opportunity of gratiâ—ying Oppianicus his Mother in law a courtesie the other had oftentimes done for him before I believe there were no Apothecaries at that time in that place but in 1220 or 1221. when Physick was first made an Vniversity-Faculty and Doctors thereof created in imitation of those in Theology then were the Profession of Physick and that of the Apothecary made distinct and that with so mnch caution that it is a question amongst the Imperial Lawyers Whether a Physician may have any manner of Contract with An Apothecary though to drive on other Traffick than that of Pharmacy In the Lombard-Chronicles there are many cases of Princes and no doubt than others by Physicians there was one Sedechias in the dayes of Charles sirnamed the Bald in France and in the reign of Queen Elizabeth one Doctor Lopez and Giulio If some mens reading extends not to this knowledge I would have taught D. M. and W. C. this and much more had not the Artifice and interest of some men debarred me from publishing it If any man can shew me any Dispensatory made by any European Physicians since there was so much as a Graduated Doctor that was previous to the distinct Profession of Apothecaries I will own then though it be a certain untruth that the practise I do not say practising of the Apothecary in the Quartane was contrary to the rules of Physick and the case well proposed by D. M. All men are at the mercy 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 maâ—e 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 Therapentic 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 lave 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 hâ—â— 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 Galenists 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 followers of Erasistratus upon this subject But above all that ever intermedled I will give this character to Thomson that never did any presume more upon so weak grounds Nor ever was Confidence so poorly mounted and so pittifully be-jaded After much trouble and enquiry the sum of all he sayes in this case amounts to this The promiscuous mass of Bloud which flows in the Veins and Arteries he divides into three parts the one is called by him the Latex the second Cruor the third Sanguis or most properly Blood The Latex so called by Helmont by some Lympha by the Greeks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 is a diaphanous clear liquor 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 fabricated in the second digestion by virtue of a ferment there residing It is the inseperable companion of the Bloud and closely pâ—rambulates with it through all the wandring Maeandrous pipes in this Microcosme It is the matter of Vrine and Sweat Spittle c. and renders several other considerable services to the body The goodness or pravity of the Latex depends much upon the bloud as it is constituted for albeit it is no essential part thereof yet is it altered for better or worse according to the channels it passeth through the lodging it taketh up and the condition of its associate notwithstanding that it may be sometimes impaired in its due excellency and the bloud withall remain very pure and sincere The second part is called Cruor from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 i. e. Crudus concretus It is the more crude impure part of the bloud the purer part of the chyle being digested into a saline juyce is carried into the milky vessels and veins and mingling at last with that ruddy liquor is called Cruor and at last becomes perfect bloud It undergoes manifold guises and is often the subject matter of a multitude of diseases being sometimes changed into an Ichor Tabum or Sanies The third part is properly called Sanguis or Bloud 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 it is a most pure sweet Homogeneous Balsamie Vital juyce for the most part of a bright Red or Reddish colour made by the Archaeus by virtue of ferments implanted in the ventricles of the heart lungs veins and arteries causing a formal transmutation of the Ckyme or milky substance into this sanguineous liquor ordained to be the seat of Life and and the principal matter for sense motion nutrition accretion and generation It is for good reason called Balsamum seu Condimentum totius corporis â—orasmuch as it hath a sanative power sweetly uniting all the parts of the body for the conspiration of the good of the whole It is a great preservative against putrefaction as long as it remains in its integrity for consisting of many saline particles it seasoneth whatsoever it toucheth with a pleasing sapour It is the proper habitation of the vital spirit the immediate instrument of the soul in which it shines displaying its radiant beams every way that sensation motion nutrition and all other functions may be exquisitely performed God and Nature never intended other then that the bloud should be Homogeneous pure plain symbolical with that single principle of the Vniverse Now these Peripatetick Philosophers deliver to the world that the contexture of this vital juyce is made up of Choler Phlegm Melancholy and Blood which united produce this compounded body which we call Sanguis How grosly erroneous and dangerous this Tenet is most Learned Helmont hath made evident Wherefore we conclude with that noble Philosopher that Bloud is an Vnivocal substance divisible only by some external accidental means as the Air or Fire which cause a various texture and different position of its Atomes whereby it seems to consist of parts which are not really inherent in it as is manifest in its degeneration from its native colour sapour consistence and goodness which it had before it became corrupt in the pottinger or underwent the torture of fire Both of which do strangely larvate and disguise the puniceous Balsome giving occasion to the Galenists to frame their four fictitious humours no where really existent This being the foundation of all his declamations against Phlebotomy before I proceed any farther it may seem requisite that I should make some Animadversions thereon I might take much notice of and dislay his errours as to what he sayes that the Latex is by the Greeks called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 this is the first time I ever read it called so the usual terms being 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The notion whatever Helmont say is not new at all an hundred Galenists have mentioned and treated of it as the vehicle of the bloud and nourishment But that cruor should come from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 crudus concretus is an opinion singular to the Baconical Philosopher That 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 doth signifie cold I know well and that cruor properly signifies the the bloud of dead people or the mortified bloud issuing from putrefied wounds I no less understand though Authors frequently confound it with Sanguis But that his Latex and the Lympha so called by moderns are the same is news for it is not held that the Lympha in its peculiar form was pre-existent in the Arteries and as such did accompany the Blood through the Maeandrous piteâ— but is generated as it is discharged into the Lymphaeducts and from them is re-mixed with the bloud And if it were yet would not the definition of this Latex agree with it for the Lympha is no inseparable companion of the bloud as appears by its peculiar vessels it is seldome a diaphanous clear liquor being commonly tinged with several colours oftentimes whitish sometimes yellow or as it were stained with bloud And whereas this Latex is devoid of all sensible qualities those who have experimented the Lympha do not find any such thing but a variety of tasts Nor is it true that the Serum which accompanies the Bloud is such a Latex as our Helmontian describes it being never to my taste free from a salsuginous sapour though it retain that with a great Latitude nor devoid of colour so as to be clear and diaphanous and 't is very seldome seen that the said Serum will not coagulate unless preternaturally upon a gentle fire so that it is no more to be termed a Latex than the whites of eggs beaten to the like fluidity In like manner that in the Lympâ—aeducts will coagulate as Bartholin observes and others As for the Cruor that there are graduations of the Bloud as to its crudity and impurity is no doubt amongst the Galenists and that it may oftentimes transcend the state of due maturation and so become degenerate is as easily granted as that it should come short of its desired perfection and when this Blood degenerates any way into a Tabum or sanious matter I must tell him
improper to admit of our Phlebotomy to be stiled our direct Method oâ— curing because it is but a part of our Method which will include if not some other prescriptions yet at least dyet In many cases we use Phlebotomy as one part of our Method but not as the principal as when we use it antecedently to other remedies Pharmaceutical and dietetical to prepare way for or facilitate their happy operation I am not now to write Institutions in Physick for the documentising of this Disciple of my Lord Bacon 't is enough that he may learn any where almost as in Vallesius Mercatus Claudinus and Plempius that we propose more than one scope to our selves in Blood-letting neither is it ever except in diseases arising from a partial or total Plethora our direct method of healing If it be but a part and necessary or useful part thereof we are sufficiently justified Thus his Major is enervated for if he would have opposed the modern practise he ought to have urged it thus The means used to let out bad blood without removing the efficient cause thereof is no direct Method of healing nor an useful or necessary part thereof This is manifestly false as I shall shew anon As to his Minor That Phlebotomy lets out bad bloud without removing the efficient cause thereof This would the Ancients deny who bled their Patients in many cases until they swooned or fainted with great success â— and we must say it is not absolutely true there being no Practitioner I believe but hath seen some cases in which sole Phlebotomy hath effected the cure he may see many Instances of this in Botallus and that in diseases where the body was undoubtedly cacochymical I have seen Agues tertian and anomalous perfectly cured with once bleeding in women with child and in children I have seen some Atrophies so cured that the principal cause of their recovery was to be attributed to their Bleeding the like I have observed in several Chronical diseases even in inveterate quartanes as also others have done nor is there any thing more common almost in our Cases than the relation of several diseases absolutely cured by single Phlebotomy which I shall not transcribe here but in my large discourse of Phlebotomy in Latine I intend to represent all such cases at large with their circumstances and the History of Phlâ—botomy with all that variety of success which judicious Practitioners relate of it in several diseases and persons I add now that No man can be an accomplished practitioner who is not versed in the History of Diseases and particular cures for the general rules and directions make no more a Physician than such a knowledge in Law would do a Lawyer the res judicatae import more with us than they do in Lawâ—cases and as Reports of the Iudges in special cases must be known by a compleat Lawyer so must our Book-cases be our presidents and regulate our practise Duobus enim tanquam cruribus innititur Medicina neque solis theoreticis rationibus contenta insuper etiam practicas experientias particularium requirit indefessam ad singulos casus intentionem Thus is his Minor false as was his other Proposition and it should have run thus But Phlebotomy lets out the bad blood without removing the efficient cause thereof or conducing thereunto But he proceeds to defend the Minor thus If the Cause of bad blood were removed then would the effect cease but oftentimes we see that notwithstanding such a depletion the disease continues and if it be not mortal yet it becomes more truculent Here he commits the same errour that before expecting a greater effect from Phlebotomy than we propose generally to our selves in it we do it sometimes for revulsion of the matter flowing to any part as in some Pleurisies Squinancies the Colick Bilious and Rheumatismes c. wherein we never rely solely upon bleeding and though oftentimes the effect transcend our expectation yet do we not presume upon it Sometimes we let blood for prevention of future diseases as in great contusions and wounds Sometimes we let blood only to prepare way for future Pharmacy Ita