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A27335 Animadversions on the medicinal observations of the Heidelberg, Palatinate, Dorchester practitioner of physick, Mr. Frederick Loss by Alius Medicus. Alius Medicus.; B. T., 17th cent.; Loss, Friedrich. 1674 (1674) Wing B178; ESTC R5485 95,653 168

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according unto which the advice of the Physician ought to be directed For the concern is not what a Patient's Age is but what his strength is Therefore a strong Child is safely Cured Thus Avenzoar makes mention of his successful bleeding his own Son at three years old and we find by experience that Children of four or five years old do by bleeding most commonly escape dangerous Diseases The same Author likewise in his Praxis and Chapter of a Pleurisie says thus Adeo necessaria est Venaesectio in principiò ut nunquam omitti debeat nedum in sene puero gravidâ puerpera menstruas purgationes Patienti docuit ènim Experientia hisce omnibus utilissimam fuisse Venaesectionem presente hoc morbo So necessary is opening of a Vein in the beginning of a Pleurisie that it must never be omitted no not in an old Man or Child or Woman with Child or that hath her Terms for Experience doth teach us that in all these in this Disease opening of a Vein hath been most profitable By Experience It is not long since that I knew a Girle not five years old that fell into an Atrophy a meer wasting and pining away without any Symptoms of a Consumption or Phthisis she was too young forsooth to be bled and all other means were to no purpose for she died and upon the opening of her Body her Liver was found so largely grown as to out-weigh the Spleen seventeen times Now whether the Liver be the Fons Sanguinis or the Heart or neither but that every Bowel contributes its office towards the making of the Blood yet since the Liver by separating the Choler into the Gall sweetens the Blood much and that sweetness helps to increase both Liver and Blood as also doth the absence of the acid ferment from the Spleen and I am prone to think that the Helluo the Blood eat her up and caused such an over-fast growing of the Liver as starved the Spleen and other parts Should another such a Case offer it self of such a Plethora would any rational man forbid bleeding until the Child were fourteen years old of which there is no likelyhood it should live until seven I am sure I did not in a Brother to this Sister about seven years old that not long after was treading in her steps and making haste apace unto the same end but being forwarned I bled him and I never saw more advantage by bleeding befal a Man than hapned unto this Child his recovery was so speedy and his health so good ever since as those then about him can witness I might instance also in the two above-mentioned Experiences wherein Mr. Loss himself can bear me witness of successfulness of bleeding under fourteen years of Age. Yet by all this which I have said I do not mean that I would encourage any Physician to be rash and venturous one that should hand-over-head pell-mell bleed all younger Patients as readily as Men without due consideration of their tender Age but I only urge from what I have written That there may be a time wherein it may be necessary to bleed a Child by Lancet under fourteen years old 2. That this Gentlewoman young Mrs. Moore might be bled by Lancet Here were several Indications for Bleeding and Co-Indications and there were no Contraindicantia nor Correpugnantia The Indications Here was Plethora quoad vires such a fulness of Humors in the Mass of her Blood as Nature could not rule well or manage so as to preserve them in their due Temperament and Mixture from separating and corrupting and therefore to remove this Morbifick Cause and to disburden the Body of a good share of that load it was pressed under that so Nature might the better comport with the remainder and by degrees master and subdue the Disease opening of a Vein was requisite Here was also need of Revulsion from a weak Part and Revulsion did Indicate Bleeding for this Patient was represented to me when I first visited her as a Child always Sickly Splenetick and Scorbutick and having her left Side weak by being Splenetick and pained in her left Breast more or less for two years before she fell sick Formerly she was obnoxious to Catarrhs and now also there was a flux of Humors in the mass of Blood flowing to her left Side part of the inflamed Blood had already got thither and lodging it self within the Pleura and Vicine Muscles caused in her a Symptomatical Pleurisie and there was great fear lest that inflammation should increase farther and therefore as bleeding was principally Indicated by the Plethora so was it likewise accidentally Indicated by Revulsion Here was Heat likewise that did Indicate accidentally the opening of a Vein in order unto the cooling her whole Body which was in a flame she having a putrid Scorbutick Feaver for her principal Disease Now this Preternatural Heat and Fire was to be put out and bleeding would help upon two accounts 1. By it part of the Fire even part of the Inflamed Blood might be taken away 2. By it Insensible Transpiration whose Evacuation alone is greater far than all the sensible together as Sanctorius observs in his Medicina Statica might be promoted the Pores of the skin opened whereby the Heat might breath forth and perhaps the cold Air get some ways in These Pores were before as it were wedged up with the plenty of Humors as is sometimes a Church-door by a throng of People each hindering another from getting forth but bleeding might unwedg them by letting some out another way and giving Nature room to drive forth what was superfluous by an open and free Transpiration as was also effectually done in this Patient who not long after fell into a great universal Sweat which completed her Cure The Coindications Some were taken from her Naturals and some from her Non-Naturals To her Naturals did belong her 1. Strength This was good even Mr. Loss himself being Judg so good as nothing could hurt 2. Habit of Body For lean people are generally fuller of Blood and have larger vessels than those that are fat and gross their Blood also wants more sweetning and 3. Her Age Though it was not fourteen yet was it about four It seems noways unagreeable to Reason to assert that one and the same thing may both Contraindicate and Coindicate bleeding as it is diversly considered For example He that considers of age under fourteen years that it is tender and wasts very much by the pores or habit of Body may so far look upon it as a Contraindicans as not to bleed in such an age except there be great need and good strength for fear the Patient should not be able to bear two large Evacuations at once And thus Mr. Loss seems to have considered this Patient's Age but notwithstanding this if need requires and strength will bear bleeding in a Patient not fourteen years old this Age as it intimates predominancy of Blood it may coindicate bleeding and
