if it appeare yellow and thin let him straightway suppresse it CHAP. 5. Whether letting of bloud be to be admitted in the plague or pestilent feuer as also in the Pox and such other contagious infirmities and when and how AVicenna in his eeuenth canon concerning bloud-letting as Montanus hath deuided them doth set it downe for a rule that in what agues soeuer there is a most vehement inflammation there must be no letting of bloud Montanus discoursing vpon that place sayth that we must regard not so much what the disease requireth as what the strength can beare In respect of the disease Phlebotomy doth agree but not in respect of the powers He bringeth in an instance of a pestilent feuer and sheweth that bloud is not to be let in it because although of it selfe in regard of the pestilent feuer there is no greater remedie then letting of bloud seeing that by it the body is made apt to vent and vapour out the spirits the inward heate is extinguished and putrified bloud is euacuated yet if bloud be let all do dye and therefore we must absteine from Phlebotomy in the pestilent feuer because in a moment of time the strength vtterly decayeth Platerus sheweth sundry great dangers which letting of bloud doth bring vnto them that are infected with the plague and that little good helpe can be expected thereby I can not see how Phlebotomy can auayle to pluck that venemous quality from the heart or to bring it out of the body together with the bloud seeing that it is rather procured thereby that the infection which from outwardly commeth into the body and doth presently infect the spirits should be drawne more deepely inward And moreouer the motion of nature whereby straightwayes in the first inuasion it goeth about to shake out the poyson by sweates by outward pustles and by botches may be hindred by letting of bloud and the powers thereby weakened which we ought to keepe strong to expell that poyson It neither doth auoyd the cause of the disease neither is there any neede heere of any euentilation of heate seeing it is not heere so vehement Hereupon he concludeth that vpon rash and vnaduised letting of bloud in plague times many meÌ„ are killed Yet he acknowledgeth that when the plague hath taken hold vpon bodies which are summè plethorica vel cachectica full of bloud or of corrupt humours whereby a feuer is kindled then if by opening of a vayne the plenty and putrefaction of the bloud be taken away all the other symptomes will become more tolerable but that must be done sparingly and with a due regard of the strength And if in the beginning strength be decayed then is Phlebotomy not to be admitted though the fulnesse of the vaynes doe require it for of lusty youthes we haue found by experience more to escape in the plague time without letting of bloud then by letting of bloud If Phlebotomy be vsed it must be done rather in respect of the feuer then of the pestilent qualitie seeing that this venome doth not consist in the bloud but comming from outwardly doth sodainely possesse the heart and we do not thinke that it can be expelled or drawne out from it by Phlebotomy And if the case do so stand that by the meanes of the plenitude and feuer a vayne must needs be opened then he sheweth in what order it must be done First it must be done in the beginning for vnlesse the vayne be opened within 24. howres of the beginning it will rather hinder nature then do any good Also it must be considered whether the party be in a sweate or no for in no wise must the sweate be hindered by Phlebotomy But after the party hath sweat and hath bin refreshed with a little meate or some cordiall receipt then may a vayne be opened howsoeuer there hath gone no clyster nor purging before because the time hath not giuen leaue Choose the vayne in that side which is most grieued If any eruption appeare about the flanck open the saphena If in the vpper parts then some vayne in the arme or hand of the same side If vnder the arme-hole take the basilica If about the â—ares the cephalica If in the face open the vayne vnder the tongue And euer to the botches appearing let cupping glasses be fastned that the poyson may abide in the same place and not by Phlebotomy be drawne into the inward parts Trincauel doth accompt it very dangerous to let bloud when pimples do outwardly appeare but when as well by the pulse as by the former manner of diet which the party hath vsed it is found to be expedient then let it be done straight in the beginning before the putrefaction of the pestilent feuer be much increased and before nature do seeke to expell vnto the skin Thus he prooueth out of Galen who commenting vpon one of Hippocrates his patients called Crito who dyed vpon a kind of pestilent feuer he doth excuse Hippocrates and sayth that he did not let him bloud because he was not sent for at the beginning of the disease Which signifieth that if he had bin sent for at the beginning a vaine no doubt should presently haue bin opened Montanus in his epistle to Crato doth allow letting of bloud in the small pocks and such other contagious diseases so that it be in the beginning before signes of putrefaction appeare but when it hath once preuayled then to let bloud he doth call it a pernitious and a deadly thing For nature is then checked when it should wholy be intentiue to expell the venom and infection of the disease Fernelius Hollerius and Syluius three famous and worthie Physitions consulting about the sweating plague called sudor Anglicus did deliuer to the English Embassadour the vse of bloud-letting amongst the meanes to preuent the disease in full bodies the bodies being first orderly purged but the disease hauing once taken hold they aduised no bloud-letting but prescribed good cordials to expell from the heart the venemous infection But in that which is commonly called by the name of Plague although the body be already infected yet if it be corpus pletharicum the notes whereof are in the first Chapter of the booke next ensuing wee may be bold to begin the cure with bloud-letting obseruing as neere as may be the cautions before expressed and especially taking heed as Montanus giueth warning that wee choose the vayne as farre as we can from the principall parts from the heart liuer and braine for if we draw the pestilent humour vnto them he sayth we shall kill the patient CHAP. 6. How letting of bloud is to be vsed in phrensies quinsies plurisies inflammations of the raynes or wombe and other inward inflammations happening often without agues IN the phrensy which is a deprauing of all the principall faculties of the braine caused by the inflammation of the filmes thereof Rhazes doth allow Phlebotomy in the
vrine Secondly whether he haue bin wont naturally to abound with many ill and vicious humours and whether any outward signs therof haue appeared by itches pustles ring-wormes swellings inflammations and such like Thirdly whether any accustomed or naturall euacuations haue lately ceased as vomits hemorrhoides fistulaes fluxes bleedings at yâ— nose termes sweats and such like Fourthly whether they hauing bin accustomed heretofore to auoyd superfluities by Phisick and haue of late neglected it and not vsed such purgings vomits and bathes as heretofore they haue done Fiftly to examine not only the vrine but other excrements as egestions spittings sweates for as he sayth a little after The sweate declareth what humour aboundeth in all the body for it is whiter paler or yellower according as the humours be more or lesse phlegmatick or cholerick and if the humours be puâ—rified the sauour of the sweate will greatly bewray it But in matters that do concerne the vaynes as doth especially Phlebotomy Galen will haue vs especially to respect the vrine We haue no effectuall and euident signe to discerne the superfluities that are in the vaynes but only that which is by vrine If the humour be altogether crude and raw the vrine will be thinne and watery and neither haue any hypostasis or sediment nor haue any cloudy matter hanging in the 〈◊〉 but when it is concocted these things do appeare and besides some thinne clowdes do swimme vpon the top If the thinne and thicker parts do quickly deuide and that the sediment be white and smooth and in euery part equall that sheweth that straightway care one can speake the word nature will euercome