HARWARDS Phlebotomy: Or, A Treatise of letting of Blood, Fitly serving, as well for an advertisement and remembrance to well minded Chirurgeons, As also to give a caveat generally to all men to beware of the manifold dangers, which may ensue upon rash and unadvised letting of Blood.  
Comprehended in two Books: Written by SIMON HARWARD.  
Imprinted at London by F. Kingston for Simon Waterson. 1601.   

❧ To the Right Honourable his singular good Lord, Gilbert Earl of Shrewsbury, Baron Talbot, Lord Coming of Badenho, Valence, and Montchency, Lord Strange of Blanch-minster, of Brimsfeld, Corfham, Furnivall, Verdon, and Louctoft, Knight and companion of the most noble order of the Garter, and one of her majesties most honourable privy Counsel: many joyful and happy years, with all increase of Honour.  
IT is a property (Right Honourable, my singular good Lord) naturally given to every workman and artificer, that be his work never so rude and homely, yet would he be loath that his labour should vanish, and perish: but seeing that it is the best that his ability can perform, he desireth the same as long as may be, to remain and continue upon the earth. This cause maketh also many to be so forward in publishing their writings in print, that when they themselves are taken away by death, yet by their works there may still remain some lasting record, and remembrance of the workmen. But the especial cause which hath moved me at this time to set forth these my two books of Phlebotomy, is, the sincere affection and desire that I have to bring some supply and help (if I can) unto two very great wants and abuses, which I daily perceive to be now too common and grassant in sundry corners of this realm. For first, although in Cities, as principally in the famous City of London, the people enjoy a great blessing of God, in having so many worthy and expert Physicians and Chirurgeons so nearly dwelling together, that at all times the one may be able and ready to advise, and the other also as willing and sufficient to lend a helping hand: yet in Country towns, there are many nowadays▪ which do practise the opening of veins (almost in every other Village one) and most of them neither have any learned counsel to direct them, neither are of themselves sufficiently instructed in the matter which they take in hand: whereby, though many of them do mean well, and intent all for the best, yet in the event, both to the harm of their patients, and also to their own grief, there often ensueth more hurt and danger, than ease and succour. And another as great an occasion there is of many detriments and hindrances to man's health, to wit, the wilful temerity and rashness of some ignorant people, which for every small impediment have recourse presently to letting of blood, and by their unadvised importunity do urge forward the Chirurgeon, and even greedily draw upon themselves those manifold inconveniences, from which afterward they can not again so easily be delivered and made free. For although on the one side the benefits be most excellent which redound by Phlebotomy being rightly & duly administered, for thereby the fullness of the body doth come to a mediocrity, griefs which come by extension are pacified, the spirits are refreshed, & natural heat evented, the limbs being as it were eased of a great burden, are made more quick & ready to execute every office, nature is enabled to concoct what is requisite, and to expel the unprofitable, flowing humours are either drawn back, or turned aside, from the place where they annoy, or else are they dispatched and utterly avoided, 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 harms which may ensue by letting of blood, if the same be rashly and unconsiderately attempted, the spirits and blood are spent and wasted, the natural heat is plucked away and dispersed, the principal parts are made overcold, and utterly lose their strength, old age is hastened on, and made subject 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 jaundises, many have the one half of their hearing and sight diminished, and the one arm and the one side utterly weakened, and many also are brought to an unrecoverable destruction of their health and life.  
To redress in some part these most perilous incidents, I have collected out of the most famous Physicians both ancient and modern this discourse of Phlebotomy, which although it be penned (as commonly Physic treatises are) in plain and familiar words, most fit for them to whom it is principally directed; yet because it comprehendeth the handling of one of the greatest remedies of corporal griefs, as a learned Physician commenting upon Galen ad Glauconem doth write, 
Trincauel in expla●. lib. 1. de arte c●ra●ua ad Glauconem. Alex. Messer. lib●. ●escop●s mittendi sanguinem.  Venae sectio in magnis remedijs ab omnibus medicis semper habita est. And Messaria, the chief Doctor and professor of Padua, in a treatise of Phlebotomy, dedicated to Contarenus a worthy Senator of Venice, saith, 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 chief peers and governors do bear in common wealths, this seemeth not to be the least, which concerneth so nearly the health, the strength, and even the life itself of so large a part of the inferior commons, I have therefore adventured most humbly here to present and offer this my first part of the great Physic remedies unto your Honour's patronage, and favourable protection, not doubting but that according to your Lordship's accustomed clemency you will vouchsafe the same thereof, not so much respecting the poor gift, as the good heart of the giver, and according to your prone inclinatiion unto the truth, and to the general good of the commons, your Honour will have greater regard unto the grave authorities of the authors out of whom these observations are collected, then unto the homely phrase and plain method of the observer and collector thereof. The eternal God, who hath heaped upon your Lordship all those degrees of honour, unto which your noble progenitors have often heretofore been most worthily advanced, grant unto your Lordship with the like good success as they in former times have done, many prosperous years happily to enjoy them, to your daily increase of honour, and to the good and glory of our English nation, ever continuing you in the high favour of our most gracious Sovereign, and blessing you perpetually both in this world with the love and hearty affection of the whole Commons, and also for ever with the happy society of the Saints in the life to come.  
From Tanridge in Surrey this 29. of August. Anno. 1601. Your Honour's most humble in all duties to be commanded Simon Harward.   

The Preface, declaring the order and contents of these two books of Phlebotomy.  
BEing purposed and resolved for the more general benefit of my countrymen to publish in two english treatises (the first whereof I do here in title Phlebotomy: and the other, god willing, hereafter, as soon as leisure shall serve, Cathartice) as compandiously and as orderly as doth or shall lie in my power, all the chiefest aphorisms and conclusions, which have been handled and written by the most famous Physicians of all ages, as concerning such cautions and circumstances as are to be observed in letting of blood, or purging the body of man: Although in practise it doth in many cases fall out, that purging aught to take place before the opening of any vain (as shall h●ereafter more at large appear in this book) yet for as much as blood is the most excellent and principal humour that is dispersed in the whole body, according to that of Galen, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, 
Gal. libr. 2. de temperamentis.  the best and most familiar juice in man is blood. I have therefore thought good in my method of declaring how we must deal with these several humours, 
Fuc●s. Instit. libr. 2. Brigt●●us in therapeutica.  to follow the example of divers learned men of our time, to wit, in respect of the disposing of them, to give unto blood the first place and pre-eminence. These two remedies are not only accounted the chiefest amongst the kinds of evacuations, but also amongst all other corporal helps prescribed or invented for the curing of man's infirmities: As well affirmeth Mercurialis, 
Hieron. Mercurial. Consil 42.  Duo magnorum auxiliorum genera reperiuntur, purgatio nempe & sanguinis missio, There are two kinds of great remedies found out, to wit, purging, and letting of blood. These 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, 
Galen 2. Ap●. 29.  are called great helps, because they are applied unto great diseases, and also because (howsoever they being abused do bring the greatest harms) yet being well and rightly administered, they do bring the greatest and most present cases and remedies, that ever either inwardly or outwardly were devised for man's health.  
This my first part of the Remedia magna in Physic, I have comprehended in two books, the sum and contents whereof, as also of every part thereof, I have thought it not amiss first briefly to prefix and lay open to the view of the well willing reader.  
The first book showing what Phlebotomy is, and to what use it serveth in several diseases, containeth ten Chapters.  
The first, what Phlebotomy is, and of the four distinct kinds and uses thereof.  
The second, how letting of blood ought to be used in continual agues, as also in burning fevers.  
The third, how blood-letting may be admitted in some kinds of diary agues made by obstructions.  
The fourth, how far letting of blood may be allowed in intermitting agues, quotidians, tertians, and quartans.  
The fifth, whether letting of blood be to be admitted in the Plague, and pestilent fever, as also in the Pox, measles, and such other contagious infirmities, and when and how.  
The sixth, how letting of blood is to be used in frenzies, quinsies, pleurisies, inflammations of the reins or womb, and other inward inflammations, as they are considered in themselves without agues.  
The seventh, in these dangerous inflammations aforesaid, whether evacuation or rewlsion be more necessary, on whether side the vain is to be taken for rewlsion, and what is the meaning of Hypocrates his rule 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, to flow rightly, or with a right course.  
The eight, whether letting of blood be to be practised in cold diseases, as palsies, cramps, apoplexies, and whether it may fitly be used in melancholic winds, colics, and dropsies.  
The ninth, whether in rheums and distillations, as also in the gout and in Morbus Gallicus, any benefit may ensue by letting of blood.  
The tenth, whether letting of blood be expedient for such as have hot livers and cold stomachs, as also for such as have itches and scabs, and such other faults of the skin. Further, whether it be fit for the disease called of seafaring men the scurvy, and for the cachexia, or bad habit of body: and finally, what and how many are the drifts and scopes in letting of blood.  
The second book concerning the rules and circumstances which are to be observed, when for the preventing or curing of a disease any vain is to be opened, containeth likewise ten Chapters.  
The first, whether the party that is to be let blood have truly that distented plenitude which is called of Physicians corpus plethoricum, and how the several kinds of plenitude may be known.  
The second, of the consideration of the temperature of the party, what it is by manner of diet, or by exercises, or by place of abode, or by custom, or by habit, or by constitution of body.  
The third, whether the body have need to be prepared before letting of blood.  
The fourth, of the age, sex, and solubilitie of the party, whether old men, or children, or women being either with child, or having their terms, may be let blood. Also, whether any having bodies either too costive or too soluble, may be let blood.  
The fifth, of the state and time of the disease, what consideration is to be bad thereof in blood-letting, and which we must regard most of the powers, the animal, the natural, or the vital.  
The sixth, of the time of the year, the time of the constellations of the planets, and the time of the day most fit for letting of blood.  
The seventh, on whether side the vain is to be taken when we let blood to prevent diseases, or to avoid or derive their matter, as also what vain must chiefly be chosen for sundry infirmities.  
The eight, what manner of incision must be made, how large, how small, how deep, what quantity of blood may be taken, and therein of the meaning of Galens' word to let blood ad animi deliquium.  
The ninth, what order must be taken with them that are let blood, as well in the act itself to prevent swoonings, as also afterward for their government and diet.  
The tenth, how defects and errors are to be supplied and mended, and how the Physician, and in his absence the Chirurgeon may know by the blood being a little while reserved, what course is further to be taken with the patient.  
Before I enter into the discourse upon these several arguments, I must pray the reader first to give me leave briefly to answer certain doubts and occasions of offences which perhaps might arise upon the publishing of this treatise. First therefore if any (because I baning heretofore committed to the pressse certain Sermons, and matters of Divinity, do now begin to set forth a Physic work) do therefore gather or suspect that I have converted my studies from the scriptures unto Galen, let him know that in this point I am utterly mistaken by him, for most of my physic observations were then collected when first I gave my mind that way, which was long before I published any matter of Divinity: so that if there have been any alteration or conversion of studies, it hath been from the perusing of Physic authors to the reading of writers wholly theological. And yet still (the conjunction betwixt the body and soul being so ne●re, and the sympathy so great) I see no cause but that he which studieth Divinity, may lawfully now and then so bestow a spare hour in viewing of the remedies ordained by God for man's infirmities, that he may be able in corporal extremities to yield relief as well particularly to himself, as in common to his good friends. If any do think otherwise, if he be a Divine, I pray him that he will grant me licence to compare small enterprises to those which were so far more noble and excellent, and to offer to his consideration that example of Moses, 
Act. 7. 22. Aug. de civitate dei lib. 8. cap. 38. Basilius pag. 404.  which was learned in all the wisdom of the Egyptians, that is (as Augustine doth expound it) in Astronomy, Geometry, Arithmetic, and such like, which knowledges, though they came sometimes from heathen men, yet were they the gifts of God, Qui operatur per malos non in malis. Or to call to his remembrance Solomon, 
Eccl. 1. 1.  whom the holy Ghost doth entitle with the name of Preacher: and yet God gave him wisdom also to discourse upon philosophical matters concerning beasts, 
1. Reg. 4. 31.  birds, fishes, and every sort of simples even from the greatest to the least, from the Cedar tree to the moss that groweth upon the wall. If he be a Physician, which supposeth that the study of Physic can not be tolerated in them whose vocation is spiritual, then do I only oppose against him the authority of the most worthy Physician and grave interpreter of Plato, Marsilius Ficinus, who, because some did object against him, Nun est Marsilius sacerdos? Quid sacerdotibus cum medecina? Quid cum astrologia commercij? Ficinus maketh an apology for himself, 
Marsil. Ficinus in apologia praefixa lib. 1. de studiosorum sanitate tuenda.  proving evidently, Antiquissimos quondam sacerdotes fuisse medicos pariter & astronomos. He addeth for proof, quod sanè Chaldaeorum, Persarum, Aegyptiorum testantur historiae. Ad nullum praetereà magis quam ad pium sacerdotem pertinere singularis charitatis officia. He concludeth, officium verè praestantissimum est procul dubio, & maximè necessarium, & inprimis ab hominibus exoptatum, efficere videlicet ut sit mens sana in corpore sano, id autem tum demum praestare possumus si con●ungimus sacerdotio medicinam.  
Now if there be any that shall think it strange that I do so often allege the testimonies of Fernelius, Fuchsius, Montanus, and others (as relying much upon them) and yet do in some points a little dissent from them, I wish them to be certified, that I have a reverend opinion of those writers, and am very willing that in those positions which are best determined by them, they should in no wise be frustrated of their due praise and glory. But if others in some doubts have found out more than they, then do I challenge liberty as near as I can to make choice of the soundest, and in these humane matters to be as the Poet speaketh of himself:  
Nullius addictus jurare in verba magistri. 
Horat. epist. libr. 1. epist. 1.  Where Galen doth well, I must needs give him his due commendations, and even admire those singular gifts of nature which God bestowed upon him, but where he skoffeth (as he doth sometimes) at Christianity, 
Gal. de differentus puis. lib. 2. & lib. 3. de sectis proteruis medicorum.  there I detest and abhor his blasphemies, and leave him to the judgement of that God, to whom only it is known, whether ever before his death his heart were better lightened with some beams of sparkles of his grace. The words of those excellent Greek and Latin Physicians (upon whose authorities and the reasons delivered by them these my assertions are grounded) I have not set them down in the proper languages of the first authors, because my purpose was, as near as I could, to reduce the whole matter into a brief and compendious treatise: but I have both faithfully Verbatim translated them, and also in most places caused the chiefest parts of their arguments and conclusions by a several print to be apparently distinguished, very plainly to be discerned. By which distinct form of character, as also by the books and discourses cited in the margin, it may evidently appear, that howsoever (to put some difference betwixt this my labour and an other english Phlebotomy heretofore published) I have prefixed my name to the title of the whole work, yet I do not presume to carry away the matter as of myself, but am very desirous that the loving reader should be satisfied with the judgements of those worthy and famous writers, whose counsels and advises can not (I hope) but be welcome unto them, which with modest and well affected minds shall desire to embrace the truth.   

The first book of Harwards Phlebotomy.  

The first Chapter.  
What Phlebotomy is, and of the four distinct kinds and uses thereof.  
PHlebotomy is the letting out of blood by the opening of a vain, for the preventing or curing of some grief or infirmity. I take in this place blood, not as it is simple and pure of itself, but as it is mingled with other humours, to wit, phlegm, choler, melancholy, and the tenue serum, which all (as Fernelius showeth) as they are contained together in the veins, 
Fernel method. medendi lib 2. cap. 1. & 3.  are by one word usually called by the name of blood. And although it still fall out that other humours are also by Phlebotomy evacuated out of the whole body, 
Fuchs. Instit. lib. 2.  yet (as Fuchsius doth prove out of Galen) it is properly the remedy of those diseases, which of the rankness of blood have taken their original. There are four several sorts and uses of letting of blood. The first is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, 
Montanus in medicine universalis part. 3.  evacuatio: The second is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and of Montanus eventatio: The third 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, revulsio: The fourth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, derivatio. The first, which is called evacuation, is the avoiding of that repletion and fullness whereby the body is overcharged.  
Repletion or fullness, called of the Grecians Plethora, is an universal redounding of blood. It is of two sorts, the one is called quoad vasa, when the veins and vessels containing blood, 
Fernel. method. medend. lib. 2. cap. 1.  have their whole capacity fully and thoroughly filled: and the second repletion is called quoad vires, in which the veins do not swell, and yet they contain more blood and nourishment then by nature can be ordered and governed. In the repletion quoad vasa (as Montanus showeth) are two dangers, 
Montanus medicinae universalis part. 3.  first, lest by the immoderate quantity there should happen either suffocation, or the rupture of some vain: and secondly, lest the abundance of blood should corrupt and putrefy. For the avoiding of both these perils, it is very expedient that in a full body a vain should be opened, although no grief do draw us thereunto, but only the mere fullness. 
Hippocr. 1. Aph. 1.  For as Hypocrates saith, The full habit of the bodies of champions, if it come to the highest degree of fullness it is frail and slippery, for it can not contiune long in the same estate. The second kind of repletion termed quoad vires, is rather to be holpen by medicines then by letting of blood. For if raw and undigested humours do abound in the body, the opening of a vain will draw out much good blood: but as for the bad blood which is gathered in the first veins about the liver and the middle entrails, it will draw it into the whole body, 
Gal. libr. 3. 〈…〉 t●●nda.  as Galen doth at large demonstrate, and therefore evacuation by some purging potion shall in this case be more fit than letting of blood. Yet when by the nature of the disease there is evident danger of a corruption and putrefaction of humours to ensue, than a little quantity of blood drawn shall be much available to anticipate and prevent it, if always regard be had how far the strength will permit, and what humour is especially mixed together with the blood in the veins. 
Fernel. method. medend. lib. 2. cap. 4.  For as Fernelius showeth, there is another way two kinds of repletion or plethora, the one is called pure, the other impure. Montanus maketh also two, the one simple, and the other compound. The pure doth consist of (in a manner) an equal portion of all the best juices. The impure is an abounding of vicious humours in the veins. If the plenitude come by choler, the vain may the more plentifully make evacuation. But if the fullness come by phlegm or by melancholy, then must the evacuation be made by little and little at several times when necessity requireth, and when the veins being over-full do threaten danger. How all these several kinds of plenitude shall be known, I shall have occasion to declare more at large in the first Chapter of the second book.  
The first use of Phlebotomy, to wit, evacuation, hath place not only in pure repletions, but also in all dangers of putrefaction, according to that of Galen: 
Gal. therap. method. lib. 11.  It is good to open a vain not only in fevers called synochis (which have one continual fit, and do proceed of inflamed blood) but also in all other humours that stand in danger of putrefaction, when the regard which is had of age and strength doth nothing prohibit. For nature which doth dispose and govern our bodies, being lightened, and having put off that which a● a burden did overcharge her, will easily overcome the rest in such sort, that it will concoct what is to be concocted, and expel what is to be expelled.  
The second use of letting-bloud is called of Montanus eventatio, 
This 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 is called of Platerus eventilatio.  whereupon he maketh a second kind called Phlebotomia eventativa, which is the venting of any humour that doth boil and bubble within the veins. For as the former, to wit evacuation, hath respect unto the plenitude; 
10. Bapt. Mont. part 3. Medicinae universalis.  so this 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 hath properly a relation to the boiling and bubbling. So (●ayth he) in quotidians and quartans we do often let blood, not because there is any fullness or great multitude of ill humours, but because we would by venting take away the boiling and bubbling thereof. This venting hath place both whether there be any putrefaction in the humour or no. But if our scope and purpose be only simply to vent, then is it best to do it by letting a little blood, and often according to the rule of Auicenna, Melior est multiplicatio numeri quam quantitatis. Otherwise if the case be compound that both there be a fullness and a boiling, that we must both evacuate and vent, then shall it be most fit to do it at once, and plentifully and as long as the strength will permit, as is taught at large by Galen in the eight book of his Methodus medendi. And in the same book speaking of some agues that are like to Diarian fevers, and do come of obstructions, he doth use these words: 
Gal. method. therapeut. libr. 8.  That the humour may be vented we have need of the great remedy, we must let blood the party being of sufficient strength, although there be no signs of plenitude. How it shall be known when the humours do thus boil and have need of venting, it sha●l be laid open at large in the two Chapters next following.  
The third use of letting blood is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Revulsion: Montanus calleth it Phlebotomia diversina, which is a plucking back of humours, when they are carried from any one part of the body into an other with force and violent course. evacuation doth respect the fullness, Venting the bubbling up, and Revulsion the violent course of the humour. How this revulsion must be made, is discussed in the seventh Chapter of this first book.  
The fourth use of blood-letting is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, derivatio; of Montanus, Phlebotomia derivativa, which is a deriving of a humour from any place where it is settled and impacted, into some other near place, by which it may best be overcome or avoided. It differeth from revulsion two especial ways. First, revulsion is into places far distant, as Hypocrates showeth: 
Hippocr. libr. de ●●●ium natura. pag. 245.  We must endeavour to open a vain distant as far as may be from the place where the grief is made or the blood gathered, for so there shall be no danger of a sudden change, and besides the custom being translated an other way, thou shalt make that there shall be no more flowing to the former wont place. But derivation of humours is into the nearest places, as by which they may most fitly be avoided, according to that of Galen: Derivation is made into places nigh joining, 
Gal. lib. 5. de c●● and morb. cap. 3.  but revulsion is made into places plain opposite. Again, an other difference there is, that revulsion is of humours now flowing, but derivation is of them that are already settled, as is witnessed by the same Author: 
Gal. lib. 4. method. therapeut. cap. 6.  If the flowing be still carried in his violent course, we must use revulsion to draw it to the contraries, but when the humour is settled and impacted in the place, than it is better to derive it. He giveth the reason of it, for the change is nearer, and both the access and the drawing force of the purging medicine is more ready when the place is nigh. And what there he speaketh of medicines, 
Gal. libr. 2. ad Glaucon. cap. 7.  the same he writeth of Phlebotomy. Rewlsion is the remedy of fluxes or rheums still flowing, but derivation is their help when they have taken hold of any part: but both these kinds of evacuation doth Hypocrates command to be done by the common veins. Thus much briefly concerning the first question, what Phlebotomy is, and of the four several kinds or rather uses thereof.   

