In the year of our Lord God 1566. in which year there was great mortality throughout all France, by reason of the pestilence and pestilent diseases, I earnestly and diligently inquired of, all the Physicians and Chyrurgions of all the Cities (through which King Charls the Ninth passed in his progress unto Bayon) what success their patients had after they were let blood and purged: whereunto they all answered alike, that they had diligently observed, that all that were infect∣ed with the Pestilence, and were let bleed some quantity of blood, or had their bodies some∣what strongly purged, thence forwards waxed weaker and weaker, and so at length died; but others which were not let blood nor purged, but took cordial Antidotes inwardly, and applied them outwardly, for the most part escaped and recovered their health: for that kind of Pe∣stilence took its original of the primitive and solitary default of the Air, and not of the cor∣ruption of the humors.
The like event was noted in the hoarsness that we spake of before: that is to say, that the pa∣tients waxed worse and worse by purging and phlebotomy; but yet I do not disallow either of those remedies, if there be great fulness in the body, especially in the beginning, and if the matter have a cruel violence, whereof may be feared the breaking in unto some noble part. For we know that it is confirmed by Hippocrates, that what disease soever is caused by repletion, must be cured by evacuation; and that in diseases that are very sharp, if the matter do swell, it ought to be remedied the same day, for delay in such diseases is dangerous; but such diseases are not caused or inflicted upon mans body by reason or occasion of the pestilence, but of the diseased bodies, and diseases themselves commixed together with the pestilence: therefore then peradventure, it is lawful to purge strongly, and to let a good quantity of blood, least that the pestilent venom should take hold of the matter that is prepared, and so infect it with a contagion, whereby the pestilence taketh new and far greater strength; especially as Celsus ad∣monisheth us, where he saith, that, by how much the sooner those sudden invasions do hap∣pen, by so much the sooner remedies must be used, yea, or rather rashly applyed; therefore if the veins swell, the face wax fiery red; if the arteries of the temples beat strongly; if the pa∣tient can very hardly breath by reason of a weight in his stomach; if his spittle be bloody; then ought he to be let blood without delay, for the causes before mentioned. It seems best to open the Liver-vein on the left arm, whereby the heart and spleen may be better discharged of their a∣bundant matter; yet blood-letting is not good at all times, for it is not expedient when the bo∣dy beginneth to wax stiff, by reason of the coming of a Fever: for then by drawing back the heat and spirits inwardly, the outward parts being destitute of blood, wax stiff and cold; there∣fore blood cannot be let then without great loss of the strength, and perturbation of the hu∣mors. And it is to be noted, that when those phlethorick causes are present, there is one Indi∣cation of blood-letting in a simple pestilent Fever, and another in that which hath a Bubo, id est, a Botch or a Carbuncle joined therewith. For in one or both of these, being joined with a vehe∣ment and strong burning Fever, blood must be letten by opening the vein that is nearest unto the tumor or swelling against nature, keeping the straitness of the fibres, that this being open the blood might be drawn more directly from the part affected; for all and every retraction of putrefied blood unto the noble parts, is to be avoided, because it is noisom and hurtful to na∣ture, and to the patient. Therefore, for example sake, admit the patient be plethorick by reple∣tion: which is called Ad Vasa, id est, unto the Vessels, and Ad Vires, id est, unto the Strength: and therewithal he hath a tumor that is pestilent in the parts belonging unto head or neck; the blood must be let out of the cephalick or median vein, or out of one of their branches dispersed in the arm on the grieved side. But if through occasion of fat, or any other such like cause, those veins do not appear in the arm, there be some that give counsel in such a case to open the vein that is between the fore-finger and the thumb, the hand being put into warm water, whereby that vein may swell and be filled with blood gathered thither by means of the heat.
If the tumor be under the arm-hole, or about those places, the liver-vein, or the median must be opened which runneth alongst the hand: if it be in the groin, the vein of the ham, or Saphena, or any other vein above the foot that appeareth well, but alwaies on the grieved side. And phlebotomy must be performed before the third day: for this disease is of the kind or nature of sharp diseases; because that within four and twenty hours it runneth past help. In letting of blood you must have consideration of the strength. You may perceive that the patient is ready to swound, when that his forehead waxeth moist, with a small sweat suddenly arising, by the a king or pain at the stomach, with an appetite to vomit, and desire to go to stool, gaping, black∣ness of the lips, and sudden alteration of the face unto paleness: and lastly most certainly by a small and slow pulse: and then you must lay your finger on the vein, and stop it untill the patient come to himself again, either by nature, or else restored by art; that is to say, by giving unto him bread dipped in wine, or any other such like thing: then if you have not taken blood enough, you must let it go again, and bleed so much as the greatness of the disease, or the strength of the patient will permit or require: which being done, some of the Antidotes that are prescribed be∣fore will be very profitable to be drunk, which may repair the strength, and infringe the force of the malignity.