beseech you how should bloud letting necessarily weaken Seâ—ing such as are strong and â—ull or Plethorick seem to find the contrary by experience and to justifie it Py. If the sacred Text be not of power enough which warns us of the inhabitation of the life within the bloud it will at least be made manifest if you offend by a more liberal emission thereof For presently the Spirits and the Patient are dejected If 32. The Mathematiks prove bloud-letting alwais hurtfull therefore in the Mathematicks six do hurt notably Three cannot chuse but hurt though not so sensibly Now for him to hurt Nature which should cure her and restore her is not permitted If Nature must be her own Physitian and that she is by so much the happier by how much the stronger let it suffice the Physitian that the Patient fals otherwise into an excusable weakness through the disease fastings wants of appetite unquiet restings pains anxieties watchings sweats and the like and let not him who is called as a faithful helper add weakness unto weaknesses Ph. But is this bloud letting so much cried up and so much used so fraudulent a remâ—dy as you seem to make it Py. It is so fraudulent and so uncertain that no Physitian hath hitherto had the boldness to promise any future cure by it Ph. I but every Artificer doth what he promiseth the Stone-cutter makes Statues the Shoo-maker makes shooes and that undoubtedtedly 33. The incertainty of Physitians argues a defect of their principles why should the Physitian onely want the daring to uphold what his Art promiseth Py. Because he builds upon foundations which are uncertain and therefore he is by accident alone and fraudulently profitable For which way soever the business be turned it is a thing that 's full of ignorance to go about to cure by a procured weakness viz. by a sodain emptying or effusion of the bloud made at once in quantity together Nature is for the most part so danted that she neglecteth the expulsion of her enemy Which expulsion I have notwithstanding demonstrated to contain the whole Scene or Stage of Fevers and of Nature Ph. But besides this is it not confessed that the matter of the Fever consists not in the vein above the heart Py. It is so but what of that Ph. It followes then that bloud letting 34. Bloud letting cannot diminish the cause of fevers draws not by any means the occasional matter or that it effectively cureth by any direct intention of curing if I be not deceived Py. You are not deceived therefore let us go on Ph. To conclude then what say you of 35. An Argument drawn a sufficiente enumeratione the bloud that 's let for the more perspiration of the Arteries Py. That is at the least in the beginnings and increase of fevers fruitless when the heat is not yet in its full strength And seeing that neither in the state or height thereof a vein is to be opened nor yet in the declination when is it good then to let bloud Ph. Never but how prove you that it is good to let bloud in the state or height of a fever Py. Because it hinders the Crisis when Nature as they write strugleth especially being hindered and being for the most part conqueress she may then least of all tolerate the loss of forces or be called from the duel Now if in the height or state Nature be conquered what will bloud letting then bâ—e Ph. A meer Man-slaughter Py. Right but if it be not convenient to open a vein in the state of fevers whil'st the greatest heat and Anxiety or difficulty is extant and the greatest respiration of the Arteries is required it will be certainly much less convenient in the beginnings and increases of them Especially considering that the fear of a fulness goes presently away in the first days of those fevers And by that means the perspiration of the Arteries will be easie enough Ph. What say you to infirmities in their declinations Py. I say it is clear and manifest and commonly testified by the votes and voices of all men that then they neither require nor tolerate any bloud letting Ph. Let us yet further consider in fevers 36. Another from the quality of the bloud the bloud within the veins what say you thereof Py. I say it is either good bad or neither if it be good it will be good to keep what 's good because it addeth to the forces For as I elsewhere shew the fear of fulness did even from the beginning cease if there were any Ph. But they say they let good bloud to cool it and breath out the puâ—refaction Py. That 's needless That is there is neither heat nor puâ—refaction in it as is proved for both are taken away already and that imaginary good which they suppose comes by it bringeth a real and a necessary loss of forces Ph. But they teach further that bloud-letting in a fever is not commanded for the goodness of the bloud since they suppose it to be both ill and puâ—red Py. But I have sufficiently taught that during life there 's no bloud in the veins corrupted and consequently that the scope of the Schools in letting bloud is ruined They must shew me therefore what other malice 37. Whereto the Schools are constrained is in the bloud besides its corruption They must also shew me or demonstrate to me that this bad bloud is detained in the vein from the heart to the hand if they will have their bloud-letting be ratified as such or as a Revulsion They must I say teach us that this ill bloud is not in the first Shops or Offices thereof and that it being drawn out by the vein of the arm there be not worse bloud drawn unto the heart in that place the hollow vein makes the hearts right ventricles Let them in like manner instruct us that the upper veines being emptied there is not a greater liberty and impunity whereby things feverish and hurtful may approach unto the heart then formerly So that instead of breathing out of the purrefaction which I have proved to be truly nothing there be not rather a free access of putted breath unto the heart occasioned For whether doth the vacuity of the emptied veines draw the bloud downward Let them shew me I say by what reason the pouring out of the bloud and the diminution of the forces by the arm should hinder the putrefaction or should import a correction or renuing of what is putred In like manner let them express themselves what they mean when they say that bloud should be let or drawn that the Arteries may breath more freely considering that putrefaction if there were any such thing possibly to bee found within the veins affecteth not the arterial bloud which is the Steward of our whole Nature Let them moreover prove that the good bloud being diminished and the forces also spent proportionably there is greater power in that
