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
or whatsoeuer eruption bee made in any other place through the skinne it is likewise a particuler Euacuation Again of Euacuations some are of their owne accord some are done by Art Naturall or voluntary Euacuation is when any thing is expelled out of the body without any medecine this chanceth sometime euen naturally For nature while it is in health rightly gouerneth the state of the body and doth expell thence whatsoeuer supersluously aboundeth or is corrupted this Euacuation is both naturall and conuenient This also chaunceth sometime contrary to nature as when the strength of the body is so infeebled that it cannot gouerne and restraine the Humors of the body but letteth them quite flow forth or when the vertue is strong yet it is somtime so prouoked either with abundance or acuity of the Humor that it permitteth the Humor to passe of his owne accord out of the proper vessels and receptories thereof Both these are accidentall vnprofitable and besides nature because the good bloud commeth forth mingled with the bad without choise or order Artificiall Euacuation is when the same commeth by outward help this is two fold The one right profitable onely Euacuating that which offendeth in iust quantity quality The other contrary to this extraordinary and vnprofitable exhausing the Humor that annoieth not which commeth by the vnskilfulnes of the Phisition Nature by her owne force and by the vertue expulsiue accomplisheth her Euacuation The Phisition doth his by diuers necessary helps prouided for the same And in letting bloud he openeth the veyne either with a fine penkife sleme or lancet or some other applyable medicin Purgation hee attempteth with medicins expelling euil humors from the body either by vomit or by siege Also he expelleth euill humors by breathings euaporations exercise rubbings mouings heat bathings specially sulphurious accidentally by abstinence Also the Physition vseth particular Euacuations in particular parts as ye haue heard Hee purgeth the braine through the nosthrils by medicaments called in Greeke Errhinae And through the palate of the mouth with medecines called Apophlegmatismi which chewed in the mouth bring Humors from the head the brest and lungs with medecines called Berhica The Raines and Bladder with Diuretica The wombe or belly with Hysterica Againe the belly is softned with suppositories and clisters againe euacuation or eruption is made in particular parts by medicines called Digerentia â— resoluing medicins by Suppuratoria â— medicines breeding matter by medicines called Amycticam Caustica Idest burning things by horseleches cupping glasses which drawe bloude with scarrifieng the skinne by launcinges or cuttings by iron red hot All these are vsed of Phisitions The kinds of Euacuation reckoned vp of Fuchlius Phlebotomy Purging  Vomiting Scarrifieng  Boxing Abstinence  Long sleepe Carnal copulation  Fluxe of bloud from the Nose   Termes   Hemorroids Euacuations some are Naturall Phlebotomy  Artificiall Purgation  common partaking of both  What Phlebotomy is and from whence the opening of a vaine doth e uacuate Chap. 3. FOR so much as the bloud in generall is mixed with the foure Humors which are also bedewed as it were with a thin watry substance and that they all are so mingled together through the heat and concoction of the Liuer that neuer an humor can be seene neuer so little to be seuered from the others therefore I saie the retentiue vertue cannot so strongly hold back the bloud in the crooked small veines when a great vaine is opened and that with a sufficient large wound but the same will issue and come foorth If by chaunce it happen that the retentiue vertue go about gredily to suppresse the bloud yet at length it will poure it out plentifully with oft handling rubbing of the veines Neither doth this or that humor by it selfe alone come foorth as in purging but bloud generally that is to saie mixt with other humors in the veines Touching the definition what it is Phlebotomia which is worde for worde out of the Greeke the cutting of a veine is an artificiall eduction of bloud either abounding iu quantitie or offending in qualitie by opening of a veine I call it an artificiall incision because it must not want art and iudgement For in it consideration must be had of the inflicted wound of the quantitie of the bloud of choosing the aptest vaine either to pull backe bloud or to euacuate it quite or to make it onely lesse in quantitie Also for that consideration is to be had whether the veine must be opened streight downe or ouerthwart of the same side of the bodie or of the other with diuers considerations besides whereof we will speake in their proper places Therefore Phlebotomie which is one of the greatest remedies the Phisition vseth is for good cause defined an artificiall kind of educing Galen in his 2. Aphoris Coment 17. defineth it to be an exquisite euacuation of al the humors equally Auicen defineth it vniuersalem euacuationem quae multitudinem humorum euacuat or thus Vena sectio est vniuersalis euacuatio quae anctionem humorum super aequalitatem in venis exuperantium euacuat i. an vniuersal euacuation which taketh away abundance of humors replenishing the veines aboue measure Though the bloud in the veines be in a moderate meane or but little in quantitie yet of the proper mouing vehemencie of it self it issueth out nature litle or nothing at al protruding the same Phlebotomie indifferently euacuateth both good bad humors conteined in the veines with the bloud Neither in diseases proceeding of corrupt constitution of humors can nature so moderat the matter as that that humor alone shal flow forth that aboundeth in quantitie or offendeth in qualitie I confesse that in the iudicials of diseases called Crises many times nature separateth as it were excludeth by wayes conuenient those ill humors prepared before by concoction yet notwiâ—hstanding if then at that instant we open a veine nature cannot therby in so short time expel the hurtfull humor Whereas Auicen saith Phlebotomie euâ—cuateth good bloud the ill remaining behind that he feareth lest opening a veine bring the patient either to abundance of hot chollerik humors or cruditie of flegmatike humors if he mean it of the humors mixt in the veines it is most fals for neither doth the watrie humor issue forth before choler nor choler before flewme or Melancoly nor the bad humor before the good VVhich daily experience proueth to be true for when the bloud commeth forth it appeareth simple of one forme but in the porrenger it loseth his colour euery part therof congeleth seâ—crally in his own region The watrie humor swimmeth aboue not farre vnlike vâ—ine Thinne choler the flowring part of the congealed bloud is also aboue next the water Melancoly abideth in the bottom the red bloud the paler flewme keepe in the middle region So that opening of a veine euacuateth all humors which are in the veines equally
auncient learned Phisicions may seeme as yet hard to the vnskilfuller sort that yet rashly and without skill or regarde of these things vse the practise of letting bloud It will not be lost labour in my poore iudgement with more plaine wordes to illustrate their sayings if it may be to the vnderstanding of all men that are this way studious and yet want the helpe of the Latine tongue Latine writers It appeareth by the premisses what Repletion is vz a superfluous aboundance of humors in mans body which happeneth two waies either in quantitie or in qualitie VVe may also learne that repletion in quantitie is when the foure humors are more in aboundance than is proportionable to the bodie that conteineth them or when one humor much exceedeth the rest in quantitie For the bloud contained in the veines is not simple or of one kind as hath beene said but consisteth of flewme blacke yellow choler and pure bloud mingled together which humors notwithstanding so mingled by comon agreement and continuall vse of speaking we commonly call bloud The iust and agreable proportion of humors is this That in a man throughly healthfull of good temperature there is lesse yelow choler than Melancoly lesse Melancoly than flewme lesse flewme than pure bloud so that that bloud is accounted best not that hath like proportion of all humors but such an equalitie of the foure as hath beene now specified Bloud therfore faulteth in quantitie when the humors being setled in a iust proportion do passe and exceede the agreable measure of Nature for then the whole frame of the bodie swelleth the veines aboue measure are stretched and all the members specially after any exercise are wonderfully retched This constitution of humors though they be good yet it faulteth beclause it is come to an immoderate abundance which accustomably is wont to bring great perill VVhether therefore there be in the bodie abundance of other humors aboue the bloud so that the equabilitie of the proportion be not obserued that waie or that there be too much abundance of pure bloud Yet because the pure bloud in the permixtion greatly exceedeth the other humors it is a â—ault not in the qualitie but only in the quantitie and therfore both of these are conteined vnder this kinde of repletion in quantitie and this is simply absolutely most properly commonly iudged repletion is called Plenitudo ad vasa as is aforesaid because it doth throughly fill the large capacitie of the veines which are termed the vessels or receptacles of the body though it enforce not the powers therof First therefore where al the humors superfluously increase filling extending the receptories of the bodie as the stomacke the veines and the bowels It is most properly called in English fulnesse or repletion in Latine plenitudo in Greeke Plethora as before Repletion in qualitie is when the bloud or other humor is hotter or colder thicker or thinner than is conuenient to the bodie This is the seconde kinde of repletion mentioned by the foresaide auucient writers in Phisicke and which is referred to the force strength and abilitie of the bodie In this repletion although