according unto which the advice of the Physician ought to be directed For the concern is not what a Patient's Age is but what his strength is Therefore a strong Child is safely Cured Thus Avenzoar makes mention of his successful bleeding his own Son at three years old and we find by experience that Children of four or five years old do by bleeding most commonly escape dangerous Diseases The same Author likewise in his Praxis and Chapter of a Pleurisie says thus Adeo necessaria est Venaesectio in principiò ut nunquam omitti debeat nedum in sene puero gravidâ puerpera menstruas purgationes Patienti docuit ènim Experientia hisce omnibus utilissimam fuisse Venaesectionem presente hoc morbo So necessary is opening of a Vein in the beginning of a Pleurisie that it must never be omitted no not in an old Man or Child or Woman with Child or that hath her Terms for Experience doth teach us that in all these in this Disease opening of a Vein hath been most profitable By Experience It is not long since that I knew a Girle not five years old that fell into an Atrophy a meer wasting and pining away without any Symptoms of a Consumption or Phthisis she was too young forsooth to be bled and all other means were to no purpose for she died and upon the opening of her Body her Liver was found so largely grown as to out-weigh the Spleen seventeen times Now whether the Liver be the Fons Sanguinis or the Heart or neither but that every Bowel contributes its office towards the making of the Blood yet since the Liver by separating the Choler into the Gall sweetens the Blood much and that sweetness helps to increase both Liver and Blood as also doth the absence of the acid ferment from the Spleen and I am prone to think that the Helluo the Blood eat her up and caused such an over-fast growing of the Liver as starved the Spleen and other parts Should another such a Case offer it self of such a Plethora would any rational man forbid bleeding until the Child were fourteen years old of which there is no likelyhood it should live until seven I am sure I did not in a Brother to this Sister about seven years old that not long after was treading in her steps and making haste apace unto the same end but being forwarned I bled him and I never saw more advantage by bleeding befal a Man than hapned unto this Child his recovery was so speedy and his health so good ever since as those then about him can witness I might instance also in the two above-mentioned Experiences wherein Mr. Loss himself can bear me witness of successfulness of bleeding under fourteen years of Age. Yet by all this which I have said I do not mean that I would encourage any Physician to be rash and venturous one that should hand-over-head pell-mell bleed all younger Patients as readily as Men without due consideration of their tender Age but I only urge from what I have written That there may be a time wherein it may be necessary to bleed a Child by Lancet under fourteen years old 2. That this Gentlewoman young Mrs. Moore might be bled by Lancet Here were several Indications for Bleeding and Co-Indications and there were no Contraindicantia nor Correpugnantia The Indications Here was Plethora quoad vires such a fulness of Humors in the Mass of her Blood as Nature could not rule well or manage so as to preserve them in their due Temperament and Mixture from separating and corrupting and therefore to remove this Morbifick Cause and to disburden the Body of a good share of that load it was pressed under that so Nature might the better comport with the remainder and by degrees master and subdue the Disease opening of a Vein was requisite Here was also need of Revulsion from a weak Part and Revulsion did Indicate Bleeding for this Patient was represented to me when I first visited her as a Child always Sickly Splenetick and Scorbutick and having her left Side weak by being Splenetick and pained in her left Breast more or less for two years before she fell sick Formerly she was obnoxious to Catarrhs and now also there was a flux of Humors in the mass of Blood flowing to her left Side part of the inflamed Blood had already got thither and lodging it self within the Pleura and Vicine Muscles caused in her a Symptomatical Pleurisie and there was great fear lest that inflammation should increase farther and therefore as bleeding was principally Indicated by the Plethora so was it likewise accidentally Indicated by Revulsion Here was Heat likewise that did Indicate accidentally the opening of a Vein in order unto the cooling her whole Body which was in a flame she having a putrid Scorbutick Feaver for her principal Disease Now this Preternatural Heat and Fire was to be put out and bleeding would help upon two accounts 1. By it part of the Fire even part of the Inflamed Blood might be taken away 2. By it Insensible Transpiration whose Evacuation alone is greater far than all the sensible together as Sanctorius observs in his Medicina