plerumque in febribus mittitur sanguis qui non superat naturalem mensuram neque simpliciter neque in hoc homine sed quia nisi mittatur ob febrilem calorem qui adest succorum putrescentium mistionem corrumperetur ac fortasse malignè cutis rarefactioni ventilationi vasorum relaxationi ad futuram expurgationem necessariâ— impedimento esset Itaque mittitur non quia multa subest copia sed quia ea quae subest tunc est inutilis noxia ac proinde facultate ferente deponenda etsi causa morbi non inclinet ad ideam sanguinis modo non ab ea plurimum evariet i. e. Thus in feavers we usually let blood not that the blood abounds above its due proportion either in general or in reference to this or that individual but because the blood which flows in the veins is infected with a feavourish heat and would be corrupted thereupon and by reason of the intermixed humours now inclined to putrefaction and that perhaps joyned with malignity for the prevention thereof and least that plenitude and depravation of the Blood should hinder that transpiration in the habit of the body ventilation of the blood and laxity in the vessels which is requisite for the subsequent purge do we use Phlebotomy not imagining that there is any superfluous abundance of blood but that there is then in the body some that may well be spared and which if the Patient hath strength to bear it may with prudence be let out to prevent so great dangers as are imminent and to secure unto us the good effect of the subsequent Physick And if the disease do sometimes encrease upon Phlebotomy it behoveth wise persons to distinguish whether those symptomes happen by reason of bleeding or only succeed it in course the disease being in its increment for this makes a great difference in the case as also whether amidst those symptomes which are in due course most violent in the progress and state of the disease whereas we bleed usually in the beginning only there be not some that yield signs of concoction and melioration which if they do as we may justly attribute those hopeful consequences in part to Phlebotomy so we need not be amazed at the present truculency of the disease which affrights none but the ignorant If notwithstanding all our care and due administration of Medicaments according to Art the Patient do dye yet is neither Phlebotomy nor the other Physick to be blamed but we ought rather to reflect upon Physick that 't is a conjectural skill in the most knowing men and that we are not as Gods to inspect into the bowels and secret causes of diseases that besides the special judgment of God upon particular persons all diseases are not curable in all individuals either by reason of the
fuerit nulla insalubris aeris anomalia quae febri occasionem submiâ— nistraret Nihilominus etiam hujusmodi homines praecedente insigni aliqua aeris vel victus caeterarumque rerum non-naturalium ut vocant mutatione identidem febre corripiuntur propterea quod eorum sanguis novum statum conditionem adipisci gestit qualem ejusmodi aer aut victus postulaverint minime vero quod particularum vitiosarum in sanguine stabulantium irritatio febrim procreet 'T is true he did not pen it in Latine but another Mr. G. H. for him and perhaps his skill in that tongue may not be such as to know when his thoughts are rightly worded But it seems strange and irrational to attribute such an understanding to the Blood and to transmute a natural Agent into one that is spontaneous and which is more having represented it as such to make it so capricious as not to know when it is well but to run phantastically upon such dangerous changes as occur in putrid Feavers and the Small Pox for even in this last ariseth from a desire the Blood hath to change its state Since natural Agents demean themselves uniformly and of them 't is most true Idem quatenus idem semper facit idem I was surprised to see these new principles and to see effects of this nature arise without any cause It doth not seem possible for him ever to demonstrate that there is no Plethora or Cacochymy or obstipation of the pores of the body antecedent to a Feaver nay the contrary seems evident to all Physicians nor ever was there any whereunto they did not attribute some procatarctick cause Besides he doth not alledge any Reasons or Experiments to shew that there is any alteration in the blood before and after the Small Pox or a Feaver or any difference betwixt the Blood of such as have had those diseases and of those which have not had them So great a supposition ought not to be made without ground And since it is natural and Nature is constant why is not the Disease more ancient and universal than it appears to be For if there be any grounds to think the Small Pox to be of long continuance 't is certain 't is but seldom spoken of by any old Writer perhaps once by Hippocrates yet so as never to be understood by any that hath not seen the indisposition and never by Galen It may be imagined to have come from Aegypt by contagion and might have been called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Quia urbi Bubasti Aegyptiae familiaris hic morbus It infesteth some places more than others In Graecia non adeo frequens Ideo antiquiores Medici vix ejus meminerunt In the West-Indies it was not heard of till the Spaniards came thither and they as also the English there seldome have it I believe the Disease to be novel and of no longer date than the Sarracenical revolution I could instance in the nature of such great altâ—rations that they have ever been preceded and accompanied with many peâ—ty changes in other things and if ever I have so much vacant time aâ— to make political reflexions upon the rise of Mahomâ—â— I may declare much to this purpose This is that invidiâ—us subject about which Eâ—â—bolius Glanvili makâ—â— so â—uch noise as if to avow that Mahomet â—ere a Gentleman of noble extraction marrieâ— to one who â—â—r birth riches and beâ—uty might hâ—ve bâ—en a Princâ—ss and accomplished with that sober Uertue Wit â—lâ—quence and Education by much travâ—l â—or he travelled all over Aegypt Africk and â—pain aâ— to â—â—nder himself one of the most considerable of his Age or to say that the Christians were so ignorant and debauched and perfidious and addicted to Legends more than to the sound Doctrine of the Gospel at â—hat time that most of the Fables in the Alcoran were accommodated to the honour of the times more than to truth â—nd so Mahamet told them or to say He pretended to revive Ancient Christianity were to be an Apologist for the Mahometans and an abettor of the Alcoran Whereas none but the Illiterate can deny these things and the Age our Virtuoso speaketh of is the Age of Apostacy according to the Doctrine of our Church Oh Heavens to what an height is Impudence and Ignorance arrived Or what can be safe if so prudential and generous a design as I had must be calumniated by such a R in this manner Bnt to resume my discourse in the behalf of my opinion concerning the novelty of this disease besides what the learned Mercurialis hath said I shall conclude with the words of Rodericus a Fonseca which are these Si ex nativitate esset ab initio mundi fuisset aut saltem ita frequenter tunc ut nunc solet esse et licet antiqui aliquam de his pustulis mentionem fecisse visi sint ea certe exigua est dubia ut câ—rtum sit vix illis temporibus fuisse talem morbum negligentissimi certe habendi essent si tam ingens commune frequens malum illotis manibus silentio involuissent cum morbus sit puerilis Hippocrates eas numerasset inter aetates 3. Aphor. ubi diligentissime puerorum morbos connumerat tamen nullam hujus mali fecitmentionem sed illud satis demonstrat hunc morbum novum esse quod in multis mundi partibus nunquam visus fuit ubi nunquam apparavit nisi postquam Hispani eo pervenere siquidem per contagium Aethiopis cujusdam illuc delati magnam Indorum partem sustulit I might here insist upon the Hypothesis of Doctor Sydenham concerning the Inclination of the Blood to change its state I cannot believe but that the Physicians understood themselves as well before he writ when it was said that there was in every one that was born something of impurity in the body which was naturally to be purged out by an ebullition in the blood and such an effervescence as terminated in those Abscessus called the Small Pox. Quandoque accidit in sanguine ebullitio secundum semitam putredinis cujusdam de genere ebullitionum quae accidunt succis talia quidem accidentia fiunt per eam ita ut partes eorum ab invicem discernantur Et de hoc est cujus causa est res quasi naturalis faciens ebullitionem sanguines ut expellatur ab eo illud quod ad miscetur ei de reliquis nutrimenti sui menstrualis quod erat in hora impraegnationis aut generatur in eo post illud ex cibis faeculentis malis de illis quae rarificant substantiam ejus faciant eam ebullire donec fiat substantia recta fortior prima magis apparens sicut illud quod natura efficit in succo uvae ita quod rectificat ipsum faciendo vinum similis substantiae jam expulsa est ab eo spuma aerea faex terrena He that can English this
as an efficient cause the the perfect Idaea or image of this specifick disease is pourtrayed part of the vital spirits being as it were tinged by the intermixture of these contagious particles and part remaining in its integrity being exasperated at the presence of such an hostile intruder stirrs up nature i. e. musters up all the faculties forces or strength belonging to the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or Archaeus and withall summoning the Latex or Lympha to be assistant to the ablution and ablation of this fermenting malign impurity which is sent forth by an extream sweat The inward procuring occasional excitative cause was a pestilent venome a tabefying matter immediately lodging in the degenerate juyces about the stomach and spleen Hâ—lmont's duumvirate not in the veins or fictitious humours which sending forth fetid putrefactive particles annoying the Archaeus caused an indignation or fretting disposition at presence of that which is altogether Exotick and incongrucus with nature whereupon thus put upon the stress it exerts all its power and faculties to the expulsion of such a virulent Guest performed most conveniently by large sweats before which there must necessarily precede a feaver from the collision conglomeration tumult and confusion of the vital spirits thus assaulted as is frequently observed to fall out when any extraneous thing to Life getteth into the flesh to wit a thorn or splinter so that a feaver is but a consequent of the fury and rage of the Archaeus and a precedent of the expulsion of the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the matter of the disease In this discourse there are so many un-intelligible canting terms that to speak well of them a man must be a Virtuoso for that kind of men being obliged by their constitution to be very civil one to the other will bestow the Elogies of Learned and ingenious upon the most ridiculous speaker that ever opened his mouth amongst them The turning of a malignant vapour into Gas Sylvestre and making them synonimous is an unpardonable errour in the Helmontian Phylosophy which makes the Gas and vapour to be distinct things in nature Itaque Gas distinguitur à vapore quod in hâ—â— sal assurgat cum mercurio habeat sulphur inclusum Gas vero sulphur extravertit atque subdividit The plastick power of the Archaeus are empty words and more difficult expressions than ever poor Aristotelian used The whole paragraph is nothing but jargon and non-sense yet suiting to the revocable Hypothesy of this Age. The juyces in tâ—e stomach were not degenerate seeing that the disease did invade the most youthful and healthy His placing of the infection in the degenerate Iuyces of the Stomach and Spleen and Latex another canting term is contradictory to what the Lord Bacon saith that the malign vapour did flye to the heart and seized the vital spirits and not the mass of blood or other grosser juyces called Humours Oh most excellent Advocate and Baconical Philosopher If it did not invade and affect the blood how came those sanguinary evacuations 'T is to no purpose to reply that the bloud and other humours which composed that fetid sweat and occasioned the heat thirst and other symptomes were only secondarily affected for then in the declination of the disease there must have been Carbuncles or spots according to that Iudicious Historian I think the Galenisâ—s give a better account of it when they say that a particular venome or peculiar kind of superlative putrefactiâ—n did at that time infect the air which encountring bodies predisposed to sweating-diseases by the heat and moisture of the preceding