of such as write what they will and defame as they please and permit not others to vindicate themselves nor undeceive the World 'T is ungenerous to pinnion a mans hands and then beat him In reference to that Controversie I add that the Statutes of the Colledge command the Physicians to send their Bills to an honest Apothecary And our Laws make the Colledge Judges of all Receipts as well as Methods of Physick which Act as it conforms with the general practise of Europe so it is very prudential for hereby provision is made not only against noxious Medicaments and the high prizes of Arcana but illegitimate Methods of practise by which last it is as easie to destroy a man as by poyson and more privately How the designs of the Experimentators will consist with our Laws and be accommodated to them I know not I know a Physician may be tryed upon giving his own Medicaments if the Patient miscarry how he shall defend himself I know not I have not seen any reason alledged that is likely to convert the Magistrates throughout Europe to permit it or to gain a repeal of the two last Edicts in Denmark against it 'T is an evil president to dispute against wise Laws 't is worse to act against them and what consequences it will bring upon the Land to see one Profession retrench upon another let the Lawyers judge The beginner of this Novelty the Lord Bacon stopped not at Natural Philosophy but carried on his humour to attempt or project a change of our Laws I do recommend it to the consideration of our Sages in the Law that if Physick Divinity and other Faculties be overthrown by a company of Wits whether it be probable that they shall long continue free from the attempts of the Omniscient But I shall resume the examination of the remaining Arguments of my Adversary Because I often observe many squaring their Therapeâ—tic intentions according to the Definition of the Feaver indeavouring to cool those that are in a scorching heat by breathing a vein let them know that a Feaver whose essential nature is to be inquired into for the use of man is very erroneously defined an Accident for a febrile heat is certainly the product of a foregoing Cause which is primarily to be searched after then whatsoever depends thereon will quickly vanish Now this cutting an hole in venal vessels for the removing a bare Quality is all one as if one should laâ—e out of the Pot ready to boil over a spiritous or some precious Liquor therein contained to the intent it may thereby be quailed neglecting to withdraw the fire the impulsive occasion of the violent motion made therein Do not they take the like absurd course who do think to cool the body in a Feaver by throwing away whole Porringers of the Nectar of life never looking after the ablation of the Causo-poietick cause and focular matter sited about the Stomach which makes an estuation and effervescence in all the other parts That way of frigidation which pillageth the vitals increasing the malady only obliquely abating a tedious quality is never to be approved by a Legitimate Physitian He that will bring to a moderation the finger excessively heated from a thorn impacted therein must extract the same otherwise he will take a wrong course by the use of meer frigefactives So he that will positively refrigerate in any preternatural heat must eliminate that spinous aculeate acid acrid matter which goads the Archaeus incensing it that it becomes exorbitant fretting raging Heautontimorumenos gauling it self at the presence of that which it abominates never to be pacified till it be excluded or some extraordinary Sedative given I mean not Opium vulgarly prepared which may for a time asswage its fury till it have leisure to thrust out the unwelcome guest I could wish my Adversary instead of consulting the Novum Organum of the Lord Bacon had been conversant in that more ancient one of Aristotle he had not then committed so many errors in point of Ratiocination as he now does which renders his discourse intricate confused and oftentimes impertinent to the great distraction of his Reader and vexation of his Antagonist He perpetually mistakes through an Ignorantio Elenchi he never apprehends what he opposeth That the Galâ—nists do define a Feaver by a preternatural heat diffused through the whole body is true They are contented to call that a Feaver which the vulgar does so and accordingly to define it Not but they distinguish in Feavers the Material and Formal cause thereof as also the several Efficients thereof and in their Method of curing except necessity put them upon another procedure they do alwayes and are obliged to do so by the Rules of their Art to remove the Cause of the Feaver and this is notorious to all that understand the first Elements of Physick They consider the evident occasional procatarctick Causes they consider the Antecedent causes which though they are not the immediate and conjunct Causes of the Feaver yet dispose unto it and are of such importance as that they may often degenerate into immediate and conjunct Causes and which is more in the Cure they do not only regard the Cause which gave birth unto and produced the Disease but that which doth foment and continue it and that which may produce or increase it Censeri debet causa non quae facit aut fecit solum sed quae faciet nisi quis obstet And although the curing of the Disease or Feaver be the object of their designs yet As all wise men consider by what means the ends they propose to themselves may be effected so do they deliberate how they shall effect their designs and that is by removing the Cause of the Malady But as in other designs it frequently happens so here they often meet with impediments which must be removed before they can prosecute their intentions by direct means Upon this account they are forced upon many actions which they confess are not immediately conducive to the cure of a Feaver which yet they pursue because without doing so the indisposition either could not be cured or not with such safety as becomes prudent persons Few of them ever bleed that I know of meerly for refrigeration and the extirpation of the formal heat without regard to the material cause of it which is to be concocted and ejected by Nature Though Phlebotomy be but one operation yet it produceth sundry effects in the body and in order to each of them is both indicated and practised For it evacuateth that redundancy of blood which frequently occasioneth diseases alwayes is apt to degenerate into a vitious morbifick matter during the Feaver and by an indirect and exorbitant motion to afflict some or other principal parts to the great danger if not destruction of the Patient upon this account we do use Phlebotomy in Feavers sometimes to diminish the Plethora and so to prevent the violence of the succeeding
disease and dangerous symptomes that may insue and then the veins are too much distended to facilitate and secure the operation of subsequent Medicines that are used to evacuate the Antecedent Cause and to maturate and expedite the continent morbifick cause Besides it promotes transpiration incredibly gives a new motion to those humours which together with the blood oppress and indanger the internal and principal parts it diverts them from the head and draws them from the heart lungs stomach and bowels into the habit of the body whereby Nature being alleviated prosecutes her recovery by maturation and expulsion of the peccant depraved matter deducing to its proper state that which is semi-putrid and not irrecoverably vitiated and separating first then exterminating what is incorrigible So the Patient recovers Nor is there any thing more true than this which every Practitioner may daily observe in his practise that Of all the Medicaments which are vsed by Physitians there is not any may compare for its efficacy and utility with Phlebotomy so expedite so facile and so universal is it The universality of its use appears herein that it evacuates the redundant it alters the exorbitant Fluxes of the peccant or deviating humours and blood It relaxeth the vessels and pores of the body and refrigerates the habit thereof And therefore is so absolutely necessary in putrid Feavers that though I do not say they are incurable without it yet I pity the languishing condition of such as omit it the violence of the symptomes being increased thereby and the cure procrastinated to the great trouble and hazard of the sick and his great detriment afterwards for you shall ordinarily meet with a slow convalescence