takynge awaye of bloud the phisitiō may boldly at one time take away as much as shal be cōueniente to the curyng of the disease but in case the strength of the paciente be feble and weake then the bloude wolde not be taken awaye al at one tyme but rather at twise or thrise as the sicke maye departe withall In extreme burninge feuers if the strength serue the best remedy is as Gallen sayeth to let bloude vntyll the bodye waxeth faynte and swoune with all for the coolynge of the body wyll extinguishe the feuer and in manye bothe lose the bellye and also prouoke sweate In letting of bloude the naturall constitution of the body must be wel loked vpon for they that haue great vaynes be nether to leane nor to whyte may spare more bloude then they y t be very leane white haue but small and litell vaines The region may not be forgotten nether for such as doe dwell in regions which be very muche distēpered ether w t heate or colde may not abyde the takynge awaye of much bloude because that theyre bodies whiche dwell in the colde region or contrye losing much naturall heat w t theyr bloud waxe afterward to colde the strength of theyre bodyes whiche dwell in y e hote contrey is afterwarde dissolued or dissipate w t ouermuche heate and by this reason nether summar nor wynter be conuenient to let bloude in but the springe only because that it is temperate As cōcerning what time or houre of the daye Gallenes counsell is that theye that be hole in the morninge within an houre after that they be risen they that be sicke at all houres both of the day and nyght so that theyr strength and sicknesse do so require The Phisitiō ought before he let any vaine be opened to inquire diligently of hys formar life and diet For yf he haue liued ydellye and haue bene fed with such meates as nurrishe much he may take boldly w tout feare y e greater quantitie of blud howbeit yf he haue bene a greate riottour a common drunkarde then Gallen sayeth that it is mere foolishenesse to do any thynge at all for such by theyr intemperat lyfe wil fil as fast as they be emptyed In bloud lettyng the especiall care ought to be of the vayne For seinge that ther is .iii. vaynes in the arme y e innar vayne which is called of the Surgiens basilica and is the lyuer vayne shoulde be opened for all swellynges or payne vnder the necke But the vtter vayne which is called cephalica in englishe the head vayne owghte to be smitten whan the partes aboute the necke be troubled as y e head and face The middell vayne which is called Mediana wolde not be medled with but there as the other vaynes appere not There be vaynes also at the knees and anclees which whan y e disease liethe lowe is most meet to be opened The last care and charge showlde be of the stintyng of the bloud For how much the better it runneth so muche the soonar it wolde be stinted or stayed but after that y e vaine is ones smitten it shoulde not be stayed vntyl ether that the bloud or pulse were chaunged The seconde way of emptiynge the body is by medicyne receyued in to the stomake which should not be vsed but whā the body is replete with euyll and corrupt humors wherfore such as be in healthe and haue good and swete humors Hippocrates wold in no case to be purged by any medicine for feare of dissoluing theyr power But such as haue nede of pourgynge must first make them selfes apt meete for the same by bathes eatyng of moyst meates for so they shall delyuer theyre guttes from obstructions Howbeit yf the humors be thicke clammy then they must be made thinne subtell and apt to runne by suche decoctions syrupes as doe incyde grosse matter But yf y e humors be thinne and subtell thē they haue no nede of any preparatyue and the Phisition ought alwayes to obserue that he pourge no humors whiche be crude and rawe except for theyr multitude they swell the bodye then withoute any more delyberation they muste forthwithal be taken away with a pourginge medicyne leste the strength of the body be dissolued or the fyerye heat of the feuer encresed or finally the humors be dryuen to sū principall part wherby Nature shalbe lesse able to deliuer the body For yf nature be not holpen before that tyme she shall be in suche a rage that nothynge can be done well or orderlye in the bodye The next care is what humor should be pourged Therefore the Phisition shoulde take heede that he pourge no moo humors thē be hurtfull to the bodye As yf fleume do redounde hurt y e body it only is to be pourged yf chollar ether yelowe or blacke offende the bodye then he should vtterly abstaine frō fleume and likewise whan water aboundeth it only shoulde be taken awaye for as Hippocrates sayeth if such humors be pourged as ought to be it profiteth the bodye and is donne withoute gryefe or payne but elles it is cleane cōtrary Besyde this the time of y e yeare woulde be considered as well in pourging as in lettyng of bloud For there be summe tymes