Mr. Loss his slanderings of me and the dammage I sustained by them in my Practice though I do not much matter that for else I would never have lived thus retired and in my reputation also but this I will not so easily part with except I lose it in my Vindication And now after all this to Answer directly to this first Accusation I say I am not conscious of any unworthy slandering of this Gentleman and I have now owned in print more against him than ever I related to any one in private and I am ready to answer unto any particular wherein he shall say I have wronged him Touching this Case I knew his temper by those experiences above mentioned which were before this young Gentlewoman was sick and therefore was so far from provoking him that I desired Mrs. Moore to have me excused from medling in the Case for I was rather willing to have lost the profit of so generous a Patient than to have to do with her first Physician but it being the Mother's earnest desire we should consult I modestly proposed and not Magisterially what I thought best and told Mrs. Moore that I should not be honest if being sent for to consult I should not freely deliver what my judgment was but having so done I did not desire that my opinion should out-ballance his yea I pressed her not to follow my Advice but rather his urging that he was both an elder Physician and her old Acquaintance but she protesting before us both that in her Judgment I spoke more reason than he sided with me against him whether I would or no telling him then unto his face that he must lay aside his prejudice which angred him I believe the more and put him upon falling thus upon me in print But this first Accusation is evidently and plainly proved to be false by witnesse for it is matter of Fact and who can better tell whether I accused all that Mr. Loss had done than Mrs. Moore her self who was present and would be so to all our Consultations and who says in her Letter which I have yet to shew I must profess that you never to my knowledg censured Mr. Loss or accused him of any thing that is of what had been done To his Second Accusation Especially that Bleeding by Lancet was neglected THough I did not accuse what was done yet I could not advise bleeding of her by Lancet without tacitly blaming what was left undone Turning therefore this Accusation of Mr. Loss from me upon himself what I did not uncivilly before I do now directly accuse him for even that bleeding by Lancet was neglected and the reasonableness hereof will appear in these three Propositions well understood and prov'd 1. A Child under fourteen years old may be bled by Lancet 2. This Gentlewoman young Mrs. Moore might have been bled by Lancet 3. Mr. Loss was to blame that she was not bled by Lancet before the sixth day 1. That a Child under fourteen years old may be bled by Lancet This I prove three ways by Reason by Authority and by Experience By Reason Where there may be a Plethora be it quoad vasa or quoad vires there bleeding by Lancet may be appointed if weakness of strength do not contraindicate But there may be a Plethora whether ad vasa or vires in a Child under fourteen years old and yet no weakness of strength to contraindicate Therefore a Child under fourteen years old may be bled by Lancet If the strength do not contraindicate by being too weak the Age cannot for that is a consideration subservient to strength and it never prohibits bleeding but upon this account that a person of such an Age is not able to bear so noble a Remedy as bleeding by Lancet Now some Persons of ten are as strong as others at fifteen and some at sixty as others at fifty Although therefore the consideration of tender Age and of evacuating much by insensible transpiration ought to take place in a Physicians enquiry after the strength of his Patient yet if the strength be still good the Age is inconsiderable Sicut enim unum tantum ab una indicatur it a unum uni tantum contraindicat and since virium imbecillitas is the one Contraindicans to Venaesection the Age cannot be another Contraindicans By Authority Riverius in his Institutions Lib. 5. Part 1. Sect. 3. Cap. 3. answers directly unto Mr. Loss his Quotation of Galen touching this point viz. Vires in pueris sunt it a debiles ut vix ferre queant Venaesectionem Pueri enim corpus habent molle tenerum patens quod sponte suâ assidu● digeritur diffluit Ideo Hippocr 4. de Victus Ratione in morbis acutis aetatem florentem cum magnitudine morbi virium robore ad sanguinis missionem requiri praecipit quem sequutus Galenus 11. Meth. Cap. 14. ante annum decimumquartum venam secare vetat Quod de pleniori illâ veteribus consuetâ vacuatione audiendum est nam moderatam quae viribus plenitudini aut par aut inferior sit omnis fere aetas ferre potest si vegeta robusta sit aetas enim non tam annorum numero quam habitus virium robere metienda est quod eleganter Celsus confirmavit Lib. 2. Cap. 10. Antiqui inquit primam aetatem sustinere non posse hoc auxilii genus judicabant postea vero usus ostendit potiores observationes adhibendas esse ad quas dirigi curantis Consilium debeat interest enim non quae aetas sit sed quae vires sint ideo firmus puer tuto curatur sic Avenzoar Filio suo trino se utiliter venam secuisse commemorat nos plerunque experimur pueros 4to aut 5to anno aetatis a gravissimis morbis venaesectione liberari Strength in Children is so weak that they can hardly bear opening of a Vein for Children have a soft tender and patent Body which daily and of it self digests and dissolves Therefore Hippocrates in his 4 th of Dyet in acute Diseases commands that there be required to the opening of a vein a flourishing Age with the greatness of the Disease and the strength of Nature and Galen following him in his 11 th of Meth. the 14 th Chapter forbids such bleeding before fourteen years of age But saith Riverius this is to be understood of that large bleeding so much in use amongst the Ancients For almost every Age can bear that moderate bleeding which is equal if not inferiour to the strength and Plethora in the Patient if he be strong and lusty of his Age. For Age is not so much to be reckoned by the number of the years as by the habit of Body and its strength That which Celsus elegantly confirms in Chap. 10. Book 2. The Ancients says he were of opinion that the first Age of Man could not bear this sort of Remedy but use afterward shewed that there were other considerations more eligible