CHAP. 2.  
How letting of blood may be used in continual agues called synochis, in hot agues, and how also in burning fevers.  
BEing now to declare particularly, how Phlebotomy is to be used in most of the usual diseases which commonly do reign amongst men, seeing there is no kind of infirmity that hath more sorts of itself subject to letting of blood than hath the Ague, I have thought it not amiss to begin first with it. In the ague synochus, which hath one continual fit, seeing that it proceedeth of the inflammation of blood, needs must the opening of a vain be very fit and convenient for it. But there are two kinds of it. The one is called synochus mitior, or ephemera extensa, in which only the thinner part of the blood is kindled, it is dissolved very often before the fifth day, it hath the urine somewhat reddish and thick, the pulse great and thick, but not evidently unequal. And the other is called synochus vehementior, wherein the whole substance of blood is inflamed. It carrieth manifest notes of crudities, to wit, unequalnes in the pulse, and the urine red and thick, and the tongue waxeth somewhat rough and blackish. In either of these synochis letting of blood is requisite, and that as plentifully as strength will permit. If at the first it were omitted, it may be done in the fourth day or in the seventh day, or after the seventh day. But the best and safest time is even in the beginning of the infirmity, 
Fernel. method. med. lib. 2. cap. 6.  as Fernelius saith, It is more safe to let blood when the disease approacheth, than when it hath already taken possession of us, according to the old verse:  
Aegriùs eijcitur, quam non admittitur hospes.  
It is a more hard thing to cast out a bad guest, than it is at the first not to admit him.  
And therefore Platerus willeth us in these synochi sine putredine, 
Platerus de febribus pag. 113.  wherein the blood is not putrefied but inflamed, to hasten the letting of blood, not only to vent or eventilate the blood inflamed, but also to pluck back the same, least breaking out of the veins into the principal parts, it doth stir up there most perilous inflammations. For Platerus and Fontanonus be both of this opinion, that the inflammations in the noble parts do follow these synochis, and not go before them. And therefore they do advise in the first beginning to open a vain, and if in the first day it be omitted when the ague is thought to be but an ephemera, an inflaming of the spirits for one day; yet the next day following, when it appeareth plainly that it is no ephemera, because it lasteth longer than a day, but that it is a plain synochus, then let out blood boldly a good quantity, according to the strength of the party; or else take the less blood at once, and open the vain either the same day or the next day again, which is the safest way for such as be weak. In this ague doth the second use of Phlebotomy, to wit, eventatio, or eventilatio greatly show forth his power, according to that of Galen, writing of the hot ague called synochus: 
Gal. method. therap. libr. 9  In whom soever the body in the multitude of humours being made unapt to vent and breath out, hath gathered such a heat that now it is come to a fever, the party must be let blood as much as strength can endure, knowing that if this remedy be not taken, they which are so affected shall either be strangled by suffocations, or suffer syncopies and very dangerous swooning wholly to overthrow them: Montanus writing upon the thirteenth Canon of A●icenna concerning blood-letting, 
Montan. medicinae universalis part. 3.  doth make three several sorts of this hot ague coming of blood inflamed, and showeth in which of them blood may best be let. The first is called Homotona, which from the beginning to the end doth keep the same tenor. The second Epacmastica, which increaseth more and more until it come to state and vigour. The third Paracmastica, which always decreaseth. In the first and the last he admitteth boldly to let blood, but in the second sparingly, lest strength and power failing the disease should overcome nature. So also if it be febris putrida, or synochus cum putredine, a fever wherein the humour is putrefied, he doth require a little before in the same book, that we should not let blood in any great quantity: Because where the humour is already putrefied, although though we should let blood even till the strength fail, yet should we not avoid the putrefaction: for putrefied blood is become earthly, and therefore can not be expelled. And if we let blood in a great quantity, the putrefaction will still remain, and the virtue and strength will be made so weak, that we shall not be able to remove that putrefaction which remaineth. He objecteth the example of Galen his practice, who in a certain servant having this synochus cum putredine, did let blood plentifully to swooning or fainting. 
Gal. therap. meth. libr. 9 ad 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 vide li. z. ca 8.  But he answereth to that place, that when Galen came to that servant, the humour was not fully putrefied, but only that there appeared some signs of putrefaction, and in the second day he opened a vain. So that when the signs of putrefaction did begin he let blood, and not when the humour was already putrefied: 
Montan. medicinae universalis part. 3.  and further, it was a fever always declining. But he concludeth there, I say plainly that of the fever should be with a putrefaction and a vain should be opened, the patient should be killed. The most certain sign to know when the ague is faulty only by means of the inflammation, and when it is faulty by the putrefaction, 
Trincau. in explanation lib. ●. Galeni de d●fferenti●●●ebrium.  is (as Trincauel in his explanation upon Galen doth show) by the systole and diastole of the pulses. For there is a double use of the pulse, the one for cooling of the spirits, and to that doth serve the diastole, or enlarging of the artery, for when the artery is enlarged a more cooling air being drawn in, doth temper the heat of the spirits. The other is that the smoky vapour (which must needs be engendered by the force of heat working upon moisture) may be so let out, that the spirits may be purified: and to this use serveth systole the contraction or compression of the artery. For while the artery is drawn and priest together, the hot air and smoky vapours are expelled and avoided. Now it must needs be that betwixt these two contrary motions, a rest must of necessity go between them. When there is need of cooling, there the diastole or enlarging of the artery is swifter, and the inward pause or rest is shorter: but where there is more need of avoiding moist and putrefied excrements, there the systole or contraction of the artery is swifter, and the outward pause is shorter. And this later he maketh to be the most certain note to know all putrefied agues, in which the humours rotting, many smoky vapours must needs be engendered, this he calleth so proper, familiar, inseparable, and certain a sign to know and discern putrefied agues from others, that it neither doth nor can deceive. another sign there is of a putrefied ague, when exspiratio est inspiratione insignior, when the breathing out is more evident than the breathing in, because there is more need of exhaling putrefied vapours, then of cooling. Alex. Massaria pag. 134. showeth sundry causes why letting blood should be good in putrefied agues, first, it cooleth and drieth, and all cooling and drying things are good for putrefactions. Again, it is good in respect of the ague, and last of all it helpeth much transpiration, by means whereof it must needs be good to help putrefaction. 
Mont. medic. vniuers. part. 3.  When Montanus affirmeth that to let blood in putrefied agues is to kill the patient, he meaneth a liberal evacuating of blood, but otherwise his words before do show plainly that it may be done moderately to vent the vapours. 
Platerus de febribus pag. 113.  And Platerus showeth an other cause why it ought to be done, because the occasion of putrefied agues doth lie hid in the blood and in the branches of the hollow vain, together with the blood is avoided some portion of the putrefied humour. 
Fernel. in methodo general● de curand●● febribus.  Of the same judgement is Fernelius, The opening of a vain which may take away both the multitude and also a great portion of the putrefied humour, doth greatly avail to the curing of the fever. 
Gal. method. therap. lib. 11.  And an other reason showeth Galen why this must be done, because nature being disburdened of a part, shall the more easily overcome the whole, as I have declared in the Chapter going before in the first use of Phlebotomy.  
If the ague be that which is called Causo the burning fever, whose matter is not the heat of blood, but the burning of choler (and whose signs are tossing of the body, 
Hippocr. de ratione victus in acutis, sect. 4.  an unsatiable thirst, the tongue dry and rough either yellow or black, a nipping about the stomach and liver, yellow excrements, the urine very thin and something wan, the pulse swift, thick and hard, doting, a little sweat about the forehead and neck, but every where else the skin very dry, and therewithal a little rough) letting blood may also well be used at the beginning, but in no great quantity, only four or five ounces for venting or eventilation are sufficient. Auicenna in his curing of the Causo doth affirm, 
Auicennae prima quarti.  that blood is not to be let in it, unless there do appear redness and thickness of urine, but that is not Causo, 
Montanus in canonem. 11. Auicennae in medicinae universalis part. 3.  but rather synochus. Montanus showeth, that the true continual burning fever seeing that the matter which doth putrefy in it (to wit choler) is most hot and most dry, it becometh in a manner altogether fiery.  
Hppocrates teacheth the way of curing a burning 
Hippocr. de ratione victus in acutis, sect. 4 pag. 382.  fever by quenching the burning heat, by giving water and mulsa aquosa, but he maketh no mention of letting of blood, thereupon Montanus doth conclude: that letting of blood is not to be permitted in a burning fever. But I think Montanus his argument in that disputation upon the eleventh Canon of Auicenna is of small force. For although Hypocrates do not precisely command in that place blood to be let in a burning fever, yet he maketh it in the same place to be a sign of the dissolution of the disease if the patient do bleed at the nose: and presently upon it he uttereth these words, At in morbis acutis sanguinem detrahes si vehemens fuerit morbus, & qui aegrotant aetate florenti fuerint, & virium robore valuerint. Platerus doth require in the Causo or burning fever, 
Platerus de febribus pag. 115. & pag. 55.  that there should be a liberal letting of blood if strength do permit, because he thinketh it not to proceed of pure choler (as many other Physicians have taught) but of blood putrefied and inflamed in the great artery, and causing so much the more dangerous fever as it is kindled in the trunk of the great artery nearest unto the heart. If Hypocrates do require Phlebotomy in morbis acutis, then must it needs be good in the burning fever, which as Trincavell declareth is maximus & acutissimus morbus. 
Trinc. de ratione curandi part. corp. affect. lib. 2. cap. 11.  But still in the quantity Hypocrates his rule must be observed, to have a due regard of the age and strength.   

CHAP. 3.  
How blood-letting may be admitted in agues caused by obstructions, as Diaries etc.  
GAlen showeth, 
Gal. meth. med. lib. 8. cap. 4.  that by obstructions sometimes the transpiration and vapouring out may be intercepted, and by the obstructions they which have bad humours fall into agues, as Diaries and such like, and in them he requireth as very expedient the opening of a vain, first for venting or eventilation: for as he saith, unless the bad humour be vented, it must needs become putrefied: and secondly, because those things which you shall minister afterward to deliver from obstructions will work more effectually. For it is best to come to deterge and loose obstructions, having first by blood-letting (for he speaketh there of Phlebotomy) avoided part of the evil humours. For we seeking to deliver the obstructions before we have made evacuation, it is in danger that we shall imp●●t the obstructions more firmly than before. How the greatness of the obstruction shall be known, Galen showeth a little after in the same book, 
Gal. method. therapeut. libr. 8.  The declaration of the quantity of the obstruction is made manifest by the ague: for upon greater obstructions the ague is greater, and upon less obstructions it falleth out to be less. 
Bapt. Montan. medicinae universalis part tertia.  Montanus being fallen into the consideration of this place of Galen, doth make three several kinds of obstructions, and showeth in which of them blood-letting is requisite, and in which not. The first obstruction is when in the pores of the skin in the outward parts the transpiration and vapouring out is stayed and prohibited. The second kind of obstruction he calleth coarctatoria, when such a multitude of humours is contained within the veins, that the passage of the spirits being stopped, they cannot pass through the veins, whereby there cometh a peril of suffocation. The third obstruction is called oppilatio, when some tough matter doth so stop the conduits and channels of the veins, that neither matter nor spirits can pass through them.  
In the first kind of obstructions Phlebotomy is good, because by it the body is made more thin, and humours being without the veins in the compass of the skin, are by blood-letting drawn into the veins, and so do pass away, as Montanus doth demonstrate out of Galen.  
In the second kind of obstruction letting blood is also convenient, 
Gal. de sanit. tuenda libr. 4.  that the thronging together of humours may cease, and that blood may be vented. But in the third kind of obstruction it were ill done to let blood, because the thick humour which is impacted in the first veins, is not thereby evacuated, but rather increased, as the same author doth prove out of the same fourth book of Galen de sanitate tuenda. I think he hath respect to that position of Galen: 
Ibid.  In a wearisome and faint body there is little good blood, and many raw humours, Phlebotomies do avoid the good blood, but as for the ill blood which is gathered together in the first veins, especially that which is about the liver and mid bowels, they disperse and spread it throughout all the body. How in the two last kinds of obstructions the humour must be prepared and made fluxible, before we attempt any letting of blood, it is to be declared hereafter in the third Chapter of the second book. But the question is here only of the first kind of obstructions, when in an ague called diaria or ephemera (which lasteth not above 24. hours) by reason either of the constipation or thickness of the skin the spirits and vapours have lost their accustomable flowing out, whereby the spirits are inflamed, whether in this ague blood is to be let or no? I answer, that according to the judgement of many excellent Physicians of our time, 
Platerus de febribus pag. 286. Fuchsius de morbis medendis. lib. 4. cap. 1. Brigthus in therapeutica.  this ague is best overcome by causing kindly sweats, by medicines losing obstructions, and by using fit baths without letting of blood. But if it do continue more than a day, that it be now diaria plurium dierum, or as some call it ephemera extensa, than all do agree that letting of blood is very expedient, for fear least of an ague not putrefied it do become a synochus putrida, and so bring greater danger. For as diaries or agues of one day do pass into diaries of many days, unless the obstruction be loosed as Galen saith; 
Gal. lib. 10. method. medendi.  Unless the obstruction be cured they fall into agues of many days: so also the diaries of many days do fall into putrefied agues and hectic fevers, unless they be in time holpen and eased, as the same Galen showeth in the first page of his ninth book de methodo medendi. But concerning letting of blood, Galen doth in the tenth book generally set down his judgement very briefly concerning all diaries caused by obstructions. 
Gal. method. therap. lib. 10.  One obstruction cometh by multitude, and an other by the quality of the humours being too tough, or too thick. In that which cometh by multitude, letting of blood is the chiefest manner of curing, but in that which cometh by the quality of the humour, the use of the extenuating things is best.   

CHAP. 4.  
How far letting of blood may be allowed in intermitting agues, quotidians, tertians, quartans.  
Montanus' affirmeth, 
Mont. medicinae universalis part. 3.  that in a phlegmatic ague, if the phlegm be thick and of a glassy green colour, as it falleth out in the agues called epialae, then in no wise may any vain be opened, because although there be a great boiling, yet we have need of a great heat, that the matter may be concocted, and the passages opened, and therefore he thinketh that we have need rather of frictions. But if it be pituita dulcis, such a phlegm as may easily be converted into blood, than he alloweth letting of blood as a fit help to remove the obstruction. He showeth in the same place a little before, that the chiefest cause why we sometimes use phlebotomy in quotidians & quartans, is to vent the vapours. 
Vide finem tertiae partis medicinae universalis Mont●ni.  It respecteth not the multitude, but the quality, because it is done only to help the bubbling of the humour. In the tertian he saith, that Phlebotomy is not necessary, neither evacuative, because there is no fullness of blood, but only evil humours mixed with the blood, nor yet Euentative, because the paroxysms of the tertians continue not above twelve hours, and have a great distance of intermission, and therefore can not have so great a boiling as should need to be vented with so great a remedy as is Phlebotomy. And as touching the quartain, he saith, that blood-letting doth not agree unto it of itself as it dependeth of melancholic humour, but per accidens, as when it cometh upon the suppressing of the menstrua or haemorrhodes, or when it cometh ratione sanguinis adusti by means of burnt blood, than he alloweth the letting of blood. Platerus doth think that all intermitting agues do proceed of a putrefied cause, 
Platerus' de febribus pag. 151. & 154.  lying hid in the mesaraick veins, and therefore if any of them could be opened, he supposeth some help might come: but seeing those mesaraick veins do no where appear at the skin, it were best not only in quartans but also in tertians (if possibly it may be) to cause a flux of the hemorrhoids, because the haemorrhodiall veins are branches of the mesaraik veins. He will have no vain to be opened there, unless it appear exceeding well, because a small wound made there, doth bring oftentimes great torments: but he will have either the flux to be procured by some medicine, or else leeches to be applied. He alloweth not phlebotomy in exquisite tertians, and such as are afflicted with most vehement heat, by reason of choler inflamed, neither doth he think it fit in phlegmatic agues, in which cases he which shall rashly and unskilfully let blood, shall not only avoid nothing of the cause lying hid in the mesaraik veins, but also as he saith, the matter being plucked out of the mesaraick veins into the hollow vain, he shall of an intermitting ague make a continual ague; 
Plat. ibid.  or else, the purer blood, by reason of emptying the branches of the hollow vain, being drawn out of the mesaraick veins, that choleric and putrefied humour which remaineth (and whereunto blood was before a bridle and a means to assuage it) will now become more fierce. Therefore he concludeth, that in these kinds of agues more harm is done by admitting Phlebotomy then by omitting it, unless some grievous symotome do happen, that by the inflaming of blood an inflammation also of some of the inward parts be feared, or unless there be a plethora or plenitude in the body (which may be observed by the redness and thickness of the urine, and by the long continuing of the heat after the fit, and when there is no fit) than not in the beginning of the ague, but about the third or fourth fit, in the day of intermission, out of that vain of the arm that appeareth most filled, it will do very well to let blood 5. 6. 7. or 8. ounces. In quartains it must be done in the left arm, & somewhat later than in tertians: 
Plater. Ibid.  For quartans are at the beginning gently to be handled, lest a double quartain or a triple quartain be made, and lest also the strength should decay, which here we must preserve by reason of the long continuance of the disease. Fuchsius in an exquisite tertian (which proceedeth of mere choler, 
Fuchsi. de medendis morbis lib. 4. cap. 6.  not mixed with any other humour) doth prove out of Galen ad Glauconem, that neither letting of blood, nor vehement purging medicine can be convenient for it. 
Brigthus in therapeutica.  Doctor Bright doth think requisite that in the first day of intermission (to ventilate the body) 6. or 8. ounces of blood be taken. 
Fernelius in methodo generali de curandis febribus.  These judgements do seem to be contrary, but yet the several circumstances being considered, they may both be very well reconciled. For as Fernelius showeth the opening of a vain in respect of itself is hurtful to an exquisite tertian, it taketh away the profitable and necessary humour, and leaveth behind the impure and hurtful. Again, in this kind of ague the body is wont to be very thin and of little blood: But the sharp choler which is the matter of the ague, and doth abound and boil under the hollow part of the liver when blood is taken away doth wax more fierce. Yet he alloweth there letting of blood in respect of other symptoms, such as are headache, beating of the temples, and heaviness of the body, in corpore plethorico. In tertiana notha, or the bastard tertian, where choler is for the most part mingled with phlegm, or where choler doth not make itself the matter of the ague, but doth kindle other humours (which may be known in that the pulse is much less, 
Fuchs. de morbis medendis lib. 4. cap. 7. Brigthus in therapeut.  thinner and slower than the other, and the heat also less) then is no blood to be taken at the beginning of the Ague; but afterward the matter being prepared, when the urine doth appear red and thick, a vain may be opened the day going before the fit, and four ounces of blood may be taken. But if the blood prove thin and somewhat yellowish, then must you straightway suppress it. In the melancholic quartain if it come upon the staying of any usual or natural purging of blood, then stir up that if you can: if you can not, then within the 14. or the 20. day let a little blood out of the salvat, if the strength be weak; or otherwise out of the basilica of the left arm, having before given a clyster. But if the quartain do come ex atrabile of black choler, which hath fits beginning with less shaking, and those also shorter than the melancholic (for the melancholic continueth 24. hours) and is also accompanied with a sharp heat and vehement thirst, and with much more unquietness than the melancholic, than you may let blood in the beginning four or five ounces out of the basilica of the right arm, and the next day after if strength will permit two or three ounces out of the salvat of the left hand. If that the black choler do proceed of burnt blood you may let out more than if it proceed of any other humour. 
Heurnius lib. 2. method. ad pra●n.  That learned Heurnius saith, Black choler is ugly, and doth spring of some burnt humour; but melancholy is the very melancholic juice or the dregs of blood. These are of a nature far differing. For to black choler are due those things which may pacify the fierceness of it, as Violets, Endive, and such like: but to melancholy are due such things as are moderately warm and opening, as the roots of Capers, the aperitive roots, and such like, always adjoining to them such things as have vim humectandi a moistening force. And as in potions and medicines these two require a far differing method, so also (as you have already heard) in the manner and time of letting of blood.  
In the intermitting agues we must not have a bare and naked respect only to the fever itself, but we must heedily regard all the symptoms and dangers which may ensue by the means of other accidents, 
Trincau. in 〈…〉 ad Glauconem.  as Trincauel in his Commentary upon Galen ad Glauconem doth at large declare by the example of an exquisite tertian. An exquisite tertian (saith he) was never in respect of itself counted amongst great diseases, and therefore Phlebotomy doth not properly appertain unto it. But in other respects it is not only profitable, but also necessary, when regarding the state of the body, our scope and purpose is to prevent and avoid future mischiefs. 
Trincau. Ibid.  For often may an exquisite tertian pass either into a continual ague, or into a burning ague, when the body is full either of blood or of choler. His reason is because blood may by reason of the multitude putrefy: and also choler if it be much, and the strength do grow so weak that it neither can govern it nor expel it, it must needs more and more putrefy. 
Hippocr. libr. de morbis.  And also according to Hypocrates easily may a tertian be converted into a pleurisy. For these causes (saith Trincavel) the opening of a vain may have place in an exquisite tertian, 
Trinc. in expl. libr. 1. ad Glauconem de arte curativa.  but that according to Auicenna must be until the third fit. Thus in all intermitting agues, though not in all after the same manner, nor in the same time, nor in the same quantity, nor for the same end and purpose, that axiom of Galen holdeth firmly, 
Gal. therap. method. lib. 11.  that not only in continual agues but also in all other agues whatsoever where any humour doth putrefy, it is good to open a vain. You have his words and his reason in the first Chapter of this book set down at large in the first use of Phlebotomy. One general note to know in tertians and quartans whether any blood may be spared, is the thinness and the yellowishnesse of the blood. For the same which D. Bright doth write in bastard tertians, 
Brigt in therapeut.  that if the blood do prove thin or yellowish, we must strait stop. The same doth Fuchsius require in quartans, 
Fuchs. de redend●● morbis lib. 1. cap. 8.  that if the blood do appear black and thick, such as is commonly in splenetic men, than we shall let the party bleed more largely; but if the blood do prove thin and yellow, then must it be presently stayed: for such a humour is not unprofitable, but as well by his substance as also by his quality it doth amend the thick and cold humours.  
Alexander Massaria chief Doctor and professor of the University of Padua, a man of excellent judgement, 
Massaria de ●upis mit●endi sanguinis pag. 132.  doth in his late treatise concerning Phlebotomy differ from the opinions of Platerus and Fernelius, as touching letting blood in tertian agues; and alloweth letting blood sometimes in exquisite tertians, and sometimes in bastard tertians, alleging the authority of Galen, 
Gal. lib. 1. ad Glauconem cap. 10.  so that it be done 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, strait in the beginning, and other things duly considered, as the strength and plenitude, and due preparation of the body. And he wondereth what Avicen should mean, when he saith, 
Massaria pag. 91.  that upon immoderate bleeding choleric humours do more boil and rage, whereby the patients are more inflamed, whereas experience doth testify that unseasonable or excessive bleeding doth bring rather dropsies and cold and bad habits of body, than any boiling heat or inflaming. If in tertians the choleric humours of the body be first drawn away and the bowels evacuated by a glister, and a fit time chosen for the opening of the vain when the stomach is fasting and empty, I see no reason but the stomach and bowels should draw back sufficiently to keep the mesaraick veins from sending any such store of humours into the hollow vain, as should putrefy the blood in it or the branches thereof. And the rather do I yield more to the judgement of Massaria, then of Fernelius and Platerus in this point, because the most learned and expert Physician Heurnius doth testify, 
Heurnius libr, de morbis cap●●is cap. 10.  that in letting blood in choleric bodies we do often avoid more choler than blood, and by experience I have found it very oft to do much good & bring present help towards the beginning of tertians, although after the fifth or sixth fit I have not seen much good to come thereof. 
Massaria pag. 133. Gal. libr. 1. ad Gauconem. cap. 11.  But in quartain agues Massaria cleaveth to that of Galen, We must deal softly and gently with quartain agues at the beginning, and neither use any strong purging nor evacuation of blood, unless it do mightily abound: And if to him that openeth the vain the blood do appear black and thick, such as especially is found in splenetic persons, let him let blood the more boldly; but if it appear yellow and thin, let him straightway suppress it.   

CHAP. 5.  
Whether letting of blood be to be admitted in the plague or pestilent fever, as also in the Pox and such other contagious infirmities, and when and how.  
AVicenna in his eeventh canon concerning blood-letting (as Montanus hath divided them) doth set it down for a rule, 
Mont. medie. vniuers. part. 3.  that in what agues soever there is a most vehement inflammation, there must be no letting of blood. Montanus discoursing upon that place, saith, that we must regard not so much what the disease requireth, as what the strength can bear, 
Mont. Ibid.  In respect of the disease Phlebotomy doth agree, but not in respect of the powers. He bringeth in an instance of a pestilent fever, and showeth that blood is not to be let in it, because although of itself in regard of the pestilent fever there is no greater remedy than letting of blood, seeing that by it the body is made apt to vent and vapour out the spirits, the inward heat is extinguished, and putrefied blood is evacuated: yet if blood be let all do die, 
Mont. Ibid.  and therefore we must abstain from Phlebotomy in the pestilent fever, because in a moment of time the strength utterly decayeth. Platerus showeth sundry great dangers which letting of blood doth bring unto them that are infected with the plague, 
Platerus de febribus pag. 225.  and that little good help can be expected thereby. I can not see how Phlebotomy can avail to pluck that venomous quality from the heart, or to bring it out of the body together with the blood, seeing that it is rather procured thereby, that the infection which from outwardly cometh into the body and doth presently infect the spirits, should be drawn more deeply inward. And moreover the motion of nature (whereby straightways in the first invasion it goeth about to shake out the poison by sweats, 
Plater. Ibid.  by outward pustles and by botches) may be hindered by letting of blood, and the powers thereby weakened, which we ought to keep strong to expel that poison. It neither doth avoid the cause of the disease, neither is there any need here of any eventilation of heat, seeing it is not here so vehement. Hereupon he concludeth, that upon rash and unadvised letting of blood in plague times many men are killed. Yet he acknowledgeth that when the plague hath taken hold upon bodies which are summè plethorica vel cachectica, full of blood or of corrupt humours whereby a fever is kindled, then if by opening of a vain the plenty and putrefaction of the blood be taken away, all the other symptoms 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 fullness of the veins do require it: for of lusty youths we have found by experience more to escape in the plague time without letting of blood then by letting of blood. If Phlebotomy be used it must be done rather in respect of the fever then of the pestilent quality, seeing that this venom doth not consist in the blood, but coming from outwardly doth suddenly possess the heart, and we do not think that it can be expelled or drawn out from it by Phlebotomy. And if the case do so stand that by the means of the plenitude and fever a vain must needs be opened, than he showeth in what order it must be done. First, it must be done in the beginning: for unless the vain be opened within 24. hours of the beginning, it will rather hinder nature then do any good. Also it must be considered whether the party be in a sweat or no: for in no wise must the sweat be hindered by Phlebotomy. But after the party hath sweat and hath been refreshed with a little meat or some cordial receipt, then may a vain be opened howsoever there hath gone no clyster nor purging before, because the time hath not given leave. Choose the vain in that side which is most grieved. If any eruption appear about the flank open the saphena. If in the upper parts, than some vain in the arm or hand of the same side. If under the armhole, take the basilica. If about the ●ares, the cephalica. If in the face, open the vain under the tongue. And ever to the botches appearing, let cupping glasses be fastened, that the poison may abide in the same place, and not by Phlebotomy be drawn into the inward parts. Trincavel doth account it very dangerous to let blood when pimples do outwardly appear: 
Trincauel tractat. de febre pestilentiali.  but when as well by the pulse, as by the former manner of diet which the party hath used, it is found to be expedient; then let it be done strait in the beginning before the putrefaction of the pestilent fever be much increased; and before nature do seek to expel unto the skin. 
Hippocr. de morbis vulgar. lib. 1. sect. 7.  Thus he proveth out of Galen, who commenting upon one of Hypocrates his patients called Crito, who died upon a kind of pestilent fever, he doth excuse Hypocrates and saith that he did not let him blood, because he was not sent for at the beginning of the disease. Which signifieth that if he had been sent for at the beginning, a vain no doubt should presently have been opened.  
Montanus in his epistle to Crato doth allow letting of blood in the small pocks and such other contagious diseases, 
Montan. in initio consultationum medicarum.  so that it be in the beginning before signs of putrefaction appear: but when it hath once prevailed, then to let blood he doth call it a pernicious and a deadly thing. For nature is then checked when it should wholly be intentive to expel the venom and infection of the disease. 
Fuel. consil. 67.  Fernelius, Hollerius, and Silvius, three famous and worthy Physicians, consulting about the sweeting plague called sudor Anglicus, did deliver to the English Ambassador the use of blood-letting amongst the means to prevent the disease, in full bodies, the bodies being first orderly purged: but the disease having once taken hold, they advised no blood-letting, but prescribed good cordials to expel from the heart the venomous 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 book next ensuing) we may be bold to begin the cure with blood-letting, observing as near as may be the cautions before expressed, and especially taking heed (as Montanus giveth warning) that we choose the vain as far as we can from the principal parts, 
Montanus medicinae universalis part. 3.  from the heart, liver, and brain, for if we draw the pestilent humour unto them he saith we shall kill the patient.   

