and maketh her the more able to ouercome the same Repletion being somewhat lessened in quantity by bleeding It is not therefore repugnant but very agreeable to reason in this case to vse Phlebotomy For we see by daily experience that a small fire is put out by laying on too much wood at once or such wood as is greene and that then it burneth when the woode is remooued which hindered the burning thereof Euen so is inward heate of the bodie choaked with multitude of humors and the same is againe refreshed when some portion of them is withdrawen The second cause of crudity of humors is the debility of the inward naturall heate which happeneth in men of colde Complexions in men that haue beene long sicke and in olde folke in these bleeding is not vsed because bloud being taken away from them which is the restorer and maintainer of the inwarde naturall heate as yee heard before out of Isaacus consequently the body must waxe colde and crudity of humors increase Bloud therfore must remain in these persons to concoct and ouercome the humors in the body And therfore very well saith Auicen Non quotiescunque videris signa Repletionis est facioÌ„dâ— Phlebotomia That is Phlebotomy is not alwâ—ies presently to bee practised whensoeuer wee see signes of Repletion as namely when there is fulnes of raw humors in the body and this doth Galen also affirme lib. 12. Method Medend The tenth impediment is the vnfit disposition of the Aire when the same is too hot too cold too dry or too moist Also when the same is not cleare but troubled And therefore vnder the starre called Canis in the canicular or dogge dâ—ies when thereis excessiue heate and drith it is good to refraine bleeding Except great necessity doo vrge it So likewise in seasons too moist and too colde as in the winter in a state of the Aire temperately hot as when the wind is south or southeast wee may bleede temperarately and sparingly In a more cold state of the Aire as when the North-winde bloweth or North-west winde wee must bleede more sparingly than before In a right temperate and mild state of the heauens we may bleed plentifully especially the Aire not beeing greatly disquieted with great force of tempestious weather And here may be made a profitable collation in this practise by folding vp together as it were in one three impediments here specified The state of the Country being coâ—de the time of the yere beeing cold the present constitution of the Aire beeing colde All which three are outward causes and â—oyne in this third point which is common to them all three that is the Country the Aire and season of the yeare compasse about euery Patient Therefore in a cold Country and in winter and when the Northwind bloweth open no veyne If in a colde Country and in winter the wind blow South and that so necessity require wee may proceede with this practise so in a hot Country and in summer the winde blowing at the South bleede not If necessity in summer require bleeding open a veyne when the North-wind tempereth the immoderate heate of the season For surely these outward causes though obscurely and without any great perceiuing yet they doo either keepe in or disperse abroade and extenuate the substance both of inward heat and also of the inwarde humors And as in a temperature or complexion hot and moist Phlebotomy is vsed best and not to be vsed in complexions hot dry or complexions cold and dry So when the season is hot and moist as in the spring we may bleed safely But not so in a season hot and dry as is the summer or very cold as is the winter The eleuenth let is some great inflammation or extreme ach and paine as appeareth by Galen and Auicen who both forbid bleeding in hot inflamed feuers and in apostumations of great paine In these cases the opening of a veyne doth cause much busines and agitation of humors in the body Bleeding on the one side drawing and emptying humors the inflammation and ach on the other side striuing there against and attracting humors thither For all paine if it be much and all heat which concurreth with paine attracteth and hindereth the fluxe of humors VVhereby it commeth to passe that by bleeding in this case the inflammation is thereby increased and nature more infeebled and the same most chiefly when the bleeding hath beene temperate and done according to Art But in the foresaid cases if the bloud be withdrawen in great quantity euen till the Patient giue ouer and faint it profiteth very much for thereby the abundance of boyling bloud in gâ—eat inflammations is expelled and the inflamed member is cooled so that in vehement paines opening a veyne is a present helpe keeping backe the fluxe of bloud which otherwise would haue recourse to the pained place And here it is not to be forgotten that sometime the expulsiue vertue making hast to expell the cause of the griefe causeth thereby sometime an inflamma â—on The reason is for that the expulsiue vertue hauiâ—g done no good at the first â—nd 〈◊〉 more venemently than before to expeâ—â— that matter which causeth annoyance and doth therewithall wring out forâ—ibly some bloud out of the vpper partes or members into the lower afflicted part as Galen â—heweth at large lib. 23. cap. 3. Method Medend And therefore to keepe backe the saide inflammation bleeding greatly profiteth as yee haue heard before Cap. 6. And this is the intent and meaning of Galen where he saith In ardentissimis febribus si vsque ad animi defectionem sanguis mittatur statim totius corporis habitus refrigeratur febris extinguitur In extreame hot feueâ—s if we bleede euen to giuing ouer and sowning presently the state oâ— the whole body is cooled and so the feuer is extinguished In vehement pâ—ines and grieses therefore there is no better remedy fouâ—de than â—o â—et blouâ— euen tiâ—l the Paâ—â—ent ouercome Reade more hereof in Galen lib. 9. Method Med. cap. 4. lâ—b de curaâ—d Râ—tâ— saâ—g Mâ—ssionem capit vndecim Fuchlium libr. secund sectione quint. cap. quart sext institutionum Medic. The twelfth impediment is the extreame coldnes of the Region a Country which being cold cannot tollerate so large an Euacuatioá¹… as is this kind that wee nowe presently handle The reason is for that the body being before sufficiently cooled through the colde temperament of the place must needes waxe more cold when the naturall heate is drawen forth with the bloud Moreouer a country too hot cannot admit this practise because in such a place extremity ofheate draw eth from the body much inward heat of nature dissoluing of it selfe and dispersing the naturall forces and humors of the body and therefore in hot Countries the naturall powers are lessened there is lesse bloud in the veyns which is the reason that also in extreame hot countries the bleeding must be none at all or very litle A country