and the blood be so depraved by so long and violent an effervescence that it becomes remediless and degenerates into an evil habit of body Scorbute Dropsie c. This being premised which is more clearly proved by Experience than Reason I answer to his Argument that we do not go about only to refrigerate the Patient but to concoct and eject the morbifick matter that we take the most befitting course to exterminate that spinous offensive cause and as upon the prick of a Thorn if part stick in the wound and be buried therein we proceed to maturate and bring to a paculency the vitiated blood and humours inherent in the part affected and with the suppurated matter draw out the fragment of the Thorn so we do in Feavers where the depraved humours are not so easily separated and extirpated as in the prick of a Thorn maturate and eject the morbifick cause and thereby atchieve the Cure And I do profess my self to concurre with the Ancients in their Opinion that there is a great Analogy betwixt the generation of the Hypostasis in the Vrine after a Feaver and the production of purulent matter in an Apostimation and that Feavers are but a kind of Abscesse in the mass of blood for the proof whereof I do remit my Reader to Ballonius de Hypostasi Vrinarum Amongst the Ancients I find two wayes commonly practised to extinguish this Febrile Heat by a course corresponding with the usual wayes of extinguishing a fire which are 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by substracting the fewel from it thus they did Phlebotomise at once till the Patient did swoone the other 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by quenching it thus they gave them cold Water to drink largely until the sick grew pale and fell into a shivering this last was not practised till there were manifest signs of concoction But 't is observable that upon either of these Medicaments they did expect that happy issue that Nature thereupon should presently discharge it self by sundry evacuations of the morbifick matter so that they did not thereby intend bare resignation but the extermination of the concocted febrile matter And thus much may suffice in answer to this Objection The last Objection he makes is this as I shall form it The great Indications of the Galenists for Phlebotomy are either Evacuation of the â—edundant blood in a Plethora or the Revulsion and direct pulling back of what is in flux or flowed into any part already But neither of these Indications are valid and oblige them to that practice Therefore the practise of Phlebotomy is not to be continued As to Phlebotomy in a Plethorick body he thus explodes that It by plenitude be meant an excess of pure blood I absolutely deny there is any such 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or indication for Phlebotomy for during the goodness of this juyce there must needs be perfect Sanity arising from integrity of all the actions of the body so that it may justly be reputed madness to go about to broach this Balsome of life weakning Nature thereby as long as there is health with abundance of strength Imprimis not andum saith Van Helmont in cap. de febr p. 8. ut nunquam vires peccare possint abundantia ne quidam in Methusalem ita nec bonis sanguis peccat minuitate eo quod vires vitales sanguis sint correlativa i. e. We are to take special notice that too much strength can never be offensive to any yea not to Methusalem no more can any one have too much blood for as much as vital strength and blood are correlatives Well then it is plain that whatsoever sickness seems to indicate Phlebotomy upon the account of an 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 sanguineous superpletion must needs come from an apostate juyce generated by vitious digestions which being hostile to life irritates the Archaeus to frame the Idaea of a disease not as it is meerly provoked by nimiety or plurality but from the pravity of the matter wherefore the case is altered now and the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 signification or demonstration of evacuating doth in a strait line respect the Crâ—or or Cacochymy directing the Artist to reform mundifie and rid those impurities contained in the seemingly corrupted marred juyce by proper means sequestring the vile from the precious not to let out indistinctly what comes next at randome to the furtive castration of the Eutony lustiness liveliness and strength of the Patient which is to be preferred before all motives whatsoever 'T is certainly known to those who are throughly versed in the Analysis and Synthesis of the parts of bodies that ebullition aestuation effervescence of febrile liquors arising from a pleonasme of degenerate Sal. and Sul. c. as they would have it may be appeased and allayed by Remedies assisting the vitals to make separation and afterwards an exclusion every way of what is reprobate reserving what is acceptable This being performed there is no fear that a plenitude simply of it self can do any harm for hereby so expedite a course is taken that the overplus is in a short time sent packing away by vomiting stool urine expectoration and sweat For this reason considering what strict abstinence the Patient is put upon in a Feaver
concretus It is the more crude impure part of the bloud the purer part of the chyle being digested into a saline juyce is carried into the milky vessels and veins and mingling at last with that ruddy liquor is called Cruor and at last becomes perfect bloud It undergoes manifold guises and is often the subject matter of a multitude of diseases being sometimes changed into an Ichor Tabum or Sanies The third part is properly called Sanguis or Bloud 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 it is a most pure sweet Homogeneous Balsamie Vital juyce for the most part of a bright Red or Reddish colour made by the Archaeus by virtue of ferments implanted in the ventricles of the heart lungs veins and arteries causing a formal transmutation of the Ckyme or milky substance into this sanguineous liquor ordained to be the seat of Life and and the principal matter for sense motion nutrition accretion and generation It is for good reason called Balsamum seu Condimentum totius corporis forasmuch as it hath a sanative power sweetly uniting all the parts of the body for the conspiration of the good of the whole It is a great preservative against putrefaction as long as it remains in its integrity for consisting of many saline particles it seasoneth whatsoever it toucheth with a pleasing sapour It is the proper habitation of the vital spirit the immediate instrument of the soul in which it shines displaying its radiant beams every way that sensation motion nutrition and all other functions may be exquisitely performed God and Nature never intended other then that the bloud should be Homogeneous pure plain symbolical with that single principle of the Vniverse Now these Peripatetick Philosophers deliver to the world that the contexture of this vital juyce is made up of Choler Phlegm Melancholy and Blood which united produce this compounded body which we call Sanguis How grosly erroneous and dangerous this Tenet is most Learned Helmont hath made evident Wherefore we conclude with that noble Philosopher that Bloud is an Vnivocal substance divisible only by some external accidental means as the Air or Fire which cause a various texture and different position of its Atomes whereby it seems to consist of parts which are not really inherent in it as is manifest in its degeneration from its native colour sapour consistence and goodness which it had before it became corrupt in the pottinger or underwent the torture of fire Both of which do strangely larvate and disguise the puniceous Balsome giving occasion to the Galenists to frame their four fictitious humours no where really existent This being the foundation of all his declamations against Phlebotomy before I proceed any farther it may seem requisite that I should make some Animadversions thereon I might take much notice of and display his errours as to what he sayes that the Latex is by the Greeks called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 this is the first time I ever read it called so the usual terms being 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The notion whatever Helmont say is not new at all an hundred Galenists have mentioned and treated of it as the vehicle of the bloud and nourishment But that cruor should come