Statica might be promoted the Pores of the skin opened whereby the Heat might breath forth and perhaps the cold Air get some ways in These Pores were before as it were wedged up with the plenty of Humors as is sometimes a Church-door by a throng of People each hindering another from getting forth but bleeding might unwedg them by letting some out another way and giving Nature room to drive forth what was superfluous by an open and free Transpiration as was also effectually done in this Patient who not long after fell into a great universal Sweat which completed her Cure The Coindications Some were taken from her Naturals and some from her Non-Naturals To her Naturals did belong her 1. Strength This was good even Mr. Loss himself being Judg so good as nothing could hurt 2. Habit of Body For lean people are generally fuller of Blood and have larger vessels than those that are fat and gross their Blood also wants more sweetning and 3. Her Age Though it was not fourteen yet was it about four It seems noways unagreeable to Reason to assert that one and the same thing may both Contraindicate and Coindicate bleeding as it is diversly considered For example He that considers of age under fourteen years that it is tender and wasts very much by the pores or habit of Body may so far look upon it as a Contraindicans as not to bleed in such an age except there be great need and good strength for fear the Patient should not be able to bear two large Evacuations at once And thus Mr. Loss seems to have considered this Patient's Age but notwithstanding this if need requires and strength will bear bleeding in a Patient not fourteen years old this Age as it intimates predominancy of Blood it may coindicate bleeding and
perstarent de venâ secandâ cogitavi ut quae summum in pleuritide commodum afferre soleat Cum vero venaesectionem Galenus in pueris ante decimumquartum annum vix suscipiendam suadeat praesertim in corpore molli raro atque ad dissolutionem prono quale erat hujus puellae siquidem internam habent copiosam perpetuam vacuationem ab actione sui innati coloris excitatam qui substantiam humidiorem facilè digerit absâ—mit unde timendum ne huic liberali vacuationi altera addita vires prosternat Itaq sanguinis uncias quinque sic jubente Doctissimo Sennerto hirudinibus ex internâ sinistrï cubiti vena emungendas curava praemisso enemate emolliente refrigerante Hoc facto dolorem lateris fotu unctione lenire studeo Fovebam autem malvarum florum Camomillae meliloti anethi seminum lini decocto admota insuper inunctione ex unguento dialtheae pectorali oleo amygdalarum dulcium superimposito cataplasmate dolorum lenitivó Recipe Malvae florum Camomillae ana M. 1. Meliloti Anethi Violariae ana M. s Floram Violarum P. 1. Seminum Foenugraeci Lini ana unc s Decoquantur in aqua contusis adde Olei Amygdalarum dulcium unc i. Pinguedinis Gallinae unc s farinae hordei fabar ana q. s Fiat Cataplasma quibus continuatis dolor plurimum alleviatus Hinc ad promovendum sputum conversus mane in jusculis exhibui Oleum Amygdalarum dulcium recenter sine igne extractum quo alvus quoque fluidior reddita subsequente promtâ facili anacatharsi interdiu verò utebatur linctu ex Syrupo Violaceo capillorum veneris diatragacantho frigido diaireos Saccharo Cando atque penidiis In principio morbi assumpsit tincturam florum papaveris erratici cum aqua cardui Mariae scabiosa cum spiritu sulphuris addito pugillo uno vel altero Florum Violarum extractam Postea etiam Decoctum pectorale officinarum hausit pro potu ordinario bibit decoctum hordei cum passulis liquoritia Seminibus Anisi His summâ diligentiâ administratis aspirante Gratiâ Divinâ Natura cooperatrice intra paucos dies puella haec a lateris dolore sputo cruento liberata ut e lecto surgeret remanente tussi non admodum molestâ cui removendae phthiseos vano metu visum est nobilissimae Matri instigatione avunculi Alium Medicum in Concilium adhibere Hic acta pro more multorum accusans maxime veró quod venaesectio neglecta quae sanguinis per hirudines detractio instituta fuisset nullius sit momenti venaesectionem instituit sexto morbi die cum febris reliqua symptomata cessassent detractis ne nihil fecisse videretur quatuor circiter unciis sanguinis ex basilicâ dextrâ oppositi scil lateris id quod inter errores Medicorum a doctissimo Fuchsio numeratur qua plures rationes in contrarium allegat Die septimo exhibet pulverem senae quo sexties vel septies fuit purgata Sub vesperam ejusdem diei incidit in sudorem spontaneum copiosissimum a quo omnino convaluit assumpto tamen aliquandiu Balsamo Peruviano Haec licet 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 sine ratione instituta nullo tamen aegrae damno quod vires ubi valentes sunt quales erant in hac Puellâ omnia contemnant tolerent ubi infirmae fuerint a quovis offendantur Observation the 15 th Book 2 d. A Benign Pleurisie resolved in a Week THE most Noble Damsel Elizabeth Eldest Daughter of the most