Book III OF PESTILENT FEVERS 219

and remove the contagion from it. However, those doctors
who prefer to decrease the blood by means of numerous cuppings
are certainly following a safer procedure. 'Therefore, do not
allow yourself to be persuaded to employ venesection on the
ground that the disease is serious; for it will become still more
serious if you open a vein, and there will be also greater ebulli—
tion and corruption in the blood, while there will be less trans—
piration. Moreover the fact that, after phlebotomy, an erup—
tion of lentil spots has been observed in certain cases, does not
prove that greater resistance was thereby added to the vital
energy of the patients; it was a more serious symptom. For,
just as hot water, from. being stirred, gives forth more evapora—
tion, so in this case also, when the blood has been set in motion
and agitated, a more violent evaporation is excited, which great—
ly stimulates the vital energy, and so causes an irregular expul—
sion, very different from that which nature chooses when left
to herself, when she is trying to produce a crisis. A signal
proof of this is that expulsions of the kind called symptomatie
usually disappear at once; hence, even when they appear, there
is not much ground for hope.

"There is & similar disagreement among doctors with regard to
the evacuation that is produced by purgative drugs; some doc—
tors use such drugs sparingly, because they observe that, after
taking them, patients suffer a complete collapse. Others how—
ever, employ them even frequently, some prescribing milder,
and others more violent drugs. On this question I must say
almost the same thing as I did about phlebotomy; for purga—
tive drugs both draw the contagion inwards and greatly disturb
and mix the blood, and hence many patients have been observed
to suffer from failure of all their vital energy. Therefore, unless
there seems to be serious plethora, it is well to abstain from
drugs. But if such plethora be present and is of a kind that
can be evacuated, above all in the initial stage, (for many sub—
stances are not crude, even in the initial stage), then you may
employ solvent drugs. But for my part I should prefer the
milder sort to the more violent, and when the former are not
strong enough to eliminate the thicker humors, then I advise
you to administer the more violent sort, but in a smaller dose.
Moreover, you must not neglect the evacuation that is produced
through urine and sweat.

Nou must not overlook those remedies which have been men—