from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 crudus concretus is an opinion singular to the Baconical Philosopher That 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 doth signifie cold I know well and that cruor properly signifies the the bloud of dead people or the mortified bloud issuing from putrefied wounds I no less understand though Authors frequently confound it with Sanguis But that his Latex and the Lympha so called by moderns are the same is news for it is not held that the Lympha in its peculiar form was pre-existent in the Arteries and as such did accompany the Blood through the Maeandrous pipes but is generated as it is discharged into the Lymphaeducts and from them is re-mixed with the bloud And if it were yet would not the definition of this Latex agree with it for the Lympha is no inseparable companâ—on of the bloud as appears by its peculiar vessels it is seldome a diaphanous clear liquor being commonly tinged with several colours oftentimes whitish sometimes yellow or as it were stained with bloud And whereas this Latex is devoid of all sensible qualities those who have experimented the Lympha do not find any such thing but a variety of tasts Nor is it true that the Serum which accompanies the Bloud is such a Latex as our Helmontian describes it being never to my taste free from a salsuginous sapour though it retain that with a great Latitude nor devoid of colour so as to be clear and diaphanous and 't is very seldome seen that the said Serum will not coagulate unless preternaturally upon a gentle fire so that it is no more to be termed a Latex than the whites of eggs beaten to the like fluidity In like manner that in the Lymphaeducts will coagulate as Bartholin observes and others As for the Cruor that there are graduations of the Bloud as to its crudity and impurity is no doubt amongst the Galenists and that it may oftentimes transcend the state of due maturation and so become degenerate is as easily granted as that it should come short of its desired perfection and when this Blood degenerates any way into a Tabum or sanious matter I must tell him that Aristâ—â—le and his followers acquainted us therewith before that Helmont was ever heard of whose Cruor bred in the Liver and distinct from the Bloud impregnated with vitality is such a piece of non-sense as ought not to be mentioned in this Age but to Baconical Philosophers who not only connive at but applaud any Hypothesis Concerning the Blood when I read the Elogies he bestowes upon it as the Seat of the Soul by which sensation motion nutrition generation are performed I thought â—pon the opinion of Aristotle and his zealous sectators â—mongst the Physicians who have denied all Animal spiâ—its fixed the principality of the Members in the Heart and from thence derived even the nerves If G. T. will defend the generality of his Assertion I assure him that Hofman Van der Linden and Harvey will be more serviceable to him than Van Helmont But this consideration hath little influence upon the present Controversie that which follows hath nothing of Truth in it that the Bloud is an Homogeneous pure body for nothing homogeneous can ferment But it is most evident that the bloud is in a perpetual fermentation and that it is such a liquor as is constantly generating constantly depurating and constantly expending it self so that nought but Imagination can represent unto us such a thing as pure bloud and I hope the specious pretences of a Real Philosophy will not terminate in Speculation and Phansie When the bloud either naturally issues forth or upon incision of a vein it representeth unto
is conveyed as it were in conduit-pipes the Heart being the great Elastic Engine which drives it being fed by the vena Cava and disburthening it self by the Aorta though even the motion of the Heart depend upon a Superiour influence by its Nerves which wherein it consists and how derived from the Brain and Soul is a thing to us incomprehensible I do suppose that the Circulation is continued and carried on principally by Anastomoses betwixt the Capillary veins and Arteries many whereof having been discovered by Spigelius Veslingius and others the rest may well be supposed and perhaps in the coats of the Veins and Arteries there may be a certain texture requisite whereby the transpiration is managed in order to the safe continuance of the digestive fermentation in the Blood and the nutrition of the body The impulse of the Heart together with the pulsation is sufficient to convey the blood to the lesser capillary Arteries and there though the pulse be lost which yet a little inflammation in the extremities of the body will make sensible and in some Ladies as also in Children the least preternatural heat yet it is impelled by the subsequent blood still into the veins and having acquired by the common miscele in the Heart and the digestive fermentation which naturally ariseth in such heterogenious liquors an inclination to expand it self the compression in the Capillary vessels adds to its celerity of motion when the larger veins give liberty for it the Aiery corpuscles of several kinds which are easie to be discovered upon burning by their expansion and contraction adding much thereunto Thus in Water-engines the narrowness of the â—ipes do add to the impetus with which the Water issues forth And I do conceive by the Phaenomena which daily appears in practise that the Animal heat in the Blood actuating that heterogeneous miscele and according to the diversity of its parts producing therein with the help of its fermentation a rarefaction of what is aiery and according to the room there is a liberty or inclination to expand and evaporate themselves this is the principal cause of the continuance of the motion of the blood in the veins and of its saliency upon Phlebotomy Thus upon Scarification there is no salience or spurting out of the blood there being no room for such an expansion or for the Aiery halituous parts in which there is as great a difference as in those exhaling from the terraqueous Globe to rush forward out of the continued Arteries and together with themselves to protrude the blood Upon this account the Methodists and old Physicians as also the Aegyptians where the tender bodies and constitutions of Children and Women or Men admit not of or requireth that great relaxation of the pores and texture of the body which a more robust and firm habit wherein as the natural resistance in health is greater so the recess from it in a bad estate is much greater would be cured by they use these Scarifications and prefer them most judiciously to Phlebotomy This constitution of the Body doth evince the great utility of Phlebotomy and best as I suppose explicates the effects thereof which we daily experiment From hence not only is manifest how the Body is evacuated in a Plethora but in case of Revulsion and Derivation It is manifest in Aqueducts and Siphons that the liquors though much differing in nature from the Blood nor so inclined to evaporate does accelerate their motion and issue out so rapidly upon an incision or fracture in one of the Pipes that a lesser in such a case will deplete the greater notwithstanding its free passage in its own entire Canale Thus the most learned and considerate Physician Sir George Ent having observed first thus much Videmus aquam per siphones delatam si vel minima rimula hiscat foras cum impetu prorumpere And Sanguis per aortam ingressus fluit porro quocunque permittitur peraeque sursum ac deorsum quia motus continuus est quemadmodum in canalibus aquam deferentibus contingit in quibus quocunque feruntur aqua continuo pergit moveri Quare nugantur strenue qui protrusionem hujusmodinon nisi in recta linea fieri posse arbitrâ—ntur After this He explains the doctrine of Revulsion in this manner Quae postea de revulsionibus dicuntur nullum nobis facessunt negotium â—antundem enim sanguinis a pedibus ascendit per venas quantum ad eosdam delabitur per Arterias Facto itaque vulnere in pectore aut capite revulsio instituitur si modo tam longinqua instituenda sit in â—rure Quia sanguis alias quoquoversum ruens facto nunc in pede egressu copiosius per descendentem ramum procul a vulnere delabitur Non enim arbitramur sanguinem aeque celeriter sua sponte per arteriam aut venam fluere atque is secta earum aliquo effluit Nec sanguis ad laesum pectus aut caput per venam cavam impetu affluit quia fluxus ille aperta inferius vena intercipitur I do acknowledge that the reading of these passages did first