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
Catalogue details

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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    to .the application of them—rather, therefore, to the second than to the first of the questions proposed. 1. In order to estimate aright the comparative value of the two remedies, it is necessary to have a clear perception of their mutual influence on each other's agency, and particularly of the influence of bloodletting in promoting the action of purgatives. Now, on the one hand, it may be confidently asserted, that the antiphlo- gistic effect of general bloodletting is very materially aided by that of copious and repeated watery evacuations from the bowels; and that, once produced, the constitutional effect of bloodletting may be kept up for the time, and to the extent required, at a smaller ultimate expense to the system, by means of purgatives, than in any other way. But, on the other hand, it is equally true, and it is perhaps still more important to keep in mind, that the action of purgatives, and the extent of their operation, are very materially influenced by, and in this particular disease very dependent upon, the previous abstraction of blood. How singu- larly obstinate the bowels naturally are in this disease, every one knows. If, however, bloodletting is early resorted to, and carried to a due extent, the purgatives subsequently exhibited act readily and fi-eely. Nor is it unimportant to direct attention to another kind of influence exerted by bloodletting, in relation to purgatives, in this disease. The stomach is almost uniformly so irritable (so to speak), and especially at the outset, when alone any remedies are of much avail, as to reject everything taken into it. Now nothing will so effectually allay that irritability, and enable the stomach to retain the purgative medicine, as bloodletting. A previous bleeding, Dr. Watson remarks, will often correct this [ii-rita- bility] ; and it is no small part of the benefit derived from the abstraction of blood, that it thus prepares the way for the more effectual operation of aperients. As subservient^ then, to the action of purgatives, bloodletting may be regarded as exceedingly important in this disease; and it may be confidently maintained that, from the known irritability of the stomach and obstinacy of the bowels, purgatives will be of little avail unless bloodletting has been premised. Without it, in the far greater number of cases, purgatives will either not be retained, or, if retained, produce but little effect. Important as these considerations seem to be, it may be ques- tioned whether have been sufficiently attended to, either in actual practice, or in estimating the relative value of the two remedies. But is bloodletting to be looked upon as merely or chiefly an auxiliary to purgatives, and to be carried no further than is requisite to secure their retention on the stomach, and their full action on the bowels? We apprehend not; for if the acute hydrocephalus be an inflammatory disease, our experience of