the vessels of the bodie be not so much puffed vp nâ—ither swell as in the other yet they conteine more good bloud and nourishment than the nature of the patient can wel rule or ouercome For a litle nourishment to a weak nature is often troublesome and grieuous and although at the first it be right good yet it doth not long so continue but being forsaken of the bodily heat as not able to concoct the same in protract of time and number of daies it corrupteth and becommeth the causes of diseases This constitution of the Greekes properly called Cacochymia is when the bodie is infarced either with choler yelow or black or with flewme or with watrie humors and of late writers is thus defined Cacochymia est vitiosa humoris qualitas qua is a iusta mediocritase desciscit Cacochymia is a corrupted qualitie of the humors by reason whereof the humor departeth from his iust mediocritie Vnder which Cacochymia is contained all corruption of humors in qualitie wherby the powers of the bodie are hindred from their proper functioÌ„s wherby also the whole bodie waxethfilthie daily decayeth Of this corruption of humors in qualitie one kind is somewhat better and more tollerable as namely when either superfluous humors are excessiuely heaped vp together or when the humors mixt with the bloud do not keepe their iust and naturall concord or proportion the other kind is worse and intollerable when the superfluous humors or iuces in the bodie both primi secundarii both the principal humors and these next the principall are fallen into corruption from their naturall and conuenient temperature which is the destruction and corruption either of the substance or of the temperament Againe both these happen sometime with rottennes and putrifaction sometime without VVhere note moreouer that the name Cachochymia largely taken comprehendeth also the corruption of the excrements Hippocrates Aphoris 15. saith where meate is receiued much aboue nature it causeth sicknes Galon in his Commentaries declaring that place saith more meate then accordeth with natures measure is named Replecion And afterward hee expoundeth that worde aboue nature to signifie too much and superfluously As who would say where the meate is superfluously taken it causeth sickenes Meate but a little exceeding doth not forthwith cause diseases but may yet keepe the bodie within the bounds of health for meat ingendring sickenes must not a little but much exceede the exquisite measure It appeareth by Galen that in his time certaine denied this foresaide diuision of fulnes set downe by the auncient writers and approued of the late practisioners saying that the same was to bee considered onely by the strength of nature granting plenitudo secundum vires but not quo advasae These he confuteth in his booke de plenitud about the beginning in these wordes Qui ex ipsis tantum viribus plenitudinem metiuntur hi videnter nunquam vtres praeter modum repletosvidisse nec se etiamplus quapar est vnquam impleuâ—sse â—ibo ita vt ventriculus inde distenderetur 1. Those that measure Replecion onely according to the forces of nature they seeme neuer to haue seene mens bodies puffed vp like bladders or bottels neither at any time to haue stuffed themselues with meate more than moderation required and whereby the stomacke was ouerstretched Againe others in Galens time graunted onely that plenitude which is quo ad vasa and denied the other quo ad vires These hee confuteth in the same place in these vvordes Itaque subiecimus duas esse tum notiones tum relationes multitudinis alteram ad robur virefque illi us qui defert alteram ad eius qui suscipit capacitatem Idest Therefore vve haue added that there are two notions and reportes of fulnesse one according to the strength of the patient the other
of the bodie in this case wee vse Phlebotomie without purging Fourthly we may safely let blond without medicine those that are whole for abundance of bloud only are accustomed to yerely bleeding and that haue in the yere taken little or no Phisicke as it chanceth to many persons in many countries of the North. Fiftly we may open without purging the inner vaine of the arme in women with child if they carrie Corpora Phletorica full bodies that in the 5. 6. or 7. moneth after the conception yea also before they be quicke This practise wee are to vse specially when they being with child waxe verie slowe heauie as it were ouerladen with abundance of bloud we may take Salua tella veine or if plenitude so require the inner veine of the arme for the quantitie respecting a discreete moderation Sixtly we may let those bloud without medicine that haue fallen from some high place taken hurt in the brest and stomacke in whome is to be feared an inconuenience called of the Greekes Egchymosis Seuenthly we speedily let bloud such persons without further Phisick as by reason of their fulnes through some accident as feare or such like waxe domme in which case wee let bloud abundantly so that both armes are opened together Here I am to note a great error in Auicen both repugnant to trueth it selfe and also contrarie to Galen For Auicen affirmeth that when colde and thicke humors are in the bodie first wee must begin with purging and then open a veine Diuers and many waies hath he erred in this First because in flegmatick humors grosse and colde mixt with bloud hee woulde haue Phlebotomie not vsed before purging And in this case by all likelyhood of reason the cure should begin with bleeding Secondly in this hee dissenteth from Galen who 11. Method Chap. 4. though there were obstructions in the bodie of thicke and clammie humors yet first hee would begin the cure with Phlebotomie If Auicens meaning be when flegmatike humors ouercome the bloud in multitude or abundance that then wee must first vse purging then is hee greatly deceiued for as much as hee proponeth a case in which Phlebotomie should not auaile except with those many colde humors there be also some excesse of bloud which chaunceth verie sildome or not at all But it may seeme that Auicen hath reason namely this that the bloud being extracted those humors would waxe more rawe and so by opening a veine the patient is brought to a marueilous cruditie of colde humors This is no reason for by Phlebotomy wee detract bloud not because of obstructions caused of grosse and colde humors but because bloud superaboundeth For the stopping is afterward remoued with other helpes Therefore when obstruction concurreth with abundance of bloud wee must not extract verie much bloud but keepe backe some till the time of the cure as Galen teacheth 11. Method Chap. 14. And thus much of the order betweene Phlebotomie and Purging whereby wee see that a strong purgatiue must followe bleeding and that an easie purgation or clister may go before Of the effectes that is Of the profits and disprofits of opening a veine Chap. 5. Schola Salerni in two verses reckoneth vp three effects of bleeding Exhilerat tristes iratos placat amantes Ne sint amentes Phlebotomia facit It swageth wrath and cheeres the sad Preserues loue-sick from being mad FIrst it maketh glad those that are pensiue Secondly it appeaseth such as are angrie Anger is especially caused through mixture of much yellow choler with bloud And sadnesse by commixture of much Melancoly with bloud And forasmuch as both these humors choler Melancoly are exhausted with the bloud these two effectes must consequently follow Thirdly it preserueth loue-sicke persons from madnesse by drawing humors from the head to the lower partes and so expelling the same Although occasion will hereafter better serue to shewe the causes why wee vse Phlebotomy yet here nowe speaking of the effectes I will briefely shewe fiue causes for which wee vse to let bloud and by the which may be gathered the profitable effectes of this practise of the which fiue causes one onely cause is the direct the other foure are indirect The direct cause of bleeding is euacuation of the bloud But forasmuch as bloud is good for nature therfore Phlebotomy must be vsed â—duissdly that the same bloud only may be expelled which is vnprofitable hurtfull to nature Bloud as you haue partly heard is made vnprofitable to nature two waies either when it doth not throughly keepe the proper qualitie that it cannot so nourish as it did before when it was good or when in quantitie it so increaseth that it either presseth downe the powers of the bodie or stuffeth stoppeth both the veines the arteries In these two cases bleeding is good as one of the direct euacuating helpes Yet in these cases bleeding is not to be vsed indifferently but with this difference in abundaÌ„ce of bloud much may be detracted In little plentie small euacuation serueth Hereupon Galen writeth lib. 9. cap. 10. Method Si sanguis vitiosus in corpore fuerit paulatim quod vitiosum est euacuare oportet paulatim ad in o icem quod salubre est pro eo reponere If corrupt bloud be in the bodie wee must by little little take away the bad and by litle litle procure in the place therof that which is good which way of curing or amending of corrupt bloud the Phisicions call in Greeke Epicrasis And to this Alexander Tralleanus subscribeth lib. 9. ca. 2. The reason why this is not to be done at once is for that the powers of the bodie would relent giue ouer And although that which is euacuated be superfluous yet by a sudden thorough mutation it doth more hurt than good It is better therefore to emptie the bodie safely and by little at once than by making hast to dispatch both the disease the partie diseased And here it appeareth how much they abuse Phlebotomy which detract the ill bloud so long til the good also begin to come wheras it may fall out that all the bloud will flowe forth of the bodie before that the good will appeare It behoueth therefore the euacuatioÌ„ to be little And as Gaelen councelleth in this case before the opening of a veine to vse Epicrasis i. to giue the patient such meat as may cause good bloud that good bloud may still come in place of the bad and then a little after more bloud may be taken This therfore is called the direct bleeding because it is don of it self to euacuate that which by opening a veine ought in deede to be withdrawen namely multitude of humors of bloud of bloud principally of humors secondarily in asmuch as they are mingled with the blod The other are called indirect causes and are vsed only to reuoke or call backe the violent force of humors to the contrary part or
