requisite as if you doe pourge when bloodletting is onely necessarie then is the disease aided against nature wherby greater dauÌ„ger of death dooeth ensue then would haue dooen if nature had been let a lone But to conclude briefly note that in all diseases the duetie of the Phisicion is to vse the contrarie remedie to the disease that healthe maie bee restored as to take awaie that whiche is superfluous to adde to that whiche lacketh to soften hardnesse and to rarifie grossenes and contrariwise alwaies endeuouryng to recouer the naturall state of the member diseased Likewise in hollowe vlcers and woundes to cause fâ—leshe to growe and to set in again bones that are out of ioynt and soche other like alwaies addyng subtractyng or amondyng that whiche is wantyng haboundyng or out of his dewe forme and place ¶ The. xii Chapiter ⧠What thynges the Phisicion ought to knowe before be attempte the cure of any disease I Haue declared sufficieÌ„tly in the former Chapiter how that it is the propertie of nature onely to striue and fight againste diseases And how that the PhisicioÌ„ is but the minister and seruaunt of nature either to adde soche thynges to her as she maie vse to destroie the disease withall or els by pluckyng cleane awaie the greatesse parte of that matter whiche causeth and maintaineth the sicknes And therefore it is mete and necessarie for the PhisicioÌ„ before he minister any thyng to learne and searche out perfectly the cause of the disease in whiche if he be ignoraunte it is more by good fortune then by cunnyng that he cureth any disease For how is it possible to help nature w t that that she hath nede of excepte it bee firste knowen what she needeth whiche none can knowe excepte the cause of the disease be manifeste to hym so that he maie minister thinges directly contrary to the cause of the disease And therefore I can not but lamente the ignoraunce of the common people that are perswaded that one medicin is sufficient for one disease not consideryng that one disease maie come of sondrie causes And therefore it necessarilie requireth diuerse medicines As for example weakenesse of the stomacke that it cannot digest well or that it hath no good appetite is one disease whiche neuerthelesse may bee caused a dosen sundrie wayes therefore the cure of it can not be alwayes with one medicine but rather in eche cause with a sundry medicine As if weakenes of the stomake come of a colde disteÌ„pure of it selfe only then it must be made hote bosome meanes If heate causeth the weakenes then it must be cooled Likewyse you must moisten drines and drie moisture But if the weakenes be caused of some humour that doth abounde whiche hath flowed into the stomake or hathe been there engendred then must that superfluous humour be pourged out either by vomite or purgation with a meke medicine As if it be fleme with a medicine that expelleth fleme if choler be abounding there then must it be soche a medicine as pourgeth choler And likewyse for Melancholie a mete purgatioÌ„ must be vsed to drawe out the humour But if the imbecillitie of the stomake be caused by a distilation and rewme that falleth out of the head into it then is the cure to be wrought in the head and not at all in the stomake And likewyse if distempure of the liuer or splene dooe weaken the stomake the cure consisteth in healing those members and not in ministring any thing for the stomake for it wilbe well as sone as they are cured Thus it is declared at large in one example the diuersitie of causes in one disease that thereby all men might likewyse consider that euery disease in eche member of the bodie may and doth likewyse come of diuerse causes against which causes if the medicines be not directly ministred it auaileth nothinge but rather hurteth Therefore let no man thinke it sufficient for the Phisicion if he knowe that a man hath soche a disease as the ague the Colicke the Flixe or soch other like that then he may straightwaye if he be conning minister a medicine mete for it No not so but he must first searche by al meanes possible the verie cause of the disease which the ignorauÌ„t people haue long time been persuaded that a cunning Phisition may doe in all diseases by the onely fighte and inspection of the vrine But alas thei are craftely bewitched or couetously blinded For to come to the knowlege of the cause of some inward disease the vrine profiteth nothing And in moste inwarde diseases of the bodie there ought as good regard to be had to the pulse and to the disposicions and state of the brain of the sicke as there should be of the vrin Also the egestions sweate spettle and other excremeÌ„tes ar not to be neclected in so moche as at some time thei do declare the cause of the disease and the state thereof when the vrine sheweth nothyng at all As for exaÌ„ple In a pleurisie or in an inflamacion of the lunges or in a squinancie or soche like There is more to be knowen by spittle then by Vrine likewise in a laxe or in a bloodie flixe or in a Colike or Iliacke there is more certaintie of iudgemente to bee geuen by egestion or ordure then is by vrine whiche thinges those that bee not altogether addicte so their own fantasie maie quickly by good reason be perswaded to credite For Vrine is nothyng els but the watrie and