our presidents and regulate our practise Duobus enim tanquam cruribus innititur Medicina neque solis theoreticis rationibus contenta insuper etiam practicaes experientias particularium requirit indefessam ad singulos casus intentionem Thus is his Minor false as was his other Proposition and it should have run thus But Phlebotomy lets out the bad blood without removing the efficient cause thereof or conducing thereunto But he proceeds to defend the Minor thus If the Cause of bad blood were removed then would the effect cease but oftentimes we see that notwithstanding such a depletion the disease continues and if it be not mortal yet it becomes more truculent Here he commits the same errour that before expecting a greater effect from Phlebotomy than we propose generally to our selves in it we do it sometimes for revulsion of the matter flowing to any part as in some Pleurisies Squinancies the Colick Bilious and Rheumatismes c. wherein we never rely solely upon bleeding and though oftentimes the effect transcend our expectation yet do we not presume upon it Sometimes we let blood for prevention of future diseases as in great contusions and wounds Sometimes we let blood only to prepare way for future Pharmacy Ita plerumque in febribus mittitur sanguis qui non superat naturalem mensuram neque simpliciter neque in hoc homine sed quia nisi mittatur ob febrilem calorem qui adest succorum putrescentium mistionem corrumperetur ac fortasse malignè cutis rarefactioni ventilationi vasorum relaxationi ad futuram expurgationem necessariae impedimento esset Itaque mittitur non quia multa subest copia sed quia ea quae subest tunc est inutilis noxia ac proinde facultate ferente deponenda etsi causa morbi non inclinet ad ideam sanguinis modo non ab ea plurimum evariet i. e. Thus in feavers we usually let blood not that the blood abounds above its due proportion either in general or in reference to this or that individual but because the blood which flows in the veins is infected with a feavourish heat and would be corrupted thereupon and by reason of the intermixed humours now inclined to putrefaction and that perhaps joyned with malignity for the prevention thereof and least that plenitude and depravation of the Blood should hinder that transpiration in the habit of the body ventilation of the blood and laxity in the vessels which is requisite for the subsequent purge do we use Phlebotomy not imagining that there is any superfluous abundance of blood but that there is then in the body some that may well be spared and which if the Patient hath strength to bear it may with prudence be let out to prevent so great dangers as are imminent and to secure unto us the good effect of the subsequent Physick And if the disease do sometimes encrease upon Phlebotomy it behoveth wise persons to distinguish whether those symptomes happen by reason of bleeding or only succeed it in course the disease being in its increment for this makes a great difference in the case as also whether amidst those symptomes which are in due course most violent in the progress and state of the disease whereas we bleed usually in the beginning only there be not some that yield signs of concoction and melioration which if they do as we may justly attribute those hopeful consequences in part to Phlebotomy so we need not be amazed at the present truculency of the disease which affrights none but the ignorant If notwithstanding all our care and due administration of Medicaments according to Art the Patient do dye yet is neither Phlebotomy nor the other Physick to be blamed but we ought rather to reflect upon Physick that 't is a conjectural skill in the most knowing men and that we are not as Gods to inspect into the bowels and secret causes of diseases that besides the special judgment of God upon particular persons all diseases are not curable in all individuals either by reason of the variety of distempers complicated which interfere with and contra-indicate one to the other or for some unknown idiosyncrasy or other intervening cause which defeats our Methods as well as it disappoints the Arcanum of Pepper-drops I must here take an occasion to remind this Helmontian that he doth ill to disparage Phlebotomy by reason that after it there may follow some truculent Symptomes and yet to reject that imputation where his Dietetical rules are in dispute When he gives his vinous and spirituous liquors in Feavers a practise not peculiar to the Helmontians but allowed with regard to due circumstances by Hippocrates not only in diaries but acute-feavers so Galen would have told this Ignoramus if any seemingly frightful Symptomes appear as extraordinary heat an inquietude a little raving a swerving from right reason the Patient must not be startled in a vulgar manner but be satisfied that these are but the effects or fruits of an Hormetick motion in the Spirits excited and increased by good liquors easily united with them for the routing and putting to flight every way whatsoever doth disturb its vital government Though Hippocrates say it is good in all diseases that the Patient retain his senses though he reckon inquietude and restlessness in the sick amongst evil signs yet our Helmontian dissents from him whatever time of the disease it be and whatsoever other circumstances attend thereon For oftentimes madness deviation from the right understanding a Lethargical or sleepy disposition suddenly break forth Nihil
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 relaxeth 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 suppurated matter draw out the fragment of the Thorn so we do in Feavers where the depraved humours are not so easily separated and extirpated as in the prick of a Thorn maturate and eject the morbifick cause 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 â—edundant 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 practice Therefore the practise of Phlebotomy is not to be continued As to Phlebotomy in a Plethorick body he thus explodes that It 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 not andum 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 which being hostile to life irritates the Archaeus to frame the Idaea of a disease not as it is meerly provoked by nimiety or plurality but from the pravity of the matter wherefore the case is altered now and the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 signification or demonstration of evacuating doth in a strait line respect the Crâ—or or Cacochymy directing the Artist to reform mundifie and rid those impurities contained in the seemingly corrupted marred juyce by proper means sequestring the vile from the precious not to let out indistinctly what comes next at randome to the furtive castration of the Eutony lustiness liveliness and strength of the Patient which is to be preferred before all motives whatsoever 'T is certainly known to those who are throughly versed in the Analysis and Synthesis of the parts of bodies that ebullition aestuation effervescence of febrile liquors arising from a pleonasme of degenerate Sal. and Sul. c. as they would have it may be appeased and allayed by Remedies assisting the vitals to make separation and afterwards an exclusion every way of what is reprobate reserving what is acceptable This being performed there is no fear that a plenitude simply of it self can do any harm for hereby so expedite a course is taken that the overplus is in a short time sent packing away by vomiting stool urine expectoration and sweat For this reason considering what strict abstinence the Patient is put upon in a Feaver
his Patient to alleviate the disease in its course by preventing all troublesome and mitigating all dangerous symptomes and to facilitate as well as hasten his recovery It is not questioned but Patients have been and may be recovered of Feavers with little or no blood-letting yet when I consider the great hazard they run in that course the vexatious and perillous symptomes which they languish under longer and with more violence than others I cannot approve of the practise nor think the Physician dischargeth his duty and a good conscience in so doing Extrema necessitas in moralibus ut certum est vocatur quando est probabile periculum and the Patient doth offend against himself if he refuse to take a befitting course against dangers that probably are impending and the Physician doth trespass against his neighbour if he do not propose and practise such a course I cannot to use the words of the incomparable Riolanus I cannot without pity to the sick and some resentment against the Physician read in Platerus's Observations how sundry of his Patients were broyled and torrefied with burning Feavers whom he never let blood He doth relate of himself how he was sick of a most burning Feaver yet did he never so much as let himself blood therein albeit that it were requisite in those cases Such are not obliged to their Doctors but peculiarly to the Divine Providence for their recovery It was the mature consideration of that tenderness w ch is requisite in Physicians towards their Patients which advanc'd the present course of Physick to its glory above all other Methods it being endeared to our esteem by all those regards that represent it as prudential It was not introduced by chance or the subtlety of some persons but the choice of all and so established by the Magistracy that to transgress against the traditions of this Art was criminal in a Physician even by our Laws It may in some cases seem to be troublesome and unpleasant yet SAFETY requires it It may seem tedious sometimes by multiplication of Medicines yet Prudence obligeth by all those means to preserve and secure life and if the omission thereof be criminal in a Physician in case of any sinister accident why is not the practise laudable Would Men but seriously consider How much danger they run and How much more they suffer upon the negligence or indulgence of a Physician who leaves all to Nature and adviseth them to wear out a distemper they would rather hate than love such a Man and the apprehension they should have for the unnecessary jeopardy he put them on would extenuate his credit very much The most rash and brutish counsels may succeed well but yet the most prudent are to be preferred Amonst Physitians I do not reckon the Helmontian as any there is no doubt but a Plethorick indisposition requires Phlebotomy Nature being surcharged with blood forceth us thereunto least some vein should break in the Lungs or the Patient be strangled with that excess this is called Plethora quoad vasa when the vessels are so full of blood that there is danger of their breaking or that the blood should stagnate in the Heart Lungs or Head there wanting room for its motion or take