all If it be longer care the separation be made longer it will be care the humours be ouercome But if in the vrine there be no separation at all but that it remayne still as it was made or else if it do breake it be with a bad sediment then is nature weake and hath neede of some other help to digest the humours Many other signes there are of crudities as the small quantity of vrines signifying that by their rawnesse they are hardly sent out Likewise the thicknes of vrine shewing abundance of raw humours and thereupon depriuation of concoction Further the ill contents in vrine and the inequalitie of the palses but these and many other signes of diseasy crudities must not stay vs from letting of bloud if the greatnesse of the disease do require it and the party haue a full body and sufficient strength but rather as Fernelius sheweth when signes of crudities are we must vse Phlebotomy as the remedy Only touching our food last taken let the stomack bowels and if it may be also the mesaraick vaynes be cleared from raw and corrupt humours and let such a time be chosen wherein also the disease hath most quietnesse from the motions of the paroxysmes The greatest rest is in the middle time of the intermission or remission for so shall we be in no danger of drawing the inflammation into the greater vaynes whereby of an intermitting feuer may be made a coÌ„tinuall and the powers also of the patient shall least be indangered But seeing so often Galen and all Phisitions in the matter of Phlebotomy do still make their prouisoâ—s that the powers be not dissolued a question may here be mooued of what powers they do especially speake and how the strength of those powers shall be knowne Galen describeth three powers in man the first he calleth the naturall or nutritiue power that hath his fountaine in the liuer and conteyneth vnder it the attractiue power the retentiue the expulsiue and the fourth the alteratiue power which is generally to turne the nourishment into substance and particularly to make bloud The second vertue or power is called the vitall power hauing the seate in the heart giuing life to the whole body and conseruing the essence of the vitall spirits The third he calleth the animall or rationall power hauing the seate in the brayne and bringing forth sense motion and vnderstanding Each of these three powers haue their particular instruments to worke by To the naturall power do serue the vaynes to the vitall the arteryes and to the animal the sinewes Now which of these powers in letting bloud must most be respected No doubt there must a care be had of all for as Galen sayth there If any one of them do perish it must needs be that all the rest shall perish also And giuing precepts of letting bloud when he hath taught how we shal try the animall power by the voluntary motions and the vitall by the pulses and the naturall by good or bad nourishment or by good and bad colour he concludeth generally when these powers are strong let bloud So whereas Hippocrates doth bid vs when diseases are in the vigor to rest and not to vse phlebotomy or purging for so Galen doth expound it Galen doth giue the reason there of it because the animall power is then weake and in danger although the vitall and naturall be strong Yet certaine it is that the vitall power is that which chiefely we are to obserue in Phlebotomy as he doth elsewhere at large declare The greatest dignity of all is that which concerneth the actions of the heart and of all most needefull to be considered in them that are sick He doth in that place compare the operations of the liuer and of the brayne with the vitall powers of the heart but he will haue the heart to be principally respected In extreame apoplexies the animal powers are decayed yet because the vitall powers are not extinguished Phlebotomy is allowed and doth often worke good effect That is the cause that Galen doth giue out that precept in his booke of Phlebotomy In all these former rules thou must still haue an eye to the strength of the party touching his pulses By that word touching his pulses he sheweth both that the vitall power is most to be regarded and also doth point out the meanes how we shall take triall of it to wit by the distemperature and the inequalitie of the pulses CHAP. 6. Of the time of the yeare the time of the constellation of the planets and the time of the day most fit for letting of bloud THe best time of the yeare for Phlebotomy is knowne of all men to be the Spring according to that aphorisme of Hippocrates The Spring must be the time of letting bloud and purging The Autumne is in fitnesse the neerest vnto the Spring The extremitie of the heate of sommer is most dangerous as Galen sayth hauing named a little before the canicular dayes They which are sinisterly euacuated in very hoate times of the yeare do perish either with sâ—ounings or with resolutions The extreame cold also of the winter will not permit Phlebotomy or if it do it must be little Montanus giueth the reason because the body is ouermuch cooled and is also
or by deriuing meanes as in agues by sieges vrines and sweates in a ripened pleurisie by spitting in inflammations of the liuer if they be in cauo hepatis by soluble medicins if in gibbo hepatis by things diuretick or causing vrine And the more to condemne Auicen Fernelius doth plainely auouch that letting bloud is most fit then when signes of crudittes do appeare At what time so euer yea if it were the twentith day of the sicknesse if signes of cruditie do appeare we may open a vayne for we measure Phlebotomy not by the number of dayes but by the concocting of the matter and the dissoluing of strength If neither of those do happen Phlebotomy may be vsed Montanus interpreteth the meaning of Auicenna that when he will not haue bloud to be let before concoction he doth ayme especially at such diseases in which a thick grosse humour doth abound as in quotidians and melancholick feuers whose humour being tough and raw would be made more rebellious if bloud were taken away First therefore he wil haue that humour to be concocted and euacuated and then if it be thought conuenient to open a vayne if the bloud be corrupt and in great plenty Trincauel maketh this to be the chiefest concoction that is required before letting bloud in respect of the bloud it selfe to wit when it is too thick to make it more fluxible as is before in the third Chapter of this booke There are two kinds of concoctions the first called properly 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 wheÌ„ naturall heate doth turne the food into due nourishment conteyning vnder it those three sorts or degrees of concoction mentioned by Galen whereof the first is called by him the concoction in the stomack and bowels wherein the purer part is sent towards the liuer to be made bloud and the impure is cast out by siege The second the concoction in the vaines wherein the moyst whitish iuice being by the mesaraick vaynes caryed to the liuer and by the liuer turned into bloud is by the vaynes and arteryes perfected and distributed into all the body in respect of the purer part thereof to wit bloud as it conteyneth the principall iuices and seede and the impure is by the vaynes 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 conueyed into the bladder and from thence cast out by vrine The third the concoction in the flesh wherein the purer part of the bloud being by the vaynes and arteryes caryed into all the body is by an other separation in respect of the purer part thereof turned into substance and spirits and the impure is cast out by sweate as Weckerus nameth three kinds of excrements appertayning to the three degrees of concoction excrementa primae concoctionis stercora secundae vrinae tertiae sudores exhalationes These three concoctions being finished the best part of the nourishment is assumilated and made one to the flesh body bloud and spirits of him that is to be nourished Galen sayth When the third concoction is ended there is an assimilation made to the part that is to be nourished These concoctions and the seuerall degrees thereof do all deale with that matter quae est benigna familiaris which is good and familiar vnto the party that hath receiued it There is an other kind of concoction called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 