whaishe parte of the blood for it is strained from blood in the Liuer and sucked from thense into the raines from whens it distilleth doune into the bladder and so passeth forthe Since therefore vrine is the excremente that is separate from blood there is good cause why it should shewe the estate of the liuer and of blood in all partes of the bodie And also it can well declare the estate of soche members as it passeth by as of the raines the blader and soche like But certainlie in other diseases that bee out of the vaines and be distaunt froÌ„ the places by which the vrin passeth there is no certain iudgemente to bee geuen by the vrine vnlesse the vehemencie of the disease hath infected the blood or liuer after some sort Neuerthelesse soche is the ignoraunce of the common people that thei thinke him worthie of no estimacioÌ„ in Phisick whiche can not at the first sight of the vrin although it hath been caried .xx. miles tell whether it be a mannes water or a womaÌ„nes and how the disease greueth the paciente better then hymself also whether he shall liue or die what disease so euer it be whiche thinges vndoubtedly in diuerse diseases are impossible to be tolde by the onely sight of the vrine And therefore it is thought méete for hym that will minister Phisick duely and rightfullie First to se the pacient and to talke with hym or her
abeunde and trouble the bodie he must minister a medicen whiche purgeth fleme and so likewise for other humours abounding The minister of medicen ought to haue respecte to the strengthe of the sicke for if he be very weak and feble there oughte no purgation to be ministred vnto him because all purgations doe weaken nanure and diminishe strengthe and the stronger they be the more they weiken Let all men therfore beware of vehemēt and strong purgatiōs lest they put their life in hasarde and daunger By the age of the patient the Phisicion is put in minde that children and old men ought not to receiue purgations except great necessitie require it The tyme of the yeare is not to be neglected for there be sometimes of the yeare wherein purgations ought not to bee ministred as in Somer specially the Dogge daies as they are commonly called during the time that the Sunne is in Leo for then is nature burnt vp made weake y ◠she is not able to suffer the force violēce of a purgation but the Spring time is moste apte for purgations because it is temperate Last of al y e Phisicion ought diligently to beholde and contemplate the disease that he knowing what kind of disease it is may the better finde out of what humour it is caused As for example if the Phisicion perceiue the disease to be a tertian feuer straightway he knoweth that it is caused of aboundaunce of choler and therefore he must minister a medicine to pourge choler so foorth in other diseases Note that it there be none of the impedimentes aboue named a purgation is good to bee ministred to all soche as haue aboundaunce of euill iuyce or corrupt humours in y ◠bodie for it draweth out the humours that dothe moleste and thereby restoreth the bodie to his naturall estate again But if a purgation be rashely ministred either to one that nedeth it not or at an vnmete time or that it be soch a medicine as draweth not out the humour whiche then aboundeth or if the medicine bee vehement and very strong it will surely put the pacient in daunger of his life These thinges therfore ought to be well taken hede of by al men lest they catche great hurte when they hope for some profite But if a purgation bee ministred discretely to hym that hath nede of it in due time by an apte medicine whiche is able to drawe out the abounding humour in sufficient quantitie then dooeth the medicine singulare commodities to the bodie for it euacuateth and emptieth out al the causes of diseases and sicknesses either present or to come being engendred of any superfluous or corrupt humour as bee feuers tertians quartains quotidians fluxes caused of rawe humours or sharp choler Dropsies Goutes Palsies Litargies and diuerse other Note that before a purgatiō be ministred ther ought a medicine to be taken whiche shoulde prepare the body make it apt to purge and therfore it is called a preparatiue it is geuen for two caused either to deuide extenuate and make theim grosse and clammy humours that they may be redie to Aowe out whē the medicine draweth them or els it is geuen to open vnstoppe the cōduites and vessels of the body by which y e purgation must drawe the superfluous humour to it And this is that whiche Hipocrates doth counsail in the first Aphorisme of his secōd booke where he saith Corpora cum quisque purgare voluerit oportet fluuia facere that is when any man wil pourge the body he must make it flowing by opening vnopening the vessels The moste mete time to receiue a purgation is the morning for then are all the digestions perfectly finished and the stomake is without meate there is heede to be taken in what signe the Moone is before a purgation be ministred for some signes ar good for it and some are euill whiche are declared in the table before so that if any man desire to knowe a mete time for to pourge there he may learne it A purgation must be taken hote for so it offendeth the stomack lesse and it wil worke the soner Those that be