many ways Py. Galen himselâ— proves the Minor Teaching that in every fit of fevers there is more Choler breathed out or spent then there is in two dayes generated In the mean time the other members cease not to be nourished by the bloud accustomed that is besides the consuming caused by the fever they likewise consume their shares of the bloud as they were accusâ—omed which I have computed by the humor avoided by vomit in the foregoing Dialogue Ph. But now again may not the same computation with greater permission connivency be intimated and â—e-inforced Py. It may and therefore I say that iâ— 4. A Logistick proof in a sound body there be eight ounces of bloud made daily of necessity there must other eight ounces be daily spent in aliment otherwise a man would quickly grow as they say from a horse load to a Cart load If therefore from a sound man there go daily eight ounces of bloud certainly a fever will not consume less Therefore where there is little or no appetite to meat as little digestion and no more sanguification of necessity also that fulness which we spake of if there were any in the beginning it will presently within two days fail and the indication will cease for so much as concerns the letting bloud in that fever Ph. But how should we know that in fevers there is presently no more of that fulness Py. This is manifest to every one that â— Fulness of good bloud impossible hath an Issue because they are presently dried in fevers neither do they yeeld their wonted matter But here is principally to be noted how the forces can nâ—ver offend in their abundance no not in Mathusalem Neither doth good bloud ever offend in being too much in that the vital powers and bloud are correlatives because according to the Scripture the soul or vital strength is in the bloud and consequently therefore in good bloud there can never be a fulness On the other side I have in the precedent Dialogue demonstrated that corrupt bloud is never contained in the veines Therefore if 6. Never any corrupt bloud in the veines at any time there should be any fulness of the veines possible it should be in a middle state of bloud between that is corrupt and that which is very sound Whether we should consider that state as of Decidency and 7. No fulnes in a neuter stare of bloud Convalescency for Neutrality comprehends both these states or as it is mixed of both those states let Galenists at least remember that good comes of an entire cause but ill out of particular defects and that therefore this state is not called Plethorical or the state of fulness but Cacochymical or of evil juyces Neither doth it require bloud-letting but Purgation rather which may 8. Bloud-letting never indicated by the Theses of the Schools by election or choise bring out the evil and leave the good behinde it And therefore our of their Theses it is not hitherto proved that bloud letting is any way indicated or to be used Ph. How so I pray Py. Because according to the truth of the 9. What Cacochimie in the veines is properly thing I have already shewed that there is no Cacochymy in the veines as being only a disturb â—â—â— of the bloud to the taking away whereof there is no drawing of the bloud required but onely a taking away of the disturbing affect And so much the rather because it is the purâ—r bloud which passing by the centre of the heart hath obtained its purification And therefore that which is drawn out of the arm and comes 10. Co-indications in place of a proper indication and oppofite to contraindications agree but fondly out first of all will be the purer and that which staves behinde will be the impurer Ph. Now seeing it appears there is no fulness in fevers which may require the bloud letting what followes Py. This followes that the Schools having smelt so much they hâ—ve in place of an indication substituted certain co-indications as counterpoising an adjusted indication in Nature and weighing down a contrary indicâ—tion 11. A Proposition of the Author against bloud-letting in a fever which ought otherwise being taken from the conservation of the forces wholly to obtain the prime place in this respect alone that every fever is soon safely and perfectly curable without bloud-letting For in every putrefaction of so many sundry client humors and in the fevers flowing 12. The Schools defame their purgatives by their allowance of bloud letting thence they presently make use onely of the help of bloud-letting bâ—cause as they say it presently easeth and is stopt at pleasure Ph. But do they not by this distinction in some sort discredit their purgatives For they say though bloud-letting seem to be required for a sulness by its natural and onely indication yea and though it do not propeâ—ly 13. The ends of Co-indications take away such humors as putrefied yet it cools and disburdeneth the veines it recreates the forces or spirits it takes away part of the evil humor with the good and by derivation and revulsion it stops and pacifies the flux of humors calling them another way from running to the nest of putrefaction whereupon Nature finding her self comforted doth what is else required much more happily and easily Ph. What said the Sow when she eat up the Penitential Psalms These are good words but they do not satisfie the hungâ—r I mean these are Co-indications whereby they perswade men to continue their afflictions But in these I will particularly give satisfaction Ph. And herein you will much oblige posterity Py. But before all I would have you 14. A forewarning by the Author know That though in a more strong and full body there be no notable hurt done yea and sometimes such as are sick also seem presently to bee bettered and cured Yee bloud-letting cannot but bee dis-allowed considering that such as have fevers are moâ—â— happily recovered without it Ph. Do we not see that at the first or iterated bloud-lettings the violence of fevers is oftentimes remitted Py. 'T is confessed But how comes this to pass think you Note no otherwise then thus The Archeus or spirit of Life finding it self suddainly robbed of its forces and surprised by a disagreeing coolness is strucken with so manifest an horrour that it neglects the expulsion of the feverish matter and to do its duty But those which seem to be â—â—red by Phlebotoâ—â—y they either certainly relapse or at least they come more slowly to their health and when they have obtained it is not so firm as it was formerly Ph. The Turks and a great part of the world make this assertion good unto you which never heard of bloud-letting as being that which is no where read to have beene either instituted by God in Nature or that it was approved by him or that he ever did so much as mention it But now
