A manual of the practice of medicine / by George Hilaro Barlow.

  • Barlow, George Hilaro, 1806-1866.
Date:
1861
Catalogue details

Licence: Public Domain Mark

Credit: A manual of the practice of medicine / by George Hilaro Barlow. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    tlie biiffy coat at the commencement of an inflammation, and wlien we have good evidence from other sources of its existence, is not to be regarded as a sufficient proof that the bleeding will not prove beneficial. For the same reason we can understand tliat as long as the inflammatory action continues, this altered condition of the blood must be kept up, after the period at which blood-letting is beneficial, as when inflammatory exuda- tion has taken place, or even ulceration and suppuration have commenced ; so that whilst in the former case we are not to regard the absence of the bufiy coat as a proof of the impro- priety of bleeding, we must not, in the latter, receive its pre- sence as an evidence of its expediency. Again, in anssmia there is a large quantity of fihrine, proportionately to the red cor- puscles, and therefore one of the conditions favouring the for- mation of the huffy coat, wljich is accordingly, found to occur without the presence of inflammation, or any other condition indicating the use of the lancet. Not, however, that we are to infer from this, that because there exists an antemic condition, there can therefore be no inflammation, for the subjects of auasmia are as prone to inflammation as otliers, or even more so, but we must look for the proofs of its existence elsewhere than in the huffy coat. The danger of death occurring directly from the loss of blood, need hardly be considered, when the operation is per- formed by, or under the dii-ection of, a dulj^-qualified practi- tioner (and by none other should it ever be allowed to be imdertaken), since there are always the premonitory signs of paleness, collapse, cold sweat, failing pulse, &c. ; but in esti- mating the direct ill eflects of excessive depletion, we must not forget, that after a considerable loss of blood, there com- monly ensues a reaction, accompanied by a fulness and sharp- ness oi: the pulse, and an apparently febrile heat of skin, with a giddiness and tinnitus auriiim, which may be mistaken by the unwary for a return of the inflammatory action, and be sui^posed to indicate a repetition of the bleeding, which if not directly dangerous to the patient, woidd have an injm-ious eflect upon the progress of the disease. This state of vas- cular excitement is, however, tolerably well known, and easily recognized, the iralse, which is frequent, full, and some- times even sharp (having what is familiarly known as the haimorrhagic jerk), differs from the true inflammatory pulse, in which bleeding is indicated, in its want of hardness, for it is readily compressed; the heat of the skin too is never per- sistent, disappearing when the clothes are removed from the part: there is pallor of the lips; and the giddiness, and tinnitus aurium, are increased by the erect, and relieved by the recum- bent, posture. This state of tilings may indeed co-exist with H