Medical Inquiries and Observations, Vol. 3: The Second Edition, Revised and Enlarged by the AuthorRush, Benjamin
Science
Medical Inquiries and Observations, Vol. 3: The Second Edition, Revised and Enlarged by the Author
Rush, Benjamin
Medicine; Yellow fever -- Pennsylvania -- Philadelphia
9. In determining the quantity of blood to be drawn, I was governed by
the state of the pulse, and by the temperature of the weather. In the
beginning of September, I found one or two moderate bleedings sufficient
to subdue the fever; but in proportion as the system rose by the
diminution of the stimulus of heat, and the fever put on more _visible_
signs of inflammatory diathesis, more frequent bleedings became
necessary. I bled many patients twice, and a few three times a day. I
preferred frequent and small, to large bleedings, in the beginning of
September; but towards the height and close of the epidemic, I saw no
inconvenience from the loss of a pint, and even twenty ounces of blood at
a time. I drew from many persons seventy and eighty ounces in five days;
and from a few, a much larger quantity. Mr. Gribble, cedar-cooper, in
Front-street, lost by ten bleedings a hundred ounces of blood; Mr.
George, a carter in Ninth-street, lost about the same quantity by five
bleedings; and Mr. Peter Mierken, one hundred and fourteen ounces in five
days. In the last of the above persons the quantity taken was determined
by weight. Mr. Toy, blacksmith near Dock-street, was eight times bled in
the course of seven days. The quantity taken from him was about a hundred
ounces. The blood in all these cases was dense, and in the last, very
sizy. They were all attended in the month of October, and chiefly by my
pupil, Mr. Fisher; and they were all, years afterwards, living and
healthy instances of the efficacy of copious blood-letting, and of the
intrepidity and judgment of their young physician. Children, and even old
people, bore the loss of much more blood in this fever than in common
inflammatory fevers. I took above thirty ounces, in five bleedings, from
a daughter of Mr. Robert Bridges, who was then in the 9th year of her
age. Even great debility, whether natural or brought on by previous
diseases, did not, in those few cases in which it yielded to the fever,
deprive it of the uniformity of its inflammatory character. The following
letter from Dr. Griffitts, written soon after his recovery from a third
attack of the fever, and just before he went into the country for the
re-establishment of his health, will furnish a striking illustration of
the truth of the above observation.
"I cannot leave town without a parting adieu to my kind friend, and
sincere prayers for his preservation.
"I am sorry to find that the use of the lancet is still so much dreaded
by too many of our physicians; and, while lamenting the death of a
valuable friend this morning, I was told that he was bled but _once_
during his disease. Now if my poor frame, reduced by previous sickness,
great anxiety, and fatigue, and a very low diet, could bear_ seven_
bleedings in five days, besides purging, and no diet but toast and water,
what shall we say of physicians who bleed but once?
"_October 19th, 1793._"
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