what say you further in those Co-indications Py. Touching the first scope of Co-indication 15. How bloud letting cooleth which is called resrigeration or cooling I say bloud-letting doth no otherwise cool then as it steals away part of the vital heat Not that it hath any positive power of cooling and therefore at the least in this respect this kinde of cooling must be huâ—â—full I pray you tell me why do they not let bloud in an Hectick fever vulgarly called a Consumption Doth not a fever want cooling Or doth a Hectick cease to be a fever Ph. No for in those who are fick of Hecticks there is a want of bloud Py. Therefore I said that where there is â— detect or want of bloud and strength the hurts of bloud-letting are casiâ—y taken notice of which do otherwise in such as are of stronger forces lye more concealed And of this I could bring you lamentable presidents Ph. Good Sir were it not too tedious or troublesomâ— I should intreat you to recount me one of them Py. I will In the year 1641. on the 16. A lamentable history of the Infant Cardinal â—ighth of November there was a dissâ—ction made of the body of Prince Ferdinando brother to the King of Spain and Cardinal of Toledo Who lying sick of a Tertian fever the space of 89 dayes died at the age of 32 years This noble Prince having his Heart Lungâ— and Liver taken out and by that means his Veines and Arteries dissected there hardly came from them one spoonful of bloud into the hollow capacity of his breast his Liver shewed no bloud within it his heart was limber like an empty purse yet two days before his death he would have eaten more had he been permitted For though he was so â—xhausted by bloud letting purgations and by Leeches as I told you yet the Tertian desisted not to keep its fits accustomed Ph. What pâ—ofit found he tâ—en by this loss of bloud Or how did these evacuations 17. A note against Physitians greedy of bloud to be most seriously regarded cool him Py. Nothing at all they shewed this kind of câ—ring vain and fruitless which took not away one tittle of the fever Ph. Is this then that method of cuuring which makes that Physiâ—an whom the most Hâ—gh created and commanded to be honâ—ured 18. A guiâ—ty minde a thousand witnesses for the necâ—ssity which is of him If it knowes not how to cure a Tettian in a young man whereto servâ—s this kinde of method Is this that Art whereof the infirm have need and not the healthy Py. I would to God this good Prince had never made use of it who when he returned from Cortrick and was saluted by the Senate of Bruxels at his recovery from the agony of death which fell upon him by the loss of so much bloud and forces walked strongly up and down in his Chamber Wherefore let Physitians be wary how they expose their severish Patients to the occurse of coolers I mean such as they should presently and largely finde the vertue of by a manifest token that they trust not too much unto their rules of heaters and of coolers For seeing it is now apparent that all the heat in a sever is of the spirit of life it self it follows that the coolings by bloud-letting is a meer exhausting and impoverishing of that Spirit and the bloud together For if a sever should be cured as a distemper by bloud-letting as a cooling remedy alas the contrary appears by the exhausting of all the bloud out of this Prince Infant of Spain In whom yet three dayes before his 19. An argument taken from thence death the Tertian sever notwithstanding so much cooling kept its courses Or if they by cold alone intend the curing others should also in a Quoâ—idian which they pretend out of a puâ—red Phlegme to be enflamed finde that this cooling would at least with much more easiness be obtained by exposing their Patienâ—s half naked to the Noâ—th and Western Windes or by haâ—ging â—hem in waâ—â—r or in some deep Wâ—â—l â—ill they should confess thâ—y were suffâ—cienâ—ly cooled for so they should presently and â—bundantly do their cure iâ— a guilty inward ignorâ—nce did not condemn their fevâ—â—â—sh essence of hâ—at Ph. It should â—â—em â—hen that a sever is not a nâ—ked dâ—ftemper of heat Py. No it is not but there is an occasional 20. The Essential seat of Fevers offending matter for whose expulsion the Archeus doth by accident inflame it self being as it were displeased with iâ— Which so long as it is neglected by the Schools the cures of fevers will be prâ—posterous pernicious and conjectural and by that mâ—ans no man shall owe any thanksgiving to the Physâ—ian bâ—cause of their own accord through the goodness of Nature they are cured and I wish they wâ—re not put back 21. An explanation of the precedent Argument concerning cooling and the Schâ—â—â—s evasiâ—â—â— and hindered by Physiâ—â—â—ns Ph. But to this Argumâ—nt of curing by sodâ—in cooling I should think the Schools should make some answer Py. They do in saying it is dangerous to pass from one extreâ—m unto another By which excuse of their ignorance they stop the mouths of the people as if they had said something worthy to be credited not taking notice that they contradict themselves therein while they commend bloud-letting and prefer it before laxatives for this cause especially that presently and abundantly it yeelds relief by cooling and therefore they have entituled it the speedy and universal remedy tying their impotency founded upon ignorance to the arbitrement of an Axiom ill understood and woâ—se applied For who doubts but a man may presently cut the hâ—lter 22. Not to go from one extream unto another ill drawn fro the Mathematiks and applied in Physick of one that 's hang'd that he may presently enjoy the ayr whereof he is deprived Who doubts but wee may presently lay a drown'd man shelving downwards upon his belly that he may cast the water off of his Lungs 't is lawful also to draw one that 's saln into a River presently to the Banks side thereof and presently to frâ—e a wound that 's indisposâ—d and close it with a Cicatrice For so many wounds are in one day healed because the solution of union wants nothing more but its re-unition So is it lawfull to put a broken or displaced bone presently into its place again So may we likewise in a fit of Falling-sickness in a fit of Fainting in the Cramp or Convulsions recal the infirm as soon as may be and presently dissolve and call away detained excrements For we must conjecturally think that Nature delighteth in her own destruction or that out of the state of health she presently suffers death to enter and will refuse a remedy which speedily repels diseases Otherwise she should not do that which in things possible is far the best neither should she desire to be or bee conserved In