thorow fault of the lunges and brest as sometime it doth in whom notwithstanding the vitall force may be sufficiently strong The contraries to these declare firme strength of the vitall vertue These thinges declare the animall po wers to be enfebled tumblings and tossings of the bodie the senses offended watchinges rauings and other principal actions hindered The contraries hereunto shew the contrarie that is firmnes strength of the animal vertue By these functions then you see how it may be coniectured what power in nature is hurt or offended Againe these powers are offended or seem enfebled two waies either because they are outwardly oppressed or because they languish inwardly of themselues in the euacuation it helpeth greatly to know the one from the other for the forces oppressed require large euacuatioÌ„ the other none at al. And the distinction of these is to bee sought out of their euident causes If causes haue gone before which haue already altered or wasted the substance of the forces naturall then wee may iudge them that they are faint and languished If these causes haue not been precedent but that the Patient is only troubled with an vnaccustomed ponderosity then these are but wronged and oppressed The euident and outwarde causes which alter the temperament of the setled vertues are burning Agues which melt the bodily moystures or whatsoeuer els that excessiuely heateth cooleth moysteneth or dryeth the sounde massiue strong and solide parts of the bodie The substance of these parts is wasted by very long sicknes which bringeth the Patient into an Atrophia that is a kind of consumption wherein the body consumeth away with leannesse and is not nourished albeit the sicke continually eate his meate Or into Tabes which is an other kinde of consumption wasting the body by long sickenes and lacke of nourishment consuming and putrifieng the Lites drying away the Patient for want of naturall moysture hauing matter and bloud mixt together The threefold spirit of the flowing humor is altered ether through some distemperature or some poisoned qualitie of the aire which compasseth vs about or through the il quallity of other thinges which violently breake in vppon vs or through some wâ—cked disposition of the bowels or other humours The heate of the aire not onely of that which outwardly compasseth vs about but also that which wee draw into our bodies by breathing inflameth first the lunges then the hart all the spirits so far till often times a feuer is kindled and caused thorow the same Thorow which distemperature of the spirits needs must the strength of the body languish becom enfeebled yea by this excessiue heat of the air the spirits are not only subiect to alteration of temperament but besides they are also thereby greatly wasted diminished Euen so in like maner immoderat cold outwardly the same receiued inwardly into the body by breathing weakneth the spirits inward heat yea soÌ„time altogether put out and extinguish the saá¹e The aire venemous pestilent drawen into the bodie with an infection quite ouerturneth the spirits of life and ofnature wherof â—nsuâ—th grieuous sicknesses to the body no litle decay of bodily strength yea life it selfe is taken away by the so daine disease commonly called the plague Now much more apparantly are the spirites infected with biâ—ings of Scorpions mad dogs and venemous beasts than by the contagion of the Aire Moreouer they are inwarde and hidden causes which doo greatly alter the spirits and whensoeuer any principall part of the bodie is troubled with any distemperature vpon any occasion If the same proceed far it must of necessity goe to the spirites there bred and ingendred And so by offending of them will lessen the strength and vertue of nature Also if any corruption of humor rule in the body the spirits are disperced and offended by the corruption or distemperature of the same humors Therefore when abundance of rawe humors passeth either the whole body or the stomacke and chiefly the mouth of the stomacke the substance both of inward heate and of the spirits waxe cold the Patient languisheth yea sometime hee giueth ouer the Ghost and soundeth Herevppon also when hot choler burneth as it were the inwarde spirits with immoderate heate or nippeth and pricketh the mouth of the stomacke it is the cause of no small euils in the body of man Sometime also it falleth out that some one or other humor in the body is mixed besprinckled or bedewed as it were with some kinde of venemous filth as when the seedy moysture is kept in and putrifieth Or menstruall termes in weomen longer retained than is their due course or when any clodded bloud remaineth behind and is not expelled the vapour of these and such like infecting and decaying the spirits bringeth sometime Sincope sometime suffocation of the wombe sometime the falling sickenes and such other mischiefes which greatly annoy the forces of nature And thus diuersly are the spiriets offended through distemperature Againe the substance of the spirits and naturall forces is diminished sometime euen of it self and as a man may speak voluntarily of his owne accord for the substance being of it selfe thin and wastable and included in an hot thin and open body Therefore of it selfe it dissolueth vaniâ—heth away Sometime the same is decayed by occasion of outwarde and euident causes as are namely these The aire which compasseth vs round hot and dry immoderate euacuations vehement motion affects of the minde paines watchinges great emptines and all vnprofitable excrements which cannot but carry with them from the body as they passe a great quantity or portion of the vitall spirits seeing their substance is spread ouer the whole body and also flowing with other humidities whereby it commeth to passe that whether the belly be very laxitiue by nature or by medecin or that the vrine bee made immoderately as in the infirmity called Diabete or that matter or water go plentifully forth of the brest stomack belâ—y or any great apostumation thereby of necessity the forces of nature must be mightely decayed Much more manifestly must it so fall out when there is any great euacuation of bloud or good humors whether the same pas forth of a wound the nose hemorroids Piles belly or other place In like maner abstinence which taketh away from the body needefull nourishment enfeebleth nature Labor likewise and heat disperseth the substance of the spirits by vapors sweat And therfore they which liue continually in labor about furnaces hot baths because daily some of their substance decayeth doo not commonly so abound with excrements as those that leade a slouthfull delicate and idle life Moreouer they that liue very incontinently haue also for the most part very enfeebled bodies able almost to abideno Phisick by a continuall decay of seedy moystures they haue their spirits mightely consumed wherof look before in the 8. cap. Fig. 17. Great ach paine worketh the same effect more than
