Medical Inquiries and Observations, Vol. 4: The Second Edition, Revised and Enlarged by the AuthorRush, Benjamin
History
Medical Inquiries and Observations, Vol. 4: The Second Edition, Revised and Enlarged by the Author
Rush, Benjamin
Medicine; Yellow fever -- Pennsylvania -- Philadelphia
In thus deciding in favour of bleeding in warm weather, I do not mean to
defend its use to the same extent, as to diseases, or to quantity, in the
native and long settled inhabitants of hot climates, as in persons who
have recently migrated to them, or who live in climates alternately hot
and cold.
2. Being born, and having lived in a warm climate. This is so far from
being an objection to blood-letting in an inflammatory disease, that it
renders it more necessary. I think I have lost several West-India
patients from the influence of this error.
3. Great apparent weakness. This, in acute and violent fevers, is always
from a depressed state of the system. It resembles, in so many
particulars, that weakness which is the effect of the abstraction of
stimulus, that it is no wonder they have been confounded by physicians.
This sameness of symptoms from opposite states of the system is taken
notice of by Hippocrates. He describes convulsions, and particularly a
hiccup, as occurring equally from repletion and inanition, which answer
to the terms of depression, and debility from action and abstraction. The
natural remedy for the former is depletion, and no mode of depleting is
so effectual or safe as blood-letting. But the great objection to this
remedy is, when a fever of great morbid excitement affects persons of
delicate constitutions, and such as have long been subject to debility of
the chronic kind. In this state of the system there is the same morbid
and preternatural action in the blood-vessels, that there is in persons
of robust habits, and the same remedy is necessary to subdue it in both
cases. It is sometimes indicated in a larger quantity in weakly than in
robust people, by the plethora which is more easily induced in their
relaxed and yielding blood-vessels, and by the greater facility with
which ruptures and effusions take place in their viscera. Thus it is more
necessary to throw overboard a large part of the cargo of an old and
leaky vessel in a storm, than of a new and strong one. I know that
vomits, purges, sweats, and other evacuating remedies, are preferred to
bleeding in weakly constitutions, but I hope to show hereafter, that
bleeding is not only more effectual, but more safe in such habits, than
any other depleting remedy.
4. Infancy and childhood. This is so far from being an objection to
bleeding, that the excitable state of the blood-vessels in those periods
of life, renders it peculiarly necessary in their inflammatory diseases.
Dr. Sydenham bled children in the hooping cough, and in dentition. I have
followed his practice, and bled as freely in the violent states of fever
in infancy as in middle life. I bled my eldest daughter when she was but
six weeks old, for convulsions brought on by an excessive dose of
laudanum given to her by her nurse; and I bled one of my sons twice,
before he was two months old, for an acute fever which fell upon his
lungs and bowels. In both cases, life appeared to be saved by this
remedy.
Public-domain text, read in full here on John Shaqi.
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