Gilbert continues:  “I will tell you also what I myself saw in a woman suffering and screaming with pain in her right wrist (assuere?), which was greatly swollen, hot, red and much distended.  She was fat, full-blooded, and before the attack had lived freely on milk and flesh.  Accordingly she was robust, and I bled her from the basilic vein of the left hand and the saphena of the right foot, both within an hour.  Each hour I withdrew a half-pound of blood, then I fed her and for three hours I drew half a pound of blood from the saphena.  In the last hour the pain and throbbing (percussio) ceased entirely, and the woman begged me to bleed her again from the hand, for she had experienced great relief.  I wished, however, to divert the material to the lower extremities for two reasons, one of which I ought not to mention in this place, while the other is useful, and indeed necessary in such cases.  You should know that this woman was suffering pain in her left hand also, though this pain was of a less severe character than in the right.  For this reason I desired to divert the peccant matter downward, a point which the physician should consider and observe.  Once, while treating a man suffering from sanguineous gout, the pain of which involved the joints between the assuerus and the racheta (?) of the right hand, I asked him whether any pain was felt in the other hand or in the feet.  He replied that similar pain was felt in the left hand or its joints, and that hitherto it had been more severe, but that no pain had ever been experienced in the feet.  Hence I was unwilling to bleed him at all from the left hand, but I bled him from the right foot.  A physician who had treated him before, and had bled him from the right hand for acute swelling of the joints of the left, quieted, indeed, the pain in the left hand, but diverted the disease to the right, where a swelling developed larger than in the left.  And when I asked him about this, he understood that I knew more about medicine than the other doctor did.  And this is one of the reasons why one ought to divert the material to another part, especially when the pain is so located that it may be increased at the beginning.  For 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