Besides, the ligature is competent to occasion the afflux in question without either pain, or heat, or _vis vacui_. Were pain in any way the cause, how should it happen that, with the arm bound above the elbow, the hand and fingers should swell below the bandage, and their veins become distended? The pressure of the bandage certainly prevents the blood from getting there by the veins. And then, wherefore is there neither swelling nor repletion of the veins, nor any sign or symptom of attraction or afflux, above the ligature? But this is the obvious cause of the preternatural attraction and swelling below the bandage, and in the hand and fingers, that the blood is entering abundantly, and with force, but cannot pass out again. Now, is not this the cause of all tumefaction, as indeed Avicenna has it, and of all oppressive redundancy in parts, that the access to them is open, but the egress from them is closed? Whence it comes that they are gorged and tumefied. And may not the same thing happen in local inflammations, where, so long as the swelling is on the increase, and has not reached its extreme term, a full pulse is felt in the part, especially when the disease is of the more acute kind, and the swelling usually takes place most rapidly. But these are matters for after discussion. Or does this, which occurred in my own case, happen from the same cause? Thrown from a carriage upon one occasion, I struck my forehead a blow upon the place where a twig of the artery advances from the temple, and immediately, within the time in which twenty beats could have been made, I felt a tumour the size of an egg developed, without either heat or any great pain: the near vicinity of the artery had caused the blood to be effused into the bruised part with unusual force and quickness. And now, too, we understand wherefore in phlebotomy we apply our fillet above the part that is punctured, not below it; did the flow come from above, not from below, the bandage in this case would not only be of no service, but would prove a positive hinderance; it would have to be applied below the orifice, in order to have the flow more free, did the blood descend by the veins from superior to inferior parts; but as it is elsewhere forced through the extreme arteries into the extreme veins, and the return in these last is opposed by the ligature, so do they fill and swell, and being thus filled and distended, they are made capable of projecting their charge with force, and to a distance, when any one of them is suddenly punctured; but the fillet being slackened, and the returning channels thus left open, the blood forthwith no longer escapes, save by drops; and, as all the world knows, if in performing phlebotomy the bandage be either slackened too much or the limb be bound too tightly, the blood escapes without force, because in the one case the returning channels are not adequately obstructed; the other the channels of influx, the arteries, are impeded. CHAPTER XII