a slow Consumption and they are subject every year unto relapses Ph. Indeed according unto Galen whosoever is not perfectly cured within 40 dâ—yes fals into a Consumption Py. But I cure perfectly this disease neither are my Patients sensible of those relapses But I keep my secret to my self herein Yet I have seen a Country-fellow cure all 42. The Schools may learn from Rusticks that their Axioms are false Pleurisies in three times giving a Potion He used Horsdung which being dâ—ssolved in Beer he strained it well and gave it Such is the ignorance of Physitians and such the pertinacity of the Schools that God giveâ— knowledge unto Clowns and little ones which is denied to such as are pufe up with Ethnick learning Ph. But now Sir let us see whether there be any use of Revulsion of the bloud in fevers Py. With all my heart for the work of 43. Revulsion a rule in fevers revulsion is primarily nothing else but a bloud-letting or vein-cutting whereto by accident it is hoped that the following bloud should come and by benefit thereof thâ—t it will not flow unto the part affected Ph. What may be grounded on this Thesis Py. That by this kinde of evacuation the offending feverish bloud I speak this winking dispersed in the veins which otherwise hiding it self in its own nest far from the heart would not so fiercely communicate the ferment or Leven of its mischief Which is as much as to say by this Revulsion it will come to pass that the peccant humor would be drawn from an ignoble part to one more noble In that the more câ—ude and feculent bloud is in the Mâ—saraick veins but that is better purefied which comes nearer the heart Otherwise Nature had been indiscreet to place the main murthering weapons or instruments of paâ—â—icide so near the fountain of life Seeing therefore the feverish matter flowes or floats not in the veins nor hath its mansion near the heart God forbid we should beleeve that it is stirrâ—d or moved from place to place by vein-cuttings or bloud lettings howsoever otherwise by re-iterated Phlebotomy bloud may be drawn out from thence of divers colours Ph. If then another bloud come from remote parts to the place whereout the bloud must issue I should think that this may prove a dreadfull remedy Py. You think as it is for by that means the mischief of one particular place should be communicated to the whole and so unto the parts more noble and there is an easie mingling and defiling in or between such things as symbolize partake or communicate each with other Ph. Now growing to the end of our discourse what if our Modern men should cast away these Ethnick errors and look more carefully into the lives of their neighbours should they know any thing the more hereby Py. In this place they would know that 44. What is by Physitians to be learned out of this Dialogue the Comments of Revulsions are frivolous that the loss of the treasury both of bloud and forces is pernicious also that no hurt results from the bloud in the veins but onely from the enmity of strange and forraign excrements As also that God hath ordained sufficient store of emunctories for any sort of filth that is within us And that we need not tear the veins to get the victory of fevers THE FIFTH MEETING OF PHILIATRUS AND PYROSOPHILVS About the Examination of Purging in Fevers Ph. YOu spake in your former discourse of two remedies which you were to examine Bloud letting 1. The first confession of the Schools about their pâ—rging Medicines and Purging the first is ended now to Purging Py. The Schools acknowledge that their Putgatives from the highest down as far as Agarick want correction because they injure Nature And I would those corrections were not weak and unadvised but serving rather to beget an innocency of the Medicine then to the Gelding or taking away the strength thereof Ph. Why wish you this Py. Because gelding the strength of Medicines 2. Deceit of Correctives carries a deceit along with it as done by reason that the sick might not understand that there is a venome under it Likewise the hemlocked Shop-remedies are like tame Wolves who while they are trusted turn upon occasion given to their accustomed wild and Wolvish nature By this means they dare not call corrected Medicines by their proper Etymology but they hide Scammony under the veil of Diagridium And they besmire Colloquintida with the paint of Alahaendal And then the compounded Purgatives in Dispensatories fight under a false title of ringleader In the mean time they cannot 3. Another confession deny but Scammony and Colloquintida are the two Pillars whereon the whole edifice of Purging leaneth which being broken down what ever was built upon them fals to ruine And then the gentler Purges as Manna Cassiâ— Sena Rheubarb c. have rendred or given over to those two anti-signant Leaders or Conductors They confess 4. A third confession furâ—ther that a Purgative once given is no longer in the power of the Physitian And by this means they defame Purgatives and give the precedens to Phlebotomy Ph. But what if a laxative work more cruelly then it ought to do Py. Then do they blame either the dose 5. Foul excuses thereof or the correction or the fluid Nature or looseness of the Patient or the Apothecary or at least his Wife before the Purgative should lose its credit Yet in the mean 6. The 4th Confession season whether they will or no they do confess that all Solutives contain a poyson in them onely they have excepted innocent Aloe by a proverb Sola Aloe innocua But the râ—st must be exhibited with additament correction and circumspection and that neither too soon nor yet too late but in the proper time of giving Ph. Why are there any Presidents of their mischief otherwise Py. â—â—e tell you one A judâ—cious man and 7. A frequent history Secretary to the Senate of Brabant for consâ—â—vation of his health took a usuall Pill of washed Aloe viz. gelded and not finding the accustomed effâ—ct thereof as the Physitian passed he told him of it He presently blamed the slowness of the Aloe and told him he would prescribe Maial Pills for him which bâ—ing taken he perished miserably Because the whole Weeks labour after was spent in vain to pacifie the unbridled effect of that purging medicine For he to free himself of a future infirmity by the deceipt of his Physition died leaving eleven children fatherless Whence it primaâ—ily appeareth plainly that it is as free for a purgative to shew its raging fâ—ry on a sound man as a sick one For its lawfull under the name of a Physitian and fraud of a medicine to run headlong unpunished even upon the lives of Princes Because the earth covers the cruel illiterature of the curers Ph. Purgation or Depuration I must 8. Deceit in the â—â—me
