aegrotus moritur Neither is this the only case in which a Physician ought to practise Phlebotomy but it may be done safely and warrantably if that the Small Pox do not come out kindly but appear and then retire in again of come out so slowly or evil coloured as that the Patient may be in danger to perish during the progress of the malady For in the first case is a certain sign that Nature is not able to govern those humors in the first eruption either because of their malignity or surcharge and if it be not to be done by her when the Disease is not arrived to its height nor she as yet much debilitated how can we imagine but she must fail in the vigour of it It is therefore requisite that a Physician duly considering all circumstances do proceed to secure the infirm by a minute and perhaps iterated blood-letting For it is not here as in other putrid or malignant Feavers in which we have a greater latitude of practise and what Nature cannot effect by one way of termination may be accomplished by another The concomitant Pox alter the course of the Feaver and suffer it to admit of no other issue but by a due maturation of the Pustules since therefore that Phlebotomy promotes the eruption and by altering the texture of the whole body and facilitating transpiration doth diminish the morbifick matter hinder putrefaction extinguish the Feaver and so alleviate Nature that she is enabled to prosecute happily her work I see no reason but that it ought to be administred and the same considerations do sway me to approve of it in the latter case for if the Pox appear malignant in their first coming forth their continuance will prove fatal if this Remedy be not applyed for we have none so effectual No Minoratives can be used to disburthen part of the humour no powerful Cordials for those however they seem to yield a present benefit do in the issue debilitate Nature dissipate the spirits retard the maturation and oftentimes increase the Feaver and occasion a Phrenitis or other deadly symptomes Vesicatories are attended with no less jeopardy not only for that they frequently cause bloody Vrines and exulcerate the Bladder and procure a vexatious tenasmus which I have seen to fall out when they were applyed in other distempers but because the ill-conditioned matter being attracted to them may cause a Gangrene or otherwise endanger the Patient upon which account I do not remember any that ever proposed them in this Disease 'T is true I knew a Person of Honour who in France was four times blooded pretty largely before their eruption and then had Pigeons applyed to his face and other places because they came not forth well and so was recovered 'T is true that Prosper Alpinus doth commend Inunctions with Nitre and Oyl of bitter Almonds to be used once or twice in a day but besides what Melichius records the practise being novel in England and seldome used in Europe I believe no discreet man will adventure his credit or the life of the sick thereupon but rather acquiesce in the received warrantable happy practise of the generality of Physicians In case that there be a great redundancy of the mass of blood in the aforesaid cases so that Nature seems oppressed and to be so streightned as not to be able to free her self from the corrupted humours who can doubt but the Physician hath more reason than otherwise to phlebotomise the sick in this time of the Disease It is a Rule in Physick That we ought to attend principally in diseases to that which is most urgent yet so as not to neglect those other considerations which arise from the nature of the Disease In this last case the regard unto plenitude is most urgent For if there be so great a Plethora as that there is danger least the Patient be suffocated and the natural heat extinguished which is the supposition of Avicenna when he sayes Timetur super eum corruptio extremitatis And if Phlebotomy either hath been omitted or not administred as 't was requisite who can imagine that Nature will be able to govern and regulate so great a surcharge to the benefit and recovery of the Patient but that when the humours separate and extravasate some part will mortifie and sphacelate or the party be suffocated It is really to be supposed that the sick person will dye within a short time except Nature alleviate it self by a large esflux of blood at the Nose It is here as it is in a Synochus putrida for commonly 't is a Synochus putrida which accompanies the Small Pox in which if either by reason of the reluctancy of the Patient or ignorance of the Physician blood-letting be omitted the case becomes exceeding perillous except Nature be very strong or a great flux of blood or plentiful sweat succeed as Galen relates in the ninth Book and fourth Chapter 'T is meer folly here to object that albeit that Phlebotomy be omitted yet ought we to presume well of the Patient because the Small Pox do come forth as when sweat appears in a Synochus for there is a great disparity in the cases The sweat is discharged out of the skin the Small Pox are lodged in the surface of the body and must there be maturated besides that the Small Pox infest also all the inward parts so that the danger is greater here than upon the eruption of sweat Moreover the sweat consists of a more subtle and Ichorous substance and finds a more facile and certain exiture but the Small Pox are of a grosser substance and come not forth with equal facility It is also to be considered that as a large evacuation by sweat may happily terminate a Synochus so although the Patient do abound with blood Nature may sometimes so expel and regulate the matter that the party may avoid the imminent perils but he that trusts thereunto must well ponder not only how plentifully the Pox come forth but whether it be proportionate to the exigencies of Nature for whatever is not such is minute and what alleviation insues not to mention other things And as when sweat doth not appear in due time due quantity with due qualifications the Patient doth nevertheless dye So we daily observe it to fall out in the coming forth of the Small Pox. And therefore I do assent unto the directions of Avicenna and Augenius that in case of this urgency Phlebotomy be judiciously made use of and whatsoever danger may seem to be in it 't is prudence to submit thereunto rather than to incurre greater Hitherto I have treated of Phlebotomy as 't is an evacuative and relaxing Remedy but there is oftentimes occasion for it by way of Revulsion when not only the Eyes are in great hazard to be spoiled or the blood stagnates about the Heart Lungs and Therax or that the Small Pox very much affect the Stomach and Entrails or occasion a Diarrhaea
concretus It is the more crude impure part of the bloud the purer part of the chyle being digested into a saline juyce is carried into the milky vessels and veins and mingling at last with that ruddy liquor is called Cruor and at last becomes perfect bloud It undergoes manifold guises and is often the subject matter of a multitude of diseases being sometimes changed into an Ichor Tabum or Sanies The third part is properly called Sanguis or Bloud 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 it is a most pure sweet Homogeneous Balsamie Vital juyce for the most part of a bright Red or Reddish colour made by the Archaeus by virtue of ferments implanted in the ventricles of the heart lungs veins and arteries causing a formal transmutation of the Ckyme or milky substance into this sanguineous liquor ordained to be the seat of Life and and the principal matter for sense motion nutrition accretion and generation It is for good reason called Balsamum seu Condimentum totius corporis forasmuch as it hath a sanative power sweetly uniting all the parts of the body for the conspiration of the good of the whole It is a great preservative against putrefaction as long as it remains in its integrity for consisting of many saline particles it seasoneth whatsoever it toucheth with a pleasing sapour It is the proper habitation of the vital spirit the immediate instrument of the soul in which it shines displaying its radiant beams every way that sensation motion nutrition and all other functions may be exquisitely performed God and Nature never intended other then that the bloud should be Homogeneous pure plain symbolical with that single principle of the Vniverse Now these Peripatetick Philosophers deliver to the world that the contexture of this vital juyce is made up of Choler Phlegm Melancholy and Blood which united produce this compounded body which we call Sanguis How grosly erroneous and dangerous this Tenet is most Learned Helmont hath made evident Wherefore we conclude with that noble Philosopher that Bloud is an Vnivocal substance divisible only by some external accidental means as the Air or Fire which cause a various texture and different position of its Atomes whereby it seems to consist of parts which are not really inherent in it as is manifest in its degeneration from its native colour sapour consistence and goodness which it had before it became corrupt in the pottinger or underwent the torture of fire Both of which do strangely larvate and disguise the puniceous Balsome giving occasion to the Galenists to frame their four fictitious humours no where really existent This being the foundation of all his declamations against Phlebotomy before I proceed any farther it may seem requisite that I should make some Animadversions thereon I might take much notice of and display his errours as to what he sayes that the Latex is by the Greeks called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 this is the first time I ever read it called so the usual terms being 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The notion whatever Helmont say is not new at all an hundred Galenists have mentioned and treated of it as the vehicle of the bloud and nourishment But that cruor should come from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 crudus concretus is an opinion singular to the Baconical Philosopher That 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 doth signifie cold I know well and that cruor properly signifies the the bloud of dead people or the mortified bloud issuing from putrefied wounds I no less understand though Authors frequently confound it with Sanguis But that his Latex and the Lympha so called by moderns are the same is news for it is not held that the Lympha in its peculiar form was pre-existent in the Arteries and as such did accompany the Blood through the Maeandrous pipes but is generated as it is discharged into the Lymphaeducts and from them is re-mixed with the bloud And if it were yet would not the definition of this Latex agree with it for the Lympha is no inseparable companâ—on of the bloud as appears by its peculiar vessels it is seldome a diaphanous clear liquor being commonly tinged with several colours oftentimes whitish sometimes yellow or as it were stained with bloud And whereas this Latex is devoid of all sensible qualities those who have experimented the Lympha do not find any such thing but a variety of tasts Nor is it true that the Serum which accompanies the Bloud is such a Latex as our Helmontian describes it being never to my taste free from a salsuginous sapour though it retain that with a great Latitude nor devoid of colour so as to be clear and diaphanous and 't is very seldome seen that the said Serum will not coagulate unless preternaturally upon a gentle fire so that it is no more to be termed a Latex than the whites of eggs beaten to the like fluidity In like manner that in the Lymphaeducts will coagulate as Bartholin observes and others As for the Cruor that there are graduations of the Bloud as to its crudity and impurity is no doubt amongst the Galenists and that it may oftentimes transcend the state of due maturation and so become degenerate is as easily granted as that it should come short of its desired perfection and when this Blood degenerates any way into a Tabum or sanious matter I must tell him that Aristâ—â—le and his followers acquainted us therewith before that Helmont was ever heard of whose Cruor bred in the Liver and distinct from the Bloud impregnated with vitality is such a piece of non-sense as ought not to be mentioned in this Age but to Baconical Philosophers who not only connive at but applaud any Hypothesis Concerning the Blood when I read the Elogies he bestowes upon it as the Seat of the Soul by which sensation motion nutrition generation are performed I thought â—pon the opinion of Aristotle and his zealous sectators â—mongst the Physicians who have denied all Animal spiâ—its fixed the principality of the Members in the Heart and from thence derived even the nerves If G. T. will defend the generality of his Assertion I assure him that Hofman Van der Linden and Harvey will be more serviceable to him than Van Helmont But this consideration hath little influence upon the present Controversie that which follows hath nothing of Truth in it that the Bloud is an Homogeneous pure body for nothing homogeneous can ferment But it is most evident that the bloud is in a perpetual fermentation and that it is such a liquor as is constantly generating constantly depurating and constantly expending it self so that nought but Imagination can represent unto us such a thing as pure bloud and I hope the specious pretences of a Real Philosophy will not terminate in Speculation and Phansie When the bloud either naturally issues forth or upon incision of a vein it representeth unto