Noble Gentleman Mr. Thomas Moore Esq aged more or less about ten years thin and cholerick and of a very rare Constitution boarding at Dorchester at a School-mistress's house for her better education subject to Rheums in Autumn when eventilation is less than at other times for which cause the Body is more prone to admit of the Internal inflammations of parts after a precedent rigour was taken in a Fever mild indeed but continual and worse every day towards evening with a pricking pain in the left side reaching to the Throat a difficulty of breathing a cough and spitting of blood Being called unto her and considering what has been said I judged that this noble Maid was sick of a Pleurisie whose external cause was by catching cold seeing that in a cold season late in the evening she had gone forth a walking with naked breasts as is the manner of Noble Virgins For as heat melting the humors easily causeth a Pleurisie so doth cold likewise by compacting them the Blood being gathered by reason of cold about the Intercostal Vessels and causing an Inflammation in the Membrane compassing the Ribs called the Pleura and the neighbouring internal Muscles Presently therefore for as much as her strength was yet pretty good I was thinking of opening a Vein as being that which uses to give great relief in a Pleurisie But because Galen adviseth hardly to admit of bleeding in Children not yet 14 years old especially in a body soft and spare and prone to dissolve such as this Damsels was for these bodies have a continual and plentiful internal evacuation caused by the action of their innate heat which easily digests and consumes their moist Substance so that there was reason to be afraid lest her strength should fail if to this liberal evacuation an other should be added Wherefore following therein the command of the most learned Sennertus I took care to evacuate by Leeches five ounces of Blood from the Internal Vein of the left Arm having first ordered an emollient and cooling Glyster Afterwards I made it my business by fomentation and unction to asswage the pain of her side My Fomentation was a Decoction of Mallows Chamomile-flowers Line-Seeds and Dill after which she was anointed with Althaea and pectoral Ointments and oil of sweet Almonds and this Cataplasm was applyed Take of Mallows Camomile-flowers of each one handful of Dill and Violet-Leaves of each half one handful of Violet-flowers a pugil of Faenugreek and Line-Seed of each half an ounce boil them in Water and when hey are bruised add to them one ounce of Oil of sweet Almonds half an ounce of Hens-grease and as much Meal of Barley and Beans as is enough Make a Pultess These things being continued the pain was much asswaged applying my self therefore to promote expectoration I gave her in the morning in her Broth oil of sweet Almonds fresh-drawn without fire by which She was also more soluble and a ready and easie expectoration followed But in the day She used a Linctus of Syrup of Violets Maiden-hair Diatragacanth frig Diaireos Sugar Candy and Penidice In the beginning of the Disease she took a Tincture of Wild Poppy-flowers extracted with Waters of Card. Marand Scabioso Spirit of Sulphur and a pugil or two of Violet-flowers Afterwards she drank the pectoral Decoction of the shops and for her ordinary drink a decoction of Barley with Raisins Loquorice and Aniseeds These
seeing that in the Title he tells us that the Disease was Benign With a pricking pain in her Side It is no hard task for any Physician to reckon upon his fingers the five Pathognomonick signs of a Pleurisie but then the Spitting of Blood is none of them and why the Pulsus durus which is one of them should not be here mentioned Mr. Loss can tell We have seen something of the Narrative of the Case there is yet one thing more taken notice of by Mr. Loss but both mistaken and misplaced it appertains unto the Patient 's Non-naturals her Walking late in the Evening in a cold Time with naked Breasts This I conceive should have been mentioned in the Narrative and before he had come to pass his judgment of the Disease There were also other things belonging unto the Narrative which Mr. Loss hath not mentioned at all viz. That formerly she had an Issue in the left Arm to which humors flowed so fast that becoming troublesom by some advice or other it was shut up That not long after the shutting of it up she began to have a pain in the left side of her Breast which had continued more or less some two years time when she fell sick with such soreness as would not easily suffer an ordinary impression of ones hand That just before her sickness she over-heat her Blood at Play and then drank cold Beer Things as material I suppose as many of these which Mr. Loss hath mentioned 3. Mr. Loss his Judgment on the Case THis Judgment concerns the Disease or the Cause of it Touching the Disease his Judgment is double 1. That it was a Pleurisie 2. That it was a Benign