create in me the thoughts I now impart unto you And hereby it is evident how the Ancients with their large Phlebotomies might derive even the morbifick matter or revell it though impacted Our minute Phlebotomies do seldom produce such an effect for since it is not otherwise done but by a successive depletion out of the Arteries it would seem necessary to extract three or four pounds of Blood to effect such a matter Neither indeed is it necessary albeit that I believe the most speedy cures but great judgment is requisite in such operations were atchieved thereby for though we do not retract the Humour or Blood unto the place where we Phlebotomise we do revell it from the place whither it was flowing and the course of the Blood and Humours being diverted the Arteries leading to the part affected or depleted and the Flux of Humors which was by them is abated their tenseness there which appears by their pulsation there where they did not beat before is relaxed and so becomes less opportune to extravasate either the Blood or other Humours whereupon Nature it self alone or with a little help of the Physician doth digest and dissipate the impacted matter Whereupon if we add the motion of restitution in the parts affected which is hereby facilitated the great change in the digestive fermentation of the Blood which is manifest by the melioration of the Blood which is seen in repeated Phlebotomies and the relaxation of the whole body in order to the transpiration and other depuration of the Blood by its several Glandules the Kidneys Liver Guts the reason of those prodigious benefits which Patients have had of old and now under our practise is manifest nor do we want a justification for reiterating Phlebotomy or exercising it in different veins and divers manners I designed long ago to set aside some spare
administred it is so far from debilitating Nature that it adds to its strength mitigateth the present symptomes prevents the violence of the future and concocteth the disease apparently I will not undertake to justifie the demeanour of each particular Physician any more than I will answer for their intellectuals and skill in Physick It is not the reading of Sennertus and Riverius with a little knowledge of the new discoveries in Anatomy and a few Canting terms about Fermentation texture of bodies or such like knick-knacks and Conundrums of the novel Philosophers which accomplish a man for practice These men will never come to be ranked with Vallesius Mercatus Fernelius Duretus Rondeletius Massarius Septalius Claudinus Crato or Rulandus If Experience be our Guide let us inform our selves by the Histories of such as they have given us of Epidemical and pestilential diseases and of particular cases as also the cures and following them let us come to practise and not deserting our own reason let us be cautioned by them These others for want of judgment to consider each circumstance cannot make an Experiment or relate it whilest they extenuate the credit of the ancient and modern Physicians that are not Innovators though more observing and experimental than themselves they do it only to excuse their ignorance in that kind of Learning and whatever they have of the Lord Bacon they have this of the Russe in them that they neither believe any thing that another man speaketh nor speak any thing themselves worthy to be believed For such as these or any else that do not practise Phlebotomy according to the rules of Art I cannot make any Apology nor do I think that their errours ought to extend so far as to disparage all Physicians who demean themselves prudently and discretely Notwithstanding all our care some Patients will dye no Physician can secure all men from what their frail condition hath subjected them unto If our Method and Medicaments be such as the general rules of Medicine and an Experience generally happy do warrant 't is as much as can be expected from us and the Imperial Laws allow of this defence though they punish the immethodical and novel Experimentators and the Ignorant Sicut Medico imputari eventus mortalitatis non debet ita quod per imperitiam commisit imputari ei debet pretextu enim humanae fragilitatis delictum decipientis in periculo hominis innoxium esse non debet To conclude this Argument I say that although it often happens that diseases are cured by sole Phlebotomy Evenit ut saepius missio sanguinis sola curationem perficiat Misso sanguine saepe sponte naturae expurgatur corpus alui profluvio vomitu aut sudore succedente Yet no wise Artist will rely upon that alone but with the addition of other auxiliary medicaments Herein Spain and France are pretty well agreed And as no wise man will undertake to cure by bleeding alone so it is most foolishly done of our Helmontian to demand or expect it as he doth here I come now to his fifth Argument The means to let out bad blood without removing the efficient cause thereof is no direct method of healing Now Phlebotomy lets out bad blood without removing the efficient cause thereof Ergo Phlebotomy is no direct Method of healing The Major is proved thus Whatsoever suffers the cause to remain can never remove the effect For manente causa manet effectus Now Phlebotomy suffers the cause to remain Ergo it can never remove the effect The Minor is made good by frequent experience If the cause of bad blood were cut off the Feaver or Scorbute depending according to Dr. Willis upon the degeneration Sal and Sulph therein would quickly cease but we plainly see the contrary for after the veins are much depleted the disease becomes more truculent and oftentimes mortal which could never be if this depraved blood were any other than a product or an effect of an essential morbifick cause The same agent which in sanity sanguifies regularly without any considerable defection in sickness becomes exorbitant sending out a vitious juyce into all parts be it good or bad it still springs from a root which continually feeds the branches so that it cannot be other than great folly and wrong to the Patient to let out that juyce though it seem never so corrupt when another of the like condition must needs enter into its place derived from the shop the duumvirate where it first receives a previous rudiment which ought in all reason rather to be reformed than to give vent to those easily evanid particles inseparably joyned with this ruddy liquor how ill soever represented If all contained in the reins supposed to be corrupt were discharged yet as long as the ferments principally of the first and sixth digestion deviate from their right scope there would in a short space be a succedaneous repletion of a matter equally contemptible yea worse in respect of an enervation of strength than before This Argument though our Helmontian rely so much upon it is a pure Paralogisme First He supposeth that we use Phlebotomy in all diseases as a direct method of healing which is not true except in some maladies as Apoplexies Squinancies Haemorraghies or great eruptions of blood some Atrophies and sometimes in Feavers in which 't is frequent with us to rely solely or principally upon Phlebotomy yet even here we would think it very improper to admit of our Phlebotomy to be stiled our direct Method of curing because it is but a part of our Method which will include if not some other prescriptions yet at least dyet In many cases we use Phlebotomy as one part of our Method but not as the principal as when we use it antecedently to other remedies Pharmaceutical and dietetical to prepare way for or facilitate their happy operation I am not now to write Institutions in Physick for the documentising of this Disciple of my Lord Bacon 't is enough that he may learn any where almost as in Vallesius Mercatus Claudinus and Plempius that we propose more than one scope to our selves in Blood-letting neither is it ever except in diseases arising from a partial or total Plethora our direct method of healing If it be but a part and necessary or useful part thereof we are sufficiently justified Thus his Major is enervated for if he would have opposed the modern practise he ought to have urged it thus The means used to let out bad blood without removing the efficient cause thereof is no direct Method of healing nor an useful or necessary part thereof This is manifestly false as I shall shew anon As to his Minor That Phlebotomy lets out bad bloud without removing the efficient cause thereof This would the Ancients deny who bled their Patients in many cases until they swooned or fainted with great success and we must say it is not absolutely true there being no Practitioner I believe
