Medical Inquiries and Observations, Vol. 4 / The Second Edition, Revised and Enlarged by the Author

by Benjamin Rush

15. It suddenly cures the intolerance of light which accompanies many of the inflammatory states of fever.

16. It removes coma. Mr. Henry Clymer was suddenly relieved of this alarming symptom, in the fever of 1794, by the loss of twelve ounces of blood.

17. It induces sleep. This effect of bleeding is so uniform, that it obtained, in the year 1794, the name of an anodyne in several families. Sleep sometimes stole upon the patient while the blood was flowing.

18. It prevents effusions of serum and blood. Hæmorrhages seldom occur, where bleeding has been sufficiently copious.

19. It belongs to this remedy to prevent the chronic diseases of cough, consumption, jaundice, abscess in the liver, and all the different states of dropsy which so often follow autumnal fevers.

My amiable friend, Mrs. Lenox, furnished an exception to this remark, in the year 1794. After having been cured of the yellow fever by seven bleedings, she was affected, in consequence of taking a ride, with a slight return of fever, accompanied by an acute pain in the head, and some of the symptoms of a dropsy of the brain. As her pulse was tense and quick, I advised repeated bleedings to remove it. This prescription, for reasons which it is unnecessary to relate, was not followed at the time, or in the manner, in which it was recommended. The pain, in the mean time, became more alarming. In this situation, two physicians were proposed by her friends to consult with me. I objected to them both, because I knew their principles and modes of practice to be contrary to mine, and that they were proposed only with a view of wresting the lancet from my hand. From this desire of avoiding a controversy with my brethren, where conviction was impossible on either side, as well as to obviate all cause of complaint by my patient's friends, I offered to take my leave of her, and to resign her wholly to the care of the two gentlemen who were proposed to attend her with me. To this she objected in a decided manner. But that I might not be suspected of an undue reliance upon my own judgment, I proposed to call upon Dr. Griffitts or Dr. Physick to assist me in my attendance upon her. Both these physicians had renounced the prejudices of the schools in which they had been educated, and had conformed their principles and practice to the present improving state of medical science. My patient preferred Dr. Griffitts, who, in his first visit to her, as soon as he felt her pulse, proposed more bleeding. The operation was performed by the doctor himself, and repeated daily for five days afterwards. From an apprehension that the disease was so fixed as to require some aid to blood-letting, we gave her calomel in such large doses as to excite a salivation. By the use of these remedies she recovered slowly, but so perfectly as to enjoy her usual health.

20. Bleeding prevents the termination of malignant, in the gangrenous state of fever. This effect of blood-letting will enable us to understand some things in the writings of Dr. Morton and Dr. Sydenham, which at first sight appear to be unintelligible. Dr. Morton describes what he calls a putrid fever, which was epidemic and fatal, in the year 1678. Dr. Sydenham, who practised in London at the same time, takes no notice of this fever. The reason of his silence is obvious. By copious bleeding, he prevented the fever of that year from running on to the gangrenous state, while Dr. Morton, by neglecting to bleed, created the supposed putrid fevers which he has described.

It has been common to charge the friends of blood-letting with temerity in their practice. From this view which has been given of it, it appears, that it would be more proper to ascribe timidity to them, for they bleed to prevent the offensive and distressing consequences of neglecting it, which have been mentioned.

21. It cures, without permitting a fever to put on those alarming symptoms, which excite constant apprehensions of danger and death, in the minds of patients and their friends. It is because these alarming symptoms are prevented, by bleeding, that patients are sometimes unwilling to believe they have been cured by it, of a malignant fever. Thus, the Syrian leper of old, viewed the water of Jordan as too simple and too common to cure a formidable disease, without recollecting that the remedies for the greatest evils of life are all simple, and within the power of the greatest part of mankind.