apte to vomite and are offended with the smell of the purgation let thē stoppe their nosethrilles or smell some odoriferous thing in taking of it As soone as it is taken it is good to smell to a toste of browne bread dipped in vineger applie warme clothes to the stomake and to washe the mouthe straighte after it is taken with odoriferous wyne or to chewe sweete pleasaunt things to take away the horrible taste of y ◠medicine by this meanes vomiting shalbe eschewed For i. houres space after the purgation is taken let the pacient sit still and keepe himselfe the quiet and without sleepe that the strengthe of the medicine may passe to all partes of the body if the purgation worke slowely lette him walke vp and downe a good pace if he can When it worketh in any case there must be hede taken that the pacient doe not slepe for so the operation of the medicine woulde be stopped Also in the time of pourging immoderate heate and colde are to bee eschued and therefore a very great fier and the colde and open aire are bothe hurtfull for the bodie must be kept in a temperate heate After that the purgation is taken except the stomake be very weake it is beste not to eate any thing lest the operation of the medicine should be hindred After that the purgaciō hath doen working the pacient must be nourished with a meane quantitie of some broth that will breede good iuice and be easely digested and after by little and little returne to his accustomed diet Thus haue I as briefly as I coulde declared the commodities of bloud letting and pourging being wel and duely ministred and vsed and the discōmodities that will ensue of thē both if they be at any time misused wishing al men as they tender their healthe and life to beware of those ignoraūt persones that vse to open but one kinde of vaine for al diseases occupie but one kinde of purgation against all humours not considering at all the time the strengthe and age of the patient nor the cause of the disease nor any other of the circumstaunces afore named but let theim seke for the counsaile and aide of one that is skilfull in phisike and circūspectt in his doinges Who can consider what neede they haue and what is moste mete to be ministred vnto theim ⸫ Here followeth a Table whiche teacheth to knowe in what signe the Moone is for euer FYrst you must know what is Prime or golden number and with it you must woorke after this sorte seeke in the calender the daie of the moneth and beginne at the nomber right against it and tell so many dounwarde as you haue daies in your minde then marke that noumber you finde there And seke
whether it be Then to feele the pulse to obserue well the state thereof nexte to viewe diligentlie the excrementes not onely the vrine but also the ordure spitell and sweate Laste of all to haue respect to the place where grief is and to consider the accidentes that rise therof not omitting to knowe the former diete and trade of life of the sicke These thynges then beyng diligentlie and seuerallie marked the Phisicion maie more certainly learn the cause of the disease the strength therof and to what ende it will come then he could by seyng the vrine onelie And by that meanes he maie minister amete medicine for it whereby the sicke shall sone finde ease and hymself great good fame Otherwise he might by his error and ignoraunce tormēt the sicke worse and bring perill of death to his vtter reproche Thus haue I partlie declared what thynges ought to bee knowen of the Phisiciō that thereby he might with drawe and take awaie the fonde and folishe opinion that a great nomber of the countrie dooe credite to be true that is that the sight of the vrine is sufficiente inough for a cūning Phisicion to know the disease of the sick and the cause therof and to minister apte medicine for it ¶ The .xiii. Chapiter ⧠Of the vse and commodities of pourging and bloudletting MOte that if the bodie of man doe abounde with humours whiche are ready to oppresse nature then whether ther be sicknes in the body present by meanes of them or if there be but daūger of sicknes those humours must bee euacuate out of the bodie either by bloudletting or by pourging or by vomite swetting or bathes or by some other kinde of euacuation But I wil speake here onely of euacuation by bloudletting and pourging And first of bloudletting There be diuerse thinges to be cōsidered before bloudletting The age of the patient the complexion the time of the yeare the region the custome the strengthe the vehemencie of the disease The age must be considered because children vnder 14. yeares of age and old folke may not be let bloud without great necessitie require it The complexion is to be noted because a hote complexiō hath large vaines and aboūdeth with much bloud And therfore they may forbeare a good deale of bloud But coole complexions haue narrowe vaines and little bloude and therfore their euacuation must bee small The time of the yeare must bee marked that the weather be not to hote nor to colde And therfore the springtime is moste apte time for bloud letting because it is temperate The region and countrée is rehersed because it is to be noted that if the regiō be very hote or very colde it is not good to let bloud a temperate region is meatest for it Custome is not to be neglected for