wherein naturall heate doth deale with a matter not that is good and familiar but such as doth cause disease and doth seeke either to assimilate some part of it if she can or else to make it either lesse hurtfull to the body or more fit to be expelled These two distinct kinds of concoctions when naturall heate can not or doth not performe what it would or should then they leaue distinct kinds of crudities as Galen sheweth speaking of cholerick crudities as those whome the Grecians call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 whatsoeuer sayth he is of pature ouercome is called by Hippocrates concocted and what soeuer nature can not yet ouercome is called crude and raw as he giueth in the same place an instance of purulent matters in inflammations of spittle of rheumes and of watrish humidities such as do passe out in those vrines which are called vrinae crudae and in choler which being raw he saith it is yellow sharp ill sauoring but being concocted it is more pale and not so ill smelling As for spittings and snot such they may be that they may be the excrements of this later kinde of concoction and such they may be that they may be excrements of the last degree of the former kinde of concoction How these seuerall kinds of concoctions are to be respected in purging and whether in acute or sharp diseases we may giue minoratiue or purging receipts before there appeare signes of concoctioÌ„ of the matter of the disease I do handle at large in my second part of the great Phisick remedies called Cathartice As for Phlebotomy seeing that the chiefest intents thereof are to ease the ouer-much fulnesse of the body or to pluck back or diuert a humour from or to some place we are not so much to wait for the concoction of the matter of yâ— disease vnlesse it be the ouer-much grossenesse of thick bloud as to marke the concoction of nourishment that the first degree thereof be done and the second well forward For if we let bloud when the stomack or first vaynes are full of indigested crudities they will passe into the vaines which are emptyed and make greater obstructions As violent exercises vpon full stomacks do disperse and distribute raw humours into the body to the much hurt of the body so doth also Phlebotomy and therfore that may partly be applyed vnto it which Galen hath written of exercises Then is the best time when the meate before taken is perfectly concocted and digested in respect of the two first concoctions The way to know this time is by the colour of the vrine A waterish vrine doth shew that the iuice which is sent out of the stomack and bowels into the vaynes is yet raw and vndigested The fâ—ry red and cholerick vrine sheweth that the iuices are long ago concoâ—led already That which is moderately pale is a signe of the second concoction euen now finished I haue shewed already in the end of the eight Chapter of my former booke that in many diseases the colour of the vrine may deceiue and in what cases it may most deceiue I neede not therfore heere to speake any more thereof but only to poynt out those other circumstances signes which together with it are ioyntly to be weighed and considered To know perfectly the state of the body Galen doth in one place ioyne with the colour of the vrine fiue other things to be heedily regarded First we must ponder what diet the diseased body hath lately vsed for sundry sorts of meates and wines may cause many alterations in the
HARWARDS Phlebotomy Or A Treatise of letting of Bloud Fitly seruing as well for an aduertisement and remembrance to well minded Chirurgians As also to giue a caueat generally to all men to beware of the manifold dangers which may ensue vpon rash and vnaduised letting of Bloud Comprehended in two Bookes Written by SIMON HARVVARD Imprinted at London by F. Kingston for Simon Waterson 1601. ⧠To the Right Honourable his singular good Lord Gilbert Earle of Shrewsbury Baron Talbot Lord Comin of Badenho Valence and Montchency Lord Strange of Blanch-minster of Brimsfeld Corfham Furniuall Verdon and Louctoft Knight and companion of the most noble order of the Garter and one of her Maiesties most honorable priuie Counsell many ioyful and happy yeeres with all increase of Honour IT is a propertie Right Honourable my singular good Lord naturally giuen to euery workman and artificer that be his worke neuer so rude and homely yet would he be loth that his labour should vanish and perish but seeing that it is the best that his abilitie can performe he desireth the same as long as may be to remayne and continue vpon the earth This cause maketh also many to be so forward in publishing their writings in print that when they themselues are taken away by death yet by their works there may still remaine some lasting record and remembrance of the workemen But the especiall cause which hath mooued me at this time to set foorth these my two bookes of Phlebotomy is the sincere affection and desire that I haue to bring some supply and helpe if I can vnto two very great wants and abuses which I dayly perceiue to be now too common and grassant in sundrie corners of this realme For first although in Cities as principallie in the famous Citie of London the people enioy a great blessing of God in hauing so many worthie and expert Phisitions and Chirurgians so neerely dwelling together that at all times the one may be able and readie to aduise and the other also as willing and sufficient to lend a helping hand yet in Countrie townes there are many nowadayes which doe practize the opening of vaynes almost in euery other Village one and most of them neither haue any learned counsaile to direct them neither are of themselues sufficiently instructed in the matter which they take in hand whereby though many of them do meane well and intend all for the best yet in the euent both to the harme of their patients and also to their owne griefe there often insueth more hurt and danger then ease and succour And another as great an occasion there is of many detriments and hinderances to mans health to wit the wilfull temeritie and rashnesse of some ignorant people which for euery small impediment haue recourse presently to letting of bloud and by their vnaduised importunitie do vrge forward the Chirurgian and euen greedily draw vpō themselues those manifold inconueniences from which afterward they can not againe so easily be deliuered and made free For although on the one side the benefits be most excellent which redound by Phlebotomy being rightly duly administred for thereby the fulnesse of the body doth come to a mediocrity griefes which come by extension are pacified the spirits are refreshed naturall heate euented the lims being as it were eased of a great burthen are made more quick ready to execute euery office nature is inabled to concoct what is requisite and to expell the vnprofitable flowing humours are either drawne back or turned aside from the place where they annoy or else are they dispatched and vtterly auoyded narrow and obstructed passages are opened and finally very present help is brought thereby to many dangerous infirmities Yet on the other side great also are the harmes which may ensue by letting of bloud if the same be rashly and vnconsiderately attempted the spirits and bloud are spent and wasted the naturall heate is pluckt away and dispersed the principall parts are made ouercold and vtterly lose their strength old age is hastened on and made subiect to palsies apoplexies dropsies and cachexies or bad habits many the bridle of choler being taken away do in a moment fall into most faint Iaundises many haue the one halfe of their hearing and sight diminished and the one arme and the one side vtterly weakened and many also are brought to an vnrecouerable destruction of their health and life To redresse in some part these most perillous incidents I haue collected out of the most famous Phisitions both auncient and moderne this discourse of Phlebotomy which although it be penned as commonly Phisick treatises are in plaine and familiar words most fit for them to whome it is principally directed yet because it comprehendeth the handling of one of the greatest remedies of corporall griefes as a learned Phisition commenting vpon Galen ad Glauconem doth write Venae sectio in magnis remedijs ab omnibus medicis semper