Volume 4 — A DEFENCE OF BLOOD-LETTING AS A REMEDY FOR CERTAIN DISEASES. (continued 2)

I do not mean to insinuate that bleeding is a new remedy in parturition. It has long ago been advised and used in France, and even by the midwives of Genoa, in Italy, but never, in any country, in the large quantities that have been recommended by Dr. Dewees, that is, from 20 to 80 ounces, or until signs of fainting are induced, nor under the influence of the theory of parturition, being a violent disease.

But the advantages of this remedy are not confined to lessening the pains of delivery. It prevents after pains; favours the easy and healthy secretion of milk; prevents sore breasts, swelled legs, puerperile fever, and all the distressing train of anomalous complaints that often follow child-bearing. Dr. Hunter informed his pupils, in his lectures upon midwifery, in the year 1769, that he had often observed the most rapid recoveries to succeed the most severe labours. The severity of the pains in these cases created a disease, which prevented internal congestions in the womb. Bleeding, by depleting the uterus, obviates at once both disease and congestion. Its efficacy is much aided by means of glysters, which, by emptying the lower bowels, lessen the pressure upon the uterus.

Let it not be inferred, from what has been said in favour of blood-letting in parturition, that it is proper in all cases. Where there has been great previous inanition, and where there are marks of languor, and feeble morbid action in the system, the remedies should be of an opposite nature. Opium and other cordials are indicated in these cases. Their salutary effects in exciting the action of the uterus, and expediting delivery, are too well known to be mentioned.

I have expressed a hope in another place[64], that a medicine would be discovered that should suspend sensibility altogether, and leave irritability, or the powers of motion, unimpaired, and thereby destroy labour pains altogether. I was encouraged to cherish this hope, by having known delivery to take place, in one instance, during a paroxysm of epilepsy, and having heard of another, during a fit of drunkenness, in a woman attended by Dr. Church, in both of which there was neither consciousness, nor recollection of pain.

2. During the period in which the menses are said to dodge, and for a year or two after they cease to flow, there is a morbid fulness and excitement in the blood-vessels, which are often followed by head-ach, cough, dropsy, hæmorrhages, glandular obstructions, and cancers. They may all be prevented by frequent and moderate bleedings.

3. It has been proved, by many facts, that opium, when taken in an excessive dose, acts by inducing a similar state of the system with that which is induced by the miasmata which bring on malignant and inflammatory fevers. The remedy for the disease produced by it (where a vomiting cannot be excited to discharge the opium) has been found to be copious blood-letting. Of its efficacy, the reader will find an account in four cases, published in the fifth volume of the New-York Medical Repository.

4. It is probable, from the uniformly stimulating manner in which poisons of all kinds act upon the human body, that bleeding would be useful in obviating their baneful effects. Dr. John Dorsey has lately proved its efficacy, in the case of a child that was affected with convulsions, in consequence of eating the leaves of the datura stramonium.

5. It has been the misfortune of diabetes to be considered by physicians as exclusively a local disease of weak morbid action, or as the effect of simple debility in the kidneys; and hence stimulating and tonic medicines have been exclusively prescribed for it. This opinion is not a correct one. It often affects the whole arterial system, more especially in its first stage, with great morbid action. In two cases of it, where this state of the blood-vessels took place, I have used blood-letting with success, joined with the common remedies for inflammatory diseases.

6. In dislocated bones which resist both skill and force, it has been suggested, that bleeding, till fainting is induced, would probably induce such a relaxation in the muscles as to favour their reduction. This principle was happily applied, in the winter of 1795, by Dr. Physick, in the Pennsylvania hospital, in a case of dislocated humerus of two months continuance. The doctor bled his patient till he fainted, and then reduced his shoulder in less than a minute, and with very little exertion of force. The practice has since become general in Philadelphia, in luxations of large bones, where they resist the common degrees of strength employed to reduce them.

In contemplating the prejudices against blood-letting, which formerly prevailed so generally in our country, I have been led to ascribe them to a cause wholly political. We are descended chiefly from Great-Britain, and have been for many years under the influence of English habits upon all subjects. Some of these habits, as far as they relate to government, have been partly changed; but in dress, arts, manufactures, manners, and science, we are still governed by our early associations. Britain and France have been, for many centuries, hereditary enemies. The hostility of the former to the latter nation, extends to every thing that belongs to their character. It discovers itself, in an eminent degree, in diet and medicine. Do the French love soups? the English prefer solid flesh. Do the French love their meats well cooked? the English prefer their meats but half roasted. Do the French sip coffee after dinner? the English spend their afternoons in drinking Port and Madeira wines. Do the French physicians prescribe purges and glysters to cleanse the bowels? the English physicians prescribe vomits for the same purpose. Above all, do the French physicians advise bleeding in fevers? the English physicians forbid it, in most fevers, and substitute sweating in the room of it. Here then we discover the source of the former prejudices and errors of our country-men, upon the subject of blood-letting. They are of British origin. They have been inculcated in British universities, and in British books; and they accord as ill with our climate and state of society, as the Dutch foot stoves did with the temperate climate of the Cape of Good Hope[65].

It is probable the bad consequences which have followed the indiscriminate use of the lancet France, and some other countries, may have contributed in some degree to create the prejudices against it, which are entertained by the physicians in Great-Britain. Bleeding, like opium, has lost its character, in many cases, by being prescribed for the name of a disease. It is still used, Mr. Townsend tells us, in this empirical way in Spain, where a physician, when sent for to a patient, orders him to be bled before he visits him. The late just theory of the manner in which opium acts upon the body, has restrained its mischief, and added greatly to its usefulness. In like manner, may we not hope, that just theories of diseases, and proper ideas of the manner in which bleeding acts in curing them, will prevent a relapse into the evils which formerly accompanied this remedy, and render it a great and universal blessing to mankind?

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