some inordinate course and so strangle the Patient There is another redundancy of Blood which is called Plethora quoad vires or such a plenitude of blood as brings along with it no apparent hazard of breaking the vessels yet doth it oppress Nature so as thereby to become redundant It is more than she can bear in the present juncture 't is more than she can rule and it will suddenly fall into an exorbitant motion to the detriment of some principal part in case timely prevention be not used In both these cases in which the blood is not supposed to be much depraved from its natural estate all do allow of Phlebotomy and if it be timely put in execution it may hinder the progress however it expedites the cure of the disease In these cases we consider not only the present plenitude but also the future what may be in a few dayes to the great exasperation of the disease and peril of the Patient For it is possible that in the first beginnings of a disease there may be neither of these plenitudes but they may ensue a little after For when the insensible transpiration shall have been a while abated as inquietude pain and watching will abate it the Blood degenerates and no longer continuing its usual depuration those excrementitious particles which were lodged in the habit of the body and pores do remix with the sanguine mass and become like so many fermentative corpuscles agitating and attenuating the blood so that whereas before there was no plenitude now there is that the excrementitious particles do contract a fermenting heterogeneous quality different from what they had in the Blood appears hence that those which sweat much as the new-comers in the Indies their sweat is less noysome and bilious by far than it is in those that sweat more seldome Thus Soot is a different body from any thing that is burned Hence it is that those particles being reimbibed into the blood are so offensive to the nervous parts and introduce a lassitude as if the body were surcharged with a plenitude Besides these two cases in which Phlebotomy seems to be directly indicated by a Plethora or surcharge of blood It is practised in other cases by way of revulsion when the Blood and intermixed Humours flow into any determinate part or are fixed there as in Apoplexies Squinancies and Pleurisies for as upon dissection it is manifest that in such diseases there is a greater efflux of Blood than upon other occasions so it is evident by long experience that Phlebotomy doth alter its course and draw back the blood so as that sometimes after that the first blood hath run more pure and defaecated the subsequent hath been purulent as if the conjunct cause of the Pleurisie or Squinancy had been evacuated thereby In reference to such fluxes of the blood to determinate parts we usually consider what in all probability may happen as well as what is at present urging and therefore for prevention thereof we let blood upon great contusions and wounds It is also practised by way of derivation when we let blood near to the affected part thereby to evacuate part of the imparted matter Thus Van der Heyden did frequently let his Patients blood in the same foot for the Gont Thus in a Squinancy to open the Iugulars it is a derivative Phlebotomy In all these cases all Physicians agree to the received practise but in case that the disease be not meerly sanguine but seem to arise rather from a Cachochymy or redundance of evil humours than any plenitude or exorbitant motion of the Blood here many Physicians cry up that Rule That Plethorick Diseases require Phlebotomy but those that arise from a Cachochymy
concretus It is the more crude impure part of the bloud the purer part of the chyle being digested into a saline juyce is carried into the milky vessels and veins and mingling at last with that ruddy liquor is called Cruor and at last becomes perfect bloud It undergoes manifold guises and is often the subject matter of a multitude of diseases being sometimes changed into an Ichor Tabum or Sanies The third part is properly called Sanguis or Bloud 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 it is a most pure sweet Homogeneous Balsamie Vital juyce for the most part of a bright Red or Reddish colour made by the Archaeus by virtue of ferments implanted in the ventricles of the heart lungs veins and arteries causing a formal transmutation of the Ckyme or milky substance into this sanguineous liquor ordained to be the seat of Life and and the principal matter for sense motion nutrition accretion and generation It is for good reason called Balsamum seu Condimentum totius corporis forasmuch as it hath a sanative power sweetly uniting all the parts of the body for the conspiration of the good of the whole It is a great preservative against putrefaction as long as it remains in its integrity for consisting of many saline particles it seasoneth whatsoever it toucheth with a pleasing sapour It is the proper habitation of the vital spirit the immediate instrument of the soul in which it shines displaying its radiant beams every way that sensation motion nutrition and all other functions may be exquisitely performed God and Nature never intended other then that the bloud should be Homogeneous pure plain symbolical with that single principle of the Vniverse Now these Peripatetick Philosophers deliver to the world that the contexture of this vital juyce is made up of Choler Phlegm Melancholy and Blood which united produce this compounded body which we call Sanguis How grosly erroneous and dangerous this Tenet is most Learned Helmont hath made evident Wherefore we conclude with that noble Philosopher that Bloud is an Vnivocal substance divisible only by some external accidental means as the Air or Fire which cause a various texture and different position of its Atomes whereby it seems to consist of parts which are not really inherent in it as is manifest in its degeneration from its native colour sapour consistence and goodness which it had before it became corrupt in the pottinger or underwent the torture of fire Both of which do strangely larvate and disguise the puniceous Balsome giving occasion to the Galenists to frame their four fictitious humours no where really existent This being the foundation of all his declamations against Phlebotomy before I proceed any farther it may seem requisite that I should make some Animadversions thereon I might take much notice of and display his errours as to what he sayes that the Latex is by the Greeks called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 this is the first time I ever read it called so the usual terms being 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The notion whatever Helmont say is not new at all an hundred Galenists have mentioned and treated of it as the vehicle of the bloud and nourishment But that cruor should come from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 crudus concretus is an opinion singular to the Baconical Philosopher That 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 doth signifie cold I know well and that cruor properly signifies the the bloud of dead people or the mortified bloud issuing from putrefied wounds I no less understand though Authors frequently confound it with Sanguis But that his Latex and the Lympha so called by moderns are the same is news for it is not held that the Lympha in its peculiar form was pre-existent in the Arteries and as such did accompany the Blood through the Maeandrous pipes but is generated as it is discharged into the Lymphaeducts and from them is re-mixed with the bloud And if it were yet would not the definition of this Latex agree with it for the Lympha is no inseparable companâ—on of the bloud as appears by its peculiar vessels it is seldome a diaphanous clear liquor being commonly tinged with several colours oftentimes whitish sometimes yellow or as it were stained with bloud And whereas this Latex is devoid of all sensible qualities those who have experimented the Lympha do not find any such thing but a variety of tasts Nor is it true that the Serum which accompanies the Bloud is such a Latex as our Helmontian describes it being never to my taste free from a salsuginous sapour though it retain that with a great Latitude nor devoid of colour so as to be clear and diaphanous and 't is very seldome seen that the said Serum will not coagulate unless preternaturally upon a gentle fire so that it is no more to be termed a Latex than the whites of eggs beaten to the like fluidity In like manner that in the Lymphaeducts will coagulate as Bartholin observes and others As for the Cruor that there are graduations of the Bloud as to its crudity and impurity is no doubt amongst the Galenists and that it may oftentimes transcend the state of due maturation and so become degenerate is as easily granted as that it should come short of its desired perfection and when this Blood degenerates any way into a Tabum or sanious matter I must tell him that Aristâ—â—le and his followers acquainted us therewith before that Helmont was ever heard of whose Cruor bred in the Liver and distinct from the Bloud impregnated with vitality is such a piece of non-sense as ought not to be mentioned in this Age but to Baconical Philosophers who not only connive at but applaud any Hypothesis Concerning the Blood when I read the Elogies he bestowes upon it as the Seat of the Soul by which sensation motion nutrition generation are performed I thought â—pon the opinion of Aristotle and his zealous sectators â—mongst the Physicians who have denied all Animal spiâ—its fixed the principality of the Members in the Heart and from thence derived even the nerves If G. T. will defend the generality of his Assertion I assure him that Hofman Van der Linden and Harvey will be more serviceable to him than Van Helmont But this consideration hath little influence upon the present Controversie that which follows hath nothing of Truth in it that the Bloud is an Homogeneous pure body for nothing homogeneous can ferment But it is most evident that the bloud is in a perpetual fermentation and that it is such a liquor as is constantly generating constantly depurating and constantly expending it self so that nought but Imagination can represent unto us such a thing as pure bloud and I hope the specious pretences of a Real Philosophy will not terminate in Speculation and Phansie When the bloud either naturally issues forth or upon incision of a vein it representeth unto