year 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Quando aestas est similis veri tum sudores multos in febribus expâ—ctare oportet or perhaps by celestial influences occasioned that disease whereof the Cure was to be learned it bâ—ing a new disease â—rom the observation of that course by which Nature did ease it self for of all the venenate qualities which by infection of the air or diet are ingendred â—nd commixt with the constitutive parts of men scarce one produceth the same sâ—mptomes or is cured the same way by which another is Thus some spotted feavers have been cured by fluxes others by sweat and urine some have had tâ—eir critiâ—al motions others have been so malignant as to admit of no such periods or delayes And hence it is that very eminent Physicians have not restrained the name of Plague to any one form of disease but left it unconfin'd In this disease since none recovered but by sweat and most recovered that were sweated moderately according to the relations given it was their business to promote Sweat and therein to shew themselves subservient to nature and herein the latter part of my Lord Bacon's account agrees with that of the Phâ—â—â—cians viz. To keep the Patient in an equal temper both for clothes fire drink moderately warm with temperate cordials though it be most false that Nature was stirred to cast forth the venome by extream sweats for such dyed and therefore such emotions must have been the consequence of Nature erring through a virulent irritation or fainting under a putrid exolution As for the comparison betwixt this venome or Gas which Thomson understands not what it is being ignorant in his own principles and a thorn or splinter 't is most absurd for those occasion only symptomatical Feavers these venenate aerial or dietetical poisons produce originary and real feavers they are intimately commixed with the mass of bloud and humours and as in fermenting Wine or Ale the incoercible Gas hinders not the purification and generation of those generous liquors so neither would it here but 't is rather like those ferments or mixtures which corrupt the VVine or Ale several wayes according to their several natures but are not comprehended under the name of Gas peregrinum sylvestre But I will not give my self the trouble of instructing these ignorant Baconical Virtuosi 't is an endless work 't is enough that Helmont supposeth that the Gas endureth not the Sulphur whereas these noysome Sweats must have had much of that if the Chymical writers may be believed As to the reason which my Lord Bacon gives why it was not seated in the veins or mass of blood because there were no purple or livid spots nor carbuncle or the like In defence of that all that Thomson sayes is That the reason did well become him which I easily grant since he understood not Physick for in reality the effects of this Anomalous poyson was most eminent in the Serum or Latex a concomitant of the bloud a great depraved quantity whereof was collected in the body through the then unaccustomed ill natural texture of the air c. This is all that he saith to the purpose wheâ—â—in for proof he gives us his own assertion which the most illiterate Mountebank or Virtuoso may do and 't is contrary to all those presumptions which the History of the disease doth suggest unto us
though one of the best of the Chymical practisers did not gain him credit in Switzerland but that his famed extracts proved fatal to many persons of quality there There is not any thing so lying as a Chymist and the Medicines they boast of and the Laboratories they talk of so much are commonly found to be delusory braggs I shall not prove this out of Agyrto-mastix nor insist upon it that Mr. Odorde did pretend to as great Arcana as any of the Fraternity God had been pleased to communicate unto him a Method in the plague to preserve thousands from the grave which he promised to administer publickly and freely to all that should desire it Yet did he and his wife dye thereof in 1665. They will write books of Theories Processes and Medicaments yet never make or try them Thus Faber of Montpelier writ much in Chymistry but most notorious untruths An eminent person told Becherus that being excited with the renown of the man and a curiosity in Chymistry he went from Italy into France on purpose to converse with him but could not find that he had so much as one Furnace or was at all versed in the practice of Chymistry So Agricola who writ upon Poppius was put to publick shame by an Apothecary for writing so many untruths So that it behoveth the people to consider not so much with what impudence a man vaunts himself 't is an usual sign of a proportionable ignorance and imposture but to examine rather as I do the solidity of their aiscourses and efficacy of their Medicaments 't is not a casual cure that makes a man knowing 't is not a sudden alleviation which lasts not long and perhaps throws the Patient into a worse disease or destroyes him in a short time that argues the goodness of his Medicines No the constitutive qualities of a Physician are skill in the real causes or such as are as effectual as if they were so and the signs of diseases the diagnosticks and prognosticks and a Method of curing authenticated by the History of Medicine and Medicaments such as the Experience of Sage practisers recommends unto us to which end he must be well read in the History of the Materia Medica and not set up with two or three praxes these render him accomplish'd He that understands Humane Nature best and the operation of the non-natural and preternatural things upon it is the person to be employed not everry one that can proclaim a catalogue of diseases which oftentimes are of necessity to be cured several wayes and boast of effectual pleasant and universal medicaments is to be regarded 'T is not the most acute experimental Philosopher that is the best practitioner many Theoremes are plausible which practice refutes this was the death of Van Helmont thus Des Cortes died of a pleurisie when through a prejâ—dicate novelty he refused to be let bloud 'T is not great ingenuity and parts employed in florid or different studies that make any man a competent judge of a disease or the operation of a Medicament The Lord Bacon is a great instance of this truth and the instance of the Sweating-Sickness convinceth us of the vanity of him and the Comical wits in their pretences to discourse of or reform what they so little understand I had thought to have prosecuted some other points by him agitated and to have demonstrated the vanity of the courses he takes and Medicines by him recommended and to have vindicated the ancient Physick and Medicaments particularly and given an Historical account of the inconveniences that have befallen this last Century by reason of these Pseudo-physicians but I have not leisure now to do it nor is my Adversary so considerable that I should take so much pains to expose him what I have writ here is enough to shew his intolerable ignorance and folly and represent him as unfit to be entrusted with the life of any man A POSTSCRIPT I Think I cannot better conclude this Treatise than by representing to Thomson that account which he himself gives elsewhere of the Sweating-Sickness for thereby it will appear how out of an ambition to contradict me he opposeth himself yet is even that as little agreeable to truth as 't is to the relation of my Lord Bacon G. T. Of the true way of preserving the Blood pag. 24. Here I cannot but make an animadversion upon that truculent disease which formerly raged in England to the destruction of some thousands It had its original undoubtedly from a degenerate Latex turned into a malignant Ichor which caused a tabefaction or colliquation of the Blood and nutritive juyce which issuing forth in a copious measure symptomatically witbout any Euphoria or alleviation quickly consumed the stock of life The attempt made at first to cure this malady by stopping the sweat by astringents and cooling things proved not only frustraneous but also very mortal for the malignity being thereby more concentrated wanting a Momentaneous vent through the universal membrane it forthwith preyed upon the Archaeus extinguishing the lamp of Life in such sort as a Mephitis or subterraneous damp doth obfuscate and at length put out the flame of a Candle Now the proper adequate remedies that took effect in this feral evil were Eustomachies as likewise counterpoysons that did immediately resist the venome by obliterating the Idaea thereof by corroborating the enormon exterminating the intoxicated Ichor and ill-condition'd Latex through the habit of the body carrying it that way quo natura vergere studebat This Baconical Philosopher here directly contradicts what he would seem to assert against me viz. His Author and he say there that the mass of bloud in the veins was not infected for then there would have ensued spots and botches but only the vital spirits Whereas here he saith that It had its original doubtless from a degenerate Latex turned into a malignant Ichor which caused a tabefaction or colliquation of the blood and nutritive juyce And undoubtedly he is deceived in fixing the original of that disease in the Latex whereas it depended and had its beginning and being from a particular venome and corruption of the Air for notwithstanding that the unseasonableness of the preceding year might have depraved the bodies of men yet did both arise spread and cease so suddenly that 't is evident its original and continuance was derived from another cause Whereas he sayes it was Symptomatical 't is a sign he understands not what he sayes for symptomatical evacuations at best are neither to be promoted nor provoked but only continued whereas such as did not of themselves sweat were to be forced in this case to sweat moderately otherwise they dyed I profess I do not know yet the nature of that disease whereunto to reduce it or how to speak of it in the language of a Physician they that saw it were as much perplexed with the notion of it as with the Cure That any Physician did then
bled him in the open field the bloud fell on the ground to the quantity as he guessed of a quart when a Lipothimy approached he put him to bed and giving him a Cordial he fell into a sweat and was recovered perfectly in very few dayes There is no doubt but the practice was justifiable in men of a convenient habit of body to bear it and where neither the climate which oâ—tentimes is particularly repugnant to large Phlebotomy nor idiosyncrasie which sometimes happens or evil diet preceeding or the particular malignity of the venenate disease nor the prejudicate opinion of the people do contraindicate It hath authority from Hippocrates Galen Avicenna and many others Nature doth seem to direct us thereunto by her own excessive evacuations in that kind by which diseases are frequently acted and no evacuation is to be accounted immoderate which is beneficial By this and expurgation even to Lipothymy in the first beginning of several diseases men were cured presently nor did the maladies proceed to those times which in the usual method they make their progress through In my Exercitations against Dr. Sydenham as yet unfinished I have entreated largely of the several methods of curing which I shall not now transcribe As for that way of bleeding which is now generally in use though practised with a great latitude in several Countries and by several Physicians in the same Countrey it is most manifest that if due circumstances be regarded and all other medicaments dexterously administred it is so far from debilitating Nature that it adds to its strength mitigateth the present symptomes prevents the violence of the future and concocteth the disease apparently I will not undertake to justifie the demeanour of each particular Physician any more than I will answer for their intellectuals and skill in Physick It is not the reading of Sennertus and Riverius with a little knowledge of the new discoveries in Anatomy and a few Canting terms about Fermentation texture of bodies or such like knick-knacks and Conundrums of the novel Philosophers which accomplish a man for practice These men will never come to be ranked with Vallesius Mercatus Fernelius Dureâ—us Rondeletius Massarius Septalius Claudinusâ— Crato or Rulandus If Experience be our Guide leâ— us inform our selves by the Histories of such as they have given us of Epidemical and pestilential diseases and of particular cases as also the cures and following them let us come to practise and not deserting our own reason let us be cautioned by them These others for want of judgment to consider each circumstance cannot make an Experiment