Bleeding has been used, not only as a cure for inflammation, but also
as a preventative; but this must be considered as proper, only in
particular instances. When, for instance, an wound has been inflicted,
or an operation necessarily performed, on a robust person, bleeding
immediately, or very soon after it, may be useful; because it will
tend to lessen the chance of the natural action being carried so high
as to become changed. These people cannot have their action much
increased without disease; and, therefore, it is necessary to lessen
it, and bring it down to a more proper medium. But there are other
cases, where the action is naturally rather too low, and the patient
weakly. In these cases, bleeding can do no good, but much harm; because
it increases the previous weakness, and makes the inflammation, if it
does occur, more dangerous, on account of the little power which there
is to support the action. These people even bear bleeding worse than
others, when inflammation has actually taken place. It ought never to
be practised, in order to reduce the natural action, before disease has
taken place; and, after the inflammatory action is induced, it ought to
be used cautiously, and only to such an extent, as may be necessary for
removing the tendency to immediate bad consequences. It ought, however,
to be used very early in the disease; because, in weak people, the
action does more harm in a given time, than in the strong; but it
ought likewise to be sooner abandoned, otherwise we either hasten
mortification, or prevent the act of restoration from taking place.
Bleeding is rarely necessary in inflammation of the cellular substance
alone, unless the action be extensive; in which case, the system is so
affected, as to require our interference. When the cutis is inflamed,
producing erysipelas, the system suffers considerably; but, as this
frequently ends in mortification, bleeding has been neglected by many;
but it is evident, that, if the disease be simple, and not dependent
upon any specific agens dissimilis, or epidemic contagion, venesection
is the proper cure, provided it be early employed, as we thus diminish
the action more certainly than by any other means. If, however, the
disease have been neglected, and the action be nearer a termination,
then we must either do nothing in the way of general treatment, or
must give opposite remedies from bleeding, according to circumstances.
When muscles are inflamed, bleeding is often necessary to a very great
extent, as we observe in rheumatism; and, in the beginning, we must
take a greater quantity at a time, in order to procure an abatement,
than in many other cases. When the viscera are inflamed, bleeding is
uniformly necessary, and generally requires to be frequently repeated.
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