things known to the senses it is true that in the beginning of a fever the sick are sensible of a real coldness but it is a false one and a fraudulent deceiving of the senses For though they are cold outwardly yet inwardly they are hot and bnrn with a true heat though the patient thinks otherwise Py. These are such as would rather not see or not be sensible though their eys be open But these are madnesses which every country fellow will hush out of the middle of a village In that for some hours the entrails are possessed with a most eager or intense coldness For in so plain and undoubted an history of cold which is of fact and sensible the argument which they produce 9. A loose argument of these men is very feeble they say there is inwardly a great heat though the Patients feel it not their reason is because they are oppressed with a continual thirst which as it is primarily a figne of siccitie so this siccity in living creatures presupposeth an heat equal to it And that from hence thirst deserves to bee of greater authority then sense is Ph. What say you to this assertion Py. I say they know that this thirst proceedeth 10. Feverish thirst examined not either from heat or driness as doth in a thirst that is natural Ph. How make you that good Py. Thus If this thirst did proceed from 11. An argument from the remedy of thirst heat or driness it would regularly be quenched with drinking therefore this thirst is deceitful and not that coldness Ph. From whence then should that thirst in the beginning of fevers have its original Py. From an excrement which ill affecteth and deludeth this sensitive faculty and the Organ or Instrument thereof in the same manner as if a great siccity or drought were sodainly come unto it Ph. Is this probable Py. Probable enough in that I am sure our adversaries will not allow the curing of driness by most dry remedies but by cold and moist potions rather But this thirst in fevers which we now speak of is cured by a remedy that is in it's self most dry and corrosive Ph. Good Sir what remedy may that be Py. Th' Acidite of Sulphur which quencheth this dâ—ceitful thirst in the same manner as fire is extinguished by water cast upon it Ph. But why may we not out of invincible 12. An argument a pari taken from sleep sleep or drowsiness often seen in the beginning of fevers by a strong reason guess at coldness in that beginning then they do of heat or driness by that thirstiness Py. We may doubtless and so much the rather in that the Schools affirm that sleep comes as well from an invincible coldness as thirst proceedeth from a driness Ph. But makes it not against us that sleep assaults us not in every fever Py. By no means for it sufficeth yea and it bringeth greater confusion that sleep is frequent in some patients Ph. But tell me what time or station 13. Another from thirst in the state or vigor of a feverish fit of a feverish fit is hottest whether the beginning augmentation state or declination Py. Certainly the state or vigor when the interior parts are sensibly perceived to bee most hot and in greatest trouble Ph. But are they of that opinion Py. No. Ph. Why so Py. Because in the state they say the thirst is not so great as in the beginning Ph. Now if this thirst bewray heat and that it be a signe inseperable of or from heat so that such as tremble with cold may be notwithstanding said to burn I should think the greatest thirst should oppress Patients in the hottest station of the feverish fits Py. But this they deny Ph. What evasion will they now have Or which way will they turn themselves being catcht and intangled in their own net Py. Therefore I say whosoever they be who judge of the native roots of things from accidents which follow by accident are in an errour Ph. Then assuredly if a fever be ill defined 14. It proceeds froÌ„ a deadly ignorance not to define a fever rightly and if they cure that fever after this definition it may doubtless prove a deathfull ignorance in the definers Py. Nay more by the Cornelian Law of privy murtherers the Magistrate is to proceed against such as obstinately cure amiss those patients which trusted their lives into their hands as being such by whose offence so many thousand thousands are unfortunately killed Ph. Well then if a fever or a feverish 15. An argument against the Schools about feverish heat heat should first be kindled in the heart and yet the matter of fevers which they hold to proceed from one of the four humours putrified consists not in the ventricles of the heart what followes Py. It followes that this heat or fever is not first kindled in the feverish matter and that they in vain seek after putrefaction who would finde and intimate and an immediate cause of a preter-natural heat Ph. Then is this definition of a fever ruined Py. It is so and moreover it followes 16. Another thence that a fever is not primarily effectively and immediately existent in its matter whence it is caused as they would have it materially and originally Ph. No where then I pray Py. In the heart It follows also further from the same Thesis that to make a fever it is not required that the offending and feverish matter be kindled Ph. What then I pray Py. Another inflamable thing which hath its residence primarily in the heart and is from thence issuable through the whole body Ph. What inflamable body should this be Py. That which I with Hyppocrates call Spiritum impetum facientem the invading enterprizing or way-making spirit Ph. Whence I pray you bring you this last doctrine Py. Not from the Ancients but I have 17. A third wrested it out and by force commanded it to be granted to me Ph. Shall you have any occasion to speak of this any where else Py. I shall when wee come to discourse of the efficient cause of fevers In the mean time this being violently obtained it follows at least that the peccant or offending matter of fevers is not properly kindled neither is it in its self primarily and efficiently hot nor heats it preternaturally if the first inflamable must be kindled in the heart Nor is the peccant matter thereof hot above or beyond the degree of Nature in a fever But that which is kindled in the heart was not inflamed before the fit of the fever and by that meanes it altogether differeth from the peccant or offending matter in fevers Ph. It may fitly then be hence concluded 18. A fourth that whosoever goes about to take away a fever by coolers hath no intention to cure by taking away the causes or cutting up the roots or by draining and emptying the fountain thereof or that which doth exile
