206. If Leeches get into the rectum or nostrils, or any of the other passages, they may be dislodged by using an injection of, or by simply touching them with, vinegar or a solution of salt.
207. Leeches should not be applied immediately over a large prominent vein, nor to the eyelids, nor to the bosom of a woman, especially during pregnancy, nor to the loose skin of the penis or scrotum, as the bites in these situations are apt to be followed by infiltration or inflammation.
208. Additional care is necessary in applying Leeches to young children, as they bleed so much more freely than adults; they should, when practicable, be placed where a bone is near the surface, so that in case of excessive bleeding pressure may be made against it. Morning is the best time for their application; if put on in the evening, the bites may burst out bleeding whilst the attendants are asleep, and the child die from hæmorrhage; such cases are on record. As a general rule, one Leech is sufficient for each year of a child's age up to six; after that age up to adolescence, the latter number continues to be enough in ordinary cases.
209. In Fevers attended with much Headache, Leeches are very useful, but they should only be applied in the early stages of the disease; when the patient is young and vigorous, four or six Leeches to each temple may be applied, but they sometimes give most relief if put at the nape of the neck, close to the point where the head joins to the spine. In severe Pain in the Chest or Abdomen occurring during Fevers, eight or ten Leeches applied immediately over the seat of pain often afford manifest relief.
210. In severe Headache, or fulness of Head depending upon the stoppage of a discharge of blood from Piles, Leeches close to the anus frequently afford great relief, but great care is necessary to prevent them creeping up into the rectum. When the Headache depends upon the sudden stoppage of the Menstrual Discharge, the leeches should be applied to the inner part of the thighs.
211. In Acute Dysentery, a few Leeches (six to nine) to the verge of the anus are often most serviceable in relieving the pain and straining at stool, and otherwise prove beneficial. The same measure is also of great service in Congestion of the Liver, or they may be placed over the region of the liver, but a fewer number afford a greater amount of relief when applied to the verge of the anus.
212. In all local Inflammations of the Skin, Incipient Abscesses, Boils, and in Bruises, Sprains, and Blows, where there is much pain and heat of the part, six or eight Leeches, followed by hot fomentations, tend to relieve the pain and cause the subsidence of inflammatory action.
213. Obstinate Vomiting may occasionally be checked by a few Leeches to the pit of the stomach after ordinary means have failed.
214.