dependance of our Life thereon is not so great or intimate as that upon the effusion of a little no nor of a great deal of the bloud Death or any debility extraordinary and durable should ensue unavoidably and if it happen but sometimes 't is apparent thereby that 't is but accidental and not a proper consequence of that effect 'T is manifest that the operations of the Soul are not restrained to one determinate proportion of bloud in every body nor to the same in any albeit that there seem requisite in all Animals that there be some bloud or what is equipollent thereunto 'T is also manifest that this Bloud for which some are so sollicitous doth continually expend and waste it self in nutrition and that even the nourished parts are in a continual exhaustion so that without supply it would degenerate â—nto choler except in those miraculous fasts and diminish to little or nothing as appears upon great fastings and several diseases 'T is no less manifest that upon great evacutions of bloud by wounds or otherwise when the Bloud hath been so exhausted that very little can be imagined to remain yet in a few dayes the veins and arteries do fill again and nature is so replenished and vigorated that this lost bloud seems not only as good in order to the functions of life but better in order to health and strength since the production of this last in the end of diseases is accompanied with convalescence whereas the precedent did not hinder the indisposition Out of what hath been said the Answer to this Objection is facile viz. The Blood is not so the seat and residence of the Soul nor so absolutely necessary to Life granting all that can be desired of us as that some of it may not be let out without present danger or irreparable detriment so that if the motives for Phlebotomy be cogent or so probable as to render the Action prudential no difficulty can arise from this scruple It is written in Deut. 24.6 No man shall take the upper or nether milstone to pledge for he taketh a man's life or soul to pledge Here the milstone is called the life or soul of a man as much and as properly as ever the Blood is any where else But though there be a prohibition for a man to deprive his poor neighbour thereof as of the support of his Life yet undoubtedly none was ever interdicted by virtue of this precept to help the distressed Miller to pick and dress his Milstones His third Argument is this Moreover one would think it should put a stop to their prodigal profuse bleeding if they did but consider with what difficulty Nature brings this Solar Liquor to perfection how many hazards of becoming spurious and abortive it passes through how easily it is stained by an extraneous tincture how often intermixed with something allogeneous and hostile to it how many elaborate circulations digestions and refinings it undergoes before it be throughly animated and made fit for the right use of the immortal Soul One would imagine by this Objection that the Generation of the Bloud were as difficult a work and required as much of sollicitude as the Philosophers stone and that the least errour would disappoint the process and eject the poor soul out of its tenement and mansion But there is not any such thing he that considers the perpetual supply of Chyle by the Ductus Thoracicus and with how much ease it is transformed a great part into Blood by the similar action of that which pre-existed in the veins together with the concurring aid of the Heart and sanguiferous emunctory vessels and the previous alterations in the stomach and intestines will imagine neither the production of Bloud nor the reparation of it to be so tedious and hard a matter Nor is it true that the Bloud is so easily stained with hostile tinctures since it is a liquor that is in perpetual depuration and hath the convenience of so many out-lets to discharge it self by Neither will every crudity in the immature Chyle or bloud render the blood unfit for the use of the immortal soul there is extraordinary and unimaginable difference betwixt the bloud of one person and another as appears upon distillation burning and mixing it with other liquors yet are all these within the latitude of Health and with equal perfection exercise the operations of Life Nor doth every allogeneous mixture vitiate or deprave the bloud for the Chyle Bloud and Flesh retain some particles of the original food taken into the stomach hence it is that sheep fed with pease-straw though as fat as others yield a flesh differently tasted from other mutton the like is to be observed in the feeding of other Animals generally Nor is this more evident in other Animals than 't is in Men for not to mention those Medicaments which by the alteration they make in the Vrine do demonstrate they have passed along and been once mixed with the bloud as Cassia Rhubarb Annise-seeds c. In fonticulis observavi quod si praecedente die aliquis allium aut cepam comederit pus quod in fonticulo est odorem allii aut cepae obtinebat sanguis autem qui per fonticulum expurgatur non nifi per venaâ— expurgari potest unde possumus dicere quod sanguis acutum odorem detinere possit The like phaenomenon is to be observed in wounds and ulcers which feel detriment according to the various food and drink of the patient Nay in pleurisies and other wounds it hath been taken notice of that the purulent matter hath discharged it self by the veins re-mixing with the bloud into the intestines and by urine The Bloud of some persons in perfect health hath been observed to stink worse than rotten eggs even as it was issuing from the arm upon Phlebotomy yet when it was cold it did not stink nor seemed to differ from the best bloud except that it was of a more beautiful red than is usual I conclude therefore that in this Argument many falsities are contained and there is nothing of such force as to deterr a prudent Physician who understands the rules of his Art and those cautions which are suggested to us in Phlebotomy to let his Patient bloud and emit some of this solar Liquor His fourth Argument They should never attempt yea rather abhorr to enervate in the least by the Lancet the strength with its correlative bloud and spirits without which there is no hopes of attaining a desired Cure For it is a most established verity taught by Hippocrates that Naturae sunt morborum medicatrices the most assured means of sanation is to keep up the vital pillars without which all falls to ruine So that Van Helmont is without controversie in the right when he sayes utcunque rem verteris ignorantiae plenum est procurata debilitatu sanare velle i. e. make the best you can thereof It savours of gross ignorance
disease and dangerous symptomes that may insue and then the veins are too much distended to facilitate and secure the operation of subsequent Medicines that are used to evacuate the Antecedent Cause and to maturate and expedite the continent morbifick cause Besides it promotes transpiration incredibly gives a new motion to those humours which together with the blood oppress and indanger the internal and principal parts it diverts them from the head and draws them from the heart lungs stomach and bowels into the habit of the body whereby Nature being alleviated prosecutes her recovery by maturation and expulsion of the peccant depraved matter deducing to its proper state that which is semi-putrid and not irrecoverably vitiated and separating first then exterminating what is incorrigible So the Patient recovers Nor is there any thing more true than this which every Practitioner may daily observe in his practise that Of all the Medicaments which are vsed by Physitians there is not any may compare for its efficacy and utility with Phlebotomy so expedite so facile and so universal is it The universality of its use appears herein that it evacuates the redundant it alters the exorbitant Fluxes of the peccant or deviating humours and blood It relaxeth the vessels and pores of the body and refrigerates the habit thereof And therefore is so absolutely necessary in putrid Feavers that though I do not say they are incurable without it yet I pity the languishing condition of such as omit it the violence of the symptomes being increased thereby and the cure procrastinated to the great trouble and hazard of the sick and his great detriment afterwards for you shall ordinarily meet with a slow convalescence and the blood be so depraved by so long and violent an effervescence that it becomes remediless and degenerates into an evil habit of body Scorbute Dropsie c. This being premised which is more clearly proved by Experience than Reason I answer to his Argument that we do not go about only to refrigerate the Patient but to concoct and eject the morbifick matter that we take the most befitting course to exterminate that spinous offensive cause and as upon the prick of a Thorn if part stick in the wound and be buried therein we proceed to maturate and bring to a paculency the vitiated blood and humours inherent in the part affected and with the suppurated matter draw out the fragment of the Thorn so we do in Feavers where the depraved humours are not so easily separated and extirpated as in the prick of a Thorn maturate and eject the morbifick cause and thereby atchieve the Cure And I do profess my self to concurre with the Ancients in their Opinion that there is a great Analogy betwixt the generation of the Hypostasis in the Vrine after a Feaver and the production of purulent matter in an Apostimation and that Feavers are but a kind of Abscesse in the mass of blood for the proof whereof I do remit my Reader to Ballonius de Hypostasi Vrinarum Amongst the Ancients I find two wayes commonly practised to extinguish this Febrile Heat by a course corresponding with the usual wayes of extinguishing a fire which are 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by substracting the fewel from it thus they did Phlebotomise at once till the Patient did swoone the other 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by quenching it thus they gave them cold Water to drink largely until the sick grew pale and fell into a shivering this last was not practised till there were manifest signs of concoction But 't is observable that upon either of these Medicaments they did expect that happy issue that Nature thereupon should presently discharge it self by sundry evacuations of the morbifick matter so that they did not thereby intend bare resignation but the extermination of the concocted febrile matter And thus much may suffice in answer to this Objection The last Objection he makes is this as I shall form it The great Indications of the Galenists for Phlebotomy are either Evacuation of the â—edundant blood in a Plethora or the Revulsion and direct pulling back of what is in flux or flowed into any part already But neither of these Indications are valid and oblige them to that practice Therefore the practise of Phlebotomy is not to be continued As to Phlebotomy in a Plethorick body he thus explodes that It by plenitude be meant an excess of pure blood I absolutely deny there is any such 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or indication for Phlebotomy for during the goodness of this juyce there must needs be perfect Sanity arising from integrity of all the actions of the body so that it may justly be reputed madness to go about to broach this Balsome of life weakning Nature thereby as long as there is health with abundance of strength Imprimis not andum saith Van Helmont in cap. de febr p. 8. ut nunquam vires peccare possint abundantia ne quidam in Methusalem ita nec bonis sanguis peccat minuitate eo quod vires vitales sanguis sint correlativa i. e. We are to take special notice that too much strength can never be offensive to any yea not to Methusalem no more can any one have too much blood for as much as vital strength and blood are correlatives Well then it is plain that whatsoever sickness seems to indicate Phlebotomy upon the account of an 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 sanguineous superpletion must needs come from an apostate juyce generated by vitious digestions which being hostile to life irritates the Archaeus to frame the Idaea of a disease not as it is meerly provoked by nimiety or plurality but from the pravity of the matter wherefore the case is altered now and the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 signification or demonstration of evacuating doth in a strait line respect the Crâ—or or Cacochymy directing the Artist to reform mundifie and rid those impurities contained in the seemingly corrupted marred juyce by proper means sequestring the vile from the precious not to let out indistinctly what comes next at randome to the furtive castration of the Eutony lustiness liveliness and strength of the Patient which is to be preferred before all motives whatsoever 'T is certainly known to those who are throughly versed in the Analysis and Synthesis of the parts of bodies that ebullition aestuation effervescence of febrile liquors arising from a pleonasme of degenerate Sal. and Sul. c. as they would have it may be appeased and allayed by Remedies assisting the vitals to make separation and afterwards an exclusion every way of what is reprobate reserving what is acceptable This being performed there is no fear that a plenitude simply of it self can do any harm for hereby so expedite a course is taken that the overplus is in a short time sent packing away by vomiting stool urine expectoration and sweat For this reason considering what strict abstinence the Patient is put upon in a Feaver