Pleurisie Touching the External Cause of it That it was her taking cold in her Breast by walking forth late If I do not mistake all these three are false It seldom happens that any one falls sick so as to lie by it and to be in great danger but there is a complication of Diseases in the Case and then the Physician is not to rest satisfied with the naming of some Disease or other which may be in the Patient but his Art requires of him to find out that which is the Principal and upon which the other do depend and from it to name the Case Denominatio enim est a potiori otherwise he will shew himself an Emperick and must needs make mad work in his Method of Cure This Patient 's Principal Disease was not a Pleurisie IF her Side was neither the first part ill-affected nor the Principal part that suffered then a Pleurisie was not her Principal Disease I do not see any reason to go about to prove this major Proposition But her Side was neither the first part ill-affected nor the Principal Ergo. I prove the Minor in both its Parts 1. It was not the first part ill affected for upon her drinking cold Beer when she was hot the Stomach must first suffer before the Side but because this was not considered of nor perhaps known to Mr. Loss I add that her Heart and all its Vessels were first ill-affected with a Fever in her Mass of Blood before the pricking pain in her Side and other Symptoms of her Pleurisie and this is made out both by the reason of the thing and by a double authority 1. I prove it by Mr. Loss himself in this very Observation who says She was taken in a Fever with a pricking pain in her Side If he meant that the Pleurisie was her Principal Disease he should have said She was taken in a pricking pain in her Side with a Fever for a Fever that went before though but some few minutes could never be the effect and symptom of a Pleurisie that came after though Mr. Loss says afterwards that on the sixt day of the Disease the Fever and other Symptoms were gone as if the Fever were the Symptom of a Pleurisie which followed after it 2. I prove it by Sennertus who in his Chapter de Pleuritide observes That although the Ancients did call these Fevers that do accompany the Inflammations of the Internal parts Symptomatical yet of a Truth they are nothing so Si quis enim rem diligenter perpendat animadvertet non Febres ab hisce inflammationibus sed potius inflammationes istas a Febribus originem habere If any one saith he considers the matter well he shall find that these Fevers have not their Original from the Inflammations of the Internal parts but rather that those Inflammations have their rise from the Fevers And if so the Fevers are the Principal Diseases that which also the Method of Cure shows plainly and did shew in this particular Patient 2. It was not the Principal ill-affected Amongst other Rules which Physicians give to know what Part is principally affected these three are very considerable 1 That which suffers most grievous Symptoms is the part principally affected But it is plain that the Effects of this young LADY's putrid Fever were much more grievous in her Heart than these from the Pleurisie in her Side 2. That Part which is continually affected and never at ease is the part principally affected but her Side was much at ease and if you will believe Mr. Loss her Pleurisie was gone then when Alius Medicus was sent for and then when all the Family where She lay Sick despaired of her Life And her Heart was never at ease but still troubled more or less with a continual Fever until at length the Universal Sweat compleated the Cure and the Fever once gone there was no news of the Pleurisie 3. That Part which receives no benefit by these Remedies which do help another Part is the Part principally affected but her heart was but little benefited by all Mr. Loss his Emperical Cure of her Side Therefore This Patients Pleurisie was not Benign A Benign Disease is such an one as goes on in a gentle mild manner not much troublesom or offensive to Nature nor yet so dangerous as to hazard Life And I do admire that Mr. Loss should title this Disease Benign for I am sure that before I was sent for the good Lady the Patients Mother was sent unto that She might make haste to come twenty miles out of the Country to see her Daughter that lay very sick in Town so little belief was there then of the Benignity of the Disease and I am sure that when I propounded to purge her after She had been bled Madam Moore told Mr. Loss who was against it that She would try the Purge for my Child said She is a dead Child in your account But afterwards when Mr. Loss saw that the Patient was able to bear both Bleeding Purging and Sweating and in few days was strangely recovered to my credit and his no little disturbance being to write this Observation which I think he put forth on purpose to honour himself and shame me what he could in this particular Case the good Man
