INFLAMMATIONS. 17 



by their viscidity retain a very considerable portion of the thin- 

 ner and more watery fluids, the effect of which is to moderate 

 the secre'tions and excretions, and to prevent even a considera- 

 ble part of our thinner fluids from running off. But when 

 blood is drawn from the vessels, a greater portion of the more 

 solid parts is taken away, the remaining portion will be of too 

 great a tenuity, and the whole will readily run off by the exhal- 

 ants into the cellular texture, and therefore produce anasarca, 

 which, as every body knows, is produced by excessive haemorr- 

 hagies and artificial bleeding. Moreover, the renewal of the 

 nutritious parts will always depend upon a certain degree of vi- 

 gour in the assimilating organs or in the various organs of diges- 

 tion, which, by evacuations of blood, may be so weakened as 

 not to be left in a condition to renew the necessary parts of the 

 blood. The tenuity of the blood has sometimes been considered 

 as the consequence of inflammation, when it was only the con- 

 sequence of excessive evacuations. 



" But there are other consequences from the debility which ex- 

 cessive bleeding may induce ; one particularly in the case of pleu- 

 risy and peripneumony, those instances of inflammation in which 

 we are most liable to push bleeding to excess. In peripneumony 

 there is certainly one effusion of a catarrhal kind which may be 

 supposed to arise from the mucous glands of the bronchia alone ; 

 but there is reason to believe, that besides that, a quantity of 

 serous fluid is copiously poured out into the bronchia, increas- 

 ing the expectoration ; now large bleeding has a tendency to in- 

 crease this last effusion ; and if, at the same time, the system is 

 weakened, so as to prevent an equal expectoration, or ejection 

 of these fluids, the patients may in consequence be suffocated. 

 We find several instances of this in the writings of Morgagni. 



" In the case of rheumatism large bleedings leave the system 

 more liable to be affected by such causes as may renew the dis- 

 ease. Cold affects us in proportion to our debility ; and there 

 are many cases, where, by excessive bleeding, a rheumatism has 

 been changed into an obstinate chronic form, in which it has re- 

 mained for life. 



" I must say, therefore, that there are certainly limits 'to 

 the use of bleeding in inflammatory cases, but I find it difficult 



VOL. IT. B 



