It is a common notion that bleeding in the feet draws the humours downwards, and consequently cures diseases of the head and other superior parts: but we have already observed that, in all topical affections, the blood ought to be drawn as near the part as possible. When it is necessary, however, to bleed in the foot or hand, as the veins are small, and the bleeding is apt to stop too soon, the part ought to be immersed in warm water, and kept there till a sufficient quantity of blood be let.
We shall not spend time in describing the manner of performing this operation: that will be better learned by example than precept. Twenty pages of description would not convey so just an idea of the operation as seeing it once performed by an expert hand. Neither is it necessary to point out the different parts of the body from whence blood may be taken, as the arm, foot, forehead, temples, neck, &c. These will readily occur to every intelligent person, and the foregoing observations will be sufficient for determining which of them is most proper upon any particular occasion. In all cases where the intention is merely to lessen the general mass of blood, the arm is the most commodious part of the body in which the operation can be performed.
OF INFLAMMATIONS AND ABSCESSES.
From whatever cause an inflammation proceeds, it must terminate either by dispersion, suppuration, or gangrene. Though it is impossible to foretel with certainty in which of these ways any particular inflammation will terminate, yet a probable conjecture may be formed with regard to the event, from a knowledge of the patient’s age and constitution. Inflammations happening in a slight degree upon colds, and without any previous indisposition, will most probably be dispersed; those which follow close upon a fever, or happen to persons of a gross habit of body, will generally suppurate; and those which attack very old people, or persons of a dropsical habit, will have a strong tendency to gangrene.
If the inflammation be slight, and the constitution sound, the dispersion ought always to be attempted. This will be best promoted by a slender diluting diet, plentiful bleeding, and repeated purges. The part itself must be fomented, and, if the skin be very tense, it may be embrocated with a mixture of three-fourths of sweet oil, and one-fourth of vinegar, and afterwards covered with a piece of wax plaster.
If, notwithstanding these applications, the symptomatic fever increases, and the tumour becomes larger, with violent pain and pulsation, it will be proper to promote the suppuration. The best application for this purpose is a soft poultice, which may be renewed twice a day. If the suppuration proceeds but slowly, a raw onion cut small or bruised may be spread upon the poultice. When the abscess is ripe or fit for opening, which may easily be known from the thinness of the skin in the most prominent part of it, a fluctuation of matter which may be felt under the finger, and, generally speaking, an abatement of the pain, it may be opened either with a lancet or by means of caustic.
The last way in which an inflammation terminates, is in a gangrene or mortification, the approach of which may be known by the following symptoms: the inflammation loses its redness, and becomes duskish or livid; the tension of the skin goes off, and it feels flabby; little bladders filled with ichor of different colours spread all over it; the tumour subsides, and from a duskish complexion becomes black; a quick low pulse, with cold clammy sweats, are the immediate forerunners of death.
When these symptoms first appear, the part ought to be dressed with London treacle, or a cataplasm made of lixivium and bran. Should the symptoms become worse, the part must be scarified, and afterwards dressed with basilicum softened with oil of turpentine. All the dressings must be applied warm. With regard to internal medicines, the patient must be supported with generous cordials, and the Peruvian bark exhibited in as large doses as the stomach will bear it. If the mortified parts should separate, the wound will become a common ulcer, and must be treated accordingly.
This article includes the treatment of all those diseases, which, in different parts of the country, go by the names of biles, imposthumes, whitloes, &c. They are all abscesses in consequence of a previous inflammation, which, if possible, ought to be discussed; but when this cannot be done, the suppuration should be promoted, and the matter discharged by an incision, if necessary; afterwards the sore may be dressed with yellow basilicum, or some other digestive ointment.