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A02791 Harvvards phlebotomy: or, A treatise of letting of bloud fitly seruing, as well for an aduertisement and remembrance to well minded chirurgians, as also to giue a caueat generally to all men to beware of the manifold dangers, which may ensue vpon rash and vnaduised letting of bloud. Comprehended in two bookes: written by Simon Harvvard. Harward, Simon, fl. 1572-1614. 1601 (1601) STC 12922; ESTC S103856 94,484 154

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made so thinne that the cold doth strike into the inward parts whereby are brought diseases of very long continuance Galen will haue them which are vsually sick in the spring time to be let bloud in the beginning of the spring but such as most commonly haue their sicknes in the sommer time he would haue them to open a vayne in the end of the spring a little before sommer begin The fittest time for letting bloud is when the signe as we call it or the moone is in Aries Sagittarius Cancer Libra Scorpio Aquarius or Pisces vnlesse in any of these signes the moone do predominate in that place that is to be let bloud as in Aries the head Taurus the neck Gemini the shoulders and armes Cancer the breast stomack and ribs Leo the heart and back Virgo the belly and bowels Libra the raynes and loynes Scorpio the secrets bladder Sagittarius the thigh Capricornus the knees Aquarius the legs Pisces the feete There must also a regard be had of the age of the party that is to be let bloud for to them which be growing or yong the first quarter of y● moone is most meete To middle aged people the second quarter To the declining age the third quarter and to old age the last quarter The complexion also must be respected If the party be cholerick let him bloud when the moone is in Cancer Scorpio or Pisces If phlegmatick let the moone be in Aries Sagittarius or Pisces If melancholick then let the moone be in Libra Aquarius or Pisces It is ill to let bloud when the moone is in the full or in the change or within three dayes either before or after It is ill also when the moone is in coniunction or opposition with Saturne or Mars Further it is ill when the moone is in coniunction or opposition with Venus or Mercury combust or in a quadrate aspect with Saturne Sol or Mars vnlesse the aspect be passed at the least eight degrees But it is good to let bloud when the moone is in a trine or sextile aspect with Iupiter Sol Venus and Mercury but especially with Iupiter and Venus with whome all aspects are good prouided that they be not combust In cases of extremitie there is no staying for signes or aspects for the necessitie of the disease compelling I haue my selfe opened a vayne the signe being in the same place and yet with good successe But if a man haue liberty to make his choyce of the time I hold him vnwise that will not take it as neere as he can agreeable to the auncient grounds and principles of Astronomy It appeareth very many wayes that God hath giuen a power to the heauens and an influence to the Starres and Planets which doe mightily worke in the things here below not to induce any necessities but to dispose the inclinations so farre as God hath appoynted and determined Consider how all the times and temperatures of the yeare do alter and change according to the course of the sunne and what difference there is betwixt the operation of Phisick and the dangers of diseases assaulting vs in the spring and such other as do befall vnto vs in the canicular dayes Marke the operation of the Moone in such plants as are set and such seeds as are sowne in the seuerall times of her age Waigh the force also of the moone in those which in the scripture are called lunatick Origen doth report the iudgement of Phisitions Humida moueri in capite secundum aliquam compassionem ad lumen lunare quod humidam habet naturam That moyst things are mooued in the head according to the sympathie of the moone which hath a moyst nature but he thinketh rather that some vncleane spirit doth obserue the diuisions of the situations of the moone and worke by them But Serenus and after him Mercurialis do giue this the reason because they which are conceiued or borne in the wane of the moone are much subiect to the falling sicknesse Howsoeuer it is it is sure not without some cause that they are called lunatick that is moonish or mooned And behold also the power of the Moone in the ordinarie flowers of women who are otherwise also sometimes too much subiect to that variable and tempestuous planet See what force it hath likewise in the sea concerning the ebbings flowings thereof as also in respect of cockles and diuers other shell-fishes waxing fuller or lesser according to the age and proportion of the moone Let also the experiences of mariners somewhat preuaile which finde the whole leas to be caryed by the course of the firmament from the East vnto the West whereupon they which trauaile to the west Indies do better passe thither in one moneth then they can returne againe in three besides