or relate it whilest they extenuate the credit of the ancient and modern Physicians that are not Innovators though more observing and experimental than themselves they do it only to excuse their ignorance in that kind of Learning and whatever they have of the Lord Bacon â— they have this of the Russe in them that they neither believe any thing that another man speaketh nor speak any thing themselves worthy to be believed For such as these or any else that do not practise Phlebotomy according to the rules of Art I cannot make any Apology nor do I think that their errours ought to extend so far as to disparage all Physicians who demean themselves prudently and discretely Notwithstanding all our care some Patients will dye no Physician can secure all men from what their frail condition hath subjected them unto If our Method and Medicaments be such as the general rules of Medicine and an Experience generally happy do warrant 't is as much as can be expected from us and the Imperial Laws allow of this defence though they punish the immethodical and novel Experimentators and the Ignorant Sicut Medico imputari eventus mortalitatis non debet ita quod per imperitiam commisit imputari ei debet pretextu enim humanae fragilitatis delictum decipientis in periculo hominis innoxium esse non debet To conclude this Argument I say that although it often happens that diseases are cured by sole Phlebotomy Evenit ut saepius missio sanguinis sola curationem perficiat Misso sanguine saepe sponte naturae expurgâ—tur corpus alui profluvio vomitu aut sudore succedente Yet no wise Artist will rely upon that alone but with the addition of other auxiliary medicaments Herein Spain and France are pretty well agreed And as no wise man will undertake to cure by bleeding alone so it is most foolishly done of our Helmontian to demand or expect it as he doth here I come now to his fifth Argument The means to let out bad blood without removing the efficient cause thereof is no direct method of healing Now Phlebotomy lets out bad blood without removing the efficient cause thereof Ergo Phlebotomy is no direct Method of healing The Major is proved thus Whatsoever suffers the cause to remain can never remove the effect For manente causa manet effectus Now Phlebotomy suffers the cause to remain Ergo it can never remove the effect The Minor is made good by frequent experience If the cause of bad blood were cut off the Feaver or Scorbute depending according to Dr. Willis upon the degeneration Sal and Sulph therein would quickly cease but we plainly see the contrary for after the veins are much depleted the disease becomes more truculent and oftentimes mortal which could never be if this depraved blood were any other than a product or an effect of an essential morbisick cause The same agent which in sanity sanguifies regularly without any considerable defection in sickness becomes exorbitant sending out a vitious juyce into all parts be it good or bad it still springs from a root which continually feeds the branches so that it cannot be other than great folly and wrong to the Patient to let out that juyce though it seem never so corrupt when another of the like condition must needs enter into its place derived from the shop the duumvirate where it first receives a previous rudiment which ought in all reason rather to be reformed than to give vent to those easily evanid particles inseparably joyned with this ruddy liquor how ill soever represented If all contained in the reins supposed to be corrupt were discharged yet as long as the ferments principally of the first and sixth digestion deviate from their right scope there would in a short space be a succedaneous repletion of a matter equally contemptible yea worse in respect of an enervation of strength than before This Argument though our Helmontian rely so much upon it is a pure Paralogisme First He supposeth that we use Phlebotomy in all diseases as a direct method of healing which is not true except in some maladies as Apoplexies Squinancies Haemorraghies or great eruptions of blood some Atrophies and sometimes in Feavers in which 't is frequent with us to rely solely or principally upon Phlebotomy yet even here we would think it very
non recipit potest recipere id quod fuâ—urum 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 Feâ—ver is never the proper remedy of â— 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 a great reverence for the name of Experience and the bare mention thereof commands an attention from me But it hath been the peculiar misfortune of my education that I have been taught not rashly to assent nor to believe every thing that is told me since there is nothing but may be spoken by some body I can be so civil and so curious as to give the Relator an hearing how mean soever he be but before I credit him I must consider whether the thing be possible and withall because my knowledge is not the adequate Measure of possibilities in nature Whether it were done If the thing did succeed I inquire Whether it will constantly or most commonly follow upon the like causes and circumstances Or whether it is a rare accident In the two first cases the knowledge thereof makes a Pâ—ysician the better Artist the latter adds to his general Science of natural Phaenomena but not at all to his Art except in cases as rare as the Phaenomenon related In Artibus inquit Galenus duo sunt praeceptorum genera unum eorum quae perpetuam habent veritatem alterum quae utplurimum ita se habent tolerantur quae raro fiunt ibi locum non habent At hodie multi sibi placent in scribendis obtrudendis observationibus raris tanquam novis Artium mysteriis sed rara non sunt Artis I do also consider the quality of the Relator the vain-glorious and ambitious are easily deceived because they passionately desire the thing should be so and 't is for the credit of such Observators if it be so the young are easily imposed upon by the little experience they have of things the credulity that is in them naturally and the good opinion or hopes they have of the integrity of others and because they are conceited of their own knowledge though the prospect of things be narrow they are prone to opiniatrity and vehement in their assertions though too unsetled and impatient as well as ignorant to weigh any thing maturely and with all its requisites I do not weigh the greatness and opulency or Relators but value them as they are Artists for such only can judge in their own Faculties And when controversies arise the Stagirite deluded me into an opinion that the most probable tenet was that which the most or the most intelligent did profess This Pyrotechnist upon many reasons deserves not any credit he writes Books as Mountebanks paste up Bills to invite custom the Medicines he recommends are such as by the sale thereof he would advantage himself all he publisheth is in a subserviency to this end and 't is not his skill but this ignorance that is concealed in his Arcana all that ever sweet William or Andrew related upon a Quack-salvers stage deserves as much of heed and esteem as what G. Thompson talks I do not ask thy pardon Oh! most illiterate and dull disciple of my Lord Verulam for dissenting from Thee But I with submission and deference beg leave for not adhering to Doctor Willis No man of understanding can condemn his practise he hath not altered the Authentick methods but given new and plausible reasons for an Ancient procedure This Character is due unto him that scarce any man surpassed him in his thoughts when awake and 't is his peculiar happiness that his Dreams are pleasant and coherent Amongst all that have written about Phlebotomy and its abuses I never met with one that recounted this for one evil consequence thereof that it inclines men to Feavers I find P. Castellus to reckon up twenty five evil accidents which sometimes ensue thereupon but this is none of them Nor do I see that it is reconcileable to that effect of Phlebotomy whereby it refrigerates the habit of the body and the common distempers which follow the Abuse of it are cold If it be true that it inclineth people to be fat and fat people are neither so hot nor incident to Feavers as the lean and bilious though otherwise more weak there is reason why my doubts should increase upon me It might with some colour have been said that excessive Phlebotomy did dispose to the Rheumatisme and Gout but not to Feavers except by accident that some persons having contracted a grosser and more sanguine habit of body upon Phlebotomy and such complexions being most capable of any malignant or pestilential and contagious infection not by reason of their phlebotomy but from the habit of body which whether natural or adventitious is lyable to those casualties falling upon any excess or other occasional cause into the Small-pox or Sanguine feavers the observation hath been raised into repute It is a thing I have not seen to happen vulgarly nor doth any Author â— that I know take much notice of that other effect how Phlebotomy inclines to fat I have read in Ioannes Fuchsius a Bavarian that such a thing hath fallen once or so under his observation in a Lady and Doctor Primrose denies the matter of fact that Phlebotomy will make those that are inclined to be fat fatter though persons that are extenuated and emaciated with sickness may by bleeding acquire a greater corpulency And certain it is that in those Countreys where Phlebotomy is most used there are fewest fat men and women as Spain France and Italy or Egypt in this last region it is their particular study and a distinct profession to make people fat but 't is by other
relates how many in the Pest at Mymmegen where he was Visitant had the Pest without any signs of a Feaver nor was this to be seen only in such as dyed suddenly but in those that had Botches and Carbuncles yet went up and down and pursued their business without being any way feaverish of which number himself was one And he with the allegations of many Authors and Histories of Plagues justifies his Definition in which he forbears to make the Pest to be a Feaver In like manner Casper Hofman living in Norimberg when the Town was besieged and the Plague raging had the Pest himself with a Carbuncle on his shoulder sed sine alio symptomate and taking due care of himself without consining himself to his bed or chamber he recovered He instances in others that escaped in the same condition With these agreeth Nardius who was chief Director in the Plague at Florence in 1630. And the most learned Massarias who was Physician at Vicenza when the Plague reigned there in 1577. Out of all which it is manifest that the Pest is not a Feaver 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 since there may be a Pest in which the sick party hath not any Symptome of a Feaver 'T is true that many learned men do desine the Pest by a Feaver and do hold that there is no Plague without one but since they confess that sometimes neither Pulse nor Vrine or any Symptome discover the least characterisme of a Feaver 't is against common sense to assert what they do in such cases It is granted that usually the Pest is accompanied with a putrid malignant Feaver of a very uncertain Tâ—pe which sometimes appears not before the Botch and its suppuration sometimes it begins with the first attacque of the venome If what I have said be true and that the Pest may be without any sign of a Feaver or any sensible indisposition I much doubt the reality of his opinion who talks so much of the affrighted Archaeus and the troubles which essentially and inseparably befal the Duumvirate of the Stomach and Spleen upon this invasion or insurrection of the pestilent venome and I am more confirmed in my jealousie because I have read that some of them that have had the Plague have not felt any symptome about their Stomach not so much as a debility of appetite but sometimes they have complained first of their heads being discomposed and most commonly of anxieties about their Heart But 't is not my intention to write a Treatise of the Plague 't is a disease I never saw though at Fulham-pestâ—house and at Windsor I gave such Prescripts and Medicines in the beginning of the Plague as did equal in effect any of the Arcana of this Helmontian As for the knowledge this talkative person should acquire by dissecting one body it is but little it argues want of reason in him to conclude generally from one case the Glory of the Act is much abated in this that Bontius and Rondeletius in the presence of many Students dissected several and which is more this last denies the Carcasses of such as dye of the Plague are not infectious so doth Fracastorius Iordanus Gregorius Horstius I allow that this