Medical Inquiries and Observations, Vol. 4: The Second Edition, Revised and Enlarged by the AuthorRush, Benjamin
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Medical Inquiries and Observations, Vol. 4: The Second Edition, Revised and Enlarged by the Author
Rush, Benjamin
Medicine; Yellow fever -- Pennsylvania -- Philadelphia
Again. An ignorance of the rapid manner in which blood is regenerated,
when lost or drawn, has helped to keep up prejudices against
blood-letting. A person (Dr. Haller says) lost five pounds of blood daily
from the hæmorrhoidal vessels for 62 days, and another 75 pounds of blood
in 10 days. The loss each day was supplied by fresh quantities of
aliment.
These facts, I hope, will be sufficient to establish the safety and
advantages of plentiful blood-letting, in cases of violent fever; also to
show the fallacy and danger of that practice which attempts the cure of
such cases of fever, by what is called _moderate_ bleeding. There are, it
has been said, no half truths in government. It is equally true, that
there are no half truths in medicine. This half-way practice of moderate
bleeding, has kept up the mortality of pestilential fevers, in all ages,
and in all countries. I have combated this practice elsewhere[59], and
have asserted, upon the authority of Dr. Sydenham, that it is much better
not to bleed at all, than to draw blood disproportioned in quantity to
the violence of the fever. If the state of the pulse be our guide, the
continuance of its inflammatory action, after the loss of even 100 ounces
of blood, indicates the necessity of more bleeding, as much as it did the
first time a vein was opened. In the use of this remedy it may be truly
said, as in many of the enterprizes of life, that nothing is done, while
any thing remains to be done. Bleeding should be repeated while the
symptoms which first indicated it continue, should it be until
four-fifths of the blood contained in the body are drawn away. In this
manner we act in the use of other remedies. Who ever leaves off giving
purges in a colic, attended with costiveness, before the bowels are
opened? or who lays aside mercury as a useless medicine, because a few
doses of it do not cure the venereal disease?
[59] Account of the Yellow Fever in 1793.
I shall only add under this head, that I have always observed the cure of
a malignant fever to be most complete, and the convalescence to be most
rapid, when the bleeding has been continued until a _paleness_ is induced
in the face, and until the patient is able to sit up without being
fainty. After these circumstances occur, a moderate degree of force in
the pulse will gradually wear itself away, without doing any harm.
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