534 



PHLEBOTOMY PHOCION. 



complaints were made against him, which he was 

 sent for to answer. He justified himself, and was 

 about to return to his government, when he was 

 taken sick, and died in London, about the middle of 

 February, 1694. He was a blunt, honest man, ar- 

 dent in every thing which he undertook, open-hearted 

 and generous, but vulgar in speech and manners. 

 His talents were considerable. 



PHLEBOTOMY; the act of letting blood by 

 opening a vein. Among the ancients, great regard 

 was haa to the place where the opening was to be 

 made. At present, the custom is to open one of the 

 principal veins of the ami, the hand, the foot, the neck, 

 or the tongue. The operation itself was anciently 

 performed with a spring lancet; now, for the most 

 part, with a simple lancet. Of the arteries, that of 

 the temples is the only one which is opened, and that 

 is done in cases of local complaints of the head. 

 Another mode of letting blood is by cupping, or by 

 the application of leeches for the purpose of extract- 

 ing blood from places affected by inflammations. 

 Phlebotomy is one of the most effectual means of the 

 medical art ; but its application is differently regard- 

 ed by the most distinguished physicians. Hippo- 

 crates rarely resorted to it ; for he considered the 

 cure of fevers and inflammations as the work of na- 

 ture, and regarded phlebotomy as a mode of weaken- 

 ing the efficacy of her operations. His followers 

 applied it more frequently, sometimes even to excess. 

 The schools of the empirics (250 B.C.) relying, like 

 Hippocrates, on their own experience and on the ob- 

 servation of nature, endeavoured to deter/nine the 

 cases in which bleeding was indispensable. But me- 

 dicine declined with the general decline of science, 

 Greek physicians indeed still distinguished them- 

 selves among the Romans ; but the sect of empirics 

 had degenerated. Excessive bleeding again became 

 common, until Asclepiades of Bithynia (Cicero's 

 physician and friend) taught a new method of phle- 

 botomy. He considered the cause of the greatest 

 number of diseases to be redundance of blood, and, 

 on this account, advocated the practice of bleeding, 

 but principally for the alleviation of pain, and applied 

 this remedy frequently in case of local affections. 

 After him Celsus gave an account of the cases in 

 which bleeding was necessary (A. D. 5), and his re- 

 marks and directions correspond exactly with those 

 of the greatest modern practitioners. Aretaeus, 

 founder of a new school (A. D. 70), prescribed bleed- 

 ing more frequently in acute than in chronic diseases, 

 and, in extreme cases, he bled the patient to complete 

 exhaustion. Galen (160), who referred theoriginof 

 a large class of diseases to excess of blood, ordered 

 copious bleedings ; and this practice gained great 

 repute, and prevailed for several centuries. After 

 the fall of the Roman empire, physicians were so 

 scarce in Europe, that Charlemagne died of an in- 

 flammation of the lungs, for want of bleeding and 

 medical attendance. The Arabian physicians fol- 

 lowed the authority of Galen, and spread his doctrine 

 over Spain, Italy and France. Bleeding was still 

 more generally practised by the monks, who were in 

 the sole possession of medicine, as well as of all other 

 science, in those ages. At a later period, astrology 

 was connected with the medical art, and bleedings 

 were prescribed on certain days. The popes, indeed, 

 had often forbidden the monks to practise medicine ; 

 but they either disregarded the orders, or considered 

 them as referring only to surgical operations. Thus 

 surgery began to be separated from medicine, and 

 formed a new profession, including the art of bleed- 

 ing, applying leeches, and shaving. But when, after 

 the, invention of printing, the writings of the phy- 

 s-icians of Greece, especially of Hippocrates, began 

 to circulate, and their doctrines to revive, the prac- 



tice of bleeding, at least among physicians, was again 

 confined to certain cases. In Germany, Paracelsus 

 (1525) overturned the system of Galen, and with it 

 the practice of bleeding, which is now confined 

 to the surgeons and barbers alone. In France, Italy, 

 &c., the method of Hippocrates and the degenerated 

 system of Galen were, however, not yet abandoned, 

 and the practice of bleeding was carried to the great- 

 est excess. Helmont (1600), the founder of a new 

 system, doubted the use of extracting blood, alleging 

 against it, that it weakened too much the vital spirit, 

 which he called archtcus. Harvey's discovery of the 

 circulation of the blood (1619) had some influence on 

 the modes of pldebotomy, in as far as it led to expe- 

 riments (1642) by which medicines were infused im- 

 mediately into the veins, or a portion of the infected 

 blood extracted, and supplied by the blood of healthy 

 men or animals. In England, Sydenham rose (1673), 

 who thought it possible to expel diseases by copious 

 bleedings. He extracted blood in almost all cases, 

 never less than eight ounces, generally ten or more, 

 and, in cases of inflammation, as much as forty ounces. 

 The pernicious consequences of this practice did not 

 escape him, but he thought he could not subdue 

 disease by any other means. Stahl (1707) attempted 

 to unite the system of Hippocrates with that of Hel- 

 mont, and established correct and moderate principles 

 of phlebotomy. He taught that abundance of blood 

 was no disease, but might become so by a dispropor- 

 tion created between the solid and fluid parts of the 

 system, in which case the proper balance ought to be 

 restored. But he found bleeding indispensable, in 

 cases of too great excitement succeeded by a conges- 

 tion or effusion of blood. To prevent this, he pres- 

 cribed occasional bleeding. His method was soon 

 misunderstood and misapplied. The extraction of 

 blood for the preservation of health was every where 

 thought necessary. Bordeu endeavoured to stop 

 this abuse in France. Cullen (1777), who regarded 

 all diseases as proceeding from an unnatural state 

 of the nerves ; all irregularities of the fluids as the 

 consequences of weakness and spasm, recommended 

 bleeding as the best means to diminish the activity 

 of the whole body, and especially of the system of 

 the blood-vessels. He recommended, however a due 

 regard to circumstances, and mainly adopted Stahl's 

 doctrine of the superabundance of blood. Stoll of 

 Vienna (1780), an admirer of Sydenham, resorted 

 frequently to bleeding. Several of the later physi- 

 cians sought, however, to limit its too frequent ap- 

 plication. Wollstein (1791) recommended it only in 

 a few cases. Gall, also, improved the system still 

 more. Brown adhered to the same maxim, and 

 limited the practice of bleeding too much. In mo- 

 dern times, the abuses of phlebotomy have again 

 considerably increased, because the antiphlogistic 

 method of healing has risen into great repute. Bleed- 

 ing is one of the most effectual, but also one of the 

 most dangerous means of checking disease. 



PHLEGETHON (<p*.vyi6uv, burning), in the Grecian 

 mythology ; a river of fire in the infernal regions. 

 See Cocytus. 



PHLEGREAN FIELDS ; a place in Macedonia, 

 where the battle of the giants was said to have taken 

 place. The name was also applied to a place near 

 Naples (Forum Vulcani, Solfatara), where the ground 

 is impregnated with sulphur. See Giants, and Naples. 



PHLOGISTICATED AIR; nitrogen, or azote. 

 See Nitrogen. 



PHLOGISTON ; the supposed general inflam- 

 mable principle of Stahl. See Oxygen, and Combus- 

 tion; also Chemistry. 



PHOCAS'S COLUMN. See Column. 



PHOCION ; an Athenian general, and one of the 

 most virtuous characters of antiquity. Though of 



