A heavy man received a wound in the back of his head from an iron spike; he was kept very low, complaining occasionally of want of food. Repeated hæmorrhage took place at intervals of a day or two, which no local applications could suppress, and he ultimately died from loss of blood. The wound was found to extend through the bone into the lateral sinus, which contained only some fluid blood. No inflammatory action had taken place within the skull, nor had any attempt apparently been made to close the wounded vessel. Any vitiated secretion in contact with the lacerated edges of the vessel would, in such a case, have free access to the circulation. The constitutional treatment of cases, liable to be succeeded by purulent deposits, is most important; for during the healing of the primary wound, the system may be influenced by remedies, which may be subsequently quite useless. It is evident, observes M. Cruveilhier,[39] that the treatment of phlebitis ought to be concentrated on the first period of the disease, viz., that of the coagulation of the blood; for as soon as pus has become mixed with the circulating blood, medicine is generally of no avail. When there are indications of the extension of inflammation along a vein, the mode of treatment usually adopted in this country has been the administration of calomel and opium; and, in France, general bleeding, but especially the application of large numbers of leeches. "We may subdue inflammation of veins, whatever their situation, by general blood-letting, and especially by local bleeding, repeated sufficiently often and in sufficient quantities!"[40] It is true that patients recover after such treatment; but the published records of cases not unfrequently terminate with such a description as the following: "The patient was repeatedly bled, and with apparent relief every time, the blood being extremely sizy. _Two days, however, previous to death, the vital principle was so exhausted as to need the use of cordials!!_" [39] Op. cit. p. 662. [40] Op. cit. p. 662. If the explanation of the mode of adhesion in veins already given be correct, neither the propriety of bleeding, nor of the administration of mercury, as a rule, derives much support from a consideration of the pathology of the disease. Careful comparative experience is still wanting, before we can form a satisfactory judgment of the value of these remedies. The theoretical views upon which they have been adopted, are confirmed neither by the statistical records of cases, nor by the principles of sound physiology. The numerical evidence which we have in some instances, even tends to indicate an opposite plan of treatment.