Medical Inquiries and Observations, Vol. 3: The Second Edition, Revised and Enlarged by the AuthorRush, Benjamin
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Medical Inquiries and Observations, Vol. 3: The Second Edition, Revised and Enlarged by the Author
Rush, Benjamin
Medicine; Yellow fever -- Pennsylvania -- Philadelphia
It was remarked that fainting was much less common after bleeding in this
fever than in common inflammatory fevers. This circumstance was observed
by Dr. Griffitts, as well as myself. It has since been confirmed to me by
three of the principal bleeders in the city, who performed the operation
upwards of four thousand times. It occurred chiefly in those cases where
it was used for the first time on the third or fourth day of the disease.
A swelling of the legs, moreover, so common after plentiful bleeding in
pneumony and rheumatism, rarely succeeded the use of this remedy in the
yellow fever.
2. Many of the indispositions, and much of the subsequent weakness of
persons who had been cured by copious blood-letting, have been ascribed
to it. This is so far from being true that the reverse of it has occurred
in many cases. Mr. Mierken worked in his sugar-house, in good health,
nine days after his last bleeding; and Mr. Gribble and Mr. George seemed,
by their appearance, to have derived fresh vigour from their evacuations.
I could mention the names of many people who assured me their
constitutions had been improved by the use of those remedies; and I know
several persons in whom they have carried off habitual complaints. Mr.
Richard Wells attributed his relief from a chronic rheumatism to the
copious bleeding and purging which were used to cure him of the yellow
fever; and Mr. William Young, the bookseller, was relieved of a chronic
pain in his side, by means of the same remedies.
3. It was said, that blood-letting was prescribed indiscriminately in all
cases, without any regard to age, constitution, or the force of the
disease. This is not true, as far as it relates to my practice. In my
prescriptions for patients whom I was unable to visit, I advised them,
when they were incapable of judging of the state of the pulse, to be
guided in the use of bleeding, by the degrees of pain they felt,
particularly in the head; and I seldom advised it for the _first_ time,
after the second or third day of the disease.
In pneumonies which affect whole neighbourhoods in the spring of the
year, bleeding is the universal remedy. Why should it not be equally so,
in a fever which is of a more uniform inflammatory nature, and which
tends more rapidly to effusions, in parts of the body much more vital
than the lungs?
I have before remarked, that the debility which occurs in the beginning
of the yellow fever, arises from a depressed state of the system. The
debility in the plague is of the same nature. It has long been known that
debility from the sudden abstraction of stimuli is to be removed by the
_gradual_ application of stimuli, but it has been less observed, that the
excess of stimulus in the system is best removed in a _gradual_ manner,
and that too in proportion to the degrees of depression, which exist in
the system.
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