CHAP. 6.  
How letting of blood is to be used in frenzies, quinsies, pleurisies, inflammations of the reins or womb, and other inward inflammations happening often without agues.  
IN the frenzy (which is a depraving of all the principal faculties of the brain) caused by the inflammation of the films thereof) Rhazes doth allow Phlebotomy in the beginning of the disease, 
Heurnius de morbis caepitis cap. 10. pag. 114.  but not if it be a hectic frenzy of any continuance. Celsus doth affirm, that the face being red and the veins swelling, a vain may be opened after the fourth day, if strength be sufficient. But if it come of a choleric cause, than it should seem to be ill done to let blood, because as Heurnius objecteth fraenum bilis est sanguis, blood is the bridle of choler. To this he answereth, Male sanguinem sine bile educeremus. imo plus bilis educimus quam sanguinis, Hardly can we avoid blood without choler, yea rather by Phlebotomy we do bring out more choler than blood. And if it were done but only for derivation sake, yet were it well done. But at what time must this Phlebotomy be used? Caelius Aurelianus saith that it must be done within three days of the beginning, and not beyond, because in such diseases the strength of the body is in peril. Aretaeus also saith, that it ought to be done either the first or the second day. If the frenzy begin after the fourth day, then open the vain after the seventh day: but if it do come in the sixth or seventh day, then let no blood, for that is a critical frenzy. A●tius saith, that if the frenzy do come with an ague any day before the fourth day, and signs of plenitude appear, we may well open the middle vain. When the frenzy is old, letting blood is not safe. Caelius saith, that to let blood after the eight day est iugulare homines, is nothing but to murder men. The quantity must be according to the cause. If it proceed of inflamed blood, you may let blood usque ad animi deliquium, till the heart begin to fail. For there is a vehement inflammation, a very sharp fever, and exceeding great grief, 
1. Aph. 13. & 1. Aph. 23.  in which three cases Galen alloweth large Phlebotomy. But if the blood be much mixed with choler, than six ounces shall suffice, or if the party be strong, ten ounces. Aretaeus his opinion is, that if it have the first beginning from the parts about the midriff, than the party may bleed more largely, because thereabouts lieth the fountain of blood. What you do you must do at once, for the disease doth give no long truce. Trallianus commandeth the vain of the forehead to be opened. But that Heurnius doth condemn, 
Heurnius de morbis capitis cap. 10.  as ministering a further increase to the disease, especially if the frenzy come of blood: for both the blood should turn his course into the head, and also the evacuation should be made by the very place affected, which should be as he thinketh very inconvenient. The course which Heurnius doth best like of, is this, first to open the middle vain of the arm, and after to open either the vain of the forehead, or the vain under the tongue.  
For the Quinsy or squinancy, the swelling of the throat, 
Trincau. de ratione curandi partic corp. affect. lib. 5. cap. 7.  causing difficulty of breathing, and hardness of swallowing, Trincauel doth advise a speedy letting of blood; yet a glister being used before if the disease will give leave: but if the disease (as it is a very sharp disease) will give no space, then may we do as Hypocrates sometime did, 
Hippocr. 2. de ratione victus in morbis acutis. Fuchsi. de medendis morbis lib. 2. cap. 5.  that is, first let blood, & afterward minister the Clyster. Fuchsius willeth us to open the basilica of the arm of the same side where the swelling is. But he will have it to be done at several times by little and little, and not all at once, lest there should happen a swooning, and so a peril of suffocation: and beside, By two sudden coolings and by fainting of the heart, the matter may be carried from the jaws unto the lungs, and so bring inevitable danger. Yet must not the incision be made too little, least by means of the narrowness of the hole the good blood should be as it were strained out, and the thick part remain within, which is the cause of the grief. If the patient be a woman whose terms are stayed, open first the saphena, and then the vain under the tongue. For the pleurisy, how convenient blood-letting is for it, it is a thing so well known to all men, that there needeth no proof thereof. But on what side the vain must be taken, whether on the same side that hath the inflammation, or on the contrary side, seeing that there is amongst learned Physicians a great controversy about that matter, I have appointed one Chapter, to wit, the Chapter next following, wholly for the discussing of that question. And for as much as also all the arguments laid open in that disputation do as well concern the inflammation of the reins and of the womb, and all other inward inflammations as the pleurisy, I have thought it good to speak no more of the particulars here, but rather to conclude with that general speech of Galen. To speak briefly, 
Gal. libro de ratione carandi per venae sectionem.  when inflammations do begin, we must evacuate them by rewlsion (that is, pluck it back into the parts furthest distant) but when they are of long continuance, we must empty them out of the places affected, or as near unto those parts as we can. For at the beginning of inflammations it is good to turn back that which floweth, but when they have remained a long time, we must avoid and expel that which is impacted and fastened in the part affected.   

CHAP. 7.  
In these dangerous inflammations aforenamed, whether evacuation or rewlsion be more necessary, and what is the meaning of Hypocrates his rule 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, to work directly, and with a right course of flowing.  
PEtrus Brissotus, and Matthaeus Curtius, two learned Physicians, the one a Frenchman, and the other an Italian, have by many arguments proved, that in a pleurisy the vain aught still to be opened in the arm of the same side where the grief lieth. 
Trincaevel Consil. pag. 971.  Trincauel in his treatise which he calleth rudimentum, hath undertaken to confute them. The first reason of Brisso●us is, 
Ratio prima Brissoti.  because in such sharp diseases, unless you help presently the party dieth. And the first scope in an inflammation is to avoid blood out of the place inflamed, for the performance whereof the same side is most convenient. Trincavel answereth, that when the party hath no full body, than that position may well stand. But if there be a full body, than he holdeth with Galen, that the scope and purpose of the Physician must be to forbid that the blood shall not flow to the place of grief. For the flux of the blood doth Galen make to be the cause of the vehement inflammation. 
Gal. libr. 2. add Glauc.  And this staying of the flowing of blood he thinketh may best be done by evacuating, so that we may also revel the same by drawing it back to the contrary side. Brissotus again objecteth, 
Ratio secunda Brissoti.  that by rewlsion there is often stirred up a pleurisy on the other side, unto which the rewlsion is made. Trincavell doth answer, that doth happen by means of the fullness of the whole body, especially of the lower parts, when the opening of the upper veins can not avoid so much as is drawn upward out of the inferior parts of the body: whereupon the humour following, the motion which is made by the force of the vain cut, settling on that side, doth give an occasion of a new inflammation. And therefore when there is a plenitude in the whole body, especially about the lower parts of the belly, he doth greatly commend the custom practised for many years with good success by the Physicians of Venice, to wit in this, to open the vain about the knee, or about the ankle. And he showeth, that in his own experience in the same time that he was writing that treatise, he cured an old man of 60. years of age (who having a body verè plethoricum, was fallen into a pleurisy) by causing the vain to be opened hard by the ankle. If Hypocrates did sometimes open the vain in the arm of the same side where the pleurisy did lie (as Trincauel doth make account he did in the curing of Anaxion the Abderite) it was because the disease was fully made, 
Hippocr. lib. 3. epidem.  and the matter already flowed. But in the beginning of the flowing of the humour, neither Hypocrates nor Galen do allow the same kind of evacuation, which afterward-they admit when the flux is already made. 
Hippocr. 6. epidem. par. 2. aph. 19  Hypocrates saith, If humours be carried into that part which they ought not, we must revel them, but if they flow the same way they ought, then to open the passage to them according as every one is bend. And what his judgement is touching this matter, you have it set down in the end of my Chapter last going before, 
Vide finem ●exti capitis huius libri & finem primi capitis.  and also toward the end of my first Chapter, where are cited the words of Galen concerning an ulcer caused of a flux, that if the flowing be vehement we must pluck it back into the contrary parts, but when it doth cease and rest settled in a place, then is it best to derive it. Upon which point also Galen doth infer there a general conclusion. 
Galen lib. 4. method. therap. cap. 6.  It is a general thing that when fluxes do begin, we must use rewlsion; but when they are settled in any affected part, then evacuate them either from the same place, or from some other place as near as can be. He speaketh there of purging by medicines, but in the 13. and 14. book of the same method of healing, he requireth the same order likewise in letting of blood, and repeateth again as a general axiom, 
Gal. method. therapeut. lib. 13.  ever make the rewlsion to the furthest parts off. So commenting upon Hypocrates, he biddeth us first make rewlsions, and afterward set upon the contraries, to make local evacuations as he himself doth expound it by the example of grief in the hinder part of the head, 
Gal. libr. 2. comment in 6. epidem. prop● finem commentary. Gal. method. therapeut. lib. 13. 〈◊〉 Institut. lib. 2.  which is taken away by opening the vain of the forehead. And so in an other place, if the right leg have an inflammation, he appointeth a vain to be opened in the left. Fuchsius hath framed sundry answers to those testimonies of Galen in the 13. book of his Methodus therapeutica. First he saith, that his general axiom, that rewlsion must be made always to places furthest distant, can in no wise be wrested unto letting of blood, seeing that Galen doth not speak there of letting of blood, but of purge, vomits, cupping-glasses, and such like. I wonder that Fuchsius should make that answer, seeing that Galen doth not only often in the leaves last going before make mention of Phlebotomy, but also when he hath made this general precept with 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, semper, always revel to the furmost, he saith in the lines next following, that he hath spoken of this in his books of Plenitude and Phlebotomy. 
Gal. method. therap. lib. 13.  These things are written in my books of fullness and blood-letting. Secondly, Fuchsius saith further, aliquando venae sectione ad longinqua revellimus, sed hoc fit in futuro morbo, sometimes we make rewlsion by blood-letting into places far distant, but that is when the disease is to come. If Fuchsius confess so much, than he agreeth with Auic●n, Montanus, Trincavell, and such a● hold with them. For they all do teach that reveling into places furthermost distant is not always requisite, but only in the beginning, when the humour is yet flowing, before the humour be settled, antequam sit morbus factus, before it be a disease made, and that is indeed in futurso morbo, Thirdly, for that place where Galen doth bid that if the one leg have an inflammation, we should let blood in the other: Fuchsius answereth, that Galen doth speak in that place of scarifying, that when one leg hath gotten an inflammation we must scarify the other, because scarifying doth stir up a grief and pain, and dolour attrahit, grief draweth the flux to the place scarified. But I marvel that Fuchsius would not take the words as Galen hath let them down. Galen speaketh plainly in that place not only of scarifying, but also of blood-letting, his words are these: 
●al. method. 〈…〉  We must either open a vain, or scarify the places not affected, as the hand being grieved to take the leg, or the one leg being pained, the other.  
Fuchsius having objected the practice of some which first do diminish the plenitude by opening the saphena, or else the basilica of the contrary arm, and after do take away the relics out of the same side where the grief lieth, doth cry out against this counsel of the Arabian Physicians with the same words that Fernelius also doth, 
●ernel●in me●●●● medendi 〈◊〉 cap. 5. 〈◊〉 institist. 2.  What an odd counsel is this to torment the patient so often, when you may with one act ease him of his pain? But although these two were both of them famous and learned men, yet as good Physicians as they do prescribe the act of letting of blood to be often repeated either in one day or in days immediately following, and yet are in very good hope that they do not thereby torment the patient, but work much more for his ease. 
Hieron. Mercurial. consil. 15.  Mercurialis giving counsel to one which in a cough did spit blood, saith, If the casting up of blood do remain, it would like me well that blood should often be let a little at once out of either arm, and therewithal rubbings and bindings applied both to the ankles and to the knees. Montanus who doth as much reverence Auicenna, 
Montan. medicinae universalis part secunda, pag. 312.  as Fuchsius and Fernelius do persecute him. For he saith of him, Avicen was a most divine man, a follower of Galen, and to be preferred before all that have drawn their learning out of Galen: We have Greek translators (as he nameth there Aëtius, Paulus Aegineta, and Oribasius) but compare them with Avicen and they are nothing. 
Pag. 393.  And a little after he saith, we must know that Avicen doth never speak any thing but what was before approved by antiquity. This Montanus as in other points he commendeth Auicenna, so in the several states of pleurisy he alloweth his judgement, 
Montanus medicinae universalis part. 3.  that first blood be drawn from the saphena, then from the opposite vain of the arm, and last of all from the same side: The first taketh away the multitude; the second maketh the diversion, and the third doth empty the place affected. For the diversion to the contrary part Montanus doth not only allege the authority of Auicenna and the Arabians, but of Archigenes and of Aretaeus. Aretaeus is brought in giving his reason, If there should be multitude of blood and you should draw it from the side where the pleurisy is, either you must draw it plentifully to fainting and swooning, and so the patient should either die, or get an impostume in the lungs, or else you must draw a little, and so choke and stifle the party diseased, because (the plenitude being so great) much more will flow then shall be avoided. 
Trincau. in rudimento in consil. pag. 1043.  Trincavell in the conclusion of that treatise which he made against Brissotus and Curtius, doth describe several considerations which are to be had in the pleurisy: If there be a great fullness of blood, and a vehement force of the humour rushing on, and that we fear moreover lest the inflammation should overmuch increase, than we do attempt both a rewlsion, and also an evacuation as far off as we can, and by the contrary side: but if there be no great fullness of blood, nor great force of the flowing of humours, nor great inflammation, than there is no need to begin with parts far off, because less rewlsion is requisite. So he expoundeth the meaning of Galen, that if the knee or the feet be taken with an inflammation, this must first be considered, whether there be such a fullness of body as doth also fill all the upper parts, whereby there is feared an increase of the swelling, for than we must let blood out of the veins of the upper parts. But if the repletion be not so great, and that it be only in the inferior parts, then shall it be sufficient to let blood out of the opposite foot. The inflammation may be so little and light, that it will be enough to open a vain in the foot of the same side. If the testimonies which Fuchsius doth allege out of Hypocrates and Galen be considered by these circumstances, 
Fuchsius Instit. libr. 2.  then shall the two opinions be easily reconciled. 
Galen method. 〈◊〉 lib. 13. cap. 11.  He citeth Galens' authority, when the liver hath begun to gather an inflammation, the blood is both to be plucked back, and evacuated, by opening the inward vain of the right arm, because it is direct unto it, and a great way hath a society with the vain which is called the hollow vain. Galen doth there suppose the case to be first, a liver beginning to be inflamed, and therefore yet a light inflammation: then consider principally whether the whole body have ●eede of evacuatiou: then consider the strength of the patient, whether he be able to endure to evacuate once plentifully: and whether he do stand strong in power, then by Phlebotomy in the right arm revel or take away the blood that is carried towards the liver. This doth nothing overthrow the positions before set down. 
Fuchs. Instit. lib. 2. & de morbis medendis lib. 2. cap. 8. & in Apologia adversus Brachelium.  Fuchsius every where doth build mightily upon that place of Galen in his book of Phlebotomy: In pleurisies the Phlebotomy which is used right upon the side that is pained, doth often bring a most evident help: but that which is used upon the opposite hand, doth bring either an obscure help, or else it is long ere it come. 
Gal. de ratione curandi per venae sectionem.  No doubt Galen there doth mean such in whom there is morbus iam factus, the disease already settled, and of them you may see what Galens judgement is, if you read the conclusion of the sixth Chapter of this my treatise. For ever according to the several scope and drift of the Physician, there must be a several manner of Phlebotomy. So in the inflammations of the womb Galen teacheth, that in the beginning of them, 
Gal. ad Glauconem therap. libr. 2.  when the humour is now in flowing, thou shalt divert it, if thou open the varne in the cubit. But if the humour be settled in the place, thou shalt derive it by opening the vain in the knees or in the ankles. 
Gal. libr. de ratione curandi per venae sectionem.  True it is that he doth elsewhere teach, that Phlebotomies in the arm do stay women's terms, as the letting blood in the legs doth bring the terms down, but (as Galen showeth) in the beginning of the inflammations of the womb it is not good that the terms should be provoked, 
Gal. method. therap. lib. 13.  because they bring down a humour to the place affected, especially in a body that is full of humours apt to flow. When we take upon us to cure an inflammation of the womb, if there be no other intent nor drift but to case the inflammation, then may we open some vain in the leg: but if we take our scope and purpose from the flowing of the humours to the diseased part, and from the fullness of the whole body, then both to empty the plenitude, and to pluck back the humours that are sliding down, we must (as Galen judgeth) attempt it by the veins of the cubit. 
Fuchs. Instit. ●ibr. ●.  Fuchsius allegeth also the counsel of Hypocrates, who adviseth in a pleurisy to open the inward vain of the arm of the same side right upon it. There is none that doth make any question but that in the pleurisy being a confirmed disease, and the humours having already flowed, evacuation is more fit than rewlsion, and both may be done by the nearest place: yea, such a manner of pleurisy it may be (as Hypocrates showeth) that you can not fitly use any Phlebotomy at all, 
Hippocr. 6. ●pidem. part. 3. ●ph. 32.  his words are these, There be some such as in whom in due time blood may be let. But in others it is not so fit as in them. The impediment is unto them which spit blood, time, the pleurisy, and choler. 
Fuchs. comment. 〈◊〉 6. epidem.  Fuchsius in his Comment upon that place showeth, that there be three hindrances that do stay them that spit blood from being let blood, the first is time, being too hot or too cold. The other two he joineth together, and thinketh that he meaneth that in the pleurisy proceeding of choler Phlebotomy is not convenient, 
Trincavel ●pist. 22. ad Alexandrum Trivellum etc.  Trincavel being by occasion fallen into the consideration of that place of Hypocrates, doth show that Galen commenting upon that place, doth say, that the points concerning the time of the year and choler may well be admitted, but that the exception about the pleurisy doth seem somewhat hard, because if any disease (the strength and age consenting) do require letting of blood, the pleurisy doth most of all require it. But (he saith) the knot is strait by Galen loosed, to wit, that the words of Hypocrates are thus to be understood, that always he which spiteth blood must have a vain opened, unless the said spitting of blood do come of a pleurisy, for then blood must not always be let, but we must use such lineaments as do particularly respect the pleurisy. And afterward he showeth the reason why it is not necessary that such as have pleurisies, should always be let blood, because by experience he knew one mended of a pleurisy without letting of blood, his pleurisy being a light pleurisy, and void of all fear of plenitude. for the grief was but small, and the blood was cast out by spitting: now those pleurisies are most gentle in which blood is spit out. 
Hippoc epide● lib. 6. sect. 2.  〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Hypocrates signifieth directly, and as it were in a right line: a benumbing of the thigh right on the same side, is a sign of the stone in that kidney, 
Gal. lib. 2. ad Glauconem cap. 7.  so Galen doth expound it 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, it signifieth according to rectitude. And in an other place he doth interpret it by the word 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, directnes. 
Gal. libr. 3. d. iudicies cap. 3.  For a good sign blood must flow directly as out of the right nostril, if the liver or right side be affected: and out of the left nostril, if the spleen or the parts thereabouts be grieved. 
In Coacis praenotionib●●.  The contrary to 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, is 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, as Hypocrates saith, blood to flow out of the contrary side is an evil sign. Good it was for Bion being a splenetic man to bleed out of the left nostril, and good for Herophon after the swelling of his spleen, to have a kernel to rise 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 of the same side. So the auctor of the book de renum affectibus. By the benumbing of the thigh directly on the same side you shall know which rain is affected: for if there be a benumbing in the right thigh, then is the stone in the right kidney; if in the left thigh, then in the left kidney. This 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 hath place in the crisis of diseases, but Hypocrates doth never appoint Phlebotomies to be made of necessity always, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, directly upon the same side. Fernelius expoundeth this word 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, to signify the rightness of the fibrae or vills, 
●ernel. lib. 2. method. me●end●.  as it were little thready or hairy strings, stretched out and running by the longitude of the veins. But Andraeas Laurentius, and Reusnerus upon Willichius, 
Andraeas I aventius in A●t●m. ●●usa●rus in 〈…〉.  do at large confute that opinion. For if Fernelius do make those rectae fibrae helps for evacuation or expulsion, then doth he not well, for the transverse fibres and not the right do serve for expulsion: and if he make them (as they are) helps of attraction, then must they draw equally as well on the one side as the other, because they run out equally by the length of the veins on both sides. And the like answer they make to them which would have the word to signify the continuing and joining together of parts, as though all the veins of the right side were joined one to and in an other amongst themselves, and the veins of the left side joined among themselves, and did not rather participate and communicate one with an other. But seeing the trunk of the hollow vain is one, the branches thereof on both sides are equally joined to the liver. The breaking out of blood out of the left nostril doth empty as well the right side as the left, and (as Reusnerus saith) he saw often by experience that the diseases of the spleen were holpen sometimes by opening the liver vain, and sometimes by blood gushing out of the right nostril. And moreover, as Andraeas Laurentius showeth, there is no meeting together betwixt the veins of the nostrils and the spleen, and yet the spleen being inflamed (as you have heard) the blood that floweth out of the left nostril doth flow 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, directly. And therefore that word of Hypocrates is not to be referred to the joining together of the veins one in an other, but to the rectitude of the whole parts of the body, 
Andraeas Laurentius in anatom.  quia dextra dextris & sinistra sinistris sunt 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, because the right limbs to the right, and the left to the left are as it were of one tribe or kindred, and therefore like good neighbours do one labour to help an other. Maior est vis in forti contentione obsessae partis quam in venarum situ, There is a greater force in the strong contention and striving of the side that is besieged or set upon, then is in the situation of the veins. And a good critical sign it is when that side that is impugned, can expel part of that wherewith it is overcharged and oppressed. But when for any inflammation a vain is to be opened, we have many other things to be regarded besides the consideration of the side. We must mark well whether the whole body have a fullness of the veins: whether the humour be flowing, or now already flowed and settled: whether it doth require evacuation or rewlsion or diversion, and which of them ●ore than other, and how these uses of Phlebotomy and the order thereof shall best be performed, of all which points you have seen already ●hat the best Physicians of our age have gathered out of the best Physicians in times past. Only I will add one observation more out of Montanus, and so an end of this overtedious controversy. 
Mont. medici. vniuers. part. 3.  Montantus will have in every inflammation two things principally to be regarded, the first, membrum mandans, the member that doth send the humour, and the second, membrum recipiens, the member or part that doth receive the humour. As he giveth his instance thus of the pleurisy. Let there be (saith he) one of a hot liver, who hath laboured in the sun, hath drunken strong wine, hath inflamed his head, hath rested suddenly in a cold place, and then (as it cometh commonly to pass) by the cold the matter is expressed by the veins, and descending by the veins it doth flow down either to the higher or lower ribs, and there followeth a pain. Here the member sending is the head, and the member receiving, the ribs. Let the place of the inflammation be in the right side, where must we then let blood? He answereth, that seeing the humour is carried downward, if we should open the basilica of the same side we should draw the humour more downward, and so increase the impostume and endanger the patient. The fullness is in the head, but above the head there is nothing; if there were, we would evacuate from it: Therefore either a derivation must be made to derive the humour from the head, by opening the veins which are behind the ears, or by bleeding at the nose (which were excellent) or by striking the vain under the tongue, or else we must follow the expert Arabian Physicians, to let blood on the contrary side, that so by rewlsion the humour may be drawn according to the directness of the situation, from the right side to the left. But if the pleurisy do come of another cause that the flux be not from the head, but it be the liver full of blood and choler sending humours unto the ribs by the ascending vain, because there is a plucking of the humours from the lower parts unto the higher, in what vain then must we let blood? He answereth, not from the basilica of the same right side, for than we shall draw the humour to the place: but (as Auicenna doth teach) either we must draw it down by opening the saphena of the same side, or else we must deal with the opposite side above. The rest of Montanus his opinion you have seen before in this Chapter, where I have compared his judgement with the judgement of others the most excellent Physicians of our age.   