habita est And Messaria the chiefe Doctor and professor of Padua in a treatise of Phlebotomy dedicated to Contarenus a worthy Senatour of Venice sayth Inter medica remedia nullum sanguinis missione nobilius nullum praestantius nullum tutius and doth call it further generosum praesentaneum vitae hominis praesidium And seeing also that amongst the high cares and charges which chiefe peeres and gouernours do beare in common wealths this seemeth not to be the least which concerneth so neerely the health the strength and euen the life it selfe of so large a part of the inferiour commons I haue therefore aduentured most humbly here to present and offer this my first part of the great Phisick remedies vnto your Honours patronage and fauourable protection not doubting but that according to your Lordships accustomed clemencie you will vouchsafe the same thereof not so much respecting the poore gift as the good heart of the giuer and according to your prone inclinatiion vnto the truth and to the generall good of the commons your Honor will haue greater regard vnto the graue auctorities of the auctors out of whome these obseruations are collected then vnto the homely phrase and plaine method of the obseruer and collector thereof The eternall God who hath heaped vpon your Lordship all those degrees of honour vnto which your noble Progenitours haue often heretofore bin most worthily aduanced graunt vnto your Lordship with the like good successe as they in former times haue done many prosperous yeares happily to inioy them to your dayly increase of honour and to the good and glory of our English nation euer continuing you in the high fauour of our most gratious Soueraigne and blessing you perpetually both in this world with the loue and hartie affection of the whole Commons and also for euer with the happie societie of the Saints in the life to come From Tanridge in Surrey this 29. of August Anno. 1601. Your Honours most humble in all duties to be commaunded Simon Harward The Preface declaring
of old age more fit for sleepe and rest then for toyle and labour to whome agreeth that of the Poet Vt lauit sumpsitque cibum det membra sopori WheÌ„ washt he hath food for sustenaÌ„ce receau'd His liâ—s of rest and sleepe let seldome be bereau'd The third sort he nameth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 such as are ready to be sent away and haue one foote in the graue Although many be very much stricken in yeares yet if they fall into those diseases which require bloud-letting as sometimes they do then may a vayne be opened as Trincauel sheweth that in a pleurisie he did let an old man bloud being threescore yeares of age and he did happily speedily recouer but he made choyce of the vayne of the ankle and had a due regard of the strength of the party For as Galen sayth of diet so it may be sayd of Phlebotomy if old men do neuer so little exceede a due measure they take great harme whereas yong men though they transgresse very much yet their harmes are of short continuance Fernelius recordeth of Razes that by an occasion of a vehement pleurisie he did open a vayne euen in crooked old age but the old verse must be remembred Aetatis mediae multum de sanguine tolle sed puer atque senex tollet vterque parum Middle age mickle Old and yong little As for children how old they must be before they can admit Phlebotomy Platerus sayth If they passe once tenne yeares old if danger of an inflammation do hang ouer them I would be bold to open a vayne Fernelius doth aduenture further for when he hath set downe the example of Auenzoar who with good successe did open a vayne in his owne sonne being three yeares old he after maketh mention of his owne practise This we do commonly proue that in the sixt or fift yeare of age three or foure ounces of bloud doth end the pleurisie and such grieuous diseases He addeth his reason because they do often bleede at the nose and finde helpe and why should not arte imitate nature He concludeth There is no age which cannot indure some measure of euacuation Montanus doth giue two reasons why children should not be let bloud First because bloud is as it were the foode of children seeing that thereby they are not only nourished but also do grow and increase Secondly because when bloud is taken away one part doth succeede in the place of an other vt non fiat vacuum because there can be nothing cleane voyd and empty and thereby the body is made either windy or thinne and spungious and all the powers resolued as there he prooueth by the auctority of Galen But no doubt although Galen doe rehearle children amongst the number of them which are not fit to be let bloud as when he forbiddeth Phlebotomy to those which are apt by nature to haue the pores open as children and likewise when the constitution is very hoate and dry also to all which are of a thinne habit of body and moreouer to them which haue the mouth of the stomack either troubled with a sharp flux of choler or weake or of more sensibilitie then it ought to be his purpose is not vtterly to condemne letting of bloud in all these sorts of people when vpon vrgent necessity they are driuen to it but to shew that it must be done as seldome as may be as sparingly as may be and alwayes carefully endeuouring to remedy and meete with that impediment and danger for which the prohibition was made and whereunto that nature is found most subiect For in an other place Galen alloweth Phlebotomy in children Some Phisitions thinke that children haue no strength but they thinke amisse we may let them bloud if the disease be great But Galen doth in the same place except 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 yong children and he calleth them 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 yong children vntill they come to be fourteene yeares old and vntil that age he doth not permit their vaynes to be opened But if the hoat ague which he hath spoken of in the line before shall be in a yong child not yet fourteene yeares old it is not good to vse Phlebotomy for in such warme and moist bodies euery day there floweth out and vapoureth or sweateth out very much of the substance of the body Hippocrates also doth not allow Phlebotomy in yong children because their strength is soone ouerthrowne Quickly doth the power decay in children by meanes of the store which they haue of stowing out but it will continue sufficient in flourishing age Many doe exclayme vpon Galen as though his practise of Plusick were too strong and violent for the present estate of mans nature But we see in this point that Hippocrates and he are a great deale more wary and circumspect and more loath to ouercharge the strength of man then many of our late practicioners I thinke it farre more safe to follow them then to be so rash as to imitate those Spanish Phisitions of whome Massaria doth report that they vse to let bloud in infantibus vix annum secundum aut tertium natis in infants scarce two or three yeares old or that bold Auenzoar of whome Auerroes writeth that he let his sonne bloud being but three yeares old or yet to thinke that the experiments of Fernelius Fuchsius and Valeriola who aduentured to let bloud at fiue or sixe yeares old though perhaps sometimes they wrought good effect are therefore to be commonly tried againe by vs. For the reason which Fernelius doth alleage that seeing that by eruptions of bloud out of the nose they finde often case and therefore the Phisition must imitate nature Massaria answereth that he hath often obserued that those eruptions of bloud in children haue not bin healthfull to them but haue bin occasions of dropsies and of bad habits of body And for the experiments which as they say haue often done good he accompteth that either they were rather of fortune then of any good reason or else that the help was such as whereby they were better vncured then cured For many may haue for a time a mitigation of paine for which afterward they may be sory for many yeares following But if yong infants who vndoubtedly may sometimes fall into hoate agues called synochi and that also with aboundance of bloud may not haue their vaynes opened what course is then to be taken with them in those feuers which can hardly be taken away without diminishing of bloud Mercurialis doth appoynt two helps for them the one by cuppings and the other by leaches The leaches being applyed aut natibus aut cruribus they do draw out bloud by so small holes that there is no danger of wasâ—â—ng any vitall spirits As for cuppings whereas Rafes doth defend that they may be vsed vnto children at fiue moneths old and Auicenna will not