but hath seen some cases in which sole Phlebotomy hath effected the cure he may see many Instances of this in Botallus and that in diseases where the body was undoubtedly cacochymical I have seen Agues tertian and anomalous perfectly cured with once bleeding in women with child and in children I have seen some Atrophies so cured that the principal cause of their recovery was to be attributed to their Bleeding the like I have observed in several Chronical diseases even in inveterate quartanes as also others have done nor is there any thing more common almost in our Cases than the relation of several diseases absolutely cured by single Phlebotomy which I shall not transcribe here but in my large discourse of Phlebotomy in Latine I intend to represent all such cases at large with their circumstances and the History of Phlebotomy with all that variety of success which judicious Practitioners relate of it in several diseases and persons I add now that No man can be an accomplished practitioner who is not versed in the History of Diseases and particular cures for the general rules and directions make no more a Physician than such a knowledge in Law would do a Lawyer the res judicatae import more with us than they do in Law-cases and as Reports of the Iudges in special cases must be known by a compleat Lawyer so must our Book-cases be our presidents and regulate our practise Duobus enim tanquam cruribus innititur Medicina neque solis theoreticis rationibus contenta insuper etiam practicaes experientias particularium requirit indefessam ad singulos casus intentionem Thus is his Minor false as was his other Proposition and it should have run thus But Phlebotomy lets out the bad blood without removing the efficient cause thereof or conducing thereunto But he proceeds to defend the Minor thus If the Cause of bad blood were removed then would the effect cease but oftentimes we see that notwithstanding such a depletion the disease continues and if it be not mortal yet it becomes more truculent Here he commits the same errour that before expecting a greater effect from Phlebotomy than we propose generally to our selves in it we do it sometimes for revulsion of the matter flowing to any part as in some Pleurisies Squinancies the Colick Bilious and Rheumatismes c. wherein we never rely solely upon bleeding and though oftentimes the effect transcend our expectation yet do we not presume upon it Sometimes we let blood for prevention of future diseases as in great contusions and wounds Sometimes we let blood only to prepare way for future Pharmacy Ita plerumque in febribus mittitur sanguis qui non superat naturalem mensuram neque simpliciter neque in hoc homine sed quia nisi mittatur ob febrilem calorem qui adest succorum putrescentium mistionem corrumperetur ac fortasse malignè cutis rarefactioni ventilationi vasorum relaxationi ad futuram expurgationem necessariae impedimento esset Itaque mittitur non quia multa subest copia sed quia ea quae subest tunc est inutilis noxia ac proinde facultate ferente deponenda etsi causa morbi non inclinet ad ideam sanguinis modo non ab ea plurimum evariet i. e. Thus in feavers we usually let blood not that the blood abounds above its due proportion either in general or in reference to this or that individual but because the blood which flows in the veins is infected with a feavourish heat and would be corrupted thereupon and by reason of the intermixed humours now inclined to putrefaction and that perhaps joyned with malignity for the prevention thereof and least that plenitude and depravation of the Blood should hinder that transpiration in the habit of the body ventilation of the blood and laxity in the vessels which is requisite for the subsequent purge do we use Phlebotomy not imagining that there is any superfluous abundance of blood but that there is then in the body some that may well be spared and which if the Patient hath strength to bear it may with prudence be let out to prevent so great dangers as are imminent and to secure unto us the good effect of the subsequent Physick And if the disease do sometimes encrease upon Phlebotomy it behoveth wise persons to distinguish whether those symptomes happen by reason of bleeding or only succeed it in course the disease being in its increment for this makes a great difference in the case as also whether amidst those symptomes which are in due course most violent in the progress and state of the disease whereas we bleed usually in the beginning only there be not some that yield signs of concoction and melioration which if they do as we may justly attribute those hopeful consequences in part to Phlebotomy so we need not be amazed at the present truculency of the disease which affrights none but the ignorant If notwithstanding all our care and due administration of Medicaments according to Art the Patient do dye yet is neither Phlebotomy nor the other Physick to be blamed but we ought rather to reflect upon Physick that 't is a conjectural skill in the most knowing men and that we are not as Gods to inspect into the bowels and secret causes of diseases that besides the special judgment of God upon particular persons all diseases are not curable in all individuals either by reason of the variety of distempers complicated which interfere with and contra-indicate one to the other or for some unknown idiosyncrasy or other intervening cause which defeats our Methods as well as it disappoints the Arcanum of Pepper-drops I must here take an occasion to remind this Helmontian that he doth ill to disparage Phlebotomy by reason that after it there may follow some truculent Symptomes and yet to reject that imputation where his Dietetical rules are in dispute When he gives his vinous and spirituous liquors in Feavers a practise not peculiar to the Helmontians but allowed with regard to due circumstances by Hippocrates not only in diaries but acute-feavers so Galen would have told this Ignoramus if any seemingly frightful Symptomes appear as extraordinary heat an inquietude a little raving a swerving from right reason the Patient must not be startled in a vulgar manner but be satisfied that these are but the effects or fruits of an Hormetick motion in the Spirits excited and increased by good liquors easily united with them for the routing and putting to flight every way whatsoever doth disturb its vital government Though Hippocrates say it is good in all diseases that the Patient retain his senses though he reckon inquietude and restlessness in the sick amongst evil signs yet our Helmontian dissents from him whatever time of the disease it be and whatsoever other circumstances attend thereon For oftentimes madness deviation from the right understanding a Lethargical or sleepy disposition suddenly break forth Nihil
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 Physician the better Artist the latter adds to his gâ—â—eral 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 Ido 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 of 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 his 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 that I know take much notice of that other effect how Phlebotomy inclines to fat I have read in Ioannes Fuchsâ—us 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 eâ—aciated 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 courses then Phlebotomy In short I my self have been let blood above fourscore times and yet am lean and so far from being feavourishly inclined that I never had any except the Measils once and Small-pox twice and twice a tertian Ague and I find no imbecillity or prejudice in the least that should induce me to repent what I have done or resolve against it for the future But we must distinguish upon what is produced by any thing as its cause and what is only a concomitant thereof If it ten thousand times proves otherwise we must not impute the growing fat of one Patient to Phlebotomy indefinitely but rather to some alteration the disease in which it was applyed hath wrought in his body to his Analeptic diet and course of life subsequent thereunto or to his individual temper And perhaps it may be not impertinent to add here that as Distillation and the burning of the blood of a Multitude of persons hath convinced me that there is no such deflagration of blood as that learned Physician imagines nor any vital fermentation in the blood depending upon the Chymical ingredients of Salt Sulphur and Spirit c. so neither is the Blood of corpulent persons I never tryed the Obese because they do not bear Phlebotomy except once in a Youth lately that was extream fat and in danger of an Apoplexy and it did not burn with so vigorous and lasting a flame as that of many lean men but by its crackling gave testimonies of much Salt