the colour that is whiter or blacker then it should be or by the yellowness greenishness or brownness of it Or by the matter as being too clammy too thick too waterish too thin Or at last by the substance as being without fibers and scarce coherent c. But I declare or protest unto you under penalty 25. Example out of the variety of bloud of a convicted lye that if any man would make proof thereof he shall finde that many of the blouds of two hundred Country fellows sound and wanton as those were which in one day were by me examined he might finde as I found many of them to view very unlike the rest in colour matter and consistents of which I distilled many and in cuting found them to be equally wholsome for our Peasants are wont the second day in Whitson week to let bloud that they might drink more freely And though many of them seemed putrefied rusty like Iron or melancholike yet those from whom these blouds were taken were all very sound men which is a thing worth noting Therefore these blouds did by the cause confirm themselves notwithstanding the signes of corruption to be no whit alienated from the nature of the Balsam Ph. What thought you then Py. I thought not so much as I laughed 26. A ridiculous fable of bloud drawn at the table of Judgements upon the sight of bloud after Phlebotomy and this means I was confirmed and those blouds were commanded by Physitians to be kept that they might score up at least one visit more upon the recovering of the Patients For if corruption 27. An argument from the Plague against use of the Schools of bloud have place any where and should under that title indicate its letting out this should be rather in the Plague then in any other infirmity But it s a deadly thing to let bloud in the Plague there putrefaction is no where in the bloud nor is there any fear that putrefaction should grow strong therein And consequently the scope of bloud-letting is in this case erroneous Ph. Could you not illustrate this passage better by some instance Py. I could and will And therefore I 28. Another from the Pluriâ—ie suppose also that thirty men were equally sick of a Plureâ—ie and ten of them had by Phlebotomy drawn bloud apparently vitious for the bloud in this disease is like red Wine wherein are clotts of Milk I will cure the other twenty without bloud-letting It is certain in the mean while that these twenty had their bloud affected in the same manner that those ten had And again that those twenty cured if they should open a vein the bloud would be found rectified restored to the former perfection and far different from Pluritical in all or any of them Therefore the bloud of one that is Pluritical is not corrupted though it seem so Ph. May this be proved Py. It may for from a corrupted or deprived thing there is no going back again to life health or former habit Therefore no blackness blewishness greenishness or other such like colours of the bloud do testifie the corruption of it but onely tell us the tokens of a boyling or a fermental turbulency or troubledness For if the more watry or yellow bloud should especially tell us the faults thereof the arterial bloud should bee far worse then that of the veins is which were an errour in that the bloud is in the same manner distinguished by the former signes as Wine when it is troubled while the Vine is blooming which is not therefore corrupted because the trouble being gone the Wine of it self doth come cleâ—r again In like manner a fever diversly disturbs the bloud and makes the face thereof of sundry ill colours But 29. Heats and turbulences of bloud no testimonies of its faultiness But the Bug beats or Scare-crowes ceasâ— when the fever 's over Indeed I am wont to liken these men that look into the bloud to such as give their judgement of Spanish Wine and think they are casâ—ing of an Urine Ph. But they will say If putrefaction be 30. The poor deceit of the Schools not in the bloud why streams it not out of the vein purely red the third time and not the first or the first and not the third time Py. This argument at least convinceth that one part of the bloud is more or sooner disturbed then another and not the whole and all together For it is certain that Nature tendeth 31. Ridiculous to suppose putred humors in fevers to the perfection appointed her by little and little and by a direct and lineary way And that therefore the bloud near the heart is purer then about the first shops or offices thereof And that is the reason why they say a Tertian as well continual as intermittent consists of Choler a Quarran of Melancholly and a Quotidian of Phlegme but all putred and they err therein For what necessity had they to suppose these humors which I have elsewhere demonstrated to be fictious putred seeing they confess a Synochus continual and more cruel then the three former not to be putred Which if they be conferred with the proposed definition of fevers the bloud in every Synochus and the spirit of life in a Diary Ephemera or Day-fever must of necessity in life be putred that is they will have attained or be arrived to the bound of putrefaction Then whereas 32. Some absurdities alledged against the definition of fevers in the precedent Dialogue the Schools confess that these putred humors do not consist in the ventricle of the heart and that therefore they are not primarily kindled in a fever by this meanes putrefaction is consequently in vain required to the kindling of a feverish heat in the heart If therefore the putred humors shall a far off inflame the spirit in the heart this by all law of Nature should first be done nearer hand then at a greater distance and should rather inflame all the intermediating bloud by the heat of putrefaction and so all must give a necessary putred Synochus Whereupon the Quartan shall neither stop it's course nor make it's recourse if the same putred matter of it can lie quietly in expâ—ctation in the Spleen for a year together Gangrens teach me certainly that nothing which is putred for every thing that 's putrefied is dead can long persist without further contagion Neither am I capable how the very spirit of Life it self the Archeus shall become putrefied 33. A â—rivolous excuse by an Ephemirâ— to give Galen satisfaction for a Diary But if they understand a Diaria to be the daughter of that putrefaction which at last is inserted or comes into the spirit of life So all fevers in the Schools should be Diaties To conclude if a Diaria be the daughter of putrefaction it is then presupposed to be fermented with the spirit of life whence they fall again into the same straights But if