haue them vsed vntill the infants be at least a yeare old Mercurialis iudgeth it more safe to stick to the opinion of Auicen not to vse them till the children be a yeare old and that with these three conditions first that the child be full of bloud and of good strength secondly that they be rather applyed to the legs then to the vpper parts because bloud drawne from the lower parts doth not so much impaire the strength nor wast the spirits as that which is drawne in the vpper parts and thirdly that there neuer be taken aboue one ounce or two at the most In the Chapter following he addeth an other caution to wit that if we seeke to draw bloud out of places farre off we apply such cupping instruments as haue wide and large mouthes but if we purpose to draw from neere places then to vse such as haue narrow mouthes and therefore if we apply them to the legs they must haue wider mouthes and if to the places about the loynes the narrower Galen for old age telleth a pretty history of a mad Phisition which raâ—hly did let himselfe bloud Acertavne Phisition of fifty yeares of age being now a seauennight sick and not very strong hauing a great paine in his head not able to stay vntill some of his fellowes could come to him did in the night time let himselfe bloud and his paine quickly ceased But a long time after he was discoloured in his body weake in strength thinne and without nourishment so that hardly he could recouer that habit of health which before he had For women being with child Montanus sayth that wee must greatly suspect as well letting of bloud as any other euacuation in them both in respect of the nourishment of the woman and child and also for feare of an abortement or vntimely birth Especially he will haue them to be auoyded at those times when there is most danger of vntimely birth that is before the fourth moneth and after the seauenth moneth For whereas Hippocrates doth permit to purge women with child being foure moneths gone vntill they come to seauen moneths but them which are yonger conceaued or which haue gone longer we must beware of dealing with them Galen commenting vpon that place doth compare the child in the mothers wombe to the fruit of a tree which when it is very yong is soone fetched off with any wind or blasâ—ing and when it is very ripe it is ready to fall off it selfe but in the middle time it will remayne strong on the tree against all stormes and tempests So the infant in the wombe is most in danger of vntimely birth when the woman is either in the beginning or towards the end of her accompt But Montanus sayth purging bringeth more danger then phlebotomy Phlebotomy is then the mere dangerous if the child be great as is noted by Hippocrates A woman being with child is deliuered before her time if that be great wherewithall she is conceaued Galen expounding that aphorisme doth giue the reason of it because the bigger the infant is the larger nourishment it requireth Yet Montanus addeth that sometimes women with child do receiue much good by opening a vayne especially if they be full of bloud he sayth I haue seene some such women that if they had bin let bloud euery moneth it would haue bin without danger and againe if they had not had sometimes a vayne opened they would haue bin so grieuously sick that there would haue bin danger of an vntimely birth When superfluous bloud is taken away the foode remayneth more holesome for the child Fernelius doth more plainely oppose himselfe against the axiome of Hippocrates and yet not in his owne words but alleaging against him this censure of Cornelius Celsus Ould Phisitions did thinke that childhood and old age could not endure such a help as is Phlebotomy and they were perswaded that the woman which should vndergo such a kind of curing should procure an vntimely birth But afterward experience hath shewed that none of these cautions are perpetuall but that better obseruations are to be marked vnto which the Phisitions counsaile is to be directed for it skilleth not what are the yeares of age nor what the party doth cary in the body but what the strength is a stout boy a strong old man and a woman with child hauing an able body may safely this way be cured As Montanus doth limit and restrayne this liberty appoynting it not to be vsed vnlesse the woman be very full of bloud so Massaria doth likewise require that the Phisition should not only respect the present estate of a woman being with child but to forecast how she shal haue sufficient nourishment and strength to hold out vnto the appointed time of her deliuery Concerning women hauing their termes whether they may securely be let bloud it is thus resolued by Montanus writing vpon the seauenth canon of Auicenna concerning bloud-letting that if they haue them immoderately then may they open the vayne basilica for diuersion But if moderately and naturally then is Phlebotomy not requisite Yet he sayth if such a woman haue a pleâ—risie or a sharp feuer and be in danger that vnlesse the flux of bloud be eased by spitting there should come an inflammation of the lungs and vnlesse the force of the humour flowing to the breft be stayed there would be danger of a suffocation then must the saphena be opened though the woman haue her flowers For costiuenesse I referre the reader to the third Chapter of this second booke how it must be corrected before Phlebotomy As for the flux of the body Platerus doth giue a câ—aueat generally that such persoÌ„s as are apt to swouâ—nings should not be let bloud wheÌ„ they haue a dia rrhaea or loosenesse of the body because the flux doth make them more apt to swoune But otherwayes letting of bloud is of it selfe good for such flâ—xts as Auicen sheweth in his fourth canon and vpon it Montanus because there can be no vacuuin no voyd emptinesse therefore there is made an attraction out of the whole body by succession of parts one vayne draweth from an other vntill at the last it draw from the stomack as the like doth happen in hunger Now when the vaynes haue drawne first one from an other then they from the liuer then the liuer from the mesaraick vaynes and the mesaraick vaines from the stomack thereby the moysture being plucked away the body is made more bounden And besides that stimulating and tickling choler which did before passe downe and cause the flux to be more violent is by Phlebotomy drawne back from the bowels But how is it then that so many vpon letting of bloud do become straightway loose bodyed Montanus doth answere out of Auicen that it is non per se sed per accidens not of it selfe but by meanes of some other accident as of some timorousnesse and feare
or else by ouermuch cooling of the body when by bleeding much of the strength is resolued Fernelius sayth The raw and vndigested flux which hapneth in a burning feuer the stomack being dissolued by the drinking of cold water doth not forbid the opening of a vayne but a regard must alwayes be had of the power Alexander Massaria doth aduise that if the flux do come of venome or any poysoned humour we should not let bloud because the greatest violence is then offered to the powers and the spirits are in danger of sainting CHAP. 5. Of the state of the disease what consideration must be had thereof in bloud-letting and in the examining of the strength of the party which we must regard most the vertue animal or naturall or vitall WHereas euery disease hath foure seuerall times the first is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 princiâ—ium the beginning which indureth vntill there appeare some signes of concoction the second 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 vel 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 incrementum augmentum vel ascensus the time of the increase so long as the fits or griefes doe waxe more painefull the third 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 vigor status the vigour of the disease when it standeth in one stay and neither increaseth nor decreaseth the fourth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 