CHAP. 8.  
Whether letting of blood may be practised in cold diseases, as palsies, cramps, apoplexies, and whether it may fitly be used in melancholic winds, colics and dropsies.  
FOr the diseases mentioned in this and the two Chapters following, I purpose not to show the censures of many Physicians, but only for every infirmity to content myself with the authority of one or two of whom I make best reckoning, and so to hasten to those other points which more generally and universally are to be considered in the whole practice of Phlebotomy. 
Trincavel de ratione curadi part. corp. affect. is lib. 3. cap. 3.  Although cramps, and palsies, convulsions, and resolutions be cold diseases; yet Aetius, Paulus Aretaeus, and divers do appoint to begin the cure with letting of blood. Galen doth allow it, 
Gal. libr. 1. ad Glauconem cap. 14.  but not generally & always. He only doth admit it in these cases, and with these conditions, First, when these cold diseases have their beginning by the suppression of the terms or hemorrhodes. Secondly, if they be with a fever; but than it must be done moderately, & sparingly. Thirdly, if there be great plenty of blood either in the whole or in the head. 
Hippocr. 4. de ratione victus in morbis acutis. Trallian. lib. 1. cap. 14. Heurnius de morbis capitis cap. 25.  For as Galen showeth and also Hypocrates, by the overmuch fullness of the veins there are made oftentimes epilepsies and apoplexies. Trallianus beginneth his cure of a lethargy by letting of blood, if other circumstances do not prohibit. Heurnius in his Chapter of convulsions doth like well of the judgement of Aretaeus, to wit, that whether the cramp or convulsion do come of coldness, or by a wound, or by untimely birth, the vain in the arm is to be opened, especially if blood be the cause; or if it be such a crick that the neck or body can bend no way; or if it be an inflammation, or a wound. Montanus alloweth Phlebotomy in epilepsies and apoplexies when they depend of blood, 
Montanus medicinae universalis part. 3.  but he addeth this clause, hoc autem faciendum debitis temporibus praecipue vere, this must be done in due time, especially in the spring time. For melancholic winds caused by obstructions of the liver or spleen, Mercurialis giving advise in that case to a Noble man of Germany, 
Mercurial. consil. 66.  saith, first; you must think of letting blood, not that the abundance of it doth plainly show any such matter, but because other noble helps can hardly be safely administered, unless letting of blood do go before. And in an other place, writing counsel for a woman which had five years suffered the obstruction of the spleen, 
Mercurial. consil. 104.  and was now come to a schirrus, or hard swelling, he saith, I think it were excellent well, that she should be let blood, first out of the common vain, then out of the lienaris, and last of all out of the vain of the left foot, so that at thrice there be in all taken a pound of blood. Trincauel his judgement is, 
Trincauel consil. 15. pro melancholia hypochondriaca.  that we must abstain from blood-letting, when the melancholic humour is dispersed into the veins of the hypochondria, and the whole body, and that then we must rather purge or procure the hemorrhodes if the party have had them usually before. For the Colic, Avicen doth forbid blood-letting to be used in it. Montanus writing upon the sixth Canon of Avicen, 
Montan. medicinae universalis part. 3.  giveth the reason of it, because the colic cometh of some cold and thick matter, and phlebotomy both doth make more cold, and also hath no power to avoid the thick and gross causes of the grief. Yet he addeth this, But if the colic do come by the inflammation of the colum, one of the lowest guts, by means of blood or choler flowing to the place, in this case if you let not blood the patient will die.  
For the Dropsy Trincavel teacheth, that if it come by the suppression of some usual flux, 
Trincavel de ratione curadi part. corp. aff. lib. 8. cap. 10.  as the terms, the hemorrhodes, and bleedings at nose, whereby (by the superfluous abundance of blood) the natural heat of the liver beginneth to be quenched, than the first thing in the cure must be phlebotomy. But if it come of phlegm, then omitting blood-letting, we must only seek to purge the phlegm. He maketh there an objection what we must do if the terms be not suppressed, and yet the urine do appear high coloured, whether may we then let blood or no, 
Auicenna prima quarti.  seeing that Avicen saith, that if the urine do appear red and thick, a vain must presently be opened? Trincavel answereth, that yet we must not let blood, because in this disease that rule of Avicen doth not take place. For the red tincture of the urine doth not come by abundance of blood, but first, because little urine is made in these diseases, therefore it is the higher coloured: for the thin juices of choler and blood, from the which doth come the colour of the urine, being mingled with a little moisture, do give the greater tincture, and make it higher coloured. And a second cause of the high colour in the urine, he saith, may be the debility of the reins, which by reason of their weakness being not able perfectly to separate the blood from the excrement, do let some little portion of blood pass with the urine, whereby the urine is died red. A third reason doth Fernelius give why the colour of the urine may often deceive, because when the choler is cast out by the liver, it doth not only colour the thin part of blood, but maketh the urine also to look as though the blood were inflamed, as he giveth an instance by jaundises and Dropsies, 
Fernelius in method general de curandis sebribu●.  and concludeth, They do therefore offend, which by the urine being of citrine colour, and thick, do judge strait that blood is to be let. For such an urine doth not come by the abundance or by the kindling of blood, but by the pouring out of choler out of the liver. I will not speak here of the razing of the stone in the reins, and some other occasions that may be, that a little blood issuing, may alter mightily the colour of urine. This which hath already been spoken, may put us sufficiently in mind in the matter of blood-letting, not so much to be led by the colour of the urine, as by other evident tokens which shall be hereafter more at large declared. But when the urine doth concur with other signs; than vis unita munita. Et quae non prosunt singula multa iwant.   

CHAP. 9  
Whether in rheums and distillations, and also whether in the Gout, and the disease called Morbus Gallicus, any benefit may ensue by letting of blood.  
Montanus' doth make this to be one of the principal and general uses of Phlebotomy, 
Montanus medicinae universalis part. 3.  then to take place, When any hath some notable heat of some member, by means of which heat it doth easily receive excrements, and so fall into a disease; as if there be a heat of the reins, there is made the stone; if of the liver, the jaundice; and if of the breast the salt rheum. Razes doth commend in a rheum letting of blood. 
Heurnius de morbis capitis pag. 335.  But Heurnius doth restrain it with certain limits. He will not have it to be used unless there do appear the signs of fullness of blood, as the redness of the face and eyes, and extending of the veins, and unless the body & head appear to be hot, and the rheum salt, with a matter not very far differing from blood; and further, unless there be some danger of the instruments of breathing, the lungs and the sides; then he admitteth blood-letting, but as he saith, sparingly, and not too much: but in a cold rheum the sweet mitigation of blood is not to be taken away. In the Gout Phlebotomy is not to be used, unless great fullness do of necessity urge thereunto. There may this reason be given of it, because that thin distillation, which floweth from the brain into the joints, and being there thickened and settled doth cause the gout, doth not fall down by any vain, 
Fernel. co●sil. 12.  as Fernelius showeth in his answer to the Physician Bucherius, 
Aliter Montanus consil. 132.  but doth distill from the brain to the neck & shoulders, and from thence to the feet parts consecuta subcutaneas, having gotten for passage the parts under the skin, and because it is thin, doth flow unsensibly. Bucherius thought, that because in the blood that he saw drawn out of veins there appeared sometimes phlegmatic matter to flow out with the blood, therefore that phlegm slipping out of the veins might be a cause of the gout. But Fernelius doth confute him, and showeth that that which swimmeth so whitish in the basin is a kind of phlegmatic blood, such as doth abound in the disease called Leucophlegmatia, and that it is so far from sliding out of the veins into the joints, that it can not be drawn out of the veins by strong medicines. For that phlegm which is fetched out of the body by purge and vomits, doth not come from the veins, but it is wholly either from the brain, or from the stomach, or from the bowels. He addeth, I think this to be one of the greatest errors of the common sort of people, that in all diseases they place the faults of the humours no where else but in the veins, and when the question is of humours, they understand nothing of those which do abound in other places, but only of those which are mingled with the blood in the veins. Although the cause and nourishment of the gout doth not flow from the veins, yet if the party have a full body, it will be very dangerous for him to omit letting of blood, for that attenuating and resolving diet (which by means of his disease he must use) will make his plenitude the more perilous, unless having first purged his body, he do also cause some vain to be opened. The like reason doth Fernelius give in his curing of morbus Gallicus, 
Fernelius de lue ●en●rca pag. 108.  after that he hath advised the body to be twice or thrice purged, he saith that also he must be let blood as his fullness shall require, and sterngth permit, for so not only the inward parts and whole body shall be cooled, but also the dangers of plenitude, which may be stirred up by the use of attenuating and resolving things, shall be thereby avoided. What vain must be chosen in the gout when blood-letting is thus found requisite, 
Gal. libro de ratione curandi per venae scciionem.  Galen doth declare towards the end of his book of Phlebotomy. In the gout we must open the vain in the cubit, but in the falling sickness, and in that swimming in the head which maketh all things seem to go round, we must do it rather in the legs. But how doth this agree with that place which I have alleged before out of Galen in my seventh Chapter: 
Gal. method. therap. lib. 13.  If one leg have an inflammation, scarify and let blood in the other. Humours do seem with greater difficulty to ascend then descend, and (the hollow vain in the lower part of the body dividing his branches equally to both the legs) it should seem that the leg is not only the fittest place (according to some) 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, to divert or revel, but also the meetest place to make evacuation. Fuchsius saith, 
Fuchsi instit. lib. 2. sect. 5. cap. 5.  that Galen doth command in the gout to let blood in the arm for two causes, first, because both the legs in that disease are afflicted, though not both at once, but per vices, one after an other: and secondly, because in the gout the blood doth only offend in plenty, and is not so putrefied and vicious, as it is in a hot and red inflammation. But seeing the chiefest intent of Phlebotomy in the gout is to evacuate the fullness of the whole body, it may therefore seem especially for that cause most fit to open a vain in the cubit. As for the matter of the disease, it is rather avoided by a good fit diet, dry, and moderately warm, and the use sometimes of things that do extenuate and resolve, then by seeking to draw out either the cause, or the nourishment thereof by the use of Phlebotomy.   

CHAP. 10.  
Whether letting of blood be fit for such as have hoa● livers and cold stomachs, as also for such as have itches and scabs, and such other faults of the skin. Further, whether it be good for the disease called of the seafaring men the scurvy, and for the cachexia or bad habit of body: and finally, what and how many are the drifts and scopes of letting of blood.  
Montanus' in his conference had with a Doctor called Sonzinus, 
Montanus' 〈…〉 132.  about a man which had been lately a soldier, who was judged by his busy fierce practices, by the redness of his face, and by the fullness of the veins about the eyes and other places, to have a hot brain, a hot heart, and a hot liver, and by the red sand and heat of urine appeared also to have hot rains: and yet having so many parts hoa● had the stomach cold, by means of the heat of the liver, wasting and consuming the fatness of the cawl or sew, which should conscrue and keep in the due natural heat of the bowels: and who also by these occasions for want of good concoction, had many rheums & distillations, making his body very soluble, by means of their slippery descending, which otherwise in regard of so many hot parts must needs have been very costive: he saith, Here I would commend principally blood-letting to take away the heat of the liver and of the inferior parts, the body being first gently purged by cassia. Yet if the infirmity have continued long, and brought the body to a great weakness, Trincauel will then in no case admit phlebotomy. 
Trincauel consil. 4.  For giving his advise to one which had a boat and a dry liver, but a moist stomach, and who was troubled with plentiful thin spitting, with pains in the joints and lassitude of the whole body, he saith, In this body so spent with leanness and lingering sickness, and moreover so full of crudities, I dare not so much as once make mention of letting of blood. As for the itch, which is thought by Melinus a learned Physician to be the same which Galen calleth after Hypocrates, 
Gal. desanita te tuenda lib.  〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, spontaneae lassitudines. The same Physician Melinus being himself fallen into it, when the other Physicians about him, and a Chirurgeon (who was procured to come by the French kings Ambassador) did all earnestly persuade him to be let blood, and showed what good they had done in the like cases by blood-letting: Melinus did refuse to yield unto it, clea●ing steadfastly to the judgement of Galen, who in this impediment of the itch and scabs will have either no blood to be taken at all, or else very little, and that rather to pluck back then to evacuate. The common opinion of Chirurgeons was, that the more corrupt the blood was, the greater quantity he might spare of it. 
Ibid.  But he relied wholly upon that authority of Galen, Of these kinds and degrees of sanguisication, some little differ from blood, some more, and some most of all. In those which on either side differ but a little from blood, you may boldly use Phlebotomy. In them which differmore, do it more warily, but in them which are most departed from blood use it not at all. 
〈…〉.  If the good blood be little, and the other humour much, then abstain from letting blood: but if the humour be little and the blood plentiful, then boldly use Phlebotomy. Melinus though he knew these conclusions of Galen, yet because the case was his own, and did so nearly concern himself, he sent a letter to Fernelius; 
●ernel. 〈…〉. 46.  laying open the whole case unto him, and desiring him that he would declare his judgement concerning this matter. Fernelius sub●●ribeth to the opinion of Melinus, and showeth, that in a pure plenitude of blood the fullness may safely be diminished by Phlebotomy, but in an impure plenitude that hath a cacochymia, or vicious humour mingled with it, the fullness must be a little eased by opening a vain sparingly, and by distances of time, and the rest of the impurity must be taken away by purging. But than doth blood ●etting most harm, when the ill humour is bred (as it is most commonly) by the fault of the liver and stomach. For the blood (though impure) being taken away, a much more impure doth succeed. He giveth instance of the jaundice, the cachexia, and that kind of dropsy which maketh the flesh spongy, and the whole body to swell. For the jaundice in a full body, it may sometimes be used either when it cometh by the overmuch heat of the liver according to Montanus, 
〈…〉 30.  or when it cometh by the obstruction of the gall according to Fuchsius. The ca●hexia, or bad habit of body is perceived as Trincanel showeth by many outward signs, which are commonly these: 
Trincau. de ratione curandi part. corp. affect. l. b. 11. cap. 8.  the swelling of the face especially under the eyes, the countenance and whole body discoloured, a swelling in the belly, such moist and waterish pussings up of the legs and feet, that if you press in your finger it will leave a dent or hole, the mouth always full of spittle, vomitings up of some watery matter, and nipping about the heart. The scurvy, seeing (as Wierus declareth) it cometh of the obstruction of the spleen, 
johannes W●crus ●ract. de sco●buto.  whereby the thinner part of melancholy is carried upward, and with a sharp corrosion doth infect the gums, and the grosse● part thereof falling down doth infect and spot the legs. I shall need to say no more of it then I have set down already in the eight Chapter concerning the obstructions of the spleen, and experience hath taught us sufficiently, that much ease may come unto it by the right and advised use of Phlebotomy. 
Baldwin Rous. in commentartolo 〈◊〉 magni● lienibus Hipp.  Baldwinus Roussaeus declareth what vain (in his judgement) is most fit to be opened in the scurvy. If the humour be not fallen down, he counseleth blood to be let out of the middle vain of the left arm: but if the melancholic juice hath already flowed down to the hips, then open the vain of the knee, or of the ankle. I leave it to the reader to examine and measure this advise of his, as well by those principles and grounds which I have discussed at large in the seventh Chapter of this present book, as also by those circumstances and other obscruations, which I shall have occasion to entreat of hereafter in the former five Chapters of the book next following.  
Thus you have in this first book the first scope and intention of blood-letting briefly laid open, to wit, in what infirmities the greatness of the disease doth require a vain to be opened. For (as first Hypocrates, 
●ippocr. 4. de ●tione vict. ●ut. 19  and after him Galen doth declare) there are three especial points to be marked in the drift & purpose of letting of blood. 
●alen. de rati●e curandi 〈◊〉 venae sect. ●p. 9  The first is called by them the greatness of the disease, whether it be present or to come, whether acute, or of long continuance, 
〈◊〉. Epid sect. 3. ●ap. 3.  if it be great, dangerous, strong, or grievous. The second is a flourishing age, neither too young, 
〈◊〉. Epid. 1. 29.  nor too old, for the undergoing of that remedy. The third is the strength of the powers of the patient. True it is that Galen doth sometimes name divers other scopes and intents in the matter of Phlebotomy. 
●al. method. ●●tedendi lib. 9 ●ap, ult.  In his method of healing he reckoneth eight, There are in this opening of a vain many scopes and observations, 1. The first, nature and temperature of the party, 2. his manner and custom, 3. his age, 4. the place of abode, 5. the time of the year, 6. the constitution or the state of the heavens, 7. the affection of the disease which we have in cure, 8. the strength of the patient. 
Galen de rati●ne curandi ●er venae secti●nem cap. 6.  Sometimes he nameth ten besides the age, as in his treatise of Phlebotomy: If in respect of age they be neither children nor old folks, then consider of Phlebotomy, having a regard especially to these first scopes and drifts, 1. 
1  the quantity and quality of the plenitude, 2. 
2  the strength or weakness of the powers, 3. 
3  the natural habit of the whole body, 4. 
4.  and the time of the year, 5. 
5.  and the region or place of habitation, 6. 
6  the former life, whether the party so affected have used a fullness of meats and drinks, and especially such as are of great nourishment, 7. 
7  custom or discontinuance, 8. 
8  what motions and exercises he hath used, 9 
9  whether he have had heretofore any evacuations, which are now withholden against custom, 10. 
10  and moreover besides all these, whether the party be lean or gross. All these varieties doth Galen bring into a briefer division, and reduce them into two several heads: first, such scopes as declare whether blood be to be let or no: and secondly, such as show what quantity of blood is to be taken. To the first, do appertain the three general scopes of Hypocrates, and to the second sort do belong also all the rest. 
Galen. ibid.  For so be the words of Galen: Therefore by the disease, and the age, and the powers, we know that blood is to be let, but the quantity of the evacuation is to be gathered not only by these, but by all the other intentions.    

The second book of Harwards Phlebotomy, concerning the rules and circumstances which are to be observed, when for the prenenting or curing of a disease any vain is to be opened.  

The first Chapter.  
Whether the party that is to be let blood have that d●●bented plenitude, which is called of Physicians corpus plethoricum, and how the feveral kinds of plenitudes may be known.  
THe principal thing (whereof consideration is most to be had in letting of blood) is named of most writers to be magnitudo morbi, the greatness of the disease, of which I have no purpose now to write, seeing it is in a manner the whole matter subject of the book already ended. When it is found by the nature of the disease that a vain is to be opened, than we are next to examine the constitution of the party from whom the blood is to be taken, and especially by all signs and tokens exactly to weigh whether he have corpus vere plethoricum, a body overcharged with the fullness of the veins, 
Gal. lib. 2. de composite. medica neat. se●●●du●● 〈…〉.  or rather with excess of humours over the whole body, as Galen doth define it, Plenitude is an abundance, or an excess of humours throughout all the body. 
〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉.  There are two sorts of plenitude, the one is called ad vasa, in respect of the vessels containing, and the other ad vires, 
〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Gal●bidem in initio.  in respect of the power, not to be able to bear those humours that are. The plenitude quoad vasa, is made by Galen to be of two sorts, the first he calleth simply a plenitude, which he defineth to be the four humours being proportionably increased. The second kind he calleth a plenitude, with an addition, or a plenitude compound, when some other humour besides blood doth abound more than it ought. These I will not stand upon, because I have already deciphered them in the first Chapter of the first book. There remaineth only here to set down the marks and evident signs, whereby they may best be known when the patient cometh in presence. 
Brigthus in therapeut.  If there be a fullness of blood in respect of the veins and other vessels, 
Plethora ad vasa.  than the colour both of the face and the whole body will be much inclined to red, after any strong motion the veins will swell, and the arteries beat, a sweat will easily break out, a weariness doth oppress the body and limbs, which are loath to move by reason of their own weight, the hand can hardly be clutched together, the drawing breath will be very thick after exercises. In the fullness in respect of overcharging the powers and strength these things do happen, 
Plethora ad Vires.  the motions of the body & limbs are somewhat slower, the sleep is heavy but troublesome, the party doth often dream that he is overcharged with some burden, and that he can not stir himself, and he feeleth likewise a weariness and heaviness as is in the former, but it is without those full and distented veins. 
Other signs of blood abounding.  If the blood do particularly exceed in these plenitudes, than some do add moreover these signs, the pulse thick, full and soft, the laughters great, the head inclined to aches, the body somewhat costive, the spittle sweet, the urine red and thick, the dreams either of colours red, or of things amorous, and in women their terms usually in the first quarter of the moon. When any other humour doth abound, it is called a cacochymy. 
Signs of choler abounding.  A cacochymy is an abounding of any other humour but blood. If choler do abound, the colour of the face and eyes and whole body will be pale, or yellow, or of a citrine or tawny colour, the party will be watchful, and of little sleep, griefs will be most on the right side, vomitings will be often, the thirst much, and the appetite to meat faint, the pulse will be slender, hard, and swift, in the mouth sometimes a bitterness, the urine of a fiery colour, and with little ground or sediment, the dreams will be much of matters of fire, and the terms unto women happen most in the second quarter of the moon. 
Signs of phlegm abounding.  If phlegm do abound, the colour of the face and body will be white, the body itself weighty, fat, soft, and cold, the taste weak, the griefs most about the ribs, stomach, or the hinder part of the head, the pulse slow, soft, and weak, the urine pale or white, sometimes thin, and sometimes thick, with much grounds or sediment, the sleep sound and much, the dreams either of drowning, or watery matters, and the terms unto women usually in the old of the moon. 
Signs of melancholy abounding.  If melancholy do exceed, the colour of the face and whole body will be brown, dusky, and blackish, sometimes equally, and sometimes somewhat bespotted, fears will come needelesly, and sorrows without cause, the pulse will be hard, the urine will be thin and white, and sometimes when melancholy doth avoid it will be thick and black, or black and blue, or somewhat greenish, the sleep troublesome, and full of fearful dreams, and the terms to women commonly after the full. I could here rehearse many other signs (whereof Levinus Lemnius doth make mention) drawn from the fashions, 
Levinus I emnius' in libris duobus de complexionibus.  studies, and manner of life of the party, to make trial of every one by the manner of his gate, by the devices of his brain, and by the performance of his actions, but then I should (perhaps) make some to think too well and some too ill of themselves (although in deed hardly will any think too ill) and I should increase this latter book into a greater quantity than is now my purpose to perform. Briefly, I conclude this first point concerning the plenitudes, with the censure and judgement of Galen, 
Gal. method. therap. lib. 13.  who when he hath brought them all to two general heads, When the humours are equally increased they call it in Greek plethoes, or plethora, but when the body is full of yellow or black choler, or of sleame, or of thin whayish moistures, than they call it not plethora, but eacochymia: He doth presently after show how they must be holpen, and amongst the remedies of plethora he maketh letting blood the principal. Plethora is cured by letting of blood, but for cacochymia, he maketh the chiefest remedy to be purging. But cacochymia is cured by that purging which is proper and peculiar to every several abounding humour. If this cacochymia be also with a dissented fullness, then must also Phlebotomy be used, but sparingly only, so much as may ease the plenitude, 
Fernel. consil. 46.  and rather (as Fernelius doth advise) ex interuallis detrahendo quam universim & affatim vacuando: sublata plenitudine praecipiti & periculosa, reliqua impuritas & cacochymia purgatione eximenda est. But of this already in the last Chapter of the former book.   

CHAP. 2.  
Of the consideration of the temperature of the party, what it is by manner of diet, or by exercises, or by place of abode, or by custom and habit, or by constitution of body.  
IT is not without good cause that Fuchsius loath require in Phlebotomy, 
Fuchsius instit. sect. 5. cap. 4.  that an especial regard be had in it of the diet which the party hath used, whose vain is to be opened, for if he have used much surfeiting, and so gotten an abundance of raw humours, he is then not to be let blood, as he seeketh to prove out of those words of Galen: 
Gal. libr. de 〈◊〉. ratione per venae sectionem.  To intemperate men, wine-bibbers, and gluttonous surfetters, thou shalt bring small profit either by purging, or letting blood. Although the purpose of Galen indeed is not in that place to deny purging and letting of blood to them, which by surfeiting are already filled with raw humours (as Fuchsius doth seem to apply it) but to show that it is a needless enterprise, and a very lost labour to apply unto intemperate men these sovereign remedies, seeing that they have gotten such a custom and habit of riotousness, that they will presently fill themselves again with all noisome humours; for so doth Galen there give his reason. For they which do use an intemperate diet, do quickly gather an abundance of raw humours, and therefore we must not so much as endeavour to heal them. Besides excess and surfeiting, a due regard must be had whether the party that is to be let blood have used (though temperately) such drink, and especially wines, as are apt to engender much blood: for in houses of great personages, and in cities where wine is much in use, there is far greater necessity of letting blood, then in those country villages where their accustomed drinks are of lesser and weaker nourishment. And especially seeing the former living in ease and without any great exercises, do soon gather store of superfluous humours, they may therefore admit a more liberal bleeding, but the later continually labouring & toiling, do leave in their bodies the less store of superflu●●e●, and therefore may the less endure any plentiful Phlebotomy, 
Fuchs. Instit. libr. 2. sect. 5. cap. 4.  And yet as well in cities as in countries the temperature of the place of abode may also make some difference. They which have hot and dry habitations in sandy places, have much of their natural heat and humours spene; discussed and scattered, and therefore must bleed less than they which dwell in more cold and moist places, where the strength of the natural heat is not so apt to be disperseth, provided always, that the place be not by reason of hard weather so extreme cold, that the blood should be as it were congeased, for then to let blood would be very perilous, as likewise it would be inconvenient when the constitution of the party is over-hoat and dry, to use any great evacuation by Phlebotomy. 
Galen. ad Glauconem therapeutic. lib. 1. cap. 13.  Galen saith, As many as are by nature boat and dry, they all do easily receive harm by liber all evacuations. And in that place Galen in the words immediately following doth show that custom also is of great force, as to all other things, so likewise to show what persons may best admit Phlebotomy. For they which have been often accustomed to it, do incur more danger in omitting of it, than they whielt●euer were acquainted with it. 
Hippocr. 2. Aph. 50.  Hypocrates doth give it out as a general axiom, Things accustomed though they be bad, yet do they, 〈…〉 less than those wherewithal we were never 〈◊〉. Auice●●a: in his sixteenth. Canon of blood letting (as Montanus hath divided them) doth declare three sundry dispositions of, 
Montanus medicinae untuersalis part. 3.  man's stomach, which cannot permit the opening of a vain: 
Gal. therap. meth. lib. 9  first, if there be a great and quick sensibilatie of the mouth of the stomach: secondly, if it have a faint debility and thirdly, if there be a flux of choler flowing unto it. For the first, Montanus saith, of all the limbs the mouth of the stomach is made of quickest fecling, and sharpest sensibility, that thereby there might be an apprehension of hunger: and being for that cause very sinody, it hath great affinity and consent with the brain and the heart, whereby if there be a fl●x of 〈◊〉 sharp humour unto it, the brain and the heart do strait suffer with it, and thereupon doth come a fainting and swooning. By the debility of the stomach he meaneth not that weakness which doth come by distemperature, but that which cometh by thedo●senesse of the stomach, when the stomach can not bind in itself, and gather itself together upon the meat. That looseness cometh of the moisture of it, and they which have this imbecility upon every light occasion, they swoon and faint away, and are therefore unfit to be let blood. By the flowing of the choler to the mouth of the stomach, he showeth what indeed doth most offend the sensibility of that place, and bring not only swooning, but also other great dangers. For as Galen writeth, 
Galen. lib. 12. method. the●apeutices.  The mouth of the stomach by the quicknsse of the sense thereof doth bring both many other symptoms, and also swoonings. From the liver and the gall there are two passages one greater, the other less. The greater goeth down to the gut, which is called ●eiunum, and the less goeth to the bottom of the stomach. Some have but one of these passages, by means whereof many times choleric men, because they have only that passage which goeth to intestinum ieiunum, and want that passage that should go to the bottom of the stomach, do never vomit choler. And on the other side, other that are phlegmatic do vomit often choler, because they have that passage which goeth to the bottom of the stomach, but want the other which should go to the gut called ieiunum. 
Montan. in Canonem 17. Auicenae.  Montanus saith of these, that infaelicitatem habent à generatione, they are unhappy by the manner of their procreation and birth. Those which have the passage wholly to the stomach, whereby choler is carried to the mouth of it, are known (as Avicen saith) by this, that they have the mouth often bitter, and do vomit choler upon every small cause, such have porum felleum infaeliciter compositum, the passage of the gall unluckily made. Avicen showeth, that if there be a necessity of letting blood in any that hath any of these impediments, the party hath need to be prepared and strengthened before any vain be opened. The manner how it must be done shall appear in the Chapter following.   

