ITS VITAL PROPERTIES, AND RELATIONS TO LIVING ORGANISM. 219 



in the circulating fluid. If the former be, his conclusion, he has then to endea- 

 vor to rectify the excess or the deficiency, by reducing the former, or by supply- 

 ing the latter; as when he bleeds and prescribes low diet for plethora, and 

 employs iron and generous living in anaemia. But it is his duty to take care 

 that his means are appropriate to his ends; and especially to abstain, when 

 endeavoring to draw off an excess of one constituent, from doing serious injury 

 by reducing another which may be already below par, and of which the pres- 

 ence may be essential to enable the system to resist the further progress of the 

 malady. Thus, as we have seen, bloodletting has no decided effect in lowering 

 the proportion of fibrin in the blood, whilst it has a most direct influence in re- 

 ducing the number of red corpuscles ; and there can be little doubt that the too 

 copious venesection which was formerly practised almost indiscriminately in 

 acute inflammations, had a most decided influence in postponing the final reco- 

 very from them, whilst it had often but a doubtful efficacy in subduing the 

 first violence of the disease. As a general rule it may be stated, that general 

 bloodletting is likely to be rather injurious than beneficial in toxic inflamma- 

 tions, in which the vitality of the blood as a whole is decidedly lowered, not- 

 withstanding the large increase in the proportion of fibrin ; and to this rule the 

 results of careful and extended observation have recently shown that Rheuma- 

 tism is seldom to be considered an exception, notwithstanding that this disease 

 was formerly considered to be one of those in which the efficacy of copious 

 depletion was most undoubted. In diseases of toxic origin, the treatment must 

 be conducted upon principles exactly the same as those by which the practitioner 

 would be guided in his treatment of a case of ordinary poisoning ; but as regards 

 the two classes into which it has been shown that these maladies may be divided, 

 a difference must be made in their application. 



213. The "morbid poisons" of our second class ( 211) are distinguished by 

 this, that there is a continual new generation of them within the system ; and 

 the first indication of treatment, therefore, will be to check their formation, so 

 far as this may be possible. This is the rationale of the dietetic and regiminal 

 treatment of the lithic, lactic, and oxalic diatheses, of lepra and psoriasis, of 

 chronic gout and rheumatism, and many other chronic diseases of toxic origin. 

 Secondly, we should endeavor to destroy or neutralize the poison, if we have 

 any remedies which possess such an action upon it. Perhaps the curative in- 

 fluence of arsenic in some of the chronic skin diseases, is one of the best ex- 

 amples of this kind ; but it must be admitted that such direct " antidotes" to 

 morbid poisons are very few in number. Thirdly, where we cannot thus destroy 

 the poison, we must endeavor to moderate its action upon the system ; this is 

 the rationale of palliative treatment of every description, in which the fans et 

 origo of the malady is left unchanged. But fourthly, our main object must be 

 to eliminate the poison from the system as rapidly as possible, by the various 

 channels of excretion ; acting upon these by remedies which will increase their 

 activity, or which will so alter the condition of the morbific matter, as to enable 

 it to be more readily drawn off. The judgment of the well-informed practitioner, 

 in the treatment of diseases of this class, is more shown in his discriminative 

 selection of the best means of thus aiding the Blood to regain its normal purity, 

 than in any more apparently " heroic measures ;" and a candid review of the 

 most approved systems of treatment for disease of the type here alluded to, will 

 show that the ratio of their efficacy is in accordance with that of their harmony 

 with the above indications. 



214. In the toxic diseases of the zymotic class, in most of which the poison 

 is introduced from without, the course of the morbid phenomena to which it 

 gives rise is usually more definite and specific, and its duration more limited. 

 There is no source within the system whence a new supply of the poison is 

 continually arising ; and its operation ceases, therefore, as soon as it is entirely 



