Handbook of the science and practice of medicine / by William Aitken.

  • William Aitken
Date:
1858
Catalogue details

Licence: Public Domain Mark

Credit: Handbook of the science and practice of medicine / by William Aitken. 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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    of the remedy once, imagine that when again attacked with inflam- mation they may be again relieved by its use. Accordingly they anxionsly desire the remedy, when seized by an apparently similar attack. Of any one of these illustrious examples from personal I experience, it might be said, as Dr. Gregory said of Dr. Radcliffe, that he was at least no fool; and we may depend upon it he would not have allowed a hundi-ed ounces of blood to be taken fi-om him in one day without good reason for it {Eclin. Med. Jour., March, 1857). Although much has been done, writes Dr. Alison, particularly by the French pathologists, to enable us to judge of the texture within the chest which is the subject of idiammation, and although this is a matter of real importance, because we know that the history of the changes to be expected fi-om inflammation in the bronchise, substance of the lungs and pleura, is materially different, and of course the diagnosis of these gives us a great advantage in studying the progress of any individual case,—yet as to the specific questions of blood-letting or not, the quantity, or the repetition of the blood-letting, our predecessors were very nearly as well informed as we are.%It is an i|pportant practical error, he also con- tinues, to fix the attention, p^-ticularly of students of the profession, too ; much on those characters of disease wh^q^ are drawn fi-om changes of structure ah-eady effected, and to trust too exclusively to these as the diagnostics of different diseases; because, in many instances, these characters are not clearly perceptible untH the latest and least remediable stage of diseases. The very object of the most important practice, more- over, in many cases, is to prevent tie occurrence of the changes on which these lesions depend. After these lesions are once estabhshed, the cases are very often hopeless, or admit only o^ palliative treatment. In those diseases in which most can be (Jone by art, our practice must always be guided in part by conjecture, because, if we wait for certainty, we very often wait until the time for successful practice is past; and ther^re, I although an accurate knowledge of the whole history of each disease is I essential to its proper treatment, yet, in a practical view, the most im- ! portant part of its history is the assemblage and succession of symptoms., by ' which its nature at least, if not its precise seat, may often be known, before j any decided lesion of structure has occurred. Accordingly, when this i department of pathology is too exclusively cultivated, the attention of students is often found to be fixed on the lesions to be expected after death, more than on the power and application of remedies, cither to con- trol the diseased actions, or relieve the symptoms, durmg life. The immediate effects of loss of blood as a remedy in inflammation are—^1.) A sedative result on the heart's action, by diminishing the ] quantity and altering the quality of the blood, tlie withdi-awal of a '■ considerable amoiuit of stimulus from the central organ, and the r depressing effect of sudden loss of blood, the excitability of the i nervous system being tlius reduced. (2.) The loss of blood generally has a derivative influence upon the blood in the jiart about to