1838. HOUSE—No. 72. 17 
arrests, for a time, the progress of the disease, removes a hindrance 
to the free circulation of the fluids, brings a temporary respite or 
mitigation ; it does not cure, but opens a prospect of curing, and the 
final termination will depend much on the course pursued during the 
interval of relaxation. ‘The next step is the administration of a pound 
and a half of Epsom salts in warm gruel, to which may be added from 
10 to 15 grains of tartar emetic. ‘T’o secure its operation, it is neces- 
sary that it should be given carefully, that is, it should not be poured 
down the throat hastily and at once, as it will be very likely to fall 
into the first stomach or paunch, where it will remain inactive, or in 
a great measure inert. If, on the other hand, it is given slowly, it 
will be more likely to pass over the opening into this, and pass on 
to the fourth stomach. 
To those who do not understand the effect of bleeding, or other 
remedies, or who do not know what changes to expect from their opera- 
tion, either singly or combined, I state farther.—T here are two kinds 
of changes which follow bloodletting, both of which are favorable ; 
they depend on the previous state of the circulatory system. If it is 
oppressed from engorgement ; bleeding, (if its effects are favorable, ) 
will produce a more frequent, fuller, and rounder pulse, or the artery 
will be more expanded, seem. larger in circumference ; but, if the 
pulse, previous to bleeding, is bounding, frequent, or hard, it will be 
less bounding, less frequent, and softer. The system, in the first 
case, will be relieved of a load, under which it could not freely act ; 
in the last, there are abstracted from the circulation, fluids, which, by 
their over-stimulating effects, tend rapidly to the extinction of the vi- 
tal principle, or the destruction of some vital organ. The first state, 
is one preceding reaction, and in which nature requires assistance to 
develope ; the latter is one of reaction, and requires moderating, be- 
fore any of the vital organs suffer from structural derangement. ‘The 
first state is one, much like that which follows a blow on the head, 
the whole system is laboring under a depression, and this may be so 
great, that the circulation in the capillaries is wholly impeded. The 
appearances after death in such a case, are black extravasations in 
the diseased part, or decided mortification. The last is more like 
the excitation from stimulating liquids, and ends in the suppuration of 
some part, on which the disease falls. Sometimes some organs are 
(a7 
2 