somwhat colder and moister than this nowe specified keepeth in the humors and inward heate dissoluing very little thereof Therfore men in such countries may bleede more abundantly The contrary to this hapneth in extreme cold countries scituated far Northward For the bloud congeled through extreme colde will not giue place to euacuaâ—ioÌ„ And again if the inward members should be depriued of their natural inward heate they were greatly in danger to perish with extremity of outward cold Look more of this before in the tenth impediment The thirteenth hinderance is the time or season of the yeare which is a matter also in letting bloud to be considered as namely whether it be too hote a season as in Sommer or too colde a season as in VVinter specially when it is frost and snowe For to what purpose is it when the bodie is alreadie sufficiently cooled through the colde season of the yeare to make it more colde by bleeding And for hote seasons if the heat be extreme those that bleede in them oftentimes die by sowning or fainting called Sincope or resolutio for extreme heat enuironing the patient doth ouercome the vital spirites which come foorth with the bloud drying weakening the state of the whole bodie Therefore in seasons extremely note it is a point of wisedome to forbeare bleeding which thing Galen teacheth lib. 11 câ—p 4 Method Medend in these wordes Et omnino quidem non mittes in tempore aestai is regione aestuosa caeli statn calido sicco Thou shalt not at all let bloud in Sommer time in an hote countrey and in an hote and drie state of the aire as vnder the dog-starre and from mid Iuly to mid September or rather to mid August By Galens wordes wee may perceiue that there is the like reason of the countrey and of the time of the yere concerning the heat and coldnes of them both But to put practisioners in â—iâ—de that these rules are not alwayes pâ—eciâ—ely to be obserued I giue aduertisement still as I haue done in other the like cases before that in this circumstance of the extreme colde or the extreme heat either of the time or of the countrey that it doeth not quite exclude bleeding at all time euen in cases of meere necessitiâ— but onely thus farre that these cannot admit so large euacuation by bleeding as their contraries may The Spring therefore beeing the most temperate time of the yeare when the forces naturall humors them-selues most abound is the best time to open a veine to auoide future maladies The next conuenient season is Autumne or Haruest And of the Spring the beginning thereof to be best Hippo setteth downe 7. Aphorism Aphoris 54. But hereof looke more hereafter in his pâ—oper pâ—â—ce and before in the tenth impediment The fourteenth let of Phlebotomy is former bathings or hote washings especially resolutiue bathes VVhich as Galen witnesseth in his booke of the Vtilitie of respiraâ—ion Cap. 7. do so forciblie euacuate the spirites from the whole bodie that it stayeth opening a veine And againe Hippocra writeth in his second booke Aphoris 51. That it is verie perillous much and vpon the sudden presently one after another by diuers euâ—cuations to emptie the bodie The fifteenth is a disposition to vomit of what cause so euer the same proceedeth For in this cause of lothsomnes of stomack if we let bloud the veines by bleeding exhausted do soone drawe vnto them that wicked and lothsome matter which lyeth in about the stomacke whereof looke more in the fifth impediment The sixteenth impediment may be custome or a former order oflife wherein wee are to consider to what meates wee haue beene most accustomed what excrementes are still reteined in the bodye contrâ—rie to former wont For too much former repâ—etion of the bodie with meate and 〈…〉 bleeding as appeareth in the first impediment But if there haue beene before a moderate meane obserued in eating and drinking wherewith the bodie hath beene safely nourished then we may boldly bâ—eed If it be otherwise then forbeare Yeâ— fâ—om this point also is takeÌ„ a sure note of the quantity ofblod that must be extracted For those that haue bin acustomed to be let bâ—od may bleede more in quantitie than they that haue not bin accustomed to bleede In this impediment moreouer consideratioÌ„ must be had whether Hemorroids or Termes are restreined contrarie to former custome Or whether wee still vse our accustomed exercises or no. But although diuers matters herein are to be regarded yet in custome princicipally these three are to be marked The precedent order of dyet the kinde of life that we haue spent before and former euacuations Those that haue liued sparingly either by their owne ordinarie prescription or by occasion of sicknes are to bleede lesse Those that haue liued more frankly may bleede more plentifully He that hath been alreadie let bloud so that the natural powers be not thereby too much enfeebled may as I now said better abide to bleed than they that neuer were let bloud For this is a generall rule Things accustomed yea if they be euill things are the lesse grieuous whereby is confuted the opinion of the vulgar sort who greatly commend the first opening of a veine as a matter greatly healthfull and discommend all the other bleedings making their reconing of this in their most extremities that though they were neuer let bloud before yet now they will send for the Phlebotomer as their last refuge The seuenteenth impediment is carnall copulation presently after which the opening of a veine is also forbidden because Venus so lately embraced hath thrown down and weakened the powers of the bodie and warmed the same more than was conuenient How the powers of mans bodie are loosened enfeebled through venerious actes Galen most excellently declareth lib. 1. de Semine cap. 25. saying In the time of carnall copulation the stones or genitors drawe forth of the veines all such seedie humor as is conteined in them which is not much in quantities and that which is the same is admixed with the bloud in the likenes of dewe and this to do is the office of the Testicles So that first by the genitors hauing more strength than the veines the seedie moysture is violently drawen from them And againe the veines drawe the same from the members next vnto them These partes againe exhaust from those next vnto them in like sort so that this extraction ceaseth not till it haue gone thorow euery part or member of mans body by reason whereof all the bodily partes are depriued of their proper nourishment and always that part which is perfectly throughly euacuated violently taketh from that which is next adiacent and hath more plentie of seedie moysture to be extracted This I say being done alwayes and all partes mutually participating among themselues necessarily all the receptories and partes of the whole bodie must be euacuated till the strongest of all the partes be filled
And further it commeth to passe not onely that the seedie moysture is drawen from the partes of the bodie through carnall copulation but also the vitall spirites passe out of the arteries with the same And therefore it is no â—â—arucile if such as vse lecherie immoderatly become weake both these being taken from the bodie that is to saye the seedie moysture and the vitall spirite VVhereunto may be added the pleasure of Venus which of it selfe is able to vnloose the vitall firâ—itie of the bodie Yea it is knowen that some haue dyed of too much pleasure in the act Marsilius Ficinus in his booke de Sanitate tuenda Cap. 7. confirmeth in these words aâ—l that hath been hitherto said Venus saith he if it do but little exceede the powers naturall of the bodie presently it exhausteth the spirites and specially those that are most subâ—ile Also it enfeebleth the braine weakneth the stomack and hart-strings yea there cannot be a more hurtfull thing to the witt and memorie VVhy did Hippo. iudge Coitum to be like the falling sicknesse but bâ—cause it woundeth the minde which is diuiâ—e and heauenly The immoderate vse of ust is so hurtfull that as Auicen sayeth in his boode de Animalibus If but a little seede issue foorth more than nature can afoorde it offendeth more than if fouâ—tietimes so much bloud had proceedâ—d And therefore not without some good grounde dâ—d the auncient wâ—iters immagine the nine Muses and Minerua her selfe to be vi giâ—s Reâ—d moâ—e hereof in Galen Chap. 86. Artis Medicinae Pauli Aegnieta lib. 1. Chap. 35. In Aetius lib. 3. Chap. 8. The seuenâ—eenth impediment is long continuance of a disease wherewith the strength of the bodie being wearied a long tract of time the same cannot nowe tolleraâ—e bâ—eeding And forasmuch as now the bodie is more than inongh enfeebled brought lowe thorough a long continuing and languishing sicknesse by bleeding wee maye more easily quite extinguish the patient than remedie the disease Galen de Curand ratio per sanguia missio Chap. 20 And Auicen confirme the same giuing aduiâ—e to forbeare opening of a veine in bodies which haue endured long griefes except corruption of bloud moue vnto it In which case sometime bloud may be detracted from persons that haue continued sicke of long time And Fuchsius councelleth saying People in consumption oâ—de folke weomen with chiâ—de yong chiâ—dâ—en are not lightly to bleede The nineteenth impediment is small quantitie of humors being in the bodie for a good consideration is to be had how the humors offend in the bodie in quantitie or in qualitie VVhether there be many or fewe humors in the pacient And therefore sometime vpon this ground wee open a veine in weomen with child if there be abundance of bloud sufficient both for the mother and the infant in the wombe if the bodily strength be firme and that the greatnes of the disease in them so require it But hereof more at large I meane to write