Ars chirurgica a compendium of the theory and practice of chirurgery in seven books ... shewing the names, causes, signs, differences, prognosticks, and various intentions of curing all kinds of chirurgick diseases ... : to which is added Pharmacopoeia chirurgica, or, The medical store, Latin and English ... / by William Salmon ...

CHAP. XII. The OPENING of a VEIN.

I. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, (à 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, di∣vido) Diaeresis, a divi∣ding asunder, is the second part of the Operations of Chirurgery, and shews the separation of Parts, whether naturally or unnaturally joined, by Manual Operation.

II. It teaches the opening of Veins and Arteries, the Wind-pipe, Brest, Belly, closed Orisices, Ustion, making of Issues, applying the Seton, Scarification, opening of Abscesses or Apostems, dividing of Bones by Perforation, Exci∣sion, Scraping, Filing, or Saw∣ing, together with the Applica∣tion of Cupping-Glastes, for the drawing forth of Blood out of the fleshy Parts, &c.

III. The Way and Manner of opening a Vein. Make a Ligature about the Arm, about 2 Inches above the place you intend to cut, of a Womans Fillet, or the like, so as it may be easily loosed, if need be; then put a thick Staff into the Patients hand to gripe fast, and with your hand, chafe well the Vein, that it may rise full. If it lies deep and small, foment it with warm wa∣ter, rubbing it hard with a Lin∣nen Cloath, till it sufficiently appear; make the Orifice large, not deep: If it be too small, it will soon puff up with Wind. Strike the Vein (not just along, nor quite over-thwart, but) slanting. If it be not deep e∣nough at first, quickly thrust in∣to the same place again deeper; but before you cut it, lay your thumb gently upon the Vein, just by the place, and with the Lancet, between the finger and thumb, in the other hand (the other singers leaning upon the Arm, to keep your hand the more steadier) gently thrust in the Lancet, as far as you think may reach the Vein, a little stretching up your hand, by which you shall enlarge the O∣rifice.

IV. Bleed as much as may be convenient; then by loosing of the Ligature, the Blood will stay. with your Finger squeeze the thickned Blood out of the Ori∣fice, lay on a Pledget of Lint, dipt in cold water, and a Lin∣nen Cloth, two or three times double upon that, (which ought to be in a readiness before∣hand;) then with a Band or Ligature, bind up the Arm, go∣ing cross above and below the Elbow, making the Band to cross upon the Boulster: then pin or tie it fast, so as the Patient may

endure it, which let remain till the next day, letting the Arm be held up, or with a Linnen Cloth be fastned to the Brest.

V. It is in vain to tell you all the particular Ʋses and Intentions, for which Our WARWICK-LANE BLOOD-SUCKERS institute Bleeding: 'Tis a General and Ʋ∣niversal Remedy with them, a∣gainst all Diseases, at all Times, and in all Persons, of what Age, Sex, or Constitution soever: So that should we particularly enu∣merate them, from their admi∣red Practice, it would not only be Labour in vain, but also cost me many Sheets of Paper to do it, which now I have saved in these very few words; and told you in a Sentence, whatever you are to expect from it, according to the REVELATION-MENS way of Quacking.

VI. What our own Thoughts are of it, we have in part told you in the Third Edition of our Synopsis Medicinae, Lib. 1. Cap. 77. Sect. 20. ad 46. Where we have laid down several Propositions, self-evident, against the received way of using it; but because possibly that way of arguing, may be above the Capacity of OƲR WARWICK LANE SPARKS, and that Discourse not thought satisfactory in every re∣spect: We, for the Satisfaction of every sincere Inquirer, will here resume the Argument again; and, by a new Set of Propositi∣ons, demonstrate that to the very external Senses, which be∣fore we proved only to the In∣ternal.

VII. Prop. 1. Tho' we deny not, but that there may be a Vacuum in Nature; yet Nature generally ab∣hors it. This is evident in Wa∣ter Pumps, and in many other things, where there is a violent Suction, by reason of the Pro∣trusion of the Air.

VIII. Prop. 2. That in any long and narrow Cylindrical Body, if it be filled with a continued and liquid Matter, that Matter will not easily run out, unless it may receive a supply at the other end, or some other parts of the Cylinder, where there are Pores or Passages. This Children demonstrate with a Reed, where, putting it end∣ways into the Water, it will fill, and then nipping the upper part of it close, though they take it out of the Water, yet will not the Water easily fall out of it, unless they open it at the other end again.

IX. Prop. 3. That the Veins and Arteries may not unfitly be compared to Cylindrical Bodies, yet with many capillary Pores or Pas∣sages into their larger Cavities. This is manifest from the Capil∣lary or small Twigs of Veins and Arteries, derived from the grea∣ter Stocks, Arms and Branches.

X. Prop. 4. That these Cylin∣drical Bodies are filled with a continuous and flowing Liquor, which is the Blood. This is evi∣dent in Phlebotomy and Disse∣ction.

XI. Prop. 5. That there are no Anastomoses between the Ar∣teries and Veins, yet discovered by any Anatomist, except that fa∣mous one of the Splenetick Ar∣tery, with the Ramus Splenicus of the Vena Porta; and possibly

some of the Arteria, with the Vena Pulmonaris of the Lungs. This all the latter Scrutinators of Anatomy affirm and maintain; and why we should believe that to be, which was never yet seen, I see no reason for.

XII. Prop. 6. That there being a Circulation of the Blood, proved by the Experience of these last Ages, and Ocular Demonstration, if there be no general Anastomoses over the whole Body (as none have yet been discovered;) the Arteries in this Circulation, must cast their Blood every where, into the Sub∣stance of the Flesh. For the Flesh being any where cut, bleeds.