't is very unlikely a plenitude should be of any duration Is it not then greater prudence in a Physician to minorate what is superfluous by safe profitable wayes of secretion and excretion still advancing the principal Agent then for that end to give vent indiscreetly to what comes next without any election incommodating if not hazarding the loss of the vital principles For believe it whosoever hath any great quantity of blood taken from him either rues it for the present or hereafter Let him that is heterodox prate what he will alledging examples of those sturdy lusty bodies which have hereby received immediate succour I can make good by practise and challenge any one to come to that otherwise let him forbear his Garrulity whosoever is cured by a Lancet in this sort is either prone to relapses or to live more crazy in his younger or elder years although for some short time he may not by reason of a robust ingrafted constitution be sensible of these inconveniences As for Phlebotomy in order to Revulsion he thus explodes it Another pretended way for sanguâ—â—â—ission is Revulsion by which they say a violent slâ—â—x of morbifick lâ—quâ—r into any noble parts is intercepted for this end they use the Lancet in a Pleuriâ—ie Peripâ—eumony or any inward inflâ—mmation But how far they erre herein is well known to the best Practitioners for although I confess they do sometimes in the beginning suppress and as it were crush the aforesaid diseases yet is it done accidentally very uncertainly rather by way of distraction of the Nature for the loss of its substantial treasure than from any true Revulsion or direct pulling back of what is in flux or already stowed in 'T is true where the vessels are depleted a repletion is forthwith made ob fugam vacui to avoid a vacuity but the supply is from what comes next for as intro as well as intro for as However there is no streight immediate Revulsion intended from the part affected to the Orifice It seems strange to me that any man should pretend thus long to have diligently attended on the practise of Physick and yet never have seen or have the impudence to deny that there can be any such thing as a surcharge of Blood which is that which Physicians call a Plethora or Plenitude But the continuance of these Baconical Philosophers will in time free us from any admiration of this kind In Greece when the Athletae or Wrastlers were publickly maintained the observation indeed was more facile than now but every Countrey almost yields frequent cases of such an indisposition particularly 't is easily to be remarqued in strong healthy and plethorick Children whose sudden death â—s it often ariseth from no other cause so it astonisheth the vulgar and usually raiseth in them suspicions of Witchcraft Hippocrates and Galen having taken notice of the evil consequences attending this habit of body do advise the owner to attempt the change of it though it be accompanied with the most perfect health and vigour imaginable 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 And this habit of body and fulness of blood which he saith would do Methusalem no harm is observed by those who had daily opportunity to see the sad experience of it to abbreviate the life and occasion many diseases as Apoplexies Cardiacal Syncopes and Ruptures of veins in the Lungs Squinancies Pleurisies c. So that Hippocrates condemns that habit of body again in his book De Alimento and Celsus concurs with him therein Ea corpora quae more corum Athletarum repleta sunt celerrime senescunt aegrâ—tant i. e. Those bodies which are dieted and brought up to an Athletick habit do soonest of all decline into sickness and premature old age I never read of any Physician who in his directions for health recommended unto his Patient that course of life wherein the Athletae were bred up thereby to acquire such a Plethoric habit and whatever the present sanity were which they injoyed as to strength of body their intellectuals were very dull and the most understanding persons would have thought it prudential in such a case to broach some of the Balsome of life and weaken Nature thereby rather than to live in a perpetual danger of such perillous diseases as that Euexy subjecteth men unto But our Helmontian doth think otherwise If such an habit of body be thus perillous during perfect health how ought a Physician to apprehend it upon the first approaches of sickness Doth not then Nature add to the redundance of blood by a defective transpiration whereas the veins are so full as not to be able to contain more Is not the pulse weak slow and oppressed and the Heart so debilitated as not to be able to discharge it self of the Blood which flows into it and in danger to stagnate in the Lungs or coagulate in the Ventricles Can there seem any thing more agreeable to common reason in this case than to practise Phlebotomy whereby Nature is at present alleviated the surcharge of blood abated and the imminent dangers prevented Is it not prudential were a little blood so precious a thing and the loss thereof attended with some small irrepairable debility Is it not I say a part of prudence to submit to lesser though certain inconveniences then to run an almost inevitable hazard of the greatest imaginable I read not that the famous Milo arrived to the years of Methusalem nor yet to those of Hippocrates though I am apt to think he was so solicitous for to preserve his strength in its vigour as not to have been much Phlebotomized At the Olympic Games being Victor and going to receive the Garland from the judges he fell down dead suddenly and was thence carried to his Grave It is to be supposed according to our Helmontian that in that Euexy of body something so virulent or odious put the Archaeus into such a fury that it ran mad and destroyed him whereas had it been sublimate or Arsenic it would not have been half so exasperated or hasty 'T is a most humoursome and sensless Kitchin boy that no man knows how to please Suppose that the Brain might be in him a little oppressed with a Vertigo or some petty disorder must this capricious Duumvirate immediately produce the Idaea of no gentler a disease than an Apoplexy or Epilepsy But to pass from these phantastic causes the allegation whereof least becomes an Experimental Philosopher I shall instance in the effects of Bleeding in a Plethora Anton. Benivenius Medicinal observat c. 69. Men commonly attribute much to the Pulse in the discovery of diseases If that be weak low and small they frequently presage death or mortal dangers if it be full and strong they give hopes or assurance of recovery Yet we meet with one Philip a drunken and corpulent fellow who lying sick in his bed I found his Pulse so weak that it was scarce perceivable and I should have
his Patient to alleviate the disease in its course by preventing all troublesome and mitigating all dangerous symptomes and to facilitate as well as hasten his recovery It is not questioned but Patients have been and may be recovered of Feavers with little or no blood-letting yet when I consider the great hazard they run in that course the vexatious and perillous symptomes which they languish under longer and with more violence than others I cannot approve of the practise nor think the Physician dischargeth his duty and a good conscience in so doing Extrema necessitas in moralibus ut certum est vocatur quando est probabile periculum and the Patient doth offend against himself if he refuse to take a befitting course against dangers that probably are impending and the Physician doth trespass against his neighbour if he do not propose and practise such a course I cannot to use the words of the incomparable Riolanus I cannot without pity to the sick and some resentment against the Physician read in Platerus's Observations how sundry of his Patients were broyled and torrefied with burning Feavers whom he never let blood He doth relate of himself how he was sick of a most burning Feaver yet did he never so much as let himself blood therein albeit that it were requisite in those cases Such are not obliged to their Doctors but peculiarly to the Divine Providence for their recovery It was the mature consideration of that tenderness w ch is requisite in Physicians towards their Patients which advanc'd the present course of Physick to its glory above all other Methods it being endeared to our esteem by all those regards that represent it as prudential It was not introduced by chance or the subtlety of some persons but the choice of all and so established by the Magistracy that to transgress against the traditions of this Art was criminal in a Physician even by our Laws It may in some cases seem to be troublesome and unpleasant yet SAFETY requires it It may seem tedious sometimes by multiplication of Medicines yet Prudence obligeth by all those means to preserve and secure life and if the omission thereof be criminal in a Physician in case of any sinister accident why is not the practise laudable Would Men but seriously consider How much danger they run and How much more they suffer upon the negligence or indulgence of a Physician who leaves all to Nature and adviseth them to wear out a distemper they would rather hate than love such a Man and the apprehension they should have for the unnecessary jeopardy he put them on would extenuate his credit very much The most rash and brutish counsels may succeed well but yet the most prudent are to be preferred Amonst Physitians I do not reckon the Helmontian as any there is no doubt but a Plethorick indisposition requires Phlebotomy Nature being surcharged with blood forceth us thereunto least some vein should break in the Lungs or the Patient be strangled with that excess this is called Plethora quoad vasa when the vessels are so full of blood that there is danger of their breaking or that the blood should stagnate in the Heart Lungs or Head there wanting room for its motion or take some inordinate course and so strangle the Patient There is another redundancy of Blood which is called Plethora quoad vires or such a plenitude of blood as brings along with it no apparent hazard of breaking the vessels yet doth it oppress Nature so as thereby to become redundant It is more than she can bear in the present juncture 't is more than she can rule and it will suddenly fall into an exorbitant motion to the detriment of some principal part in case timely prevention be not used In both these cases in which the blood is not supposed to be much depraved from its natural estate all do allow of Phlebotomy and if it be timely put in execution it may hinder the progress however it expedites the cure of the disease In these cases we consider not only the present plenitude but also the future what may be in a few dayes to the great exasperation of the disease and peril of the Patient For it is possible that in the first beginnings of a disease there may be neither of these plenitudes but they may ensue a little after For when the insensible transpiration shall have been a while abated as inquietude pain and watching will abate it the Blood degenerates and no longer continuing its usual depuration those excrementitious particles which were lodged in the habit of the body and pores do remix with the sanguine mass and become like so many fermentative corpuscles agitating and attenuating the blood so that whereas before there was no plenitude now there is that the excrementitious particles do contract a fermenting heterogeneous quality different from what they had in the Blood appears hence that those which sweat much as the new-comers in the Indies their sweat is less noysome and bilious by far than it is in those that sweat more seldome Thus Soot is a different body from any thing that is burned Hence it is that those particles being reimbibed into the blood are so offensive to the nervous parts and introduce a lassitude as if the body were surcharged with a plenitude Besides these two cases in which Phlebotomy seems to be directly indicated by a Plethora or surcharge of blood It is practised in other cases by way of revulsion when the Blood and intermixed Humours flow into any determinate part or are fixed there as in Apoplexies Squinancies and Pleurisies for as upon dissection it is manifest that in such diseases there is a greater efflux of Blood than upon other occasions so it is evident by long experience that Phlebotomy doth alter its course and draw back the blood so as that sometimes after that the first blood hath run more pure and defaecated the subsequent hath been purulent as if the conjunct cause of the Pleurisie or Squinancy had been evacuated thereby In reference to such fluxes of the blood to determinate parts we usually consider what in all probability may happen as well as what is at present urging and therefore for prevention thereof we let blood upon great contusions and wounds It is also practised by way of derivation when we let blood near to the affected part thereby to evacuate part of the imparted matter Thus Van der Heyden did frequently let his Patients blood in the same foot for the Gont Thus in a Squinancy to open the Iugulars it is a derivative Phlebotomy In all these cases all Physicians agree to the received practise but in case that the disease be not meerly sanguine but seem to arise rather from a Cachochymy or redundance of evil humours than any plenitude or exorbitant motion of the Blood here many Physicians cry up that Rule That Plethorick Diseases require Phlebotomy but those that arise from a Cachochymy