thereby we may know that they that haue ben accustomed to blede may better suffer bloud letting thē those that neuer were letten bloud The strengthe of the persone must be regarded for if there be great weakenes it is very daūgerous to let bloud at all except extreme necessitée compelleth Also the vehemēcie of the disease is worthie to bee marked for if it be a vehement disease you must let bloud streight if the former circumstaunces doe suffer it These thinges considered if thei wil permitte bloud letting and if it bee in a necessarie cause it shalbe good and expedient to knowe in what signe the moone is for you must take hede that she be not in the signe that gouerneth that member wherein you entende to open the vaine and also forsee that she be in soche a signe as is good to let bloud in which the table in the ende of this booke wyll teache you The vses and commodities of bloudletting are as foloweth First this is a general rule that bloudletting is a very good and moste conuenient remedy for all diseases that bee engendred of aboundaunce flowing or eruption of bloud as be chiefly the feuers called Synochi Also the phrenesie squinancie pleurisi peripneumony opthalmie against al inflammations and impostumations engendred of bloud in the lyuer the splene the raynes the wombe the share the armeholes the armes the legges to conclude in al inward or outwarde partes wheresoeuer the inflamation bee bloudletting is good for it whether it be nowe present or that ther be daunger that it will shortely engender Also bloudletting is good in feuers whether they be continual or intermittent if so bee the obstructions and stoppinges of the vaines be caused of immoderate repletion of humours And note that bloudletting dothe emptie and enuacuate from the bodie all humours alike as wel good as bad And therefore it is chiefly to bee vsed when there is to great an aboundaunce in the bodie of bloud other humours whiche do straine and stuffe the vaines that there is a great daunger and ieoperdie and breaking of some vaine or bruysing out of some flure of bloud or of choking and ertinguish natural heate And therfore in soche cases you must let bloud with all spede although sicknes be not already present For by lettinge bloud in due season the superfluous fulnes of y ◠vaines is brought into a meane state againe the paines that came of fulnes and stretching of the vessels bee eased The heauines that was felt in the bodie is taken awaye and the bodie is lightened and made more quicke and nimble to doe all soche actions as nature hath ordained it to doe Also it causeth natural heat to haue a larger scope and a free passage by opening and emptiyng the straightwayes passages of the vaines and arteries Last of all if it be done in time it preuenteth diseases into the whiche the bodie was ready to haue fallen Many more commodities might here be rehersed of bloudletting whiche is done when it ought and as it oughte to be done but to conclude omitting all other note for a generall rule that bloud letting is good against all kinde of diseases whiche be caused and engendred of bloud not onely when the diseases ar present but also it is good letting bloud to preuente any soche diseases if they be forséen or feared alwayes obseruinge that there be none of these impedimētes aforesaid whiche prohibite and forbidde bloud letting except it be in great necessitie and extremitie for then as the prouerbe is Necessitas non habet legē that is necessitie hath no lawe Here woulde I leaue of to speake of bloudletting but that there commeth to my mynde the common opinion of the ignorante people which dooe certainly beleue that if any persone be let bloud one yeare he muste bee lette bloud likewyse euery yeare or els he is in I can not tell howe great daunger whiche fonde opinion of theirs whereof soeuer it sprong at the firste is no more like to be true then I should saie when a man hath a great wounde by chaunce in any part of
his body wherby he loseth moch bloud after it is healed he must nedes haue the like wouÌ„de again the next yeare to auoyde as moche bloud or els he is in daunger of great sickenes or of deathe Whiche opinion if I did affirme it to be true although it bee moste false yet I might vse the like reason and autoritee to defende it that the common people vse for theirs for they can saye nothing if they be asked why they thinke so but that they haue hearde manye saye soo Therefore I would wishe that no man should credite any longer this foolishe opinion being moste false onle she can shewe good reason for it whiche I am sure no manne can dooe Mary this I thinke that like as bloud letting is not good against al diseases so also it is not good in all persones but onely in those that will be content to vse afterwarde a moderate and conuenient diet Those therefore that doe abounde with bloude wilbe let bloud to preserue themselfes from the daunger of any disease that is like shortly to ensue and moleste them They must longtime after be contente to vse a moderate and conuenient diet for those whiche be vntemperate gluttonous in meates or great drinkers and wyne bibbers they do not only receiue no commoditie at all by bloud lotting but also often times they catche more hurte by it then they should haue hadde without it