to turne the fluxe of them aside another way The first indirect cause is for the greatnes of a disease or for vehement inflamation of an impostume for in apostumatioÌ„s of great heat in hote feuers in vehement griefes there is not found a more excellent remedie than opening of a veine The second indirect cause is to allure the matter to the place of euacuation Therefore in stopping of Termes or Hemorroids the veine Saphena is to be opened Fulnes coÌ„ming by suppression of Termes is to be euacuated by the legges from the knee to the anckle whether we cut a veine or vse scarifying or launcing for veines opened in the armes of weomen reuoke draw vpward their naturall purging The third indirect cause is that the humors may be turned to some other place contrary or opposite to the place vnto the which they flow of their own accord Therfore in immoderat fluxe of Termes we open the Basilica veine that is the inward veine of the arme which is also called Hepatitis that the matter being called to a contrarie place may be turned from his fluxe The fourth indirect cause is that some part of the matter being takeÌ„ away by bleeding nature may the more easily ouercom the rest For the vertue of the bodie being weaker then that it can rule such aboundance of humors wee take away by bleeding some portion of them least thorough impotencie and debilitie of nature the same humors should flowe to the weaker members and there breede apostumations and swellings contrarie to nature But of this more shal be spoken at large in the proper place therof namely in the Chapter of reuulsion and deriuation of plucking backe and turning aside of the bloud of humors Touching the vtilitie of bleeding great is the profit therof For Galen reporteth that therewith he hath oft cured feuers and that it is boldly to be taken in hand when necessitie requireth it Therfore we may worthily blame those which in our time contrarie to Galens iudgement against reason al experience speak euil of this profitable practise First it sharpeneth the sight making the same more cleare the reason thereof is for that it diminisheth those humors which thorough their fumes hinder the clearnes of the eies so that consequently the sight thereby is sharpened Secondly it purgeth the braine sharpeneth the wit by the foresaid reason Thirdly it heateth the marrow wasting those superfluous humors by whose commixture flowing the marrow in the bones waxeth cold Fourthly it purifieth all the senses taking away those fumes and euaporations which ascend vp to the head and there trouble the senses Fiftly it purgeth the bowels and entrailes The reason is because nature gouerning the body being disburdened of that bloud which was as it were an oppression to nature and greued her as it were with some heauy burden doth now with ease concoct and ouercome rawe and rude humors deteined in the bowels Sixtly it stayeth vomits and laskes for it draweth the humors from the inwarde parts to the outward parts VVherevnto Auicen agreeth writing thus Phlebotomia propteriae quod ad diuersum trahit naturam secundum plurimum retinet Phlebotomy because it draweth to the contrary part therefore commonly it reteineth nature In which place it is to be vnderstood that in fluxes of the womb the veine of the Arme is to be taken which presently helpeth But if you doo otherwise that is take the veine in the foote or legge it profiteth nothing Sometime it chanceth that the belly by opening of a veine is more flowing than before and that especially chanceth two waies first because nature being disburdened by bleeding strength is increased so that sometime it stirreth vp other euacuations as namely by siege The second way is when through imbecility of the retentiue vertue which imbecility by opening of a veyne is increased so that the wombe is more stirred and prouoked Seauenthly it profiteth against immoderate watching for it emptieth abundance of humors from the which commonly diuers sharpe fumes ascend vp to the head and hinder sleepe Eighthly it taketh away heauines sluggishnes wearines of the body For as hath bin already said before bleeding disburdeneth nature which ruleth our bodies of multitude of humors which before was pressed downe by them oppressed with them And again Melancholly the chiefest cause of heauines is expelled with the bloud as the dregs and grounds thereof Ninethly it cureth difficulty of hearing abating abundance of humors whose thicke slatuous spirits carried vpward into the head stop the hearing port and passege of the eares Tenthly it helpeth the voice taking away superfluous humidiâ—ies which too much moisten the arterie or veyne of the voyce and speaking From which humidities horcenes of speech proceedeth Eleuenthly it refresheth and increaseth the powers and strength of the body For the body beeing freed from a multitude of humors must of necessity haue the vertue and strength thereof augmented These commodities of bleeding are thus set downe in verse by Schola Salerni Lumina clarificat sincerat Phlebotomia Mentes cerebrum calidas facit esse medullas Viseera purgabit stomachuÌ„ ventremque coercet Puros dat sensus dat somnum taedia tolliâ— Auditus vocem vires producit auget It cleareth sight the wits and braine It marrow warmes doth cleane procure The entrailes stomacke this is plaine It stayeth lasks makes senses pure It causeth sleepe expelleth griefe To eare to tongue it brings reliefe To be short these are the commodities of Artificiall bleeding therby the organs of the senses are cleansed weake bodies are made strong if yeares serue By it are helped Repletions Pluresies hot tertians frensies pestilences and dâ—uers other diseases as shall appeare in the Chapter ensuing The onely disprofit in bleeding is this that the vitall spirits thereby are â—havven foorth which thing Galen witnesseth in his booke de Scarrificatione saying to open a veine oft in the yeare I iudge not profitable for with much bloud the vitall spirits are also exhaled which beeing done too often wasteth the whole body making the same cold and causing the liuely operations thereof to waxe worse and worse To frequent bleeding therefore bringeth on old age apace and maketh the same subiect to many diseases as the dropsie gowt shakings palsies falling sickenesses and apoplexies For naturall heate being too much cooled and the principall moysture diminished the bowels languish and crudity ruleth with many flegmaticke humors which are the causes and originall of the foresaid cuils This Schola Salerni remembreth And Auicen in primo testefieth the same The best remedy to recouer vitall spirites decaied is drinking of wine for wine among things nourishing quickly and in short time is the most principall By meats also vitall spirits are recouered in time but not so soone Wherin is to be noted that after bleeding must be taken meate easie of digestion of good iuces and of much nourishment as potched-egs such like which meate easie of digestion