the trials which they haue of their loadstone poynting towards the North and their needles and compasses answering thereunto In Phisick the criticall dayes falling out either in hard or benigne constitutions of the planets do dayly giue vnto vs abundant testimonies In histories what auctor can you almost reade but you shal finde therein the troublesome alterations which haue followed vpon great eclipses In diuinitie see how Iob doth attribute vnto the Pleiades a sweete influence to cause the kindly spring and to Orion a power to cause raines and showers but so that God doth loose or hold back the bridle at his only will and pleasure And waigh those words spoken in the creation of the Sunne Moone let them be said God for signes and for appointed times and for dayes and for yeares I do vtterly condemne the abuses of Astronomy as first when men will make them signes of southsaying to foretell things to come and so to take that vnto them which is proper to God only as it is in the Prophet Shew vs the things that are to come that we may know that ye are gods God sayth I w●ll destroy the tokens of the s●othsayers and make the wise coniecturers fooles The will of God is free and soueraigne ouer all his creatures in euery moment to order alter rule and dispose them as seemeth best to his heauenly wisedome Fata mouere deus tollere fata potest We see in one battayle or in one time of pestilēce God being angry with sinne or permitting the Diuell to rage many thousands do dye at one time which no doubt most of them were borne in diuers manners of constellations of planets Weaker natures are subiect to the stronger and particular causes are subiect to the generall Saint Augustine sayth In the liues of them which are borne twinnes in their actions casualties professions preferments and in their very death there is so great a diuersitie that many meere strangers are more like one to another then those which in birth were separated with a very small distance of time and sowen as it should seeme by coniunction in one and the selfe same
beginning of the disease but not if it be a hectick phrensy of any continuance Celsus doth affirme that the face being red and the vaynes swelling a vayne may be opened after the fourth day if strength be sufficient But if it come of a cholerick cause then it should seeme to be ill done to let bloud because as Heurnius obiecteth fraenum bilis est sanguis bloud is the bridle of choler To this he answereth Male sanguinem sine bile educeremus imo plus bilis educimus quàm sanguinis Hardly can we auoyd bloud without choler yea rather by Phlebotomy we do bring out more choler then bloud And if it were done but only for deriuation sake yet were it well done But at what time must this Phlebotomy be vsed Caelius Aurelianus sayth that it must be done within three dayes of the beginning and not beyond because in such diseases the strength of the body is in perill Aretaeus also sayth that it ought to be done either the first or the second day If the phrensy begin after the fourth day then open the vayne after the seauenth day but if it do come in the sixth or seauenth day then let no bloud for that is a criticall phrensey A●tius sayth that if the phrensy do come with an ague any day before the fourth day and signes of plenitude appeare wee may well open the middle vayne When the phrensy is old letting bloud is not safe Caelius sayth that to let bloud after the eight day est iugulare homines is nothing but to murder men The quantity must be according to the cause If it proceede of inflamed bloud you may let bloud vsque ad animi deliquium till the heart begin to fayle For there is a vehement inflammation a very sharp feuer and exceeding great griefe in which three cases Galen alloweth large Phlebotomy But if the bloud be much mixed with choler then sixe ounces shall suffice or if the party be strong tenne ounces Aretaeus his opinion is that if it haue the first beginning from the parts about the midriffe then the party may bleed more largely because thereabouts lyeth the fountayne of bloud What you do you must do at once for the disease doth giue no long truce Trallianus commaundeth the vayne of the forehead to be opened But that Heurnius doth condemne as ministring a further increase to the discase especially if the phrensy come of bloud for both the bloud should turne his course into the head and also the euacuation should be made by the very place affected which should be as he thinketh very inconuenient The course which Heurnius doth best like of is this first to open the midle vayne of the arme and after to open either the vayne of the forehead or the vayne vnder the tongue For the Quinsie or squinancie the swelling of the throate causing difficultie of breathing and hardnesse of swallowing Trincauel doth aduise a speedie letting of bloud yet a glister being vsed before if the disease will giue leaue but if the disease as it is a very sharp disease will giue no space then may we do as Hippocrates sometime did that is first let bloud afterward