[175] DIEHL, op. cit. [note 173]; JOHN C. HARTNETT, "The Care and Use of Medicinal Leeches in 19th Century Pharmacy and Therapeutics," _Pharmacy in History_, volume 14 (1972), page 133. [176] Broussais offered the following explanation for the effectiveness of leeching. Congestion of blood vessels in a healthy person gives rise to a sympathetic irritation in the mucous surfaces of bodily orifices. Equilibrium may be restored naturally by hemorrhage through the nose. Without this release of blood, congestion builds up into an inflammation. Local bloodletting relieves the congestion when applied on a portion of the skin corresponding to the inflamed organ. Broussais's favorite remedy was the application of leeches to the stomach and head. For this purpose he ordered hundreds of leeches daily. See F.J.V. BROUSSAIS, _A Treatise on Physiology Applied & Pathology_, translated by John Bell and R. La Roche, 2nd American edition (Philadelphia, 1828), page 414, and Castiglioni, op. cit. [note 40], page 609. [177] THORNDIKE, op. cit. [note 3], page 477. See also KARL-OTTO KUPPE, _Die Blutegel in der Aerztlichen Praxis_ (reprint, Stuttgart: Hippocrates-Verlag, 1955), pages 9-11. [178] HARTNETT, op. cit. [note 175], page 132. [179] JONATHAN OSBORNE, "Observations on Local Bloodletting, and on Some New Methods of Practicing It," _Dublin Journal of Medical and Chemical Science_, volume 3 (1833), pages 334-342. [180] See, for example, MAISON CHARRIERE, ROBERT ET COLLIN, op. cit. [note 149], page 42 and plate 9. [181] JOHN BERRY HAYCRAFT, "On the Coagulation of the Blood," 9 pages, extracted from _Proceedings of the Royal Society of London_, volume 231 (1884). [182] THORNDIKE, op. cit. [note 3], page 477. MERAT, op. cit. [note 172], page 528, cited an extreme case in which a woman suffering from peritonitis was given a total of 250 leeches in 24 hours. She died soon after. [183] STILLE AND MAISCH, op. cit. [note 173], page 715; THACHER, op. cit. [note 173], page 231. [184] HARTNETT, op. cit. [note 175], page 132; J. K. CRELLIN, op. cit. [note 33], pages 127-134. [185] ANDREW H. SMITH, "An Artificial Leech," _Medical Record_, volume 4 (1869-70), page 406. [186] In addition to the references below, articles on artificial leeches include DR. MONTAIN, "Considerations therapeutiques sur l'emploi du pneumo-derme, nouvel instrument destine a remplacer les sangsues et les ventouses," _Bulletin General de therapeutique_, volume 11 (1836), pages 311-315; J. J. TWEED, "A Description of the Apparatus for Employing the Mechanical Leeches," _Medical Times_, volume 21 (1850), pages 36-37; and SAMUEL THEOBALD, "An Improved Method of Applying the Artificial Leech," _American Journal of Medical Science_, new series, volume 70 (1875), pages 139-142.