administred it is so far from debilitating Nature that it adds to its strength mitigateth the present symptomes prevents the violence of the future and concocteth the disease apparently I will not undertake to justifie the demeanour of each particular Physician any more than I will answer for their intellectuals and skill in Physick It is not the reading of Sennertus and Riverius with a little knowledge of the new discoveries in Anatomy and a few Canting terms about Fermentation texture of bodies or such like knick-knacks and Conundrums of the novel Philosophers which accomplish a man for practice These men will never come to be ranked with Vallesius Mercatus Fernelius Duretus Rondeletius Massarius Septalius Claudinus Crato or Rulandus If Experience be our Guide let us inform our selves by the Histories of such as they have given us of Epidemical and pestilential diseases and of particular cases as also the cures and following them let us come to practise and not deserting our own reason let us be cautioned by them These others for want of judgment to consider each circumstance cannot make an Experiment or relate it whilest they extenuate the credit of the ancient and modern Physicians that are not Innovators though more observing and experimental than themselves they do it only to excuse their ignorance in that kind of Learning and whatever they have of the Lord Bacon they have this of the Russe in them that they neither believe any thing that another man speaketh nor speak any thing themselves worthy to be believed For such as these or any else that do not practise Phlebotomy according to the rules of Art I cannot make any Apology nor do I think that their errours ought to extend so far as to disparage all Physicians who demean themselves prudently and discretely Notwithstanding all our care some Patients will dye no Physician can secure all men from what their frail condition hath subjected them unto If our Method and Medicaments be such as the general rules of Medicine and an Experience generally happy do warrant 't is as much as can be expected from us and the Imperial Laws allow of this defence though they punish the immethodical and novel Experimentators and the Ignorant Sicut Medico imputari eventus mortalitatis non debet ita quod per imperitiam commisit imputari ei debet pretextu enim humanae fragilitatis delictum decipientis in periculo hominis innoxium esse non debet To conclude this Argument I say that although it often happens that diseases are cured by sole Phlebotomy Evenit ut saepius missio sanguinis sola curationem perficiat Misso sanguine saepe sponte naturae expurgatur corpus alui profluvio vomitu aut sudore succedente Yet no wise Artist will rely upon that alone but with the addition of other auxiliary medicaments Herein Spain and France are pretty well agreed And as no wise man will undertake to cure by bleeding alone so it is most foolishly done of our Helmontian to demand or expect it as he doth here I come now to his fifth Argument The means to let out bad blood without removing the efficient cause thereof is no direct method of healing Now Phlebotomy lets out bad blood without removing the efficient cause thereof Ergo Phlebotomy is no direct Method of healing The Major is proved thus Whatsoever suffers the cause to remain can never remove the effect For manente causa manet effectus Now Phlebotomy suffers the cause to remain Ergo it can never remove the effect The Minor is made good by frequent experience If the cause of bad blood were cut off the Feaver or Scorbute depending according to Dr. Willis upon the degeneration Sal and Sulph therein would quickly cease but we plainly see the contrary for after the veins are much depleted the disease becomes more truculent and oftentimes mortal which could never be if this depraved blood were any other than a product or an effect of an essential morbifick cause The same agent which in sanity sanguifies regularly without any considerable defection in sickness becomes exorbitant sending out a vitious juyce into all parts be it good or bad it still springs from a root which continually feeds the branches so that it cannot be other than great folly and wrong to the Patient to let out that juyce though it seem never so corrupt when another of the like condition must needs enter into its place derived from the shop the duumvirate where it first receives a previous rudiment which ought in all reason rather to be reformed than to give vent to those easily evanid particles inseparably joyned with this ruddy liquor how ill soever represented If all contained in the reins supposed to be corrupt were discharged yet as long as the ferments principally of the first and sixth digestion deviate from their right scope there would in a short space be a succedaneous repletion of a matter equally contemptible yea worse in respect of an enervation of strength than before This Argument though our Helmontian rely so much upon it is a pure Paralogisme First He supposeth that we use Phlebotomy in all diseases as a direct method of healing which is not true except in some maladies as Apoplexies Squinancies Haemorraghies or great eruptions of blood some Atrophies and sometimes in Feavers in which 't is frequent with us to rely solely or principally upon Phlebotomy yet even here we would think it very improper to admit of our Phlebotomy to be stiled our direct Method of curing because it is but a part of our Method which will include if not some other prescriptions yet at least dyet In many cases we use Phlebotomy as one part of our Method but not as the principal as when we use it antecedently to other remedies Pharmaceutical and dietetical to prepare way for or facilitate their happy operation I am not now to write Institutions in Physick for the documentising of this Disciple of my Lord Bacon 't is enough that he may learn any where almost as in Vallesius Mercatus Claudinus and Plempius that we propose more than one scope to our selves in Blood-letting neither is it ever except in diseases arising from a partial or total Plethora our direct method of healing If it be but a part and necessary or useful part thereof we are sufficiently justified Thus his Major is enervated for if he would have opposed the modern practise he ought to have urged it thus The means used to let out bad blood without removing the efficient cause thereof is no direct Method of healing nor an useful or necessary part thereof This is manifestly false as I shall shew anon As to his Minor That Phlebotomy lets out bad bloud without removing the efficient cause thereof This would the Ancients deny who bled their Patients in many cases until they swooned or fainted with great success and we must say it is not absolutely true there being no Practitioner I believe
of such as write what they will and defame as they please and permit not others to vindicate themselves nor undeceive the World 'T is ungenerous to pinnion a mans hands and then beat him In reference to that Controversie I add that the Statutes of the Colledge command the Physicians to send their Bills to an honest Apothecary And our Laws make the Colledge Judges of all Receipts as well as Methods of Physick which Act as it conforms with the general practise of Europe so it is very prudential for hereby provision is made not only against noxious Medicaments and the high prizes of Arcana but illegitimate Methods of practise by which last it is as easie to destroy a man as by poyson and more privately How the designs of the Experimentators will consist with our Laws and be accommodated to them I know not I know a Physician may be tryed upon giving his own Medicaments if the Patient miscarry how he shall defend himself I know not I have not seen any reason alledged that is likely to convert the Magistrates throughout Europe to permit it or to gain a repeal of the two last Edicts in Denmark against it 'T is an evil president to dispute against wise Laws 't is worse to act against them and what consequences it will bring upon the Land to see one Profession retrench upon another let the Lawyers judge The beginner of this Novelty the Lord Bacon stopped not at Natural Philosophy but carried on his humour to attempt or project a change of our Laws I do recommend it to the consideration of our Sages in the Law that if Physick Divinity and other Faculties be overthrown by a company of Wits whether it be probable that they shall long continue free from the attempts of the Omniscient But I shall resume the examination of the remaining Arguments of my Adversary Because I often observe many squaring their Therapeâ—tic intentions according to the Definition of the Feaver indeavouring to cool those that are in a scorching heat by breathing a vein let them know that a Feaver whose essential nature is to be inquired into for the use of man is very erroneously defined an Accident for a febrile heat is certainly the product of a foregoing Cause which is primarily to be searched after then whatsoever depends thereon will quickly vanish Now this cutting an hole in venal vessels for the removing a bare Quality is all one as if one should laâ—e out of the Pot ready to boil over a spiritous or some precious Liquor therein contained to the intent it may thereby be quailed neglecting to withdraw the fire the impulsive occasion of the violent motion made therein Do not they take the like absurd course who do think to cool the body in a Feaver by throwing away whole Porringers of the Nectar of life never looking after the ablation of the Causo-poietick cause and focular matter sited about the Stomach which makes an estuation and effervescence in all the other parts That way of frigidation which pillageth the vitals increasing the malady only obliquely abating a tedious quality is never to be approved by a Legitimate Physitian He that will bring to a moderation the finger excessively heated from a thorn impacted therein must extract the same otherwise he will take a wrong course by the use of meer frigefactives So he that will positively refrigerate in any preternatural heat must eliminate that spinous aculeate acid acrid matter which goads the Archaeus incensing it that it becomes exorbitant fretting raging Heautontimorumenos gauling it self at the presence of that which it abominates never to be pacified till it be excluded or some extraordinary Sedative given I mean not Opium vulgarly prepared which may for a time asswage its fury till it have leisure to thrust out the unwelcome guest I could wish my Adversary instead of consulting the Novum Organum of the Lord Bacon had been conversant in that more ancient one of Aristotle he had not then committed so many errors in point of Ratiocination as he now does which renders his discourse intricate confused and oftentimes impertinent to the great distraction of his Reader and vexation of his Antagonist He perpetually mistakes through an Ignorantio Elenchi he never apprehends what he opposeth That the Galâ—nists do define a Feaver by a preternatural heat diffused through the whole body is true They are contented to call that a Feaver which the vulgar does so and accordingly to define it Not but they distinguish in Feavers the Material and Formal cause thereof as also the several Efficients thereof and in their Method of curing except necessity put them upon another procedure they do alwayes and are obliged to do so by the Rules of their Art to remove the Cause of the Feaver and this is notorious to all that understand the first Elements of Physick They consider the evident occasional procatarctick Causes they consider the Antecedent causes which though they are not the immediate and conjunct Causes of the Feaver yet dispose unto it and are of such importance as that they may often degenerate into immediate and conjunct Causes and which is more in the Cure they do not only regard the Cause which gave birth unto and produced the Disease but that which doth foment and continue it and that which may produce or increase it Censeri debet causa non quae facit aut fecit solum sed quae faciet nisi quis obstet And although the curing of 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 Malady 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 many actions which they confess are not immediately conducive to the cure of a Feaver which yet they pursue 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 heat 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