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 Type 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-pest-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 inâ—ustice he triumphs over the Galenists for his having dissected 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 fuerunt 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 mortuo 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 specifick 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 deemed 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 cujusdam qui experientiam testem citat multos ex peste mortuos esse quibus testiculi intumescebant solum nullo praeterea symptomate aegrotos illos invadente It matters not what is the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 of the disease which way the venenate matter inclines or what part it principally affects a Carbuncle in the throat as in the Garrotillo is as pestilential as a Carbuncle on the hand or toe if it be as epidemical contagious and mortal So the Chin-cough may be pestilential upon the like qualifications and I believe that to be the disease whereof Ballonius speaks that it was Epidemical amongst the Children in France in 1579. He calls it Tussis Quinta and admires how it came by that name and so doth his Scholiast Mr. Thevart undoubtedly it was transmitted from England and thence came that name which the French mistook for Tussis Quinta and Quintana that is the disease I am sure he describes he saith none ever writ of it and I believe it to be true as to forreign Physicians Such mistakes will hereafter make work for Criticks who will make strange glosses hereupon as on the Milordus of H. ab Heere and the Cerevisia Trihopenina in Mercatus the first imports no more by unus ex iis quos Angli Milordus vocant then one whom the English call My Lord and the other intends nothing by Cerevisia Trihopenina than Three-half-penny Ale and contradistinguisheth from Cerevisia dupla or double Beer But to resume my discourse I
I have blooded my self on purpose two hours after dinner to make the tryal and have an hundred times examined the blood of others who have been blooded at such times as we might expect to see that Phaenomenon of his Yet hath the reality of his observation been confirmed unto me by other credible witnesses so that I question not but he may have seen it though I could not in these Ladies who all dined together about one of the clock and had done bleeding by four Neither may I pass by this Observation that of all the Serum which I have tasted I never found any to be bitter though I extracted some once that seemed so bilious that being put into aâ— Vrinal none could know it from urine highly tinged as soon as I set it on the fire it coagulated with a less heat than I imagine it to have had in the veins and it exchanged its hue for the usual white smelling like a roasted Egg. Yet doth Van der Linden say that some have tasted the blood of Icterical persons and found it bitter Actu nihil naturaliter in sanguine amarum est Sed nec esse potest redderet enim sanguinem ineptum suo muneri ceu observare est in Ictericis In his enim sanguinem amaricare accepimus ab iis qui ipsum vena emissum urinam ejus gustarunt Asclepiadio more And Vesalius gives us an account of one Prosper Martellus a Florentine Gentleman much inclined to and troubled with the Iaundise whose Liver was scirrhous but Spleen sound and his Stomach turgid with choler and wheresoever he opened any of his veins they were full of thick choler and the fluid liquor which was in the Arteries did tinge his hands as if it were choler I find the like Oservation in Th. Kerckringius that an Icterical Woman brought forth a dead Child in the eighth moneth which was so yellow all over that it rather seemed a Statue of such wax than an humane Abortion being dissected By him instead of blood in the veins there was nothing but choler and all the bones were tinged with such a yellow that one would have thought them painted The Scholiast upon Ballonius observed that however the blood is naturally sweet even such as upon obstructions from the Menstrua hath regurgitated and discharged it self at the Gums of women as they have told me yet in one that was troubled with the Green-sickness the blood though florid was salt Potest esse floridus color in se esse acrior biliosior unde quaedam mulier 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 ejusmodi praedita temperamento mihi affirmavit siquando vel ex dentibus sanguis affluit vel e capite eum sibi gustum sentiri salsum molestum When I was at Barbadoes we carried off several poor English thence to Iamaica where many of them falling sick and some being well were let blood I observed that in those poor people which live upon nothing almost but Roots and drink Mobby a liquor made of Potatoes boyl'd and steep'd in water and so fermented that their blood did stream out yellow and in the Porringer did scarce retain any shew of red in the coagulated mass yet are they well and strong but look pale and freckled such persons which are frequent in Barbadoes are called Mobby-faces It were infinite at least beyond my present leisure to relate all that variety of morbid blood which hath been observed in sundry diseases and in several persons languishing under the same distemper as in Pleurisies the Scurvey French-pox Hypochondriacal Melancholy and the like wherein if it be true as it is that oftentimes diseases vary in individuals 't is no less certain that the blood doth also vary in them so that oftentimes ignorant Physicians do imagine a greater corruption in the blood and a greater recess from what is natural to the person and a greater danger in the disease or in the practise of Phlebotomy than they need yet in Epidemical or some Sporadical diseases if the Phaenomena be as general as the disease 't is certain then that the resemblance of the blood argues a resembling cause which prevails over the idiosyncrasy of particulars I know it will be expected that I should say something about the Controversie whether the Blood be one Homogeneous liquor the recrements whereof make up the four Galenical Humours which are no otherwise parts thereof than the Lees and Mothers of Wine are constitutive parts thereof Or whether the four Galenical Humours viz. that which is properly Blood Melancholy Choler and Phlegm are the constitutive parts of the Blood in its natural consistence and Crasis I shall say therefore about this point as much as may be requisite to my present purpose First I observe that the Galenists are at a difference whether the Mass of blood contain those Humours actually or only potentially so that one may hold according to them that the blood is as homogeneous a liquor as any Neoteric doth hold it to be though it arise by the mixture of their five principles Amongst others Erastus hath a disputation in which he amply asserts that all those Humours when they are actually in the blood they become excremenâ—itious and are no longer parts thereof but such as the ejectment thereof depurates and perfects the other remaining blood which he confesâ—eth to consist of several parts constituting one body to which they are as essential as the serous caseous and butyrous part are to Milk which if they be deficient 't is no longer Milk Nam ut non potest lac bubulum intelligi sanum perfectum sine tribus suis partibus sero caseo butyro ita non potest sanguis probus animo concipi definiri absque partium illa varietate Fernelius doth compare the generation of Blood to that of Wine wherein the Chyle is supposed to resemble Must which by fermentation separates and throws out such parts as are not actually in that liquor but arise upon fermentation and are ejected several wayes the more crude parts are by time digested and then the noble wine brought to perfection so he supposeth it to be in the blood and thus though all the humours be at once as it were produced in the Chyle yet are they no more parts of the blood than the Tartar and Mothers are parts of Wine Both these Similitudes of Milk and Wine to Blood were first I think introduced by Galen I am sure he made mention of them and so did his Successours to Mercatus Fernelius Platerus Palleriaca then Carolus Piso began to carry the comparison further in his discourse of Feavers and after him Quercetan and since that our learned and judicious Countrey-man Doctor Willis Others held that the blood as it flows in the veins and is designed by Nature for the Aliment and other uses in man is not to be understood as one liquor consisting of some variety of parts yet united
