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Show 190 and practice in fever. Fluctuation of opinion experience to evince that on the onset of inflammation, not erysipelatous, scarcely any prostration of strength or weakness with frequency of pulse, precludes the lancet. Even where it shall be used without success, we can be by no means sure that it ought to bear the blame of the fatal event. The uncertain issue every prudent practioncr will declare to the parties interested, as also that it is the only chance he knows. In case of failure dissection should be pressed.----I"believe that to improve the disposition to contract, which the vessels may acquire underthe operation, cordials ought to be given during the very flow of blood as well as afterwards. Local bleeding should be conjoined. In congestion about the fauces, blood-letting sometimes becomes urgent in the last stage offevcr.""‘ \Vlrere an internal phlegma- kindled strength of pulse, it 191 ought to be treated, without much consideration of the pre- ceding disease, according to its own symptoms. A case already mentioned belongs here. When from the bed on which he is laid, the invalid suddenly beholds spread out before him, in luminous prospect, the scenes of his early years up almost to the very cradle, on which he was rocked as an infant; when he recovers for- gotten languages ; when he suddenly converses with rational vivacity, the heat and pulsations about the head should be examined with aview to cutaneous bleeding, cooling the part, and darkening the room. For an action has proba- bly commenced, which unless checked will reduce the brain to a fatal state of exhaustion. Dr. Ploucquet justly argues against the and that it succeeded-‘r When the swoln parotid glands did not suppurate and the patients were threatened with suflfoca- merely mechanical view of blood-letting. The time, within which a given quantity of blood flows out, every one now understands to be almost of as much importance as the quantity itself. But in respect to place, we still keep too strongly in view the common undivided circu- lating mass of fluid. Had the human animal been constructed with several hearts and indent tion from rapid swelling of the face and distension of the pendent sets of vessels, it would, I dare say, sia arises in the midst of fever with newly kindled * In a fever, in which Darlue expressly says that venaesec, tion dizl not generally succeed (Vandermonde viii. 365), he suhjoins that subsequent inflammations always required it, muscles about the throat, I was forced to recur to bleeding without delay, and sometimes to repeat it the same day. It was not without dread. The pulse was so miserable and the patients so reduced that you would have thought them at the last gasp. The practice succeeded. similar circumstances" p. 369. Riverius employed it in have been delivered as a precept from physio" logy to medicine, that blood should be drawn from the vascular system most irritated. The case is in reality now nearly the same. For different |