Phlebotomy

Use in the book

The causal discussion insists on two opposed possibilities. With an evident excess of bad humours and melancholy blood, neglecting timely bleeding is said to risk inflammation and madness. Used without judgement, at an unsuitable time or excessively, it is said to do equal harm by cooling the body, dulling the spirits and consuming them. Curio and Calenus develop the warning; Calenus adds the condition of careful diet afterwards. Salvianus reports that patients in his hospital became worse, allowing bleeding only when the illness plainly proceeds from blood. Plater offers contrary experience of people allegedly saved after twenty or sixty bleedings. Burton does not resolve their competing observations into consensus: he leaves the matter to physicians. These historical claims and quantities are not current treatment advice.

The surgical account asks who can endure the loss, how much can be spared and when the procedure should occur. Age, strength, bodily fullness and exhaustion matter, while timing in relation to food, drugs and celestial positions is disputed. In head melancholy, practice before and after drugs is qualified by “if there be any need at least of it.” A disorder arising primarily in the brain need not call for bleeding unless another reason exists; Hercules de Saxonia disallows it in the cold condition of the spirits called immaterial melancholy, whereas Laurentius cites approval. Burton closes with Aretaeus’s call for deliberation about all circumstances.

The place of the supposed disorder changes the account. When melancholy blood occupies the whole body as well as the brain, the recommendation is stronger, yet the amount depends on strength and clear, good blood is to be retained. Repeated small evacuations, alternative sites when the arm is unsuitable, suppressed habitual bleeding and a reported cure after an accidental thigh wound belong to that particular discussion. For hypochondriacal melancholy, bloodletting is again restricted to a stated excess and movement of blood. Even the favoured haemorrhoidal outlet remains disputed: Montanus objects that it draws away the thin blood and leaves the thick behind.

The later love-melancholy discussion reuses the medical procedure only after asking whether altered humours or accumulated matter require medicine. It calls bloodletting a principal remedy on the authority of Avicenna and other writers, then recounts an alleged Scythian practice of bleeding below the ears to suppress sexual appetite and produce infertility. That report extends the historical purposes attributed to bloodletting; it does not establish the efficacy of either claim.

Bloodletting also has a diagnostic and an analogical life. In the symptoms of whole-body melancholy, the appearance of drawn blood is considered alongside the relative absence or lesser force of head and hypochondriacal symptoms. Drawing blood from an arm to check a nosebleed supplies an analogy for expelling one passion by another. Finally, bleeding in “vena Hymenæa,” Hymen’s vein, is a sexual conceit in the argument for lovers’ marriage and union. The surrounding bed and wedding imagery prevents a literal anatomical reading.

Related entries

Purging

Blood and sanguine

Chirurgery

Evacuation and retention

Places to read

1. Subsection 4 Retention and Evacuation as Causes, and How They Act · paragraphs 19–26Omission and excess, contrary hospital experience, and the deferral of judgment.
2. Subsection 3 Symptoms of Melancholy Abounding Throughout the Body · paragraphs 22–25Bleeding as a diagnostic sign within a comparison of symptoms.
3. Subsection 2 Help From Friends Through Counsel and Comfort Gentle and Harsh… · paragraphs 29–32Arm bleeding as an analogy for counteracting passions.
4. Member 3 Surgical Remedies · paragraphs 1–10Patient, quantity, timing and the principal surgical means.
5. Subsection 2 Bloodletting · paragraphs 21–29Head melancholy, disputed indications, and the concluding requirement of deliberation.
6. Member 2 Treatment of Melancholy Throughout the Body · paragraphs 14–18Whole-body melancholy, limits of strength, retained good blood and accidental bleeding.
7. Member 3. Subsection 1 Treatment of Hypochondriacal Melancholy · paragraphs 23–25Restricted indication in hypochondriacal melancholy.
8. Member 3. Subsection 1 Treatment of Hypochondriacal Melancholy · paragraphs 36–38Haemorrhoidal bleeding and Montanus’s objection.
9. The Cure of Love Melancholy by Work, Diet, Medicine, Fasting and Other Means · paragraphs 38–43Conditional medical treatment of love melancholy and the separate infertility report.
10. Subsection 5 the Last and Best Cure for Love Melancholy Is to Let Lovers Have… · paragraphs 3–9Hymen’s vein: a marriage and sexual conceit.

