58 PRACTICE OF PHYSIC. 



to bear after-bleedings better than the first, this allows the se- 

 cond and subsequent bleedings to be larger, and to such a quan- 

 tity as the symptoms of the disease may seem to demand. 



CCCLXIII. It is according to the state of the symptoms 

 that bleedings are to be repeated ; and they will be more effec- 

 tual when practised in the course of the first three days than af- 

 terwards ; but they are not to be omitted although four days of 

 the disease may have already elapsed. If the physician shall 

 not have been called in sooner, or if the bleedings practised dur- 

 ing the first days shall not have been large enough, or even al- 

 though these bleedings shall have procured some remission, yet 

 they should be repeated at any period of the disease, especially 

 within the first fortnight, and even afterwards, if a tendency to 

 suppuration be not evident ; or if, after a seeming solution, the 

 disease shall have again returned. 



CCCLXIV. With respect to the quantity of blood which 

 ought, or which with safety may be taken away, no general rules 

 can be delivered, as it must be very different, according to the 

 state of the disease and the constitution of the patient. In an 

 adult male of tolerable strength, a pound of blood, avoirdupois, 

 is a full bleeding. Any quantity above twenty ounces is a 

 large, and any quantity below twelve, a small bleeding. A 

 quantity of from four to five pounds, in the course of two or 

 three days, is generally as much as such patients will safely bear ; 

 but if the intervals between the bleeding and the whole of the time 

 during which the bleedings have been employed have been long, 

 the quantity taken, upon the whole, may be greater. 



CCCLXV. When a large quantity of blood has been already 

 taken from the arm, and when it is doubtful if more can with 

 safety be drawn in that manner, some blood may still be taken 

 by cupping and scarifying. Such a measure will be more par- 

 ticularly proper, when the continuance or recurrence of pain, 

 rather than the difficulty of breathing, becomes the urgent symp- 

 tom ; and then the cupping and scarifying should be made as 

 near to the pained part as can conveniently be done. 



CCCLXVI. An expectoration takes place sometimes very 

 early in this disease ; but if, notwithstanding that, the urgent 

 symptoms should still continue, the expectoration must not su- 

 persede the bleedings mentioned ; and during the first days of 



