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?]
Catalogue details

Licence: Public Domain Mark

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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    supposition of drawing blood from the inflamed internal parts. A man has pneumonia or nephritis, resulting fi'om changes in the ves- sels which arc supplied direct from the aorta, and leeches are applied to the integuments supplied by vessels derived from the mammary or epigastric arteries. Any direct anastomosis between the vessels on the surface and those in the parts inflamed is not to be thought of, as has been shown anatomically by Dr J. Struthers.^ How, then, does the loss of this small amount of blood operate in these important cases ? It cannot be by any conceivable theory of diminishing either the current to, or the amount of blood in, the part. As in the majority of cases, therefore, the loss is not large enough to afi'ect the general circulation, and as anatomy prevents our belief in the idea that it can influence the inflammation directly, it may well be asked how can local blood-letting be of any benefit at all ? Is it not more probable that leeches and cupping do no good by drawing blood, but that the relief of pain they undoubtedly occasion is owing to the reflex influence of counter UTitation, and in the vast majority of cases to the soothing and sedative influence of the warm fomentations which generally follows their employment ? Dry cupping is often as effectual as local blood-letting. From these considerations, it follows that neither general nor local blood-letting can possibly be supposed to diminish the amount of blood in internal parts affiected with inflammation. 4iA. Should the character of the pulse indicate the propriety of bleeding f That an accelerated and strong pulse in inflammation demands interference on the part of the medical practitioner, seems to be a principle which has been very generally acted on. In other words, because nature accelerates and strengthens the pulse, it has been thought that art ought to interfere and diminish its force and frequency. But here, again, as it appears to me, the result has been mistaken for the cause ; and so far from getting rid of inflammation by weakening the pulse, we not only fail to do so, but prolong the time, as previously explained, for the transformation of the exu- dation. Tliis, indeed, is acknowledged by Louis, Chomel, and Grisolle, who distinctly' show that the progress of a pneumonia is never shortened by bleeding. Dr Alison also admits that he has seen dulness with crepitation continue to spread after bleeding. But the inconsistency of the therapeutical rules on this head will become more manifest when we remember that it is necessary, in the opinion of many medical practitioners, not only to weaken the pulse when it is strong, but to strengthen it when it has been made weak. Now, although it is obviously good practice to support the strength when the calls upon the nutritive functions have exhausted the economy, it is injurious to diminish by bleeding the nutritive processes themselves, when they are busily engaged in operating on ' Anatomical and Phi/siolngiml Observations. Kdinburp;!!, Svo, 18;)4.