Nine books of physick and chirurgery written by that great and learned physitian, Dr Sennertus. The first five being his Institutions of the whole body of physick: the other four of fevers and agues: with their differences, signs, and cures.

CHAP. XVI. Of the abating abundance of blood with Leaches, Cupping-glasses, Scarrifications &c.

THe other fault amongst morbifique causes is quantity and the common Indication which is taken from hence that that which aboundeth may be deminuished, * 1.1 and that which is diminuished, may be increased, but since nothing can be said to abound, unlesse that at other times it be na∣turally present; but in the body blood only and such ex∣crements are contained which proceed from nature; blood and naturall excrements in this second manner may be the causes of diseases, as also milke and seed, and moreover the spirits and solid parts of the body, all which if they are defi∣cient in quantity, ought to be increased, but if they exceed are to be deminuished; naturall excrements are seldome de∣sicient in quantity, but they often exceed; but since the same reason is of evacuating naturall excrements, which there is of the humours, in their kind preternaturall, here only we will speak of taking away of blood when it abounds.

Therefore if Plethory, be present and the blood abound, * 1.2 the blood is to be diminuished, and that which aboundeth to be taken away, and too great plenty of blood indicates diminution of the same.

But concerning the manner how we abate the blood, * 1.3 some performe it more strongly, others more weakly; fri∣cations, Sweates, Bathes, Exercise, Fastings performe it more weakely; Leaches, opening of the Hemethodes, pro∣vocation of courses, Cupping-glasles, and Scarrifications performe it more strongly; but the most generous, and powerfull remedie here, is opening of a veine.

Frications, sweates, Bathes, and Exercises, they diminu∣ish the blood one way, because they stir up the heate in the body, which dissolves and dissipates the substance of our bodyes.

But fasting doth not evacuate by its selfe, * 1.4 but by reason that it takes away humours, and diminuisheth the body, be∣cause it puts nothing in the stead of that which is consum∣ed by heate, and denyes necessary aliment to the bo∣dy; but because fasting evacuates the whole body equally, tis then requisite when the humour abounding

doth abound not in one part but in the whole body; yet shorter fasting first evacuates humours out of the sto∣mach and about the stomach; but because fasting evacu∣ates by degrees it is not profitable, nor sufficient for an in∣dication, when plenitude is suddenly to be abated. But tis endured when the strength is powerfull, to which all other things, which prohibit fasting are to be referred, as tem∣perature of body, hot and dry, hot and moist, a thin habit of body, griping or biting in the Orifice of the stomach, vomiting, flux of the belly.

Leaches by opening the mouths of veines, * 1.5 and sucking blood, evacuate blood by themselves, and sensibly, yet by little, and little, in which respect they may diminuish the plenitude of the whole body and helpe diseases of many parts to which they are applyed, and evacuate, sometimes a greater, sometimes a lesser quantity of blood, as they are applyed to a greater, or lesser veine, in the application therefore of them, you are to observe, whether they are pla∣ced for the evacuation of the whole body, or for a disease of some private part, for if they are applyed for the evacua∣tion of the whole, they are to be put to the great and pro∣minent veines, in the Legs and Armes or Hemerhodes, yet in women that are with child, they must be applyed on∣ly to the Armes; but in regard of peculiar diseases they are to be applyed to divers parts, as this or that part is affec∣ted.

The Hemerhodes if they use to flow at other times, * 1.6 the opening of them may be instead of breathing a veine, but otherwise the Physitian in opening of them shall labour with little profit, unlesse happily they are opened by leaches putting to them; but since the Hemerhodes are twofold, externall and internall, the externall are opened to abate a Plethory, as also for diseases of the Reines, Wombe, Back, Hips, and other diseases arising from the hollow veine with profit; as in diseases which proceed from the Hypocon∣dries, the Liver, Spleen, Mesentery, the internall may be conveniently opened; but the externall are opened with frications, the leaves of a Fig, course rags, Leaches applyed, the juice of an Onion, the juice of Century, or Sow-bread, the Gall of a Hog, or Bullock, or with rags wet in these, but the internall with suppositers and sharpe Glisters.

The courses whilst they flow exacuate also and diminish perfluour blood; * 1.7 but nature appointed that flux, which

if it be supprest is to be opened; in which businesse this is to be observed, that in provoking them, the Physitian should make use of that time, when at other times they use to flow, for if he should endeavour it at another time, he looses his labour.

Cuppings, which Scarrification also, * 1.8 but by die, evacuating blood by themselves, and sensibly, but by degrees; for which reason they are something applyed for good reasons, sometimes instead of opening a veine; if they are applyed with good reason, they are indicated from no great fault of the blood. But when they are used in∣stead of Phlebotomie they are applyed for some great fault in the blood, which indeed requires the breathing of a veine, which notwithstanding weak strength will not endure; but Cupping-glasses properly evacuate cutaneous blood, yet because some of the blood which comes out of the skin is powred into the capillary veines from the great veines, in this respect also they are said to evacuate the whole body: but if that evacuation be more sparing it doth not reach the whole. And when Cupping-glasses evacuate by drawing, the use of them is most profitable if any revulsion be requi∣red at the same time: as for the place of applycation, if they are applyed in respect of the whole, they should be put to the inferior parts; if in respect of any part, then to that part which requires this remedie; yet in those that are pregnant, they are not to be exhibited to the inferior parts but rather to the Armes.

Lastly simple scarification also without cupping, * 1.9 may eva∣cuate blood; which truly is used sometimes instead of o∣pening a veine; and tis appointed in the Legs especially, by which meanes it may not only evacuate but also re-vell from the head, and superior parts, yet sometimes in the Arme and back also, but in its proper use tis exhibited, when there is a purpose to evacuate only out of some one part, but especially when we would evacuate some acrid, ma∣lignant, and venemous matter, least being retained, it should cast the sick into danger, which is used also in a Gangrene, and by the ancients in a callous Ulcer.

Notes

• * 1.1

  What shews the fault con∣cerning quantity. What offends in quantity.
• * 1.2

  Plethory what it shews.
• * 1.3

  The man∣ner of a∣bating blood.
• * 1.4

  Fasting.
• * 1.5

  Leaches.
• * 1.6

  Hemer∣hodes.
• * 1.7

  Courses.
• * 1.8

  Cupping with scar∣risying.
• * 1.9

  Scarrifica∣tion.