last is not a constant truth and that there are some Observations recorded by which it appears that the Carcasses of such as dyed of the Pest before putrefaction have been infectious But to shew with how much injustice he triumphs over the Galenists for his having disâ—ected one single body I shall let the World see that the Galenists without proclaiming the fact or causing a Picture of it to be cut have done as much and that the variety of Pests and the different effects they produce in bodies is demonstrable At Palermo in Sicily in 1647. there was a Plague in which upon the dissection of many bodies by a sort of fellows all whose knowledge did not enable them to cure a cut-finger whose skill is but words and advances nothing these Galenists did Anatomise them Haec visa vasa omnia venae cavae sanguine ita nigro adusto atrabilari turgida ac repleta ut fusi atramenti similitudinem prae se ferret Idem sanguis tum in corde tum in faucibus repertus fuit pulmones atque hepar tumefacti inflammati ventriculus bile turgidus nulla in venis Meseraicis nulla in intestinis laesio Eadem haec uniformiter in singulis â—uerunt observata If it be said that 't was no great attempt because it was no very mortal Pest yet this is certain that it lay in the mass of blood and that the Duumvirate was not so much concerned as G. T. could have wished nor the blood in the vena porta altered according to Circulation Well that last at Naples I am sure was as pernicious as ours at London and there the Colledge of Physicians caused many to be dissected I have not met with the Programme published by them but the Duumvirate gains nothing by what I do read Nam dissecta cadavera hepar pulmonem intestina nigris maculis interstincta cor vero atro sanguine concreto luridum praebuere ut Medici Senatus Neapolitani programmata die secunda Iunii edita promulgarunt Neither doth it appear that what this Pyrotechnist saw in the body after the man was deceased was either the cause or seat of his distemper when he first fell sick the last strugglings for life might express many liquors into the stomach and vitals and they upon their commixture setling and refrigescence create other Phaenomena than were meerly the effects of the Pest. 'T is averred by C. Celsus Neque quicquam est stultius quam quale quid vivo homine est tale existimare esse moriente imo mortâ—o That I may the better decide the subsequent controversies it will be requisite I represent a more exact Definition of the Plague and to do that well I must distinguish upon the word Pest which is either taken in a general sense and so comprehends any Epidemical contagious disease of which many in the same Country do dye be it attended with a Feaver or destitute of one be it occasioned by any speciâ—ick malignity or anomaly of the Air or arise from evil diet or imported by contagion Thus the Epidemical contagious and pernicious Colick recorded in Aegineta was a Pest thus Squinancies Catarrhs Pleurisies Peripneumonies Diarrhaeas Dysenteries the Measils Small-pox have been pestilential nay the Garrotillo or Strangulatory disease in Spain Sicily and Naples though it seized upon and infected scarcely any but Children was a Pest and esteemed so by Aetius Cletus and others Thus it was deemâ—d at Venice to be a Pest of which so many once died though there were not any other Symptomes perceivable in it but a tumor of the testicles accompanied with sudden death Legi superioribus menstibus libellum Veneti â—ujusdam qui exâ—erientiam te stem citat multos ex
the Disease or Feaver be the object of their designs yet As all wise men consider by what means the ends they propose to themselves may be effected so do they deliberate how they shall effect their designs and that is by removing the Cause of the Malâ—dy But as in other designs it frequently happens so here they often meet with impediments which must be removed before they can prosecute their intentions by direct means Upon this account they are forced upon maâ—◠〈◊〉 which they confess are not immediately 〈…〉 of a Feaver which yet they purâ—â—â— because without doing so the indisposition either could not be cured or not with such safety as becomes prudent persons Few of them ever bleed that I know of meerly for refrigeration and the extirpation of the formal heâ—t without regard to the material cause of it which is to be concocted and ejected by Nature Though Phlebotomy be but one operation yet it produceth sundry effects in the body and in order to each of them is both indicated and practised For it evacuateth that redundancy of blood which frequently occasioneth diseases alwayes is apt to degenerate into a vitious morbifick matter during the Feaver and by an indirect and exorbitant motion to afflict some or other principal parts to the great danger if not destruction of the Patient upon this account we do use Phlebotomy in Feavers sometimes to diminish the Plethora and so to prevent the violence of the succeeding disease and dangerous symptomes that may insue and then the veins are too much distended to facilitate and secure the operation of subsequent Medicines that are used to evacuate the Antecedent Cause and to maturate and expedite the continent morbifick cause Besides it promotes transpiration incredibly gives a new motion to those humours which together with the blood oppress and indanger the internal and principal parts it diverts them from the head and draws them from the heart lungs stomach and bowels into the habit of the body whereby Nature being alleviated prosecutes her recovery by maturation and expulsion of the peccant depraved matter deducing to its proper state that which is semi-putrid and not irrecoverably vitiated and separating first then exterminating what is incorrigible So the Patient recovers Nor is there any thing more true than this which every Practitioner may daily observe in his practise that Of all the Medicaments which are vsed by Physitians there is not any may compare for its efficacy and utility with Phlebotomy so expedite so facile and so universal is it The universality of its use appears herein that it evacuates the redundant it alters the exorbitant Fluxes of the peccant or deviating humours and blood It retaxeth the vessels and pores of the body and refrigerates the habit thereof And therefore is so absolutely necessary in putrid Feavers that though I do not say they are incurable without it yet I pity the languishing condition of such as omit it the violence of the symptomes being increased thereby and the cure procrastinated to the great trouble and hazard of the sick and his great detriment afterwards for you shall ordinarily meet with a slow convalescence and the blood be so depraved by so long and violent an effervescence that it becomes remediless and degenerates into an evil habit of body Scorbute Dropsie c. This being premised which is more clearly proved by Experience than Reason I answer to his Argument that we do not go about only to refrigerate the Patient but to concoct and eject the morbifick matter that we take the most befitting course to exterminate that spinous offensive cause and as upon the prick of a Thorn if part stick in the wound and be buried therein we proceed to maturate and bring to a paculency the vitiated blood and humours inherent in the part affected and with the suppâ—â—â—â—â—d mâ—tter drâ—â— out the fragment of the Thorn so we do in Feavâ—â—s where the depraved humours are not so easily sepâ—â—â—ted and extirpated as in the prick of a Thorn maturate the eject the morbifick câ—â—se and thereby atchieve the Cure And I do profess my self to concurre with the Ancients in their Opinion that there is a great Analogy betwixt the generation of the Hypostasis in the Vrine after a Feaver and the production of purulent matter in an Apostimation and that Feavers are but a kind of Abscesse in the mass of blood for the proof whereof I do remit my Reader to Ballonius de Hypostasi Vrinarum Amongst the Ancients I find two wayes commonly practised to extinguish this Febrile Heat by a course corresponding with the usual wayes of extinguishing a fire which are 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by substracting the fewel from it thus they did Phlebotomise at once till the Patient did swoone the other 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by quenching it thus they gave them cold Water to drink largely until the sick grew pale and fell into a shivering this last was not practised till there were manifest signs of concoction But 't is observable that upon either of these Medicaments they did expect that happy issue that Nature thereupon should presently discharge it self by sundry evacuations of the morbifick matter so that they did not thereby intend bare resignation but the extermination of the concocted febrile matter And thus much may suffice in answer to this Objection The last Objection he makes is this as I shall form it The great Indications of the Galenists for Phlebotomy are either Evacuation of the redundant blood in a Plethora or the Revulsion and direct pulling back of what is in flux or flowed into any part already But neither of these Indications are valid and oblige them to that practise Therefore the practise of Phlebotomy is not to be continued As to Phlebotomy in a Plethorick body he thus explodes that If by plenitude be meant an excess of pure blood I absolutely deny there is any such 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or indication for Phlebotomy for during the goodness of this juyce there must needs be perfect Sanity arising from integrity of all the actions of the body so that it may justly be reputed madness to go about to broach this Balsome of life weakning Nature thereby as long as there is health with abundance of strength Imprimis notandum saith Van Helmont in cap. de febr p. 8. ut nunquam vires peccare possint abundantia ne quidam in Methusalem ita nec bonis sanguis peccat minuitate eo quod vires vitales sanguis sint correlativa i. e. We are to take special notice that too much strength can never be offensive to any yea not to Methusalem no more can any one have too much blood for as much as vital strength and blood are correlatives Well then it is plain that whatsoever sickness seems to indicate Phlebotomy upon the account of an 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 sanguineous superpletion must needs come from an apostate juyce generated by vitious digestions
to be very serous and that of a livid and citrine colour and in Hydropics that have bled at the nose there was not any serum in the blood at all In the Febris alba virginea which I here contradistinguish from the Chlorosis I extracted four hours after dinner out of the Saphena of such blood as that the Crassament was laudable for colour and consistence but the serum was so white as not to be distinguished from milk the lacteous serum did coagulate but retained no smell whereas it usually resembles a roasted egg it was saltish to taste At the same time I blooded two more in the foot neither of which had any such lacteous serum but a citrine serum Hers which was a young Lady and in health burned very well and crackled the other being aged sixty years was excellently and equally coloured from top to the bottom and the serum inclining to citrine but would not burn at all only crackled much and puffed with wind She had no indisposition on her only was troubled with a flushing in her face swelling of the nose and an inward hear such as is commonly attributed to an hot liver I do not attribute that lactescense in the first Ladies blood to the mixture of new Chyle which Doctor Lower saith he hath observed in Men and other Animals being phlebotomised a while after meat to create a lacteous ferum for I never in all my life was so happy as to see that though I have blooded my self on purpose two hours after dinner to make the tryal and have an hundred times examined the blood of others who have been blooded at such times as we might expect to see that Phaenomenon of his Yet hath the reality of his observation been confirmed unto me by other credible witnesses so that I question not but he may have seen it though I could not in these Ladies who all dined together about one of the clock and had done bleeding by four Neither may I pass by this Observation that of all the Sâ—rum which I have tasted I never found any to be bitter though I extracted some once that seemed so bilious that being put into an Vrinal none could know it from urine highly tinged as soon as I set it on the fire it coagulated with a less heat than I imagine it to have had in the veins â— and it exchanged its hue for the usual white smelling like a roasted Egg. Yet