CHAP. 3.  
Whether the body have need to be prepared before letting of blood.  
IF the party (from whom blood must needs be taken) be found to have a great sensibility of the mouth of the stomach (which is known by this, that if you offer any sharp, sour, or biting thing, 
Montan. medicinae v●tuersalis part. 3.  such as is the juice of lemons or pepper, he is strait offended) then before he be let blood, that there may be no flux of choler to the mouth of the stomach, you must give him a few morsels of bread steeped in some astringent thing, as in the juice of quinces, and of ripe pears. If there be a relaxation of the stomach by overmuch humidity (which is known by this, that though the body be empty, yet there is no perfect right feeling of hunger) than you must give also of the juice of quinces: but if there be a coldness with the humidity, than you must add unto it some sugar, with a little cinnamon, or some spice convement. And if choler do slow unto the stomach by the unluckiness of the passages of the gall, then give warm water, and s●rupus acetosies, and provoke a vomit, and when the choler is by vomit cast out, strengthen the stomach with a morsel of bread, and so let the vain be opened. another occasion may be of a needful preparation, to wit, if the party that is to be let blood have his blood over-grosse and thick; for then for two or three days before letting blood, 
●uch. 〈◊〉 lib. 2. sect. 5. Fernel. lib. 2. met●●d. medend●. cap. 14.  he must use extenuating things, as a decoction of hyssop, ●ep, wild maricrom, and pennyroyal, in which is boiled a little white wine and honey. Fuchsius addeth further, that baths may be also sometimes used, especially when blood must be let in some part far from the liver, as in the hands, or in the feet. But in a full body and in suspicion of an inflammation, the use of bathe must be avoided as very pernicious. 
Trincavel. in explaratione lib. 1. Ga●ca● ad Gla●●●●em de arte cu●atiua. cap. 12.  Trincavel commenting upon Galen, after that he hath showed that blood-letting doth not require so great a concoction of humours as other evacuations do, because blood hath no need to be prepared for the bringing forth, unless when it is too thick we do by bathe or some other means make it more thin, that it may flow more readily, yet sometimes not only concoction, but also evacuation by purging must go before Phlebotomy, not in respect of the blood, but in respect of some other danger, as he giveth an instance of quotidian agues, in which there is much phlegm gathered in the stomach, and many crudities in the first veins, unless this phlegm be first digested, and drawn out of the stomach, it may be (as he proveth out of Galen) that when the veins are emptied by Phlebotomy, 
Galen de sanit. tu●nda. lib. 1.  they will draw that raw phlegm, and dispersing it by other veins into all the principal parts, will make greater obstructions than before: he concludeth, therefore let first the phlegm be either concocted by abstinence, or brought out by avomit, or avoided by purging, and then ma●st thou safely open a varne. Galen saith, 
Galen. lib. 4. desan●tate tuenda.  In a faint body wherein is little good blood and many raw humours, Phlebotomies do avoud the good, and as for the evil, which is contained especially in the veins about the liver, and mid-bowels, they do pluck them into all the body. 
Mont. med'cin. ●●●uers part. 3.  Montanus writing upon the eight Canon of Auicenna, doth discuss this matter at large: Let us suppose (saith he) that there be a raw humour without the mesaraick veins, yet Auicenna will have us then to absteme from blood-letting, for the raw humour 〈◊〉 drawn into the inward veins, and the obstruction is made greater, and the fever increased: we therefore give first things that may concoct, and not such things as may distribute into the varnes. 
Gal. libr. 4. ●e●anitate tuenda.  He allegeth the advise of Galen, who prescribeth, that if there be any raw humours in the mesaraick veins, we should abstain from diospoliticum diacalaminthum, and from baths, because they do distribute into the veins, and that we let only sleep suffice, and the use of diatrion pipereon, because that doth concoct humours, and not distribute them into the veins. When the crudities being concocted we come to letting blood, than Avicen doth there counsel us, 
Aui●m. Ca●. 8.  that if the blood be little and nought, we must take but an ounce or two, and refreshing the patient with some meat of the best nourishment, then to take the like again: which Montanus doth think to be the same 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or tempering of humours, which Galen doth so much require. 
Gal. lib. 9 〈◊〉. med●●●●●.  This 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 temperatio humorum, is nothing else but by little and little 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, to take away bad humours, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, to add and restore good humours. 
〈…〉 77.  Trincavel giving his advise about a woman who had the terms suppressed, although he perceived her to have a reasonable full body, and to be of the fittest age to let blood in (which he accounteth to be about the fortieth year) yet because there was in her body abundance of raw, gross, and tough humours, he did appoint her to abstain from letting blood. If you take away blood, you take away the bridle of raw matters, and make them more raw and more gross●. He buildeth his counsel upon that precept of Auicenna, Take heed that thou bring not thy patient to either of these two extremities, either to have cold humours made raw, or to have the hot to be brought to boil and bubble. Montanus discoursing upon Auicenna his canons, 
Montanus in canonem. 8.  doth require that not only in raw phlegmatic matters, but also in abundance of choler, some avoiding of it either by vomit or purging, should go before Phlebotomy, lest the bridle, to wit, blood being gone, the fierceness of choler should more increase. In those, in whom by reason of the tempering of the humour blood must be let a little at once and often, Galen doth wish as well the reiterating of the purging, 
Galen. lib. 5. method. medendi. cap. 14●  as of the Phlebotomy. As many as shall seem to have little blood, when you have brought them to some probable humour, you may let them blood, and then refresh them, and again you may purge them, and afterward refresh them, and again you may let them blood, especially them whose whole blood is like vicious and thick slime. But he addeth presently, but in them which are strong and full of blood, you may begin in them with Phlebotomy. 
Fernelius methodo gene●al● de ●●randis schribus.  So saith Fernelius, that in the fever synochus you must let blood straightway in the beginning without any purging before. But in what particular diseases you may begin with Phlebotomy and in which not, it is showed in their several Chapters in my other former book.  
Concerning such as do think that the body is not fit for Phlebotomy, unless it be first cuacuated with some purging receipt or potion, the learned Massaria doth mightily condemn them which do never attempt the opening of a vain, 
Alex. Massarta●●d sputationibus duabus pag. 202.  unless they have first once, or perhaps twice, or more often used some purging medicine, which without doubt doth trouble the fit occasion of the remedy, and is altogether contrary to the doctrine of Galen, who doth teach, that in the beginning of diseases one of the two remedies may be fit, to wit, either Phlebotomy, or purging▪ but in novise both of them: So that if a man do diligently mark this kind of healing, which now is commonly and every where practised, nothing can be devised more filthy than it, nothing more repugnant to the decrees of Hypocrates and Galen. 
Mercurialis de mor●●s puero●u. lib 1. cap. 2. pag. 50.  As Mercurialis in his treatise concerning the small pocks and measles doth forbid purging medicines to be received into the stomach at such time as nature should expel the disease by the skin, because such purgations do trouble the motion of nature, and yet at the same time doth allow a clyster of barley water one pound and a half, of oil of violets four ounces, of butter three ounces, of red sugar candy one ounce, or of each of them proportionably a less quantity if it be for a child, and doth there condemn Nicholaus Florentinus, for that he forbiddeth the ministering of a clyster, at such time as the said diseases do begin to break out: 
●tercur. ibid.  for (saith he) it is a fond thing to think that the motion of nature i● hindered by clysters, seeing that they do work only in the bowels, and the motion of nature is both near the skin, and in the veins, neither do clysters so overthrow the pours that we need to conceive any fear. Even so, for as much as in letting blood, our drift is especially either to case nature, being overburdened, or to expel some dangerous causes of putrid matter, by transpirations, sweatings, evaporating and such like, very expedient it is that we avoid such purge, as whereby the work of nature may be either troubled or weakened, and content ourselves with a more fit preparing, brought to pass by glisters. It is a great fault amongst very many in England, that they are so nice and scrupulous in receiving of a glister, as seeming to suspect some danger in that, which indeed is the most easy and harmless remedy of all others. And as great a fault it is in many of our country Surgeons, which so boldly do commonly practise the opening of veins, neither having before any direction of learned counsel, neither being themselves stored with those things which should orderly prepare their patient thereunto. They which do minister purging potions at that time, when nature doth begin to move, say they do it because nature doth move unperfectly, but to them Mercurialis doth answer, 
Mercur. ibid. pag. 49.  intelligere an perfect moveat, in initio non possumus, we can not know in the beginning whether nature will work perfectly or no. The safest and surest way is by a clyster so to ease the fullness and costiveness of the body that we do not disease the emptiness and looseness of nature's powers. If the impurities and crudities be above in the stomach, then shall it be requisite before Phlebotomy to use some vomit, 
Massaria lib. descop. m●ttendisang●●nem pag. 76.  as to take of the decoction of barley two or three ounces, of oil of sweet almonds and oxymel simplex each one ounce, of oil of dill two drams, mingle them and give them for a potion. Or if the matter be grosser and colder, take of the seeds of rocket, leeks, radish, & broom, each the weight of a shilling, of the roots of asarabacca and betony, each the weight of six pence, boil these in water so much as being well boiled will make a good draft, and being strained dissolve into it two ounces of ox●mel simplex and drink it off. In hotter diseases the former will be more convenient. Fit vomits and clysters they make a preparation speedily, and do nothing trouble the work of nature in expelling to and by the outward parts. P●rgations if they be strong they weaken nature: if gentle, then are they long in working, and having some hot qualities in them, must needs as well by their heat as by their drawing a contrary way, trouble that work whereunto Phlebotomy is directed. 
Dionysius Fontanonus de morborum internorum curatione lib. 4. cap. 2.  Fontanonus a learned Doctor of Mountpelier, writing of that synochus or hot continual ague, which proceedeth of blood inflamed in the veins near unto the heart, after that he hath appointed to begin the cure with present letting of blood, What hour of the day soever it be, for fear lest the blood do creep unto the lungs, and thereupon should come an inflammation of the lungs, or lest it should slip into the bulk, and thereof should arise a pleurisy, or finally lest it should putrefy, and so there should be made a putrid ague of a not putrid, he showeth after how the body must be made fit for this Phlebotomy, not with a purging potion, lest while the purgation is long in working, the patient should receive harm by the abundance of boiling blood, but by a clyster made after this sort. Take of the four emollitives each one handful, (the four emollitives are, 
Heurnius method. ad p●a●i. 〈◊〉. 1. pag. 6.  as skilful Heurnius doth lot them out, 1. mallows, 2. marsh mallows, 3. violets, or in stead thereof pellitory of the wall, or mercury, 4. branck ursine, or in steed thereof beets) of endive and lettuce each half a handful, ten prunes, boil all in a reasonable quantity of water until the third part be consumed, then strain it, and take thereof one pound and a half, dissolve into it of cassia newly extracted, and red sugar-candy each one ounce, of salt a little, and you have your clyster. In stead of the pulp or flowers of cassia, may be used diacassia Mesuae, or diacatholicum Nicholai, or electuarium lenitiwm Rhasis, any quantity betwixt half an ounce and an ounce and a half, according to the strength of the party: the most convenient oil to be added to them is the oil of violets. In stead of the aforesaid things the clyster may be made of a little soluble chicken-broth, goats-milk, and the yolk of an egg stirred and mingled, and putting into it of manna and fresh butter each an ounce first melted together, these be the ingredients most fit for the clysters of such as are to be let blood. And if any Surgeon by reason of his seat and place of abode be so situated, that he shall be enforced sometimes to open a vain before the counsel of a learned Physician may conveniently be obtained, let him be careful to have some provision of these things in store, as he tendereth either the testimony of a good conscience in respect of himself, or sound and perfect health in regard of his patient. For (as before is showed) many are the harms and dangers which ensue, if at the time of letting blood there be crude and corrupt humours in the stomach and bowels, priest and ready to be sucked and drawn into the veins now newly emptied by the administering of Phlebotomy.   

CHAP. 4.  
Of the age, sex, strength, and solubilitie of the party, whether old men, or children, or women being either with child, or having their terms, may be let blood. Also whether any having bodies either too soluble or too costive may be let blood.  
FOr the beginning of old age there is no question but that blood may be let very safely in it, if other things be corespondent. 
Trincauel 〈◊〉 77.  Trincavel saith, that about the fortieth year of age, that is, about the beginning of old age, we may most fitly be let blood. But Galen doth make three degrees of old age, 
Galen de sanit●te tue ●da lib. 5. in fine.  the first he calleth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, signifying such as have a green and lusty old age, such as are able yet to deal in the astayres of the world. The second he calleth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, the midst of old age, more fit for sleep and rest then for toil and labour, to whom agreeth that of the Poet, Vt lavit sumpsitque cibum, det membra sopori. When washed he hath, & food for sustenance received, His li●s of rest and sleep, let seldom be bereaved. The third sort he nameth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, such as are ready to be sent away, and have one foot in the grave. Although many be very much stricken in years, yet if they fall into those diseases which require blood-letting (as sometimes they do) then may a vain be opened as Trincauel showeth, 
Trincauel in rud●mento c●●tra Brisso●um.  that in a pleurisy he did let an old man blood, being threescore years of age, and he did happily & speedily recover: but he made choice of the vain of the ankle, and had a due regard of the strength of the party. 
Galen lib. 5. de tuenda sanitate.  For as Galen saith of diet, so it may be said of Phlebotomy, if old men do never so little exceed a due measure they take great harm, whereas young men though they transgress very much, yet their harms are of short continuance. 
Fernel. lib. 2. methodi medendi. cap. 11.  Fernelius recordeth of Razes, that by an occasion of a vehement pleurisy he did open a vain even in crooked old age, but the old verse must be remembered, 
Aetatis mediae multum de sanguine tolle,  
sed puer atque senex tollet uterque parum.  
Middle age much,  
Old and young little.  As for children how old they must be before they can admit Phlebotomy, 
Platerus de ●ebribus pag. 105.  Platerus saith, If they pass once ten years old, if danger of an inflammation do hang over them, I would be bold to open a vain. Fernelius doth adventure further, 
Fernelius methodi medendi libr. 2. cap. 11.  for when he hath set down the example of Auenzoar, who with good success did open a vain in his own son being three years old, he after maketh mention of his own practice, This we do commonly prove, that in the sixth or fifth year of age three or four ounces of blood doth end the pleurisy and such grievous diseases. He addeth his reason, because they do often bleed at the nose and find help, and why should not art imitate nature? He concludeth, There is no age which cannot endure some measure of evacuation. Montanus doth give two reasons why children should not be let blood. 
Montanus medicinae ●●●uersalis part. 3.  First, because blood is as it were the food of children, seeing that thereby they are not only nourished, but also do grow and increase. Secondly, because when blood is taken away, one part doth succeed in the place of an other, ut non fiat vacuum, because there can be nothing clean void and empty, and thereby the body is made either windy or thin and spongious, and all the powers resolved, as there he proveth by the authority of Galen. 
Galen thereat. method. lib. 12.  But no doubt although Galen do rehearle children amongst the number of them which are not fit to be let blood, as when he forbiddeth Phlebotomy to those which are apt by nature to have the pores open as children, 
Galen. method. therap. libr. 9  and likewise when the constitution is very hot and dry; also to all which are of a thin habit of body, and moreover to them which have the mouth of the stomach either troubled with a sharp flux of choler, or weak, or of more sensibility than it ought to be: his purpose is not utterly to condemn letting of blood in all these sorts of people, when upon urgent necessity they are driven to it, but to show that it must be done as seldom as may be, as sparingly as may be, and always carefully endeavouring to remedy and meet with that impediment and danger for which the prohibition was made, and whereunto that nature is found most subject. For in an other place Galen alloweth Phlebotomy in children. 
Galen. libr. de ●atione curandi per Phlebotomiam.  Some Physicians think that children have no strength, but they think amiss: we may let them blood if the disease be great. But Galen doth in the same place except 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 young children, and he calleth them 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 young children, until they come to be fourteen years old, and until that age he doth not permit their veins to be opened. 
Gal. method. medendi. lib. 11. 14.  But if the hot ague (which he hath spoken of in the line before) shall be in a young child not yet fourteen years old, it is not good to use Phlebotomy, for in such warm and moist bodies every day there floweth out and vapoureth or sweateth out very much of the substance of the body. Hypocrates also doth not allow Phlebotomy in young children, 
H●ppocr. 1. de 〈◊〉 victu● 〈◊〉 b. 45.  because their strength is soon overthrown. Quickly doth the power decay in children, by means of the store which they have of stowing out, but it will continue sufficient in flourishing age. Many do exclaim upon Galen, as though his practice of Plusick were too strong and violent for the present estate of man's nature. But we see in this point that Hypocrates and he are a great deal more wary and circumspect, and more loath to overcharge the strength of man then many of our late practitioners. I think it far more safe to follow them, then to be so rash as to imitate those Spanish Physicians, of whom Massaria doth report, 
Alex. Massaria descopi● mitt●ndi sang. pag. 55. Aver. 〈◊〉. 7. Col. c. 3.  that they use to let blood in infantibus vix annum secundum aut tertium natis, in infants scarce two or three years old: or that bold Auenzoar, of whom Averroes writeth, that he let his son blood, being but three years old: or yet to think that the experiments of Fernelius, Fuchsius, 
〈◊〉 metho● 〈…〉. 2 cap. 11.  and Valeriola, who adventured to let blood at five or six years old (though perhaps sometimes they wrought good effect) are therefore to be commonly tried again by us. For the reason which Fernelius doth allege, that seeing that by eruptions of blood out of the nose, they find often case, and therefore the Physician must imitate nature. Massaria answereth, 
Massaria. pag. 56.  that he hath often observed that those eruptions of blood in children have not been healthful to them, but have been occasions of dropsies, and of bad habits of body. And for the experiments which (as they say) have often done good, he accounteth that either they were rather of fortune then of any good reason, or else that the help was such as whereby they were better uncured then cured. For many may have for a time a mitigation of pain, for which afterward they may be sorry for many years following. But if young infants (who undoubtedly may sometimes fall into hot agues called synochis, and that also with abundance of blood) may not have their veins opened, what course is then to be taken with them in those fevers, which can hardly be taken away without diminishing of blood? Mercurialis doth appoint two helps for them, 
〈…〉 lib. 2. 〈◊〉. 1. & lib. 2. ap. 2.  the one by cuppings, and the other by leeches. The leeches being applied aut natibus aut cruribus, they do draw out blood by so small holes, that there is no danger of was●●ng any vital spirits. As for cuppings, whereas Rafe's doth defend that they may be used unto children at five months old, 
Cases libr. de es●e. cap. 4. tuicenna 4. doct. 5. ap. 21.  and Auicenna will not have them used until the infants be at least a year old. Mercurialis judgeth it more safe to stick to the opinion of Avicen, not to use them till the children be a year old, and that with these three conditions, first, that the child be full of blood, and of good strength, secondly, that they be rather applied to the legs then to the upper parts, because blood drawn from the lower parts doth not so much impair the strength nor waste the spirits, as that which is drawn in the upper parts: 
Mercurial. de 〈…〉 2. Cap. 2.  and thirdly, that there never be taken above one ounce or two at the most. In the Chapter following he addeth an other caution, to wit, that if we seek to draw blood out of places far off, we apply such cupping instruments as have wide and large mouths; but if we purpose to draw from near places, then to use such as have narrow mouths, and therefore if we apply them to the legs, they must have wider mouths, and if to the places about the loins the narrower. 
Galen. lib. 12. method. medendi. cap. 1.  Galen for old age telleth a pretty history of a mad Physician which rashly did let himself blood. Acertaune Physician of fifty years of age, being now a seven-night sick and not very strong, having a great pain in his head not able to stay until some of his fellows could come to him, did in the night time let himself blood, and his pain quickly ceased. But a long time after he was discoloured in his body, weak in strength, thin, and without nourishment▪ so that hardly he could recover that habit of health which before he had.  
For women being with child Montanus saith, 
Mont●●. medici●ae universal. part. 3.  that we must greatly suspect as well letting of blood, as any other evacuation in them, both in respect of the nourishment of the woman and child, and also for fear of an abortement or untimely birth. Especially he will have them to be avoided at those times when there is most danger of untimely birth, that is, before the fourth month, and after the seventh month. For whereas Hypocrates doth permit to purge women with child, being four months gone, until they come to seven months, 
Hippocr. 4. aph. 1.  but them which are younger conceived, or which have gone longer we must beware of dealing with them; Galen commenting upon that place, doth compare the child in the mother's womb to the fruit of a tree, which when it is very young is soon fetched off with any wind or blasting, and when it is very ripe, it is ready to fall off itself, but in the middle time it will remain strong on the tree against all storms and tempests: So the infant in the womb is most in danger of untimely birth, when the woman is either in the beginning or towards the end of her account. 
Montanus in Canon. 7. Au●ceanae.  But Montanus saith, purging bringeth more danger than phlebotomy. Phlebotomy is then the mere dangerous if the child be great, as is noted by Hypocrates, A woman being with child is delivered before her time, 
Hippocr. 5. Aph. 30.  if that be great wherewithal she is conceived. Galen expounding that aphorism, doth give the reason of it, because the bigger the infant is, the larger nourishment it requireth. 
Montan. medicinae universal. part. 3.  Yet Montanus addeth, that sometimes women with child do receive much good by opening a vain especially if they be full of blood: he saith, I have seen some such women, that if they had been let blood every month, it would have been without danger; and again, if they had not had sometimes a vain opened, they would have been so grievously sick, that there would have been danger of an untimely birth. When superfluous blood is taken away, the food remaineth more wholesome for the child. Fernelius doth more plainly oppose himself against the axiom of Hypocrates, 
Fernelius method. medina's. lib. 2. cap. 12.  and yet not in his own words, but alleging against him this censure of Cornelius Celsus: Old Physicians did think that childhood and old age could not endure such a help as is Phlebotomy: and they were persuaded, that the woman which should undergo such a kind of curing, should procure an untimely birth. But afterward experience hath showed, that none of these cautions are perpetual, 
Cornel. C●ls. lib. 2. cap. 10.  but that better observations are to be marked▪ unto which the physicians counsel is to be directed, for it skilleth not what are the years of age, nor what the party doth carry in the body, but what the strength is: a stout boy, a strong old man, and a woman with child having an able body, may safely this way be cured. As Montanus doth limit and restrain this liberty, appointing it not to be used, unless the woman be very full of blood, so Massaria doth likewise require, 
Ale●. Massaria. pag. 105.  that the Physician should not only respect the present estate of a woman being with child, but to forecast how she shall have sufficient nourishment and strength to hold out, unto the appointed time of her delivery.  
Concerning women having their terms, whether they may securely be let blood, it is thus resolved by Montanus, 
Montanus medi●●nae universalis part. 3  writing upon the seventh canon of Auicenna concerning blood-letting, that if they have them immoderately, then may they open the vain basilica for diversion. But if moderately and naturally, then is Phlebotomy not requisite. Yet he saith, if such a woman have a pleurisy or a sharp fever, and be in danger that unless the flux of blood be eased by spitting, there should come an inflammation of the lungs, and unless 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 have her flowers. For costiveness, I refer the reader to the third Chapter of this second book, how it must be corrected before Phlebotomy. 
Platerus de febribus pag. 113.  As for the flux of the body, Platerus doth give a c●aueat generally, that such people as are apt to swou●nings should not be let blood when they have a diarrhea or looseness of the body, because the flux doth make them more apt to swoon. But otherways, letting of blood is of itself good for such fl●xts as Avicen showeth in his fourth canon, and upon it Montanus, 
Vt dividit Montanus Canores med. 〈◊〉 part. 3.  because there can be no vacwin, no void emptiness, therefore there is made an attraction out of the whole body by succession of parts; one vain draweth from an other, until at the last it draw from the stomach, as the like doth happen in hunger. Now when the veins have drawn first one from an other, than they from the liver, than the liver from the mesaraick veins, and the mesaraick veins from the stomach, thereby the moisture being plucked away, the body is made more bounden. And besides that stimulating and tickling choler which did before pass down, and cause the flux to be more violent, is by Phlebotomy drawn back from the bowels. But how is it then that so many upon letting of blood do become straightway loose bodied? Montanus doth answer out of Avicen, that it is non per se, sed per accidens, not of itself, but by means of some other accident, as of some timorousness and fear, or else by overmuch cooling of the body, when by bleeding, much of the strength is resolved. Fernelius saith, The raw and undigested flux which happeneth in a burning fever, 
〈◊〉 lib. 2. 〈…〉 cap. 11.  the stomach being dissolved by the drinking of cold water, doth not forbid the opening of a vain, but a regard must always be had of the power. Alexander Massaria doth advise, that if the flux do come of venom, or any poisoned humour, we should not let blood, 
Alex. Massa●ria lib. d● cap●s 〈◊〉 sangu.  because the greatest violence is then offered to the powers, and the spirits are in danger of fainting.   