and had experience once or twise before of aborsion the third moneth if shee had not bled the seconde moneth In the other moneths the fifth and eighth shee was in danger of suffocation except shee had bled againe VVhen women are brought a bed they must not bleede except their seconde birth be suppressed or a Feuer molest them In the which cases also carefully consider in the Patient her naturall strength Those that haue their termes naturally according to the due course of nature and the course of the moneth are not to bee let bloud except in immoderate Fluxes to drawe backe the matter VVhen they breake forth naturally the whole matter is to bee let alone to nature Eighthly bleeding is not good for such persons as are bounde and haue the excrements retained For as yee heard in the eighth Chapter Fig. 2. The veynes beeing emptied they attract matter from the next members and they attract from the stomacke the moystnes of the excrements whereby they become more dried and baked bring diuers waies annoyance to the body In which case the wombe by Art is to be made solluble as appeareth in the place now cited Finally a veyne may and is to bee opened without hurt or daunger whensoeuer wee feele our selues to bee heauy lumpish and stopped or stuffed in our bodies first considering the quantity and quality of the fulnesse which wee may knowe and discerne by certaine tokens whether it bee Plenitudo quo ad vasa or quo ad vires as was shewed in the first Chapter the more heauy and drowsie a man feeleth him selfe to be so much the more it appeareth to bee that fulnesse which is quo ad vires But if hee feele the former stuffing in his body increased than is it that plenitude Quo ad vasa And thus much to know the quantity of the Repletion The quality of the fulnesse is knowen partly by the colours partly by those things which are very neerely ioyned to the nature of the humors But of these signes sufficient hath been spoken before in the first Chapter In these cases of Repletion if the strength of the body shall bee answerable wee are to open a veyne for as much as bleeding is the chiefest remedy to abate fulnesse But if the stuffing and fulnesse of the body bee greatly grieuous and the state of the body not answerable it is not alwaies necessary to let bloud As Galen noteth lib. de Curand ratio per sanguinis missio And againe Phlebotomy is not onely profitable when any of the foresaid fulnesses grieue and oppresse vs But also as hath beene saide in cases without any fulnesse As in the beginning of an inflammation which commeth either of a blow ache paine or weakenesse of the member For paine as was saide draweth the bloud vnto it and of the weakenesse of the bodily parts cause an inflammation without fulnesse Also when the disease is great and vehement we let bloud although no fulnes appear in the Patient yet alwaies hauing a regard to the age and strength of the party as Hyppocrates setteth downe in these wordes 4. Vict. acutorum 17. In acutis morbis sanguinem deâ—rahes â—ivehemens morbus videatur florueritque aegrotanti aet as virium affuerit robur That is in sharpe disease thou shalt let bloud if the sickenes seeme great if the age of the Patient permit and that there be sufficiencie of naturall strength And thus much of the persons that are to bleede concerning the which point more may be easily coniectured and collected of the studious Practitioner from the Chapters precedent What corruption of Humors bleeding remoueth from the veines Chap. 10. IT hath beene said that bleeding generally is the present and proper helpe when Humors offend in the veyns either in quantity or in quality It hath been already declared that some humors it euacuateth other some it reuoketh and pulleth backe which is called revulsion whereof hath beene spoken in a distinct Chapter by it selfe Now order requireth in some briefe sort to shew what corruption of humors generally bleeding euacuateth from the veynes The defect of humors in the veynes is either Plethora or Cacochymia as was shewed in the first Chapter The onely and peculiar remedy of Plethora or abundance of bloud is the opening of a veyne And forasmuch as fulnes of bloud is of two sorts One of fulnes simple and pure consisting of a like proportion of the best humors and the other vnpure and compounded taking part with Cacochymia that is abundance of humors corrupted in the veynes Therefore it is to bee marked that in both these Repletions the opening of a veyn greatly profiteth VVhen so euer therefore the muscles are sounde whole and full the veynes large great and swelling menacing thereby imminent danger to the members presently bloud must bee detracted After which eu cuation these effects will insue mitigation of paines caused by ouermuch retching of the veynes ease vnto the body which seemeth as it were nowe disburdened of a grieuous and waighty ponderousnes a more nimblenes to all exercise and labour than was before an increase and refreshing of the naturall heate an opening of the straight passages and pores of the members Finally there will follow a happy repulse of diuers imminent dangers and diseases wherevnto by all probability in short time the body would haue beene brought For it is greatly tobee feared lest the veynes ouerreatched with fulnesse of bloud should open and breake and through that meanes cause inflammation or lest some generall obstruction should arise which might keepe backe the inwarde heate and so vtterly choke vp the bodily forces wherby might bee caused some vehement hot feuer or as it oft hapneth a sodaine death of the party Now from these daungers can no man bee safely and speedely freed either by purging exercise or abstinence but by bleeding and with the bloud is this Repletion most safely abated That fulnes which is vnpure and compounded is not so safely cured by bleeding and yet the more nigh that it commeth in likenes to that Repletion which is simple and pure the more confidently and the more plentifully we may let bloud And the more vnpure that it is the more carefully and sparingly ought a veyne to bee opened Therefore those persons that haue an il constitution of body and yet haue their veyns abundantly filled or that beeing of a constitution are yet repleat with corrupted meates These I say are to bleede no longer but to auoid the danger of fulnes and the impurities remaining behinde are to bee expelled by Purgation Hot chollericke Repletions of all vnpure constitutions are most safely abated by bleeding because bleeding in this case not onely diminisheth choler but also cooleth the same mightily Melancholly Repletions can nothing so well away with this practise because it doth not so exceede in heate that it neede at all any refrigeration or cooling and the flegmaticke constitution can in no case brooke it for being a very cold