I have blooded my self on purpose two hours after dinner to make the tryal and have an hundred times examined the blood of others who have been blooded at such times as we might expect to see that Phaenomenon of his Yet hath the reality of his observation been confirmed unto me by other credible witnesses so that I question not but he may have seen it though I could not in these Ladies who all dined together about one of the clock and had done bleeding by four Neither may I pass by this Observation that of all the Serum which I have tasted I never found any to be bitter though I extracted some once that seemed so bilious that being put into aâ— Vrinal none could know it from urine highly tinged as soon as I set it on the fire it coagulated with a less heat than I imagine it to have had in the veins and it exchanged its hue for the usual white smelling like a roasted Egg. Yet doth Van der Linden say that some have tasted the blood of Icterical persons and found it bitter Actu nihil naturaliter in sanguine amarum est Sed nec esse potest redderet enim sanguinem ineptum suo muneri ceu observare est in Ictericis In his enim sanguinem amaricare accepimus ab iis qui ipsum vena emissum urinam ejus gustarunt Asclepiadio more And Vesalius gives us an account of one Prosper Martellus a Florentine Gentleman much inclined to and troubled with the Iaundise whose Liver was scirrhous but Spleen sound and his Stomach turgid with choler and wheresoever he opened any of his veins they were full of thick choler and the fluid liquor which was in the Arteries did tinge his hands as if it were choler I find the like Oservation in Th. Kerckringius that an Icterical Woman brought forth a dead Child in the eighth moneth which was so yellow all over that it rather seemed a Statue of such wax than an humane Abortion being dissected By him instead of blood in the veins there was nothing but choler and all the bones were tinged with such a yellow that one would have thought them painted The Scholiast upon Ballonius observed that however the blood is naturally sweet even such as upon obstructions from the Menstrua hath regurgitated and discharged it self at the Gums of women as they have told me yet in one that was troubled with the Green-sickness the blood though florid was salt Potest esse floridus color in se esse acrior biliosior unde quaedam mulier 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 ejusmodi praedita temperamento mihi affirmavit siquando vel ex dentibus sanguis affluit vel e capite eum sibi gustum sentiri salsum molestum When I was at Barbadoes we carried off several poor English thence to Iamaica where many of them falling sick and some being well were let blood I observed that in those poor people which live upon nothing almost but Roots and drink Mobby a liquor made of Potatoes boyl'd and steep'd in water and so fermented that their blood did stream out yellow and in the Porringer did scarce retain any shew of red in the coagulated mass yet are they well and strong but look pale and freckled such persons which are frequent in Barbadoes are called Mobby-faces It were infinite at least beyond my present leisure to relate all that variety of morbid blood which hath been observed in sundry diseases and in several persons languishing under the same distemper as in Pleurisies the Scurvey French-pox Hypochondriacal Melancholy and the like wherein if it be true as it is that oftentimes diseases vary in individuals 't is no less certain that the blood doth also vary in them so that oftentimes ignorant Physicians do imagine a greater corruption in the blood and a greater recess from what is natural to the person and a greater danger in the disease or in the practise of Phlebotomy than they need yet in Epidemical or some Sporadical diseases if the Phaenomena be as general as the disease 't is certain then that the resemblance of the blood argues a resembling cause which prevails over the idiosyncrasy of particulars I know it will be expected that I should say something about the Controversie whether the Blood be one Homogeneous liquor the recrements whereof make up the four Galenical Humours which are no otherwise parts thereof than the Lees and Mothers of Wine are constitutive parts thereof Or whether the four Galenical Humours viz. that which is properly Blood Melancholy Choler and Phlegm are the constitutive parts of the Blood in its natural consistence and Crasis I shall say therefore about this point as much as may be requisite to my present purpose First I observe that the Galenists are at a difference whether the Mass of blood contain those Humours actually or only potentially so that one may hold according to them that the blood is as homogeneous a liquor as any Neoteric doth hold it to be though it arise by the mixture of their five principles Amongst others Erastus hath a disputation in which he amply asserts that all those Humours when they are actually in the blood they become excremenâ—itious and are no longer parts thereof but such as the ejectment thereof depurates and perfects the other remaining blood which he confesâ—eth to consist of several parts constituting one body to which they are as essential as the serous caseous and butyrous part are to Milk which if they be deficient 't is no longer Milk Nam ut non potest lac bubulum intelligi sanum perfectum sine tribus suis partibus sero caseo butyro ita non potest sanguis probus animo concipi definiri absque partium illa varietate Fernelius doth compare the generation of Blood to that of Wine wherein the Chyle is supposed to resemble Must which by fermentation separates and throws out such parts as are not actually in that liquor but arise upon fermentation and are ejected several wayes the more crude parts are by time digested and then the noble wine brought to perfection so he supposeth it to be in the blood and thus though all the humours be at once as it were produced in the Chyle yet are they no more parts of the blood than the Tartar and Mothers are parts of Wine Both these Similitudes of Milk and Wine to Blood were first I think introduced by Galen I am sure he made mention of them and so did his Successours to Mercatus Fernelius Platerus Palleriaca then Carolus Piso began to carry the comparison further in his discourse of Feavers and after him Quercetan and since that our learned and judicious Countrey-man Doctor Willis Others held that the blood as it flows in the veins and is designed by Nature for the Aliment and other uses in man is not to be understood as one liquor consisting of some variety of parts yet united
is conveyed as it were in conduit-pipes the Heart being the great Elastic Engine which drives it being fed by the vena Cava and disburthening it self by the Aorta though even the motion of the Heart depend upon a Superiour influence by its Nerves which wherein it consists and how derived from the Brain and Soul is a thing to us incomprehensible I do suppose that the Circulation is continued and carried on principally by Anastomoses betwixt the Capillary veins and Arteries many whereof having been discovered by Spigelius Veslingius and others the rest may well be supposed and perhaps in the coats of the Veins and Arteries there may be a certain texture requisite whereby the transpiration is managed in order to the safe continuance of the digestive fermentation in the Blood and the nutrition of the body The impulse of the Heart together with the pulsation is sufficient to convey the blood to the lesser capillary Arteries and there though the pulse be lost which yet a little inflammation in the extremities of the body will make sensible and in some Ladies as also in Children the least preternatural heat yet it is impelled by the subsequent blood still into the veins and having acquired by the common miscele in the Heart and the digestive fermentation which naturally ariseth in such heterogenious liquors an inclination to expand it self the compression in the Capillary vessels adds to its celerity of motion when the larger veins give liberty for it the Aiery corpuscles of several kinds which are easie to be discovered upon burning by their expansion and contraction adding much thereunto Thus in Water-engines the narrowness of the â—ipes do add to the impetus with which the Water issues forth And I do conceive by the Phaenomena which daily appears in practise that the Animal heat in the Blood actuating that heterogeneous miscele and according to the diversity of its parts producing therein with the help of its fermentation a rarefaction of what is aiery and according to the room there is a liberty or inclination to expand and evaporate themselves this is the principal cause of the continuance of the motion of the blood in the veins and of its saliency upon Phlebotomy Thus upon Scarification there is no salience or spurting out of the blood there being no room for such an expansion or for the Aiery halituous parts in which there is as great a difference as in those exhaling from the terraqueous Globe to rush forward out of the continued Arteries and together with themselves to protrude the blood Upon this account the Methodists and old Physicians as also the Aegyptians where the tender bodies and constitutions of Children and Women or Men admit not of or requireth that great relaxation of the pores and texture of the body which a more robust and