in another place And agâ—ine beside the quantitie the diuersitie of nature in humors is also a profitable consideration in this practise For euen according to the varietie of humors the patient is oft either to be let bloud or not letteÌ„ bloud which Galen seemeth to witnesse li. 4. de Sanita tuend saying Some humors come to perfect nutriment before the bloud some are as it were halfe concocted some altogether rawe and vndigested Some are but little different from the forme of bloud some are wholly changed into bloud some verie litle some more some verie much VVhen humors are a verie little as it were from the nature of bloud as not yet turned into the same or when they haue a verie little exceeded further than the nature of bloud wee may confidently open a veine VVhen the same is more than a verie little either the one way or the other on this side or beyond wee are to deale herein more considerately If the humors want much of or exceed much beyond the nature of blond we are altogether to forbeare bleeding The twentieth let after the small quantitie of the other humors may be the quantitie of the bloud which the wise Phisition in this practise will most wisely regard As for example if there be little good bloud in the body and abundance of other humors wee are to make staie from opening a veine If any of the other three humors be but litle in quantitie and the bloud abundant we may boldly let bloud Yea by diligent obseruation the Phlebotomer shall easily perceiue what hurtfull humor may be withdrawen with the bloud and therfore if there be many cholerike humors in the body of man and yet not mixt with the bloud or that there be many flegmatike and rawe humors and but little bloud by no meanes is a veine to be opened This doth Anicen forbid in quarta primi Cap. 20. If the bloud be good and little and that there be in the same bodie many ill humors also bleeding taketh away the good and leaueth the bad behind And a little after he addeth that the Phisition is diligently to beware lest by vnskilful bleeding in these cases hee bring the patient after he hath extracted the bloud the ill humors still remaining to an excessiue heat of cholericke humors or too much cruditie of colde and vndigested humors And although as ye haue heard before Phlebotomy doth equally euacuate all humors Yet because now so little bloud is in the veines whereof a little portion is withdrawen by bleeding it followeth that but a little bloud and lesse than before remaineth now in the veines with the other humors and that there is great plentie of the other humors forasmuch as they come not out so redily when a veine is opened as the bloud doth and therefore by a necessarie consequent bloud being gone which was as it were a bridle to other humors choler must excessiuely boile and flegme become more colde and vndigested VVhereupon also I gather that those haue done ill and verie vnskilfully which haue reproued Auicen of error in this place seeing he is rather verie highly to be commended then vpon euery small and light occasion to be reprehended Finally wee are to forbeare letting of bloud after continuall vomitings hunger great watchings extreme labours and after all such things as immoderately 〈…〉 body drying and dissoluing the 〈…〉 thereof as Rhases noteth lib. 7. 〈…〉 Almonsorem Touching the causes 〈…〉 ring Phlebotomie they may soone be gathered of their contraries by those impediments here specified And in the fifth Chapter before yee haue heard both the direct indirect causes which may moue to let bloud Vnto the which place I referre the studious reader at this time concluding this Chapter with the verses of Schola Salerni wherin are set downe most of the impediments here spoken of Frigida natura frigens regio dolor ingens Balnea post coâ—tum minor aetas atque senilis Morbus prolixus repletio potus
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
remedies for hot distemperature and thus much for this matter How to know by certainâ— signes the greatnes of the disease and the firmenes of the naturall forces wherby coniecture may be made whether the Pacient bee to be let bloud or no. Chap. 13. IN euerie affect wherin bleeding auaileth the same is out of hand to bee done if the disease be vehement and the strength of nature agreeable Touching the disease it is sometime so small that it is cured alone of it sâ—lfe without the helpe of art And although at other times the same be very vehement great yet the forces of nature not onely sceme but also are indeede so weake that they can not tollerat any euacuation Yea vndoubtedly this practise would vndoo disâ—roy dissolue the whole substance of the naturall forces for whose preseruation sake in truth we take the cure in hand Therfore to know thorowly and perfectly how much bloud is to be takeÌ„ in euery disease we must first consider how great and greeuous the sicknes is and how firme and strong the powers of nature are Now a disease is either already caused and in state or is now a beginning or proceeding to state Againe a disease is called great greeuons ether in regard of it selfe or of the cause thereof which consisteth in the humors or in regard of the greuousnes of some accident But first it is great of his owne kinde and nature Thus an inflammation in any meÌ„ber is more greeuous then a simple distemperature in the same member And again the greatnes of a disease is iudged by the great vse and excellency of the meÌ„ber which it possesseth as if it be any principall member namely the hart braine or Liuer and it is contraty when the griefe is in a base vnnoble or no principall member Againe iudgement touching the greatnes of a disease is to be giuen according to the locall placing of the members as they stand next to the principall partes Therefore next the diseates of the hart braine and liuer are to be accompted those of the lunges sides stomacke and splen and wee are otherwise to iudge of those that are in parts further off as namely the bowels raines bladder and the outward limmes consisting of bones flesh and sinewes called in Latine Artus and in all the other members placed in the extremities of the body Againe in this point iudgement may be giuen by the sensiblenes or feeling of the member wherein the griefe is if the diseased member haue a quick sense and a liuely feeling the greater ferre is the danger than if the member were but of a blunt and dull sence The greatnes of the cause in any disease is iudged by the condition and nature of the humour that is gathered to the part affected is there the continual matter of the griefe wherein we are to consider whether the humour be good or bad putrified or not putrified or of what ill quallity it is any maÌ„ner of way And also whether the same humour be too much or too litle if the humor which is the cause of the sicknes be wicked corrupt theÌ„ we may soon iudge the griefe to be great The greatnes of the antecedent cause is perceiued by the fulnes or emptines of the veins bowels of the whole body by the purity or impurity of humours coÌ„teined in the same We iudge the greatnes of the accidents by the intention remission of those things which do chaunce as the increasing or diminishing of paine thirst appetit watchings and such like all which bring down the forces of nature and make the Pacient to languish As for example If any yll disease as namely an inflammation possesse the Liuer braine or parts next the hart and that there be a venomed and putrified humour whâ—â—ewith the veines of the body appeare to bee stuffed and filled so that there insueth in the patient agitation of the bodie ill appetite thirst paine watchinges this sicknes wo may esteeme vehement in the which euacuation may do great good And againe a disease in which these do not concurre but rather their contraries we may iudge a small infirmitie and not requiring any euacuation Betweene these are their interiected sicknesses of a middle sorte which are to bee euacuated more or lesse according to the remission or intention of the disease and the accidents thereof Now let vs come to the estimation of the forces of nature of the natural powers some are setled and bred in particular members and are common and flowing to all partes of the bodie The forces of nature bred and setled in a member haue one and the selfe same essence as it were of the inward heat and they are called one nature and are ingendred as a man might say of the internall spirits and the first begotten moisture whereunto is added as a matter thereunto requisite a sound and whole substance of bodilie members The essence of the common forces of nature haue as it were a threefold originall or beginning or is â—â—threefold spirit diffused and spred into the whole body The force called virtus animalis the animall vertue is diffused from the braine by the sinewes The vitall force from the hart by the arteries The naturall strength from the Liuer by the veines The bodily powers that are bred in ech of these parts the brain the hart and the Liuer are susteined by those common and flowing powers of nature so that the whole liuing creature name ly man is ruled and gouerned of both these vertues Insitae communes setled and common to vse as good english wordes as wee may to make manifest this great point of phisicks skill Therefore if this liuing creature and most excellent creature man bee in perfect health of necessitie these powers of nature must be sound and vncorrupted which they will bee if their substance consist in a iust moderation that is to say in a iust or right quantity and in a good temperament And contrary wise if the quantitie or temperament of their substance be inuerted chaunged turned or altered they must needes suffer hurt and offence and so become weake and enfeebled Whereby their functions are presently hindered the rule of all the bodie is disordered and at length there will follow euen extinction of life it selfe And therefore whether the natures forces are weake or strong may be knowen by their seuerall operations duties Thus raw and vndigested excrementes either by siege or by vriyne when either the one or the other is thinne watrish or like vnto water wherein flesh is washed do shew imbeâ—illity of naturall force so doth holding backe of these excremntes or any other function naturall that is staied or hindered Wee discerne the vitall strength to be enfebled by obscure languishing and smal pulse by breathing hardly and with paine and oftner more quickly thaÌ„ was accustomed by smalnes and faintnes of speach so as the same onely come thereby and not
