A Plethora or redundance of Blood, is certainly the most general cause of the Night-mare, and requires immediate evacuations, which principally consist in bleeding or purging. But the former is most effectual. However, Bleeding should not be often repeated, unless absolutely necessary, lest, it should become a custom, which might, at the same time, procure a short intermission, and increase the cause of the Disease; and also prove inconvenient and dangerous; for if, at any establish’d period, Bleeding should be omitted, then the person is expos’d to all the bad effects of a Plethora, enumerated by Boerhaave, viz. Inflammations, Suppurations, Gangrenes and Death[46]. It is well known, that nothing genenerates Blood faster, or contributes more to a Plethora, than bleeding often, which some are fond of, without assigning any reason for it, except its being a custom, which experience proves a very bad one. Van Sweiten says, “He saw a Woman, who, being subject to violent affections of the Mind, was bled above sixty times in one year. She by that means grew very fat, and increas’d her weight 150 pounds in a few months. By bleeding often new Blood was generated, and the necessity of bleeding became more frequent, ’till she was so far relax’d, that she fell into a Dropsy[47].” He adds, “That bleeding, which some use by way of precaution, is a bad custom, since it weakens the Solids, and renders the Body more subject to a fresh accumulation of Fluids.” Experience has convinced me of the truth of this observation; for, while I practis’d bleeding every month or six weeks, I found the Night-mare return’d on me at these periods, rather aggravated than abated. My bad success made me alter my method; and, instead of drawing eight or ten ounces of blood at once, I drew twenty, and liv’d low, on thin, astringent diet, for a few days afterwards; in which time the dilated vessels contracted themselves, and resisted the sudden distension, which taking large quantities of nourishing diet, after plentiful evacuations, must always produce; as our medical Bard justly expresses it, “Too greedily th’ exhausted Veins absorb The recent Chyle[48].” By observing Boerhaave’s method of curing a Plethora, viz. using a thin, light diet after bleeding, and gradually prolonging the time between each evacuation, I have reduc’d my bleedings to one every autumn; and (thank Heaven) have in a great measure conquer’d that Monster of the night, which so often threaten’d me with immediate destruction. Experience also assures us, that large evacuations may be made by strong purges; such as Jalap, Scammon. &c. which greatly dissolve, and diminish the quantity of the Blood. Hence, we see the reason why Paulus Egeneta justly prescrib’d Scammony in this Disease[49]. But in this kind of evacuations, Boerhaave’s salutary rule should be also observ’d; viz. “Omissione sensim introducta.”