firm habit wherein as the natural resistance in health is greater so the recess from it in a bad estate is much greater would be cured by they use these Scarifications and prefer them most judiciously to Phlebotomy This constitution of the Body doth evince the great utility of Phlebotomy and best as I suppose explicates the effects thereof which we daily experiment From hence not only is manifest how the Body is evacuated in a Plethora but in case of Revulsion and Derivation It is manifest in Aqueducts and Siphons that the liquors though much differing in nature from the Blood nor so inclined to evaporate does accelerate their motion and issue out so rapidly upon an incision or fracture in one of the Pipes that a lesser in such a case will deplete the greater notwithstanding its free passage in its own entire Canale Thus the most learned and considerate Physician Sir George Ent having observed first thus much Videmus aquam per siphones delatam si vel minima rimula hiscat foras cum impetu prorumpere And Sanguis per aortam ingressus fluit porro quocunque permittitur peraeque sursum ac deorsum quia motus continuus est quemadmodum in canalibus aquam deferentibus contingit in quibus quocunque feruntur aqua continuo pergit moveri Quare nugantur strenue qui protrusionem hujusmodinon nisi in recta linea fieri posse arbitrâ—ntur After this He explains the doctrine of Revulsion in this manner Quae postea de revulsionibus dicuntur nullum nobis facessunt negotium â—antundem enim sanguinis a pedibus ascendit per venas quantum ad eosdam delabitur per Arterias Facto itaque vulnere in pectore aut capite revulsio instituitur si modo tam longinqua instituenda sit in â—rure Quia sanguis alias quoquoversum ruens facto nunc in pede egressu copiosius per descendentem ramum procul a vulnere delabitur Non enim arbitramur sanguinem aeque celeriter sua sponte per arteriam aut venam fluere atque is secta earum aliquo effluit Nec sanguis ad laesum pectus aut caput per venam cavam impetu affluit quia fluxus ille aperta inferius vena intercipitur I do acknowledge that the reading of these passages did first create in me the thoughts I now impart unto you And hereby it is evident how the Ancients with their large Phlebotomies might derive even the morbifick matter or revell it though impacted Our minute Phlebotomies do seldom produce such an effect for since it is not otherwise done but by a successive depletion out of the Arteries it would seem necessary to extract three or four pounds of Blood to effect such a matter Neither indeed is it necessary albeit that I believe the most speedy cures but great judgment is requisite in such operations were atchieved thereby for though we do not retract the Humour or Blood unto the place where we Phlebotomise we do revell it from the place whither it was flowing and the course of the Blood and Humours being diverted the Arteries leading to the part affected or depleted and the Flux of Humors which was by them is abated their tenseness there which appears by their pulsation there where they did not beat before is relaxed and so becomes less opportune to extravasate either the Blood or other Humours whereupon Nature it self alone or with a little help of the Physician doth digest and dissipate the impacted matter Whereupon if we add the motion of restitution in the parts affected which is hereby facilitated the great change in the digestive fermentation of the Blood which is manifest by the melioration of the Blood which is seen in repeated Phlebotomies and the relaxation of the whole body in order to the transpiration and other depuration of the Blood by its several Glandules the Kidneys Liver Guts the reason of those prodigious benefits which Patients have had of old and now under our practise is manifest nor do we want a justification for reiterating Phlebotomy or exercising it in different veins and divers manners I designed long ago to set aside some spare
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 faellatious disease and frequently after hopes of a recovery by a benign Anacatharsis after that the stitches have abared 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 flatulent 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 seemed principally to go was that a Physician was to imitate the progress of Nature and to carry off the peccant humours by such wayes as he inclined them to go which in one case appeared to have a tendency to the Arm in the other to the Bowels But Galen considering the uncertainty that is in the operation of purging Medicaments as also the hazard of irritating inflammations thereby and the diverting that sputation which is so requisite in that disease and that since a Looseness was perillous therein purging could not be safe and I suppose that the sad case of Scomphus may have discouraged him from it who being purged in a Pleurisie became frantick and died on the seventh day the discourses upon which lamentable History in Vallesius and Van der Linden do deserve to be pondered The purge did not work much yet killed him Some other cases as sad as this are recorded upon the account whereof the generality of Physicians have prudently been swayed from purging in a Pleurisie until the latter end Because it is very convenient in a Pleurisie that the body be moderately soluble they do give their Patients Glysters and because the disease is a Catarrh accompanied with a Feaver they conceive their main work to be this to prevent the increase of the fluxion by diverting the course of the Blood another way and to evacuate by a concoction and expectoration the matter inflamed and impacted To do this they place the beginning and foundation
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 cu juscunque generis ad sanguinis accensi vel simul putridi vel maligni etiam portionem educendam causamque sic minuendam in adultis plurimnm competet Quae infantibus majoribus cum in minoribus natu 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 justifies 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 variolaeâ—erumpant dum vires adhuc constant sanguinis tanta copia ad ambitum corporis consâ—uxit vena aperienda ut natura oneris parte levata quodreliquuum est facilius vincere possit Post quartum autem diem ubi maculae 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 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 Writers 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 proposed that the generality of the world the wisest of Physicians the most able and judicious of our Professors principled by Avicenna do approve thereof 't is not bare complyance with the Mode of France but the Dictates of Reason confirmed by a prosperous success in several to my knowledge I would fain see any man justifie the Rhodomontade of Doctor Whitaker by producing ten Physicians that reject Phlebotomy I remember none but Fracastorius Langius Rolfinckius and Densingius and one or two more and a company of old Wives and Nurses I never yet Phlebotomised any yet 't was because I either had no exigency for it or the Patients were too timorous to admit of it But were my own life concerned I would undergo it and I hope the Baconical Philosophers have not so irrecoverably infatuated this Nation but that we may come to be undeceived in this point as well as we have been in others Although it be not my intention to write an intire Tract about the Small Pox yet that I may demonstrate the Rationableness of their procedure who do let blood in the Small Pox 't is necessary that I acquaint my Reader with those cases wherein they do apprehend themselves obliged to act as they do In the cure of the Small Pox whensoever a Physician employes his thoughts about Phlebotomy he considers the Feaver which attends it and the dangers into which the Patient is likely to fall and the strength he hath to bear them not to
est quod tam magnifice prodest quod non aliquo ex modo obest What matters it if the heat be magnified besides the main purpose to some small trouble if ten times greater benefit accrue to the sick It is impossible any Physician should perform his duty as he ought if he boggle at the foppery of heat and cold meerly momentany and transient often deluding our senses Surely he that is thus negligent of the Animal faculty in its principal operations may bear with a pitiful Galenist for not regarding much the loco-motive strength whilst he is as sollicitous as any Helmontian to support the vitals and let any one judge which is most likely to impair the vital faculty a little blood-letting duly administred or such an increase of the feavourish heat restlessness deliriums phrensies lethargies as our Author here despiseth I must not yet dismiss him not that I intend to laugh at his six-fold digestion he might as well make a dosen of digestions but it is necessary that I tell him that the production of good or evil blood doth alwayes depend upon one root that feeds the branches for 't is possible that the stomack and pancreatick or bilious mixtures in the guts may not be faultless and yet the blood of the Patient either not vitiated the errors of the first concoction being amended by the primigenial sanguifying Blood for 't is the Blood in the vessels which principally sanguifies or if it be depraved yet not so as to generate any disease or abbreviate the life for cacochymical persons with a little can live more long and more free from diseases than those of a purer and more generous blood Nor is it less true that oftentimes it happens that the blood is infected with recrementitious heterogeneous and noxious mixtures from obstruction of the pores or other occasional causes wherein the stomach and vitals otherwise sound and vegete are only oppressed and distempered by accident some of those impure humours being discharged upon them and in these cases repeated Phlebotomy alone may cure If the credit of Botallus will not satisfie him herein let him believe his beloved Hippocrates a man who did extraordinarily practise blood-letting so as that the French do impatronise him to their Phlebotomy he tells us this story A certain man amongst the Oeniada was sick when he was fasting he felt as it were a great suction in his stomach and a violent pain and after he had eaten any meat as it digested his pains returned He grew very tabid and wasted away in his body his food yielding him no sustenance but what he took came away in ill-concocted and adust stools But when he had newly taken any sustenance at that instant he felt none of that vexatious pain and suction He took for it all manner of Physick both emeretics and cathartics but without any alleviation But being let blood alternately in each arm or hand till he had none left in his body that was vitious he amended upon it and was