is conveyed as it were in conduit-pipes the Heart being the great Elastic Engine which drives it being fed by the vena Cava and disburthening it self by the Aorta though even the motion of the Heart depend upon a Superiour influence by its Nerves which wherein it consists and how derived from the Brain and Soul is a thing to us incomprehensible I do suppose that the Circulation is continued and carried on principally by Anastomoses betwixt the Capillary veins and Arteries many whereof having been discovered by Spigelius Veslingius and others the rest may well be supposed and perhaps in the coats of the Veins and Arteries there may be a certain texture requisite whereby the transpiration is managed in order to the safe continuance of the digestive fermentation in the Blood and the nutrition of the body The impulse of the Heart together with the pulsation is sufficient to convey the blood to the lesser capillary Arteries and there though the pulse be lost which yet a little inflammation in the extremities of the body will make sensible and in some Ladies as also in Children the least preternatural heat yet it is impelled by the subsequent blood still into the veins and having acquired by the common miscele in the Heart and the digestive fermentation which naturally ariseth in such heterogenious liquors an inclination to expand it self the compression in the Capillary vessels adds to its celerity of motion when the larger veins give liberty for it the Aiery corpuscles of several kinds which are easie to be discovered upon burning by their expansion and contraction adding much thereunto Thus in Water-engines the narrowness of the â—ipes do add to the impetus with which the Water issues forth And I do conceive by the Phaenomena which daily appears in practise that the Animal heat in the Blood actuating that heterogeneous miscele and according to the diversity of its parts producing therein with the help of its fermentation a rarefaction of what is aiery and according to the room there is a liberty or inclination to expand and evaporate themselves this is the principal cause of the continuance of the motion of the blood in the veins and of its saliency upon Phlebotomy Thus upon Scarification there is no salience or spurting out of the blood there being no room for such an expansion or for the Aiery halituous parts in which there is as great a difference as in those exhaling from the terraqueous Globe to rush forward out of the continued Arteries and together with themselves to protrude the blood Upon this account the Methodists and old Physicians as also the Aegyptians where the tender bodies and constitutions of Children and Women or Men admit not of or requireth that great relaxation of the pores and texture of the body which a more robust and firm habit wherein as the natural resistance in health is greater so the recess from it in a bad estate is much greater would be cured by they use these Scarifications and prefer them most judiciously to Phlebotomy This constitution of the Body doth evince the great utility of Phlebotomy and best as I suppose explicates the effects thereof which we daily experiment From hence not only is manifest how the Body is evacuated in a Plethora but in case of Revulsion and Derivation It is manifest in Aqueducts and Siphons that the liquors though much differing in nature from the Blood nor so inclined to evaporate does accelerate their motion and issue out so rapidly upon an incision or fracture in one of the Pipes that a lesser in such a case will deplete the greater notwithstanding its free passage in its own entire Canale Thus the most learned and considerate Physician Sir George Ent having observed first thus much Videmus aquam per siphones delatam si vel minima rimula hiscat foras cum impetu prorumpere And Sanguis per aortam ingressus fluit porro quocunque permittitur peraeque sursum ac deorsum quia motus continuus est quemadmodum in canalibus aquam deferentibus contingit in quibus quocunque feruntur aqua continuo pergit moveri Quare nugantur strenue qui protrusionem hujusmodinon nisi in recta linea fieri posse arbitrâ—ntur After this He explains the doctrine of Revulsion in this manner Quae postea de revulsionibus dicuntur nullum nobis facessunt negotium â—antundem enim sanguinis a pedibus ascendit per venas quantum ad eosdam delabitur per Arterias Facto itaque vulnere in pectore aut capite revulsio instituitur si modo tam longinqua instituenda sit in â—rure Quia sanguis alias quoquoversum ruens facto nunc in pede egressu copiosius per descendentem ramum procul a vulnere delabitur Non enim arbitramur sanguinem aeque celeriter sua sponte per arteriam aut venam fluere atque is secta earum aliquo effluit Nec sanguis ad laesum pectus aut caput per venam cavam impetu affluit quia fluxus ille aperta inferius vena intercipitur I do acknowledge that the reading of these passages did first create in me the thoughts I now impart unto you And hereby it is evident how the Ancients with their large Phlebotomies might derive even the morbifick matter or revell it though impacted Our minute Phlebotomies do seldom produce such an effect for since it is not otherwise done but by a successive depletion out of the Arteries it would seem necessary to extract three or four pounds of Blood to effect such a matter Neither indeed is it necessary albeit that I believe the most speedy cures but great judgment is requisite in such operations were atchieved thereby for though we do not retract the Humour or Blood unto the place where we Phlebotomise we do revell it from the place whither it was flowing and the course of the Blood and Humours being diverted the Arteries leading to the part affected or depleted and the Flux of Humors which was by them is abated their tenseness there which appears by their pulsation there where they did not beat before is relaxed and so becomes less opportune to extravasate either the Blood or other Humours whereupon Nature it self alone or with a little help of the Physician doth digest and dissipate the impacted matter Whereupon if we add the motion of restitution in the parts affected which is hereby facilitated the great change in the digestive fermentation of the Blood which is manifest by the melioration of the Blood which is seen in repeated Phlebotomies and the relaxation of the whole body in order to the transpiration and other depuration of the Blood by its several Glandules the Kidneys Liver Guts the reason of those prodigious benefits which Patients have had of old and now under our practise is manifest nor do we want a justification for reiterating Phlebotomy or exercising it in different veins and divers manners I designed long ago to set aside some spare
subsequent cure No man can in reason doubt but the best and most direct means to moderate the primary Feaver is to begin betimes for then the distemper is less violent and Nature least debilitated What we are to do then the course of the Disease best teacheth us in which the most enormous vomitings are so far from doing hurt that they are beneficial to the sick It is therefore manifest that a Physician who is to imitate Nature may in the beginning as he sees occasion and upon due pondering of all circumstances◠administer a vomit for it is neither repugnant but congruous to any of those primary Feavers nor contraindicated by the Associate For hereby those excrementitious humours are evacuated which would otherwise in the progress of the disease add to the distemper producing Phrensies Sopors or other malignant symptomes also part of the super-abundant turgent matter is exhausted and the Lungs who are frequently endangered by a Catarrh in the beginning are disburthened as also the eruption of the Small Pox is facilitated Vomits being alwayes held by the Methodists amongst those Medicaments which principally relax the habit of the body In case that there appear urgent Reasons against a Vomit the next thing under consideration is a Minorative purge whereby the Stomach and Intestines being cleansed and part of the Morbifick matter discharged from the Head Lungs and mass of Blood Nature will be better able to overcome and regulate what remains And herein the Physician is guided by Nature which oftentimes alleviates the Patient by a slight Diarrhaea before the Small Pox do come forth Nor is there any danger in such fluxes as our Practitioners observe Si Diarrhaea fuerit in principio non nocebit And most of them allow a gentle befitting purge in the beginning of this Disease not doubting thereby but to make the subsequent course of it to be more benign and safe for the most turgent urgent bilious and accrimonious humors being carried off together with the promiscuous faeculencies of the Intestines 't is not easie to be imagined that any dangerous malignity can reside in the pustules or any dysentery or flux ensue in the state or declination of the Disease at what time it is extreamly perillous I shall not inlarge upon this subject further it not being my present intention but refer my Reader for his more particular instruction to Horatius Augenius Ranchinus Gregorius Horstius Sennertus and Riverius and if he desire Experiments for the happy use of Vomits and Purges and evidence that they do not retract the humors from the circumference to the center Alas 't is not the time of their separation or motion that way or impede their eruption let him consult Angelus Sala and Forrestus I come now to the practise of Phlebotomy about which sundry Questions arise As Whether it may be `administred in the beginng of the Disease and After the Pox come forth In the State and Declination In all which times I do assert that there may happen such circumstances as may make it necessary But in the beginning I think it may frequently be done with great convenience 1. In the beginning of this Disease that which urgeth is the Feaver and its symptomes which if it be so violent that the Patient may be indangered before the Small Pox do come forth or so debilitated that Nature may not be able to command them and concoct them by reason of their multitude or virulency which the extremity of the Feaver as well as habitual cacochymy or the adventitious malignity may create 't is prudence in the beginning to prevent those perils which in a stort space will become remediless If the body be Plethorical with either sort of plenitude 't is indubitably requisite to bleed and our case here is like to those cases which possess the Brewers or Vintners who whilest they attend diligently to the depuration and fermentation of their liquors employ a part of their thoughts upon the preservation of the Cask least it break Nor is the present plenitude only to be considered but the future which will happen upon the increase of the ebullition and attenuation of the blood together with the defective transpiration which alwayes abates proportionably to the greatness of the Feaver and in case any peril threaten from the violence of the Feaver there doth not appear any more ready course in such as are 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or in the beginning are at their height perhaps there is no other then to let blood whereby the redundancy is diminished the course of the blood diverted from circulating or stagnating in the inward vessels the habit and texture of the body changed in order to the more facile expulsion of the Small Pox and transpiration promoted then which nothing contributes more to the alleviation of the first and precaution of any subsequent Feaver and malignant putrefaction of the Humors in the Pustules Quoties cunque enim corpus ventilaturi nullo modo transpiratio prohibetur facile putridae fuligines per poros exhalantur nec cordi communicantur neque proin sequitur ulla febris unica enim causa legitima immediata febris est prohibita transpiratio uti etiam illis qui a limine salutarunt Medicinam notum est i. e. Whensoever the blood is well ventilated and insensible transpiration free whatever noxious and venenate vapours are contained in the body which might otherwise fly up to the head and cause incurable Phrensies deadly Sopors and Epileptick fits or create Lipothymies in the Heart or difficulty of breathing which is a mortal sign in this Disease in the Lungs or a Diarrhaea and Dysentery in the Intestines or a virulency in the suppurating Pustules and corrode even the bones and ligaments these vapours exhale by the opened dores and the Feaver abates for any one that knows never so little in Physick understands that the sole legitimate and immediate cause of Feavers is prohibited transpiration From what hath been said it is evident that of all Remedies Phlebotomy is the most important in the Small Pox in the first beginning whether the Feaver be a simple Synochus or one that is putrid and malignant and 't is more a wonder that any man should oppose the due administration of it then that all Europe in a manner should agree to the practise thereof Neither is it only to be administred to allay the plenitude which generall occurs in this Malady or to prevent the evils forementioned but frequently for revulsion when the malignant matter begins to affect the Brain Stomach Lungs Intestines For if during the Feaver the Humors seise upon those parts with any violence the Patient is in apparent danger of death there being no way to prevent the suppuration there and little hopes that the Patient will survive the distemper or if he do escape a Consumption or Dropsie afterwards Sunt aliae ita malignae ut non solum carnosum genus adoriantur