minister the Clyster Fuchsius willeth vs to open the basilica of the arme of the same side where the swelling is But he will haue it to be done at seuerall times by little and little and not all at once least there should happen a swouning and so a perill of suffocation and besides By two sodaine coolings and by fainting of the heart the matter may be caryed from the iawes vnto the lungs and so bring ineuitable danger Yet must not the incision be made too little least by meanes of the narrownesse of the hole the good bloud should be as it were strained out and the thick part remaine within which is the cause of the griefe If the patient be a woman whose termes are stayed open first the saphena and then the vaine vnder the tongue For the pleurisy how conuenient bloud-letting is for it it is a thing so well knowen to all men that there needeth no proofe thereof But on what side the vayne must be taken whether on the same side that hath the inflammation or on the contrary side seeing that there is amongst learned Phisitions a great controuersie about that matter I haue appoynted one Chapter to wit the Chapter next following wholy for the discussing of that question And for as much as also all the arguments layd open in that disputation do as well concerne the inflamation of the raynes and of the wombe and all other inward inflammations as the plurisy I haue thought it good to speake no more of the particulars heere but rather to conclude with that generall speech of Galen To speake briefly when inflammations do begin we must euacuate them by reuulsion that is pluck it back into the parts furthest distant but when they are of long continuance we must empty them out of the places affected or as neere vnto those parts as we can For at the beginning of inflammations it is good to turne back that which floweth but when they haue remayned a long time we must auoyd and expell that which is impacted and fastened in the part affected CHAP. 7. In these dangerous inflammations aforenamed whether euacuation or reuulsion be more necessary and what is the meaning of Hippocrates his rule 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 to worke directly and with a right course of flowing PEtrus Brissotus and Matthaeus Curtius two learned Phisitions the one a Frenchman and the other an Italian haue by many arguments prooued that in a pleurisy the vayne ought still to be opened in the arme of the same side where the griefe lyeth Trincauel in his treatise which he calleth rudimentum hath vndertaken to confute them The first reason of Brisso●us is because in such sharp diseases vnlesse you help presently the party dyeth And the first scope in an inflammation is to auoyd bloud out of the place inflamed for the performance whereof the same side is most conuenient Trincauel answereth that when the party hath no full body then that position may well stand But if there be a full body then he holdeth with Galen that the scope and purpose of the Phisition must be to forbid that the bloud shall not flow to the place of griefe For the flux of the bloud doth Galen make to be the cause of the vehement inflammation And this staying of the flowing of bloud he thinketh may best be done by euacuating so that we may also reuell the same by drawing it back to the contrary side Brissotus againe obiecteth that by reuulsion there is often stirred vp a pleurisy on the other side vnto which the reuulsion is made Trincauell doth answere that doth happen by meanes of the fulnesse of the whole body especially of the lower parts when the opening of the vpper vaynes can not auoyd so
moment It was a damnable opinion amongst the Chaldaeans to make the constellations of the starres to be a table of all fatall lawes as though the whole life of man were written therein As Tarutius Firmianus being skilfull in the Chaldaean sciences tooke vpon him by the manner of Romulus his life and death to calculate what time he was borne that because he wrought such actes and dyed in such a manner therefore he must needes be borne such a yeare and such an howre The superstitions of the Chald●eans were such that they would not build a house nor attempt any iourney nor so much as put a new garment vpon them but they would first haue a regard of the constellations and planets These fond and wicked abuses of astronomy I do wholy reiect and disallow But in the vse of Phisick seeing that a great part thereof doth concerne the flowing and issuing the staying and the passing away of humours and that it is found by the termes of women by the fluxes and refluxes of the seas and many other wayes that the moone hath by the maker thereof certaine influences giuen vnto her much auaylable to the auoyding and correcting of humours I do not thinke but if it be found by the experiences of former ages that at sometimes and in some signes or aspects her forces are more violent then at other we may haue some consideration thereof and make choyce of such as are most meetest for our purpose euen as the husbandmen may also take such