made in theÌ„ than in others When the veine is opened we oft also loose the band from the vpper partes that the bloud may runne the better If the bloud run sufficiently let it alone if but slowly that through fault of the incisioÌ„ amend it If throgh grosnes of the bloud or of any other cause let the patient bend his fist hard together or turne the staffe about in his hand or by coughing or lowd speaking let him enforce the sinewes Muskles sydes And if need so require bath the wound with warme water If he be fearefull or faint harted when he seeth the bloud that it be stayed through feare leaue off a while til the strength be recouered by such meanes as we shal declare anon Yea albeit the bloud flow reasonably wel yet it is good in the midst of bleeding to stop it with the finger both to recreat the strength that it be not too much wasted also that the filthie corrupt bloud may with the more speede come from the inmost partes so be expelled The quantitie of bloud passed forth is to be considered as wee shewed before 14 15 Chapters that it may be stayed in due time in this behalfe therof two regards are to be had especially First the necessitie of the disease Secondly the constancie firmenes of natural strength wherof looke in the foresaid places more at large After good bloud apeares bleed no more for feare of the crampe convulsion palsie dropsie such like In a simple plenitude to auoid imminent dangers it shal be sufficient only to abate the abundance albeit a mediocritie stil remain But in an vniuersal disease as is a feuer a mediocritie will not serue but bloud is abated more then so And in inflamations we are not only to regard the quantity but in like maner the alteratioÌ„ of the colour substance of bloud and when great paine or inflamation is in places neere the incision stay not the bloud before the paine begin to asswage or the colour of the bloud to change For alteration of colour sheweth that the same bloud vnlike the other that good is proceeded from the inflamed part If the humor cleaue fast to the member or that by euacuation the strength of nature bee wasted then wee are vrged to stay bleeding before the bloud doo chaunge in colour and to detract that which remaineth by reiterating Phlebotomy either the same day or the day after Hyppocrates 2. vict acuto 10. In the cure of the Pluresie writeth that in the cure of that disease the inner veyne of the arme is speedily to be opened and bloud plentifully to be withdrawen vntill the same appeare far redder than it did at the first or that for pure and red bloud the same appeare swart and blacke which both happen in Plurisies If the bloud were before rawe crude vndigested and that it come from the inflamed place neere an incision it becommeth redder or yeallower because this bloud is horter than that which went before If it were at the first thus coloured namely redde or yeallowish than when it commeth from a member inflamed it turneth to be black and swart thorough adustion and thus you see how to stop the fluxe of bloud by the quantity by the substance and by the colour of the same As wee are to consider the foresaide thinges in the bloud so are wee to consider strength in the Pacient Of defect of strength these are the signes The fluxe of bloud relenting paâ—e colour in the face gapings stretchings noise in the eares webs in the cies and defect of seeing All these shew a decay of the spirits oflife they shewe faintnes of the heart and that the bodily parts are forsaken of inward heate To these may bee added the hicket and a desire to vomit which commeth of fluxe of the humor to the mouth of the stomacke as were already shewed But the most certaine and assured marke is the alteration of the Pulse which changing from thicke to slow from great to little from strong to weake from equall to vnequall prognosticate defect of nature and a perturbation in the body not much vnlike Epilepsia that is the falling sickenes If these come through feare or of humors nipping the stomacke stay bleeding recreate and strengthen the Pacient a while that afterward the residue of the euacuation may be perfected The waies to recouer and fetch strength againe if the same giue ouer before a conuenient and commodious quantity of bloud may be taken are these to cast colde water on the face of the Pacient to sprinckle vppon the face white odoriferous wine to put to the nose of the same party vineger strong wine muske or other aromatick thinges if these helpe not wee must close vp the veyne a while with the finger and if neede be the euacuation is to be imparted or diuided But to auoide all these accidents the remedy is to let bloud the party lying in his bed for so the partes of the body are reduced into one equality of position whereby the principall parts mutually bestow one on an other inward heat and vitall spirits if the Patient bee not brought againe by the foresaide thinges then prouoke vomit by tickling in the throat or by pouring in a litle oile for the force of vomiting stirreth vp strength and draweth away weakenesse of the stomacke and heart and presently after recouery renue the strength of nature with wine iuce of Pomgranats broth of flesh with the receit called Diamoâ—cho and other cordiall things The instrument may bee annointed with oile or other such liquor that it may inflict the wound without paine and for the most part the wounde must bend somewhat aslaunt or crookedly The incision is made two waies as Hyppocrates saith one straight Secundum rectum or Edirecto downeright the other contrary crookedly or a swash In these two waies wee must vse great discretion to vse them as neede requireth and not deceiue our selues vsing the one when wee should the other as many are deceiued in these daies To shewe which of these is to bee preferred would require a long discourse whereof read at large Fuchsius in his Apologie against Brachelius There is newe kinde of instruments to let bloud withall nowe a daies as the Rapier Sword and long Dagger which bring the bloud letters sometime to the Gallowes because they strike too deepe These instruments are the Ruffians weapons more malitious than manly But in this practise the veyne must be opened with a fine Launcet no fleme with a beard like a bloud-iron wherewith Smiths let horses bloud for they will sometime cut a veyn thorough on both sides causing a crampe and deadly convulsion And here I giue aduise that no Surgion except he be very skilfull himselfe open any veyne without the counsaile of the learned Phisition or the iudgement of some others that haue auncient and tried experience in the practise Ignorant Barbers doo great hurt herein
taking that which comes to hand first or which appeareth greatest perhaps a sinew for a veyne so letting out the vitall spirits and killing many and when it is done this is all their defence to say the signe was there and he would needs be let bloud Vnction or annointing is oft vsed in this practise sometime we rub the member whose veyne is to be taken with oile that thorough the warmth thereof bloud may bee made the more flowing sometime the instrument is annointed as was saide before to mittigate the paine of the inflicted wound Sometime the wound it selfe is annointed that it may bee the longer time before it bee couered with the Scarre and that the humors left behinde may with the more liberty breath foorth and that the ill humors remaining may bee also the better dispersed Drinke and especially wine may bee very well taken both in the bleeding if Syncope happen and after bleeding to cause good bloud and to recouer againe the vitall spirits Bathing two or three daies before is vsed in some causes as was declared in the former chapter but not the selfe same day The common opinion is that bleeding must be done fasting and vppon an empty stomacke but this is not approoued of the best writers for many of them giue aduise to eate before bleeding a soft or poched egge with a draught of wine about nine or ten of the clocke â—n the forenoone and then presently to open a veyne For nature the stomacke being empty and being altogether destitute of nourishment doth mightily holdfast and retaine the bloud whereas when a little nourishment is taken in small quantitie as is a poched egge a draught of wine shee permitteth the bloud easily to passeforth It hath bin declared before Chapter 16. that if necessitie vrge there is no prescribed time of bleeding but that if the disease require the same may be done at all times yea euen in the night Yet the forenoone of the day is the most vsuall time There is an houre of necessitie which is any houre in the day or night and beside this hora necessitatis there is hora commodiâ—atis which is the morning or forenoone houre viz. Galen de Curan râ—tio per sang missio cap. 13. 20. in praesagio experientia Comprobatâ— cap. 4. Aetium lib. 3. cap. 16. Oribasi lib. 1. cap. 11. Moreouer if a veine opened send forth bloud whitish in coloure stay the same for it appeareth that the humours in the bodie are rawe colde and vndigested through defect of naturall and digesting heate This is affirmed by Aristotle lib. 1. 