405 
DR. ELLIOTSON’s CLINICAL LECTURES. 
you wish to open the bowels, you are to scour a person out, and 
reduce him to the last extremity. No person should determine 
to employ free bleeding, or to give any strong medicine, till he 
has weighed two things—the danger of the disease on the one 
hand, and the powers of the patient on the other. If you have 
ascertained these points carefully, and satisfied your own mind 
how far you may proceed, then you should employ the means 
vigorously, and watch the effect of your means. I have never 
regretted having been too active in acute diseases; but I will own 
to you, that very often, when I have failed in their treatment, 1 
have blamed mvself for not being more energetic. I have, in my 
life, frequently lost a patient with inflammation, from saying, 
I will not bleed again till to-morrow, because he may be better 
by that time. Many people say this is all nonsense; but I have 
seen it; I have done so, and frequently repented it; whereas I 
never regretted being active. My judgment has led me to say, 
he ought to be bled; yet my fears and my fancies have come over 
me, and I have said, no, I will not be active till there is imperious 
necessity. This is a thing that happens to all of us, and of 
which I have repented ; but I have never repented of the reverse, 
because I never think of prescribing energetically unless I have 
first carefully weighed all the circumstances. Many medicines, in 
acute diseases, aregiven most inefficiently on this account. But in 
chronic diseases, the cause of failure is in the want of perseverance. 
When, in chronic diseases, you have made up your mind as to 
what remedy is most calculated to do good—not that it will do 
good, because you cannot say that beforehand, but what remedy 
is calculated to do good, what is the best you can employ—then 
persevere; do not change it to-day for this, and to-morrow for 
that, and then go back again, and then exchange it for something 
else, and go back two or three times. This is a sort of old 
woman’s treatment, and nothing is more disgusting. But although 
you have made up your mind to persevere, yet a certain time 
ought to be allowed; and when you know from experience that 
sufficient time has elapsed, and yet the thing will do no good, 
then persevere in it no longer; then change it for something else, 
but not before. 
