Remarks on the treatment of inflammation, with special reference to pneumonia.

  • Lawson, L. M. (Leonidas Merion), 1812-1864.
Date:
1860
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on the treatment of inflammation, with special reference to pneumonia. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    6/26
    circulation, and therefore should be reduced. There is too much excite- ment, and too abundant a flow of blood, both of which are abnormal con- ditions, and should be diminished. But the question arises, can bloodletting diminish this morbid condition ? In the third place Dr. Bennett asks :— 3. Can bloodletting diminish the quantity of blood in the inflamed partV This question he answers in the negative. Most assuredly, then, his previous argument, that bloodletting proved injurious by lessening the quantity of blood, and thereby checking cell-action, is wholly gratuitous; but not to take advantage of this evident discrepancy, we will proceed to show the fallacy of this third argument against bleeding. Dr. Bennett expresses the opinion that the idea of lessening the amount of blood in the inflamed tissues constitutes one of the principal objects in bloodletting, and he denies that such an effect will follow. The chief reasons which he assigns for this opinion are: first, that the blood is stag- nated in the inflamed part, and therefore cannot be withdrawn or lessened ; second, that if it could diminish the blood in the vessels, it would not assist in removing the exudation which is outside. If the bleeding is large, he argues that it will prostrate the vital powers, and thereby prevent the transformation of the exudations; if the quantity abstracted is small, it cannot produce any effect. He thinks, also, that local bleeding is inefficient, because it cannot be explained on the ground of any direct anastomosis between the vessels of the surface and those of the inflamed part! From these considerations, he says, it follows that neither general nor local bloodletting can possibly be supposed to diminish the amount of blood in internal parts affected with inflammation. It would be difficult to crowd a greater amount of error in any similar number of words. Dr. Bennett appears to have misconceived the whole spirit of depletory practice, and constantly combats monstrous errors, which no sound pathologist for a moment entertains. In the first place, the chief object in abstraction of blood for the relief of inflammation, is not, as Dr. Bennett asserts, designed to withdraw the blood-corpuscles which have already become adherent, nor to remove the lymph which has exuded outside the vessels ; but it is designed to retard and limit, or even arrest, both the processes of stagnation and exudation. And this is accom- plished by diminishing the quantity of blood sent to the part, by lowering excitement, and thereby checking exudation. The stasis of blood, and the exudation of lymph, are evidently proportioned to the force of the circula- tion and the degree of inflammatory excitement; indeed, if there is any other law than the degree of excitement directly favouring these actions, I am at a loss to conceive its character. If the excitement and determination of blood are sligh^J^'-f'^t^illbe merelv active hyperemia, or at most