times for their grafting sowing planting and such like as by the proofes of all nations haue appeared to be fittest for the fruitfull growing and propagation thereof To returne now to our argument of letting bloud seeing that as I haue shewed the signe may sometimes seeme to be good and yet by other aspects the same may be controuled what course is then to be taken when for want of good helps we can not come to the knowledge of the aspects Surely then our best way will be to obserue the manner of the weather When the weather is setled to be very dry then are not humours apt to flow but in open and moyst weather we find them very fluxible Fernelius sayth The north wind vtterly forbiddeth letting bloud only the south wind doth best admit it in the cold time of winter The time of the day is made by Galen and out of him Fuchsius to be the fittest within an howre or thereabouts after the party is risen after the yesterdayes meate is prety well digested and the body eased as well by stoole as by making water Fernelius sayth in suffocante pleuritide angina quouis tempore fiat If the disease be an intermitting ague I haue shewed in the last Chapter that the fittest time is the middle betwixt two fits at what time of the day soeuer it be and the party must a little before be dicted thereafter Montanus sayth If he looke for the fit in the morning let bloud in the euening before Marsilius Ficinus will have schollers who abounding with bloud do vse Phlebotomy to preuent diseases to vse it both morning euening but at either time a little foure ounces in the morning and as many in the euening because it is dangerous to auoyd too much bloud at once but of this in the eight Chapter CHAP. 7. On whether side the vayne is to be taken when we let bloud to preuent diseases or to auoyd or deriue their matter also what vayne must chiefely be chosen for sundry infirmities ON what side the vayne must be taken in great dangerous inflammations where there is cause of reuulsions I haue shewed alreadie in the seauenth Chapter of the former booke It is not denyed but that in some cases it is requisite that the vayne should be opened in the same side where the inflmmation lyeth But if any do vrge a necessitie that it must needs be euer on the arme of the same side Trincauel doth aske one question Si in muliere supprimantur solitae purgationes ex ea occasione superuenerit pleuritis Item si ex retento sanguine ex hamorrhoidibus fluente vt ait Hippocr 6. epid in libro de humor quod quibus sanguis ex haemorrhoidibius fluere solet illi neque pleuritide neque peripneumonia capiuntur quae vena iam secanda illane quae costis affectis communicat an potius alia impellens particula but of this alreadie I hope sufficiently in the Chapter aboue named The doubt is now on what side the vayne must be opened when we do it to preuent diseases the old verse is commonly knowne Aestas Ver dextras autumnus hyemsque sinistras The spring sommer right side vains would haue But autumne and the winter left do craue But here we must take heed that we vse not too much to let bloud on one side for that thereby we see many to be brought to particular palsies and to lose the vse of one eye or care or the strength of one arme or side partly because the longer that superfluous humours haue found a vent in one place the more apt they are to haue recourse to the same place and if they haue not their former passage they will easily either make obstructions or breede some inconuenience and partly because the letting bloud too much on one side may perhaps coole that side more vehemently then is requisite If therefore thou hast bin heretofore let bloud on the one side thy best way is the next time to take the other side and to labour by all meanes that the humours may flow equally and that they may be caryed with no greater force towards thy one side then thy other When there is neede of euacuation and deriuation and not reuulsion then doth Galen appoynt vs to take the vayne alwayes on the same side If the right side of the wombe be grieued auoid bloud out of the right hand or right leg and if the left side be enflamed then take the side that is right with it for that is the meaning of the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 of Hippocrates to wit that we open the 〈…〉 hepatica and lienaris directly for they ar● neerest to the affected parts and most right vpon it And in an other place The euacuation out of the neerest va●nes and which are common to the place affected is both best and easiest As concerning what vayne is to be opened this rule is most generally prescribed that if the parts beneath the neck be grieued we must open the inward vayne of the arme called generally in●erna or basilica or axili●ris and more particularly if it be in the right arme called recoraria or hepatica in the left henaris this is opened commonly on the left side if the heart lungs or spleene be affected and on the right side if the liuer or stomack be affected If the parts which be afflicted be aboue the neck then we open the