perfectly cured Read but that case you that are so timorous with the Comment of Van der Linden in his Selecta Medica c. xiii and tell me if upon Phlebotomy as ill blood alwayes succeed as is let out I could add more parallel stories But to demonstrate unto this Pyrotechnist that single Phlebotomy will amend and inrich the mass of Blood I propose this case An ancient Gentlewoman of a very strong and corpulent habit of body but frequently troubled with hysterical and hypochondriacal vapours was taken with a violent catarrh upon her stomach together with great pains in her right and left hypochondria as if the liver and spleen had been tumified sometimes she complained of an insupportable acidity in her stomach and sometimes a saline humour molested her Sometimes she fell into cold clammy sweats sometimes her sweats were so hot that she complained as if her skin were burnt and even when her stomach felt any alleviation she complained of a burning fire as it were in her bowels near and in the region of her liver a perpetual sputation did follow her I being sent for after several Medicaments prescribed methodically but with little or no alleviation I proposed earnestly that she should be let blood notwithstanding she were above sixty years old I took away eight ounces or more She found immediate alleviation there seeming no default in the blood or serum I burned the blood in an arched fire it came to ignition but flamed not at all but crackled like Bay-salt and after some while a sudden eruption of ventosity made such a noise as equalled the cracking of a Chesnut in the fire She took a stomack-powder of Ivory Pearl Crabs-eyes c. and was pretty well for three or four dayes but upon a small fright relapsed I bled her again as before and in that short time in which she had taken very little sustenance but behold this blood which looked no better than the other did burn with a vivid and lasting flame as well as any I ever tryed in my life and without any sign of flatulency She recovered presently after with some further Medicaments but not so as to be perfectly well at stomach of a long time I doubt not but if others would try that way of burning blood they would soon be convinced that Phlebotomy makes a great alteration therein But I proceed to his other Argument This is taken out of Van Helmont whose Latine words I shall not transcribe now but only the English Let them make it appear if this do not imply a contradiction that a Feaver hath the property to pollute the blood and that this property can be taken away a posteriori by a posterous manner to wit by withdrawing what is putrified For if first the fouler blood be let out they open a vein again all this while they overthrow and confound the strength and so thereby wholly disappoint a Crisis But suppose sometimes a fresh ruddy blood run out they presently cry as cock-sure that a whole troop of diseases is cut off at the first dash as if the resting place of the Feaver did only extend from the heart to the bending of the arm and the good blood did take up its abode about the liver This Argument proceeds upon a most gross falshood in that part of it where we are supposed to place such a value upon the colour of the blood as by the goodness or ruddiness thereof we should esteem our selves as cock-sure that a whole troop of diseases is cut off at the first dash whereas no intelligent Physician ever thought so for we do say that the blood of all men is not alike neither as to colour nor consistence naturally and therefore in diseases we do not expect to see such nor intend to make any alteration to such a degree as transcends the natural estate of the body for 't is our business to preserve each man his natural habit be
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 aptiores 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 sit ut qui crebro mittunt sanguinem non tantum in febres proclives sint verum etiam pinguescere soleant propter cruorem succo Sulphurco 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 conjunctions 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 aut 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 antem 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 tumore 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 non recipit potest recipere id quod futurum est The Major being thus false in that sense which was most pertinent to his purpose 't is most ridiculous in the other For who will not immediately laugh at him that should thus determine That which may in some persons and in some circumstances incline unto a Feaver is never the proper remedy of a Feaver And how can this Bacon-face upbraid us herewith who doth himself prescribe to his Patients in Feavers the most generous liquors of the subtilest smack exhibited largely without insisting upon the nicety of any danger from heating and yet his Sack and other generous liquors may ingender Feavers and other distempers in the healthy In fine Whoever rejected the use of a thing for the abuse or condemned peremptorily any cause for accidental inconveniencies following thereon but such a Dulman as this Helmontian and his brethren the disciples of my Lord Verulam To the Minor I reply that for the observations made by this insipid pretender to Pyrotechny I regard them not at all he hath not judgment enough to make one Ego vero sicuti experientiam multi facio dummodo commodum expertorem nacta sit Ita si unicuique qui se expertum dicat temere credidero ridiculus profecto habear ut qui fori circulatores ac loquales vetulas agrestes quoque sacerdotes in pretio habeam Nam si quaeras omnes uno verbo quae proponunt se expertos dicunt It is true
I have some groundâ— for this suggestion but I never could 〈◊〉 any 〈◊〉 or thin concretion upon the turned blood and to 〈…〉 fect thereof I have been willing to attribute the â—â—â—â—nomenon when the turned blood hath not equalled in floridness the first superficies Some have attributed that florid colour to the concretion and shooting of some volatile Salts in the surface of the Blood and think that Kiâ—cher mistook those saline striae for Worms in his Microscope Besides this difference in the Mass of Blood as to several Individuals it may not be amiss to consider the difference that is betwixt the Blood in sundry vessels and parts of the body It is the most common tenet amongst Anatomists that the Blood of the Arteries differs very much from that of the Veins Though Harvey seems to deny it with much confidence and appeals to Experience for the proof of his Opinion yet the Generality as Doctor Ent Walaeus and Lower grant there is a great difference in the colour of them and that the Arterious blood is the most florid the venous is of a darker red Besides this difference in colour there is a greater which ariseth from the quantity of serum which abounds in the Arterious blood more than in the venous Comprobavimus in accepto per nos ex crebris Arteriotomiis cruorum duplem ferme compertam ichoris portionem qua fit fortassis ut crediderit Auctor lib de util respir. Sanguinem Arterialem non concrescere velut venalem quanquam nos eum concrescere non semel observavimus So Aurelius Severinus with whom Bartholin agrees And Doctor Ent sayes it is more dilated than the venovs Besides this there is a discrepancy in the venous blood it self for in the Lungs the Blood acquires by the mixture of the Air a tenuity of parts and florid colour exceeding any other venous Blood this Columbus first observed and gave this reason for the colour and great change which is made in the Blood by passing the Lungs proceeding to an imagination that the vital spirits in the Arterious blood might be the result of this intermixture of Air with the Blood in the Lights Most of whose opinion is taken up by Doctor Willis of late and Doctor Lower Besides this there is a discrepancy betwixt the Blood of the Vena porta commonly and that of the Vena Cava which is not barely supposed by Riolanus but yielded by Bartholin Sanguinem in cava prope cor puriorem esse illa qui in vena portae continetur omnibus in confesso est qui circulum norunt Upon this account it is that by the Emerods there is often discharged a black faeculent blood to the great benefit of the Patient but whensoever it is florid the effusion thereof brings a great debility sometimes very lasting unto many persons May I be allowed here to take notice of the Observation of Spigelius concerning the Saluatella that the Blood which issues thereat is more florid and Arterious than any can be drawn from the greater veins this he attributes to the frequent Anastomoses that are betwixt the Arteries and Veins in the remote parts of the body wherein he was defended by Veslingius and Van der Linden Doctor Harvey observed in the most healthy and robust persons a certain muccaginous humour to jelly upon the surface of their Blood which he esteemed to be the most spiritous part thereof others take it to be not an excrementitious Phlegm but indigested Chyle concerning this Maebius doth profess he never observed any of it in the blood drawn or issuing from the veins in the head but frequently in that let out of the arms and most of all in that which hath been taken by Phlebotomy in the feet It hath been observed that the Blood which hath issued from the head at the nose hath been of a laudable colour and consistence when that which hath been let out at the same time by Phlebotomy hath seemed impure And the like difference hath been taken notice of betwixt the Menstruous evacuations of Women and the blood taken from their armes This variety in the blood of several persons oftentimes is a cause of that discrepancy which is to be in the blood of Men that are sick in so much that when sundry men are afflicted with the same Malady yet may it happen so that there be little or no resemblance found in their blood Oftentimes it is observed that in â—utrid feavers the blood that is let out by Phlebotomy is seemingly good Saepe ad speciem visum purus est qui aliqui 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 malus est Vt contra impurus cernitur â— specie qui non ita 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 malus The blood often seems to be good when it is essentially corrupted and noxious and it seems often to be bad when as yet it is incorrupt and alimental In malignant and pestilential Feavers the blood is sometimes good to see to whilest yet the sick languish under most violent symptomes and commonly such blood is of an evil prognostick Pessimum signum est timoris plenum cum sanguis vena scissa extrahitur â—i purus rubicundus inculpâ—tus educatur veneno siâ—atem superare indicum est aut putredinem in penitioribus cordis latitare In me ipso olim observatum nam ter per hanc febrem misso per venam sanguine nulla prorsus putredinis nota apparebat aliis signis immani ferocitate saevientibus In like manner doth Simon Paulli observe such outward goodness of blood to be a sign of malignity in a Feaver and to be of an ill presage which he illustrates with the case oâ— an ancient man fifty six years old who being sick of a Feaver which the Doctor concludes to have been pestilential was let blood that which issued out was so florid that it transcended what any pencil could paint or pen describe now out of any Artery or the Lungs ever surpassed it after it had stood twenty four hours the mass was all coagulated and no serum to be seen the Patient died suddenly and without any pangs of death a little after With this doth that Observation somewhat correspond Coyttarus doth make though he take it for no ill presage that in Epidemical pestilential Feavers at the beginning if they be phlebotomised the blood of the Patient will seem very good and sound but in the progress it will come out putrilaginous Circa morborum Epidemialium principia sanguis si educatur ruber sano similis apparet quoties iterum tertio mittitur corruptior quam prius elicitur This he illustrates with Instances and makes this Hypothesis most judiciously the foundation of his Method to cure such Feavers by letting the sick blood in the progress not beginning of the Disease And undoubtedly if then the blood do not seem corrupted but florid it must be from some venenate or