doth Van der Linden say that some have tasted the blood of Icterical persons and found it bitter Actu nihil naturaliter in sanguine amarum est Sed nec esse potest redderet enim sanguinem ineptum suo muneri ceu observare est in Ictericis In his enim sanguinem amaricare accepimus ab iis qui ipsum vena emissum urinam ejus gustarunt Asclepiadio more And Vesalius gives us an account of one Prosper Martellus a Florentine Gentleman much inclined to and troubled with the Iaundise whose Liver was scirrhous but Spleen sound and his Stomach turgid with choler and wheresoever he opened any of his veins they were full of thick choler and the fluid liquor which was in the Arteries did tinge his hands as if it were choler I find the like Observation in Th. Kerckringius that an Icterical Woman brought forth a dead Child in the eighth moneth which was so yellow all over that it rather seemed a Statue of such wax than an humane Abortion being diffected By him instead of blood in the veins there was nothing but choler and all the bones were tinged with such a yellow that one would have thought them painted The Scholiast upon Ballonius observed that however the blood is naturally sweet even such as upon obstructions from the Menstrua hath regurgitated and discharged it self at the Gums of women as they have told me yet in one that was troubled with the Green-sickness the blood though florid was salt Potest esse storidus color in se esse acrior biliosior unde quaedam mulier 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 ejusmodi praedita temperamento mihi affirmavit siquando vel ex dentibus sanguis affluit vel e capite eum sibi gustum sentiri salsum molestum When I was at Barbadoes we carried off several poor English thence to Iamaica where many of them falling sick and some being well were let blood I observed that in those poor people which live upon nothing almost but Rooâ—s and drink Mobby a liquor made of Potatoes boyl'd and steep'd in water and so fermented that their blood did stream out yellow and in the Porringer did scarce retain any shew of red in the coagulated mass yet are they well and strong but look paâ—â— and freckled such persons which are frequent in Barbadoes are called Mobby-faces It were infinite at least beyond my present leisure to relate all that variety of morbid blood which hath been observed in sundry diseases and in several persons languishing under the same distemper as in Pleurisies the Scurvey French-pox Hypochondriacal Melancholy and the like wherein if it be true as it is that oftentimes diseases vary in individuals 't is no less certain that the blood doth also vary in them so that oftentimes ignorant Physicians do imagine a greater corruption in the blood and a greater recess from what is natural to the person and a greater danger in the disease or in the practise of Phlebotomy than they need yet in Epidemical or some Sporadical diseases if the Phaenomena be as general as the disease 't is certain then that the resemblance of the blood argues a resembling cause which prevails over the idiosyncrasy of particulars I know it will be expected that I should say something about the Controversie whether the Blood be one Homogeneous liquor the recrements whereof make up the four Galenical Humours which are no otherwise parts thereof than the Lees and Mothers of Wine are constitutive parts thereof Or whether the four Galenical Humours viz. that which is properly Blood Melancholy Choler and Phlegm are the constitutive parts of the Blood in its natural consistence and Crasis I shall say therefore about this point as much as may be requisite to my present purpose First I observe that the Galenists are at a difference whether the Mass of blood contain those Humours actually or only potentially so that one may hold according to them that the blood is as homogeneous a liquor as any Neoteric doth hold it to be though it arise by the mixture of their five principles Amongst others Erastus hath a disputation in which he amply asserts that all those Humours when they are actually in the blood they become excrementitious and are no longer parts thereof but such as the ejectment thereof depurates and perfects the other remaining blood which he confesâ—eth to consist of several parts constituting one body to which they are as essential as the serous caseous and butyrous
revulsion when the â—lood and intermixed Humours flow into any determinate part or are fixed there as in Apoplexies Squinancies and Pleurisies for as upon dissection it is manifest that in such diseases there is a greater efflux of Blood than upon other occasions so it is evident by long experience that Phlebotomy doth alter its course and draw back the blood so as that sometimes after that the first blood hath run more pure and defaecated â— the subsequent hath been purulent as if the conjunct cause of the Pleurisie or Squinancy had been evacuated thereby In reference to such fluxes of the blood to determinate parts we usually consider what in all probability may happen as well as what is at present urging and therefore for prevention thereof we let blood upon great contusions and wounds It is also practised by way of derivation when we let blood near to the affected part thereby to evacuate part of the imparted matter Thus Van der Heyden did frequently let his Patients blood in the same foot for the Gout Thus in a Squinancy to open the Iugulars it is a derivative Phlebotomy In all these cases all Physicians agree to the received practise but in case that the disease be not meerly sanguine but seem to arise rather from a Cachochymy or redundance of evil humours than any plenitude or exorbitant motion of the Blood here many Physicians cry up that Rule That Plethorick Diseases require Phlebotomy but those that arise from a Cachochymy require expurgation Here they accumulate a multitude of Arguments and undoubtedly since so great men are of that side it must needs be that they have cured those diseases without Phlebotomy But the contrary practise hath so many abettors whose credit equalleth or exceeds that of the others and Experience in a multitude of cases hath shewed the great efficacy of Blood-letting in a Cachochymy or meer impurity of the Mass of Blood and so prodigious is the efficacy thereof in promoting transpiration and opening all the emunctory passages of the body in preventing of putrefaction and expediting of the concoction and in refrigerating the whole habit that Hippocrates and Galen did resolve it in general That whensoever any great Disease did seise upon any Person if he were of Strength and Age to bear it he ought to be let blood The Arabians dissented from this practise but Massarias after Iacchinus and the Florentine Academy did prudently revive it and solidly defend the Tenâ—t and the happy Cures did so convince the World of the truth of their Assertions that all Italy in a manner was presently reduced under them and France and Spain so that though they did and do still in Spain and Italy retain Avicen to be read in their Vniversities as well as Hippocrates yet herein they have abandoned the Arabians` and they which do adhear to that old Maxime of purging out the evil humours when they abound do also comply with the Hippocratical practise and by new excuses accommodate it to their principles So that as to most diseases 't is agreed though upon different grounds what may or must be done Few now are so timorous in bleeding as heretofore and where that apprehension is still continued the Physicians rather comply with the prejudicate conceits of the people then act out of Reason He that can doubt the strange effects of bleeding notwithstanding the concurrent judgment of Physicians let him either read over Prosper Alpinus concerning the Physick practised in Aegypt amongst the Turks where Phlebotomy is the principal and frequently the sole remedy or advise with any Fâ—rrier and he will be satisfied that in a Cachochymy nothing is more beneficial though it be particularly said of Beasts that the Life or Soul is in their Blood For my part I am sufficiently convinced of the solidity of their judgment who do much use Phlebotomy and I have frequently observed that the best Medicaments have been ineffectual till after Phlebotomy and then they have operated to the recovery of those Patients who found no benefit by them before so that to begin the cure of most diseases therewith is the most ready and certain way of curing them and to make that previous to purging is the direct course to purge with utility 'T was most Oracularly spoke by Vallesius Facile concesserim venae-sectionem esse optimum omnium auxiliorum quibus Medici utuntur Est enim valentissimum maxime presentaneum multiplex Dico autem multiplex quia vacuans revellens refrigerans venas relaxans omnem transpiratum augens quam ob causam est a Galeno valde celebratum in nullo magno morbo non est opportunum si vires ferunt puerilis aetas non obstat When I considered the strange efficacy of blood-letting in several diseases and that the discovery of the Circulation of Blood had rendered most of the Reasons which were formerly used to be more insignificant or false I was not a little surprised I observed that the effects were such as did exactly correspond with their Hypothesis and that the practise was not faulty or vain though the principles were neither ought any man to quarrel with or laugh at such Arguments as 't is certain will guide a man rightly to his utmost ends 'T is a kind of impertinency that swayes this Age for 't is not so much a Physicians business to talk but to heal It was most judiciously said long ago Ac nihil istas cogitationes ad Medicinam pertinere eo quoque sensudisci quod qui diversa de his senserint ad eundem tamen sanitatem homines perduxerint Itaque ingenium facundiam vincere morbos autem non eloquentia sed remediis curari Quae siquis elinguis usu discreta benenorit hunc aliquanto majorem Medium futurum quam si sine usu linguam suam excoluerit Neither did Hippocrates place any great value upon Philosophical curiosities and Natural discourses but esteemed it very well in Physicians if they could demonstrate by their success the solidity of their judgment 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 I resolved with my self that if the Circulation of blood and other modern discoveries taught us but the same practise we already followed it was useless If it contradicted it it must be false I observed that it was the great work of the wiser Novellists to accommodate the new Theories to an old and true way of practise and perceiving that the effects of Phlebotomy were such as the Ancients insisted on I perplexed my self in considering what there might be therein to produce so different effects I abstracted from all common Principles and called to mind the Opinion of the Methodists who were a judicious sort of Physicians and the most prevalent at Rome in Galen's dayes They held that Diseases did not arise from peccant humours since many lived and lived long with Cachochymical bodies and in diseases if in the beginning a multitude of humours and such as