changeth his Note of the great danger our little Patient was in and out of a Malignity to the other Physician Benigns the Disease That which is also the more ridiculous because this Gentleman in the immediately preceding Observation viz. the 14 th of his 2 d Book says thus of a Pleurisie in general 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Graecè a loco affecto nimirum Pleurâ Latinis morbus costalis seu lateralis dicitur estque inflammatio Membranae costas succingentis quae Pleura nominatur Haec inter morbos acutos lethales vel imprimis numeratur gravia Symptomata pericula secum adfert morbus est gravissimus A Pleurisie is called in Greek Pleuritis from the part affected to wit the Pleura or Side In Latin it 's called the Rib or Side-Disease and it is an Inflammation of the Membrane that covereth the Ribs within which is called Pleura Amongst acute and mortal Diseases a Pleurisie is especially reckoned it brings with it grievous and dangerous Symptoms and is a most grievous Disease A Pleurisie then is a most dangerous Disease when Mr. Loss cures it but when Alius Medicus cures it it 's a Benign Pleurisie The Nature of an Acute Disease consists in two things in its being a great Disease and in its moving nimbly with vehemency and danger Young Mrs. Moore 's Fever was peracute putrid continual worse every night it had joined with it an Inflammation of an internal Part next neighbour to the Heart It was occasioned by Choler in a Bilious thin Body it caused bad Symptoms and threatned death and if notwithstanding all this it must pass for one of Mr. Loss his Benign Pleurisies so let it Mr. Loss his Judgment of the Cause of this Patient's Pleurisie Examined THE Conjunct Cause of her Pleurisie was Inflamed Blood The antecedent-Antecedent-Causes were of two sorts some did cause the Blood to be inflamed as her Plethora quoad vires and her Cacochymia Some did cause her inflamed Blood to fall upon her left Side as the the weakness and debility thereof that Side being weakned first by an Issue and afterwards by an Afflux of Humors causing a soreness in her left Breast some years before her sickness The Procatarctick Causes were her being obnoxious to Catarrhs her Cholerick Constitution her over-heating her Blood by play and her drinking cold Beer whilst she was hot that which Sennertus takes especial notice of for a Cause of a Pleurisie But Mr. Loss mentions no other Cause but an External only her catching cold by walking forth late in the Evening in an Autumnal cold Season with her Breasts naked as is the manner of most Noble Virgins This is but a vulgar account any one that comes in to see such a sick Patient can readily suggest that She might get her sickness by taking some cold and being too late out in the Evening It is too general an account and although it gives sometimes very good satisfaction unto ordinary Persons that understand little of Physick or Philosophy yet how will any wise man acquiesce if asking after the Cause of a Particular Disease his Physician tells him he hath got cold which is in a manner a general Cause of all Diseases It is an illogical Inference She got cold therefore She got a Pleurisie for we may predicate of an Individual the Species and next Genus and so upwards For example Peter is a Man A Man is an Animal an Animal is a Corporeal Substance c. But we cannot invert this order and go downwards saying A Corporeal Substance is an Animal An Animal is a Man A Man is Peter Thus we may say That a Pleurisie may be caused by catching of cold but we cannot say catching of cold is the cause of a Pleurisie because a Genus cannot be confined to one Species and catching of cold might as well have caused other Diseases as a Pleurisie The Consideration of such a Cause is useless to a Physician he can make no benefit of it for Causa transiens non indicat because it is one of the conditions of an Indicans that it be Manens in corpore for how else can it indicate its ablation from thence What though this young Lady did catch cold that was past before Mr. Loss was sent for and the need a Patient hath of a Physician is to find out and remove the Cause that doth actually cause the sickness not to talk of that which is already gone If Mr. Loss had understood that the division of Causes of Diseases into External and Internal is an error among some Physicians because it may so fall out that against the Rules of Logick both Members of the division may be predicated of one and the same thing as when a Dagger is stuck into the flesh He would not have called the cold Air an External but a Procatarctick Cause of her Disease Besides all that hath been said this only account which Mr. Loss gives of this Patient's Sickness is also false either this young Lady was too hard for this old Gentleman by concealing her over-heating her self at play and then drinking cold Beer or else our trusty Observator according unto his manner of seeing and proving things in his Observations never