feuers caused and kindled of a putrifieng humor which should not seeme to bee true especially in intermittant fâ—uers which leaue off for a time as are tertian and quartan agues Forasmuch as in these bloud offendeth not in the veynes but some other humor beside bloud putrifieth without the veyns which by bleeding in reason cannot be euacuated This place of Galen cannot sound to reason or experience except we vnderstand Galen to giue vs aduise to euacuate by bleeding the matter of such intermittant feuers as haue also with the bloud fulnesse and abundance of other humors concurring So that this may bee his meaning Bleeding may bee vsed in intermittant feuers if they fortune to haue abundance of humors ioyned with the bloud For obstruction as Galen sheweth li. 11. Meth. Meden cap. 4. happeneth in rotten and putrified feuers sometime through abundance of humors sometime through the clammines grosnes and thickenes of them Galen therefore counselleth to let bloud in staying and intermittant feuers rather because of the abundance than the rottennes or putrifaction of the humor without the veynes And that this is his meaning appeareth by the words which Galen afterwards vseth saying Forasmuch as nature ruling the body by bleeding is lightned and disburthened of that wherwith she was before oppressed therfore shee will with ease ouercome that which resteth and remaineth behinde which is a 〈◊〉 signe that Plethora or fulnes is also annoxâ—d to such feuers Fourthly in bleeding we are not onely to consider the disease it self which wee determine to remedie but also oft times the cause therof so that whatsoeuer the sicknes be if Phlebotomy may remoue the cause then also it taketh away the griefe it selfe in the ende HereupoÌ„ somtime albeit the disease be cold yet when the cause moueth vs to open a vein we may safely bleede without hurt Hippo. saith Galen sheweth a cure of his done on a woman by letting her bloud in the Ankle This woman after child-birth was not freed ofher seconds then a shaking came vpoÌ„ her This woman I cured saith Hippo. by letting her bloud in the Ankle for all her shaking Shaking is a cold affect bloud is hote and they that must be heated must not haue bloud taken from them He for al that boldly did it he sheweth the reason I considered said he the cause the occasion of the cause He knew the cause of shaking was abundance of bloud kept backe which was a burthen to nature The occasion of the cause was the griefe of the matrix This abundaÌ„ce requiring euacuatioÌ„ the affected part shewing the place most fit for euâ—cuation considering both these things together he let her bloud in the ankle because the wombe or matrix was affected In griefes of the womb or bellie we take the vaine of the ankle knowing by the Anotomie the communion betweene the veines for some veines communicate to some part of the body others to other partes And euacuation is to be made from such veines as haue fellowship with the member affected For as yee heard in the Chapter of Revulsion if we take that veine which communicateth not with the part affected wee hurt the whole bodye do the griefe no easement The profitable vse of this fellowship of veines apeareth especially in revulsion or pulling backe of humors which is both wel speedily done when this coÌ„munitie of veins is obserued as was there declared But let vs return to our former purpose Fiftly by opening of a veine is cured the feuer called Synochus both that which coÌ„meth of ebullition of blod without putrifaction that which is caused with putrifaction of the bloud So are also hereby cured continuing feuers coming of putrifaction in the greater veines And to these diseases reckoned vp of Galen Fig. 2. we may adde these that follow Frensies Opthalmia parotis i. an apostumatioÌ„ about or behind the eares diseases of the Liuer splene Nephritis i. paines of the raines and backe inflammations of the wombe or matrix of the priuie partes arme-holes armes thighes ioynts Finally all inflammatioÌ„s inward or outward which the Greeks call Phlegmonae These inflamations are caused by flowing of bloud to a member when a veine is open broken which bloud there abundantly heaped togither bringeth forth a tumor or swelling To these also are to be added a consumption in the beginning vomiting of bloud bleedings at the nose bely or hemorroids at the beginning of which diseases the opening of a veine greatly profiteth staying the force of the fluxe by revulsion if the veine be opened at the contrary part calling back much of the matter froÌ„ the member affected so that bleeding is a present helpe for those diseases whatsoeuer which take the beginning from too much abundance of good bloud Those sicknesses which come of an vnpure mixt plenitude because they are somewhat neere linked vnto these they may also be cured by bleeding And although the matter of these diseases be vnpure yet either it lyeth in the veines or procedeth from the veines A gaine by bleeding are cured Carbuncles felons moyst scabs outward rednes in the skinne such like all these are cured by this practise Thus also is cured the burning ague called Causus all continuall feuers whose putrifaction is conteined in the greater venies Yet sometime a continuall feuer commeth of an humor heaped togither inflamed about the stomack chiefely about the mouth of the stomack the flat parts of the Liuer which feuer cannot be takeÌ„ away by bleeding Neither can the cause therof by this practise be remoued Pure intermittant feuers whether they be Tertians Quartans or Quotidians because the next matter proper cause of them is not in rhe greater vessels neither floweth from the veines are not conâ—eniently cured hereby And yet sometime in these also we bleede either when the veines swell with immoderat fulnes so that therby some danger at hand may be feared or when any accident of hote inflamed boyling bloud perswadeth vs therto as are namely beating paines of the head tossings mouing of the body this way that way excessiue heat almost stragnling the pacient Howbeit these many times come also of boyling choler about the inward partes called praecordia in the which cases bleeding remoueth neither the feuer nor the cause therof but onely asswageth the vehemencie of those accidents which are present or shortly like to ensue Further concerning perticuler affects cured hereby we may adioyne beating paines of the head Letargus spoken of before fig. 3 and trembling of the heart These with the foresaid are not onely cured hereby when they presently affect and afflict the patient but happening yerely vnto vs so that it is verie likely we shalbe grieued with them in time to come VVe may verie well preuent them by bleeding wheÌ„ we haue once espied plenitude to haue beene in vs the causes of these infirmities For there is one the self-same way of healing common
