On the comparative value of bloodletting and purging in the early stage of the acute hydrocephalus and on the extent to which each of them should be carried / by Alexander Harvey.

  • Harvey, Alexander, 1811-1889.
Date:
1859
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Licence: Public Domain Mark

Credit: On the comparative value of bloodletting and purging in the early stage of the acute hydrocephalus and on the extent to which each of them should be carried / by Alexander Harvey. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    recoveries fixnn head affections of the most alarming aspect take place under the use of very strong purging, than under any other mode of treatment. In most of these cases, indeed, fall and repeated bleeding had been previously employed, but without any apparent effect in arresting the symptoms.* 3. Dr. Watson, unfortunately, does not give his opinion on this subject with his wonted clearness, or at least with such precision as could be wished. After speaking of bloodletting, and stating that the first bleeding should be a sufficient one—should produce some decided and manifest impression—he goes on to say, Next in rank and importance to bleeding, if not even before it, come pur- gatives. He also quotes with approbation the observation of Dr. Abercrombie (given above) as to the special efficacy of purga- tives in all the forms of the disease, and clogs his recommen- dation of bloodletting with so many cautions, as to leave it to be inferred that he enjoins its employment to a degree considerably short of what can properly be regarded as full or free. And he concludes by saying— Upon the whole, I believe it will be found that they who have had the most ample experience of this perilous disease, have' ended with the conviction, that moderate local depletion, and the regulated exhibition of mercury in small doses [as a purgative chiefly], afford generally a better chance of success than the large bleedings, and the full and frequent doses of calomel, which have sometimes been recommended.t II. In now proceeding to hazard some remarks on the state- ments that have been adduced, it may be premised that the discussion will turn entirely on the answers to be given to these two questions—fo'st, What is the comparative value of bloodlet- ting and purging? and, secondly, What is the extent to which each of them should be carried ? Before entering on this discussion, we think it of consequence to make one preliminary observation. Since the publication of the statements to be brought under review, and likewise of others to be referred to in connection with them, a conviction has for some time been forcing itself on the minds of many, and indeed is now widely entertained, with regard to the acute inflammations generally, that of late years a change has taken place in their type or character, and that now they neither require nor admit of the same active treatment as in former years. In this conviction we participate fully. But we shall pursue the discussion inde- pendently of it, and afterwards consider how far the conclusions arrived at demand qualification on this ground, adding merely at present, that it will apply less to the conclusions themselves than * Pathological and Practical Kesearches on Diseases of the Brain and the Spinal Cord, 3d edit., p. 153. t Lectures on the Principles and Practice of Physic, 3d edit., vol. i., p. 442 (Lect. xxvi).