The workes of that famous chirurgion Ambrose Parey translated out of Latine and compared with the French. by Th: Johnson

CHAP. LIX. Of Phlebotomie, or Blood-letting.

PHlebotomie is the opening of a veine, evacuating the blood with the rest of the humours; thus Arteriotomie, is the opening of an Artery. * 1.1 The first scope of Phlebotomie is the evacuation of the bloud offen∣ding in quantity, although oft-times, the Physicians intention is to draw forth the blood which offends in quality, or either way by ope∣ning * 1.2 a veine. Repletion which is caused by the quantity is two-fold, the one ad vi∣res, that is, to the strength, the veines being otherwise not very much swelled; this * 1.3 makes men infirme and weake, nature not able to beare this humour, of what kinde soever it be. The other is termed ad vasa, that is, to the vessels, the which is so called comparatively to the plenty of bloud, although the strength may very well away therewith. The vessels are oft-times broke by this kind of repletion, so that the pa∣tient casts and spits up blood, or else evacuats it by the nose, wombe, haemorrhoids, or varices. The repletion which is ad vires is knowne by the heavinesse and weari∣somnesse of the whole body; but that which is ad vasa is perceived by their distensi∣on * 1.4 and fulnesse, both of them stand in neede of evacuation. But bloud is onely to bee let by opening a veine, for five respects: the first is to lessen the abundance of * 1.5 bloud, as in Phlethorick bodies, and those who are troubled with inflammation without any plenitude. The second is for divertion, or revulsion, as when a veine of the right arme is opened to stay the bleeding of the left nosthrile. The third is to allure or draw downe, as when the saphena is opened in the ankle to draw downe the courses in women. The fourth is for alteration or introduction of another quali∣ty, as when in sharpe feavers we open a veine to breathe out that bloud which is hea∣ted in the vessels, and cooling the residue which remaines behind. The fift is to pre∣vent imminent diseases, as when in the Spring and Autumne we draw bloud by ope∣ning a veine in such as are subject to spitting of bloud, the squinancie, pleurisie, fal∣ling sicknesse, apoplexie, madnesse, gout, or in such as are wounded, for to prevent the inflammation which is to be feared. Before bloud letting, if there bee any old excrements in the guts, they shall bee evacuated by a gentle glyster, or suppository, lest the mesaraicke veines should thence draw unto them any impuritie. Bloud must, * 1.6 not be drawne from ancient people unlesse some present necessity require it, lest the native heat which is but languid in them should be brought to extreme debility and their substance decay; neither must any in like sort be taken from children, for feare

of resolving their powers by reason of the tendernesse of their substance, & rareness of their habit. The quantity of bloud which is to be let, must bee considered by the strength of the patient, and greatnesse of the disease: therefore if the patient bee weake, and the disease require large evacuation, it will bee convenient to part the let∣ting of bloud, yea by the interposition of some dayes. The veine of the forehead * 1.7 being opened is good for the paine of the hind part of the head; yet first we foment the part with warme water, that so the skin may be the foster, and the bloud drawne into the veines in greater plenty. In the squinancie the veines which are under the tongue must be opened assant, without putting any ligatures about the neck for feare of strangling. Phlebotomie is necessary in all diseases which stop or hinder the breathing, or take away the voice or speech, as likewise in all contusions by a heavie stroake, or fall from high, in an apoplexie, squinancie, and burning feaver, though the strength be not great, nor the bloud faulty in quantity or quality, bloud must not be let in the height of a fever. Most judge it fit to draw bloud from the veines most remote from the affected and inflamed part, for that thus the course of the humours may be diverted, the next veines on the contrary being opened the humours may be the more drawne into the affected part, and so increase the burden and paine. But this opinion of theirs is very erroneous, for an opened veine alwaies evacuates and disburdens the next part. For I have sundry times opened the veines and arteries of the affected part, as of the hands & feet in the Gout of these parts; of the temples in the Megrim; whereupon the paine alwayes was somewhat asswaged, for that to∣gether with the evacuated bloud, the malignitie of the Gout, and the hot spirits (the causers of the head-ach or Megrim) were evacuated. For thus Galen wisheth to open * 1.8 the arteries of the temples in a great and contumacious defluxion falling upon the eyes, or in the Megrim or head-ach.

Notes

• * 1.1

  What Phlebo∣to••ie is.
• * 1.2

  The•…•….
• * 1.3

  Repl••tion twofold.
• * 1.4

  The signes.
• * 1.5

  〈◊〉〈◊〉 scopes in letting blood.
• * 1.6

  From whom we must not draw blood.
• * 1.7

  When and for what it is neces∣sary.
• * 1.8

  13. meth. cap. ul••.