North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826Various
History
North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826
Various
Medicine -- Periodicals
The cooling regimen as it is called, was substituted for the
alexipharmic, in so far as regards light clothing and cool air. Can
emetics and purgatives be viewed as a part of this regimen, and exert as
such a salutary influence over the second period of the disease, or that
when the eruptive effort takes place? Admitting they are but local
stimulants, can they as such be with advantage applied to a surface, as
that of the stomach and intestines, already highly irritable, and which,
as the disease advances, becomes inflamed? If our object be in this
first period to diminish the violence of the second or eruptive one, we
doubt whether our expectations will be at all met by any kind of
stimulant to parts, which so promptly transfer their irritation to the
cetaceous surface. Whatever may be thought of these suggestions; whether
they are to be regarded as well-founded, or merely speculative, must be
a subject of future investigation; since we are as yet compelled to deny
that experience can be adduced in favour of the practice of vomiting and
purging to the first period of variolous disease.
On the same line with the remedies just mentioned, have been placed
bleeding, general and local, though as we apprehend, very erroneously.
There is not in bleeding as in purging, conflicting and alternating
effects of debility from evacuation, and irritation, primary and
sympathetic, from local stimulation; but a direct diminution of morbid
action, more tranquil movements of the heart and capillary system, that
is of the circulatory apparatus, and of the membranes, mucous, serous
and cutaneous, &c. Bleeding, unlike most other remedial agents, produces
a direct calmness and ease in the animal economy: it does not like them
substitute one disturbance for another, or make the great appear the
lesser evil. The experienced physician well knows the value of this
remedy, in the first period or invasion of the phlegmasiae, and of some
fevers called general. He is fully aware, that if he cannot produce by
it a decided impression on the malady in the commencement, he is but too
often afterwards a prey to doubts and anxieties, wishing to relieve, but
unknowing what to attempt. Conceding, however, the power of venesection,
in the forming stage of the disease, now under review, so that we by
this remedy may control the series of morbid actions in the second
period, and diminish the extent of the eruption; it may yet be seriously
asked, whether we can with safety and propriety prevent or destroy the
succession of changes to which the skin is subjected, from the first
papulae on to desiccation. On this point, we believe, has turned the
practice of the profession at all times, whether in the ages of
humoralism, or in the reign of solidism. In addition to the reasons
already assigned, which would lead us to doubt the necessity of the
eruption being left uncontrolled, or even suffered to run its course, we
may appeal to the practice of inoculation, which as effectually
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