by the History of Generation that no Parenchymatous part hath any operation in the first production of the blood all their Parenchymas being post-nate thereunto And if the blood be thus generated at first it is but rational for us to imagine that it is alwayes so generated during life For as it is true that the same cause acting in the same manner will alwayes produce the same effect So in this case to argue from the identity of the effect to the identity of the cause is allowable Est enim causarum identitas quae facit ut effectus sit idem quippe effectus supponitur non esse donec a causis existentiam suam indeptus fuerit dum existentiam illam largiuntur oportet ipsius quoque identitatem impertiant qua sine effectus ipsemet nequaquam fuerit That the Spermatic vessels in which the blood moves do contribute to sanguification much seems apparent from hence that the blood is seen in them before it is in the heart And because it is observed that the fluidity of the blood seems to depend much on them and therefore in the dead it doth not coagulate except praeternaturally in the veins though it do commonly in the Heart or wheresoever it is extravasated Manat praeterea aliquid a venis nobis incognitum quod dumearum ambitu sanguis concipitur prohibet ejus concretionem etiam post mortem in cadaveribus jam perfrigidis nequis hoc colori acceptum ferat quod vero coralliorum instar aliquando repertus est concretus in venis ipsis hoc merito Fernelius ascribit morbo occulto And not only the fluidity but motion of the blood seems to depend much thereon for if by a ligature the impulse and succession of blood be prevented yet will the blood in the veins continue its course and not stagnate Exempto e corpore corde motus tamen sanguinis isque satis celer in sanis videntur Et si vena ulla etiam lactea duobus locis ligetur laxata ea sola ligatura quae cordi propinquior est dum partes adhuc calent semper Chylus ad hepar sanguis ad cor cum movebitur qui nec a corde per Arterias nec ab intestinis per lacteas objecto potuit obice propelli nec stuiditate sua potius sursum quam deorsum movetur The truth hereof seeming undeniable to Pecquet he makes use of a new Hypothesis to solve this motion of the blood as if it arose from compression of other parts or contraction in the vein it self But the Phaenomenon will appear in such cases as admit not this pretence From these reasons it is that the blood doth not need so much as any pulse in the veins and arteries as appears in the first faetus but as soon as it comes to the Heart it does to prevent coagulation the punctum saliens being endowed with no such quality practiseth its systole and diastole when yet no such motion is observable in the Arteries at that time Whence the colour of the blood ariseth is a secret unto me I know that digestion reduceth some Juyces to a redness in some Fruits the fire doth the like in some the mixture of acid Liquors begets a Vermilion But here I conceive none of these causes produce the effect the generation of the blood is manifestly an Animal Action and as such unsearchable Whatever I attribute to the veins it is not to be expected that supposing they should instrumentally sanguifie the blood should turn blew from them any more than that water put into new vessels of Oak should turn white whereas it becomes reddish Thus the Plastic form produceth blood at first and whilest there is no first concoction in the stomack supplieth that defect by that albuiginous Colliquament which is of the same nature with the Chyle we digest our meat into and convey by the Lacteous Thoraciducts into the Heart That it is of the same nature appears hence that it resembles it and that it is extracted from the Blood of the Mother and produceth in the Embryo the like excrements of Choler and Vrine and Macosities nay it hath been observed by Riolanus to have been tinged yellow How much more may be concluded hence in favour of the Galenical alimentary humours supposed to constitute the Blood I leave those to judge who consider the variety of female constitutions and their condition during their being with child perhaps the Hypothesis of a proportionate mixture of the five Chymical Principles will not seem more colourable Having thus related how Sanguification is performed in the Faetus at first I come to give an account how it is performed afterwards and even here it seems an Action perfectly Animal for even Concoction in the Stomach is not the bare effect of Heat elixating the meat nor of acid or saline Ferments dissolving it nor of any other kind of imaginary Fermentation But 't is the effect of an Animal power operating upon the Meat in the stomachs of sundry Men and Animals by several wayes This appears most evidently herein that the same meat eaten by several Persons or different Animals produceth different Blood and different Excrements therefore Chylification is an Animal operation and is modulated by the specifick and individual constitutions Having thus determined of things that the Soul in all these actions is the Efficient we may consider that the meat being masticated in the mouth and commixed with the salival juyce or spittle is prepared in order to Chylification then it descends into the stomach and is there sometimes in a longer sometimes in a shorter space reduced into a cremor which is so far from being acid as Helmont saith that it is generally rather saline as are also the recrements of it that remain in the empty stomach It is true that according to the stomachs of Individuals and the meat they eat it happeneth so that this Cremor hath no certain taste nor colour Undoubtedly it must have been bitter in that Marriner and such as he of whom Vesalius writes that the Gall did naturally discharge it self into his stomach yet did he digest very well and never was apt to vomit or to be so much as sea-sick From the stomach the Cremor descends into the Intestines not all at once but as it is digested and there undergoes a second digestion receiving into its mixture the Gall and Pancreatick juyce I shall not speak of the variety that hath been observed in those two liquors nor trouble my self about the manner how they operate on the Chyle It is manifest that upon that mixture the Chyle suffers a great alteration if not some effervescence and some parts are coagulated and as it were precipitated and by a succession of changes the several particles are so blended and refracted in their qualities that the excrements at last are neither acid nor bitter but in dogs both sapors are extinguished In the mean time during
health not so much as being obliged to keep his armes in Bed On the fourth day he gives them one very gentle Cordial to promote their eruption and abandons them to Saffron and Milk to be given twice a day and ordains that he be kept in a constant moderate warmth such as is natural and usual to the Patient This is the sum of his Method except I add that when they are upon maturation he gives a mild Cordial twice each day morning and evening And in case that during the time of the decumbiture of the Patient by any accident a new Feaver arise then is the Patient to be kept still in such a proportionate heat as is usual to him in health if the season be temperate he is not to have a fire to be dieted with small Beer and Water-gruel stewed Apples or the like but to have no Cordial not so much as Harts-horn posset-drink By this Method Doctor Sydenham doth not doubt but this disease which so afrighteth people and is so frequently mortal will pass off with much gentleness ease and safety Betwixt these two there is a little discrepancy in their Method of curing the disease though there be some in their expressions and Doctor Sydenham doth seem the Comment the other the Text. Both of them oppose Phlebotomy Vomits Purges and Glysters as well as Sudorifics Though they differ in the râ—ason for their rejecting Phlebotomy For Doctor Whitaker doth avow that it draws from the Circumference to the Center But Doctor Sydenham yields that it produceth a quite contrary motion and causeth the Small Pox to come out Doctor Whitaker doth avow that this course of his is the old English Method and the ancient national and successful government of our Nation But Doctor Sydenham would seem to erect his practise upon his own Observations though all he propose in a manner be no more than the common actings of Countrey-people except when by any accident the Feaver be exasperated in the beginning or progress that he prohibits Cordials and what I belive was derived from Avenzoâ—r and Fracastorius Of these Writers it is remarkable that Doctor Whitaker doth never allow that there can be any malignity in the Small Pox so great and urgent as to induce a Physician to intermeddle beyond a moderate Diet and temperate Air because the Motion being Critical admits of no violence But this is a great Errour in the fundamentals of Physick For first in Diseases complicated with malignity not only the prognosticks but the issues are very uncertain as to life or death and the Critical evacuations deceitful so as that oftentimes they bring a momentany alleviation oftentimes notwithstanding those evacuations the distemper increases and the Patients dye This every man understands who is conversant in our accounts of Malignant Feavers so that to grant at any