Phlebotomy is promiscuously used before and after physic, commonly before, and upon occasion is often reiterated, if there be any need at least of it. For Galen, and many others, make a doubt of bleeding at all in this kind of head-melancholy. If the malady, saith Piso, cap. 23. and Altomarus, cap. 7. Fuchsius, cap. 33. "shall proceed primarily from the misaffected brain, the patient in such case shall not need at all to bleed, except the blood otherwise abound, the veins be full, inflamed blood, and the party ready to run mad." In immaterial melancholy, which especially comes from a cold distemperature of spirits, Hercules de Saxonia, cap. 17. will not admit of phlebotomy; Laurentius, cap. 9, approves it out of the authority of the Arabians; but as Mesue, Rhasis, Alexander appoint, "especially in the head," to open the veins of the forehead, nose and ears is good. They commonly set cupping-glasses on the party's shoulders, having first scarified the place, they apply horse-leeches on the head, and in all melancholy diseases, whether essential or accidental, they cause the haemorrhoids to be opened, having the eleventh aphorism of the sixth book of Hippocrates for their ground and warrant, which saith, "That in melancholy and mad men, the varicose tumour or haemorrhoids appearing doth heal the same." Valescus prescribes bloodletting in all three kinds, whom Sallust. Salvian follows. "If the blood abound, which is discerned by the fullness of the veins, his precedent diet, the party's laughter, age, &c., begin with the median or middle vein of the arm; if the blood be ruddy and clear, stop it, but if black in the spring time, or a good season, or thick, let it run, according to the party's strength: and some eight or twelve days after, open the head vein, and the veins in the forehead, or provoke it out of the nostrils, or cupping-glasses," &c. Trallianus allows of this, "If there have been any suppression or stopping of blood at nose, or haemorrhoids, or women's months, then to open a vein in the head or about the ankles." Yet he doth hardly approve of this course, if melancholy be situated in the head alone, or in any other dotage, "except it primarily proceed from blood, or that the malady be increased by it; for bloodletting refrigerates and dries up, except the body be very full of blood, and a kind of ruddiness in the face." Therefore I conclude with Areteus, "before you let blood, deliberate of it," and well consider all circumstances belonging to it.