declinatio so long as the disease doth decline or decrease It remayneth now to be discussed in how many of these Phlebotomy may take place and to which of these it is most fit and conuenient Montanus deliuereth this for Galens doctrine In letting of bloud there is no time to be attended but at what time soeuer by reason of the fulnesse an euacuation is shewed to be the best drift let the euacuation be made whether the disease be in the beginning or in the increase or in the state so that there be not vndigested meates in the stomack and bowels but he addeth a prouiso dummodo virtus non sit debilis so that the vertue and powers bâ— not weake But for the most part Phlebotomy is most fit in the beginning of the disease That rule of Hippocrates In the beginning of diseases if any thing do seeme sit to be mooued mooue it but when the diseases are at the highest state and vigor it is best then to rest Galen commenting vpon it doth apply it to the two great remedies and especially to Phlebotomy The first canon of Auicenna expounded by Montanus is A vayne is not to be opened in the day of the diseases motion that is when the matter of the disease doth boyle and swell and nature doth striue to concoct or expell it Montanus sayth there is duplex motus morbi two manner of motions of a disease the one particular which consisteth in the fits and paroxysines and the other generall or vniuersall in respect of the whole disease from the beginning to the end and this conteyneth the criticall dayes the fourth the seauenth the eleuenth the foureteenth the seauenteenth the twentieth c. Now we must marke how the matter of the disease is mooued whether in a criticall day or not criticall and whether it be moued because nature goeth about to concoct it or because it is furious If the motion of it be furious we must needs vse euacuation But when the motion of the disease is such that nature doth concoct the matter then is it a day of rest and no euacuation is then to be attempted And that doth he make to be the meaning of Hippocrates that we must rest when the disease is in state and vigour hoc est in die motus morbi seupugnae tempore that is in the day of the diseases motion or the time of the strife betwixt nature and it Some affirme that in the criticall day bloud is not to be letten although it prooue a day of rest But Montanus doth confute them and doth iustifie that rule of Auicenna When nature doth mooue mooue thou nothing but when she mooueth not mooue thou in the time of her motion The time of natures motion it the criticall day and therefore in the criticall day we must stirre the body But therein the Phisition must be very wary and circumspect for if nature haue moued in the fourth day which is the declarer of the seauenth then may we not euacuate in the seauenth day And if in the seauenth there appeare any motion we must not mooue in the eleuenth But if in the criticall day nature do neither mooue nor shew some good token and proofe that she will mooue then may wee indeuour to mooue by Phisick Afterward vpon the twelfth canon Montanus reprooueth them which affirme that bloud is not to be let after the fourth day of the sicknesse and prooueth out of Galen that in some infirmities a vaine may be opened a hundred dayes after the beginning thereof But in sharp feuers we let bloud only in the beginning because after the fourth day the powers do faile and for that cause he sayth Hippocrates doth appoynt In sharp diseases vse euacuations in the beginnings Trincauel likewise doth apply vnto Phlebotomy that other axiome of Hippocrates non esse vacuandum in principio nisi turgeâ—â— morbus that we must not purge in the beginning vnlesse the disease be furious and vehement Turgere dicuntur qui adeo concitato motu agitantur vt prae illorum molestia agrotus non possit quiescere quod magni morbi est indicium those diseases are sayd to rage or swell which are caryed with such violent motions as that the patient can take no rest and qui ad excretionem festinant which would faine breake out He bringeth in the example of Galens owne practise which as he recordeth of himselfe when he was sent for vnto a man sick of the pleurisie when he saw first that he auoyded bloud by spitting and secondly that as the patient being asked did confesse he felt but little griefe on his side he vsed some applications to him but would not let him bloud because it was a most gentle kind of pleurisie But how may the former part of that aphorisme of Hippocrates be applyed to Phlebotomy Purge things concocted and ripe but not while they are raw Is concoction first to be expected before we can vse Phlebotomy Fernelius and Fuchsius do in this poynt bitterly inueâ—gh against Auicen for that he forbiddeth a vayne to be opened vnlesse the humours be first concocted Their reasons are especially these first because in sharp and violent diseases and where there is aboundance of bloud it must needs be dangerous to deferre secondly though the disease be not sharp yet may the multitude of bloud of it selfe do harâ—ne if it be not presently eased thirdly because when signes of manifest concoction do appeare then as Fernelius holdeth we must deale no more by letting bloud but the rest of the cure must be finished either by purging
outward vayne called externa or humeralis or cephalica The middle vayne called communis or cardiaca or nigra or funâ— brachiâ— or mediana is then vsually opened when either one of the other doth not appeare or else when the infirmitie is as well beneath as aboue the neck for this vayne taketh part of both the other For the lower parts about the hips bladder or wombe take the vayne by the knee or by the anckle The raines as they are placed in the nuddest so as Fuchsius sheweth they do partake with both For if the inflammation in the raynes be new and that there be abudance of bloud then may you take the vayne in the arme but when it is a confirmed disease such as is called nephritis then open the vayne either in the knee or in the anckle If any ill humour be setled in those parts which are betweene the raynes and the flanck Fernelius doth appoynt that if the party haue corpus plethoricum then first we should open the basilica of the same side and afterward the saphena But if the body be not plethorâ—cum then he sayth the only saphena shall sustice that is the inward vayne of the foote for as the outward is called sciatica so the inward saphena If you will not haue the bloud to come fast and speedily then for the cephalica you may take his branch betwixt the thumbe and the fore-finger And for the basilica you may take the vayne by the little finger called saluatella or titillaris which is a branch of the basilica For deriuation to deriue the matter of a griefe if it be in the fore-part of the head take the vayne of the fore-head if in the eyes the broad vaynes at either corner if in the eares the vayne vnder the eare if in the lawes that which is vnder the tongue if in the lungs or spleane or breast or heart the inward vayne of the left arme if in the liuer the right basilica Often the same vaynes will serue both for reuulsion and euacuation as Galen sheweth speaking of an inflammation of the liuer We must both pluck back and also auoyd the bloud which is caryed to the liuer by Phlebotomy opening the inward vayne of the right cubite because directly and with a broad way it doth communicate with the hollow vayne if that do not appeare open the middle vayne if that also 〈◊〉 be perceiued then take the other third which remarneth This speech of Galen maketh me more willing to subscribe to the opinion of Platerus who defendeth that in letting bloud wee must rather choose that vayne which doth most swell with fulnesse of matter then to make any difference betwixt the vaynes of the armes seeing in one place about the throat they come all from the hollow vayne and which vayne hath best relation to the parts most ouercharged the fulnesse thereof will sufficiently make manifest CHAP. 8. What manner of incision must be made how large how small how deepe what quantity of bloud may be taken and therein of the meâ—ning of Galens word to let bloud vnto 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 deliquium animâ— IT is a notable aduertisement of Hippocrates We must open passages as the nostrils and others