On the treatment of the hemorrhagic diathesis / by James Miller.

  • Miller, James, 1812-1864.
Date:
[1842]
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of the hemorrhagic diathesis / by James Miller. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    we think, is our most trust-worthy item of local management An irritant applied at some distance from the bleeding-point, how ever, so as rapidly to excite a superficial inflammation on a com paratively unimportant part, might not only obtain the desire' increase of fibrin in the general mass of blood, but also have derivative effect on the actual source of the hemorrhage, and S' fulfil a twofold indication towards its arrest. This plan, there fore, of directly amending the proportion of the fibrin, seems bot‘ feasible and safe, and consequently worthy of trial. And, on th principle of revulsion, is it not possible that dry cupping, employe at some distance from the bleeding point, might have the effec of at least diminishing the hemorrhagic flow ? But, turning from such direct interference with the fibrin, ban we any means by which, no matter how, ice can promote satisfa■ tory coagulation of the blood, and thereby use them as hsemostn tics? Acetate of lead with opium, given internally, has long bee famous in this respect, and that not undeservedly. Dr Eliiotsc has shown that the lead can be given in heroic doses, and e\„ for a considerable time, without any untoward result,1 with ti simple precaution of keeping the bowels freely open—an indie tion which we will find to be otherwise of much importance the treatment of the hemorrhagic diathesis. As a general astri gent, according to Dr Christison, “ no remedy yet known, equa in efficacy the•■pilulesplumbi opiatoe of the Ed. Ph.; each of whir contains 8 grs. of the acetate of lead, and half a grain of opium and of which, from two to six may be given in the course of til day, according to the urgency of the symptoms.”2 This remedy doubtless has the power of calming the genei circulation; probably it increases the tendency of the blood coagulate; plainly it has a depressing influence on the nervo ; system, and we know that this “ favours coagulation of blood l <, the vessels;”3 4 besides, there is good reason to believe that a tom dj or astringent effect is exerted by it on the capillaries themselvt and thus it justly maintains a claim to our attention as a va able means of combating the hemorrhagic diathesis. In the gre f majority of cases, it can be given freely with perfect safe ,, Should it be found to disagree, it may be conveniently superse e ed, at least for a time, by the sulphas alumina? et potassa?, doses of 15 or 20 grains and upwards—a powerful, and in cases safe astringent.4. Nauseating remedies will moderate the heart's action, and they so to have besides a powerful effect in arresting hemorrhage. H during sickness tendency to firm coagulation of the blood i creased, is a fact well attested by experience. Thus it is p 1 Lancet, No. 310, p. 607. 2 Dispensatory, p. 70ft. 3 Carpenter’s Physiology, p. 476. 4 Dr Lynch, Frov. Med. and Surg. Journal, May 29, 1841, p. 162.