9. de animalibus and Hippocra witnesseth that alwaies womens termes appeare not in their proper colour that by reason of frigiditie and coldnes of white bloud they oftentimesvomit and haue fluxe of tearmes Finally as in purging so in bleeding as wee haue already said wee are to consider the standing of the wind in winter to bleed wheÌ„ the same is Sowtherly in Sommer when the same is Northerly For the North wind with cold tempereth the heat of the time The verses of Schola salerni Hac facienda tibi quando vis Phlebotomari Vel quando minuas fueris vel quaÌ„do minutus Vnctio siue lauacrum potus fascia motus Debent non fragili tibi singula mente teneri Before and after letting bloud all these are meete and requisite Vnguent a bath strong drinke and good with motion mean and bonds most fit Remember all doo none forgit A prescription or regiment of the patient after bleeding Chap. 20. WHen a sufficient quantity of bloud is withdrawen proportionable vnto the greatnes of the disease vnloose the bond and drie the wound lest beeing moistened with clodded bloud either it growe not together againe or bring some doubt of impostumation These thinges not done accordingly enforceth vs sometime the eight day after to open the wound againe If any piece of fat come forth the same must not be cut off but softly put againe into the wound When the wound is wiped cleane drie close vp the veine with linnen dipt in rose water or sweete water or with Oile if wee purpose to bleede againe Let the same bee tyed on with bondes not tooâ—hard for writhing the skinne or lippes of the wound If a sinew or Tendon be pricked yee heard in the chapter before what is to be done If there be doubt of fluxe of bloud or an inflammation through pricking of a sinew we may beside the premisses apply after the practise of others a plaster of Ceruse and in compas about that a Cataplasme of Housleeke Nightshade Plantaine and other cold things After bleeding lye a while on the backe for quietnes sake and to recreate the strength of nature and to recouer the vitall spirits He must not frequent his accustomed affaires nor moue his bodie hastely nor exercise himselfe immoderatly neither must he vse Venus delightes nor yet bath himselfe For the bloud and spirits naturall vitall and animall which haue of late bin vehemently stirred by bleeding are now by rest againe to be setled else the same bloud and spirites would by these outward vehement exercises bee inflamed and so wast and consume away Neither must the party presently sleep lest either the languishing heat be quite extinguished or the lessened spirits altogether ouerwhelmed Let him therefore watch and rest void of contention either in mind or in body When an houre or two is past after bleeding a litle meate may bee giuen him Little I say in quantity but of good iuice to nourish the bodie and profitable also to withstand the present disease when 2. hours are past this short repast he may then sleepe so as his keepers carefully take heed that he tumble and turne not himselfe on the arme that hath bled or that the bond by tumbling and tossing be not remooued which may cause the bloud to slow againe a fresh or some other displeasure to fall out Afterward the diet must bee increased by little and little both in respect of the quantity and of the goodnes of the meat Neither as yet must we hasten to a full diet for the heat of nature being abated by bleeding can not as yet receiue or digest aboundance of meat And againe the veines lately emptied would exhaust out of much aboundance of meat much raw and vndigested matter wherwith the whole bodie is stuffed againe If concoction bee perfected and accomplished so that we may eate great quantity of meat yet vse a moderation for to what purpose is it presently againe to stuffe the bodye with iuices and humours for the abating and taking away wherof we did so lately let bloud Therefore after bleeding the patient is to liue more finely and exquisitly and not to goe to his old intemperat diet againe as the dog to his vomit Neither are these intemperat persons meete men to be let bloud as we prooued and shewed before in the 8. Cap. Fig. 1. Of
Chrisi If it be very dark it betokeneth grosse bloud Greene bloud sheweth perfect adustioÌ„ When the bloud floweth soorthspedely it is suetile and thin when it spinneth not foorth but comes guttatim slowly drop by drop it betokeneth that it is grosse bloud when meanly betweene both then is it a mean bloud betweene grosse and thin Againe sometime it is quickly congeled then is it g rosse bloud somtime slowly compacted and then is it subtile Thicke and grosse bloud sheweth thicke and grosse matter in the bodie or it sheweth great heat and drith which hath consumed the humidity of bloud If it be subtile thin it sheweth want of digestion and abundance of raw vnconcocted humours of hot humours or of cold as the colour shall discrie If the bloud be oily it betokeneth either a future leprosie or too much fatnes in the body for leprosy is caused of extremity of heat in the bloud burning the same and conuerting it into an oily substance Againe take a bat round in the end and set it to the congeled bloud if it withstand it not but giue place vnto it and bee diuided it is an argument of drith If the bloud greatly resist the entrance of the bat then is it a very thicke and viscous bloud If between both then is it a meane bloud And thus of the substance of the bloud which should haue bin inserted before And touching the colour in like sort this briefe obseruation by the way which was also omitted but may come in here yet in good sort a good bloud is of diuers colours according to the diuersitie of the parts for in the vpper parte and in the compasse of the vessell it is of a red colour for the good bloud being light alwaies ascendeth vp to the higher partes in the middes it is red and not cleere in the bottom it is blacke and melancolious For melancoly being heauy resteth alwaies in the bottome Sometime there swimmeth on the toppe of the bloud a certaine fatte or oily matter like a copweb If the body bee very grosse and fat this is caused of the verie bloud which is in such bodies inclining to fat If the body be very leane it declareth the same now to beginne to melt and to languish In the bottom of the clodded bloud there is resident an earthly a filthy substance which being deuided or clouen asunder appeareth in colour either red darke blacke bright or greene whereby we may coniecture the nature of the humour mixt with the bloud yea by the colour much or little we may know how much ech humour aboundeth in the veines Some say if the bloud bee cut or deuided that there bee found in the same certaine grainees like small sande that it noteth leprosie or inclination vnto it which alwaies hath not been found true by certaine that haue obserued it It is sildome that the bloud comming from the veines doth sinke but if it doo the same sheweth corrupt and stinking humours and is a token of vncurable putrifaction and corruption No man doth willingly tast detracted bloud but if by chaunce it come into the mouth and doo tast sweet it is according to nature good and of perfect concoction If it bee bitter in tast it sheweth aboundance of choller if it be sowre sharpe and restringent it denotateth aboundance of melancoly if vnsauery aboundance of flegme if salt the bloud is mixt with salt flegme After obseruation of the substaÌ„ce and colour of the bloud conferre all the smal porringers or vessels of bloud together If they shew all equally good bloud it is to be supposed that the rest in the veines is like vnto it Yet the same is to bee withdrawen if it offend in quantity and greeue the body hurting the sences and causing in the body putrifaction and other euils If bloud appeare corrupt then with a greater profit the same is to be withdraweÌ„ because it hurteth the body two waies both with the quantity and qualitie thereof If it be not sufficiently withdrawen at one time afterward againe a veine must be opened and beside bleeding if Cacochymia concur with plenitud that is that bloud offend both in quantitie and qualitie as wee noted in the 21. Chapter beside bleeding the body must more ouer be purged with inward medicine If that bloud which came first were good and the other corrupt then suppose that yet much such bloud remaineth in the bodie to be auoided by good order of diet and orderly euacuation But if it fall out so in inflamations it is a good signe that the euacuation is absolute and perfect quite taking away the matter of the disease from the affected member The bloud poured into warme water hath thereby his partes and substances deuided the wheyish and watrìe substance is confounded with the water and cannot be knowen from it Also the thinner and more subtile part of the bloud is mingled with the water likewise whereby yet notwithstanding after a sort wee may giue iudgement of the nature of the humor The thicker parte of the bloud resteth in the bottome which is reputed good and naturall bloud if so be it be whitish thinne bright and cohering together If the same be more grosse it sheweth the grosnesse of the bloud that remaineth in the bodie If it be obscure blacke or otherwise coloured after the difference of the colour iudge the bloud to be corrupted or not corrupted with â—ilthinesse of wicked humors If it do not cohere but be distracted and diuided it betokeneth vncurable putrifaction Last of all remember that the more vnpure and vnconcocted the bloud appeareth being altered from the nature of good bloud the same is to be withdrawen in the lesse quantitie and not so plentifully as when the same draweth more nigh the substance of good bloud which is done otherwise and quite contrarie by our common barbors and letters of bloud And looke howe much the humors doe passe and exceede either lesse or more the nature of bloud so much more sparingly are wee to let bloud And when they exceede too farre from the nature of bloud either the one waie or the other then wee are altogether to forbeare bleeding as wee haue noted in a certeine place alreadie A short rehersall of eight auncient errours touching bleeding and a sufficient confutation of them by auncient authorities Chap. 23. FIrst that bloud must not be let but in the morning This is confuted by Galen lib. de Curand ratio per sanguin Missio Capitul 12. saying Feare not to let bloud by night forit is ridiculous that some doe maintaine onely letting bloud from the second houre of the daye to the fifth or sixth and no other time The second errour is that obstruction and putrifaction are the causes of letting bloud Galen also confutes this 2. Metho Med. cap. 14. in these wordes Neither obstruction nor putrifaction is the cause of leâ—ting bloud but abundance of humors for neither can stopping or putrifaction be
