Observations on the results of an advanced diagnosis and pathology applied to the management of internal inflammations, compared with the effects of a former antiphlogistic treatment, and especially of bloodletting / by J. Hughes Bennett.

Bennett, John Hughes, 1812-1875.

Date:: [1857?]

Credit: Observations on the results of an advanced diagnosis and pathology applied to the management of internal inflammations, compared with the effects of a former antiphlogistic treatment, and especially of bloodletting / by J. Hughes Bennett. Source: Wellcome Collection.

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

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$])o\. Thus Sydenham, apparently, had no idea of inflammation distinct from fever. Pie says, I think pleurisy is a fever originat- ing in a proper and peculiar inflammation of the blood—an inflam- luatioii by means of which nature deposits the peccant matters on the pleura3. Sometimes she lays it on the lung itself, and then there comes a peripneumony. This differs from pleurisy only in degree. They exhibit tlie results of the same cause with, greater intensity. In my treatment I have the following aim in view—to repress the inflammation oF the blood, and to divert those inflamed particles, which have made an onset upon tlie lining membrane of the ribs (and have there lit up so much mischief), into their proper outlets. For this reason, my sheet anchor is venesection.^ Such was the pathology and practice of Sydenham, the latter following consistently enough on the former; and the essential idea of diminishing the morbid matters in the blood has not only descended from Hip- pocrates to the days of Sydenham, but has come down from his to our own times. Now, in one sense, it is true that there is no disease whatever, even the one which is most local, that is not also associated with a general change of the system. For, inasmuch as all the nutritive functions are connected with one another, an excess or diminution of local growth, by subtracting from or adding to the constituents of the blood, must produce an alteration in that fluid both as to quan- tity and quality. The idea of Treviranus, viz., that each single part of the body, in respect of its nutrition, stands to the whole body m the relation of an excreted substance, has been ably shown by Mr Paget to account for various processes in health, under the name of complemental nutrition.^ The same notion has been still further extended by Dr Wm. Addison, who correctly points out that in the distinctive eruptive fevers, such as small-pox, the numerous small abscesses in the skin eliminate the morbid poison which formerly existed in the blood, and are in this way essential to the cure. This provident action he denominates cell-therapeutics.'' In all such cases, experience has shown, that time and a natural sequence of changes is necessary for a restoration to health, and it is now recognised that the idea of cutting short such changes by bleefling, is alike erroneous in theory and injurious in practice. Now, exactly the same principle ought to guide us in cases of inflammation, where, in addition to the local changes in the part, there must necessarily be more or less disturbance of secretion and excretion. The blood in consequence must, and does, as is now well known, undergo definite alterations, which, it is true, organic che- mistry has not yet fully explained to us, but by which we have at least learnt that the particular secretion suppressed is always accu- * &/denhani Society's Translalion. Vol. i., p. 247. ' Lectiires on Surgical Pathology, Lecture ii. ^ Addison on Cell-Therapeutics, 1856. VOL. U NO. IX. MARCH 1867. 5 F$