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Bloodletting Procedure During the Golden Age of Piracy, Page 4

Bloodletting - The Importance of the Arch

'The Arch' by Wolf Holmhard von Hohburg, 1695 "The Chirurgeon is to make the Blood flow out in manner of an Arch, and that only to satisfy the Patient and the Spectators, for the bleeding is full as well perform'd, when the Blood runs down along the Arm….

But yet the Chirurgeon must accommodate himself to the vulgar Notion, and raise or lower the Skin, in order to fix the Orifices of the Skin and Vein directly  opposite to each other, and make the Blood spring out like the Streams of a Fountain; he is to bend the Patient's Arm a little, that the Skin not pressing too much on the Orifice, the Blood may run out the better; he is also to hold up the Arm, which otherwise would be fatigued with sustaining its own Weight, if not assisted by the Chirurgeon's Hand:

He is also to prevent the Patient's looking on his Blood, if he be one of those faint-hearted Wretches who are affrighted at the sight of a Drop of that Liquor. He is to give him some round Body in his Hand, which he obliges him to turn about, without grasping it too hard; and this is to be done by a regular Motion, which may expedite the Course of the Blood towards the Orifice of the Vein." (Dionis, p. 372)

Bloodletting - Fainting

"When the Bleeding is performed, and the Arm bound up, the Chirurgeon is not yet discharged of his Operation: If the Patient happen to faint, he is immediately to restore him, by taking the Pillows from under his Head, and laying him flat, sprinkling Water on his Face, and giving him Vinegar, Hungary-water P, or something else very strong, striking him with his Hands, and opening the Curtains of the Bed and Windows to give him Air, and procure him a Liberty of breathing freely. The Patient being revived, we may give him half a Glass of Wine and Water equally mix'd; but if a Fever supervene, we are to give the Patient a Ptisan, and placing the Arm in a proper Posture, leave him to his Repose.

Bloodletting - Examining the Blood

All requisite to be done to the Patient being perform'd, the Chirurgeon approaches the Table to see the Blood. Some Chirurgeons blow off the Scum, others take it off with a Card or Feather; alledging that thereby discovering the Superficies of the Blood, they are better enabled to discover the good or ill Qualities of that Liquor. But for my part, I never take the Pains to take it off, because I am of the Opinion, that this small stirring may disorder the superficial Fibres of the Blood, and hinder our discovering the Qualities, and that the rather, by reason that the Scum never covering the whole Porrenger, we may, by what remains to be free from it, determine the Nature of the Blood. The Physician almost always, when they visit their Patients, ask whether the Bleeding was well performed, and whether he bled freely? And when the Scum is left on it, 'tis a convincing Proof that it flowed out in an arched Manner, and very swiftly: But these are Questions which might be spared, since no more is necessary than to cast our Eyes on the Blood, in order to be informed of the manner of the Patient's bleeding.

Dionis' Tools for Bleeding (p. 356) We are not to fail to mark the Porrengers, by fixing a little Bit of Paper on the first, two on the second, and three on the third: For tho's an Omission in this Case be but light, 'twill infallibly be charged on the Chirurgeon as criminal, when the Qualities of the Blood come to be determined, though any Confusion betwixt the first and second Porrenger is of very little Importance. There are some Porrengers with are mark'd one, two , three, but they must be brought in Order, and it frequently happens that a Servant mistakes, and sometimes the Figure engraven on the Edge of the Porrenger is cover'd with Blood; so that the safest way is that of marking with Paper.

One of the Domestics presents to the Chirurgeon to wash his Lancet in the Bason R, pouring into it the Water in the Ewer S, and with Napkin T the Chirurgeon wipes his Hands, and the Lancet. He is next to entertain the Patient with Remonstrances of the Necessity there was of this Bleeding; if the Blood sprung out vigorously and plentifully, he is to demonstrate to him how necessary 'twas to draw it, by insinuating that the too great Plentitude of the Liquor, under which he labour'd, might possibly throw him into some dangerous and mortal Distemper. If he faints under, and can scarce bear the Operation, the Chirurgeon is to tell him that those Bleedings which reach the Heart are the best. If the Blood is foul and corrupted he tells him, that the Part of it which he has lost, helps the Circulation of, and purifies the Remainder: If 'tis of beautiful Vermillion Colour, he felicitates the Patient, telling him that 'tis an infallible Proof that the Part yet remaining in the Veins is of the same sort, and that such Blood promises a long continued state of Health. To conclude, let the Bleeding prove how it will, he is yet thence to deduce favourable Consequences to the Patient." (Dionis, p. 374-5)

Bloodletting - Treating an Accidentally Opened Artery

"Whilst the Blood was issuing out [of a severed artery], he [Dionis' master while he was training] had put a piece of Money into a Bolster, and call'd for a second Band. In proportion to the Patient's Fainting, the Arch [or flowing blood], which was streaming out of the Blood made, began to decrease and abate; having taken off the Ligature, and the Patient swooning away, the Blood stopp'd. He took that moment to apply his Bolster, and bind the Arm tighter than ordinary, using two Bands; and folding the Arm on the Patient's Stomach, he fasten'd it to his Wastcoat for fear he should extend it; he then threw Water on his Face, made him smell to Vinegar, and recovered him from his Swoon. He took care to have the Blood thrown away before he went away, and earnestly recommended to the Patient the keeping his Arm very still, telling him, that if he unbound his Arm his Blood was so furious that he would be dead before 'twas possible to help him. In the Evening, pretending to be sent for, to a Patient in the Neighbourhood, he visited him, and found he had been very obedient, he was tired with the Posture in which he left him: The next Day he gave him another Visit, and though the Patient complain'd that his Arm was very hard bound, yet he persuaded him not to touch it till the third Day; when, after unbinding it, he laid on a fresh Bolster, and apply'd another Ligature for the greater Security; and the Orifice cicatris'd as it would have done, if it had been the Vein which had been open'd, and the Patient thought he had never been better bled in his Life." (Dionis, p. 381)

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