In this edition

“Phlebotomy” is rendered “bloodletting”. The modern sentence makes neglect the subject of the first warning and distinguishes “without judgement,” “at an unsuitable time” and “to excess” in the second. “promiscuously” is represented by “both before and after”; the qualification about actual need remains essential. The discussion of “blood-letting” contains a real difference between the body and its marginal Latin: the English allows it where the malady is increased by blood, while the Latin warns lest the disease be aggravated by the intervention. Neither wording should silently replace the other. The awkward positive “there may be again such an excellent remedy” is preserved, although the margin says there is no better remedy; the following objection remains part of the account.

bloodletting · blood-letting · local use 1

Printed “blood-letting” (English; lemma).

The deliberate removal of blood as treatment.

Here: Melancholy said to occupy both body and brain prompts a different recommendation from isolated head disease.

Context: Burton’s historical instruction is conditioned by the presumed disease seat, the patient’s strength and the appearance of the blood.

Source: original body

Source wording and original alignment: it is best to begin with blood-letting

Modern rendering: it is best to begin with bloodletting

Word and construction: The familiar compound retains the explicitly comparative recommendation, within its preceding condition.

Alignment conventions: Alignment convention.

bloodletting · Blood-letting

Printed “Blood-letting” (English; lemma).

The deliberate removal of blood as treatment.

Here: In hypochondriacal melancholy it is withheld unless excessive blood is being carried from liver and spleen to stomach and vessels.

Context: The prohibition has explicit exceptions; it is not a general ban on all bleeding.

Source: original body

Source wording and original alignment: Blood-letting is not to be used, except the Patients body be very full of blood

Modern rendering: Bloodletting should not be used unless the patient’s body is very full of blood

Word and construction: Not to be used and except remain should not be used and unless; the rest of the source sentence adds the required route of blood.

Alignment conventions: Alignment convention.

bloodletting · blood-letting · local use 2

Printed “blood-letting” (English; lemma).

The deliberate removal of blood as treatment.

Here: Applied to love melancholy under the preceding condition that medicine is needed because humours have changed or matter has accumulated.

Context: The principal-remedy claim belongs to cited medical authorities and remains a historical account of supposed efficacy.

Source: original body

Source wording and original alignment: blood-letting to be used as a principal remedy

Modern rendering: bloodletting as a principal remedy

Word and construction: The procedure contributes bloodletting; principal describes its assigned rank in the cited treatment.

Alignment conventions: Alignment convention.

let blood · let them bleed

Printed “let them bleed” (English; phrase).

To draw a person’s blood.

Here: Bloodletting is proposed as a means of distinguishing whole-body melancholy by the blood’s appearance together with the relative absence or weakness of other symptoms.

Context: Burton gives a historical diagnostic use, conditional on several signs rather than black blood alone.

Source: original body

Source wording and original alignment: The best way to discern this species, is to let them bleed

Modern rendering: The best way to distinguish this type is to let them bleed

Word and construction: Let them bleed contributes the proposed procedure; the surrounding words specify its diagnostic purpose.

Alignment conventions: Alignment convention.

let blood · letting blood

Printed “letting blood” (English; phrase).

To draw blood from a person.

Here: Drawing blood from the arm to treat a nosebleed is the bodily analogy for countering one passion with another.

Context: The comparison is offered after preceding remedies fail; the following examples are historical coercive practices, not present advice.

Source: original body

Source wording and original alignment: as they do bleeding at nose by letting blood in the arm

Modern rendering: as they treat a nosebleed by drawing blood from the arm

Word and construction: Letting blood supplies drawing blood; in the arm identifies the withdrawal site, distinct from the nosebleed.