est quod tam magnifice prodest quod non aliquo ex modo obest What matters it if the heat be magnified besides the main purpose to some small trouble if ten times greater benefit accrue to the sick It is impossible any Physician should perform his duty as he ought if he boggle at the foppery of heat and cold meerly momentany and transient often deluding our senses Surely he that is thus negligent of the Animal faculty in its principal operations may bear with a pitiful Galenist for not regarding much the loco-motive strength whilst he is as sollicitous as any Helmontian to support the vitals and let any one judge which is most likely to impair the vital faculty a little blood-letting duly administred or such an increase of the feavourish heat restlessness deliriums phrensies lethargies as our Author here despiseth I must not yet dismiss him not that I intend to laugh at his six-fold digestion he might as well make a dosen of digestions but it is necessary that I tell him that the production of good or evil blood doth alwayes depend upon one root that feeds the branches for 't is possible that the stomack and pancreatick or bilious mixtures in the guts may not be faultless and yet the blood of the Patient either not vitiated the errors of the first concoction being amended by the primigenial sanguifying Blood for 't is the Blood in the vessels which principally sanguifies or if it be depraved yet not so as to generate any disease or abbreviate the life for cacochymical persons with a little can live more long and more free from diseases than those of a purer and more generous blood Nor is it less true that oftentimes it happens that the blood is infected with recrementitious heterogeneous and noxious mixtures from obstruction of the pores or other occasional causes wherein the stomach and vitals otherwise sound and vegete are only oppressed and distempered by accident some of those impure humours being discharged upon them and in these cases repeated Phlebotomy alone may cure If the credit of Botallus will not satisfie him herein let him believe his beloved Hippocrates a man who did extraordinarily practise blood-letting so as that the French do impatronise him to their Phlebotomy he tells us this story A certain man amongst the Oeniada was sick when he was fasting he felt as it were a great suction in his stomach and a violent pain and after he had eaten any meat as it digested his pains returned He grew very tabid and wasted away in his body his food yielding him no sustenance but what he took came away in ill-concocted and adust stools But when he had newly taken any sustenance at that instant he felt none of that vexatious pain and suction He took for it all manner of Physick both emeretics and cathartics but without any alleviation But being let blood alternately in each arm or hand till he had none left in his body that was vitious he amended upon it and was perfectly cured Read but that case you that are so timorous with the Comment of Van der Linden in his Selecta Medica c. xiii and tell me if upon Phlebotomy as ill blood alwayes succeed as is let out I could add more parallel stories But to demonstrate unto this Pyrotechnist that single Phlebotomy will amend and inrich the mass of Blood I propose this case An ancient Gentlewoman of a very strong and corpulent habit of body but frequently troubled with hysterical and hypochondriacal vapours was taken with a violent catarrh upon her stomach together with great pains in her right and left hypochondria as if the liver and spleen had been tumified sometimes she complained of an insupportable acidity in her stomach and sometimes a saline humour molested her Sometimes she fell into cold clammy sweats sometimes her sweats were so hot that she complained as if her skin were burnt and even when her stomach felt any alleviation she complained of a burning fire as it were in her bowels near and in the region of her liver a perpetual sputation did follow her I being sent for after several Medicaments prescribed methodically but with little or no alleviation I proposed earnestly that she should be let blood notwithstanding she were above sixty years old I took away eight ounces or more She found immediate alleviation there seeming no default in the blood or serum I burned the blood in an arched fire it came to ignition but flamed not at all but crackled like Bay-salt and after some while a sudden eruption of ventosity made such a noise as equalled the cracking of a Chesnut in the fire She took a stomack-powder of Ivory Pearl Crabs-eyes c. and was pretty well for three or four dayes but upon a small fright relapsed I bled her again as before and in that short time in which she had taken very little sustenance but behold this blood which looked no better than the other did burn with a vivid and lasting flame as well as any I ever tryed in my life and without any sign of flatulency She recovered presently after with some further Medicaments but not so as to be perfectly well at stomach of a long time I doubt not but if others would try that way of burning blood they would soon be convinced that Phlebotomy makes a great alteration therein But I proceed to his other Argument This is taken out of Van Helmont whose Latine words I shall not transcribe now but only the English Let them make it appear if this do not imply a contradiction that a Feaver hath the property to pollute the blood and that this property can be taken away a posteriori by a posterous manner to wit by withdrawing what is putrified For if first the fouler blood be let out they open a vein again all this while they overthrow and confound the strength and so thereby wholly disappoint a Crisis But suppose sometimes a fresh ruddy blood run out they presently cry as cock-sure that a whole troop of diseases is cut off at the first dash as if the resting place of the Feaver did only extend from the heart to the bending of the arm and the good blood did take up its abode about the liver This Argument proceeds upon a most gross falshood in that part of it where we are supposed to place such a value upon the colour of the blood as by the goodness or ruddiness thereof we should esteem our selves as cock-sure that a whole troop of diseases is cut off at the first dash whereas no intelligent Physician ever thought so for we do say that the blood of all men is not alike neither as to colour nor consistence naturally and therefore in diseases we do not expect to see such nor intend to make any alteration to such a degree as transcends the natural estate of the body for 't is our business to preserve each man his natural habit be
into one similar body the rest whereof were to be excrements but a more confused Mass of several distinct Alimentary Humours which Nature never intends to unite into one similar body but to continue in a certain more loose mixture each thereof retaining its proper congruity for the continuance of life and health They do confess that there is a pure crimson part sweet and balsomical which they call in rigour Blood but they say Nature never intended this for the sole vital liquor because she never produceth it alone or if it be ever seen so 't is in a morbid condition as in malignant Feavers where the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or Blood free from the proportionate mixture of other Humours is reckoned amongst evil signs Qualis sanguis in malignis adurentibusque febribus solet excerni aut e vena tunsa educi And therefore as none of the Humours are ever seen alone any more than Blood is for they hold them all to be excrementitious when separate so they conceive they all together in a certain proportion make up that aggregate called Nutritive Blood and are all actually there because they do observe that all of them at sometimes have their distinct corruptions though they continue still in one mass which they conceive they could not have except they were actually there They do conceive them to be so there that the resemblance betwixt Gall or extravasated Phlegm is but Analogical so that they do not pretend to shew in the Blood a bitter Gall or a pontic arminonious Melancholy They will not allow these to be other than depravations of the Alimentarious Humours and the sincere alimental juyces are no more pretended to be evinced by them then the pure Elements except it be a posteriori by a diversity of effects arguing different causes They saw there was a great latitude in the blood of healthful men yet so as that the blood appeared with different colours and consonant to the colours there seemed a variety in their dispositions and other corporeal qualities they saw the Mass of blood upon perfrigeration to go into several substances and they intellectually disjoyned them more for doctrine-sake obliging themselves to produce each Humour in its imaginary purity when the Chymical fire should exhibite any body not decompounded or the Corpuscularians make more manifest their configurations of Atomes or Texture of Particles Having thus stated the Question with as much perspicuâ—ty as I could I pursue to enquire which is most conformable to the effects in Physick for I will not undertake to determine what God and Nature do in the production or mixture of bodies It is easie for a man to loose himself in those inquiries He that made us can tell how we were made our Argumentations are as vain as if one should assert that a Loaf of bread consisted of Cubes Lozenges or Trapeziums because we can cut it into parts of such a configuration Let us but imagine a subtle Chymist to analyse Chymically our Ale if ever he thereby discover that it is the product of a Barley-corn growing into a stem and grain then turned into Malt grinded boyled with water and fermented I will assent unto the Chymical resolutions of blood Physicians have been alwayes allowed hitherto to be a sort of gross Artisans and I remember Massarias some where calls it an Hippocratical demonstration Indicium autem Curatio To know bodies exquisitely mixed and to mix them intimately is a divine attribute this last is avowed by Galen Miscere corpora tota per tota non Hominis sed Dei Naturae est opus Perhaps it may be replyed that the most ignorant persons may say thus much It is true and if he speak it knowingly I confess I can say no more than he Sed quod dicemus objectioni illi Ignarus aeque ac Philosophus deum causam omnium assignabit Hoc ignarus inscienter Philosophus scienter assignabiâ— quemadmodum Aristoteles ait de Parmenide Melissâ— quemadmodum caecus alicujus tunicam albam esse afâ—erit Nil scimus Dicamus ergo Primarum rerâ—m principiorum aut elementorum cansas reddere nostri non est captus secundarum vero utcunque Id in singulis quaestionibus experiri possumus I say then that notwithstanding any allegations to the contrary it is manifest that a certain proportion of salt sulphur and spirit besides earth and water is neither requisite to perfect sanity nor its defect as to any particular the cause of diseases and this is manifest out of the constitution as well as colour of the blood in morbid and healthy bodies as appears by the burning and distillation of blood There is much of truth that T. T. sayes or may be so Now I am ready to discover in reference to miserable man that the pretended sanguine sulphur or Cacochymy of any in an high Feaver doth afford more salt water and earth each of them than sulphur I have taken that diseased blood termed corrupt which might seem to some to abound with sulphur being clearly conveyed into a Retort with a Receiver joyned thereto I have by a graduated fire regulated very strictly brought over what possibly I could In the upshot upon the separation of the several parts I have found very little sulphur in comparison of each of the rest At another time I procured the purest blood I could get from an healthful person putting it to the same igneous tryal as the former degenerate of equal proportion to it then after sequestration of the parts I could not perceive any considerable difference in the quantity or quality of the several parts of that sound and the seemingly corrupt blood I do say that in the Blood of all persons that are in health there is upon Phlebotomy somewhat that justifieth the supposition of the Galenists but not which confirms the Hypothesis of the Chymists The coagulable serum doth commonly represent their choler in part the florid fluid red their blood which if lightly washed away their is another more darkly-coloured which is proportionate to their Melancholy and if you wash the fibrous mass well it will be white and answerable to their Alimentary Pituita or Phlegm In this last part I have the concurrence of Malpighius who upon washing all the blood from the concrete Mass of blood found the remainder to be a fibrous conâ—texture of a whitish colour which he pitcheth upon as the materials for a Polypus in the Heart And had he taken more particular notice of that fluid blood in the cells of those interwoven fibres he might have discovered two sorts of blood one that readily ascends and is florid the other more black and faeculent which moveth not and both these stain the water they are washed into with different reds the one much brighter than the other That some fibrous concretion in some diseases as Rheumatismes and Plurisieâ— covereth like a pituitous mass the surface of the blood whilest that remains
