470 On the Epidemics of 1852-8. 
as an acute disease ; requiring almost always local bleeding, 
with purgatives, diuretics, and the maintenance of the action 
of the skin. 
In a case where a wounded artery had caused the loss of 
a good deal of blood, in another where the patient had been 
freely bled for enteritis, both made very good recoveries ; 
this, with the relief from epistaxis, points out the use and 
safety of blood-letting in many cases: but the type of the 
previous illnesses did not lead practitioners generally to look 
to it with much favour,—necessity only made them use the 
1 neet. 
Cases that of all others most imperatively call for the loss 
of blood are apoplectic or comatose affections, the result of 
the retention of urea in the system from diseased action in 
the kidneys; here free and copious bleeding is often well 
borne, and rapidly cuts off the symptoms calling for it, and 
relieves the system generally. One man who was apoplectic 
and anasarcous lost forty ounces of blood, and was well of 
both symptoms in three days. There is not only an increase — 
of urea in the blood, but of water also ; and the symptoms 
may be in part due to over-distention of vessels. 
Among the local symptoms, the enlarged glands will 
almost always be relieved by early leeching, and the kidneys 
called into action by turpentine epithems. - 
The throat should be early and regularly treated with 
nitrate of silver, as much of the success depends upon early 
subduing the throat symptoms, to enable the patient to take 
nourishment. 
. The diffuse inflammation of the cellular tissues bears 
depletion badly, and is often not relieved by incisions, while 
turpentine epithems and hot applications are of use. 
In the desquamative stage, warm bathing with alkalies 
and frequent purgatiyes are wanted: by careful attention 
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