Suggestions submitted to the medical practitioners of Edinburgh on the characters and treatment of the malignant cholera / by John Abercrombie.

Date:
1832
Catalogue details

Licence: Public Domain Mark

Credit: Suggestions submitted to the medical practitioners of Edinburgh on the characters and treatment of the malignant cholera / by John Abercrombie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    blood-letting in the state of collapse. When the pa- tient is in the vigour of life, and has been previously in a sound state of health,—when he is seen at a very early period from the commencement of the symptoms of the second stage, while the pulse is still of some de- gree of strength, and especially if there be severe spasms, and much pain or oppression in the epigastric region, it appears that blood-letting may still be prac- tised in many cases, with evident advantage. It seems to relieve an oppression of the circulating system, as is indicated by the pulse becoming stronger under the evacuation, and the patient expressing himself as de- livered from an insufferable load which he felt in the region of the heart. In judging, however, of the be- nefit likely to be derived from it, and the extent to which it ought to be carried, we must keep in view the circumstances now referred to, and are carefully to watch whether the blood becomes of a more healthy colour, and particularly whether the pulse rises in strength under the discharge. But if the period of collapse has continued for several hours, if the patient be of a feeble and broken dow n constitution, and espe- cially in that condition in which the blood can scarcely be made to flow, and is of a very dark colour and broken down texture, it seems to be now considered as extremely doubtful whether blood-letting ought to be employed, or whether it does not rather tend to sink the strength of the patient. In many esteemed works, founded upon the observation of the disease as it appeared in India, we are told that when a patient can be made to bleed freely in this stage of the dis- ease, he almost invariably recovers. But the fact is not to be concealed, that in this country, in a consi- derable number of cases, the patients have bled freely without deriving benefit, but rather appearing to be sunk by the discharge. This may have been owing