GASTRO-ENTERITIS. 309 



brushed, or curry-combed; and clothed warmly, particularly when he 

 feels cold and shivers ; and should the weather prove fine, he may be 

 walked out a little. In case the urinary and faecal excretions appear pent 

 up, the hand, oiled, is to be introduced, per anum^ and the rectum emptied, 

 and afterwards a clyster given, composed of gruel, or linseed-tea, or 

 mallow-decoction. 



In the country, where in regard to bloodletting we are not wont to be 

 scrupulous or apprehensive, four or five pretty copious bleedings at the 

 beginning of an attack may be found requisite. We have frequently 

 pursued this practice, and by it have appeared to prevent many of those 

 sympathetic phlegmasia which accompany and aggravate the gastro- 

 enteritic affection, and to have subdued an acute inflammation, particularly 

 when this has been associated with an attack of the pulmonary or cerebral 

 apparatus. We drew from the two jugulars of one of our own horses, 

 attacked in 1825, eighteen quarts of blood in twelve hours; in fact, we 

 continued the bleeding until the fulness and hardness of the pulse gave 

 way, without which we are persuaded we should have lost the horse. It 

 is only, however, in cases manifesting decisive inflammation that such 

 large and repeated bloodlettings can be permitted ; and in such as these 

 we are not to be deterred either by the first signs of prostration or the 

 fear of adynamy: we are to use little hesitation under such circumstances, 

 though much caution is to guide our practice in this respect when the 

 inflammatory symptoms are but slight. The state of the pulse, the con- 

 dition of the patient, his age, strength, and form, and the degree and 

 extent of the inflammation present, must regulate our proceedings. [To 

 this let the author add, that bloodletting in large quantity or to great 

 extent, is forbidden by more recent experience.] 



Local Bloodletting. — As far as concerns the mucous membrane itself of 

 the alimentary canal, it must be borne in mind that these general bleedings 

 exert comparatively but little influence upon it : a large quantity of blood 

 withdrawn from the jugular takes but little away from this membrane, 

 and this large abstraction may occasion a debility which is not compen- 

 sated for by the decrease of the gastro-enteritic inflammation. On this 

 account, after a time, it becomes advisable to draw blood locally. As a 

 substitute for leeches upon the epigastrium, which are applied with so 

 much advantage in human medicine, we make punctures near together 

 into both the subcutaneous thoracic veins, in a direction towards the 

 diaphragm, and repeat these emissions at short intervals. Vapour baths 

 directed upon the openings, or cupping-glasses placed upon them, may be 

 employed to obtain more blood. The second case we had was bled but 

 twice, and both times from the thoracic vein ; and venesection could not 

 have been carried further without harm. These local emissions are 

 especially useful to stay an incipient gastro-enteritis. The nearer the 