Alignment conventions: Alignment convention.

phlebotomy · Phlebotomy · local use 1

Printed “Phlebotomy” (English; lemma).

Bloodletting, the deliberate removal of blood.

Here: The intervention can be harmful when neglected amid an excess of bad humours, or when performed without judgement, at an unsuitable time or excessively.

Context: Burton balances alleged dangers of omission and misuse within humoral physiology.

Source: original body

Source wording and original alignment: Phlebotomy

Modern rendering: bloodletting

Word and construction: Bloodletting supplies the familiar noun; the reversed sentence order clarifies that neglect, rather than the procedure alone, is the first harmful circumstance.

Alignment conventions: Alignment convention.

phlebotomy · Phlebotomy · local use 2

Printed “Phlebotomy” (English; lemma).

Bloodletting, the deliberate removal of blood.

Here: Plater claims repeated bleeding saved innumerable patients, directly opposing Salvianus’s adverse experience.

Context: The positive statement is Plater’s report; Burton leaves the dispute to physicians, not to a universal rule.

Source: original body

Source wording and original alignment: all Phlebotomy in Melancholy

Modern rendering: all bloodletting for melancholy

Word and construction: The noun is bloodletting; all belongs to the treatment rejected by Plater’s opponents.

Alignment conventions: Alignment convention.

phlebotomy · Phlebotomy · local use 3

Printed “Phlebotomy” (English; lemma).

Bloodletting, the deliberate removal of blood.

Here: Its timing before or after drugs is immediately subordinated to whether it is needed at all in head melancholy.

Context: Burton describes common practice while reporting Galen’s and others’ doubt about this kind of case.

Source: original body

Source wording and original alignment: Phlebotomy is promiscuously used before and after Physick

Modern rendering: Bloodletting is used both before and after medicinal treatment

Word and construction: Promiscuously concerns use on either side of medicinal treatment; it does not erase the following condition of need.

Alignment conventions: Alignment convention.

phlebotomy · Phlebotomy · local use 4

Printed “Phlebotomy” (English; lemma).

Bloodletting, the deliberate removal of blood.

Here: A cold imbalance of spirits occasions Hercules de Saxonia’s refusal, while Laurentius approves bleeding on other authorities.

Context: Burton presents opposed medical judgments about immaterial melancholy.

Source: original body

Source wording and original alignment: will not admit of Phlebotomy

Modern rendering: refuses to allow bloodletting

Word and construction: The negative modality belongs to Hercules de Saxonia; it is not Burton’s unqualified prohibition.

Alignment conventions: Alignment convention.

phlebotomy

Printed “phlebotomy” (English; lemma).

Bloodletting, the deliberate removal of blood.

Here: Salvian admits only the haemorrhoidal form here, while Montanus objects even to that proposed outlet.

Context: Plater, Salvian and Laurentius supply approval; the next paragraph gives Montanus’s objection that thin rather than thick blood is removed.

Source: original body

Source wording and original alignment: will admit no other phlebotomy but this

Modern rendering: allows no bloodletting except this

Word and construction: The exception this points to haemorrhoidal bleeding, not to an unrestricted alternative treatment.

Alignment conventions: Alignment convention.

vena Hymenæa

Printed “vena Hymenæa” (Latin; phrase).

Hymen’s vein, a figurative vein named for the god of marriage.

Here: Bleeding in this imagined vein represents marital intercourse as the proposed final remedy for love melancholy.

Context: Burton’s sexual conceit is framed by lovers being joined in bed and in marriage, not an anatomical identification.

Source: original body

Source wording and original alignment: in vena Hymenæa

Modern rendering: in “Hymen’s vein,”

Word and construction: The Latin phrase supplies the marriage-related vein metaphor; the modern quotation marks signal the conceit.

Alignment conventions: Alignment convention.