there must in the meane season of necessitie be abundance of excrementes remaining in the bodie as the occasion of sicknesses and so at length sicknesses may ensue Yea it is far better as it seemeth to Galen lib. de Curand ratio per sanguinis missionem cap. 6. altogether to absteine from bleeding in vntemperat drinkers gluttonous persons as from such as cannot be cured either by purging or bleeding For by their vntemperat life they gather in short time againe great abundance of rawe vnconcocted humors VVith such it is not best to deale for to what purpose is it to haue the excellent vse of this practise by these mens intemperancie defaced among the common people which hath been so present a helpe to diuers See Galen lib. 11 cap. 9. Method Meden The seconde matter putting off this practise for a time are the excrementes of the bellie Therefore first exonerate the wombe before bleeding if it bee not soluble of it selfe with a Clister of decoction of Mallowes putting thereto Oyle and Salte or with a Suppositorie or with eating a little Cassia fistula The thirde impediment is some other voluntarie euacuation that may be at that present time as in fluxe of Termes in weomen and in fluxe of the Hemorroids whereunto Gaelen likewise consenteth lib. 9. Cap. 5. Method Meden in these words If saith he in time of bleeding it happen that the Termes do flowe or that the veine called Haemorrhois be open if the force of the same fluxe seeme sufficient so that it alone may euacuate that which thou requirest thou shalt leaue the matter wholly to nature if not then thou maist detract so much bloud till by both wayes that be brought to passe which thou wouldest haue done But this is not alwayes to be followed for in euacuation to turne away the matter as in immoderate fluxe of Termes or in the fluxe of the Hemorroides wee practise bleeding as was afore shewed in the Chapter of Reuulsion Againe concerning these voluntarie eruptions of bloud when wee intend to open a veine if the eruption haue been much then stay from further euacuation But if it little or nothing haue withdrawen the matter of the disease it debarreth vs not of further bleeding Therefore if the disease and present necessitie require it that the powers of nature haue not beene damnified by that voluntarie eruption wee may speedily open a veine as in a strong plurisie If there haue been much sweating vomiting or great sieges we are not to let bloud but if these slake and that the naturall powers are a little in time recreated then wee may verie safely bleede For those being but accidents not remouing the cause of the disease can not serue in steed of bleeding So in a hote agew if the wombe be laxatiue and that there happpen Lienteria which is a fluxe of the stomacke when the meate and drinke runneth from a man as he tooke it vtterly without concoction or alteration rising of great weakenes of the stomacke specially in the power retentiue which is not able to keepe the meate till nature in ful time may concoct it through immoderate drinking of colde water from which some cannot refraine in hote feuers This I say doth not hinder bleeding but because thereby natures strength is enfeebled the same considered the bleeding must be the lesse if voluntarie eruption of bloud remoue the matter of the disease or in some reason bring ease to the patient according to discretion commit the matter to nature alone If not take away some bloud that through natures worke and the Phisitions practise togither the cure may be accomplished Those things which nature of her selfe can finish meddle not withall but helpe her with Art in that which shee beginneth and cannot of her selfe make an end therfore I said in a Plurisie in a continual feuer if bloud abundantly flow frō the bellie hemorroids or nose so that the quantie of the euacuation be iust and the patient thereby eased let no further bloud If bloud come but smally from the foresaide and that the sicknesse still continue vehement that which wanteth is to be done by opening a veine yea although the patient be a woman in child-bed yea therefore sometime in a bloudie fluxe a purgation is giuen that the same which commeth foorth but softly and slowly by reson of the vnprepared passages may flowe more abundantly by a more conuenient course The fourth impediment is the age of the partie that is to bleed either being too old or too yong Old folk are not to be let bloud because there is in them little good bloud and much ill bloud bleeding from them taketh away the good and leaueth the bad behinde Olde men after 70 yeares are not to be let bloud except they be of a strong constitutiō of body that the vehemency of the disease require the same But if in these yeres the powers of the bodie be weake that bloud aboundeth not bleeding is not to be in them practised for as Galen saith in men of these yeres there is little good bloud but of rawe humors great plentie so that opening of a veine sendeth forth the good but the ill blod gathered together in the chiefe veines in the Liuer that part called Mesenterion which is the double skin that fasteneth the bowels to the backe or rather the branches of the veine called Porta which conuey the iuce of the meat concocted from the stomake to the Liuer it draweth forth into the whole bodie Consider therfore the strength of the body the vehemencie of the disease for not onely the number of yeres but the constitutiō also of the body is to be marked There are of 60 yeres that are not to bleed being weake old men The age fit for bleeding is at as florens that is after some the 17 yeare of age after some 9. after some 10. after others 14. or 13. Before the 13 yeare after the most approued writers of our time wee are not to let bloud except those youthes haue broad veines be of sanguine complexion and that the disease be dangerous require this practise necessarily In these cases wee may open a veine if the veines well appeare or we may diminish bloud by scarifying the legges or armes Schola Salerni sayeth Denus septenus vix Phlebotomon petit annus The seuenteenth yere of age scarce good To put in proofe letting of blood Children then before they come to 13. or 14. yeares are not to bleede except some great dangerous disease of necessitie require it at nine or tenne yeares the reason is because their flesh and skinne is yet but tender and easie to breath thorow as Galen witnesseth lib. 9. cap. 17. Method Medendi in these words Puerorū substantia omniūfacile digeritur ac dissipatur propterea quod est omnium humidissima est omnium minime frigida The substance or flesh of children is most easie of all resolued or separated because it is most moyst
