SECT. II.
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.