INFLAMMATION.] 



THE HOESE, AND 



[inflammation. 



part affected, by reducing the whole mass in 

 the circulation. 



Bleeding, however, is often misemploj^ed, 

 especially when regarded as the only remedy 

 for this disease, and other steps are neglected. 

 The obstinacy and vehemence of the process, 

 in weak constitutions, prove that depletion is 

 not invariably proper. When inflammation is 

 combined with an unhealthy state of the ali- 

 mentary canal, blood should be taken away 

 with great caution. A great deal of indura- 

 tion, with little pain and heat in the inflamed 

 part, the probability of a long and copious 

 suppuration, and the dependence of the in- 

 flammation on local weakness, are particular 

 instances in which phlebotomy should be spar- 

 ingly employed. Bleeding is quite unneces- 

 sary when the disease is local, and symptomatic 

 fever low. 



On the other hand, bleeding is highly bene- 

 ficial in all cases in which the disease is simple 

 and uncomplicated, and attended with a high 

 degree of febrile disturbance. Hence, inflam- 

 mation of the eye, which is a most sensitive 

 part, particularly requires a free evacuation of 

 blood. Inflammation of the lungs, brain, or 

 stomach, which are organs, the sound state of 

 which is highly essential to the regular con- 

 tinuance of all the various operations in the 

 animal machine, particularly demands the em- 

 ployment of the lancet ; for, if a successful 

 effort is not promptly made to stop such in- 

 flammation, death itself, in all probability, will 

 be the result. 



The sooner that bleeding is practised, the 

 greater will be its efilcacy, and the more 

 rapidly the blood will be evacuated. Bleeding 

 near the part affected is usually more effectual 

 than when done in a remote situation. These 

 remarks chiefly relate to general bleeding ; 

 but in local inflammation, topical bleeding is 

 scarcely ever improper. It is always a point 

 ■worth considering, whether bleeding in or near 

 the part, will answer better than taking blood 

 from the general habii ; for less may be re- 

 moved in this way, and the constitution not so 

 much affected. Although, in many cases, the 

 general habit may be relieved by bleeding, yet 

 the part specially affected will always require 

 this most. That local bleeding has a very 

 considerable influence on the inflamed part, 

 is proved by the sudden relief obtained from it. 

 258 



The modes of performing local bleeding are 

 by the lancet ; or, if in the feet, by first re- 

 moving the horn with the drawing-knife, and 

 puncturing the vein with a strong abscess 

 lancet ; other parts, such as the thigh-vein, 

 pastern, &c., are also bled with the lancet ; 

 the eye, likewise, with the small eye-lancet, 

 the temporal artery, &c. But never bleed in 

 the jugular or the plate-vein with any other 

 instrument than the common phleme and 

 blood-stick: but particularly the jugular; for 

 should a misfortune happen with any other in- 

 strument, an action at law might be the con- 

 sequence. 



In continuation of the treatment for inflam- 

 mation, the bowels must not be forgotten ; and 

 in exhibiting medicine in such cases, great 

 care is necessary. The exhibition of small 

 doses of aloes is good, or Glauber's salts, in 

 the shape of draught, will be found very effica- 

 cious, and is a principal means of diminishing 

 inflammation. 



Direct purging is in nowise to be recom- 

 mended ; as it frequently ends in superpurga- 

 tion and death. Saline medicines must lessen 

 the quantity of circulating blood, inasmuch as 

 they increase the secretion from the intestinal 

 arteries. Hence they must operate beneficially 

 in the cure of local inflammation, much upon 

 the same principle as bleeding does. A very 

 great authority and writer, was of opinion, that 

 purging lowers action without diminishing 

 strength ; by which we are probably to under- 

 stand, without producing a very lasting or 

 permanent loss" of strength. With respect to 

 mild laxatives in inflammation, none are pre- 

 ferable to the above ; but, of the two, the saline 

 draught is preferable to the aloetic. AVe may 

 here remark, that besides the benefit which the 

 local ii}flammation derives from the judicious 

 administration of purgatives, the costiveness 

 and heat which usually attend the symptomatic 

 fever, are also relieved by the same means. 



Nauseating medicines, which have the power 

 of producing sickness, lessen, for a tinje, the 

 action, and even the general powers of life. 

 This is in consequence of every part of the 

 body sympathising with the stomach, and the 

 eftect may be very quickly excited. Sickness 

 lowers the pulse, makes the small vessels con- 

 tract, and rather disposes the skin to perspira- 

 tion. But nothing more than nausea should 