of the yere in the whiche it is very madnesse to lewse y e bellie For in winter whan it is frost or snowe or in summar when the heat is outragious whosoeuer is pourged shal be much the worse for it and yet of both times the lesse mete for pourgyng is the summar For then the body is so adust with heate of the wether that it is not well able to beare the sharpnesse of the medicyne and nature also beinge made weake with the heate of the summar is more weakned of the medicyne insomuch that many being pourged then fall sicke of feuers be quite destitute of their strength Therefore the springe tyme of all other tymes of the yere is moste holsome bothe to powrge the body and to let bloude In pourgynge the body the region also must be considered For yf it be very hot it letteth the workinge of the medicyne because it draweth the humors in to y e skin and the aboundaunce of heate healpeth to dissolue the strength The age may not be forgottē For chyldren because they be not yet at their groweth be nothing mete for pourgations lykewyse olde mē whē they waxe weake shoulde not be troubled w t any medicines And as in all euacuations so in pourging of the belly the strength of the sicke must be earnestly loked vpon For so longe as the sicke maye abyde easilye the taking away of his humors he may safely be pourged no longer though all be not gone In leusyng the belly vehement stronge laxes be vtterly to be abhorred for besydes that they weaken the strength they hurt maruelously the stomacke Laste of all in pourgyng of the bellye the
excrementes wolde be taken heede to of the Phisicion because he may diuine diuerse thinges bothe of their substance qualitie and coulour The thirde way to cleanse the bodie is by vomit wherof Nature hath much good For they that vomit often for the most part be alwayes hole For there is euacuation made as well of flewme as of chollar by meanes wherof the stomacke is not filled with euyll humors the head findeth muche ease Vomiting is most profitable for them that be cholerick hauing large brestes short neckes wide mouthes it profiteth also to such as by meanes of great eatynge drinkinge reserue crude and rawe humors in theyr stomakes yet he that wyll be hole and pourposeth to be olde let hym not be to busye with vomittynge For the muche vse of it causeth deafnesse hurteth the eyes it breaketh y e vaynes of the breste and lunges it offendeth the teathe and causeth head ache Therfore it is y e Phisitions dutie to declare who is apt to vomit and who is not For suche as be not apte to vomit shoulde be pourged dounwarde and in no-case constrayned to vomit such as be not apt to vomite be they that be betwixt fat and lene hauynge theyr brestes narrowe and theyr neckes long and such as be leane slender and haue wyde brestes shorte neckes be apt to vomit In vomittyng the excrement must be loked well vpon for the sight of it shall amend the coniecture of the Phisicion The forth way of emptying y e body is by boxyng which as Gallen sayeth in hys boke y t he wrote of boxing doth not only make euacuation and drawe oute muche matter but also easeth the payne and diminisheth the swellyng dissolueth wynde and styrreth vp appetite where it was almost lost confirming the strength of weake stomakes calleth againe life in swounes and fayntynges it draweth also swellynges and fluxes from one part to another stinteth bledyng and stayeth wemens flowers There be .2 kindes of boxing on is withoute any scarifiyng which preuayleth moste in drawing backe of humours as in y e drawing back of wemens flowers whā they rūne to much these be light boxing glasses which be vsed w tout scarifiyng The other is w t scarifiyng which is vsed in hard swellynges cummynge of melancholy or whan y e partes be troubled w t the fluxe of any sharpe matter whiche muste be drawen from one to another in sharpe quicke diseases wheras y e pacient may spare no bloude scarifyinge profiteth watryng eyes and also paines both of head brest backe The .v. kynde of emptying the bodye is by bathe and here ye muste marke that there is .ii. kyndes of bathes one is naturall and an other artificiall That is called natural which springeth of his owne accorde without y e healp of mānes inuention Of naturall bathes summe be hote by the mixture of niter salte allume brimstone chaulke lyme yrō copper goulde syluer tinne which ether lieth in the bothom of the bathe or elles in the rockes or hylles from whence the springe cūmeth whereof water taketh his qualitie by this reasō y e bathes which be in a towne called Bathe here in Englande be hote to the great admiration of all ignorante people These kyndes of bathes be good for suche as be diseased in their ioyntes or haue crude raw matter in theire bodyes and be diseased ether with pockes pyles or emeroides but for men that be in health and haue swete humors they be nothyng mete yea and the vse of them is very perilous