his Patient to alleviate the disease in its course by preventing all troublesome and mitigating all dangerous symptomes and to facilitate as well as hasten his recovery It is not questioned but Patients have been and may be recovered of Feavers with little or no blood-letting yet when I consider the great hazard they run in that course the vexatious and perillous symptomes which they languish under longer and with more violence than others I cannot approve of the practise nor think the Physician dischargeth his duty and a good conscience in so doing Extrema necessitas in moralibus ut certum est vocatur quando est probabile periculum and the Patient doth offend against himself if he refuse to take a befitting course against dangers that probably are impending and the Physician doth trespass against his neighbour if he do not propose and practise such a course I cannot to use the words of the incomparable Riolanus I cannot without pity to the sick and some resentment against the Physician read in Platerus's Observations how sundry of his Patients were broyled and torrefied with burning Feavers whom he never let blood He doth relate of himself how he was sick of a most burning Feaver yet did he never so much as let himself blood therein albeit that it were requisite in those cases Such are not obliged to their Doctors but peculiarly to the Divine Providence for their recovery It was the mature consideration of that tenderness w ch is requisite in Physicians towards their Patients which advanc'd the present course of Physick to its glory above all other Methods it being endeared to our esteem by all those regards that represent it as prudential It was not introduced by chance or the subtlety of some persons but the choice of all and so established by the Magistracy that to transgress against the traditions of this Art was criminal in a Physician even by our Laws It may in some cases seem to be troublesome and unpleasant yet SAFETY requires it It may seem tedious sometimes by multiplication of Medicines yet Prudence obligeth by all those means to preserve and secure life and if the omission thereof be criminal in a Physician in case of any sinister accident why is not the practise laudable Would Men but seriously consider How much danger they run and How much more they suffer upon the negligence or indulgence of a Physician who leaves all to Nature and adviseth them to wear out a distemper they would rather hate than love such a Man and the apprehension they should have for the unnecessary jeopardy he put them on would extenuate his credit very much The most rash and brutish counsels may succeed well but yet the most prudent are to be preferred Amonst Physitians I do not reckon the Helmontian as any there is no doubt but a Plethorick indisposition requires Phlebotomy Nature being surcharged with blood forceth us thereunto least some vein should break in the Lungs or the Patient be strangled with that excess this is called Plethora quoad vasa when the vessels are so full of blood that there is danger of their breaking or that the blood should stagnate in the Heart Lungs or Head there wanting room for its motion or take some inordinate course and so strangle the Patient There is another redundancy of Blood which is called Plethora quoad vires or such a plenitude of blood as brings along with it no apparent hazard of breaking the vessels yet doth it oppress Nature so as thereby to become redundant It is more than she can bear in the present juncture 't is more than she can rule and it will suddenly fall into an exorbitant motion to the detriment of some principal part in case timely prevention be not used In both these cases in which the blood is not supposed to be much depraved from its natural estate all do allow of Phlebotomy and if it be timely put in execution it may hinder the progress however it expedites the cure of the disease In these cases we consider not only the present plenitude but also the future what may be in a few dayes to the great exasperation of the disease and peril of the Patient For it is possible that in the first beginnings of a disease there may be neither of these plenitudes but they may ensue a little after For when the insensible transpiration shall have been a while abated as inquietude pain and watching will abate it the Blood degenerates and no longer continuing its usual depuration those excrementitious particles which were lodged in the habit of the body and pores do remix with the sanguine mass and become like so many fermentative corpuscles agitating and attenuating the blood so that whereas before there was no plenitude now there is that the excrementitious particles do contract a fermenting heterogeneous quality different from what they had in the Blood appears hence that those which sweat much as the new-comers in the Indies their sweat is less noysome and bilious by far than it is in those that sweat more seldome Thus Soot is a different body from any thing that is burned Hence it is that those particles being reimbibed into the blood are so offensive to the nervous parts and introduce a lassitude as if the body were surcharged with a plenitude Besides these two cases in which Phlebotomy seems to be directly indicated by a Plethora or surcharge of blood It is practised in other cases by way of revulsion when the Blood and intermixed Humours flow into any determinate part or are fixed there as in Apoplexies Squinancies and Pleurisies for as upon dissection it is manifest that in such diseases there is a greater efflux of Blood than upon other occasions so it is evident by long experience that Phlebotomy doth alter its course and draw back the blood so as that sometimes after that the first blood hath run more pure and defaecated the subsequent hath been purulent as if the conjunct cause of the Pleurisie or Squinancy had been evacuated thereby In reference to such fluxes of the blood to determinate parts we usually consider what in all probability may happen as well as what is at present urging and therefore for prevention thereof we let blood upon great contusions and wounds It is also practised by way of derivation when we let blood near to the affected part thereby to evacuate part of the imparted matter Thus Van der Heyden did frequently let his Patients blood in the same foot for the Gont Thus in a Squinancy to open the Iugulars it is a derivative Phlebotomy In all these cases all Physicians agree to the received practise but in case that the disease be not meerly sanguine but seem to arise rather from a Cachochymy or redundance of evil humours than any plenitude or exorbitant motion of the Blood here many Physicians cry up that Rule That Plethorick Diseases require Phlebotomy but those that arise from a Cachochymy
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 Farrier 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 co quoque sensudisci quod qui diversa de his senserint ad eundem tamen sanitatem homines perduxerint It a que ingenium facundiam vincere morbos autem non eloquentia sed remediis curari Quae siquis elinguis usu discreta bene norit 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 â—steemed 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 upon 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 interlexture 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