CHAP. 5.  
Of the state of the disease, what consideration must be had thereof in blood-letting, and in the examining of the strength of the party which we must regard most, the virtue animal, or natural or vital.  
WHereas every disease hath four several times, the first is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, princi●ium, the beginning, which endureth until there appear some signs of concoction, the second 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 vel 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, incrementum, augmentum vel ascensus, the time of the increase so long as the fits or griefs do wax more painful: the third 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, vigour & 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 remaineth now to be discussed in how many of these Phlebotomy may take place, and to which of these it is most fit and convenient. Montanus delivereth this for Galens' doctrine, 
Montan. medicin●● v●tue. la 〈◊〉 part. 3.  In letting of blood there is no time to be attended, but at what time soever, by reason of the fullness an evacuation is showed to be the best drift, let the evacuation be made, whether the disease be in the beginning, or in the increase, or in the state, so that there be not undigested meats in the stomach and bowels: but he addeth a proviso, dummodo virtus non sit debilis, so that the virtue and powers b● not weak. But for the most part Phlebotomy is most fit in the beginning of the disease. That rule of Hypocrates, 
Hippocr. 2. Aph. 29.  In the beginning of diseases if any thing do seem sit to be moved, move it: but when the diseases are at the highest state and vigour, it is best then to rest. Galen commenting upon it, doth apply it to the two great remedies, and especially to Phlebotomy. The first canon of Auicenna expounded by Montanus is, A vain is not to be opened in the day of the diseases motion, that is, when the matter of the disease doth boil and swell, and nature doth strive to concoct or expel it. 
Montanus' 〈…〉.  Montanus saith, 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 general or universal in respect of the whole disease from the beginning to the end, and this containeth the critical days, the fourth, the seventh, the eleventh, the fourteenth, the seventeenth, the twentieth, etc. Now we must mark how the matter of the disease is moved, whether in a critical day or not critical, and whether it be moved because nature goeth about to concoct it, or because it is furious: If the motion of it be furious, we must needs use evacuation. But when the motion of the disease is such that nature doth concoct the matter, then is it a day of rest, and no evacuation is then to be attempted. And that doth he make to be the meaning of Hypocrates, 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 affirm that in the critical day blood is not to be let, although it prove a day of rest. But Montanus doth confute them, and doth justify that rule of Auicenna, When nature doth move, move thou nothing, but when she moveth not, move thou in the time of her motion. The time of nature's motion it the critical day, and therefore in the critical day we must stir the body. But therein the Physician must be very wary and circumspect, for if nature have moved in the fourth day (which is the declarer of the seventh) than may we not evacuate in the seventh day. And if in the seventh there appear any motion, we must not move in the eleventh. But if in the critical day nature do neither move, nor show some good token and proof that she will move, then may we endeavour to move by Physic. Afterward upon the twelfth canon Montanus reproveth them which affirm that blood is not to be let after the fourth day of the sickness, 
Montanus in canonem Auicennae 12. Gal. method. therap. lib. 3.  and proveth out of Galen, that in some infirmities a vain may be opened a hundred days after the beginning thereof. But in sharp fevers we let blood only in the beginning, because after the fourth day the powers do fail, and for that cause he saith Hypocrates doth appoint, In sharp diseases use evacuations in the beginnings. 
Hippocr. 1. Aph. 24.  Trincauel likewise doth apply unto Phlebotomy that other axiom of Hypocrates, 
Hippoc. 1. Aph. 22.  non esse vacuandum in principio nisi turge●● morbus, that we must not purge in the beginning unless the disease be furious and vehement. 
Trincavel epist. 22. ad Aloisiam Crivellum Massaria. Gal. in fine lib. 3. com●ret. in 6. de morbi● vulg.  Turgere dicuntur qui adeo concitato motu agitantur ut prae illorum molestia agrotus non possit quiescere, quod magni morbi est indicium, those diseases are said to rage or swell, which are carried with such violent motions as that the patient can take no rest, and qui ad excretionem festinant, which would fain break out. He bringeth in the example of Galens own practice, which (as he recordeth of himself) when he was sent for unto a man sick of the pleurisy, 
〈…〉 3. 〈◊〉 44.  when he saw first that he avoided blood by spitting, and secondly, that (as the patient being asked did confess) he felt but little grief on his side, he used some applications to him, but would not let him blood, because it was a most gentle kind of pleurisy. But how may the former part of that aphorism of Hypocrates be applied to Phlebotomy, 
〈…〉 22.  Purge things concocted and ripe, but not while they are raw? Is concoction first to be expected before we can use Phlebotomy? Fernelius and Fuchsius do in this point bitterly inveigh against Avicen, 
〈◊〉 libr. 2. 〈…〉 cap. 13.  for that he forbiddeth a vain to be opened unless the humours be first concocted. 
〈…〉 2.  Their reasons are especially these, first, because in sharp and violent diseases, and where there is abundance of blood, it must needs be dangerous to defer: secondly, though the disease be not sharp, yet may the multitude of blood of itself do har●ne, if it be not presently eased: thirdly, because when signs of manifest concoction do appear, than (as Fernelius holdeth) we must deal no more by letting blood, but the rest of the cure must be finished either by purging, or by deriving means, as in agues, by sieges, urines, and sweats, in a ripened pleurisy by spitting; in inflammations of the liver, if they be in cavo hepatis, by soluble medicines; if in gibbo hepatis, by things diuretic, or causing urine. And (the more to condemn Avicen) Fernelius doth plainly avouch, that letting blood is most fit than when signs of crudittes do appear: 
He meaneth of c●ud▪ tastes morbo●ae, which remain so long until the disease be overcome.  At what time so ever, yea if it were the twentieth day of the sickness, if signs of crudity do appear, we may open a vain: for we measure Phlebotomy not by the number of days, but by the concocting of the matter, and the dissolving of strength: If neither of those do happen, Phlebotomy may be used. Montanus interpreteth the meaning of Auicenna, 
Montanus 〈◊〉 Canon. 11. Au●●ennae.  that when he will not have blood to be let before concoction, he doth aim especially at such diseases in which a thick gross humour doth abound, as in quotidians, and melancholic fevers, whose humour being tough and raw, would be made more rebellious if blood were taken away. First therefore he will have that humour to be concocted and evacuated, and then if it be thought convenient to open a vain if the blood be corrupt, and in great plenty. 
Trincau. in explanation lib. 1. ad Glau. cap. 12.  Trincavel maketh this to be the chiefest concoction that is required before letting blood, in respect of the blood itself, to wit, when it is too thick to make it more fluxible, as is before in the third Chapter of this book. There are two kinds of concoctions, the first called properly 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, when natural heat doth turn the food into due nourishment, containing under it those three sorts or degrees of concoction mentioned by Galen, 
Galen libr. 4. desanitate 〈…〉  whereof the first is called by him the concoction in the stomach and bowels, wherein the purer part is sent towards the liver to be made blood, and the impure is cast out by siege. The second, the concoction in the veins, wherein the moist whitish juice being by the mesaraick veins carried to the liver, and by the liver turned into blood, is by the veins and arteries perfected and distributed into all the body, in respect of the purer part thereof, to wit blood (as it containeth the principal juices) and seed, and the impure is by the veins 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, conveyed into the bladder, and from thence cast out by urine. The third, the concoction in the flesh, wherein the purer part of the blood being by the veins and arteries carried 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 sweat, as Weckerus nameth three kinds of excrements appertaining to the three degrees of concoction, 
Weckerus' 〈◊〉: dotard. special. ●ag. 416.  excrementa primae concoctionis stercora; secundae, urinae; tertiae sudores & exhalationes. These three concoctions being finished, the best part of the nourishment is assumilated and made one to the flesh, body, blood and spirits of him that is to be nourished. Galen saith, 
Galen. lib. 4. desanitate ●uenda.  When the third concoction is ended there is an assimilation made to the part that is to be nourished. These concoctions and the several degrees thereof do all deal with that matter quae est benigna & familiaris, which is good and familiar unto the party that hath received it. There is an other kind of concoction called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, 
1. Epid. sect. 2. come. 44. 4●.  or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, wherein natural heat doth deal with a matter not that is good and familiar, but such as doth cause disease, and doth seek either to assimilate some part of it if she can, or else to make it either less hurtful to the body, or more fit to be expelled. These two distinct kinds of concoctions when natural heat can not or doth not perform what it would or should, than they leave distinct kinds of crudities, 
2. De rat. unct. morb. acut. 44.  as Galen showeth, speaking of choleric crudities, as those whom the Grecians call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, whatsoever (saith he) is of pature overcome is called by Hypocrates concocted, and what soever nature can not yet overcome is called crude and raw, as he giveth in the same place an instance of purulent matters in inflammations, of spittle, of rheums, and of waterish humidities (such as do pass out in those urines which are called urinae crudae) and in choler, which being raw (he saith) it is yellow, sharp, & ill savouring; 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 kind of concoction, 
Hippocr. 2. Aph 23. acuti morbi diebu● 14. 〈◊〉.  and such they may be that they may be excrements of the last degree of the former kind of concoction. How these several kinds of concoctions are to be respected in purging, and whether in acute or sharp diseases we may give minorative or purging receipts before there appear signs of concoction of the matter of the disease, I do handle at large in my second part of the great Physic remedies called Cathartice. As for Phlebotomy, seeing that the chiefest intents thereof are to ease the overmuch fullness of the body, or to pluck back or divert a humour from or to some place, we are not so much to wait for the concoction of the matter of the disease (unless it be the overmuch grossness of thick blood) as to mark the concoction of nourishment, that the first degree thereof be done, and the second well forward. For if we let blood when the stomach or first veins are full of indigested crudities, they will pass into the veins which are emptied and make greater obstructions. As violent exercises upon full stomachs do disperse and distribute raw humours into the body to the much hurt of the body, so doth also Phlebotomy, and therefore that may partly be applied unto it which Galen hath written of exercises, 
Galen desanitate 〈◊〉 lib. 2.  Then is the best time when the meat 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 urine. A waterish urine doth show that the juice which is sent out of the stomach and bowels into the veins, is yet raw and undigested. The f●ry, red, and choleric urine showeth, that the juices are long ago conco●led already. That which is moderately pale, is a sign of the second concoction even now finished. I have showed already in the end of the eight Chapter of my former book, that in many diseases the colour of the urine may deceive, and in what cases it may most deceive: I need not therefore here to speak any more thereof, but only to point out those other circumstances & signs, which together with it are jointly to be weighed and considered. To know perfectly the state of the body, Galen doth in one place join with the colour of the urine five other things to be heedily regarded. 
Galen desani● 〈…〉 4.  First, we must ponder what diet the diseased body hath lately used, 
〈…〉  for sundry sorts of meats and wines may cause many alterations in the urine. Secondly, whether he have been wont naturally to abound with many ill and vicious humours, and whether any outward signs thereof have appeared by itches, pustles, ringworms, swellings, inflammations, and such like. Thirdly, whether any accustomed or natural evacuations have lately ceased, as vomits, hemorrhoids, fistulas, fluxes, bleedings at the nose, terms, sweats, and such like. Fourthly, whether they having been accustomed heretofore to avoid superfluities by Physic, and have of late neglected it, and not used such purge, vomits, and baths as heretofore they have done. Fiftly, to examine not only the urine, but other excrements, as egestions, spittings, sweats, for as he saith a little after, The sweat declareth what humour aboundeth in all the body, for it is whiter, paler, or yellower, according as the humours be more or less phlegmatic, or choleric, and if the humours be putrified the savour of the sweat will greatly bewray it. But in matters that do concern the veins (as doth especially Phlebotomy) Galen will have us especially to respect the urine. We have no effectual and evident sign to discern the superfluities that are in the veins, 
Gal. ib●dem pa●lo 〈◊〉.  but only that which is by urine. If the humour be altogether crude and raw, the urine will be thin and watery, and neither have any hypostasis or sediment, nor have any cloudy matter hanging in the 〈◊〉 but when it is concocted, these things do appear, and beside, some thin clouds do swim upon the top. 
Sic Hippoc●. libr. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉  If the thin and thicker parts do quickly divide, and that the sediment be white and smooth, and in every part equal, that showeth that straightway care one can speak the word nature will overcome all. If it be longer care the separation be made, longer it will be care the humours be overcome. But if in the urine there be no separation at all, but that it remain still as it was made, or else if it do break it be with a bad sediment, then is nature weak, and hath need of some other help to digest the humours. Many other signs there are of crudities, as the small quantity of urines, signifying that by their rawness they are hardly sent out. Likewise the thickness of urine, showing abundance of raw humours, and thereupon deprivation of concoction. Further, 
Inequal●ie and distemperature of the pulls, are signs of morb●s●e crud●ates.  the ill contents in urine, and the inequality of the palses, but these and many other signs of diseasy crudities must not stay us from letting of blood if the greatness of the disease do require it, and the party have a full body, and sufficient strength: 
Fernel met●od. lib. ●. method. medend●. cap. 13. cap. 14.  but rather as Fernelius showeth when signs of crudities are, we must use Phlebotomy as the remedy. Only touching our food last taken, let the stomach, bowels, and (if it may be also) the mesaraick veins be cleared from raw and corrupt humours, and let such a time be chosen wherein also the disease hath most quietness from the motions of the paroxysms. 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 veins (whereby of an intermitting fever may be made a continual) and the powers also of the patient shall least be endangered. But seeing so often Galen and all Physicians in the matter of Phlebotomy do still make their provisoes that the powers be not dissolved, 
Galen. libr. de ratione per venae sectonem.  a question may here be moved of what powers they do especially speak, and how the strength of those powers shall be known. Galen describeth three powers in man, 
Galen. method. 〈◊〉 lib 9 cap. 10. 〈…〉 5. ca 7.  the first he calleth the natural or nutritive power, that hath his fountain in the liver, and containeth under it the attractive power, the retentive, the expulsive, and the fourth the alterative power, which is generally to turn the nourishment into substance and particularly to make blood. The second virtue or power is called the vital power, having the seat in the heart, giving life to the whole body, and conserving the essence of the vital spirits. The third he calleth the animal or rational power, having the seat in the brain, and bringing forth sense, motion, and understanding. Each of these three powers have their particular instruments to work by. To the natural power do serve the veins, to the vital the arteries, and to the animal the sinews. Now which of these powers in letting blood must most be respected? No doubt there must a care be had of all, 
Galen. method. medendi. lib. 9 cap. 10. Gal. lib. de curatione 〈…〉 sectionem cap. 6.  for as Galen saith there, If any one of them do perish, it must needs be that all the rest shall perish also. And giving precepts of letting blood, when he hath taught how we shall try the animal power by the voluntary motions, and the vital by the pulses, and the natural by good or bad nourishment, or by good and bad colour, he concludeth generally, when these powers are strong, let blood. So whereas Hypocrates doth bid us when diseases are in the vigour to rest, 
Hippocr. 2. Aph. 29.  and not to use phlebotomy or purging (for so Galen doth expound it) Galen doth give the reason there of it, because the animal power is then weak and in danger, although the vital and natural be strong. Yet certain it is that the vital power is that which chiefly we are to observe in Phlebotomy, as he doth elsewhere at large declare, The greatest dignity of all is that which concerneth the actions of the heart, 
Galen method. 〈◊〉 lib. 7. cap. vitimo.  and of all most needful to be considered in them that are sick. He doth in that place compare the operations of the liver and of the brain with the vital powers of the heart, but he will have the heart to be principally respected. In extreme apoplexies the animal powers are decayed, yet because the vital powers are not extinguished Phlebotomy is allowed, and doth often work good effect. That is the cause that Galen doth give out that precept in his book of Phlebotomy: 
Galen de ●aratione per venae sectionem cap. 11.  In all these former rules thou must still have an eye to the strength of the party touching his pulses. By that word (touching his pulses) he showeth both that the vital power is most to be regarded, and also doth point out the means how we shall take trial of it, 
Other signs of strength sailing, by the pulses, are showed after Chapt. 8.  to wit, by the distemperature and the inequality of the pulses.   

CHAP. 6.  
Of the time of the year, the time of the constellation of the planets, and the time of the day most fit for letting of blood.  
THe best time of the year for Phlebotomy is known of all men to be the Spring, according to that aphorism of Hypocrates, 
Hippocrat. 6. 〈◊〉 47.  The Spring must be the time of letting blood and purging. The Autumn is in fitness the nearest unto the Spring. The extremity of the heat of summer is most dangerous as Galen saith, having named a little before the canicular days. 
Gal. ad Glauconem therap. lib. 1.  They which are sinisterly evacuated in very hot times of the year, do perish either with swooning, or with resolutions. The extreme cold also of the winter will not permit Phlebotomy; or if it do, it must be little: Montanus giveth the reason, because the body is overmuch cooled, 
Montanus in 〈…〉  and is also made so thin, that the cold doth strike into the inward parts, whereby are brought diseases of very long continuance. Galen will have them which are usually sick in the spring time to be let blood in the beginning of the spring, but such as most commonly have their sickness in the summer time he would have them to open a vain in the end of the spring a little before summer begin. The fittest time for letting blood is when the sign (as we call it) or the moon is in Aries, Sagittarius, Cancer, Libra, Scorpio, Aquarius, or Pisces, unless in any of these signs the moon do predominate in that place that is to be let blood, as in Aries the head, Taurus the neck, Gemini the shoulders and arms, Cancer the breast, stomach, and ribs, Leo the heart and back, Virgo the belly and bowels, Libra the reins and loins, Scorpio the secrets & bladder, Sagittarius the thigh, Capricornus the knees, Aquarius the legs, Pisces the feet. There must also a regard be had of the age of the party that is to be let blood, for to them which be growing or young, the first quarter of the moon is most meet. To middle aged people, the second quarter. To the declining age, the third quarter; and to old age the last quarter. The complexion also must be respected. If the party be choleric let him blood when the moon is in Cancer, Scorpio, or Pisces. If phlegmatic, let the moon be in Aries, Sagittarius, or Pisces. If melancholic, then let the moon be in Libra, Aquarius, or Pisces. It is ill to let blood when the moon is in the full or in the change, or within three days either before or after. It is ill also when the moon is in conjunction or opposition with Saturn or Mars. Further, it is ill when the moon is in conjunction or opposition with Venus or Mercury combust, or in a quadrate aspect with Saturn, Sol, or Mars, unless the aspect be passed at the least eight degrees. But it is good to let blood when the moon is in a trine or sextile aspect with jupiter, Sol, Venus, and Mercury, but especially with jupiter and Venus, with whom all aspects are good, provided that they be not combust. In cases of extremity there is no staying for signs or aspects, for (the necessity of the disease compelling) I have myself opened a vain the sign being in the same place, and yet with good success. But if a man have liberty to make his choice of the time, I hold him unwise that will not take it as near as he can agreeable to the ancient grounds and principles of Astronomy. It appeareth very many ways that God hath given a power to the heavens, and an influence to the Stars and Planets, which do mightily work in the things here below, not to induce any necessities, but to dispose the inclinations, so far as God hath appointed and determined. Consider how all the times and temperatures of the year do alter and change according to the course of the sun, and what difference there is betwixt the operation of Physic, and the dangers of diseases assaulting us in the spring, and such other as do befall unto us in the canicular days. Mark the operation of the Moon in such plants as are set, and such seeds as are sown in the several times of her age. Weigh the force also of the moon in those which in the scripture are called lunatic. 
Math. 4 2●. Ma●h. 17. 15.  Origen doth report the judgement of Physicians, Humida moveri in capite secundum aliquam compassionem ad lumen lunare quod humidam habet naturam, That moist things are moved in the head according to the sympathy of the moon which hath a moist nature, but he thinketh rather that some unclean spirit doth observe the divisions of the situations of the moon and work by them. 
Sermus lib. 1. de medic●na. Mercer. lib. 2. de morbis puerorum cap. 3.  But Serenus, and after him Mercurialis do give this the reason, because they which are conceived or borne in the wane of the moon are much subject to the falling sickness. Howsoever it is, it is sure not without some cause that they are called lunatic, that is moonish, or mooned. And behold also the power of the Moon in the ordinary flowers of women, who are otherwise also sometimes too much subject to that variable and tempestuous planet. See what force it hath likewise in the sea concerning the ebbings & flow thereof, as also in respect of cockles and divers other shell-fish waxing fuller or lesser according to the age and proportion of the moon. Let also the experiences of mariners somewhat prevail, which find the whole leas to be carried by the course of the firmament from the East unto the West, whereupon they which travail to the west Indies do better pass thither in one month, than they can return again in three, besides the trials which they have of their loadstone pointing towards the North, and their needles and compasses answering thereunto. In Physic the critical days falling out either in hard or benign constitutions of the planets, do daily give unto us abundant testimonies. In histories what auctor can you almost read, but you shall find therein the troublesome alterations which have followed upon great eclipses? In divinity see how job doth attribute unto the Pleyades a sweet influence to cause the kindly spring, 
job. 38. 31.  and to Orion a power to cause rains and showers, but so, that God doth loose or hold back the bridle at his only will and pleasure. And weigh those words spoken in the creation of the Sun & Moon, 
Gen. 1. 14.  let them be (said God) for signs and for appointed times, and for days, and for years. I do utterly condemn the abuses of Astronomy, as first when men will make them signs of soothsaying, to foretell things to come, and so to take that unto them which is proper to God only, as it is in the Prophet: 
〈◊〉 41. 23.  Show us the things that are to come that we may know that ye are gods. God saith, I w●ll destroy the tokens of the soothsayers, and make the wise coniecturers fools. The will of God is free and sovereign over all his creatures in every moment to order, alter, rule, and dispose them as seemeth best to his heavenly wisdom. Fata movere deus, tollere fata potest. We see in one battle, 
P●ucerus.  or in one time of pestilence (God being angry with sin, or permitting the Devil to rage) many thousands do die at one time, which no doubt most of them were borne in divers manners of constellations of planets: Weaker natures are subject to the stronger, and particular causes are subject to the general. 
〈◊〉 lib. 12. 〈…〉  Saint Augustine saith, In the lives of them which are borne twins, in their actions, casualties, professions preferments, and in their very death there is so great a diversity, 
〈…〉  that many mere strangers are more like one to another, than those which in birth were separated with a very small distance of time, and sown as it should seem by conjunction in one and the self same moment. It was a damnable opinion amongst the Chaldaeans to make the constellations of the stars to be a table of all fatal laws▪ as though the whole life of man were written therein. As Tarutius Firmianus being skilful in the Chaldaean sciences, took upon him by the manner of Romulus his life and death, to calculate what time he was borne, that because he wrought such acts, and died in such a manner, therefore he must needs be borne such a year, and such an hour. The superstitions of the Chald●eans were such, that they would not build a house, nor attempt any journey, nor so much as put a new garment upon them but they would first have a regard of the constellations and planets. These fond and wicked abuses of astronomy I do wholly reject and disallow. But in the use of Physic seeing that a great part thereof doth concern the flowing and issuing, the staying and the passing away of humours, and that it is found by the terms of women, by the fluxes and refluxes of the seas, and many other ways, that the moon hath by the maker thereof certain influences given unto her, much available to the avoiding and correcting of humours; I do not think but if it be found by the experiences of former ages, that at sometimes and in some signs or aspects her forces are more violent then at other, we may have some consideration thereof, and make choice of such as are most meetest for our purpose, even as the husbandmen may also take such times for their grafting, sowing, planting, and such like, as by the proofs of all nations have appeared to be fittest for the fruitful growing and propagation thereof. To return now to our argument of letting blood, seeing that as I have showed the sign may sometimes seem to be good, and yet by other aspects the same may be controlled, what course is then to be taken when for want of good helps we can not come to the knowledge of the aspects? Surely then our best way will be to observe the manner of the weather. When the weather is settled to be very dry, then are not humours apt to flow, but in open and moist weather we find them very fluxible. Fernelius saith, The north wind utterly forbiddeth letting blood, 
Ver●el. lib. 〈…〉 cap. 11.  only the south wind doth best admit it in the cold time of winter. The time of the day is made by Galen, 
Gal. de venae 〈◊〉 ca 14. 〈…〉 2. sect. 5.  and out of him Fuchsius, to be the fittest within an hour or thereabouts after the party is risen, after the yesterdays meat is pretty well digested and the body eased as well by stool as by making water. 
〈◊〉 us me● medena● 〈◊〉. 2. cap. 13.  Fernelius saith, in suffocante pleuritide & angina quovis tempore fiat. If the disease be an intermitting ague, I have showed in the last Chapter that the fittest time is the middle betwixt two fits at what time of the day soever it be, and the party must a little before be dicted thereafter. Montanus saith, 
Montanus in 〈◊〉 de 〈…〉 de stu●●o●orum santtate 〈◊〉 lib. 1. cap. 22.  If he look for the fit in the morning, let blood in the evening before. Marsilius Ficinus will have scholars, who abounding with blood do use Phlebotomy to prevent diseases, to use it both morning & evening, but at either time a little, four ounces in the morning, and as many in the evening, because it is dangerous to avoid too much blood at once, but of this in the eight Chapter.   