troubles himself to examine the business but easily takes upon trust what as easily he puts forth in Print But suppose we that what he says were true let 's a little dive into his profound Philosophy I know this old Gentleman is no friend to the new Philosophers he had rather that those that went before him should be accounted wiser than any that come after him Antiquity he reverenceth but he doth not consider that the younger generation of Men is the older World and that as all things else here below so Knowledg and Learning cannot but grow and increase by time and the daily experiments and inventions by which it is improved and advanced or else for which I see no reason he must conclude that Learning is past its Zenith and upon the decline I shall not therefore trouble him with questioning whether Heat be an Accident or a Substance I mean that Heat which he saith so easily causeth a Pleurisie by melting the Humors but I ask him in what Subject it is It 's plain that he means by Cold the cold Air that which caused as he says this Gentlewoman's sickness and therefore I presume he means by Heat the hot Air. But how hot Air can insinuate it self into and single out the Pleura a membranous and colder part and yet there by melting the Humors easily cause a Pleurisie I cannot easily understand I acknowledg it may help to increase Choler in the Body which abounding may take fire and inflame the Blood and I can easily imagine that some of this inflamed Blood may strike to the Pleura and inflame that but then this is contrary to what Mr. Loss would have for thus the Fever must needs precede the Pleurisie whereas he says positively that the
this Mr. Loss seems not to have considered of at all though it be evident that this Age is one sign of the Predominancy of Blood for Riverius in Cap. de Signis Sanguinis in Corpore Predominantis amongst the efficient Causes of it reckons this Age for one Aetatem a Pueritia usque ad pubertatem Now Childhood in a large sense is one of the four stages of the Life of Man Youth middle-Age and old-Age being the other three And this stage of Childhood is subdivided into four parts Infancy lasts till four years old some say until seven Pueritia or Boy-hood lasts from seven to fourteen Puberty from fourteen to eighteen and Adolescency from eighteen to twentyfive Pueritia therefore from seven to fourteen years old is an efficient Cause of the bloods Predominancy in the Body for the Temperament now is hot and moist and so is the Bloods Children also do eat much and being full of play and exercise they generally digest well and they have neither cares nor fears nor any inordinate passions to waste or drink up their Blood at least its Life and Spirits so that this Patient 's not being fourteen years old at which Mr. Loss hath ignorantly made all this stir did in truth more Coindicate than Contraindicate her bleeding 4. Her Part Affected which besides her Heart was her Pleura or Side which being a Membranous part in its Substance and Temperament Spermatick not Sanguifick having exquisite Sense and in its situation being neighbour unto the Heart a part that upon all these accounts was very unfit to have any Blood much less inflamed Blood poured out upon it did also Coindicate Bleeding partly that it might be relieved from what it already suffered by having strength to discuss or concoct it whilst it was not much partly that it might be delivered from the imminent danger of new hot Blood flowing unto it by a Revulsion of it with bleeding To her Non-Naturals did belong 1. The Air to which belongs the time of the year when she lay sick It was in the Spring a Season most seasonable for bleeding for like the Sap rising in the Trees our Blood also Ferments afresh the Time it self being hot and moist and the return of the Sun towards us gives us a sort of new Life and Spirits Besides The approaching Summer gives something of encouragement to venture bleeding because in it we may the better hope for a fit Time to recover in if we should lose a little strength by bleeding 2. Eating and Drinking This young Lady drank cold Beer when she was hot by which sudden alteration that motion which Nature was then in a centro ad Circumferentiam her Body being in a Sweat was inverted a Circumferentia ad Centrum the Spirits retiring upon this Alarm inwards whither also by this means were carried all or most of those Superfluities which before were reaking forth and passing per habitum Corporis hereupon she fell into a Fever and because her left Side was weak by default in her Spleen by Catarrhs falling on her left Breast and by use and Custom of Humors falling formerly to the Issue in her left Arm with the Fever she fell into a Pleurisie in that side which doth Coindicate bleeding as the Cure of it 3. Motion and Rest To her Motion did belong her over-heating of her Blood at play by too violent exercise This also as a cause of her Fever and Pleurisie did Coindicate