202 
PATHOLOGICAL FACTS AND OBSERVATIONS. 
means in our power, to cut short the inflammation; else such a 
change of structure will very soon begin to take place as must 
for ever defy the art of man to remedy. We should keep in 
mind, that the battle is only to be fought, with any chance of 
success, at the beginning, and during the first stage of the dis¬ 
order. And here again, as in inflammation of the lungs, bleeding 
is our sheet-anchor. But if there be one disease more than 
another in which it can be shown that the local abstraction of 
blood has a decided advantage over general depletion, I will 
venture to say it is this. My own experience tells me, that the 
nearer we bleed to the part inflamed the better. Blood, therefore, 
taken from the foot will relieve with the greatest certainty. And 
here I must apply an excellent observation made by my friend, 
Mr. James Turner, in his very ingenious and well written paper 
relative to the treatment of the' navicular disease. “ It is indis¬ 
pensable,says he, u that the bleeding should be continued until 
the quantity abstracted locally should affect the system generally/' 
Now, if this be necessary in the treatment of occult contraction, 
how much more must it be in acute inflammation of the laminae ? 
But during the Peninsular campaigns we had frequently to 
treat this complaint in situations of peculiar difficulty; for in¬ 
stance, whilst marching—when we had no opportunity of leaving 
anything behind. Upder these circumstances, I found that, 
although I could relieve, in the first instance, by bleeding at the 
toe, yet in the warm climate of Portugal, I was liable to lose 
my patient afterwards, in consequence of the wound I had made 
in the foot. Suppuration was apt to take place in the sole; 
secondary inflammation would be set up; and this would be 
followed by tumefaction, burrowing up and bursting all round 
the coronet; and then the game was lost. I therefore abandoned 
the foot altogether, and began to bleed higher up, from the 
trunk of the vessels coming from the leg and foot. And the 
result of this practice I found so generally satisfactoiy, that 
I have been induced to continue it ever since. We are told, 
and by a great authority too, that bleeding at the shoulder is 
uncertain, and that “ the vein itself in general gives out but little 
blood." For my own part, however, I must say, that I have 
never found any difficulty in taking as much blood as I wished ; 
or of producing the effect I desired in this way. It is to be ob¬ 
served, that whenever there is acute inflammation in the feet, the 
vessels of the leg and arm are always full; and they may be 
rendered still more so by placing the animal in a warm bath. 
But this measure must be put in execution vigorously. The 
bleeding should be pushed, if possible, to approaching syncope. 
I have in a great number of instances, seen the most marked and 
