1804. ] 
Exercife, aad the warm bath, are, in 
fact, the appropriate and moft efficient 
remedies in inftances of rheumatical af- 
fetion. 
The cafes of fcrophula were treated 
fimply as cafes of conftitutional relaxation 
and debility. When it appears externally, 
although moredifgutting and offenfive, it is 
lefs pernicious and le(s likely to be fatal 
than in the various modes of its clandef- 
tine operation. Seldom, on that account, 
fhould we make ule of cutaneous applica- 
tions, which can conceal the outward ap- 
pearance of the difeafe only by driving: it 
inwardly upon-the brain, or other organs 
more immediately and eflentially united 
with the principle of life... In this way 
it is, that in fcrophulous patients mania, 
phthifis, or other vifceral and equally dreads 
ful diforders are fo frequently produced. 
Scrophula confifts, not’ in a peculiar 
poifon with which the fluids, are impreg- 
nated, but, in the inheritance of a muf- 
cular fibre too feeble and relaxed. Of 
courfe, the violent eyacuants former- 
ly, and even now, too commonly made 
ufe of, ought to be excluded altogether 
from a fhare in the medical management 
of this difeafe. What can be a more 
prominent violation of even ordinary rea- 
fon, than to think it were poffible to im- 
prove or to reftore the tone and vigour of 
the fyftem, by the mean of unufual and 
extravagant purgations! 
The Reporter is, by no means, difpofed 
to the carelefs and unneceffary effufion of 
human blood ; but in various cafes of violent 
and obitinate catarrh, although they were 
attended with confiderable feeblenefs, he 
has lately ventured to have recourfe to 
venefection. 
Weaknefs is not, in all cafes, an 
infuperable argument againft the pro- 
priety of bleeding. The arteries, whofe 
contractile power has, from any cau(e, been 
unduly diminifhed, are not able, without 
difficnity and febrile uneafinefs, to propel 
even their ufual. quantity of blood. .Ua- 
der fuch circumitances, they ought to. be 
in fome meafure relieved from their bur- 
den by timely and moderate evacuations, 
The exiftence of a morbid plethora is not 
to be afcertained merely by the abfolute 
mafs of fluid, or even by its proportion to 
the {pace of the veffels which it occupies, 
but likewife by a circumftance, which 
perhaps has not yet been fufficiently at- 
tended to—the lefs or greater degree of 
power which, in any particular infance, 
they may poffefs, of urging, with uninter- 
mitting conftancy, the tide of fanguineous 
circulaticn. 
Monruiy Mac, No. 113. 
Lif of Difeapis 
281 
The blood, whether it be in fo great a 
quantity as to overload the veffels, or in 
fo {mall, as not to afford a fufficient fti- 
mulus to their aftion, cannot fai! to pro- 
duce debility and its fubfequen* feries of 
difeafes. Itis by many imagined, that 
what is called local bleeding is, in a mul- 
titude of cafes, preferable to what is 
called general: in apoplexy, for initance, 
the preffure on the brain is {uppofed to be 
more expeditioufly, as weil as more 
effectually, ‘ relieved, by an operation 
on the jugular vein, than on one in 
either of the! arms; in pleurify, phthifis, 
or catarrh, by cupping or leaches on the 
breaft or fide affeéted than any where 
elle. " | 
When properly confidered, however, the 
matter muft appear in a different light. 
In fa&t, there is no fuch thing as local 
bleeding, if, by that term, be meant an 
evacuation from one part of the vafcular 
fyitem, without affecting, in the fame 
proportion, every other. When a fluid is 
ina conftant fiate of circulation through a 
round of veflels, of what con‘equence 
can it be from what portion of that circle 
any quantity of it be deducted. 
When you drink out of a canal, through 
which flows a free and uninterrupted 
ftream, in whatever place the draught be 
taken, it muft equally affeét the level of 
its furface, and the impetuofity of its 
courfe. 
It ought, however, to be obferved, that 
in the difeafes of infants and old perfons, 
hooping cough for inftance, in the one, 
and dy{pnoea or cynanche-trachealis in the 
other, by the application of leaches to 
the cheft or throat, the expenditure of the 
vital fluid may, with greater convenience, 
be accurately adjufted to the exigency of 
the cafe. | 3 
The difeafe laft in the lift arofe evidently 
from an unhappy addiction to undue 
ftimuli. 
t is a notion entertained by the vulgar 
and patronifed too generally by illiterate 
and ill-educated members of the medical - 
profeffion, that thofe drams which go by 
the denomination of cordials, are proper 
and neceflary, even for the health and fe- 
curity of females in the condijion of preg- 
nancy. No dotctrine can more precifely 
be oppofite to the faét. Under fuch cir- 
cumitances, on the contrary, al] means 
ought to be made ufe of to promote and 
fecure an uninterrupted ftate of the moft 
perfect mental and corporeal tranquillity. 
Every thing fhould be carefully with- 
drawn, that is calculated to ag*tate or to 
excite. 
Pp By 