CHAP. 7.  
On whether side the vain is to be taken when we let blood to prevent diseases, or to avoid or derive their matter: also what vain must chiefly be chosen for sundry infirmities.  
ON what side the vain must be taken in great & dangerous inflammations where there is cause of rewlsions, I have showed already in the seventh Chapter of the former book. It is not denied, but that in some cases it is requisite that the vain should be opened in the same side, where the inflmmation lieth. But if any do urge a necessity that it must needs be ever on the arm of the same side. 
Trineavel de ratione curandi part. corp. ass. lib. 6. cap. 4  Trincavel doth ask one question: Si in muliere supprimantur solitae purgationes & ex ea occasione superuenerit pleuritis: Item si ex retento sanguine ex hamorrhoidibus fluente (ut ait Hippocr. 6. epid. & in libro de humour. quod quibus sanguis ex haemorrhoidibius fluere solet, illi neque pleuritide neque peripneumonia capiuntur) quae vena iam secanda? illane quae costis affectis communicate, an potius alia impellens particula? but of this already, I hope, sufficiently in the Chapter above named. The doubt is now on what side the vain must be opened when we do it to prevent diseases, the old verse is commonly known:  
Aestas Ver dextras, autumnus hyemsque sinistras. The spring & summer right side veins would have, But autumn and the winter left do crave.  
But here we must take heed that we use not too much to let blood on one side, for that thereby we see many to be brought to particular palsies, and to lose the use of one eye or care, or the strength of one arm or side, partly because the longer that superfluous humours have found a vent in one place, the more apt they are to have recourse to the same place; and if they have not their former passage, they will easily either make obstructions, or breed some inconvenience; and partly because the letting blood too much on one side, may perhaps cool that side more vehemently than is requisite. If therefore thou hast been heretofore let blood on the one side, thy best way is the next time to take the other side, and to labour by all means that the humours may flow equally, and that they may be carried with no greater force towards thy one side then thy other. When there is need of evacuation and derivation and not rewlsion, then doth Galen appoint us to take the vain always on the same side. 
〈…〉  If the right side of the womb be grieved, avoid blood out of the right hand or right leg; and if the left side be inflamed, then take the side that is right with it: for that is the meaning of the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 of Hypocrates, to wit, that we open the 〈…〉 hepatica and lienaris directly, for they ar● nearest to the affected parts, and most right upon it. And in an other place, 
〈…〉  The evacuation out of the nearest va●nes and which are common to the place affected, is both best and easiest.  
As concerning what vain is to be opened, 
〈…〉  this rule is most generally prescribed, that if the parts beneath the neck be grieved, we must open the inward vain of the arm called generally in●erna, or basilica, or axili●ris, and more particularly if it be in the right arm called recoraria, or hepatica, in the left henaris, this is opened commonly on the left side, if the heart, lungs, or spleen be affected, and on the right side if the liver or stomach be affected. If the parts which be afflicted be above the neck, than we open the outward vain called externa, or humeralis, or cephalica.  
The middle vain called communis, 
〈…〉  or cardiaca, or nigra, or fun●: brachi●, or mediana, is then usually opened, when either one of the other doth not appear, or else when the infirmity is as well beneath as above the neck, for this vain taketh part of both the other. For the lower parts about the hips, bladder, or womb, take the vain by the knee, or by the ankle. The rains as they are placed in the nuddest, so (as Fuchsius showeth) they do partake with both. For if the inflammation in the reins be new, and that there be abudance of blood, then may you take the vain in the arm: but when it is a confirmed disease, such as is called nephritis, then open the vain either in the knee, or in the ankle. If any ill humour be settled in those parts which are between the reins and the flank, 
〈…〉 9  Fernelius doth appoint that if the party have corpus plethoricum, than first we should open the basilica of the same side, and afterward the saphena. But if the body be not plethor●cum, than he saith the only saphena shall sustice, that is, the inward vain of the foot, for as the outward is called sciatica, so the inward saphena.  
If you will not have the blood to come fast and speedily, then for the cephalica you may take his branch betwixt the thumb and the forefinger. And for the basilica you may take the vain by the little finger called salvat, or titillaris, which is a branch of the basilica. For derivation to derive the matter of a grief, if it be in the forepart of the head, take the vain of the forehead; if in the eyes, the broad veins at either corner; if in the ears, the vain under the ear; if in the laws, that which is under the tongue; if in the lungs, or spleen, or breast, or heart, the inward vain of the left arm; if in the liver, the right basilica. Often the same veins will serve both for rewlsion and evacuation, as Galen showeth, speaking of an inflammation of the liver. 
〈…〉  We must both pluck back and also avoid the blood which is carried to the liver by Phlebotomy, opening the inward vain of the right cubit, because directly, and with a broad way it doth communicate with the hollow vain: if that do not appear, open the middle vain: if that also 〈◊〉 be perceived, then take the other third which remarneth. 
Platerus de s●bus pag. 114.  This speech of Galen maketh me more willing to subscribe to the opinion of Platerus, who defendeth that in letting blood we must rather choose that vain which doth most swell with fullness of matter, then to make any difference betwixt the veins of the arms, seeing in one place about the throat they come all from the hollow vain, and which vain hath best relation to the parts most overcharged, the fullness thereof will sufficiently make manifest.   

CHAP. 8.  
What manner of incision must be made▪ how large, how small, how deep, what quantity of blood may be taken, and therein of the me●ning of Galens' word to let blood unto 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, deliquium anim●.  
IT is a notable advertisement of Hypocrates, 
Hippocr. 〈…〉. 2. 33.  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 appertaineth generally to all evacuations, so doth it greatly take place in the matter of Phlebotomy. I have showed already the greater part of these circumstances, it ramayneth here that I describe only the manner how, 
〈◊〉. lib. 2. 〈…〉 cap. 15.  and the quantity how much. Fernelius adviseth the Chirurgeon to take diligent heed that he strike not either a place swelling with some windiness, or an artery, or a tendon in stead of a vain. The tendones be instruments of moving in the top of the muscles, made of sinews and ligatures, and knitting them to the bones, they be harder than sinews, and yet not so hard as ligatures. The artery being pressed down will show itself for a vain; which if it be cut, 
He meaneth it can very hardly be healed: see the beginning of the 〈◊〉 Chapter.  it will neither come together again, nor heal, but that part will be taken with a mortification, and become as dead and senseless. He counsa●leth also the Chirurgeon, that when he hath settled the launcer in one hand, leaving out no more of the end or point then what is sufficient to pierce, and hath with the other hand so taken hold of that part of the body that is to be let blood, that he may strengthen and hold steadfast the vain with his thumb, then let him put forward h● launcer fair and softly without any hastiness gently, and no further in then is sufficient. 
Fuchsius In●●itut. lib. 2 sect. 5.  Fuchsius willeth that if the vain be trembling and not constant for the piercing, the next place must be bound as well above as also beneath: And although the vain be well opened, and the blood flow freshly, yet in the middle of the flowing set your finger awhile upon the wound, both that the strength may be more refreshed, and less scattered, and also that the corrupt blood may the better be brought out of the inward parts unto the place where the vain is opened. 
Fernel lib. 2. methodi medendi. cap. 15  Fernelius giveth one general rule to know what veins must be opened a little overthwart and somewhat sidelong, and which must be opened right along the vain. If the vain be in a joint, then let the piercing of it go a little sidelong, because in the moving of the joint the sides of the incision if they go right with the vain would gape, and so would the wound be the longer in growing together. But in the head, hands, and feet if the incisions go right with the vain he saith they heal the sooner, because there the sides do still close together. Of what bigness the orifice of the wound must be, it is discussed by Montanus writing upon the ninth Canon of Anicen. 
Montanus ●edicinae vni●ersal●● part. 3  A little hole (saith he) is best to conserve the strength of the party, both because the most that then cometh out is but thin and waterish, and also because the blood goeth not so speedily out, whereby the heat and spirits are not so suddenly exhausted. But a little orifice hath on the other side a great discommodity, in that it maketh no evacuation of the thick and gross parts. So likewise a great orifice hath one good benefit in avoiding gross humours: but it hath an other great danger, that by a too sudden and over-liberal effusion the virtues and powers may be clean overthrown. If the blood be subtle and power weak, let the hole be little: but if the blood be thick and the virtue strong, then let the hole be great. Avicen teacheth, that when we let blood to preserve from sickness, then must the orifice be great, because the powers are yet constant; and likewise when we let blood in the winter or cold weather, because then the coldness of the air doth keep the spirits from flying too fast out. But in the summer or hot weather, he will have the orifice to be narrower, because the blood is commonly than more subtle, and heat doth help much to dilatation & passage. If it fall out to be temperate weather, then to proceed in the mean betwixt both. The verses of the Salerline school are to be understood of full strength and powers,  Fac plagam largam medioc●●●ter. 〈…〉 exeat uberius. liberiusque cruor. 
Make well and wide thy blow,  
That blood and fumes may largely flow.  
Hypocrates saith, 
〈…〉  In places where 〈◊〉 no danger, and where the blood also is gross, use a broader launcer, for so the blood will pass, otherwise not but take heed of going too deep. 
〈…〉  Fernelius showeth some dangers, Under the inward vain lieth an artery, under the middle a sinew, and under both do lie the tendones of the muscles. If any of these be pierced, there may ensue much grief, and sometimes great danger. The cephalica may be opened with least peril of all the veins which appear in the cub●●e. Now for the quantity of blood how much may be taken at once, I have had occasion to declare much already concerning that point, when I entreated in my former book of Phlebotomy in particular diseases, I mean not therefore now to stand much upon it. 
〈…〉  Montanus upon the fourteenth Canon of Avicen, doth appoint that in old diseases when by long infirmity the blood is become gross, we must take but a little blood at once, and reiterate the blood-letting often, and still in the mean time to nourish the patient with a good moistening diet. If the blood appear to be whitish, then (as Avicen will have it) you must let out none at all, lest a cachexia, or bad habit or dropsy do thereupon ensue. 
〈◊〉 Insti●●● 2. sect. 5.  Fuchsius doth give unto a Chirurgeon three general notes, whereby he shall guess when is the fittest time to stay the bleeding, first, by the change of blood: 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 blood both in colour and in consistence, must then especially be attended and waited for, when the grief or inflammation for which we let blood, is near unto the place where the vain is opened. 
H●ppoc●. lib. 2. 〈…〉 10.  For Hypocrates showeth, that in a pleurisy the blood which is nigh unto the inflammation, doth far differ from that which is contained in other parts of the body, being by the vehement heat much altered: so that if the blood of the rest of the body be phlegmatic, 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 blood is not always to be tarried for, for it may be that either the strength is not able to endure it, or else that the phlegmon is such a malign and impacted humour, that it will hardly give place. In these cases we must cease before the blood do change, and the rest is to be withdrawn by a second phlebotomy. The other note to know when it is time to stay the blood, is by the violence of the flowing, now waxen more slow & feeble, for that showeth that the strength and powers are ready to decay, 
〈◊〉 justit. lib. 2. sect. 5.  especially if paleness of the face, and dazzling of the eyes do begin to draw on. But the most certain sign of all when we must stay the blood, is the changing of the pulse: for if of thick it become thin, if of great it become little, if of vehemently strong it become weak and obscure, if of equal it become unequal; it presageth that the powers are now ready to be dissolved. The safest way in letting blood is, to be sure to be within compass, what wanteth may easily be supplied by reiterating, but what is taken too much can not so easily be restored. here an other doubt may arise, when either for the toughness of the hamour, or for the weakness of the party, the blood is let not at once, but at several times, how near those times ought one to succeed an other. Fern●lius saith, 
〈◊〉 lib. 2. met●●d. med●ndt.  In diseases that universally afflict the body, the best is, to let blood twice in one day: but in the griefs of particular parts, the reiterating must be longer deferred, to wit, to the second or third day. Ficinus counseleth such as by studies are grown melancholic, 
〈…〉 sanitate 〈◊〉 lib. 1. cap. 22.  to be let blood if they feel a plenitude, and he appointeth it to be done twi●e in one day in the morning and in the co●ning, but at either time sparingly: for he saith, blood is the temperer of melancholy, the nourisher of the spirits, and the treasure of life. 
Mont. medicine. 〈◊〉 part. 3.  The like speech hath Avicen in his third canon, where he adviseth men that are troubled with a long lingering disease not to be too wasteful of their blood, because a long journey remaineth to them, and therefore they had need to gather store of good strength, he addeth this precept, Keep blood as a precious treasure. 
Galen. lib. 1. ad Glant. cap. 11.  In that quartain ague which comes ex atra bile, and in other infirmities coming of the like cause, seeing that the atra bilis may come as well of blood or phlegm, as of choler or melancholy, the black blood showeth that it proceedeth of blood adu●t, and therefore a more larger Phlebotomy is permitted unto it then unto any other atra bilis, which shall proceed of choler, phlegm, or melancholy adust. But otherwise the common opinion of Chirurgeons (who think that generally the corrupter the blood is, the more plentifully they may let it flow out) is utterly condemned by Fernelius, You must not when the blood is more impure or raw, 
Feruel. libr. 2. method. medend. cap. 17.  or is estranged and departed from his own nature, then take so much the more away, after the manner of common bad Physicians: but by how much more the humours are departed either on this side, or beyond the nature of blood, so much the more sparingly and leisurely you must let that blood s●ow: and when it shall be found to be very far from the form and shape of blood, then must you altogether abstain from Phlebotomy, for where there is little good blood, there must needs the strength be weak. The corrupt blood doth seem very fit to be expelled (as Galen saith.) That which is corrupt is against nature, 
Gal. method. 〈◊〉 lib. 9  and that showeth that it ought to be taken away. The constitution therefore of the body doth show that this aught to be our scope and drift, to evacuate the matter either by Phlebotomy, or by purging, but on the other side the weakness of the powers will suffer neither of them. How must we do then in these great contrary occasions? Galen maketh answer, 
Ibid. lib. 9 〈…〉 M.  We must in these contrary occasions and drifts by little and little avoid the bad, and by little and little restore the good, which healing of evil humours is called of physicians Epicrasis, or good tempering of humours. Why doth Galen then in the same leaf a little before in continual agues called synochis, advise to let blood 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, until the heart faint, as likewise he doth in many great inflammations in his comment upon Hypocrates? 
Hippocrat. 〈◊〉 23. 〈…〉 lib. 9 〈◊〉.  He showeth himself the cause in that place where he entreateth of agues, he doth appoint it to quench the vehement inflammation, and doth mean that it shall be as much as possibly the strength can bear. Montanus discoursing upon the fifth Canon of Auicenna, saith, 
〈…〉  that Galen doth command sometimes to let blood usque ad syncopen: but I think that in that point either he was deceived, or else that they which did commit to writing his speeches (for he wrote little himself) did not well remember his words. I read sometimes in Galen. that upon unseasonable and excessive letting of blood, 
〈…〉  or any other immoderate evacuation, a syncope or dangerous swooning may ensue, but I can no where find that he appointeth to let blood usque ad syncopen, unto a cutting off of all the powers by swooning. The fainting unto which in some cases he doth require Phlebotomy to be extended, is called by Hypocrates and him not syncope, 
〈…〉 239.  but sometimes 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, sometimes 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and sometimes 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Some do make 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, to be more particular faintings of some affections and powers of the heart and brain, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, to signify a more general dissipation of the vital spirits. But Galens words do plainly overthrow that fond distinction. For having named the words 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, he addeth immediately: 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. 
Gala. ad 〈◊〉 cap. 14.  Physicians are wont to give both these names to one thing, as they signify indeed one and the same matter. And that they both do differ from syncope, he doth show plainly when he teacheth, that gross humours, when by their toughness they do obstruct, or by their multitude oppress the passages of transpirations, 
Gal. method. medendi lib. 12. cap. ●.  they cause syncopas or swoonings. But if those gross humours do neither obstruct nor oppress, than they bring no syncopas or swoonings, but they bring a certain faintness, 〈◊〉 the Grecians call Leipoply●hia, or 〈◊〉. The ●etting of blood even unto fainting, which Galen doth allow sometimes in great inflammations, and certain hot fevers (as I have before declared) must be done very warily, and with great consideration: for many are the harms and dangers which may ensue thereby, if it be rashly or unadvisedly practised, as in one place Galen doth plainly and plentifully lay open unto us: 
Galen. method. medendt. lib. 9  I saw two men die in the very hands of the Physicians, fainting indeed away, but never recovering again. Many although they die not presently, yet afterward they come to it by the decaying of their powers, and if they had been evacuated without dissolving the strength they should not have perished. And some also their powers being by immoderate evacuation dissolved, do fall into a long linger disease. Others for all their life time afterward have then whole temperature of their body overmuch cooled, being never able to recover that harm which he hath gotten by avoiding too much blood. By which coldness some have lived afterward ill coloured, and with bad habit of body, and easily annoyed with every small thing, and others by the same means have been taken with deadly diseases, dropsies, straightness of breath by stopping of the lights, wea●●nes of liver and stomach, apoplexies, and dote. There are many unskilful Surgeons which do think and defend that for the quantity of blood, how much may be spared, they need no other observation, but to let the blood to run upon their nail, and so long as they see it to be gross and corrupt, so long▪ to let it flow. It they take this course with some diseases, they may utterly overthrow the strength of their patient. They which have much corrupt blood, have little good; and they which have little good blood, must needs have little strength; and such as are of weak powers, may soon by a great quantity of bleeding receive unrecoverable mischiefs. 
Gal. de ratione curandi per venae sectionem cap. 6.  Galen showeth, that when it happeneth that crude humours are gathered in the body, a great heed must be taken what quantity the strength will endure. For the powers being already dissolved in such constitutions of crude humours, are wont by Phlebotomy to fall into such extremities, as out of which they can never again be recovered. And therefore a little after he showeth what in this case his own practice was: 
Gal. ibid. cap. 12.  In them which have a multitude of raw humours I do avoid a little blood, and do straightway give a little water and honey well boiled together, with some extenuating thing, as hyssop, wild marierom, and sometimes calamint; and then I take away a little more blood, sometimes the same day, and sometimes the day following, in which giving again some of the aforesaid medicines, I take away blood again, and the third day likewise twice. Galen often when he nameth crudities or raw humours, speaketh not of the two first kinds of crudities, to wit, first meats undigested, and secondly, when any hurtful matter doth not obey the laws of nature, (of which two I have spoken already) but of a third kind of crudities, 
In the fifth Chapter of this second book.  when any thick or cold humours do abound in the body, for so doth Galen describe all those humours to be crude or raw which are in the body besides blood, 
Galen lib. 4. de sanitate tuenda cap. 4. & 1. de aliment. facul. cap. 2.  of a thick or cold substance. The more they depart from blood the less blood may be spared, and sometimes they depart so far from blood, as in dropsies and in some agues coming of the abundance of raw humours, that there is no place at all left for Phlebotomy. 
Massaria. pag. 77. Galen. 〈◊〉 6.  If in any place Galen doth deny and forbid letting of blood in abundance of corrupt humours, (as he doth sometimes, 
Aph 47. & Comme●t. 〈◊〉 2. 〈◊〉 8. & lib●●. de sanitate tuenda. cap. 4. Gal. method. medend. lib. 9 cap. 11.  allotting unto them rather purge than phlebotomy) we must account it to be done not in respect of the vicious humours, for Phlebotomy is common both to good humours overmuch abounding, and to ill humours overmuch annoying, it is as Galen and Avicen do make it, a remedy both against the superfluity of blood, and also against the vices of blood, 
Avicen. 〈◊〉. 1. fen. 4. cap. 1●. Gal. 〈…〉 per venae se●●●nem. cap. 9  but Galen doth prohibit it only in regard of the weakness of the strength, for so doth he expound himself: These three scopes, to wit, the greatness of the disease, the strength of the powers, and slourishing age, are sufficient for Phlebotomy: for when such a multitude of raw humours ●●gathered that it forbiddeth Phlebotomy, yet th●● my former conclusion is not reproved, for in such there is no strength sit for it. 
Gal. ibid. cap. 13.  But (as he saith afterward) If these two scopes, to wit, the greatness of the disease, and th● strength of the powers be present, there 〈◊〉 no such or so great abundance of raw humours, as that it ought to forbid this remedy of Phlebotomy. Avicen, although ●n some choleric diseases he deny letting of blood, and willeth it to be kept for a treasure, yet in firmer strength in the cure of a kind of S. 
Avicen. lib. 4. f●n. 3. tr. 1. cap. 9 & 10.  Anthony's fire coming of burning citrine choler mixed with melancholy, saith, Necessaria est Phlebotomia ut vacu●tur sanguis cholericus, Phlebotomy is necessary that the choleric blood may be avoided. Galen also alloweth letting of blood not only in continual agues coming of blood inflamed, but also in that burning fever called Causo, coming of choler putrefying in the veins, as Massaria doth prove out of the second book de crisibus, 
Massaria. pag. 82. Gal. come. in 1. aph. 23.  and out of his words upon the Aphorisms, which are these: In most burning agues letting of blood even unto fainting doth straightway cool the whole habit of the body and extinguish the fever, and also in very many the belly is wont to be made soluble, and sweats are accustomed to flow, by which deed some are altogether delivered from their ague. And he doth confirm it also by the testimony of the most ancient and excellent Physician Philotheus, who commenting upon the same Aphorism, useth these words: 
Philotheus in Comment. in 1. Aph. 23.  In whom we may let blood even unto fainting, it is manifest that it is in them who are sick of burning fevers, and yet not them all, but those in whom the powers are strong. But why dough let blood in them even unto fainting, seeing that burning fevers are kindled by humours putrefied? The putrefaction containeth two things, to wit, the matter putrefied, and the badness of the quality. Blood being let even unto fainting, doth both diminish the quantity of the matter, and moreover extinguish the sharp and inflaming quality, for by the fainting of the courage the body is cooled. And finally he doth convince the same by reason, seeing that by blood breaking out at the nostrils, the said burning fevers are oftentimes healed. Those Physicians which are of opinion that in this burning fever blood must be let only a little for eventilation from four to six ounces, longè citra lipothymiam, 
Vide Brigthi therapeuticam in tractatu de causone. Vide bic supr● pag. 11.  far less than that which doth bring lipothymye or fainting of courage (whose advise is that which I have mentioned in the second Chapter of my first book) I think they do counsel it chiefly in respect of the weakness of the powers which oftentimes doth accompany this fever, and then they descent not much from Philotheus, who doth not permit lipothymies in all, but only in them whole virtues and powers are firm and strong. Whether the humour be more thin and choleric as in choleric agues, and in frenzies, or whether it be more cold or thick, as in apoplexies, epilepsies, and lethargies, I have showed in my first book, that Phlebotomy may have in them a profitable use. 
〈…〉. 29.  Galen (when all other Physicians withstood him) did let a woman blood plentifully, when the blood came out in colour and thickness like to liquid pitch or tar. In every opening of a vain an especial consideration must be had what humour it is that doth most endanger the disease. 
〈…〉.  For in splenetic infirmities it is profitable to avoid well the thick melanecholick blood, and to stay it if it be thin, because the thin hath a good necessary use, the better to keep the thicker from obstructions: but still the chiefest respect must be had of the strength of the party. If the blood be not a thick black melancholic blood causing some melancholic disease, but otherways corrupted, and greatly degenerating from the nature of blood, Phlebotomy also may take place, but warily and sparingly, and pervices, by little and little, diminishing the ill and restoring the good, ever assuring ourselves that the less store there is of blood, the more feeble is the strength, and in no wise thinking that the trial of the blood appearing ill upon the thumb, may be a sufficient warrant to the Surgeon, to continued the more boldly the bleeding of his patient. Cold constitutions may not endure much diminishing of blood, 
Hipp. 1. ●p●. 23.  and those lipothymies, which Galen and Hypocrates do allow sometimes to cool in extreme heats, are short faintings for a time and not utter dejections and overthrowing of the strength and powers. If the blood be loath to come, Fuchsius declareth cheese helps: first, unloose a little the band: secondly, let him clutch some thing hard in his hand drawn together: thirdly, let him force himself to them and cough, and last of all bath the incision with warm water. Some do account it the readiest way both to make the vain to appear well, and to make the blood issue well, is to lap about the lower part of the arm from the place of incision downward a boat linen cloth three or four times folded.   