the Mathematicks it 's thought impossible to pass from one extream unto another without a Medium and this Medium peremptorily and utterly denieth the comming of any thing between it and those extreams which if we shall allow with some Latitude in things natural yet we may be thought to have done speedily sufficiently and very well And therefore we ought not to wrest that of the Mathematicks unto curings I confess indeed we shouâ—d not by a Paracenthisis draw out all the water of an hydâ—opical body at once together nor should we take away all the puâ—ulent matter of a great Aposthume not bring one that 's congealed with cold into a warme Stove presently nor yet nourish one that 's almost starved too too speedily But yet a slow and necessary pace as such or a progress by degrees from one extream unto another doth not hinder or restrain this Mediocrity or Medium as if Nature were averse from speedy curing for this to her is an ordinary allied innate and intimately proper indication But these are forbidden because the loss of strength or spirit thereupon depending would not endure these so speedy motions Therefore the Schools do 23. A falacie in curing by a fallacy tie up their Patients from a suddain remedy which they have not that they may hide their ignorance from the vulgar by some Axiom â—ll directed Ph. I should think that so oft as a cure may be had without loss of strength for the strength must ever have the primacy in indications the sooner it is done the greater is the Jubilee which Nature gaineth Py. You think aright and I have observed as much in fevers to my great content and admiration To our purpose therefore if it be so that a fever be meerly a preternatural 24. The Argument out of the Thesis of the Schools is opposed heat and that every cure is to be accomplished by striving contraries therefore it requires a preternatural cooling that contraries may be placed under one and the same kinde or Genus That is every fever should be necessarily cured by a more then ordinary coldness of the Ambient and the rather because the Ambient coldness gathers forces and doth not dissipate them But the consequent is false and therefore the anâ—ecedent also Ph. It should seem then that the Schools intend not the cooling of the heat by bloud-letting but primarily the taking away of bloud and mitigation of accidents which wait upon the dejected forces or they primarily intend a diminution both of bloud and forces This is that which they term a more free 25. Deceipt of the Schools out of a perverse ignorance respiration of the Arteries though with much deceitfulness But I alwayes make greatest esteem of that indication which concerns the conservation of those forces and is quite opposite to all emptying of veines how and whatsoever because the forces being diminished 26. Strength hath chiefest place in indications and cast upon their backs the disease cannot be chased away neither is there any thing further to be done by the Physitian Therefore Hippocrates concludes that the natures themselves are the curers of diseases because the indication which is taken from the conservation of the forces is that which governeth the whole scope of curing As reason therefore counsels us to keep our strength and forces so also she would have us keep our bloud because the one includes the other as the bloud the forces Ph. But Hippocrates in an Athlatical fulness commands us to let bloud presently together and in quantity Py. You say true and that is it which 27. Hippocrates de Athletis alledged but not understood the Schools proclaim in every place but this is ridiculously alledged for cures of fevers and diseases For he commanded it not out of fear of the fulness though their veines did sufficiently abound with bloud but onely that their vessels so filled might not by the exercising of their strength be broken or overstrained otherwise what have Wrestlers which are found to do with cures belonging unto fevers For the feverish have no fear of fulness nor that their veins should be broken with exercise It is further to be 28. Differences of emptyings noted that the letting of bloud is of this condition that if it be done after the accompanying of women it makes such an exhaustion of the strength as is irreparable because it takes from the in-bred spirit of the heart And to this exhaustion of that spirit by bloud-letting is a very near neighbour because it doth readily and at once rob the influous Archeus But a disease though it directly also oppugne the forces yet because it doth it not at once and together but by little 29. A fever hurteth less then the opening of the veins and little therefore it rather shakes and wearies the forces then that it doth exhaust them really Therefore the restoration of the forces impaired by diseases is made more easily then of those which are exhausted by bloud letting Ph. I should think so too but what 's your reason for it Py. My reason is that such as are weakned by bloud letting are for the most part deprived of the benefit of a Crisis And if they do recover it is but slowly and that with many perplexities in their getting up again after many dayes indurance and not without danger of relapses But such as lye sick of a disease wherein bloud letting hath not been used come presently to their wonted strength again and are restored easily But if by being destitute of remedies they sometimes come unto the extremity yet Nature endeavoureth a Crisis and relievs them because their forces though shaken much by the infirmity yet they are not perished as being not exhausted by their bloud letting which they so speedily and abundantly Ph. 30. Th' obligation of Physitians Hence may be gathered that the Physitians are out of Conscience and in Charity bound to cure not by sodain wasting of the forces nor by dangers consequently following it nor yet by a necessary shortning of the liâ—e for according to the Psalm Spiritus meus attenuabitny ergo dies mei abreviabuntur Py. 'T is well gathered And since according to the Scripture likewise the life glideth in the bloud however this be taken awâ—y largely together it cannot be done without prejudice of the life also For the 31. The general intention in fevers and bloud letting opposed thereunto perpeâ—ual intention in Nature in the cure of fevers is to do it by sweatings and therefore also the fits of fevers do for the most part end by sweatings Ph. But you think that bloud letting is diametrically imposed to this intention Py. I do so for this draws the bloud inwards to fill again the vessels which are emptyed thereof But the motion of Nature requisite â—o thâ— cure of fevers proceeds from the centre and goes outwards from the noble parts and bowels unto the skin Ph. Yet once more I