fluid and bloâ—kish underneath nay I have out of healthful blood in the Spring I am almost convinced that the blood varieth with each quarter of the year cast it up to the surface in just such a mass as covers the top of the blood in those distempers by putting some spirit of Hartshorn into the Porringer before the party bled into it I place the choler in the serum not but that I know that it hath not the taste or consistence of the excrementitious Bile but because it hath frequently the colour of it and the Vrine and Pancreatick juyce not to mention the Lymphaeducts are tinged with it and oftentimes have the Sapor of it I am sure that herein I have the suffrage of Pecquetus thus far that the choler which is separated in the Liver and which tingeth the Vrine is extracted out of the serum of the blood where it circulates first along with it and is percolated out of it in the place aforesaid Et vero nullibi per universas animalium species absque hilis mixtura sanguinem reperius flavescens id serum salsumque testatur nisi forsitan aliquot in suppositis quibus dulcem mitior natura sanguinem concoxit sicut in aliis quibus acciditatis expertem infudit aut nullo prorsus liene instruxit aut sane perexiguo I cite him the more willingly because that If the Galenists seem infatuated for saying the Gall is a constitutive part of the mass of blood whereas they cannot demonstrate signs thereof by its bitterness a great part of the scorn may fall upon Pecquet Backius and Sylvius de le boe and other Neoterics who hold it is incorporated in the Mass of blood But these Controversies can be no better decided than by an Enquiry into the Generation of Blood how that it is at first begun and afterwards continued the knowledge whereof will conduce much not only to the decision of that Question Whether there be in Nature any foundation for those Galenical Humours that they are constitutive parts of the Mass of Alimental Blood But also to the main debate in hand Concerning Phlebotomy There is not anything more mysterious and wonderful in the Vniverse I think then the production of Creatures In so much that Longinus a Paynim doth hereupon take occasion to celebrate the judgment of Moses in that He represented the Creation by a Divine FIAT and God said let there be and it was so The Mechanical production of Animals from so small and tender rudiments out of a resembling substance in all that variety which we see by a necessary result of determinate Matter and Motion is so incomprehensible and impossible that were not this Age full of monstrous Opinions the consequent of Ignorance and Inconsiderateness one would have thought no rational Men much less Christians would have indulged themselves in the promoting and propagating such Tenets 'T is an effect of that Soveraign command that every thing hath its being and faculties Quin nil aliud est Natura quam jussus ille Dei per quem res omnes hoc sunt quod sunt hoc agunt quod agere jussae sunt Hic inquam non aliud quicquam cuique rei suam dedit speciem formam Per hunc non agunt modo pro sua natura hoc est prout preceptum est ipsis res creatae omnes sed per eundem reguntur conservantur propagantur Et nunc etiam quasi creantur This is that which gives a beginning to the Faetus particularly and by unknown wayes contrives the seminal vertue its receptacle or Egg and that colliquament out of which the Body is formed Because the first rudiments of conception are tender and minute such a provision is made in order thereunto that the albuginous substance of ordinary Eggs is no other than what is derived into the female womb And if we may continue the comparison it will seem most rational to imagine that the parts of the whole are contrived at one time though they neither appear all at the same nor in a proportionate bulk for in some their minuteness in others their whiteness and pellucidity conceals them from the Observer But that even then â—â—re are exerted the preludes of those vital operations which are so visible after in Nutrition I doubt not and that as in the Coates of our eyes the minute veins and arteries convey their enclosed liquors though undisernable except in Eyes that are blood-shotten and as in the brain there hath been discovered veins by some drops of blood issuing in dissection though no Eye can see most of the capillary vessels and as even the veins and arteries themselves are thought to be nourished by other arteries and veins rendring them that service which they do to the more visible parts even so it is in the first formation wherein after some progress the vessels begin to appear and blood first discovers it self in the Chorion and thence continues its progress to the punctum saliens or heat and undoubtedly proceeds in its Circle though the smalness of the vessels as in other cases conceal the discovery So that we may imagine that the Plastick form or whatever else men please to call it doth produce the blood out of that albuginous liquor which seems as dissimilar as the blood out of which it is derived though the parts be providentially more subtilised and refined by its own power as it doth the rest through the assistance of warmth and concurrence of the contemporary fabrick for the first blood can neither give a beginning to its self nor is it comprehensible how the weak impulse thereof should shape out all the veins and Arteries in the body according as they are scituated Out of which it is evident that the Soul or Plastick form doth at first reside and principally animate in the Spermatic parts so called not that they are delineated out of the Sperme but out of the Colliquament which is Analogous to it and that they are her first work the blood is but the secundary and generated out of the Colliquament for other Materials there are none by the Plastic form which is the proper efficient thereof and besides the Auxilary Heat theâ—â—â—re no other instrumental aids but the spermatick vessels wherein the Colliquament at first flows to the punctum album which when blood is generated do become the Heart and sanguiferous Channels This is avowed by Doctor Glissen himself Liquor hic vitalis antequam sanguinis ruborem induit sese a reliquis ovi partibus quibus promiscue commiscetur segregare incipit in rivulos seu'rdmificationes quasdum excurrere quae postea venas evadunt Rivuli isti in unum punctum coleuntes in eum locum conveniunt qui postea punctum saliens cor appellatur Idque fieri videtur diu antequam sanguinis aliquod vestigium compareat Herewith agree the most exquisite Observations of Doctor Highmore Most certain it is
by the History of Generation that no Parenchymatous part hath any operation in the first production of the blood all their Parenchymas being post-nate thereunto And if the blood be thus generated at first it is but rational for us to imagine that it is alwayes so generated during life For as it is true that the same cause acting in the same manner will alwayes produce the same effect So in this case to argue from the identity of the effect to the identity of the cause is allowable Est enim causarum identitas quae facit ut effectus sit idem quippe effectus supponitur non esse donec a causis existentiam suam indeptus fuerit dum existentiam illam largiuntur oportet ipsius quoque identitatem impertiant qua sine effectus ipsemet nequaquam fuerit That the Spermatic vessels in which the blood moves do contribute to sanguification much seems apparent from hence that the blood is seen in them before it is in the heart And because it is observed that the fluidity of the blood seems to depend much on them and therefore in the dead it doth not coagulate except praeternaturally in the veins though it do commonly in the Heart or wheresoever it is extravasated Manat praeterea aliquid a venis nobis incognitum quod dumearum ambitu sanguis concipitur prohibet ejus concretionem etiam post mortem in cadaveribus jam perfrigidis nequis hoc colori acceptum ferat quod vero coralliorum instar aliquando repertus est concretus in venis ipsis hoc merito Fernelius ascribit morbo occulto And not only the fluidity but motion of the blood seems to depend much thereon for if by a ligature the impulse and succession of blood be prevented yet will the blood in the veins continue its course and not stagnate Exempto e corpore corde motus tamen sanguinis isque satis celer in sanis videntur Et si vena ulla etiam lactea duobus locis ligetur laxata ea sola ligatura quae cordi propinquior est dum partes adhuc calent semper Chylus ad hepar sanguis ad cor cum movebitur qui nec a corde per Arterias nec ab intestinis per lacteas objecto potuit obice propelli nec stuiditate sua potius sursum quam deorsum movetur The truth hereof seeming undeniable to Pecquet he makes use of a new Hypothesis to solve this motion of the blood as if it arose from compression of other parts or contraction in the vein it self But the Phaenomenon will appear in such cases as admit not this pretence From these reasons it is that the blood doth not need so much as any pulse in the veins and arteries as appears in the first faetus but as soon as it comes to the Heart it does to prevent coagulation the punctum saliens being endowed with no such quality practiseth its systole and diastole when yet no such motion is observable in the Arteries at that time Whence the colour of the blood ariseth is a secret unto me I know that digestion reduceth some Juyces to a redness in some Fruits the fire doth the like in some the mixture of acid Liquors begets a Vermilion But here I conceive none of these causes produce the effect the generation of the blood is manifestly an Animal Action and as such unsearchable Whatever I attribute to the veins it is not to be expected that supposing they should instrumentally sanguifie the blood should turn blew from them any more than that water put into new vessels of Oak should turn white whereas it becomes reddish Thus the Plastic form produceth blood at first and whilest there is no first concoction in the stomack supplieth that defect by that albuiginous Colliquament which is of the same nature with the Chyle we digest our meat into and convey by the Lacteous Thoraciducts into the Heart That it is of the same nature appears hence that it resembles it and that it is extracted from the Blood of the Mother and produceth in the Embryo the like excrements of Choler and Vrine and Macosities nay it hath been observed by Riolanus to have been tinged yellow How much more may be concluded hence in favour of the Galenical alimentary humours supposed to constitute the Blood I leave those to judge who consider the variety of female constitutions and their condition during their being with child perhaps the Hypothesis of a proportionate mixture of the five Chymical Principles will not seem more colourable Having thus related how Sanguification is performed in the Faetus at first I come to give an account how it is performed afterwards and even here it seems an Action perfectly Animal for even Concoction in the Stomach is not the bare effect of Heat elixating the meat nor of acid or saline Ferments dissolving it nor of any other kind of imaginary Fermentation But 't is the effect of an Animal power operating upon the Meat in the stomachs of sundry Men and Animals by several wayes This appears most evidently herein that the same meat eaten by several Persons or different Animals produceth different Blood and different Excrements therefore Chylification is an Animal operation and is modulated by the specifick and individual constitutions Having thus determined of things that the Soul in all these actions is the Efficient we may consider that the meat being masticated in the mouth and commixed with the salival juyce or spittle is prepared in order to Chylification then it descends into the stomach and is there sometimes in a longer sometimes in a shorter space reduced into a cremor which is so far from being acid as Helmont saith that it is generally rather saline as are also the recrements of it that remain in the empty stomach It is true that according to the stomachs of Individuals and the meat they eat it happeneth so that this Cremor hath no certain taste nor colour Undoubtedly it must have been bitter in that Marriner and such as he of whom Vesalius writes that the Gall did naturally discharge it self into his stomach yet did he digest very well and never was apt to vomit or to be so much as sea-sick From the stomach the Cremor descends into the Intestines not all at once but as it is digested and there undergoes a second digestion receiving into its mixture the Gall and Pancreatick juyce I shall not speak of the variety that hath been observed in those two liquors nor trouble my self about the manner how they operate on the Chyle It is manifest that upon that mixture the Chyle suffers a great alteration if not some effervescence and some parts are coagulated and as it were precipitated and by a succession of changes the several particles are so blended and refracted in their qualities that the excrements at last are neither acid nor bitter but in dogs both sapors are extinguished In the mean time during
