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
[63] Dr. Hunter used to teach, in his lectures, that the final cause of
the want of appetite, during the first months of pregnancy, was to
obviate plethora, which disposed to abortion. This plethora should
have been called an inflammatory disease, in which abstinence is
useful.
5. Sizy blood. This occurs almost uniformly in pregnancy.
6. A membrane. Dr. Scarpa has proved the membrana decidua, which is
formed during pregnancy, to be in every respect the same in its
properties with the membrane which is formed upon other inflamed
surfaces, particularly the trachea, the pleura, and the inside of the
bowels. Thus we see all the common and most characteristic symptoms and
effects of inflammation, in other parts of the body, are exhibited by the
uterus in pregnancy.
These remarks being premised, I proceed to remark, that blood-letting is
indicated, in certain states of pregnancy, by all the arguments that have
been used in favour of it in any other inflammatory disease. The degree
of inflammation in the womb, manifested by the pulse, pain, and other
signs of disease, should determine the quantity of blood to be drawn. Low
diet, gentle purges, and constant exercise, are excellent substitutes for
it, but where they are not submitted to, blood-letting should be employed
as a substitute for them. In that disposition to abortion, which occurs
about the third month of pregnancy, small and frequent bleedings should
be preferred to all other modes of depletion. I can assert, from
experience, that they prevent abortion, nearly with as much certainty as
they prevent a hæmorrhage from the lungs: for what is an abortion but a
hæmoptysis (if I may be allowed the expression) from the uterus? During
the last month of pregnancy, the loss of from twelve to twenty ounces of
blood has the most beneficial effects, in lessening the pains and danger
of child-birth, and in preventing its subsequent diseases.
The doctrine I have aimed to establish leads, not only to the use of
blood-letting in the disease of pregnancy, when required, but to a more
copious use of it, when combined with other diseases, than in those
diseases in a simple state. This remark applies, in a particular manner,
to those spasms and convulsions which sometimes occur in the latter
months of pregnancy. Without bleeding, they are always fatal. By copious
bleeding, amounting in some instances to 80 and 100 ounces, they are
generally cured.
Let it not be supposed that blood-letting is alike proper and useful in
every state of pregnancy. There are what are called slow or chronic
inflammations, in which the diseased action of the blood-vessels not only
forbids it, but calls for cordial and stimulating remedies. The same
feeble state of inflammation sometimes takes place in the pregnant
uterus. In these cases cordials and stimulants should be preferred to the
lancet.
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