but it must be what we must and how we must and of what sort and what way and when and how much we must as sweats and all other things This precept of circumstances as it appertayneth generally to all euacuations so doth it greatly take place in the matter of Phlebotomy I haue shewed already the greater part of these circumstances it ramayneth heere that I describe only the manner how and the quantity how much Fernelius aduiseth the Chirurgian to take diligent heed that he strike not either a place swelling with some windinesse or an artery or a tendon in stead of a vaine The tendones be instruments of moouing in the top of the muscles made of sinewes and ligatures and knitting them to the bones they be harder then sinewes and vet not so hard as ligatures The artery being pressed downe will shew it selfe for a vayne which if it be cut it will neither come together againe nor heale but that part will be taken with a mortification and become as dead and senselesse He counsaâ—leth also the Chirurgian that when he hath setled the launcer in one hand leauing out no more of the end or poynt then what is sufficient to pearce and hath with the other hand so taken hold of that part of the body that is to be let bloud that he may strengthen and hold stedfast the vayne with his thumbe then let him put forward hâ— launcer faire and softly without any hastinesse gently and no further in then is sufficient Fuchsius willeth that if the vayne be trembling and not constant for the percing the next place must be bound as well aboue as also beneath And although the vayne be well opened and the bloud flow freshly yet in the middle of the flowing set your finger awhile vpon the wound both that the strength may be more refreshed and lesse scattered and also that the corrupt bloud may the better be brought out of the inward parts vnto the place where the vayne is opened Fernelius giueth one generall rule to know what vaynes must be opened a little ouerthwart and somewhat sidelong and which must be opened right along the vayne If the vayne be in a ioynt then let the pearcing of it go a little sidelong because in the moouing of the ioynt the sides of the incision if they go right with the vayne would gape and so would the wound be the longer in growing together But in the head hands and feete if the incisions go right with the vayne he sayth they heale the sooner because there yâ— sides do still close together Of what bignesse the orifice of the wound must be it is discussed by Montanus writing vpon the ninth Canon of Anicen A little hole sayth he is best to conserue the strength of the party both because the most that then commeth out is but thinne and waterish and also because the bloud goeth not so speedily out whereby the heate and spirits are not so sodainely exhausted But a little orifice hath on the other side a great discommoditie in that it maketh no euacuation of the thick and grosse parts So likewise a great orifice hath one good benefit in auoyding grosse humours but it hath an other great danger that by a too sodaine and ouer-liberall effusion the vertues and powers may be cleane ouerthrowne If the bloud be subtile and power weake let the hole be little but if the bloud be thick and the vertue strong then let the hole be great Auicen teacheth that when we let bloud to preserue from sicknesse then must the orifice be great because the powers are yet constant and likewise when we let bloud in the winter or cold weather because then the coldnes
of the ayre doth keepe the spirits from flying too fast out But in the sommer or hoat weather he will haue the orifice to be narrower because the bloud is commonly then more subtile and heate doth helpe much to dilatation passage If it fall out to be temperate weather then to proceede in the meane betwixt both The verses of the Salerline schoole are to be vnderstood of full strength and powers Fac plagam largam mediocâ—â—â—ter 〈…〉 exeat vberius liberiusque cruor Make well and wide thy blow That bloud and fumes may largely flow Hippocrates sayth In places where 〈◊〉 no danger and where the bloud also is grosse vse a broader launcer for so the bloud will passe otherwise not but take heed of going too deepe Fernelius sheweth some dangers Vnder the inward vayne lyeth an artery vnder the middle a sinew and vnder both do lye the tendones of the muscles If any of these be pearced there may ensue much griefe and sometimes great danger The cephalica may be opened with least perill of all the vaynes which appeare in the cubâ—â—e Now for the quantity of bloud how much may be taken at once I haue had occasion to declare much already concerning that poynt when I intreated in my former booke of Phlebotomy in particular diseases I meane not therefore now to stand much vpon it Montanus vpon the fourteenth Canon of Auicen doth appoynt that in old diseases when by long infirmitie the bloud is become grosse we must take but a little bloud at once and reiterate the bloud-letting often and still in the meane time to nourish yâ— patient with a good moistening diet If the bloud appeare to be whitish then as Auicen will haue it you must let out none at all least a cachexia or bad habit or dropsie do thereupon ensue Fuchsius doth giue vnto a Chirurgian three generall notes whereby he shall gesse when is the fittest time to stay the bleeding first by the change of bloud secondly by the force of flowing waxing more faint and thirdly by the change of the pulses The first that is the change of the bloud both in colour and in consistence must then especially be attended and wayted for when the griefe or inflammation for which we let bloud is neere vnto the place where the vayne is opened For Hippocrates sheweth that in a pleurisie the bloud which is nigh vnto the inflammation doth farre differ from that which is conteyned in other parts of the body being by the vehement heate much altered so that if the bloud of the rest of the body be phlegmatick it will be about the inflammation red and if the rest be red it will be about the inflammation adust and burnt This change of the bloud is not alwayes to be taryed for for it may be that either the strength is not able to indure it or else that the phlegmone is such a maligne and impacted humour that it will hardly giue place In these cases wee must cease before the bloud doe change and the rest is to be withdrawne by a second phlebotomy The other note to know when it is time to stay the bloud is by the violence of the flowing now waxen more slow feeble for that sheweth that the strength and powers are ready to decay especially if palenesse of the face and dazeling of the eyes do begin to draw on But the most certaine signe of all when we must stay the bloud is the changing of the pulse for if of thick it become thinne if of great it become little if of vehemently strong it become weake and obscure if of equall it become vnequall it presageth that the powers are now ready to be dissolued The safest way in letting bloud is to be sure to be within compasse what wanteth may easily be supplyed by reiterating but what is taken too much can not so easily be restored Heere an other doubt may arise when either for the toughnesse of the hamour or for the weakenes of the party the bloud is let not at oncâ— but at seuerall times how neere those times ought one to succeede an other Fernâ—lius sayth In diseases that vniuersally afflict the body the best is to let bloud twise in one day but in the griefes of particular parts the reiterating must be longer deferred to wit to the second or third day Ficinus counsaileth such as by studyes are growne melancholick to be let bloud if they feele a plenitude and he appoynteth it to be done twiâ—e in one day in the morning and in the coâ—ning but at either time sparingly for he sayth bloud is the temperer of melancholy the nourisher of the spirits and the treasure of life The like speech hath Auicen in his third canon where he aduiâ—â—th men that are troubled with a long lingring disease not to be too wastfull of their bloud because a long iourney remayneth to them and therefore they had neede to gather store of good strength he addeth this precept Keepe bloud as a pretious treasure In that quartaine ague which commâ—th ex atra bile and in other infirmities comming of the like cause seeing that the