is vnprofitable and superfluous not bringing any commodity but discommoditie and perturbation to the sicke Therfore in this case this must be the practise moderately and often to giue the patient meates of good iuice and nourishment to confirm strengthen and recouer nature and such as haue some vertue in them a proprietate against the present infirmitie may redresse the inward corruption of humors And wheÌ„ thus the naturall forces shall be recouered Phlebotomy may succeed And this practise is much vsed in continual and long sicknesses in sharp diseases called morbi acuti this long stay were doubtfull and dangerous An obseruation of things present past and also a foresight of things future needful necessarie to the further knowledge of the quaÌ„titie of bloud that must be taken Chap. 15. OBseruations of euident causes touching the greatnes of the disease constancy of naturall forces doth greatly further our knowledge in this behalfe Of which euident causes three of them are in ward and bred in our selues as namely the temperament the complexion the age three of them are outward and accidentall namely the coÌ„stitution of the aire according to the seueral seasons of the year the situation of the countrie state of the heaueÌ„s All which are included in one cause as grouÌ„ded al vpon one reason secoÌ„dly former euacuatioÌ„s ether slaid or immoderatly flowing thirdly custome order in diet life or kind of euacuations proceding By knowledge of these forepassed causes we may atteine to the vnderstanding of the strength both of nature of the disease so consequently of the quantity that wee must bleed albeit that the causes present future haue not yet altered either the disease or streÌ„gth of nature yet for asmuch as they begin to dissolue some humours froÌ„ the body to wast the strength of nature they haue some moment in this practise For what these causes present or past can doo ye haue heard in the 8. 14. chap. to the which I refer you coÌ„cerning the perticulars here onely being contented to rekon theÌ„ vp by name 〈◊〉 the teÌ„perameÌ„t the state of the body the age the countrietthe time of the year the disposition of the aire sky voluntary euacuatioÌ„s custom the rest as appeareth ca. 8 It is the part property of a wife skilful phisition to consider not only the state present of the natural vertues but also to foresee what will be their state in time to come after bleeding The natural powers after euacuation are so to be conserued as that the same may be able afterwardes to take other helps continue out the prolixity of a coÌ„tinuing diâ—eâ—s Yea we must reteine alwaies some bloud for future fits and courses of the disease which are yet to come Lest afterwards vrged thervnto wee begin vnfitly and out of due time againe to nourish the same And this chiefly is to be done in bleeding for corrupted and putrifying feuers whose putrifaction obstruction is not taken away by bleeding but the putrifaction is afterwardes the better ouercome by the strong force of nature when by opening of a veine shee is somewhat relieued Therefore to this purpose alwaies some bloud must be left for natures preseruation as Galen councelleth lib 11. method cap. 14. We may coniecture the future strength of the patieÌ„t partly by the preseÌ„t causes which are also afterwards like to continue partly by accidents which may happen contrary to our opinioÌ„ Among present causes these are the chiefe the state of the heauens the order of mans life If the constitution of the aire hath bene hot dry is like so to coÌ„tinue the bleeding must be lesse than if wee suppose a cold aire to ensue Again if we perceaue that the patient will liue sparingly â—eÌ„peratly either for want of appetite or because the disease will not suffer him to feed as in Augina the Quincie which shutteth vp the Iawes we are to take lesse bloud than wheÌ„ we see he wil liue more frankly and liberallie In these cases we must still reserue some bloud as natures treasure to helpe at a pinch in time of neede Suddaine accidentes and vnlooked for which greatly enfeeble natural strength are these great paine and ach watchinge voluntarie euacuations and chiefly Sincâ—pe into the which many do fall beeing not accustomed to bleede at the first opening of a veine either because they are weâ—ke of nature or strucken with some great feare or because the mouth of the stomake fiâ—â—ed with bitter choler is becom very vnsensible and weake When we suppose that some of these matters wil fall out albeit the strength be firme yet no blood at all or very litle is to be withdrawen except by art wee naue preuented the former accidents It is I say great wisedome to foresee a farre off 〈◊〉 beware of such suddaine and vnlooked for accidents This we will manifest by an example Let the pacient be of a sanguine complexion of body thicke and well set of a florishing age that hath long time led a leacherous life feeding plentifully of good meats and that hath omitted his accustomed exercises and liued at home idely in whom also accustomed eruptions of bloud out of the nose belly or Hemoâ—roids are staâ—ed so that by concourse of these causes the body hath greatly encreased or waxed that the large veines through repletion are greatly filled WheÌ„ soeuer a strong ague or great inflammation shall possesse such a patient presently he must be let bloud and that plétifully Both the greatnes of the disease and of the cause requiring the same Moreouer this is confirmed by obseruation of thinges past if present causes agree to these namely that there bee a sit temperature of aire by occasion of the countrie season of the yeare and the present state of the weather moderatly cold and moist and that the patient bee apt to euacuation also that the sicknesse bee not like to continue long after neither apparant signification of an excessiuely hot temperature of aire to come no thveatning of future paine or of abstinence watchinges voluntarie euacuations If all these thus agree together who may doubt but that a large euacuation may in this case bee made And none at all when the conâ—raryes doo appeare Sometime these obseruations are mingled among themselues and contrary to themselues In which confusion a wise iudgement is needfull by comparison of them to prescribe the iust quantitie of euacuation The consideration of passed matters many times perswade a plentifull bleeding which the obseruation of things present by and by taketh away As for example if the Patient laying aside his accustomed exercise giue himselfe to pleasure and idlenes stuffing himselfe withmeats and hauing some notable euacuation staied in him but his body is waxed fat white of colour loose open soft full of thiniuce and that it be Summer a hot dry country a hot dry constitution of weather without stormes In