the Remedie of them bleeding 4. Passions of the Mind Her being merry and cheerly and full of play did contribute also unto the increase of her Blood and in some small measure coindicate bleeding Contraindicantia here were none The Reader may please to take notice that Indicantia and Contraindicantia do belong to things Preternatural which can be none other than these three The Cause of the Disease the Disease and the Symptoms I have already above shewed that the Disease and the Cause of the Disease did Indicate bleeding by Lancet let Mr. Loss shew how either of them did Contraindicate bleeding by Lancet in this Patient What concerns the Symptoms they do never Indicate or Contraindicate as such indeed when they urge they are considered of as a Cause and so weak strength as a Cause of increasing the Disease doth many times Contraindicate bleeding but that cannot be pleaded here Coindicantia and Correpugnantia do belong to things Natural or Non-natural even unto all such as are either Causes or Signs of a Patient's Strength I have shewed above that there were Coindicantia of bleeding this Patient let Mr. Loss again produce the Correpugnantia Juvantia and Ledentia are very good Topicks by which may be proved in a good measure the agreeableness or unagreeableness of any Remedy made use of and the success in this Case is not to be disputed And by this time I hope I have sufficiently proved my second Proposition that this young Gentlewoman might be bled by Lancet 3. That Mr. Loss was to blame that she was not bled by Lancet before the sixth day To quit himself I think from this fault was I suppose the main reason he opposed my bleeding her The sooner one bleeds in a Disease that doth require it the better for why should a Disease be suffered to take rooting or to grow to an height and hazard a Patient's Life if it may be prevented But this Patient's Disease did require opening a Vein Therefore Mr. Loss was to blame it was not done before the sixth day I do not know that the Major needs any Proof The Minor hath been proved already And Mr. Loss doth confess that he did think of bleeding this Patient in the beginning if we may believe him for saith he Venaesectio summum in Pleuritide commodum afferre solet Bleeding in a Pleurisie useth to be very advantageous His only obstacle was that the Patient was not fourteen years old but that was in truth no obstacle as hath been proved In the beginning of this young Ladie 's sickness there was none other Physician but Mr. Loss there was then no animosity or prejudice against any other Physician for to his Cure alone her Life was recommended and no body disturbed or hindred him from doing what he thought best that he did not therefore bleed her by Lancet cannot be well attributed unto any thing else but to his ignorance he did not know that a Vein might be opened in a Child under fourteen years old or if he did he was yet more to blame And thus much for his Second Accusation To his Third Accusation That the bleeding of her by Leeches which had been appointed was of no moment WE have an English Proverb Better is half a Loaf than no Bread and it is true also if we cannot do as we would we must do as we can Where the Lancet may not be had I never said bleeding by Leeches was of no moment but I do say in this Case it was but of little moment For it
was this the sixth day of the Disease To his Fift Accusation That this Patient was not bled in the Right Place From the right Basilick Vein of the opposite side that which Fuchsius says is an Error THat I bled this Patient in the right Arm I do not deny nor yet that Mr. Loss opposed me in the Consultation I told him that to satisfy Revulsion meaning proper Revulsion not that which is a sort of derivation it ought to be in the contrary Arm but he told me that whether it were for Revulsion or Derivation it must be in the same Side where the Pleurisie is And because I was not of his opinion he urged against me the Authority of Sennertus at which I wondered and told him if I understood Latin Sennertus was against him and the next day Mr. Hern a Divine at whose House the Patient lay sick coming to my study to ask if she might drink Beer with a Toast after her Physick I then shewed him Sennertus and in him the Figure engraven on purpose to shew the difference of bleeding for Revulsion and for Derivation and we did both admire that he should so mistake an Author which himself quoted But it seems having since studied upon the point though he quoted Sennertus his meaning was the most Learned Fuchsius For my part I do not intend to trouble my self or the Reader with a dispute so well and so largely handled by Sennertus who hath taken the pains to relate the opinions of near thirty several Authors touching this point and amongst them Fuchsius is one and yet Sennertus holds for me I shall only tell the Reader what Reason I had to bleed this Patient in the contrary Arm. I took my Indication