222 ON THE NATURE AND PRINCIPLES OF 



mind of the sufferer constitute his disease, that its 

 repetition is sometimes actually solicited. This very 

 valuable remedy, is therefore, like many others, from 

 a variety of causes, liable to be abused. And while 

 admitting the great advantage which attends copious 

 blood-letting in many, perhaps a majority of cases 

 of acute inflammation, I cannot avoid entertaining 

 an opinion that; notwithstanding the judicious advice 

 which has been offered by various writers, and the 

 forcible description given by Dr. Hall of the injurious 

 consequences of excessive or protracted loss of blood, 

 the treatment of inflammation is still occasionally 

 characterised by a great disregard of the evils which 

 may result from an incautious use of the measures 

 employed for its removal. 



With the exception of cases in which the impor- 

 tance of the organ or part affected is such as to 

 compel us to overlook the dangers and disadvantages 

 which may result from the subsequent debility, 

 general blood-letting seems to me to be chiefly and 

 almost solely applicable to individuals in whom in- 

 flammation has supervened on, and exists with, a 

 state of general plethora. Under these circum- 

 stances the quantity of circulating fluid is not only 

 excessive, but the proportion of its fibrinous consti- 

 tuent is also unnaturally augmented ; and a free 

 abstraction of blood, by venesection or otherwise, 

 then acts beneficially by changing the quality, as 

 well as by diminishing the quantity and impulse, of 

 the circulating mass. But where there is no reason 

 to suspect any material disorder in the quality or 

 abnormal increase in its quantity, as when tin- 