Physicians ascribe the disease unto be evacuated by vomit sweat or stool yet the distemper continues and becomes worse and more dangerous by reason of such evacuatians As little did they regard the first qualities of heat and cold siccity humidity concluding them to have no immediate effect in producing diseases but as they varied the symmetry of all or any parts of the body the grounds they went upou were such as were deduced from that Philosophy which makes Rarity and Density the principles of all bodies and they placed Health in such a conformation of the body and such a configuration of particles as did best suit with its nature they held that the intertexture of the minute particles of our bodies were such as admitted of an easie alteration the fabrick being so exquisitely interwoven not only in the solid vessels and parts but a commensuration of prorosities every where the alteration of which texture of the body into a great laxity or streightness and this change of the pores did they make the great causes of all Maladies and the restoration of them to be the way to sanity and this they called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or the variation of the texture and combination of Corpuscles in the symmetry whereof they placed Health and in the asymmetry or improportionate and incongruous state whereof they placed all Sickness It was their Tenet that amongst those Remedies which did most alter the texture of the body from streightness to laxiiy the most powerful were Phlebotomy and Purging and that their principal effects were not meerly to evacuate such or such peccant Humours but in doing so to create a new Texture and configuration of Corpuscles in the whole Body and therefore they held them to be General Medicaments and of use in most great diseases since such distempers were rather occasioned by a streightness than laxity of the pores and even such as were laxe one way as Dysenteries and Diarrhaeas might be accompanied with a streightnâ—ss in the habit of the body This Hypothesis for the furtheâ— explication whereof I remit you unto Prosper â—lpinus having been of great renown and most accommodated to the course of life by which the Romans and since the Turks and others that follow not our Physick did preserve their Health and recover theâ—â— Malâ—dies did merit my regards and I observed the truth of that part of their Opinion which avows that purging and bleeding have further effects than meerly the evacuation of Blood and other Humours that they had such an influence upon the whole body as to restore and promote all the natural evacuations of the body by its several emunctories and pores and that Phlebotomy did particularly incline to sweat promote urine and sometimes instantly allay its sharpness and make the body soluble so that upon Phlebotomy there needs no antecedent Glyster Neiâ—her is it convenient in a great Cacochâ—my to purge before bleeding not so much for fear of irritating the Humours but that the purge operating so as to attenuate and alter the whole mass of blood and promote secondarily all natural evacuations without preceding Phlebotomy it is scarce safe not secure to purge except in bodies the laxity of whose texture is easily restored or with gentle Medicaments for the Humours being powerfully wrought upon by the strong purges and inclined to be expurged by their sevâ—ral emunctories and those being either defective or the veins and arteries too full to admit a greater rarefaction in the mass of blood which is requisite to their separation and transpiration hereupon there happens a dangerour Orgasmus or turgency of humours in the sick which Phlebotomy doth prevent And 't is I conceive in reference to this alteration of texture that Hippocrates saith 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 I observed a great congruity betwixt the Static observations and those of the Methodists and that Sanctorius hath a multitude of Aphorismes which agree with them viz. That such bodies as transpire well in the hottest weather they are lighter and not troubled with any vexatious heat That nothing prevents putrefaction like to a large transpiration In fine I did observe that it was the general sense of Physicians that Phlebotomy did draw the Humours from the Centre to the Circumference and I had taken notice of it alwayes in my self even in the Colick bilious when I was tired out with pains vomiting and want of sleep when I took no Laudanum and reduced to extream debility and emaciation I determined in that forlorn case having used all other means for several weeks to bleed so long yet partitely as that I might be freed from a most troublesome pulsation of the descending Artery below the reins I bled eight ounces at first and found a vextious heat in the whole habit of my body I repeated the Phlebotomy in the afternoon and was very hot all night thus I continued to bleed twice each day for three dayes loosing above sixty ounces and then fell into sweats was eased totally in my back and afterwards recovered with a more facile Paresis in my Armes and no contracture then that disease commonly terminates in there These considerations made me think that there was some more important effect in Phlebotomy than the evacuation derivation and revulsion of the Blood and other Humours and that it must consist in promoting that Statical transpiration and I conceived that the Blood was in perpetual motion and though Motion doth hinder Fermentation yet I had observed that in Pipes at Owburne Abby where the drink runs from the Brew-house to the Cellar to be tunned up the Fermentation continues so especially in the stronger drink that the Pipes frequently break therewith as rapid as the motion is I did not imagine that the nature of the Blood was such as to be exalted into one Vniform liquor resembling Wine for such a liquor would not be liable to such sudden changes and alterations from one extream to another but that it was a miscellary of heterogeneous liquors in a perpetual digestive fermentation and depuration by halituous particles arising from it as in more gross by the emunctories which if the conformation of the pores and passages be such as to give it due vent all continues well if they be obstructed or vitiated then several maladies ensue except timely prevention be used I conceived that in Phlebotomy as the Blood issueth from the vein so as in the pouring out of other liquors the Air comes in by the orifice and mingling with the Blood produceth as great or greater effects than in the Lungs when it mixeth there with the Blood invigorating it in an unexpressible way whence we commonly see that the pulse grows stronger and stronger during the bleeding and upon this account I think it may happen that bleeding with Leeches though equal quantity be taken away oftentimes does harm never alleviates so much as Phlebotomy and such persons as by reason of their
tender habit of body cannot bear a violent transpiration swoon not by bleeding in water though otherwise they do by reason that the great effects of the Air upon the Blood are impeded by the ambient water the like happens in Scarification with Cupping-glasses and in bleeding with Leeches I did suppose that oftentimes in a Plethora quoad vires transpiration being hindered by the change of the texture of the Body the not-exhaling particles remix with the Blood and there also happens a subsidence of the vessels and change of the porosities so that the Fermentation is is not only clogged with morbose particles of several sorts but so hindered by the subsidence or compression of the vessels and alteration of the pores as not to be able to ferment for freedom of room is necessary to Fermentation nor transpire nor continue its due course nor by reason of the charge of porosities confer aliment aright so that a Plethora ariseth hereupon But as soon as the vein is breathed and the Blood as in your common water-pipes when a Pipe is cut acquires a more free passage that way it presently becomes more rapid and its motion also is accelerated by the fuliginous exhalations hastening to the vent together with the natural Fermentation resuscitated and so the whol◠〈◊〉 by a natural coherence and dependance is not only eâ—â—cuated but altered in its minute texture and conformation It is most evident that the Blood in the Veins and Arteries is conveyed as it were in conduit-pipes the Heart being the great Elastic Engine which drives it being fed by the vena Cava and disburthening it self by the Aorta though even the motion of the Heart depend upon a Superiour influence by its Nerves which wherein it consists and how derived from the Brain and Soul is a thing to us incomprehensible I do suppose that the Circulation is continued and carried on principally by Anastomoses betwixt the Capillary veins and Arteries many whereof having been discovered by Spigelius Veslingius and others the rest may well be supposed and perhaps in the coats of the Veins and Arâ—eries there may be a certain texture requisite whereby the transpiration is managed in order to the safe continuance of the digestive fermentation in the Blood and the nutrition of the body The impulse of the Heart together with the pulsation is sufficient to convey the blood to the lesser capillary Arteries and there though the pulse be lost which yet a little inflammation in the extremities of the body will make sensible and in some Ladies as also in Children the least preternatural heat yet it is impelled by the subsequent blood still into the veins and having acquired by the common miscele in the Heart and the digestive fermentation which naturally ariseth in such heterogenious liquors an inclination to expand it self the compression in the Capillary vessels adds to its celerity of motion when the larger veins give liberty for it the Aiery corpuscles of several kinds which are easie to be discovered upon burning by their expansion and contraction adding much thereunto Thus in Water-engines the narrowness of the Pipes do add to the impetus with which the Water issues forth And I do conceive by the Phaenomena which daily appears in practise that the Animal heat in the Blood actuating that heterogeneous miscele and according to the diversity of its parts producing therein with the help of its fermentation a rarefaction of what is aiery and according to the room there is a liberty or inclination to expand and evaporate themselves this is the principal cause of the continuance of the motion of the blood in the veins and of its saliency upon Phlâ—botomy Thus upon Scariâ—ication there is no salience or spurting out of the blood there being no room for such an expansion or for the Aiery halituous parts in which there is as great a difference as in those exhaling from the terraqueous Globe to rush forward out of the continued Arteries and together with themselves to protrude the blood Upon this account the Methodists and old Physicians as also the Aegyptians where the tender bodies and constitutions of Children and Women or Men admit not of or requireth that great relaxation of the pores and texture of the body which a more robust and firm habit wherein as the natural resistance in health is greater so the recess from it in a bad estate is much greater would be cured by they use these Scarifications and prefer them most judiciously to Phlebotomy This constitution of the Body doth evince the great utility of Phlebotomy and best as I suppose explicates the effects thereof which we daily experiment From hence not only is manifest how the Body is evacuated in a Plethora but in case of Revulsion and Derivation It is manifest in Aqueducts and Siphons that the liquors though much differing in nature from the Blood nor so inclined to evaporate does accelerate their motion and issue out so rapidly upon an incision or fracture in one of the Pipes that a lesser in such a case will deplete the greater notwithstanding its free passage in its own entire Canale Thus the most learned and considerate Physician Sir George Ent having observed first thus much Videmus aquam per siphones delatam si vel minima rimula hiscat foras cum impetu prorumpere And Sanguis per aortam ingressus fluit porro quocunque permittitur peraeque sursum ac deorsum quia motus continuus est quemadmodum in canalibus aquam deferentibus contingit in quibus quocunque feruntur aqua continuo pergit moveri Quare nugantur strenue qui protrusionem hujusmodinon nisi in recta linea fieri posse arbitrantur After this He explains the doctrine of Revulsion in this manner Quae postea de revulsionibus dicuntur nullum nobis facessunt negotium Tantundem enim sanguinis a pedibus ascendit per venas quantum ad eosdam delabitur per Arterias Facto itaque vulnere in pectore aut capite revulsio instituitur si modo tam longinqua instituenda sit in crure Quia sanguis alias quoquoversum ruens facto nunc in pede egressu copiosius per descendentem ramum procul a vulnere delabitur Non enim arbitramur sanguinem aeque celeriter sua sponte per arteriam aut venam fluere atque is secta earum aliquo effluit Nec sanguis ad laesum pectus aut caput per venam cavam impetu affluit quia fluxus ille aperta inferius vena intercipitur I do acknowledge that the reading of these passages did first create in me the thoughts I now impart unto you And hereby it is evident how the Ancients with their large Phlebotomies might derive even the morbiâ—ick matter or revell it though impacted Our minute Phlebotomies do seldom produce such an effect for since it is not otherwise done but by a successive depletion out of the Arteries it would seem necessary to extract three or
