CONVULSIONS. 393 



Another reason of the same kind will long continue to render bleed- 

 ing in the arm much more general than bleeding in the foot; it is al- 

 ways, or almost always possible, no matter how agitated the patient 

 may be, for us to open a vein in the bend of the arm, whereas as 

 much cannot be said as to the veins of the legs: by bleeding in the 

 arm, we act at the instant, when we please, and how we please, and 

 we take much or little, and that without any difficulty. By bleeding 

 in the foot, on the contrary, various preparations are required; we 

 must take advantage of a moment of calm, the vein is often found 

 to be too small or too deep-seated, and it frequenUy happens that 

 enough blood is not obtained.* 



898. Tepid baths allay irritation, whether sympathetically by 

 their soothing action on the skin, whether by diminishing the excit- 

 ing qualities of the fluids by the water which they occasion to pass 

 into the circulatory system, or by diminishing the force of radiation 

 of lieat. They are administered with success where the symptoms 

 of apoplexy do not predominate; but they ought not to be prescribed 

 until a bleeding has been premised, provided the state of the patient 

 is such as to admit of her losing blood without danger; otherwise it 

 might favor the affluxion and congestion in the brain; they should be 

 rejected in cases depending on flooding, a serous plethora, and where 

 there are any threats of inertia: the woman may remain immersed 

 in a bath for half an hour, an hour, or even longer, according to the 

 relief she derives from it. 



899. The application of cold water to the belly, according to the 

 recommendation of Sigaud, has not a sufl[icient number of facts in 

 its favor to enable us to recommend it in this form as a general pro- 

 position. Ablutions, and ice-water to the head, either used alone, or 

 whilst the rest of the body is plunged into a hot bath, which Den- 

 man and most of the English authors, as well as M. A. C. Baude- 

 locque, Madame Lachapelle, &c. have boasted so much of, appear 

 as if they might indeed be usefully combined with the other rational 

 means where there is reason to fear a lively reaction in the brain; 

 nevertheless their employment seems to me to require a great deal of 

 prudence and circumspection. 



* M. Velpeau does not dwell with sufficient emphasis upon the use of 

 blood-letting in these convulsions. In this country the amount of blood drawn 

 for the cure of puerperal convulsions is determined only by the ability of the pa- 

 tient to bear its loss. — I should be more pleased if M. Velpeau should recommend 

 instead of 15 ounces, the abstraction of twenty or 40 ounces; for, whatever, may 

 be the cause of the attack, it is attended with so great a determination to the 

 brain that no time should be lost in reducing it by the promptest mode, videlicet^ 

 by Blood-letting.— 31. 