may fall away They are with most safety let downe in a reede or a pipe to the affected member lest they might touch together and so by that meanes of ende those partes that are sounde and whole And first before you apply them so presse them and wring them out that they may vtter and cast forth all their venome so as their backes bee greene and their bellies reddish VVee are to choose such Leaches as are not in fowle troubled blacke waters nor such as haue long rayes or strikes in them like roddes called Hyrudines Virgulatae Nor such as are of the colour of Lapis Lazulus for these are venemous But wee are to choose them that bee redde inclining to the colour of the Lyuer hauing two redde lines or strikes or inclining to a certaine greennesse hauing little heads and beeing very slender and had out of cleare flowing waters Let them not bee blacke nor hauing a certaine white hearinesse vppon them as wee see there is vppon certaine hearbes as Clarie and vppon certaine fruites as vpon the Quince but as yee heard before take such as haue greene backes and red bellies To make them fall off if neede require put to their heads Salt Lyme Dust Ashes or Vinegar strawe any of these vppon them and they will fall away if you will haue them off sooner put a horse haire betweene their mouthes and the place and drawe them away when they are off wash the place with a spunge To â—â—nt the bloud after they bee remooued if neede so require for sometime bloud floweth out two houres after the Leaches bee gone straw vppon the place powder of roses or of buâ—nâ—d gaâ—ls or powder of a new tile or powde◠〈…〉 straw a little Sanguis Draconis or lay on the place powder of a spunge and pitch 〈◊〉 or a linen cloth burned or the hearbe 〈◊〉 Pastoris bruised â—fter the fall of the Leaches apply cupping 〈◊〉 to purge the venome and excrements which they haue left behind and to withdrawe 〈◊〉 bloud which they haue drawne somewhat outwardly but haue not quite euacuated Finally I giue aduise that before you vse them to the purposes aforesaid you apply them being hungry which is done thus by keeping them in water a day so that they eate nothing If you will keepe them longer put in the same water some Lambes bloud or such like that so they may be kept aliue some season For further matter herein I referre thee to Galen who hath written a booke De Hirudinibus That is of Bloudsuckers Of Cupping or boxing scarification the other two particular euacuations of bloud Chap. 27. FOrasmuch as it is not conuenient to be let bloud oft times in the yeare for that much of the vitall spirit passeth forth with the bloud and that the blould being taken away the body waxeth colde and the operations of nature become weake and enfeebled as we haue before in a certeine place declared therefore I counsell saith Galen that the baser partes of the bodie as the legges be boxed or cupped which is the most sure remedie as well to conserue health as to repaire the same being decayed For it cureth the eyes annoyed with long distillations It profiteth also the head vpper partes of the bodie as the brest and backe and against sundrie other diseases For in what member so euer the bloud is gathered the bodie being first purged by cupping the griefe may be cured Also Oribasius affirmeth that it helpeth Quincies in the throat dissolueth stoppings of all places Notwithstanding application of boxes about the stomack in hote feuers where reason is troubled are to be eschewed for feare of suffocation Likewise put vnto the head vndiscreetly they hurt both the head and the eyes Boxing helpeth swellings letteth foorth winde stoppeth immoderate Termes and the bloudie flixe helpeth appetite when a woman sowneth it reuiueth her â—pirites againe It draweth foorth water asswageth hard swelling clenseth Melancolie and that chiefely in weak bodies It will remoue humors from place to place as from the head to the necke from the neck to the shoulders Galen wrote a booke intituled de Cucur bitula tâ—aâ— is of the Cupping Glasse and rehâ—arâ—â— hâ—â—pâ—â—nese effectes thereof that boxing doâ—tâ— Non solum materiam euacuare sed etâ—â—m dolorem soluere Phlegmonon minuere insâ—â—tâ—onem discutere appetitum reuocare ventriculo in firmo roburaddere aâ—imi deliquio liberare ex alâ—o fluxiones transferre sanguinis eruptiones cohibere facultates mensium corruptrices extrahere mensesque supprimere i. not onely euacuate the matter but also asswage paine take away inflammations abate swellings recouer appetite strengthen a weake stomacke reuiue those that sowne drawe downe fluxes and stoppe fluxes withdrawe corruption of Termes and also stoppe the fluxe of them VVhich effectes shall hereafter be reheased with their cures by this practise more particular There are three causes which perswade vs to vse this practise and to refraine letting of bloud First because our purpose is to euacuate from some one member and not from another and therefore particular euacuation is done by boxing or Cucurbitulas which they that follow barbarous authors in Pinsicke doe also call Ventosas Nowe particular euacuation cannot be made by Phlebotomy for the same euacuateth and emptieth from the whole bodie Secondly because the strength is weake or the age vnfit to bleed or that there is some other of those impediments spoken of in the 8 Chapter For as Rhazes sayeth in 7 Ventosas drawe bloud but from the little veines and therefore the heat and spirites are thereby but a little diminiâ—hed whereas opening of a veine greatly debilitateth nature drawing from the greater veines with the bloud much heat vitall spirites Thirdly because our intent is to euacuate onely from the baser members Bleeding euacuateth from the most noble members and greater veines Ventosas from the meane members and little small veines which arein the outward bodily partes and lye without the greater veines Of boxings there are two sortes the one gentle without scarification or launcing the other with scarification which both in steede of bloud-letting are vsed when age debilitie the time of the yeare or other considerations will not permit the op ening of a veine Hereby is produced the thinne bloud next the skinne and being presently vsed after scarification when little incisions and holes are made in the member that bloud and humors may easily come foorth it mightily withdraweth by force and flame of heat not onely the thinne flowing humors and spirites which are about the member after scarifying but also that which is in places further distant If the skinne I say be first exasperated with the Iron it doth this that wee heare speake of more manifestly If the skinne be whole and not scarified it prouoketh bloud and humors from the furthest parts into the skinne and bringeth it to that parte whereunto the cupping boxes are applyed The cupping glasse infixed the skinne being incided or launced purgeth the
about the pâ—iuie parts of men or women Ventosas applyed vpon the buttockes attract from the whole body and the heade and helpeth the bowels also they helpe corruption of menstruous termes and by meanes thereof lighten the body Ventosas applyed vnder the ham behinde the knee helpe beating shaking in the hams caused of an hot humor also wicked pushes corrupt vlcers in the shanks in the feet and thus much of the particuler application of cupping or boxing glasses There is another kind of boxing that we haue not here to deale withall necessary and good sometime to bee vsed as for example sake If you haue any sawsie Lowt or loytering Lubber in your house that is either too busie of nothing but play one of the parts of the foure and twenty orders of knaues there is no pretier medicin for this nor sooner prepared than boxing is three or foure times wel set on a span long on both the cheeks althogh perhaps this wil not alter his lubberly conditions yet I assure you it will for a time change his knauish complexion and helpe him of the greene sickenes and euery man may practise this as occasion shall serue in his owne house to reforme them Because as we haue saide boxing is often vsed together with launcing therefore a word or two of scarrification and so an end Launcing is done with a Lancelot or some instrument called in Greeke Epidermes and in Latine Scalpellum The member is cut by little and litle with this Chyrurginall instrument ometime it striketh but the very skinne sometime it goeth in deeper It euacuateth onely out of the diuided member except by hap it wound and hurt the veyne Scarrification causeth the humor vnderneath to passe forth not forcibly extracting any thing from places distant and further off and the deeper the Instrument goeth in the more aboundant is the effusion of bloud It serueth to purge the skin and helpeth those affects which Leaches doo cure and those which are in the skinne and sticke stifly vnto the same As old inflamations of corrupt matter as the disease called Scirchus mentioned before as Gangraena a cankerous mortification of a member or part of a member as Sphacelus which is when any part or member is mortified thorow inflamation and such like in which diseases naturall heat beeing as it were choked vp and strangled desireth as it were to bee winnowed VVhere note that Launsing doth more plentifully draw bloud if presently vpon it boxing bee vsed as was partly signified before A profitable and compendious Table of Phlebotomy or bloudletting containing diuers points in this Treatise handled and discussed of and setting downe by diuision the generall and speciall considerations thereunto belonging Chap. 28. A principall rule and obseruation AS in other thinges so in bloudletting the cause is first skilfully and circumspectly to be considered as that it bee to purge the body of some vnnaturall naughty and superfluous humor whose substance is either simple or mixt Simple when it doth of it selfe without the admixture of any other degenerate as bloud doth when it putrifieth in the veyne the Pores