which is remaining impure and tainted by puâ—refaction as they suppose of preserving it self from an imminent purrefaction Again let them teach against the Holy Text that the life and soul are rather and more willingly in the defiled residue of bloud then in the puter taken away by bloud-letting Otherwise regularly the drawing out of the good includes an increased proportion and an unbridled liberty of the bad remaining Ph. But what if at last the bloud in the fever and veins be bad and they say ' â—is good as a signe and effect that in the letting of the bloud the bad comes out and that they think that so much at least of the bad is taken away Py. First let them prove that bloud which they suppose hurtfull to be truly hurtfull as I have formerly proved it guiltless And then let them teach that by the hasty and full emission of this bad bloud there is no prejudice brought upon the forces and that in the residue of the defiled bloud the forces being now decreased the taking away of the bloud will be cause why the corruption of that which remaineth is of less power to go forward And whether they hope at any time that in the bloud howsoever once infected viz. by this privation a regress may be given in Nature to perfection For let them shew that it contradicteth not that it 's proper to a fever to pollute the bloud and 38. A vain hope in the changes of bloud drawn by Phlebotomy that this property is taken away a posteriori viz. by removing what is purrefied For if first the impurer bloud be drawn out of the veins and they again open the vein and in the mean time deject and trouble or disturb the forces and by this means take away the hope of a Crisis what if it then come out more red then formerly Ph. They will then certainly cry out as if all the quantity of the bad had been taken away by the first effusion and that the seat of the fever was extended from the heart unâ—… the arm onely and that the good had its residence about the Liver Py. But in a Dropsie I have noted that the evacuations of the last excrements were alwaies to be feared and much more therefore in the naked drawing out of bloud which leads away the vital spirits from the heart in a direct course thorow the wound whether it be deemed bad or good or neuter Ph. You have first proved that they offend in a fallacy as well as in those things which are supposed of a Synachae or burning Petitione principii fever both purred as of those which are conceived of the emission of a purred bloud Now therefore to our purpose what think you of the helps are gotten in lieu of the forces which are taken from us Py. I always found them full of deceit that for so little a help the strength should be infeebled by bearing the burthen of diseases for it is as drink in â—he beginning of a fever which seems for a while to give a refreshing but is any man so mad as to drink if he knew that drink did rob him of his forces Ph. You conclude then that the help of cooling by bloud-letting is trustless fraudulent and momentary But now what say you of that neuter bloud which is nor good nor bad in letting Py. Of this it is best to say nothing in that what is denied in dis junction may be denied also in copulation For if that be neuter which consists of a commixture of good with bad supposing that bad which is not Or that whereinto a neutral alteration is introduced what is formerly said may satisfie the event in either of them Ph. Have you not yet done with Co-indications Py. I shall at length when I have cut off the hope which is in revulsion and so I shall equally take away all co-indications as the poor and miserable sculking-holes of perversness It is a mad remedy to let bloud for 39. Co-indication of Phlebotomy in fevers Menstrue for Revulsion a vanity to this end they draw a great quantity whether it be in fevers or in the menstrues for revulsion in that the feverish matter swims not in the bloud or floateth up and down the veins but sticks within unto the vessel as I shall tell you in its own place when I speak of the occasional matter And for the Menstrue likewise in that the separation therof is made out of the whole and not without the separating hand of the Archeus But Phlebotomy separates nothing of things separable because it works without a fore-knowledge of the end and therefore without election But the nearest always runs out first and as soon as the vessel is open away goes the innocent bloud which because after by a continued thread others follow for fear of vacuum therefore the Menstrues about the womb or Mother collected there by the industry of Nature and of set purpose are drawn from thence by bloud letting and retire back again into â—â—e whole what though Phlebotomy may sometime in a full and well complexioned woman finde success yet certainly in many others it hath given a most miserable catastrophe Ph. But what if the menstrous bloud should offend onely in quantity while it is now gathered together and set apart in the veins about the Mother Py. In this case supposed I shall willingly admit an individual indication of Phlebotomy But if Menstrue flow in a womb that 's well conditioned it will abundantly satisfie and do its own business And in this case revulsion is useless though the Hypothesis suppose an impossibility For Phlebotomy is nothing but a meer and indistinct powring out or ensptying of the bloud But the emptied veins presently recal unto themselves what bloud soever and whence soever for as they are the greedy receptacles of the bloud so they are impatient of emptiness And therefore the menstrue being destin'd to it's departing that is already once written 40. Derivation in topical diseases somtimes profitable But impertinent in fevers or inrold by Nature in the catalogue of Excrements is drawn or sucked by the empty veins But derivation because it is a sparing letting of the bloud so it be done out of fitting veins was wont often to be profitable in many topical diseases but in fevers ' â—is impertinent Ph. But they insist upon this that bloud-letting 41. Bloud lettin hurtful in Pleurisies in a Pleurisie is so necessary that it is enjoyned upon pain of death to be made use of For they say that unless this bloud which hath recourse unto the ribs be called back by much effusion thereof it is to be feared that the Pleurisie will presently kill the man by sâ—ffâ—cating of him Py. But I never let any man bloud that is sick of a Pleurisie and this kinde of curing is safe certain solid and commodious None fail that run this course whereas by Phlebotomy many of them perish through