200 Successful Treatment of a Case of Hydropholiu. 
and able authority of Dr. Christopher Robert Pemberton, 
who, when writing upon the subject of venesection in in- 
flammatory diseases, expresses himself in the following 
language : 
si Physicians have been struck at all times with the effect 
produced by taking the blood from a large orifice in in- 
flammatory diseases, and it is certainly a matter which 
cannot be too strongly urged as an indispensable point in 
practice 5 especially as the “generality of writers do not seem 
to have instituted any defined plan to regulate and secure 
the effectual performance of this operation. I wish, there- 
fore, to press, in the strongest terms, the absolute necessity 
of attending to that eittaoivlance.: which the following 
observations may perhaps tend to elucidate. 
{tis true, that from a small orifice the same quantity 
of blood may be taken as from a large one; but the time 
of its flowing is so long, that the topical inflammation, 
which demands for its relief a sudden effect upon the sy- 
stem, is not in the least influenced by it, though the ge- 
neral strength is much weakened ; which is an occurrence 
of all others to be avoided in a disease that requires re- 
peated evacuations. 
* As I consider this matter of great consequence, I shall 
endeavour to point out a method, by which a plan, of a 
more defined nature than that hitherto adopted, may be 
given for drawing blood in inflammatory diseases. 
‘< At present we are contented to order that the hlood 
should be taken from a large or from a small orifice, than 
whicb nothing surely can be more vague or undefined. 
The plan, which I propose, refers to the length of time in 
taking away the blood, which may be measured, and not 
the size of the orifice, which cannot. 
*<T find from numerous experiments, made at my desire 
for this purpose by different surgeons, that when the orifice 
is such as to permit eight ounces of blood to flow in three 
minutes, that then a patient under acute inflammation will 
receive every benefit which is expected from the remedy. 
If it flows in a longer time, he will receive less benefit ; 
and, under certain circumstances, no benefit at all, or even 
an absolute injury. 
‘* I can suppose 4 case of peripneumony, wherein a pa- 
tient shall have just general strength enough to carry on 
respiration by the assistance of the voluntary muscles, and 
that eight ounces of blood shall be taken from a very small 
orifice, by which the change will be so gradual, in conse- 
quence of the time required for the blood to flow, that no 
alteration 