being stopped mixt when it is mingled with some that is already corrupted as in the dropsie where the bloud is mixt with water The cause beeing thus allowed and certainely knowen for needefull and good to the Patient otherwise letting of bloud is very dangerous and openeth a way to grieuous infirmities as ye haue heard in this treatise There remaineth to be considered how it standesh with the Patient Inwardly For his Complexion For his Age. Outwardly For the time of the yeare and moneth generally For the time of the day and diet particularly 1 Complexion In the complexion is to be considered whether he be Sanguine i. hote and moyst Colericke i. hote and dry Melancolicke i. cold and drie Phlegmaticke i. cold and moyst 2 The Age. In his age whether he be In his youth In his manly middle age In his elderly age In his crooked old age 3 The time of the yeare Concerning the time of the yeare he is to be aduised what partes therof are good as the spring from the middest whereof to the beginning of Summer is simply the best time howbeit some thinke Autume reasonable good as no doubt it is in regard of Summer or VVinter being otherwise in it self rather to be rekoned for bad than good Bad Verie bad as Summer VVinter for the extremitie of heat colde More tollerable as Autumne being somewhat more temperate 4 The time of the Moneth Concerning the time of the Moneth these generall cautions are to be obserued that he be not let bloud in any meÌ„ber with chirurgicall instrument The Moone being in ♉ ♊ ♌ â™ or the last half of ♎ and first of â™ The Sunne the Moone or lorde of the Horroscope being in the sâ—gne that ruleth that member The Moone being in any parte of via lactea or in via combusta or in domo casus sui or being vacua or tarda cursu or in terminis infortuniorum or in the duodenarial diuision of the 12. houses placed either in 1. 6. 8. or 12. place thereof or applying to the lord of the house The dâ—y before the day it self the day after the chaÌ„ge of the Moon Halfe a naturall day that is 12. hours before as many houres after the quarters of the Moone A day before a day after the full of the Moone A day before a day after the coniunction quartile opposition of the ☽ with ♄ or ♂ A day before the coniunction of the ☽ with ☿ ♀ or the head or the taile of the Dragon infortunate and euill The conuenienst time of the yere For the Sanguine the Moone being in any of the signes For the cholericke the Moone being in ♋ or ♓ For the Melancolick in â™’ and first halfe of ♎ For Flegmaâ—ick the Moone being in ♈ or â™ Howbeâ—t some commend ♋ â™’ and ♓ for bloud letting Also the best most laudible aspectes for this purpose are these according to our soundest writers The coniunction of the Moone with ♃ or ♀ are simply the best so that ♀ bee not combust The â–³ or âš¹ of the ☽ with ♃ ☉ ♀ and ☿ are good but especially with ♃ or ☿ The ♊ or ☠of the ☽ with ♃ or ♀ doth well The â–³ or âš¹ of the ☽ with ♂ are indifferent good The time of the Moneth for Youth from the chaunge to the first quarter Middle age from the first quarter to the full Elderly age from the full to the last quarter Old age from the last quarter to the chaunge A reason of this rule is Like reioyseth in his like Howbeit as we haue taught in this Treatise no childe would bee let bloud before fourteene yeares of age nor olde man after threescore and ten vnlesse his strength be the greater and somewhat more than ordinary at those yeares 5 The time of the daie The time of the day must be
either Morning after the rising of the Sun when a man is yet fasting which is simply the best excepting the houres of ♂ and ♄ and choosing the houres of ♃ and ♀ whose nature is most temperate Afternoone after reasonable good or rather perfect digestion and expulsion of of superfluities Herewithall regard must be had of the aire that it bee neither too hote nor too colde or clowdy but milde cleare and temperate the wind being then either Northerly or westerly The Southwind is counted no friend to Phlebotâ—my whereof this is the reason heate looseneth too much cold bindeth too much An Exception NOtwithstanding the premisses of bloud-letting before The Frensie Squinancie Pluresie and Apoplexie or for a continuall headach proceeding of choler or bloud for any hote burning Feuer or other extreme paine and desperate disease A man in such a case may not tarry a chosen time regularly set downe by the Astronomer or Phisition for so the Patient might miscarry in the meane season But incontinently with all conuenient speede hee is this way to seeke his remedy except either he bee very weake or like to sowne or that the Moone bee in the same signe that ruleth that very part of the body VVhere also note that in the foresaid case of extremity bloud is not to bee let in so great a quantity as otherwise it would if a chosen time might conueniently be expected As before bloudletting these circumstances of complexion age and times are to be considered So after the same consideration is to be had of our meats and exercise For meates such must bee taken as are of an easie and light digestion For exercise wee are to abstaine from all exclusiue vntill the fourth day not onely those that be vehement as riding running leaping vawting wrastling fensing tennise c. But also such as are more milde as walking bowling bathing and especially Venerie whereof wee haue spoken in the twentith Chapteer and I doubt not but I may effectually conclude both antecedent and consequent limitations duely and orderly obserued this auncient practise of Phlebotomy to bee very commendable both for the preseruatiue and curatiue intention of Phisicke Conclusio Operis And thus according to my simple skill and poore talent I haue set downe those remedies which withdraw bloud either from the whole body generally as Phlebotomy or from certain parts particulerly as Leeches boxing and scarrification which was my purposed determination at the beginning to doo If any thing bee here set down repugnant to sound skill I craue pardon hauing no skill to iudge because Phisicke is not my profession onely drawen with a delight in this practise First for my pleasure now I trust for orhers profit I haue further trauâ—iled herein than I thought to haue done If any fault or error be in the order methode or disposition I assigne that vnâ—o my selfe 〈…〉 pardon for ought that is amiâ—se protesting in truth which a man may easily discrie tâ—at this booke is rather a collection from others than an inuention of mine owne God graunt that this my trauaile herein whatsoeuer it bee may make vnto his glory and the comfort of his people which are the two impulsiue causes moouing euery good Christian one way or other to imploy his indeuour Deo laus honos gloria in omne aeuum FINIS ¶ The Contents of the seueral Chapters in this Treatise Cap. 1 OF fulnes emptines and their diuisions 2 What euacuation is and the kindes and diffeces thereof 3 What Phlebotomie is and from whence the opening of a veyne doth euacuate 4 Whether Phlebotomie must goe before purging or contrary 5 Of the effects that is the profits disprofits of bleeding 6 Of reuulsion that is pulling back and deriuation that is turning a side of blood and humors by opening of a veine 7 Whether purgation by siedge or inward medicine receiued can not or may not euacuate the blood and the reasons answered that are brought for proofe thereof 8 Of the impediments or lets of Phlebotomy and of the causes requiring and furthering the same 9 Of such persons as are meete or not meete to be let blood 10 What corruption of humors bleeding remoueth from the veynes generally 11 A particular rehearsal of those diseases present or future which are cured by bleeding 12 What voluÌ„tary eruption of blood profiteth in sicknes 13 How to know by certayne signes the greatnes of the disease the firmenesse of the natural forces wherby coniecture may be made whether the patient be to be let blood or no. 14 To know by the greatnes of the disease and strength of the natural powers the quaÌ„tity of blod that must be withdraweÌ„ 15 An obseruation of things present and past and also a foresight of things future needfull and necessary to the further knowledge of the quantity of blood that must be taken 16 Of the times and seasons of the sicknes of the yeare of the day and houre of the day when a man is to bleede or not to bleede 17 Of Astrologicall obseruation in bleeding and of an other obseruation neerely annexed vnto the same shewing what members and parts of the body are to bee opened according to the seueral seasons of the yeare 18 What preparation must goe before bleeding 19 What is to be done in the very time of the incision 20 A prescription or regiment of the patient after bleeding 21 What veynes are to bee opened both in generall and particular diseases 22 A profitable obseruation of the blood extracted 23 A short rehearsal of 8. auncient errors touching bleeding and a sufficient confutation of them by auncient authorities 24 A sufficient confutation of the supposed necessitie of annual bleeding 25 Of incision of the arteries 26 Of particuler euacuation of blood and first of bloodsuckers and Horse-leaches 27 Of cupping or boxing and scarrification the other two particular euacuations of blood 28 A profitable compeÌ„dious table of Phlebotomy or blood letting conteining diuers poynts in this Treatise handled discussed off and setting downe by deuision the generall and speciall considerations thereunto belonging The names of the authors whose help is chiefly vsed in this Collection Aristotle Actuarius Aetius Auicen Alexius Andernacus Auerroes Arnoldus de villa noua Bacchanellus Bullein Anglus Cornelius Celsus Eliota Anglus Fernelius Fuchsius Galenus Gesnerus Hippocrates Rich. Harueius Anglus Hollâ—rius Iohannes de Santo Amando Iohannes de vigo Mesue Oribasius Paulus Aegineta Rhasis Rondoletus Schola Salerni Weckerus LONDON Printed by William Hoskins Iohn Danter dwelling in Feter-Lane 1592. â—yâ—sts i◠〈◊〉 â—* Cephalica Bâ—siliâ—â— Coraâ—â— id 〈…〉 vena Saluatel Domâ—stic◠〈…〉 Silâ—atica 〈◊〉 1. Substanti 2. Serum 3. Spuma â— Pinguedo 8. Subsidentia 7. Grana