SANGUISUGA. 



leeches in infancy must be regarded as a species of general 

 blood-letting, the precise number which will regulate, not only 

 the quantity, but be equivalent to rapidity in the detraction of 

 the blood, should be determined; and the bites should be 

 instantly closed on observing that the system is brought under 

 the influence of the loss of blood. Instances have occurred 

 in which death has followed the application of leeches to 

 children, and sometimes even to adults. 



By whatever means blood is abstracted, if the quantity be 

 more than the constitution can bear to lose, morbid effects 

 result. Thus, the delirium which frequently occurs has in 

 some instances continued, and has worn out the patient. The 

 first or second bleeding may be well borne, but a repetition of 

 it may produce sudden dissolution ; the pulse falls, becomes a 

 mere flutter, and the person rarely survives more than a few 

 hours. And this may happen whether leeches or the lancet 

 be employed. Effusion into the ventricles is not an unfre- 

 quent consequence of an extreme degree of vascular exhaus- 

 tion. Sometimes when reaction occurs, it is feeble and con- 

 tinues so, causing fainting on the slightest exertion, and 

 sometimes terminating in sinking to a hazardous degree. In 

 other cases the reaction produces symptoms resembling those 

 of inflammation of the meninges of the brain, a hard-beating 

 pulse, particularly in the 'carotids, throbbing in the head, pal- 

 pitation of the heart and pulsation of the aorta ; and these 

 symptoms in children lead us to suspect hydrocephalus, when 

 nothing but exhaustion demands attention. Instead of blood- 

 letting, light cordials, a mild and nutritious diet, rest, and qui- 

 etude should be enjoined. 



When the quantity of blood to be taken from any part is 

 considerable, and especially if it be requisite to abstract it 

 quickly, so as to produce an immediate effect, then cupping is 

 preferable to the application of leeches. From the manner in 

 which the blood is taken by cupping, syncope rarely occurs, 

 unless from fear; consequently this method .of abstracting 

 blood is ill-calculated to produce a sedative effect upon the 

 habit, although, in cases where the lancet has been previously 

 employed, a degree of sinking occasionally occurs which is 

 alarming. This, however, is less likely to happen than when 

 leeches are employed, as, from the nature of the incision made 

 by the scarificator, the bleeding is more under control than it 

 is from the orifices produced by the bites of leeches. 



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