this descent of that miscellanes the lacteous vessels do imbibe and convey the Chyle in the shape of Milk to the Receptacle where mixing with the recurring Lympha which is sometimes yellowish it passeth through the Ductus Thoracicus unto the Heart and in the Subclavian vein associating with the Blood it passeth along with it supplying the continual decay of the Blood and yielding Nutriment to the parts and new matter for excrementitious humours yet so as that it is not all transmuted into blood or perfected at one passage through the Heart but by repeated Circulations whereby it comes to loose its lacteous colour and contract a more saline taste as well as a serous limpidity or some more degenerate colour yet it is still coagulable except in a morbid state like to the white of an Egg as the depurated Chyle is It were easie to pursue this discourse so as to demonstrate that neither the separation of the Vrine in the Kidneys nor of the Gall in the Liver nor of the Spittle in the Glandules are other than vital Actions wherein the same form which at first shaped the Body is principal Efficient and that in these Operations there is somewhat more than percolation of corpuscles differently seised But I shall conclude this discourse by accommodating of it to the defence of the Galenical Alimentary Humours supposed to constitute the Blood It is manifest in this History of Sanguification that the Pituitous liquor which is derived into the Mouth by the salival vessels is most agreeable to that which is by the Galenists called Phlegme it is not like the serum in the blood for it is not coagulable as the other 't is insipid and as it makes so considerable â— part of the chyle in the stomach so it may well be presumed to continue its intermixture unto perfect Sanguification As for the Gall as its intermixture in great quantities with the Chyle is undeniable so 't is not improbable that it gives a fluidity to the Chyle beyond what it acquires in the stomach thus Painters to make their colours and oyls more fusile and accommodated to their use do mix Gall therewith That upon the mixture it should loose its bitterness and become sweet and alimentary is most agreeable to the Galenists and no wonder for the sapors as well as colours of liquors are easily altered and 't is manifest that this happens in the descent of the Excrements through the tract of the Intestines and why not in the venae lacteae there are signs of it in the flavidity usually observed in the Arterious blood and 't is remarqued by Judicious Maebius concerning the blood that it is not Homogeneous Habet enim sua stamina nigricantes fibras habet serum salino principio imbutum ad putredinem eludendam habet partem subtiliorem splendente rubore excellentem superâ—iciem in extravasato cruore ambientem Et haec in recessu videtur custodire BILEM ALIMENTAREM flavidine sub insigni rubore abscondita Quae ex rubro nigricant flavedini si misceantur talem splendentem ruborem exhibere cuivis clarum est The bitterness which it hath is produced by the Liver upon its separation there which is not done by meer percolation but an accessional of transmutation there As for Melancholy how much the Pancreatick juyce resembles that when it proves not to be bilious as Veslingius and Virsungus alwayes observed it to be let any man judge by what Regnerus de Graeff hath most ingeniously written thereof besides that the more black part of the blood seems as essential thereunto as the more bright Red. But the Degeneration of the Blood into those Excrementitious Humours seems to evince as muck as the Galenists pretend unto Since every thing is not produced out of every thing but out of determinate matter 't is not incongruous to imagine that in the due constitution of the Blood there is an Analogical difference of Alimentary juyces to make up good Blood since there is such a discrepancy in those depurated from it upon which the Soul by the innate temperament of the parts separating doth so operate that its effects are modified by the nature of the subject matter Hence that variety in the tastes of Vrine which is sometimes so bitter that Gall doth not exceed it sometimes sweet so that Fonseca relates of a Portuguess Peasant who by the sweetness of the Vrine would tell who were infected with the Plague The Gall appeared in great variety to Vesalius Longum sane esset ea que in quibusdam tertiana quartana laborantibus dein suspendio aut capite plexis in furiis mania oppressit obsessis in melancholia morbo effectis ex variis febrium quae continuae fuerunt rigorum sudorâ—m inordinatos circuitus faciebant generibus extinctis faedo ictero eoque vario vexatis malo habitu diu pressis dysenteria cruciatis subinde reperi modo commemorare Sive scilicet hic insignem bilis nunc flammae nunc atramenti quo scribimus in modum atrae sive albicantis propemoâ—um colorem qui fere conterminas partes inficeat sive sluidam aut luti modo aut unguenti cujusdam ex farinis melle terebinthina apparati ritu consistentis substantiam sive varias calculorum effigies sive biliâ— vesiculae molem instar duorum pugnorum ob contenta tumidam sive omnis bilis defectum recenserem Quae omnia me de hujus vesiculae natura adhuc magis quam antea habent solicitum As to the Pancreatick juyce its variety is no less observable So for the Phlegm and Blood it self Having said thus much in behalf of the Ancients against some Dullmen of this Age who laugh at any one that mentions but those Humours I might proceed to demonstrate practically their several motions in diseases and justifie the Medicinal Documents created thereon by such instances as countenance thereunto But the digression would be excessive I return therefore to the principal Discourse and shall from what hath been said erect an Hypothesis concerning Plebotomy which will authenticate the received practise which is so judiciously and happiâ—y followed by all prudent men 1. If it be true that there is so great a Quantity of Blood in the body as I have evinced then may we very well suppose that the loss of a few ounces is no great dammage to the Patient 2. If it be true that so great effusions of Blood have happened to several persons without any subsequent prejudice If it be true that large Phlebotomy even usque ad Lipothymiam hath been succesfully practised then is it evident that our partite and diminute Phlebotomy may be safely continued and that whatsoever ill effects follow thereupon the default is not to be ascribed to Blood-letting but to the indiscretion of him that ignorantly made use of it or the unknown idiosyncracy of the Patient or the over-ruling Providence of God which disappoints
frequently the most rational and best Methods of curing Quaedam ejus sunt conditionis ut effectum praestare debeant quibusdam pro effectu est omnia attentasse ut proficerent Si omnia fecit ut sanaret peregit Medicus partes suas etiam damnato reo Oratori constat eloquentia officium si omni arte usus sit 3. If it be true that there is so great a variety and discrepancy in the Blood then is there no secure judgment to be made of the Blood issuing out of the vein either to the continuing or stopping its Flux But the Physician is to proceed according to the Rules of Art and accordingly as they direct him may he promote stop or repeat the evacuation A seeming Cacochymy in the Blood doth not impede venae-section nor call for purging and rectifying Nothing is evil that is natural to a man but real Cachochymy or redundance of Humours offending Nature this doth call for our assistance and requires sometimes Phlebotomy and sometimes other Medicaments 4. If it be true that Sanguification is an Animal Action if it be true that the Plastick form is in being before the Blood and produceth it and the whole Fabrick and subsequent operations and that the motion of the Heart is proved by Doctor Lower to depend upon the Nerves during life then is there no such strict connexion betwixt the Soul Life and Blood as G. T. doth fancy 5. If it be true that the Blood doth continually waste and spend it self in Nutriment and Excrements then is it manifest not only that the loss of a little Blood partitely taken away is not the loss of life or prejudicial thereunto Neither doth it follow that the loss of Blood in a moderate quantity is any imminution of the vital Nectar it is neither the chief residence or seat of the Soul nor in a determinate quantity requisite to the continuance of Life but comes under a great latitude It abounds more in some seasons of the year and times than at others and why may not Artists imitate Nature in diminishing its redundance upon occasion as she does As long as he proceeds not to exhaust all or too much The loss is easily repaired upon convalescence and the qnantity is more than can be governed by Nature in sickness 't is but the observation of a Geometrical proportion in such a Phlebotomist The same Agent will produce the same effects if Nature be corroborated and the vitiated tonus of the concocting and distributing vessels be amended there is no fear of wanting a new supply proportionate to the exigence of the Patient The Blood we take away is no other than what would be expended or exhausted naturally within a few hours or dayes as the Staticks shew and it must needs be considering the quantity of Chyle which flows into the veins upon eating and drinking 6. If it be true not only that Nature doth thus expend in transpiration and Excrements as well as Nourishment much of the Blood and repairs her defests by a new supply whereby Life is continued not impaired so as that the melioration of the following Blood is rather evident in his first years by his growth vigour strength and intellectuals But also that She doth of her self make men and women apt to bleed at some times ages and seasons which is known to all then is not the effusion of this solar liquor so unnatural a thing nor so homicidial an Act as 't is represented 'T would seem a strange Law that should punish every Boy that breaks the Head or Nose of another as a Bronchotomist or Cut-throat If it be true that Nature doth oftentimes alleviate even in the beginning and in the end cure Diseases by spontaneous evacuations of Blood at the Nose and Vterus by vomiting and stool then a Physician whose business it is to imitate Nature in her beneficial Operations is sufficiently authorised and impowered to practise due Phlebotomy by the best of Presidents Hâ—ving premised these Conclusions which are all either proved in the foregoing discourse or evident in themselves to all understanding men I shall proceed to give an account of the Reasons why Physicians do so frequently and in so many Diseases practise Blood-letting and those deduced from its variety of effects in Humane bodies For it is not a single Remedy subservient unto one Indication or End but conducing to many and therefore made use of upon several occasions to different intentions Vtile est id remedium ad quamplurima vix-potest in ullo magno morbo non esse aliquid cujus gratia utile sit Before I come to particulars it is necessary I tell you that in the cure of all diseases Physicians propose unto themselves sundry considerations they regard the disease the antecedent causes and the symptomes which attend or will ensue thereupon either generally or in such an individual constitution they employ their cares to prevent some inconveniences as well as to redress others Some remedies they make use of because they are necessary of some because they are beneficial yet may the disease 't is granted be cured oâ—herwise in case the Patient have a reluctancy thereto or for some private reasons the Physicians esteem it fitting to alter their course Upon this account 't is assented unto that many distempers may be cured without Phlebotomy which yet are ordinarily cured with it or may be so And herein the disagreement of Physicians or different procedures are all according to their Art nor is it denied but that All of them may atchieve their ends by their several Methods So that it is a gross paralogisme for any one to conclude this or that Physician is mistaken or takes a wrong course because another takes or prescribes a different one All the Physicians in Spain France and Italy do not bleed with equal profuseness In Germany and England some do practise more frequent Phlebotomies than others do and neither of the parties do erre in case the other remaining Method be inviolately observed It is in humane bodies as it is in the body Politick where there is a Method of ruling though it be carried on by several wayes and means and whilst each States-man doth prudentially sway the Government procuring peace and plenty to the subject his conduct though it vary from that of his Predecessour is not to be blamed It is not to be doubted but that many grievous distempers are cured by Nature without the use of any remedies at all Yet will no wise man adventure his life on such incertainties 't is not to be denied but some are cured with fewer Remedies than others are But yet 't is not prudence to put Nature upon too great a stress or to account all means unnecessary which are not absolutely requisite or without which the effect may though with more difficulty and hazard be brought to pass It lyeth upon the Physician therefore to pursue all those means which may secure the life of