forefinger and the thombe and I let it bleede till it stayed of it selfe for â—o saith Galen I was warned by my dreame and there fl owed out not a whole pound and the continuall paine ceased that was specially in that part where the Liuer lyeth in the midriffe I knowe one long troubled with continuall paine in the side freede thereof by opening an arterie in the arme the same also being attempted through the warning of a dreame It is verie dangerous either willingly or vn willingly to cut the greater arterie vnder the veine in the arme or vnder the veine in the hammes For the bloud being thinne hote forcebly issuing out will hardly bee stopped and many haue dyed of Gangraena rising in the member where the incision hath beene as did a Gentleman of new Rumney in Kent a yeare or two past and so much the sooner commeth this putrifieng rotting and mortification to the member when the Phlebotomer goeth about with a band to stay Haemorrhagiam That is the dangerous fluxe of the arteriall or vitall bloud If the bloud bee stayed the wound cannot bee brought to a skarre without Aneurisma by reason of the continuall pulse and the thicke and hard tunicles in the same place If necessitie so require it is best to cut the whole greater artery ouerth wartly for the bloud is soonest staid when the ends and extremities of the artery cut asunder bee pulled vp whereon the plaister of Aloe before spoken of Cap. 19. is to be applied VVithout these dangers we may cut the lesser arteries which are in the outwarde lims or members as in the head hands and feete For these may bee fastened together chiefly in soft moist bodies as of women and children These are opened in continuall and great paines about the vppermost skinne of any member which paine is like a pricking or kinde of shooting because of sensiblenes and much feeling of the Membrana or outmost skinne and it is therewithall a beating paine by reason of the moouing of the arteries The cause of these pricking paines is abundance of much thinne hot bloud inclosed in the arteries of the pained place and the same is taken away when the outward arteries are found out and cut which proceede from those inwarde affected members Fewe in our daies cut arteries because they are not manifest to appeare in sight nor easie to come by Arteries cut in the temples doo remedy hote biting humors and fluxes of the eies in which cases these arteries are wholly cut and burnt with an hote iron or some burning medicine Arteries behinde the eares are cut in swimmings and continuall paines of the head caused of winde and of heate Also in rednes of the face and in other long continuing affects of the head The artery betweene the thombe and fore-finger is opened with continuall paines of the sides betweene the bowels and the Midriffe An artery about the anckle is opened in long continuing paines of the huckle bones alwaies chose that artery which is direct to the affected member as wee aduised before in opening of veynes Of particuler euacuation of bloud and first of bloudsuckers or horseleaches Chap. 26. TO this discourse of opening a veyne which is a generall euacuation of bloud is to bee added the particuler euacuation thereof by leaches and ventosas whereof wee will briefly speake in these two Chapters and so conclude this our present Pamphlet VVhen bloud is so in any member that it cannot be pulled backe by opening of a veyne or by some other practise the same is to bee withdrawen from the affected member by such remedies as may outwardly abide vpon the griefe and so free the same of the present euill Of this sort are Leaches Launsing cupping or boxing which apparantly drawe bloud from the member affected Leaches or bloudsuckers are wormes found in waters which applied outwardly to the member draw forth bloud They make a three square wound which penetrateth not only the skinne but also more deepely if the skinne bee tender as is the skin of children and infants These being empty and well applied sucke out bloud greedily and safely and that so long till they swell with fulnesse and so fall off And sometime when they are off the bloud still followeth plentifully especially if they were fixed vpon so open and manifest veyne In which case they stand in steede of Phlebotomy Thus applied to the hemeroide veynes sometime they doo so prouoke bloud that to stoppe the same we are necessarily forced to vse thinges astringent yea and applied to the arme of children they are equall to bleeding And that extraction which is thus drawen from a hollo we veyne is to bee accounted for an vniuersall euacuation But when they are fixed to the hard skinne vnder which there is no great veyne they onely empty that place that these touch extracting very litle from the neerer parts and nothing at all from the members far off And therefore leaches are onely vsuall in corruptions of the vppermost skinne as in the scab in Vitiligo which is a fowlenes of the body with spots of diuers colours whereof are three kinds In Impetigo a disease which wee call the Ringworme In the disease called Panus which after Celsus is a kind of kernell growing in the grind of a man or behinde his eares In rednes of the nose and face and little swellinges in leaprous persons So oftentimes wee apply them to the Arse-hole called Anus against melancholly diseases caused of the stopping of hemorroids In scabs itch and wicked wounds they are very profitable the body beeing first euacuated by letting of bloud Yea the drawing of horse-leaches is more conuenient in fulnes of bloud than scarrifieng is Forasmuch as they fetch bloud more deepely and also that which is withdrawen by Leaches is more of the substance of bloud Albeit the opinion of some is that they drawe no bloud but corrupt bloud and such as is not agreeable and proportionable vnto our bodies And therefore in griefes which happen betweene the skin and the flesh of bloud corrupted these are more conuenient than scarrifieng The attracting of bloud by Ventosas and horseleaches hath this difference that these drawe more deepely from the body Ventosas but from the superficiall partes Therefore let Leaches bee applyed to those places from whence we would drawe humors more deepely Their vse and application is this First before they bee put to any part of the body they must be kept all one day before and nourished with a little bloud which wee may giue them in a little piece of fresh flesh then we must put them and keepe them in cleane water somewhat warmed and before we vse them with a spunge wipe away the skinne that is about them Rubbe the part of the member affected whereto you will apply them with salt or scratch the same till it looke red or annoint the same with a little fresh bloud Some lay on them a spunge that when they be full they