XIII. Prop. 7. That to main∣tain and continue this Circulation, the Blood must be protruded, out of the fleshy Mass or Substance, into the Capillary ends of the Veins; where filling them, it smoothly slides out of the smaller Veins into the greater; and from them into the Vena Porta and Cava; and out of the Vena Cava into the right Earlet of the Heart; from thence into the right Ven∣tricle, and so by the Arteria Pulmonalis into the Lungs, out of which it is sent by the Vena Pulmonalis into the left Earlet of the Heart, and so into the left Ventricle of the same; where, by the Motion or Pulsation of the Heart, it is obtruded into the Aorta.

XIV. Prop. 8. That this Li∣quid Substance or Blood contained in the aforenamed Vessels, is gene∣rated of the Nourishment we daily receive; which if it be irregular, corrupt, or not well concocted, re∣ceives into its Substance seve∣ral heterogene and corrupt Parti∣cles. This is evident; for if the Matter of which any thing is made be corrupted, the thing constituted must have some of the Particles of that corruption.

XV. Prop. 9. That the Blood consists of a grumous Matter, a watery Substance, and a Spirit or Life; by the latter of which it is agitated and stirred up, to make a separation of those corrupt Par∣ticles it may contain, which in its Circulation are cast forth into the Substance of the Flesh, and from thence sent in a humid form into the Skin, Cuticula, and Habit of the Body. This is evident from the Small Pox, Botches, Boils, Scabs, Erysipelas, Tettars, Ring∣worms, Herpes, Morphew, Scurff, Leprosie, and other defilements thereof.

XVI. Prop. 10. That this Corruption remains in the Substance of the Flesh, and Habit of the Body, till Nature is able to expel it, and cast it totally forth, or till she is assisted with proper Medi∣cines to do the same. This is evi∣dent in all such as are troubled with Scorbutes, Botches, Boils, Scabs, Leprosies, &c.

XVII. Prop. 11. That the Blood having once cast forth this Heterogenous and Corrupt Matter into the Substance of the Flesh, by virtue of its Vital Potency, is not apt to receive it in again of its own accord; but on the contrary, still continues its Action, of expelling and casting out. This is apparent from the long continuance, and increase of the aforesaid Habi∣tual Defilements: For if that

which was once cast out was wasted and gone, the evil would cease; which we see it does not; and therefore must be con∣tinued by that means, by which it first began.

XVIII. Prop. 12. That since Nature willingly admits not of a Vacuum, by Prop. 1. That by taking away the Blood out of the Veins, such a Vacuum would ne∣cessarily follow, unless they were supplied with other Juices, out of the Substance of the Flesh, by Prop. 2. This is evident by the Construction of that second Pro∣position: And by Prop. 5. and 6. where it is proved, that there being no Anastomoses, the Veins receive their bloody Juice out of the Flesh.

XIX. Prop. 13. That then to avoid such a Vacuum in the Veins, if the Veins (upon Blood letting) receive in of the Corrupted Juices of the Body, through the whole Ʋniversal Habit, to repleat them; it follows, that the Ʋniversal bloody Mass must be at once Cor∣rupted, and defiled with an almost indelebile Pollution. This is so manifest of it self, that it needs no other Explication.

XX. Prop. 14. The Blood, by this diminution in Quantity, and loss of Spirits therewith, is so de∣pauperated in Quality, and so truly enfeebled, that by many such Out∣lets, it seems to be overcome, yield up its active Potency, and submits to the over-powering Tar∣tarous and Corrupt Matter brought in. By which it is clear, that Blood-letting pollutes the bloo∣dy Mass, and causes it to imbibe the corrupt Juices of the fleshy Substance which it had be∣fore cast out; whereby Dis∣eases are, after that Operati∣on, made ten times more re∣bellious and difficult to Cure, than they were before; and the universal human Nature becomes ten times (as I may say) more depraved, whereby those Pati∣ents are left in a deplorable, and sometimes in an incurable State. Which, before the many re∣peated Acts of BLOOD SƲCK∣ING, were in a very tolerable and hopeful Condition; which is the thing that was to be de∣monstrated, in opposition to the horrid Practices of the BLOOD SƲCKERS of our Times.

XXI. Besides, their drawing Blood in all sorts of Fevers, to me is a Paradox, not to be unfolded: For a Fever may rationally enough be compared to a boiling Pot: Now when a Pot, through the Fury of the Heat, is ready to run over, what Course is to be taken to quell its Outrage, and stop the boiling over? To this the greatest Coun∣try Clown that is, will make you a ready Answer; viz. either to put in some cold Water into the Pot, or to diminish and take a∣way the Fire: For if you take away any of the Liquor out of the Pot (which answers to Blood Sucking and Blistring) the rest of the Liquor must needs boil the faster, because the same fire or heat, has a less quantity of Matter to exercise its fury upon.

XXII. So that in the main, this is found to be an Operation of as little use as any, in the whole Art of Chirurgery; and if it is to be used at all, these four cases are

the chief, viz. 1. A Quinsey: 2. A Pleurisie: 3. A Peripneumony: 4. An inward Bruise, or Hurt in the Thorax: Which yet, if a Skilful Physician has the Matter in hand, he will easier, safer and sooner perform, by the admi∣nistration of some inward Spe∣cifick, as Spirit or volatil Salt of Mans Blood, or Flesh, or Urine, &c. than any BLOOD SƲCKER of them all can do by Bleeding. But of this, at present, enough.