for bleeding her from the Putrid Fever which was her principal Disease and not principally from her Pleurisie which was Symptomatical Now the Putrid Fever did not Indicate bleeding either for Revulsion or Derivation but Evacuation only That part of the putrid and corrupt Blood might be carried off which did burden Nature and make her unable to manage the mass of Humors in the Vessels and this Evacuation might be performed as well in the right Arm as in the left But beside the Putrid Fever I had to consider of in this Patient a Symptomatical Pleurisie in her left Side and that which made Mr. Loss so fierce for bleeding on that Side was in my judgment a main reason for the contrary for seeing bleeding for the Fever might be indifferently done in either Arm who would have chosen to have done it in the left thereby drawing the Humors more to the weaker side weak formerly as hath been mentioned and now much more so by the inflammation of the Pleura on that Side and not rather in the right Arm by which at once Revulsion was made from the Pleura inflamed and Evacuation of the putrid and inflamed Blood fully as well if not better performed than in the left Side so that what Mr. Loss alledgeth as my fault that I bled her in the right Arm would have been my fault if following his counsel I had done it in the left I know well that bleeding in a Pleurisie is usually in the same Side and I have many times so Practised when I had no fear of any great Plethora or of the flowing of Humors to the part especially weak before and when the Pleurisie was more urgent than the Fever But at this time here was no Pleurisie at all if we may believe Mr. Loss and yet angry he is that I would not help to bring it again by drawing the Humors what I could to her weak Side I could fill up much Paper upon this subject but I am not willing to anticipate Mr. Loss his Reply he may perhaps pick much meat out of this Goose-Eye yet My comfort is that although I am for the opposite Side hitherto as luck would have it it hath been for the right To his Eighth Accusation That I Purged her He gave her powder of Sena by which she was six or seven times Purged THis is the first of those faults he finds concerning Purging of her That I did Purge her In the Consultation he would by no means give way that this Patient should be purged for fear a Diarrhaea should happen and he was so angry when the Purge was given that he went from Mrs. Moore and left her to her great discomfort There can be no greater reasons to be given that I know of why a Physician should purge his Patient than these Here were Indications Coindications and there were non-considerable Contraindicantia or Correpugnantia As Plethora quoad vires did indicate her bleeding so did Cacochymia her purging that the foulness of the first region and her abundance of Choler might not still add fuel to her inflamed Blood but be removed her strength and bilious Temperament did coindicate I need not be so punctual in this particular of her purging because I have been so above in that of her bleeding Mr. Loss seems to oppose two Contraindicantia unto this which I did Obj 1. The Disease it self inasmuch as he judged that it was a Pleurisie did forbid purging Resp I do readily acknowledg that a Pleurisie as such doth forbid purging for that is not the immediate way to remove the inflamed Blood from the Pleura nor yet any corruption that is there gathered The Conjunct Cause of a Pleurisie must be either evacuated by bleeding dispersed or expectorated and purging seems a contrary motion But yet I say That in the Cure of all Diseases the first Indication that is to be satisfied by them that understand the Art though sillily neglected here by Mr. Loss is the removing of the Antecedent Cause He spent all his shot at the conjunct cause the asswaging of the pain in her Side and the helping of her expectoration and was so far from bleeding her by Lancet and purging her that he did not only neglect them himself but was so ignorant as to find fault with another in print for doing them thereby discover his own want of skill Had he understood himself aright he would not have been so mad as to have hazarded his Patient's Life by acquiescing in his safe Medicines his Emollient and cooling Glyster Fomentation Cataplasm Linctus c. in the interim to suffer the opportunity of Cure and the strength of his Patient worn out by sickness to pass away But this is his safe way of Practice for which he hath been long famous storing his Patient with Juleps Almond-Milks Pearle-Water that is a little Cordial-water with a little Cinnamon-water sweetned with Manus Christi perlata and let these that thus admire him use him still But with what reason can any Physician approve his this way curing of a Pleurisie whilst the Fever was yet permitted to rage or who besides him could have been so confident of success in expectorating the Conjunct Matter whilst yet the Antecedent Cause was so