health not so much as being obliged to keep his armes in Bed On the fourth day he gives them one very gentle Cordial to promote their eruption and abandons them to Saffron and Milk to be given twice a day and ordains that he be kept in a constant moderate warmth such as is natural and usual to the Patient This is the sum of his Method except I add that when they are upon maturation he gives a mild Cordial twice each day morning and evening And in case that during the time of the decumbiture of the Patient by any accident a new Feaver arise then is the Patient to be kept still in such a proportionate heat as is usual to him in health if the season be temperate he is not to have a fire to be dieted with small Beer and Water-gruel stewed Apples or the like but to have no Cordial not so much as Harts-horn posset-drink By this Method Doctor Sydenham doth not doubt but this disease which so afrighteth people and is so frequently mortal will pass off with much gentleness ease and safety Betwixt these two there is a little discrepancy in their Method of curing the disease though there be some in their expressions and Doctor Sydenham doth seem the Comment the other the Text. Both of them oppose Phlebotomy Vomits Purges and Glysters as well as Sudorifics Though they differ in the râ—ason for their rejecting Phlebotomy For Doctor Whitaker doth avow that it draws from the Circumference to the Center But Doctor Sydenham yields that it produceth a quite contrary motion and causeth the Small Pox to come out Doctor Whitaker doth avow that this course of his is the old English Method and the ancient national and successful government of our Nation But Doctor Sydenham would seem to erect his practise upon his own Observations though all he propose in a manner be no more than the common actings of Countrey-people except when by any accident the Feaver be exasperated in the beginning or progress that he prohibits Cordials and what I belive was derived from Avenzoâ—r and Fracastorius Of these Writers it is remarkable that Doctor Whitaker doth never allow that there can be any malignity in the Small Pox so great and urgent as to induce a Physician to intermeddle beyond a moderate Diet and temperate Air because the Motion being Critical admits of no violence But this is a great Errour in the fundamentals of Physick For first in Diseases complicated with malignity not only the prognosticks but the issues are very uncertain as to life or death and the Critical evacuations deceitful so as that oftentimes they bring a momentany alleviation oftentimes notwithstanding those evacuations the distemper increases and the Patients dye This every man understands who is conversant in our accounts of Malignant Feavers so that to grant at any time that there is a malignity or venenate indisposition in the sick and to abandon him to a temperate Air and Diet relying upon Saffron and Milk is a practise never to be justified in Physick But alas we are not to be afrighted with the bug-wâ—rd Critical motion nor half an Aphorisme out of Hippocrates viz. Quae judicuntur sinere oportet These general sentences neither qualifie a Doctor in Law nor a Physician It becomes us to consider in a Critical motion several things First Supposing it to happen in its due time we must consider whether it be only a Motion or whether it be proportionate to the Disease for no evacuation that is diminute is properly Critical If therefore the pathognomonies of the Disease be such as argue a multitude of the Small Fox to be requisite for the recovery of the sick and only a few come out the Physician is obliged to assist Nature Secondly Supposing that they do come out plentifully yet if they be not such as should come out but black livid green or interspersed with purple spots not to mention other circumstances which every Nurse can tell 't is certain that the evacuation how critical soever doth not oblige the Physician to stand an idle Spectator No more ought he to be in case that all symptomes increase upon the critical motion and his Feaver and dangers multiply thereupon 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Thirdly It is requisite that the Critical evacuation be per loca conferentia by such wayes as are necessary to the disease But if the Small Pox during their eruption be attended with a dysentery bloody urine or other pernicious excretion that scrap of Hippocrates will not excuse the Physicians negligence for it supposeth that all the conditions requisite to a good evacuation be found in that which the Physician is not to intermeddle with I need say no more to intelligent persons 't is not my present work to turn Institutionist Whether Doctor Sydenham intend to ascribe sense appetite and judgment unto the Blood I cannot well tell but either He canteth in Metaphors or explaineth himself in his general Hypothesis about Feavers as if his meaning were such Quinimo nec mea sententia minis liquet febrilem sanguinis commotionem saepe ne dicam saepius non alio collineare quin ut ipse sese in novum quendant statum diathesin immutet hominemque etiam cui sanguis purus intaminatus perflat febre corripi posse sicuti in corporibus sanis evenire frequenti observatione compertum est in quibus nullus apparatus morbificus vel quoad plethoram vel quoad cacochymiam fuerit nulla insalubris aeris anomalia quae febri occasionem submiâ—nistraret Nihilominus etiam hujusmodi homines praecedente insigni aliqua aeris vel victus caeterarumque rerum non-naturalium ut vocant mutatione identidem febre corripiuntur propterea quod eorum sanguis novum statum conditionem adipiscigestit qualem ejusmodi aer aut victus postulaverint minime vero quod particularum vitiosarum in sanguine stabulantium irritatio febrim procreet 'T is true he did not pen it in Latine but another Mr. G. H. for him and perhaps his skill in that tongue may not be such as to know when his thoughts are rightly worded But it seems strange and irrational to attribute such an understanding to the Blood and to transmute a natural Agent into one that is spontaneous and which is more having represented it as such to make it so capricious as not to know when it is well but to run phantastically upon such dangerous changes as occur in putrid Feavers and the Small Pox for even in this last ariseth from a desire the Blood hath to change its state Since natural Agents demean themselves uniformly and of them 't is most true Idem quatenus idem semper facit idem I was surprised to see these new principles and to see effects of this nature arise without any cause It doth not seem possible for him ever to demonstrate that there is no Plethora or Cacochymy or obstipation of the pores of the body
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 alterations that they have ever been preceeded and accompanied with many petty changes in other things and if ever I have so much vacant time as to make political reflexions upon the rise of Mahomet I may declare much to this purpose This is that invidious subject about which Ecebolius Glanvill makes so much noise as if to avow that Mahomet were a Gentleman of noble extraction married to one who for birth riches and beauty might have been a Princess and accomplished with that sober Vertue Wit Eloquence and Education by much travel for he travelled all over Aegypt Africk and Spain as to render 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 that time that most of the Fables in the Alcoran were accommodated to the honour of the times more than to truth and 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 Bâ—t 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 fecissevisi sint ea certe exigua est dubia ut certum 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 passage will find in it the ebullition separation expulsion and despumation of our Doctor In truth those terms nor that which he imports by them are no novelty amongst Physicians and Rhases as Sennertus saith doth not make any mention of those uterine impurities as the cause of the Small Pox but compares the Blood to Must in in which some impurities are to be separated by Ebullition Wherein the whole Hypothesis of this semi-Virtuoso is contained However I cannot allow any more to his Observations than if a man should go without his doublet and pretend to a new Mode of wearing Breeches But that which is most intollerable in Doctor Sydenham is that He seems to attribute all the evil consequences of the Small Pox to the indiscretion of those that attend them be they Nurses or Physicians Thus p. 150. Edit 2. he makes as if Nature did discharge it self in that disease into the fleshy parts only so that if the Eyes Lungs Stomach Guts Pancreas or Membranous parts be affected 't is not the violence of the Disease but the ignorance of the Attendants which occasioned that which is intolerable for any man to say and refuted by Experience I might proceed to demonstrate that there is not any thing new in the whole Cure which Doctor Sydenham useth that in the beginning of the Small Pox before the eruption being as ancient as Bayrus if not derived from the Arabians And the rest hath been inculcated by an hundred