Artificiall bathes be made by mannes witte therefore they be not in all places lyke But here in Englande they be nothing so commendable as in Germany and other places For here there is but one hotte house and therefore the subtell parte of the humor is drawen out and y e grosse is left behinde But in Germany in other places they haue diuers houses first one wher they put of their clothes an other where they be annoynted and rubbed and in the thyrde house they sweate and be washed the forthe house is not so warme as the thyrde the fyfthe is sumwhat colde nowe that I haue declared the partes of the artificiall bathes whiche were vsed in the olde tyme and yet be in many places I purpose to shewe in as fewe wordes the commodities of the same begynnyng with the firste part which is a warme house prepared with fire or wyth warme water and swete herbes to the entente that the littell pores of the skynne may open easilye and the hole body with all the humors be sumwhat warmed The nexte house beinge sumthynge warmer stirreth vp the spirites and dissolueth the grosse humors and the rubbyng with the annoyntynge correcteth amendeth the hardnes of the senewes ioyntes and loynes the thirde house by hys greate heat dissolueth mightilye the grosse humours by meanes wherof nature pourgeth the bodye of them and the luke warme water moysteth the hole body taketh away werynesse yf ther be any in the vtter partes y e fowerth house because it is sumwhat coldar reducethe nature by litell and litell to here pristinate state The fifth by meanes of his colde shutteth agayne the pores of y e skinne which beateth the naturall heate in and causeth good concoction amendyng the action bothe of the stomacke and liuer The sixt kinde of those thinges which lewseth the body is sweat and it ought to be prouoked whan any euyll humors is in the innar partes as in feuers pestilent agues It may be prouoked diuersly as by the heate of drye bathes hote stones yrons or by swete herbes and warme water ether in pottes or in blathers But in all vehement and sharpe diseases and especiallye in hote agues the Phisiciō shoulde take great hede of the sweat markynge very dilygentlye which is good and whych is euyll For by them he may coniecture muche of the cause of the grefe but as Hyppocrates sayeth those sweates in feruent and hote diseases which cōmeth in the iudgyng dayes doe ende the feuer be best and most holsume and it is not euyll whan the patient sweateth in euery part of hys body so hys paynes waxe lesse withall but whā y e body sweateth muche and the paynes encrease it is not good Howbeit it is worst of all yf the sweate be cold And whan the face head and necke sweat onlye if it be in any hot ague it declareth dethe whichout any remedy In prouokyng of sweate the Phisition shoulde take hede that it be not to much for feare of dissoluyng of the strength of hys pacient The seuenth kynde of euacuation is exercise wherof we spoke before in the fowerthe chapter of this same boke The .viii. kynde is abstinence or hungar which doth not extenuat nor make euacuation of him selfe but by meanes that that is not restored which w t abstinence or fastinge was wasted Fastyng or abstinēce may be takē .ii. wayes eyther vtterly to forbeare
tymes in disseases besydes whiche there is other called particular as in such feuers as kepe fittes the beginnyng of the fitte is the colde in the vtter partes the growynge is whiles the body waxeth hote and the state or hayght is whan the heate is egally dispersed throughout the body the declination whā the heat goeth away Before I declare howe to knowe this sudden mutation which of the grekes is called Crisis I thinke it expedient and necessary to shewe in fewe wordes the difference of y e signes tokens goinge before which be of thre sortes of the first sort is y e signes of cruditie and concoction as the excrementes of the bellye the vryne and spettel by the egestions of the nether belly it is knowen how the stomacke altereth the vryne ether declareth cruditie or good concoction in the vaynes the spettell showeth ether y e good or euill constitution of the lunges and instrumentes of breathing These signes what tyme of the disease so euer they happen kepe alwayes theyre power firme and stable For the signes of concoccion alwayes declare health the cōtrary signes ether great paines longe sicknes deth or finally the turnyng agayne of the euyll Of the .ii. sorte be the signes of life dethe as quicke slepe easy brethinge goodnes of the pulse like in face to them that be hole hansume cumly liyng in bed sweat and such as to these be clene contrary Of the third sort be the iudgynge signes of the which sorte there be .ii. kyndes for sum be as signes and causes both together as vomittynge excrementes of the belly the great quantitie of vryne and sweates bledynge at the nose or the falling of humors out of one place in to another and other