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.

    49/756
    TBBATMENT—BLEEDING, SEDATIVES. this way, clieck or control the disease; though the mode by which this result is produced is not very easily explained. Much indeed may be attributed to the revulsive action of _ the leeches or cupping-glasses, especially of the latter ; but this is hai-dly sufficient to account for the effects produced. General bleeding, then, is applicable, in active congestion, only when there is considerable increase in the force and frequency of the heart's action, as shown by the arterial pulse, this being often the condition when such congestion is merging into inflammation. Local depletion, from a part near the seat of the congestion, is beneficial when we have reason for believ- ing that the congestion is of an active character, although there be no great increase of the heart's action. It must, however, here be m-ged, that regard should be had to the general condi- tion of the system before venturing even upon this less powerful mode of depletion; for it must be borne in mind that by the means ordinarily-employed blood is removed from the smaller arteries and veins as well as from the capillaries, and therefore that the effects of the depletion are not solely confined to the latter vessels, but in some states of the system they show them- selves strongly upon the action of the heart and large vessels. The advantage of the truly local bleeding, that is, of reliev- ing directly the capillaries of the part affected, where it can be done, as when the congestion is situated on the surface, applies to the passive equally with the active form; since the blood thus removed flows almost entirely from the distended capil- laries, where it was in a state of stasis, entirely removed from tlie pale of the general cu-culation, and, therefore, unlikely, by its abstraction, to produce any depressing effect upon its moving powers. There are various medicines and applications which are reckoned as sedatives to the circulation; of these the former are chiefly of the nauseating kind, as tartar-emetic, digitalis, and colchiciun; and although it is doubted by many whether this sedative agency can be exerted, unless nausea be also in- duced, that they do exert such an agency is certain, though they do not appear to act each on the same class of vessels. Of the agency of colchicum we know but little, though its sedative effect seems to be produced mainly through thB heart and large vessels. DigitaUs, again, is a sedative to the heart, though it may very fairly be asked whether this sedative action is not produced by checking the capillary circulation. The tartarized antunony, on the other hand, though it unquestionably exercises some depressing influence on the heart, has certainly as great, if not greater influence upon tlie capillaries, and is therefore one of the most eflicient means we possess of combating active hypersemia.