cause incurable Phrensies deadly Sopors and Epileptick fits or create Lipothymies in the Heart or difficulty of breathing which is a mortal sign in this Disease in the Lungs or a Diarrhaea and Dysentery in the Intestines or a virulency in the suppurating Pustules and corrode even the bones and ligaments these vapours exhale by the opened dores and the Feaver abates for any one that knows never so little in Physick understands that the sole legitimate and immediate cause of Feavers is prohibited transpiration From what hath been said it is evident that of all Remedies Phlebotomy is the most important in the Small Pox in the first beginning whether the Feaver be a simple Synochus or one that is putrid and malignant and 't is more a wonder that any man should oppose the due administration of it then that all Europe in a manner should agree to the practise thereof Neither is it only to be administred to allay the plenitude which generall occurs in this Malady or to prevent the evils forementioned but frequently for revulsion when the malignant matter begins to affect the Brain Stomach Lungs Intestines For if during the Feaver the Humors seise upon those parts with any violence the Patient is in apparent danger of death there being no way to prevent the suppuration there and little hopes that the Patient will survive the distemper or if he do escape a Consumption or Dropsie afterwards Sunt aliae ita malignae ut non solum carnosum genus adoriantur sed ossa quoque dilanient corrumpant quandoque interna membra principalia ut hydropem generent nuper observavimus puellulum quendam D. Donati Profili nepotem mortuum ex hydrope ob variolas morbillos quandoque vidimus alios consumptos ex asthmate ob easdem variolas quandoque vidimus alios diarrhaea dysenteria confectos ex morbillis variolis alios gangrenatos esthiomenatos It is true that Physicians do not alwayes regard the distempers of the brain in this disease because albeit they may be very violent in the beginning yet they afterwards cease of themselves nor do they appear so highly concerned for the animal as vital functions and in such cases great judgment is required in a Practitioner rightly to distinguish betwixt what may affright others and what ought to terrifie him But in case the first approach be accompanied with a violent Cough hoarseness difficulty of breathing the beginnings of Squinancy from a pustulary defluxion into the Glandules of the Throat or with swoonings and perfrigerations of the hand and feet He that thinks Phlebotomy ought not to be administred if other conditions permit understands not himself or complies too much with the prejudicate opinions of the Patient and Relations The Authority of all Physicians almost justifies him the Rules of Art direct him to it the prosperous success which frequently follows thereon imbolden him to it and Nature her self authenticates the practise by her sovereign example for it is usual for Patients in the beginning of the Small Pox to bleed at the nose I have known five or six in one â—amily adult persons that bled of themselves eighteen or twenty ounces with greater benefit whilest I durst not be allowed to take away eight Novimus plures infantes in principio quibus sanguis in copia exnaribus exivit bene habuerunt neque tot tantisque variolis morbillis fuerunt afflicti unde multi autumarunt si puero multa sanguinis copia sponte vel arte exieret usque ad animi deliquium qoad vel non variolabitur vel non in tanta copia nam variolae morbilli vere sunt morbi a sanguine With this Author agrees the most experient Augenius Saluberrimum esse provocare sanguinem exnaribus docuit experientia nam quibus sponte effluxit variolae pauciores salubriores evenerunt Vidi hactenus pueros duos qui ex sluore sanguinis e nare dextra tertio die immunes a febre evaserunt quarto die supervenerunt variolae paucae benignissimae I add the words of Diomedes Amicus who having recommended the applying of Leeches Yarrow or Horse-tail to the Nose thereby to cause a flux of blood prooceeds Haec enim sanguinis evacuatio a naribus vel sponte vel arte factae adeo confert maxime cum adsint signa fluxum sanguinis portendentia cum tamen non fluat ut solo fluxu isto aegrotantes istos sanatos vidisse Rhases dicat eum solum praeservare a nocumento oculos alias faciei partes dixerit Avicenna quae sanguinis evacuatio ex naribus semper medicum excusat ab omni alia evacuatione sicuti facit etiam qui per uterum vel haemorrhoidas fit modo fiat cum alleviatione The consideration of this so beneficial an effort of Nature made Augenius and others to direct that after Phlebotomy in the Arm the Patient should be forced to bleed at the right Nostril in relation to the Liver or at both and in the cure of Antonio Borghese a Nephew of Pope Paulus V. a Colledge of Physicians at Rome did prescribe Leeches to be applyed to his Nostrils and his recovery was principally ascribed thereunto I shall not undertake to prescribe how much blood may be taken away at once nor how often Phlebotomy is to be repeated in the beginning of the disease I should expatiate too much by such a discourse the general Rules are to be found in Augenius Mercatus Horstius Ranchinus Epiphanius Ferdinandus c. and the accommodation thereof to particular cases doth depend wholly upon the judgment of the Physician employed How Children in whom the Disease if they can be ordered is less dangerous commonly and how Men according to their different habits of body and other circumstances it being more perillous in them their flâ—sh being more solid and tenacious their bodies less perspirable and their blood and humors more acrimonious are to be ordered When the Lancet when Leeches when Cupping glasses and Scarifications are to be made use of the wise do know and the ignorant may learn if they will study to improve by study that time which they mis-spend in censuring the prudent actions of their betters Before I proceed to the second Question it will be convenient to decide that Controversie about Phlebotomy Whether it draw from the Circumference to the Center and may hinder the eruption or cause the Pustules to return in or subside That there are some eminent Physicians who do hold that Phlebotomy doth draw the Humors from the Circumference to the Center I do grant and in the case of the Small Pox that it may chance to do so is the suspicion and fear of Avicenna and Hollerius as well as Doctor Whitaker But why the Doctor should be scrupulous here who hath so great a regard for the Ancients though he cite no good Authors is to me a Miracle For besides the Methodists who
or abate such are Squinancies Peripnenmonies Pleurisies the Small Pox c. Comitatae febres continuae sunt quae aliquem morbum qui ipsas vel exitavit vel qui ab illis prodiit comitem habent aliaque praeter ea quae febris solitaria affert symptomata a morbo comite prodeuntia cum febrium accidentibus complicata febriumque naturam aliquando permutantia In this distinction we are freed from those impertinencies which others molest us with as if the concomitant disease were a crisis of the other whereas indeed this concomitancy makes us look on them rather as a complication of maladies than any such succession as is feigned and we are thence obliged to consider what indications arise from this conjunction for it is confessed that in these cases the primary disease is not terminated nor altogether to be cured in the usual manner but with a regard to its associate but our care ought to spend it self so as that the primary Feaver may innocently and without prejudice to the sick introduce its Associate and that conclude with an happy recovery To do this we consider the nature of the primary Feaver which is in the Small Pox a simple Synochus or a Synochus putride and sometimes a Tertian or double Tertian or some malignant Feaver These we are so to manage that they neither become exorbitant so as to destroy the Patient before the Associate discovers it self nor then become so depraved violent or malignant as to disturb the subsequent cure No man can in reason doubt but the best and most direct means to moderate the primary Feaver is to begin betimes for then the distemper is less violent and Nature least debilitated What we are to do then the course of the Disease best teacheth us in which the most enormous vomitings are so far from doing hurt that they are beneficial to the sick It is therefore manifest that a Physician who is to imitate Nature may in the beginning as he sees occasion and upon due pondering of all circumstances administer a vomit for it is neither repugnant but congruous to any of those primary Feavers nor contra-indicated by the Associate For hereby those excrementitious humours are evacuated which would otherwise in the progress of the disease add to the distemper producing Phrensies Sopors or other malignant symptomes also part of the super-abundant turgent matter is exhausted and the Lungs who are frequently endangered by a Catarrh in the beginning are disburthened as also the eruption of the Small Pox is facilitated Vomits being alwayes held by the Methodists amongst those Medicaments which principally relax the habit of the body In case that there appear urgent Reasons against a Vomit the next thing under consideration is a Minorative purge whereby the Stomach and Intestines being cleansed and part of the Morbifick matter discharged from the Head Lungs and mass of Blood Nature will be better able to overcome and regulate what remains And herein the Physician is guided by Nature which oftentimes alleviates the Patient by a slight Diarrhaea before the Small Pox do come forth Nor is there any danger in such fluxes as our Practitioners observe Si Diarrhaea fuerit in principio non nocebit And most of them allow a gentle befitting purge in the beginning of this Disease not doubting thereby but to make the subsequent course of it to be more benign and safe for the most turgent urgent bilious and accrimonious humors being carried off together with the promiscuous faeculencies of the Intestines 't is not easie to be imagined that any dangerous malignity can reside in the pustules or any dysentery or flux ensue in the state or declination of the Disease at what time it is extreamly perillous I shall not inlarge upon this subject further it not being my present intention but refer my Reader for his more particular instruction to Horatius Augenius Ranchinus Gregorius Horstius Sennertus and Riverius and if he desire Experiments for the happy use of Vomits and Purges and evidence that they do not retract the humors from the circumference to the center Alas y'tis not the time of their separation or motion that way or impede their eruption let him consult Angelus Sala and Forrestus I come now to the practise of Phlebotomy about which sundry Questions arise As Whether it may be `administred in the beginng of the Disease and After the Pox come forth In the State and Declination In all which times I do assert that there may happen such circumstances as may make it necessary But in the beginning I think it may frequently be done with great convenience 1. In the beginning of this Disease that which urgeth is the Feaver and its symptomes which if it be so violent that the Patient may be indangered before the Small Pox do come forth or so debilitated that Nature may not be able to command them and concoct them by reason of their multitude or virulency which the extremity of the Feaver as well as habitual cacochymy or the adventitious malignity may create 't is prudence in the beginning to prevent those perils which in a stort space will become remediless If the body be Plethorical with either sort of plenitude 't is indubitably requisite to bleed and our case here is like to those cases which possess the Brewers or Vintners who whilest they attend diligently to the depuration and fermentation of their liquors employ a part of their thoughts upon the preservation of the Cask least it break Nor is the present plenitude only to be considered but the future which will happen upon the increase of the ebullition and attenuation of the blood together with the defective transpiration which alwayes abates proportionably to the greatness of the Feaver and in case any peril threaten from the violence of the Feaver there doth not appear any more ready course in such as are 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or in the beginning are at their height perhaps there is no other then to let blood whereby the redundancy is diminished the course of the blood diverted from circulating or stagnating in the inward vessels the habit and texture of the body changed in order to the more â—acile expulsion of the Small Pox and transpiration promoted then which nothing contributes more to the alleviation of the first and precaution of any subsequent Feaver and malignant putrefaction of the Humors in the Pustules Quoties cunque enim corpus ventilatur nullo modo transpiratio prohibetur facile putridae fuligines per poros exhalantur nec cordi communicantur neque proin sequitur ulla febris unica enim causa legitima immediata febris est prohibita transpiratio uti etiam illis qui a limine salutarunt Medicinam notum est i. e. Whensoever the blood is well ventilated and insensible transpiration free whatever noxious and venenate vapours are contained in the body which might otherwise fly up to the head and