CHAP. 9  
What order must be taken with them that are let blood, as well in the act itself to provent swooning, as also afterward for their government and diet.  
WHen the patient hath bled what is found to be sufficient, if there be any danger of fainting, then must his body be placed in such manner as is most ●it for a perfect case and rest, so that no one limb or part may be put to any labour. 
Mont. medici vniuers. part.  Montanus upon the tenth Canon of Auctco●●a doth affirm, that this shall be best performed if the party be laid down upon a bed with the face upward: For all the sinews in the body the instruments of motion have their beginning from the joints of the backbone, and therefore the sinews of him that lieth upon the back do rest, and do suffer no violence. 
Fuchsius Institut. li● sect. 5. ca●  Fuchsius is of the same judgement, Let the patient so lie with his face upward, that all the parts of the body may lean upon the basis or groundwork, to wit, the backbone. 
ernelius me●od. medendi br. 2. cap. 16.  Fernelius biddeth, that if the patient begin to faint away, it will be a good course to sprinkle a little cold water into the face, or to put unto the nose a cloth or piece of bread moistened in wine and vinegar, or by tickling the jaws within the mouth to provoke a vomit. But he saith, Praestantissimum est aegrum prosternere, The best thing is to lay the body down all along, meaning no doubt the same manner which is already described. Though in this case of fainting the party must be laid down, yet must he not be suffered immediately to sleep. The Salernitane school commendeth rest, Omnibus apta quies, est motus saepe nociws, yet doth it on the other side forbid sleeping for six hours after blood-letting.  
Sanguine subtracto sex herij est vigilandum.  
The appointing of six hours watching is thought by many good Physicians to be somewhat more than needeth. 
uchsius instit. b. 2. sect. 5. ●ap. 12.  Fuchsius requireth that within an hour or two after blood-letting the party be refreshed with a little food of good nourishment, and within two hours after (he saith) there is nothing doth hinder but that he may sleep, so that they which stand by do look unto it that he do not roll himself upon that arm in which the vain was opened, & that the hands do not loosen from that place which was pierced. 
ernel methoi medendi. b. 2. cap. 16.  Fernelius his opinion is, that in one hour after bleeding the party may take food, and within two hours after he may safely sleep.  
Further, 
●uchs. Instit. ●b. 2. sect. 5. ●●p. 12.  he that is let blood must have a great care, that (as Fuchsius saith) he avoid all strong labours and contentions both of body and of mind for certain days following, and that he use for a while an exact diet, not beginning rashly or greedily with too much at the first, but increasing by little and little, lest if he fall too hastily to a full diet, either the natural heat being diminished be not able to concoct it, or else the veins being made more empty should draw into themselves those undigested crudities. 
Montan●●● in Can. 17. Auicennae medicinae universalis part. 3.  Montanus' interpreting the seventeenth Canon of Avicen, granteth, that they which are of strong powers, and of a hot stomach must be fed, because their hot body doth consume much nourishment every day, but he saith, they must be fed with an abiding and substantial nourishment, not with that meat which is of quick nourishment, because such food would quickly be connerted into fumes, and dry away. Give unto a country labourer the flesh of chickens, and it will straightway be resolved and turned into fumes and choler. Avicen in that canon doth appoint the meat either to be broiled upon coals, or to be roasted speedily with a quick fire, whereby the inward moisture may not be so much consumed, for in his judgement, Nulla caro est deterior quam quae paulatim assatur, quia interius & exterius exsiccatur, There is no flesh worse than that which is roasted over-softly, because it hath the moisture dried up as well inwardly as outwardly, yet must it be sufficiently either roasted or boiled: for as Galen saith, 
Gal. lib. 4. de savitate tuenda cap. ult.  It is not possible that either bread too little baked, or flesh unperfectly boiled, should be well and profitably concocted in the stomach. His purpose is in that place to show what diet a man must keep when for some inflammation he hath been let blood. First he will have him for two or three days to abstain from wine, and to use in the mean time sometimes ptisan, and sometimes other drinks moderately cooling, or if in the third day he take wine, it must be small and white, using for a while a diet that shall nourish good juices, but in no wise procure overmuch heat: But chiefly of all we must take heed of nourishing again too plentifully at the first, for they which upon such evacuations do return straightway to their former diet, have their habit of body filled with raw humours, which the whole weight of the body doth draw into itself before they can be well digested in the stomach and in the veins, and therefore we must not fill the body hastily after Phlebotomy, nor overcharge any part with more than it may be able well to concoct, even as if the body be wasted and consumed with long abstinence, it is not good presently to fill it again too plentifully, for (as Galen saith there) Many when they have their habit of body extenuated, unless they do afterward feed moderately, they gather many superfluities into the whole habit, and get thereby no small diseases. 
●uchs▪ Instit. ●br. 2. sect. 5. ●ap. 12.  Fuchsius doth sharply condemn the gross abuse amongst Dutch men, which would God it were not too common amongst us, together with other the dutch carousings and excesses: Detestable is the custom of the Germans, which for the most part do never feed more sumptuously, nor drink more liberally, then immediately after blood-letting. And not only must the party that is let blood be careful inwardly for his diet, but also outwardly he must apply such fomentations, cataplasms, and ointments, as are most fit for the grief, for the which his vain was opened. For it is a foolish and fond conceit of many, who think that if in pleurisies, or other inflammations of the lungs, liver, rains, or other parts they once have a vain opened, they need not then to take any further care. If there be any such inflammation or impostume, there must with Phlebotomy many outward applications be also annexed. 
M●thodus generalis curandi in flammationes 〈◊〉 apostemata. 1. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 dolorent sedantia.  As first anointings and plasters made of things, called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, anodyna, which do cease pain and grief, as oil of camomile, oil of dill, meal of barley, meal of beans, fengreek, duck's grease, capon's grease, oil of sweet almonds, wormwood, mingling with them some cooling things, as oil of quinces, oil roset, or oleum omphacinum, unguentum rosaceum, or unguentum santalinum. If these prevail not, then if the impostumation have need of suppurating to be brought unto matter (as it hath if the pain being not able to be assuaged do increase more and more, for the augmenting of the pain showeth how long you must use suppurating things) to help suppuration, make your cataplasms or ointments of such things as they call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, 
2. per 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 suppu●antia.  as oil of lilies, fresh butter, hog's grease, goose grease, mallows, marsh mallows, brookelime, wheat meal, oil of camomile, oil of sweet almonds, mirth, frankincense, and safron, or in stead of these diachylon cum gummi Vigonis. But with these, if the pain be very great, you must always join some astringent things, as roses, plantain, the meat of quinces, and the oil of mastic. When the matter is fully ripened, which is known by the decreasing of the pain (for as Hypocrates saith, 2. Aph. 47. While the matter is in ripening, the pains and the fevers are greater, than when it is already ripened,) 
3. per 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 euelle●tia & extra●entia.  then break it by applying outwardly such things as are 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, as doves dung, mustard seed, nettle seed, leaven, roots of briony, hermodactyls, and old oil, with a little turpentine. And at the time of the breaking, take inwardly some of a decoction made of furmiterre, and the roots of germander, eating some salt thing upon it, and lying down upon the sounder side. Also at the same time hold in your mouth a pill made of three parts, hiera picrae, and one part colocynthis, to cause a forcible spitting, not swallowing the pill, but holding it awhile in the mouth. When it is broken (which will appear by manifest signs in the urine, siege, or spittle) then use those things which be called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, 
● per 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 antem terentia.  which do mundify & have a cleansing force, as inwardly hydromel or honeyed water, with the decoction of barley, hyssop, horehound, chichpease, liquorice, and some red sugar-candy dissolved into it: And if there be an ague, than you must mingle also with these things the four great cold seeds, the seeds of cucumbers, gourds, citruls, and pompions. You may apply also outwardly a plaster made of some of your aforesaid decoction, adding to it the meals of beans, lupines, and barley. The inflammations of the lungs (which are known by a difficulty of breathing without pain, and by a gravity and distension of the bulk with a cough, but without any feeling of grief, unless the membranes of the lungs, being along the breast knit to the breast, be inflamed) are cleansed by spittle, and also by urine, and by siege. The inflammations of the hollow part of the liver (which are known by a great pain somewhat lower, and by an aptness to vomiting and loathing of meat, but joined with an immoderate thirst of drink) are cleansed best by the siege. The gibbus hepatis, or the upper part of the liver bending somewhat compass downward, joining to the midriff, out of which the hollow vain doth issue, if it have an impostume, (which being very great will appear to the handling, unless the body be overfat or fleshy, or else it is known by a pain of the right side reaching up higher towards the throat, and causing much grief in fetching breath) is cleansed best by urine. The inflammations of the rains (which are known by a pain nearer the back bone, and an astonishment of the loins and thighs on the same side that the kidney is inflamed, together with some vomitings, and with urines, often, but painful) when they are fit for cleansing, are cleansed also the same way, to wit, by a moderate use of the diuretica, or things causing urine, as the roots of garden parsley, Petroselinum Macedonicum, kneeholme, and Sperage, or electuarium justini, but remembering still that if there be an ague, you join with them the aforesaid great cooling seeds, or the less cooling seeds, of lettuce, endive, scariole, and purslayne. If the inflammations be of the spleen (which may be known and felt by the swelling of the left hypochondrium, about the short ribs on the left side) and do suppurate (which happeneth very seldom) they may cleanse the same way that the liver doth, but you may do well to add to the outward receipts the oil of capers, and the oil of tamariske. If the inflammation be a pleurisy (which is known by a pricking pain joined with the shortness of breathing, and a cough and continual fever, the pulse being hard and rough like a saw) you may intermix in the cleansing of it such things as do best avoid the cause of it. For Galen showeth, 
Gal. libr. de constitutione artis medicae. Fuchs. & Trall. capitibus de pleuritide. Trine. in explanation lib. 2. Galeni de differentijs febr. lect. 44. Trine. de ratione curandi part. corp. aff. lib. 6. cap. 3. Gal. 4. de pulsibus cap. 8. & 12.  Aliam pleuritidem ex sanguine, aliam ex bile, aliam ex pituita ortum habere, That some pleurisies do come by blood, some by choler, and some by phlegm. Fuchsius and Trallianus make some to come of melancholy, but Trincauel showeth, that that must needs be either never, or very seldom, because melancholy is of a thick and earthly substance, and can hardly pass into that thick, solid and skinny membrane, which doth underbinde the ribs. He further declareth, that it cometh most often of choler, according to that assertion of Galen, Plerumque pleuritis fit à bilioso succo, peripneumoniae à pituitoso, For the most part a pleurisy cometh of a choleric humour, and the inflammation of the lungs of a phlegmatic. What things do best help the avoiding of these humours, you shall see in the end of the Chapter next following. Last of all, when the matter and cause of impostumes is cleansed away, you must use 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, 
●. per 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 conglutinantia & cicatricem inducentia.  things that do conglutinate, consolidate, heal, and cicatrize, as inwardly sugar rosate, bowl armine prepared, and a little of the decoction of cumfrey, but outwardly oil roset, oil of myrtils, and the white of an egg, adding some hypocistis, acatia, coriars sumach, mastic, aloe, sarcocolla, sanguis draconis, and frankincense. It shall be good also to drink some of a decoction of vulnerary herbs, as sanicle, bugle, selfeheale, herb two pence, virga aurea, great valerian, and padelion, strained, and again boiled with some sugar.   

CHAP. 10.  
How defects and errors are to be supplied and amended, and how the Physician, or in his absence the Chirurgeon may know by the blood being a little while reserved, what course is further to be taken with the patient.  
GAlen showeth, that a certain young Physician (for according to the french proverb, jeunes medecins cymitieres' bossus, vieux procureurs process tortus, Young Physicians and old advocates, the one do make uneeven churchyards, and the other many crooked actions) when he had bound the arm of his patient, 
Galen▪ method. medendi. lib. 5.  and by the binding an artery did appear high up, he struck the artery in stead of a vain, a yellowish blood and thin and hot did straightways shoot out, and that with a certain leaping and skipping. Galen when he understood thereby that an artery was cut, did first apply a fit plaster to stay the bleeding, and afterward an other to heal the incision, for he defendeth there and avoucheth by his own experience, that a wounded artery may be healed. Fuchsius doth interpret, that 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, which cometh out of arteries, to be sanguis rubicundus & igneus, a fiery red blood. 
Fernel. method. meden d● lib. 2. cap. 16.  Fernelius thinketh, that the fittest plaster to lay upon a wounded artery, is, to be made of aloe, myrrh, franckencense, bowl armine, and the white of an egg mingled with the hair of a hare. Galen appointeth the plaster to remain on four days without removing. And in the same place doth charge especially, 
Gal. therap. meth. lib. 5.  that whatsoever is laid to a wounded artery be of a very drying property. So much doth the artery require more drying things then the veins, as it is by nature of a more dry constitution. If a sinew or a muscle be pricked, 
●uchs. Instit. lib. 2 sect. 5. cap. 9  there will follow an astonishment and a convulsion or cramp, or else a great pain, and some swelling, and in this case Fernelius showeth our course must be, 
Fernel. lib. 2. method. medeudi. cap. 15.  not to suffer the wound to grow together until it be first delivered from the inflammation and swelling, and the way not to suffer it to grow together, is, to bathe it with warm oil. After three days you may suffer it to heal up, putting upon it a little turpentine mingled with Euphorbe. 
Ibid. cap. 17.  Fernelius immediately after doth show, 
Fuchs. instit. lib. 2. sect. 5. cap. 11.  as doth likewise Fuchsius, how by the blood having a little while rested, we may much perceive what humour doth most abound in the patient. When the saucers wherein the blood is contained, have been set up some little time in a place where neither wind nor sun beams may come unto them, if the blood be thick and viscous, such as is the cause of obstructions, than it will soon congeal together, and being touched, it will stick somewhat to the finger. If it be long in congealing and waxing hard, then is the blood to be accounted very thin: but if when it is cold it wax not hard at all, then is it all together either waterish, or putrefied. Much whayish and yellowish water swimming upon or by the blood, doth show either too much use of drinking, or the liver weak, or the raynes feeble and obstructed. The spume or froth that swimmeth upon it (unless it come by the violence of the flowing) it showeth the heat and inflammation of that humour whose colour it carrieth, as the red froth signifieth the heat of blood, the yellow of choler, the white of phlegm, and the blackish and bluish of melancholy. The colour of the blood continuing red, is a sign of good and profitable blood. If it be pale, it signifieth choler; if white, phlegm; if greenish, burnt choler; if of a leaden colour, pernicious melancholy; if it be of divers colours, than it is showed that divers humours do abound. There is sometimes a certain fatness like a spider's web swimming upon the blood: If it be in a full body, it signifyth a blood prone unto fatness; but if it be in a lean body, it cometh of the consuming and wasting thereof. If the blood do smell ill (as it falleth out but seldom) it is a sign of a very great putrefaction. Fernelius showeth, 
Fernelius methodi medendi lib. 2. cap. 3.  how in the blood you may behold all the four humours, Cum sanguis concrenit serum per summa innatat urinae haud absimile, bilis est tenuis & florida concreti sanguini● pars suprema, melancholia subsidet, sanguis rubentior & petuita pallidior media tenent: When the blood is congealed, there are five things offered unto our view. The tenue serum or whayish part swimmeth upon the top, much like unto urine. The choler is the thin and flourishing highest part of the congealed blood. The melancholy falleth down to the bottom. The blood is the redder part, and the phlegm is the whiter part of that which doth possess the midst betwixt the choler and the melancholy. 
Gal. lib. 2. de crisibu●. cap. 12.  Galen saith, what soever is most unctuous & light in the blood is choler but what is most gross, and as it were dregs, which by overmuch heating is dried up, that is melancholy. 
Fernel. lib. 2. method. medend●. 〈◊〉. 17.  Fernelius doth advise us not only to mark the colour and contents, but also when the blood hath settled awhile, to compare the little basins one with an other. If all be like, it is likely that all the rest in the body is like unto it, and that only the multitude did offend. For although the blood be never so good, yet if it be in overmuch plenty, it may grieve the body, offend the senses, and bring very many dangers. If all the blood be ill, or if the first be good and the last ill, it showeth that many humours do yet remain to be rooted out by good diet, and by fit evacuations, or else if the blood-letting be in a great inflammation, than the last blood being worse than the first, doth often declare, that the very matter of the disease is avoided, and the evacuation made fully complete. So likewise if the last blood be better than the first, it is a good sign of a perfect evacuation. If the blood be powered afterward into warm water that the substances of it may be severed one from an other, 
Fernelius ibidem.  it will declare much unto us. The whayish thin part will be so confounded with the water, that you can not discern the one from the other. The thinner part of blood will also be mingled with the water; but yet so, that by the colour thereof you may have a good judgement of the nature of the humour. The thicker and fibrous part of the blood will shrink to the bottom, which shall be judged to be pure and agreeable unto nature, if it be bright, thin, somewhat whitish, and cleaving well together; but if it be thick, it declareth that the blood in the body is thick. If it be black or infected with any bad colour, it showeth with what humour the blood is oppressed. If it cleave not together but do easily fall asunder, it is an argument of very great putrefaction. When thus the humour abounding is known, and therewithal a consideration had of the state, quality, and nature of the disease, if it be found that there is still a continuance of the pain or grief, then must we either use those things which do gently correct the humour appearing to abound, or else (if time and occasion require it) hearken to that practice which Hypocrates doth commend in many of his writings (as Galen doth collect out of him) When humours are increased with a just proportion amongst themselves, 
Gal. in comment. 2. Aph. 8.  he endeavoureth to bring help by Phlebotomy, but when some one humour amongst the rest is superfluous, then doth he give a fit medicine for the purging of it. If Choler abounding do yet annoy the body, 
How to avoid Choler.  then either delay it with syrupus acetosus, syrup of lemons, and syrup of citrons, or with some broths or drinks wherein are boiled lettuce, purslane, endive, the white flowers of water-lily, sorrel, stubwoort, and dandelion, joining with them some sperage and germander; or else purge it, either with some simple, as rhubarb a dram, or cassia an ounce, or manna an ounce and a half, taken either in some of the aforesaid broth, or in a decoction of tamarinds and prunes, or else by a compound, as syrup of roses two ounces, or syrupus de cithoreo cum Rhababaro one ounce & a half, or diaprunum compositum, or diaprunis laxative, or by electuarium de succo rosarum, any of them a little under half an ounce. If superfluous phlegm do seem still to bring danger, 
How to annoyed phlegm.  then either diminish it without purging, by syrup of hyssop, syrup of door hound, syrup of maiden hair, oxymel simplex, oxymel squillaticum, and by tisanes of barley water, wherein are boiled some elecampane, foelefoote, liquorice, and anise seed, or else purge it either with simples, as with infused and strained agaric about three drams, or with colocynthis about twenty grains, or with elaterium as much, being well gathered light, white and bitter, or with tithymal leaves dried and prepared, one dram, or else with some compound, as with the powder of hiera picra made into pills, with the juice of balm or sage about two drams and a half, or by pills the turbith, or pillulae stomachicae, of either one of them about one dram, or diacarthami half an ounce. Or if the disease have been so linger, and the humours be become so tough and clammy, that scammoniate things may be used, you may give of Diaphoenicum, or of electuarium Indum maius, of either one of them about half an ounce. Where I use the word (about) my meaning is still that in the young, or in the very weak and feeble you must take a little less, and in the stronger sort a little more than the quantity here specified, but otherwise usually and commonly to aim, as near as may be, to the weight and dosis here mentioned & prescribed. 
How to avoid melancholy.  If melancholy abounding do seem to aggravate the impediment, then either avoid it without purging by syrups of borage and bugloss, syrup of agrimony, or syrup of fumiterre, or by some broths or drink wherein are boiled balm, rosemary, and the flowers thereof, tamariske, dodder, hartstoong; the four cordial flowers, to wit, of roses, violets, borage, and bugloss; also capers, and ceterach, called of some fingerferne; or else purge it either by a simple, as by Seine in powder one dram, or by Seine in decocton half an ounce, or by polypody or epithyme, of either of them about half an ounce, steeped, boiled, and wrong out, or by black Hellebore about half a dram, or by lapis Armenius washed a dram; or else by some compound, as by diasena Nicholai, somewhat more than half an ounce, or confectio Hamec maior about half an ounce, or syrupus de pomis Rondelet● about an ounce and a half. 
How to avoid mixed humours.  If mixed humours do afflict the body, then either to mitigate them compound your aforesaid syrups and decoctions, taking one moiety of one, and an other of an other, or otherwise proportionably mingle them, as the humours do more or less abound, or else to purge them, do the like by the forenamed purging receipts, or take of Diacatholicum somewhat more than half an ounce, or hiera Ruffi, the quantity of a chestnut dissolved in broth, or in pills take pillulae aggregativae, or pillulae de tribus, of either one of them about a dram. At what times these and such other like purge shall be accounted most fit, and what several circumstances are to be observed therein, as well at the very instant of the ministering thereof, as also in the preparing of the body before, and the guiding of it after. These are points which I do handle at large in the Cathartice, or second part of the great Physic remedies mentioned in my Preface: wherein as I have already gathered most of the chiefest axioms and aphorisms out of many famous Physicians of all ages, concerning these and such like questions appertaining to the purging of humours, and in some sort also disposed them; so do I purpose also (god willing) to deliver them hereafter to the view of the world, as soon as leisure shall permit to transcribe, and friends advise to publish.  
Soli uni, trinoque deo sit tota tributa  
Laus, cuius coeptum dextra secundet opus.  
FINIS.    

The Index.  
The questions and matters concerning letting of blood have no need of any Index, seeing they are in the Preface to the Reader gathered into a brief sum, and the Chapters pointed out where every particular is handled. But for as much as many diseases and griefs are touched here by occasion and obiter in sundry several places, that one place may the better explain an other, and sometimes also supply, confirm, and second one an other; and moreover that the Book may be more ready for the use of the reader, I have thought good to add alphabetically the names of the infirmities and impediments, for which in these two books are found many counsels and remedies.  

A.  
Agues diaries Pag. 13. 4.  
Agues continual of blood 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. Anthony's fire p. 112.  
Apoplexies p. 44.  
Arteries wounded p. 103. & lib. 2. cap. 9   

B.  
Bladder insia●ed Pag. 100 101.  
Bl●ck choler and melancholy▪ h●w differ p. 20. 19 1ST.  
Blood abounding how known p. 57 58.  
Blood overgrosse and thick p. 64. 113.  
Blood corrupt p. 107. 108. 110. 114. See humours corrupt and raw.  
●urning fever p. 11. 12. 113.   

C.  
Cacochymia p. 59 See humours corrupt.  
Cachexia p. 52. See habit bad.  
Choler abounding how known pag. 58. & lib. 2. cap. 10.  
Choler abounding how avoided and purged book 2. Chapt. 10.  
Choler avoided by blood-letting p. 22. 27. 112. 113.  
Children what to take in steed of letting blood p. 73. 74. 75. 76. 78.  
Costivenesse how holpen by clysters p. 69. 70. 71.  
Co●ick p. 45.  
Concoction wanting how known book 2. chap. 5.  
Convulsions p. 43.  
Continual hot fever p. 6. 70. 108.  
Crudities p. 111. See raw humours.  
Crudities how known book 2. chapt. 5.   

D.  
Diary fevers Pag. 13. 4.  
Dropsey p. 45. 52.   

E.  
Ears pained p. 101.  
Epiala fever p. 16.  
Epilepsies p. 44.  
Eyes pained p. 10. 1   

F.  
Falling sickness p. 44.  
Fevers of sundry kinds, See Agues.  
Fleame abounding how known pag. 58. and book 2. chapt. 10.  
Fleame abounding how avoided and purged p. 67. 69. and book 2. chapt. 10.  
Fullness 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.  
Habit bad p. 52.  
Heart pained p. 100 101.  
Heart fainting, See swoonings.  
Headache p. 101.  
Head inflamed Pag. 42. 110.  
Hips pained p. 100  
Humours corrupt and raw whether admit Phlebotomy p. 51. 52. 60. 65. 66. 67. 71. 107. 108. 110. 111.   

I.  
jaundice p. 52.  
Inflammations and impostumes how cured book 2. chapt. 9  
Intemperancy p. 60. and book 2. chapt. 9  
Itches p. 51.   

K.  
Kidneys inflamed causing stone p. 39 47. and book 2. chapt. 9  
Kidneys inflamed p. 100 101.   

L.  
Legs pained p. 28.  
Liver hot and stomach cold p. 50.  
Liver inflamed p. 100 101.  
Liver inflamed in cano book 2. chapt. 9  
Liver inflamed in gibbo book 2. chapt. 9  
Liver full of blood and choler causing pleurisy p. 42. 100  
Looseness of body p. 79. 80.  
Lungs inflamed p. 35. 100 101. and book 2. chapt. 9   

M.  
Melancholy and black choler how differ p. 20. 19  
Melancholy abounding how known p. 58. and book 2. chap. 10.  
Melancholy abounding how purged and avoided p. 107. and book 2. chap. 10.  
Melancholy winds p. 44.  
Mixed humours how purged book 2. chapt. 10.   

N.  
Nostrils bleeding sometimes ill p. 75. sometimes good, p. 39 40. 114.   

O.  
Old and linger diseases p. 105. 107.  
Old age whether to be let blood or no p. 72. 77.   

P.  
Palsies Pag. 43.  
Frenzies p. 27.  
Plague or pestilence p. 23. 25. 26.  
Pleurisy upon what several causes it cometh p. 42. and book 2. chapt. 9  
Pleurisy when and how let blood in it. p. 31. 35. 37. 72. 98. 99 106.  
Pleurisy when not let blood in it p. 38. 39  
Pleurisy how outwardly holpen book 2. chap. 9  
Pulses distempered what signify p. 9 10. 11. 106. 7.   

Q.  
Quartain fevers. p. 16. 18. 21. 23. 4. 107.  
Quinsies' p. 29. 98.  
Quotidian fevers p. 65. 17. 4.   

R.  
reins inflamed p. 100 101.  
reins 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.  
Scurvy p. 53.  
Spleen obstructed p. 44. 53. 100 101.  
Spleen inflamed p. 39 40. book 2. chap. 9  
Splenetic blood p. 23. 113. 114.  
Spitting blood p. 34. 38.  
Spirits inflamed p. 7. 9  
Stone in the reins p. 39 101. 100  
Squinancies p. 29. 98.  
Stomach weak and loose Pag. 62.  
Stomach impure p. 64. 69.  
Strength failing p. 109.  
Sweeting sickness p. 26.  
swoonings p. 62. 63. 79. 109. 110.  
Suffocation p. 2. 35.   

T.  
Tertian fever exquisite p. 16. 17. 21. 22.  
Tertian fever bastard p. 19 22.   

V.  
Vomits how to be made when the stomach is impure or molested with corrupt humours p. 64. 69.  
Urines betokening crudities book 2. chapt. 5.  
Urines deceiving p. 45.   

W.  
Women having their flowers or with child whether fit for letting blood p. 77. 79.  
Women with flowers suppressed p. 99  
Womb inflamed. p. 37. 100   

Y  
Yellow and thin blood p. 21. 114.  
Yellow jaundice p. 52.    

Faults escaped.  
Page 2. line 22. for 1. Aph. 1. read 1. Aph. 3.  
Page 11. line 22. for rough, read cough.  
Page 71. line 12. for to an ounce and a half according, read, to an ounce according etc.  
Page 110. line 2. for c●lipsis, read celysis.