be as signes alone as watche deade slepes troublesum dreames difficultie of breathynge dimnesse of sight dulnesse of sense head necke and stomacke ache singinge in the heade involuntary teares quiuerynge of y e neyther lippe forgetfulnesse face eyes nose red abhorryng of meat vehement thurste w t other such lyke All these in that y t they declare any sudden mutation be called iudgynge signes and in that that they folow diseases they be called iudgynge accidentes These haue not theyr power alwayes firme and certayne as the signes of concoction and cruditie haue but they are to be liked if they happen after concoction that is whyles y e sickenesse is in the state and in the begynnyng and before any concoctiō they be not only not to be belyked but to be fered as deadly signes Concernyng y e Nature or propertie of signes for this tyme let this suffice but as for such signes as declare sudden mutation before called crisis to be good ▪ I entend yet god willing to speake a lyttell more whiche maye be knowen .iii. manner of wayes First yf before Crisis cum there be concoction of the disease I meane of the vryne the egestions and spettell the which eche ought to be considered in hys proper place For in the diseases of y e brest lunges the spettell should be taken moste heade of and beste marked and yet the vryne ought not to be neglected no nor the excrementes of the belly nether but in an ague which is without any inflammation eyther of the lyuer raynes bladder or splene y e vrine must be regarded especially as yf the stomake or mawe be greued the excrementes of y e belly wolde be considered before the other Yet the vryne is not then to be abiected nether Secundarily yf the cūmynge of it be signified by any of the iudgynge dayes it is to be lyked of the Phisition the declaration of the which dayes I omyt because I haue obserued that ther is in them more error then truthe more superstition then knowlege and bysyde this the scripture commaundeth vs Christen men to obserue no dayes yet yf any man be wylling to know them let him seke what Hyppocrates Gallen hath written of them then I doubte not though he be dull wytted but that he shall quicly know what is ment by them Thirdly it is good yf the mesure and forme of the excrementes be correspondent and aggreable to the disease as yf in an hot burnynge feuer the sicke blede at the nose or after a feruent shakynge sweat much and hot in all partes of hys bodye or vomite muche chollar or finally voyde much by syege for so y e feuer tertian shoulde ende the quotidian not only by much sweatyng but also by the avoydynge of flewme both vpward and dounward in greate quantitie The frenesie is iudged by much hot sweat cummynge in euery parte of the body but especially yf the head sweate feruently yet sumtyme it is iudged and ended by bledynge at the nose howe be it in the lythargie bledynge at the nose is euyll The pleuresie is betwixte these .ii. For bledyng at the nose in it is to be lyked better then in the lithargy worse then in the phrensie The inflammacions of y e liuer and splene be alwayes iudged by bledynge at the nose the liuer if it blede on the right side and y e splene f the lift beside these the age and complexion of the sicke and also hys forma◠diet and place wherin the sicke abydeth with the tyme of the yere and the present constitution of the ayer be to be considered of the Phisitiō whiles he iudgeth crisis to be ether good or euil For as the disease is cholerike all these cholericke also it is necessary that whan crisis happeneth chollar plētifully to be voyded so if flewme redounde it is nedefull for flewme to be pourged if diuers humors y e euacuation muste be also of diuers humors But whan the Phisition shall know these thinges exactly then of y e ende he may easily know the rest for yf the sicke which alredie hath suffered crisis be deliuered of his ague and other accidentes be better culloured hauyng also better pulses and more strength to rise without doubte the crisis was good The knowlege of the euyll Crisis as ther is in it much coniecture so ther is also in it much incertaynty For as where nature is strong and ruleth easily the humors she moueth orderly and maketh an ende of her actions so whan she taketh a fall her motions be both incertayne and inordinate and therfore hard to be knowen wherfore such a case requireth an artificer and a well exercised Phisitiō the which may firste declare whether there shall be any Crisis at all or no secūdarily wether this day or that last of all whether it shall kyll the sicke forthwith or but only hurte hym What shoulde nede many wordes by these .3 it is easily to be knowen whether the sick shall die or liue first by the kinde of the disease secundarily by the greatnesse of it thirdly by the manner and fashion of it fortly by the mouyng of it The kynde of the disease is knowen of y e accidentes folowing it as in example