for in three or foure dayes space after they fill stuffe them selues with more rawe iuyces and humours by meanes of vnmeasurable diet then thei had before and often times thei dye through conuulcion And therefore note that there is soche force vertue in moderate diete to eschue decline diseases that without the obseruatioÌ„ of it bloud-letting is to no purpose And therefore if the commoÌ„ saiyng of the people be true in any body that they must be let bloud often if thei be ones let bloud it is onely true in soche as kepe an immoderate diet streight after bloud letting and therfore I counsaile all men to beware of excesse in eating and drinking after bloud lettyng Also note y t after bloud letting none ought to walke apace or to runne or to vse any vehement exercise but let him be quiet and reste him self vntill his spirites berefreshed and quieted againe Note also that none ought to slepe immediatly after bloudletting but let him kepe himselfe quiet watche auoydyng all contention and exercise of bodie and mynde About twoo houres after bloud letting there may a little foode be taken but let it be soche as wil make good iuice and nourishe a pace within .iiij. howers after bloud letting or somewhat afore it may be permitted to the patient to slepe so that it be prouided for and taken hede of that he turne him not vpon the arme where the vain was opened nor that he doe not loosen the bande and so lette the bloud flowe out again Afterward lette him vse a straight and sparing diet daily encreasing it by little and little vntill you be come to your accustomed diet And note that the morning is the metest tyme for blood lettyng when euery digestioÌ„ is perfectly finished and the superfluities and excrementes of eche of them auoided out whiche must be foreseen that thei bee so Or at the leaste in a time of necessitie the next apt time to let bloud is when the stomake is somwhat emptie that is sixe or eight houres after meate Thus moche for bloudletting Nowe for pourging whose vse and coÌ„modities I promised to declare It is to be noted that euery kinde of purgation hath that secrete vertue and propertie in it self that when it is receiued in a mans body and is prouoked to exercise the vertue that it hath by naturall heate labouring to digeste it then it draweth vnto it soche humour as it hath power and vertue to pourge And therfore a pourgation is an euacuatioÌ„ of vitious corrupt humours whiche trouble and moleste the bodie but not of all corrupte humours alike For eche pourging medicine doth draw vnto it one peculier propre humour that is either fleme or choler or melancholie or waterie humours And therefore those that be perfectly in health ought not to take a purgation since they doe not abounde with corrupt humours wherefore in those when the medicine findeth no soch superfluous humours as it hath vertue to drawe it consumeth and wasteth the bloud and the fleshe And for that cause hole folkes are not pourged by pourgations but rather consumed wasted for it is manifest hereby that pourgations be very perillous to them that bée in perfect health whiche thinge is testified also of Hippocrates in the .xxxvij. Aphorisme of his seconde booke where he saieth after this sorte Qui corpore bene se habent hos purgare periculosum est that is it is daungerous pourging of those that be in perfect health Also be cause eche pourging medicine hath vertue to drawe one peculier humour there is good hede to be takeÌ„ that soche a medicine bee ministred as hathe vertue to drawe the humour abounding and no other or els instede of moch good which it would do if it were conueniently ministred it may contrariwyse doe moche hurte According to the saiyng of Hipocrates in the last Aphorisme of his firste booke in this maner Si qua lia oportet purgari purgentur confert facile feruut sicontra difficulter that is if soche thinges be pourged as ought to be it profiteth and may easely be suffered but if it be contrariwyse it hurteth and may scarsely be borne wherefore ther ought diligent hede to be takeÌ„ in the receiuing of a purgation that it be ministred by a skilfull Phisicion that hathe certainly founde out what humour it is that haboundeth But alas the greatest noumber of the common people doe holde an opinion that if they may haue a medicine for a little money whiche wil prouoke them often to the stoole what humour soeuer it pourgeth out they are safe enough howebeit I would wishe theÌ„ hereafter alwayes to haue in minde this saiyng of the moste excellent Phisicion Hipocrates in the xxiij Aphorisme of the first booke Deiectionas non multitudine sunt estimande sed fi talia deijciantur qualia conueniunt that is egestions are not to be estemed for their great quantitie but if soche humours be pourged out as ought to be that is soch vitious and corrupt humours as doe abounde and be superfluous in mannes body There be diuerse thinges to be coÌ„sidered of a Phisition before he minister â—purgation as the qualitie of the humour the strengthe of the sicke the age the time of the yeare the disease The qualitie of the humoure is to be considered that he may knowe what kinde of humour is to be euacuate and pourged out for it must be onely that which troubleth the bodie with superfluous abouÌ„daunce thereof As if fleme doe