_Of the Effects of Bleeding_
There is, perhaps, not a greater remedy in medicine than bleeding; but
good and effectual as it is, yet I will venture to say, there is none
more pernicious than this, if injudiciously applied. As I value the life
of my fellow creatures, I would at all times caution them against the
injudicious application of this operation, being persuaded, that more
have lost their lives by the lancet, than by the sword, and pestilence
itself. Not to be tedious on this important subject, I shall give here
some very few rules, whereby a patient may be judged in a proper state
for bleeding; and likewise, where that operation ought to be avoided:
for all the service we can possibly hope and receive from bleeding, is
to lessen the quantity of blood, by which the whole body becomes
relaxed, consequently less liable to the inflammatory irritation, that a
too great quantity of blood might occasion; but on the contrary, if the
solids are but weak, and the blood poor, we only augment the evil by
bleeding, which we would wish to remove, as thereby the system becomes
weakened, and not able to disengage itself from the obnoxiousness it is
incumbered with; and thus proves the very destruction it was intended to
remedy. The notion of drawing off the bad blood by bleeding, is very
erroneous and absurd; the whole is too intimately mixed, and will ever
generate the same again till the disease is removed.
_Bleeding is requisite_
1st. When a strong robust person, of a full and sanguine complexion, by
accident receives a heavy contusion; a broken limb; or wound, whereby
the parts become inflamed; a fever like to ensue; and that the pulse
becomes hard and full, the veins distended, &c. &c.
2dly. When such a person receives a great shock, fall, terror, or any
other strong emotion of the mind; whereby the blood becomes rarefied, or
threatens a fever.
3dly. In the beginning of pleurisy, peripneumony, sudden and violent
fevers, great colds, &c. as also scalding, burning, apoplexies,
convulsions, palpitations, suffocations, and all such dangerous violent
disorders; in these cases only bleeding is useful, and then it ought to
be performed immediately, and with great moderation: six or eight ounces
is enough from the strongest man; if requisite, it may be easily
repeated, but if overdone, it is not so easily replenished.
_Bleeding in general is hurtful_
1st. In agues, notwithstanding the violent paroxysm of the hot fit,
because the solids are here too much relaxed.
2dly. In all contagions distempers; this is a circumstance worthy the
greatest attention. Reason and experience prove that bleeding here is
very improper; for by bleeding, the contagious miasmata is drawn only
the more into the whole mass of blood, and this is the fatal stumbling
block, by which thousands have lost their lives. The manner of treating
such distempers with success, I shall shew in its proper place.
3dly. In all old standing diseases, where there is a low, weak, though
quick pulse; for in such cases bleeding is very improper, as the system
is already too much reduced.
4thly. In all dropsies, scurvies, lentors, consumptions, &c. for here
instead of bleeding and lessening the power of the solids, the patient
wants strengthening, and has no blood to spare.
5thly. In all rheumatic and gouty complaints; for here nature must be
assisted in order to throw off what is painful, by such means as will
strengthen the solids, expell what is obnoxious, and prevent it from
returning to the blood, or falling upon some more important part.
6thly. In all venereal cases, particularly if recent; as by bleeding,
the pox will unavoidably be the consequence; as the venereal virus will
be absorbed in the whole mass of blood.
7thly. In all paralytic cases, and such weaknesses where the strength of
the body is already impaired.
8thly. _and lastly_, In the time of other evacuations of the body; as
purging, fluxes, bloody fluxes, &c. and particularly when the body is in
a sweat, or perspiration. From this, I hope, the good and bad effects of
bleeding will be understood in many other cases, which would be too
tedious to mention here; I shall therefore proceed to the operation of
bleeding itself.
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