under such conditions we ought to refrain from
bleeding, frictions and other treatment which may attract the
_materies morbi_ to the part. Indeed we ought to require derivation of
the materies to another part whenever the affected locality contains
one of the nobler organs, towards which the material is directing, or
may direct its course. For instance: A person is suffering pain in
the joints of the right hand, but has also an acute swelling in the
bladder, the kidneys or the womb. Now, I say that in such a case we
ought not to bleed from the hand, because if we do we shall injure the
organ affected by the swelling. Perhaps, however, we may bleed from
the right foot, provided we understand that there is on the right side
a sanguineous tumor, the danger of which is greater than that of the
swelling on the right hand. Again, suppose in the liver or in the
right kidney an acute tumor, and in the joints of the right hand there
is present a moderate pain. I say that we ought first to medicate the
more dangerous lesion, and, possibly, two results may be obtained by
the attraction of the peccant material. Or suppose a woman has gout in
her hand, and with this a suppression of the menstrual flow. I say she
ought to be bled from the foot and not from the hand for two objects,
to solicit the material from the diseased hand, and to provoke a
return of the menstrual discharge.

"But to return to our original patient. I may say that after the third
venesection, with an interval of two hours, I withdrew a half-pound
of blood from the saphena vein, and that night she slept, although
she had not slept for many nights. And I did nothing more, except to
prescribe a light and cool diet. The third day after the bleeding she
was entirely free from any trouble in her hand. Hence I say that we
ought in such cases to begin our treatment by venesection."

After this sanguinary introduction, Gilbert soothes the diseased part
with cooling and astringent ointments, unless these occasion pain,
in which event he omits them entirely and trusts the case to nature,
"_quoniam natura per se curabit_."

The vigorous plan of treatment thus outlined Gilbert seems to regard
as original and peculiar to himself, for the next chapter bears the
title, "The treatment of gout according to the authorities (_secundum
magistros_)." Here he says he quotes the opinions of the modern
teachers and writers, who lay down definite rules for the guidance of
the physicia