case to the Abettors of Doctor Whitaker and Doctor Sydenham since there appears upon dissection that the Small Pox had not fixed themselves within but that a meer surcharge of the mass of blood either natural or contracted from the attenuation of the ebullient blood was the cause of her decease I forgot in the conclusion of what I writ of the Small Pox to speak about Bathing of the hands in the Small Pox the practise whereof Doctor Whitaker represents as having been fatal to the Princess Royal. His words are I observe Riverius above all other Authors to ordain the bathings of the hands and feet by reason of the density of those parts in some more dense than others as in Smiths Carpenters and Foot-posts whose hands and feet are harder than persons of a more tender and sedentary Trade or Profession I cannot but acknowledge that humectation and attenuation to mollifie those parts is properly indicated but the mode of this application is observable because upon the opening of the porosities by bathing the ambient air may obtain the advantage of repelling the morbifical matter from those ignoble and extream parts to the more noble by the ambient air in the course of sanguineous circulation and hath proved fatal in such as have rare and tender skins as is proved by the bathing the Illustrious Princess Royal. Concerning that Princess how she was ordered and at what time of the Disease bathed thus I know not but 't is an equitable presumption that in so important a case so understanding Physicians as she employed did nothing rashly or without reason I find in the relation of her being dissected causes enough of her death without imputing it to this usage her Omentum was putrified and much inflamed towards the Spleen side her Spleen was flaccid and semi putrid her Stomach was inflamed and on the inside beset with Aphthae her Liver spotted and inflamed even to a Gangrene almost her Lungs in a manner rotten and replenished with black blood spotted and pustulated in the superficies the Parenchyma of her heart was much consumed But had not these things been nothing is more certain than that of Petronius Quod non expectas ex transverso fit et super nos negotium Fortuna curat But that Riverius doth prescribe this Bathing above all Authors is a manifest falsity His words are only these Ac primum in eruptione Variolarum aut dum maturescere incipiunt ingens dolor vel pruritus interdum aegrotantes affligit praesertim vero in plantis mannum et pedum eo quod densior in iis partibus cutis eruptionem prohibeat Cui symptomati medeberis si partes illas decocto emolliâ—nte diutius foveas vel in aqua calida detineas I shall compâ—re herewith the directions of Horatius Augenius whose character I have already given He having prohibited the bathing of the whole body doth add Sed non est eadem ratio in particulari balneo cum scilicet partes aliquaspiam extremas lavacro calido fovemus ut ex illis duntaxat citius facilius variolae exeant doloremque mitigemus ut plurimum satis insignem hoc quidem praetermitti non debet Nam plerumque accidit ut ex volis manuum plantis pedum varioloe non erumpant nisi cum maxima difficultate et dolore propterea expedit fovere eas partes aqua calida aliquando simplici et aliquando simul decoquendo stores Camomillae aut Altheae aut violarum vel aliud ejusdem generis quod fuerit ad manus Haecquo antiqua extitit Arabum consuetudo nam Rhases ita scriptum reliquit lib de Pestilentia c. 8. Quod si in volis manuum expullulet tu hasce ex oleo tepente quo gossypia imbuta sint multum refricato in calida aqua foveto Verum si dolor non sedetur nec pestis facile expellatur tu sesamum perpurgatum ubi contuderis in lacte maceraveris illico illiniro in linteo per totam noctem alligato dehinc ubi amoveris calente aqua foveris rursus illinito Verum si velis palmulus ubi contuderis in butyro maceraveris vel in sesami faece illinito Siquidem haec similia cutem remolliunt faciuntque ut pestis facile excernatur dolores cedant Haec Rhases Quae omnia judicantur mihi saluberrima in praesenti casu nisi quod abstinerem ab oleo quia facit ulcus ipsum sordidissimum ac sanatu difficile Ego autem nullum inveni praestantius remedium quam fovere partes extremas manuum pedum aqua tepida vel decoctione florum camomillae altheae Quod si mollire adhuc magis voluerimus decoquo simul semâ—na faenugraeci This Bathing is no less â—ecommended unto our practise by the diligent and learned Forrestus who speaking of an ancient Woman of fifty years old which was sick of a Malignant pestilential Feaver accompanied with the Measils that came out on the sixth day concludes the Observation thus Huic tamen quod fere jam omiseram ingens pruritus punctio in plantis pedum ac volis manuum aderant pro quo symptomate mitigando quum maxime eo intolerabiliter affligeretur ut se potius mori velle diceret quam illum pruritum punctionem ferre jussi ut pedes manus continuo teperet in aqua calida Quo consilio pruritus tum puncto cessarunt et melius per cutem in volis manuum et pedum morbilli emergebant Hujus rei experimentum not aâ—u dignum ab ipso Astario Papiensi medico accepimâ—s quod etiam Arcanum a Nicolo Florentino medico sui temporis insigni mutuavit cum idem sic scribat câ—p de Variolis et Morbillis circa finem de corrigendis accidentibus eorundem Si fuerit punctio plantae pedum aut palmae manuum ponantur dicta membra assidue in aqua calida ut dicit Nicolus ego vidi multum conferre Haec Blasius Astarius Papiensis in libello suo de curandis Febribus qui adjunctuâ— est praxi Gatinariae quo quidem experimento ab hoc symptomate molosto et gravi nostra aegra liberata est et brevi Dei nutu evasit et in totum sana facta est Herewith agreeth the injunction of Hoeferus which runs thus Vbi in variolis plantae pedum et manus quod saepius fieri solet gravi pruritu vexantur immitte membra in aquam calidam quod pro secreto habet Forrestus I need not any more Authors what hath been said is sufficient to justifie the practise to any intelligent person and to disprove the Assertion of this Doctor but as that is most â—ntrâ—e so are the Reasons he gives no less vain Whereas he is pleased to think that there is no such density in the skin of the hands as is generally supposed except in laborious persons 't is certain that some have it so naturally as Scipio Nascica who was
body from streightness to laxiiy the most powerful were Phlebotomy and Purging and that their principal effects were not meerly to evacuate such or such peccant Humours but in doing so to create a new Texture and configuration of Corpuscles in the whole Body and therefore they held them to be General Medicaments and of use in most great diseases since such distempers were rather occasioned by a streightness than laxity of the pores and even such as were laxe one way as Dysenteries and Diarrhaeas might be accompanied with a streightness in the habit of the body This Hypothesis for the further explication whereof I remit you unto Prosper Alpinus having been of great renoxa and more accommodated to the course of life by which the Romans and since the Turks and others that follow not our Physick did preserve their Health and recover their Maladies did merit my regards and I observed the truth of that part of their Opinion which avows that purging and bleeding have further effects than meerly the evacuation of Blood and other Humours that they had such an influence upon the whole body as to restore and promote all the natural evacuations of the body by its several emunctories and pores and that Phlebotomy did particularly incline to sweat promote urine and sometimes instantly allay its sharpness and make the body soluble so that upon Phlebotomy there needs no antecedent Glyster Neither is it convenient in a great Cacochymy to purge before bleeding not so much for fear of irritating the Humours but that the purge operating so as to attenuate and alter the whole mass of blood and promote secondarily all natural evacuations without preceding Phlebotomy it is scarce safe not secure to purge except in bodies the laxity of whose texture is easily restored or with gentle Medicaments for the Humours being powerfully wrought upon by the strong purges and inclined to be expurged by their several emunctories and those being either defective or the veins and arteries too full to admit a greater rarefaction in the mass of blood which is requisite to their separation and transpiration hereunpon there happens a dangerour Orgasmus or turgency of humours in the sick which Phlebotomy doth prevent And 't is I conceive in reference to this alteration of texture that Hippocrates saith 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 I observed a great congruity betwixt the Static observations and those of the Methodists and that Sanctorius hath a multitude of Aphorismes which agree with them viz. That such bodies as transpire well in the hottest weather they are lighter and not troubled with any vexatious heat That nothing prevents putrefaction like to a large transpiration In fine I did observe that it was the general sense of Physicians that Phlebotomy did draw the Humours from the Centre to the Circumference and I had taken notice of it alwayes in my self even in the Colick bilious when I was tired out with pains vomiting and want to sleep when I took no Laudanum and reduced to extream debility and emaciation I determined in that forlorn case having used all other means for several weeks to bleed so long yet partitely as that I might be freed from a most troublesome pulsation of the descending Artery below the reins I bled eight ounces at first and found a vextious heat in the whole habit of my body I repeated the Phlebotomy in the afternoon and was very hot all night thus I continued to bleed twice each day for three dayes loosing above sixty ounces and then fell into sweats was eased totally in my back and afterwards recovered with a more facile Paresis in my Armes and no contracture then that disease commonly terminates in there These considerations made me think that there was some more important effect in Phlebotomy than the evacuation derivation and revulsion of the Blood and other Humours and that it must consist in promoting that Statical transpiration and I conceived that the Blood was in perpetual motion and though Motion doth hinder Fermentation yet I had observed that in Pipes at Owburne Abby where the drink runs from the Brâ—w-house to the Cellar to be tunned up the Fermentation continues so especially in the stronger drink that the Pipes frequently break therewith as rapid as the motion is I did not imagine that the nature of the Blood was such as to be exalted into one Vniform liquor resembling Wine for such a liquor would not be liable to such sudden changes and alterations from one extream to another but that it was a miscellary of heterogeneous liquors in a perpetual digestive fermentation and depuration by halituous particles arising from it as in more gross by the emunctories which if the conformation of the pores and passages be such as to give it due vent all continues well if they be obstructed or vitiated then several maladies ensue except timely prevention be used I conceived that in Phlebotomy as the Blood issueth from the vein so as in the pouring out of other liquors the Air comes in by the orifice and mingling with the Blood produceth as great or greater effects than in the Lungs when it mixeth there with the Blood invigorating it in an unexpressible way whence we commonly see that the pulse grows stronger and stronger during the bleeding and upon this account I think it may happen that bleeding with Leeches though equal quantity be taken away oftentimes does harm never alleviates so much as Phlebotomy and such persons as by reason of their tender habit of body cannot bear a violent transpiration swoon not by bleeding in water though otherwise they do by reason that the great effects of the Air upon the Blood are impeded by the ambient water the like happens in Scarification with Cupping-glasses and in bleeding with Leeches I did suppose that oftentimes in a Plethora quoad vires transpiration being hindered by the change of the texture of the Body the not-exhaling particles remix with the Blood and there also happens a subsidence of the vessels and change of the porosities so that the Fermentation is is not only clogged with morbose particles of several sorts but so hindered by the subsidence or compression of the vessels and alteration of the pores as not to be able to ferment for freedom of room is necessary to Fermentation nor transpire nor continue its due course nor by reason of the charge of porosities confer aliment aright so that a Plethora ariseth hereupon But as soon as the vein is breathed and the Blood as in your common water-pipes when a Pipe is cut acquires a more free passage that way it presently becomes more rapid and its motion also is accelerated by the fuliginous exhalations hastening to the vent together with the natural Fermentation resuscitated and so the whole boâ—y by a natural coherence and dependance is not only evacuated but altered in its minute texture and conformation It is most evident that the Blood in the Veins and Arteries