"Shall I bleed him, Sir?"
"Why should you desire to bleed him?"
"Oh! exactly; you prefer cupping?"
"Why should he be cupped?"
"Then shall I apply some leeches?"
This, too, was declined; in short, it never seemed to have occurred that neither might be necessary, still less that either might therefore do mischief.
It is the most curious thing to see the force of a well-grown conventionalism. As long as it led to moderately bleeding plethoric baronets in recent accidents, no great harm would have been done; but the frequency in other cases, in which bleeding was instituted with "apparent impunity," was too commonly construed into "bleeding with advantage," until the practice became so indiscriminate as to be extensively injurious. Now, comparatively, few persons are bled; and some few years ago I had a curious illustration of it.
In a large institution, relieving several thousand patients annually, and in which, a very few years before, scarcely a day passed without several persons having been bled; nearly a month elapsed without a single bleeding having been prescribed by either of the three medical officers.
No doubt many persons are still bled without any very satisfactory reason; but we believe that the abuse of bleeding is much diminished, and that the practice is much more discriminate and judicious. From this, and perhaps other causes, a very important class of cases which engaged the attention of Abernethy, as it had that of Hunter before him, is become comparatively infrequent. When bleeding, however, was practised, with as little idea of its importance as some other of the barber-surgeon's ministrations, on all sorts of people, and in all sorts of disturbed states of health, and probably with no attention at all to the principles which should alike guide the treatment of the largest or the smallest wound; this little operation was frequently followed by inflammation of the vein, nerve, or other contiguous structures. These cases were, most of them, more or less serious, often dangerous, and occasionally fatal.
Taking up the subject where it had been left by Mr. Hunter, Abernethy refers to the cases published in the two volumes of the "Medical Communications," by Mr. Colly of Torrington, and by Mr. Wilson, and then proceeds to give some of his own. It is in this paper that he first moots two questions which have since grown into importance, by an extension of some of the practices to which they refer. We allude to the division of fasciæ, and tendinous structures, and also of nerves in states of disease or disorder.