atra bilis may come as well of bloud or fleame as of choler or melancholy the black bloud sheweth that it proceedeth of bloud aduâ—t and therefore a more larger Phlebotomy is permitted vnto it then vnto any other atra bilis which shall proceede of choler fleame or melancholy adust But otherwise the common opinion of Chirurgians who thinke that generally the corrupter the bloud is the more plentifully they may let it flow out is vtterly condemned by Fernelius You must not when the bloud is more impure or raw or is estranged and departed from his owne nature then take so much the more away after the manner of common bad Phisitions but by how much more the humours are departed either on this side or beyond the nature of bloud so much the more sparingly and leasurely you must let that bloud sâ—ow and when it shall be found to be very farre from the forme and shape of bloud then must you altogether abâ—taine from Phlebotomy for where there is little good bloud there must needs the strength be weake The corrupt bloud doth seeme very fit to be expelled as Galen sayth That which is corrupt is against nature and that sheweth that it ought to be taken away The constitution therefore of the bodie doth shew that this ought to be our scope and drift to euacuate the matter either by Phlebotomie or by purging but on the other side the weakenesse of the powers will suffer neither of them How must we doe then in these great contrarie occasions Galen maketh answere We must in these contrarie occasions and drifts by little and little auoyd the bad and by little and little restore the good which healing of euill humours is called of Phisitions Epicrasis or good tempering of humours Why doth Galen then
diasena Nicholai somewhat more then halfe an ounce or confectio Hamec maior about halfe an ounce or syrupus de pomis Rondeletâ— about an ounce and a halfe If mixt humours do afflict the body then either to mitigate them compound your aforesayd syrupes and decoctions taking one moity of one and an other of an other or otherwise proportionably mingle them as the humours do more or lesse abound or else to purge them do the like by the forenamed purging receipts or take of Diacatholicum somewhat more then halfe an ounce or hiera Ruffi the quantity of a chesnut dissolued in broth or in pills take pillulae aggregatiuae or pillulae de tribus of either one of them about a dramme At what times these and such other like purgings shall be accompted most fit and what seuerall circumstances are to be obserued therein as well at the very instant of the ministring thereof as also in the preparing of the body before and the guiding of it after These are poynts which I do handle at large in the Cathartice or second part of the great Phisick remedies mentioned in my Preface wherein as I haue already gathered most of the chiefest â—xiomes and aphorismes out of many famous Phisitions of all ages concerning these and such like questions appertayning to the purging of humours and in some sort also disposed them so do I purpose also godwilling to deliuer them hereafter to the view of the world as soone as leasure shall permit to transcribe and friends aduise to publish Soli vni trinoque deo sit tota tributa Laus cuius coeptum dextra secundet opus FINIS The Index The questions and matters concerning letting of bloud haue no neede of any Index seeing they are in the Preface to the Reader gathered into a briefe summe and the Chapters poynted out where euery particular is handled But for as much as many diseases and griefes are touched here by occasion and obiter in sundry seuerall places that one place may the better explane an other and sometimes also supply confirme and second one an other and moreouer that the Booke may be more readye for the vse of the reader I haue thought good to adde alphabetically the names of the infirmities and impediments for which in these two bookes are found many counsayles and remedies A. Agues diaries Pag. 13. 4. Agues continuall of bloud inflamed p. 6. 70. 108. Agues burning p. 11. 12. 113. Agues epialae p. 16. Agues quotidians p. 65. 17. 4. Agues tertians exquisite p. 16. 17. 21. 22. Agues tertians bastard p. 19. 22. Agues quartaines p. 18. 16. 21. 23. 4. 107. S. Anthonies fire p. 112. Apoplexies p. 44. Arteries wounded p. 103. lib. 2. cap. 9. B. Bladder insiaâ—ed Pag. 100. 101. Blâ—ck choler and melancholy hâ—w differ p. 20. 19. 1â—â— Bloud abounding how knowne p. 57. 58. Bloud ouergrosse and thick p. 64. 113. Bloud corrupt p. 107. 108. 110. 114. See humours corrupt and raw â—urning feuer p. 11. 12. 113. C. Cacochymia p. 59. See humours corrupt Cachexia p. 52. See habite bad Choler abounding how knowne pag. 58. lib. 2. cap. 10. Choler abounding how auoyded and purged booke 2. Chapt. 10. Choler auoyded by bloud-letting p. 22. 27. 112. 113. Children what to take in steed of letting bloud p. 73. 74. 75. 76. 78. Costiuenesse how holpen by clysters p. 69. 70. 71. Coâ—ick p. 45. Concoction wanting how knowne booke 2. chap. 5. Conuâ—lsions p. 43. Continuall hoate feuer p. 6. 70. 108. Crudities p. 111. See raw humours Crudities how knowne booke 2. chapt 5. D. Diary feuers Pag. 13. 4. Dropsey p. 45. 52. E. Eares payned p. 101. Epiala feuer p. 16. Epilepsies p. 44. Eyes payned p. 10. 1 F. Falling sicknesse p. 44. Feuers of sundry kinds See Agues Fleame abounding how knowne pag. 58. and booke 2. chapt 10. Fleame abounding how auoyded and purged p. 67. 69. and booke 2. chapt 10. Fulnesse or full habit of body p. 2. 57. 98. Fluxes of body p. 79. 80. G. Gall of ill constitution p. 63. Gout p. 47. 48. 49. H. Habite bad p. 52. Heart payned p. 100. 101. Heart fainting See swounings Head-ach p. 101. Head inflamed Pag. 42. 110. Hips payned p. 100. Humours corrupt and raw whether admit Phlebotomy p. 51. 52. 60. 65. 66. 67. 71. 107. 108. 110. 111. I. Iaundise p. 52. Inflammations and impostumes how cured booke 2. chapt 9. Intemperancy p. 60. and booke 2. chapt 9. Itches p. 51. K. Kidneys inflamed causing stone p. 39. 47. and booke 2. chapt 9. Kidneys inflamed p. 100. 101. L. Legs payned p. 28. Liuer hoate and stomack cold p. 50. Liuer inflamed p. 100. 101. Liuer inflamed in cano booke 2. chapt 9. Liuer inflamed in gibbo booke 2. chapt 9. Liuer full of bloud and choler causing pleurisie p. 42. 100. Loosenesse of body p. 79. 80. Lungs inflamed p. 35. 100. 101. and booke 2. chapt 9. M. Melancholy and black choler how differ p. 20. 19. Melancholy abounding how knowne p. 58. and booke 2. chap. 10. Melancholy abounding how purged and auoided p. 107. and booke 2. chap. 10. Melancholy windes p. 44. Mixt humours how purged booke 2. chapt 10. N. Nostrils bleeding sometimes ill p. 75. sometimes good p. 39. 40. 114. O. Old and lingering diseases p. 105. 107. Old age whether to be let bloud or no p. 72. 77. P. Palsies Pag. 43. Phrenzies p. 27. Plague or pestilence p. 23. 25. 26. Pleurisie vpon what seuerall causes it commeth p. 42. and booke 2. chapt 9. Pleurisie when and how let bloud in it p. 31. 35. 37. 72. 98. 99. 106. Pleurisie when not let bloud in it p. 38. 39. Pleurisie how outwardly holpen booke 2. chap. 9. Pulses distempered what signifie p. 9. 10. 11. 106. 7. Q. Quartaine feuers p. 16. 18. 21. 23. 4. 107. Quinsies p. 29. 98. Quotidian feuers p. 65. 17. 4. R. Raynes inflamed p. 100. 101. Raynes inflamed causing stone p. 39. 47. Raw humours whether admit letting-bloud p. 51. 52. 60. 65. 66. 67. 71. 107. 108. 110. 111. S. Scabs p. 51. Scuruy p. 53. Spleane obstruâ—ted p. 44. 53. 100. 101. Spleane inflamed p. 39. 40. booke 2. chap. 9. Splenetick bloud p. 23. 113. 114. Spitting bloud p. 34. 38. Spirits inflamed p. 7. 9. Stone in the raynes p. 39. 101. 100. Squinancies p. 29. 98. Stomack weake and loose Pag. 62. Stomack impure p. 64. 69. Strength fayling p. 109. Sweating sicknesse p. 26. Swounings p. 62. 63. 79. 109. 110. Suffocation p. 2. 35. T. Tertian feuer exquisite p. 16. 17. 21. 22. Tertian feuer bastard p. 19. 22. V. Vomits how to be made when the stomack is impure or molested with corrupt humours p. 64. 69. Vrines betokening crudities booke 2. chapt 5. Vrines deceiuing p. 45. W. Women hauing their flowers or with child whether fit for letting bloud p. 77. 79. Women with flowers suppressed p. 99. Wombe inflamed p. 37. 100. Y Yellow and thinne bloud p. 21. 114. Yellow iaundise p. 52. Faults escaped Page 2.