Text book of veterinary medicine, Volume 1 (of 5)Law, James
Science
Text book of veterinary medicine, Volume 1 (of 5)
Law, James
Veterinary medicine
expectant (let alone) plan of Dietl or the stimulating method of Todd,
Bennett and others, served to hasten its abandonment. Yet in
bloodletting we have an instrument for good or evil which is not to be
judged on slight evidence. The mere lessening of the blood pressure is
to be little considered, as it requires the abstraction of nearly
one-third of the entire mass of blood to visibly affect this. The
vascular walls at once adapt themselves to the lessened amount. Nor is
the mere lessening of the volume a vital point. After moderate bleeding
this is made up in a few hours: after severe bleeding in 24 to 48 hours.
The loss of adult red globules is more lasting. Bleeding to the extent
of one per cent. of the body weight may have the number restored in
seven days. The young red globules though rapidly produced have
individually less hæmoglobin, and they can convey less oxygen to the
tissues. This should mean less oxidation, less heat, less waste, less
urea, uric acid, hippuric acid and other poisonous products in the
tissues. Yet Baur says that in anæmia there is a greater metabolism of
proteids and more excretion of urea. How easy it is to blunder in
looking from one single point of view. Again after bleeding there is a
great relative increase of the various forms of white blood globules,
most of them young and therefore with somewhat altered functions. The
paucity of red globules and excess of white are brought about by the
pneumonia and independently of bleeding, so that it is difficult to say
whether the phlebotomist is enhancing an evil, or helping a natural
therapeusis. It seems hopeless to estimate the effects of these and
other changes in the blood after bleeding, upon the metabolic processes
of nutrition, secretion and sanguification. This digression has not been
made to elucidate the results or the _modus operandi_ of bleeding, but
rather to illustrate the complexity of the problem involved and to warn
against broad and unwarranted generalizations from insufficient
premises.
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