time that there is a malignity or venenate indisposition in the sick and to abandon him to a temperate Air and Diet relying upon Saffron and Milk is a practise never to be justified in Physick But alas we are not to be afrighted with the bug-wâ—rd Critical motion nor half an Aphorisme out of Hippocrates viz. Quae judicuntur sinere oportet These general sentences neither qualifie a Doctor in Law nor a Physician It becomes us to consider in a Critical motion several things First Supposing it to happen in its due time we must consider whether it be only a Motion or whether it be proportionate to the Disease for no evacuation that is diminute is properly Critical If therefore the pathognomonies of the Disease be such as argue a multitude of the Small Fox to be requisite for the recovery of the sick and only a few come out the Physician is obliged to assist Nature Secondly Supposing that they do come out plentifully yet if they be not such as should come out but black livid green or interspersed with purple spots not to mention other circumstances which every Nurse can tell 't is certain that the evacuation how critical soever doth not oblige the Physician to stand an idle Spectator No more ought he to be in case that all symptomes increase upon the critical motion and his Feaver and dangers multiply thereupon 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Thirdly It is requisite that the Critical evacuation be per loca conferentia by such wayes as are necessary to the disease But if the Small Pox during their eruption be attended with a dysentery bloody urine or other pernicious excretion that scrap of Hippocrates will not excuse the Physicians negligence for it supposeth that all the conditions requisite to a good evacuation be found in that which the Physician is not to intermeddle with I need say no more to intelligent persons 't is not my present work to turn Institutionist Whether Doctor Sydenham intend to ascribe sense appetite and judgment unto the Blood I cannot well tell but either He canteth in Metaphors or explaineth himself in his general Hypothesis about Feavers as if his meaning were such Quinimo nec mea sententia minis liquet febrilem sanguinis commotionem saepe ne dicam saepius non alio collineare quin ut ipse sese in novum quendant statum diathesin immutet hominemque etiam cui sanguis purus intaminatus perflat febre corripi posse sicuti in corporibus sanis evenire frequenti observatione compertum est in quibus nullus apparatus morbificus vel quoad plethoram vel quoad cacochymiam 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 adipiscigestit 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
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 transverso 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 emolliâ—nte diutius foveas vel in aqua calida detineas I shall compâ—re 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 stores Camomillae aut Altheae aut violarum vel aliud ejusdem generis quod fuerit ad manus Haecquo 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 illiniro in linteo per totam noctem alligato dehinc ubi 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 faciuntque 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 mollire adhuc magis voluerimus decoquo simul semâ—na faenugraeci This Bathing is no less â—ecommended 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 intolerabiliter affligeretur ut se potius mori velle diceret quam illum pruritum punctionem ferre jussi ut pedes manus continuo teperet in aqua calida Quo consilio pruritus tum puncto cessarunt et melius per cutem in volis manuum et pedum morbilli emergebant Hujus rei experimentum not aâ—u dignum ab ipso Astario Papiensi medico accepimâ—s quod etiam Arcanum a Nicolo Florentino medico sui temporis insigni mutuavit cum idem sic scribat câ—p de Variolis et Morbillis circa finem de corrigendis accidentibus eorundem Si fuerit punctio plantae pedum aut palmae manuum ponantur dicta membra assidue in aqua calida ut dicit Nicolus ego vidi multum conferre Haec Blasius Astarius Papiensis in libello suo de curandis Febribus qui adjunctuâ— est praxi Gatinariae quo quidem experimento ab hoc symptomate molosto et gravi nostra aegra liberata est et brevi Dei nutu evasit et in totum sana facta est Herewith agreeth the injunction of Hoeferus which runs thus Vbi in variolis plantae pedum et manus quod saepius fieri solet gravi pruritu vexantur immitte membra in aquam calidam quod pro secreto habet Forrestus I need not any more Authors what hath been said is sufficient to justifie the practise to any intelligent person and to disprove the Assertion of this Doctor but as that is most â—ntrâ—e so are the Reasons he gives no less vain Whereas he is pleased to think that there is no such density in the skin of the hands as is generally supposed except in laborious persons 't is certain that some have it so naturally as Scipio Nascica who was
be granted But the nâ—tion is incomprehenâ—ible and this Scurvy Idea is more ridiculous than thaâ— Scurvy Qualities The Analysis Synthesis of inanimate 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. â—26 Hippocr sect 1. aph 3. Plato de repub l. 3. Galen in exhortat ad bonas artes discend G. Celsus Medicin l. 1. c. 1. Aeâ—iâ—n vâ—r Histor. l. 9. c. 31. Aristot. polit l. 3. c. 2. Galen adv Erasistratum c. 4. C. Celsus Medicin l. 3 c. 9. Asclepiades was he that first professed to cure cito tuâ—o jucinde C. Cels. l. 3. c. 4. Fere quos ratio non restituit temeritas adjuvat C. Celsus Med c. l 3. c. 9. Forrest obs l. 1. obs 3. in Scholio Forrest obs l. 1. obs 12 13. Si omnia membra vehementer resoluta sunt in apoplexia sanguinis detractio vel occidit vel liberat Aliud curationis genus vix unquam sanitatem resiituit saepe mortem tantum differt C. Celsuâ— Medicin l. 3. c. 27. Itaque mittitur non quia multa â—ubest copia sed quia ea quae subest tunc est inutilis noxia Valler Method med l. 2 c 3. Potestautem id dum solum est non movere quod junctum aliis maxime movet C. Celsuâ— l. 1. in praef I. Riola opusâ— Anat. nova in rot adv Gassend p. 174. Alex. Massaria de febr c. 29. Io. Riolah Enchirid Anatom l. 2 c. 27. Maebius fund med c. 12. sect 18. Riolan de circulat sang in Antropograph c. 15. p. 585. M. Slegelius de sangu motu c. 13. p. 104 Dr. Lower de Corde c. 3. p. 115 116. Schenck Obs. med l. 1. p. 172 Art Muso Brassavolus comment ad Aphor. â—3 l. 5. Marcell Donatus de variolis c 23. Amat Lusit curat 100. cent 2. cur 60. cent 7. Schenck obs med l 3. p. 312 Schenck Obs. Medic. l. 4. p. 614. Almar Blondelus de venae fectione c. 2. p. 30. Forrest Obs. Medic. l 1â— Obs. 14. cum Schâ—lio Id. ibid. Obs. 12. Alex. Massarias de â—ebr c. 29. I. Riolan inter opusc novâ— Anat. adv Gâ—ssendum p. 108. I. I. Beâ—herus Physic. subâ—erran l. 1. sect 5. c. 1. p. 30â— Almericus Blondelus de venae sectioue c. 1. p. 8. Ballonius Epidem l. 1. p. 101 102. Id. ibid. l. 2. p. 192. M. Siegel de sanguinis motu c 9. p. 75. Simon Paullâ— de febr malign sect 11. Regnerus de Graef de ge nitol p 84 85. Th Bartholiâ— Spiceleg de 〈◊〉 Lympe c 6. Van der Linden Disp. Physiol 39. §. 22. Van der Linden Disp. Physiol 41. §. 22. Simon 〈◊〉 de febr malign Harvey Exercit Anat. 2. ad Riolan â—urel Severinâ—s Epidoch de aq peric sect 8. Barthol Spic 1. de vaâ—is Lymphat c. 7 Ent de circul sâ—ng p 106. 267. Reald. Columbus Anatom l xi c. 2. Willis in Exercitat de sang accensione Lower de corde c. 3. Bartholin Spiceleg de vas Lymphat c. 7. Spigel de â—ab corp hum l. 5. c. 7. Vesling ep 30. Van der Liâ—den Select 11 ed. c. 13. se 423. Maebius fundam med c. 12 p. 258 259. Ballonius Epidem l. 1. p. 68. Ballon Epid. l. 2 p 192. Petrus a Castro de febr puncticulari p. 90. Simon Paulli de febr malign §. 11 14. Coyâ—tarus de febr pu pur p. 247. Almar Bloâ—dâ—lus de venâ—e sectione p 8. Bâ—llon Epid. 〈…〉 Id. Ibid. l. 1 p. 100. p. 101. Almaric Blondelus de venae sectione p. 68 69. Dr. Willis de sebr c. 1. En'mvero superficies candicans gelantinae similis in emisso sanguiâ—e plerumque in morbosis condensata conspicitur vidi cori instar crassam lentamque saepe in febribus acutis hoc anno observatur Th. Bartholin de lacteis dubia c. 3. (a) It was black in colour and consistence like to liquid Pitch in the Woman whose menstruâ— stopp'd eight moneths and was cured by Galen with reiterated and large Phlâ—botomies Galen 6. Epidem 3.29 cum notis Van der Linden select med c. 14. (b) Aliquando putrescentia non tam se insinuat colore quam substantiae modo ut quum erit raber sed non concrescens Vâ—lles de victu in â—cut p. 45. Both the white serum and blood burned vividly without any crackling Dr. Lower de corde c. 4. p. 217. Van der Linden disp Physiolog 51. sect 19. Andr. Vesalius de rad Câ—inâ— p. 253. Th. Kerckriegius Obs. Anatomic 57. Ballon Epidem l. 1. p. 111. sect 17. Eâ—aâ—â—us disput 19. §. 62.54 Fernel Physioleg l. 6. c. 3. â—â—len l. 2. de elem Galen 4. de usu part c. 4. de nat fac l. 3. c. 13. Vâ—llerioia loc commun l. 1. c. xi Mercat Qu. 65. Bâ—llon definit Medic. p. 7. De re ipsa â—t neque dubi tes morbi morborumq icurationes docent Nimirum hoc est maximum argumentum Hippocratis aâ—t Massarias Van der Linden disp Phys. c 2. Lacuna Epit. Caleni de temper l. 1. Francisc. Sanchez de longit brevit vitae c. x. I have lately blooded a Woman which after a Quartane was troubled with obstructions of the Spleen and Liver effervescences in the Intestines Astheâ—atic pâ—voxysmes acute pains in her head obtuse pains in her limbs visible beginnings of a Dropsie the blood at its issuinâ— out seemed very black but was pretty laudable in the porringer it burned well without any crackling or iâ—umescence almost sâ— did the Serum Here the salt seems rather defective than to abound as it ought by those principles M. Malpighi de viscer structura p 163. edit Londinens In quibus superficies fanquinâ—s durior est candicans subjectus sanguis in pelui sine fibris plane est putridus iâ—o vidi in hujusmodi ne guttulam coloris rubri Bartâ—olin de lacteis dubia c. 3. Vide Pecqueâ—i Dissertat Anatomic de circulat sanguin c. xii Videtur humor felleus sanguini firmiter adhaerescere quod in seri illius parte fundatus sit nec facile ab illo intra ulteriorem praeparationem separari possit Charleton oeconom Aniâ—al c. 7. sect 16. Erostus disput de propriet Medic. c. 15. This is the opinion of Dr. Highmore Velthusius Courvee and Everatius Io. Ioc. Wepfoâ—us de apopl p. 92. c. Bustachius de dentil c. 20. Th. Kerkring Obs. Anatom c. 26. D Highmore's Hist. of Gen. c. 5. Glisâ—â—n Anat. Hepatis c. 35. Dr. Higemore hist of Gen. c. 8. p 69 70. Glissen Anat. Hepatis c. 35. Greg Horstiuâ— Instit. Medic. disp 3. Coron 1. Append concluâ— 4. Berigardus Circul Pifan 1. part 6. circ 7. â—peâ—ta namque in cadavera vena sanguis prostuit Ent.