because we can easily perceive that diseases are, in most cases, but indirectly attacked, leaving its focus untouched. Copeland says, the morbid state of the vascular system, and of the fluid circulating through it, must be imputed, in a large proportion of cases, to changes produced primarily on the organic nervous system, which is, anatomically, most intimately connected, not only with the circulating system, but also with the organs essentially vital. This connection subsisting by ramifications pro-. ceeding to them both directly and obviously, either from the great central ganglion, or from appropriate subordinate ganglia, as well as indirectly, and less appropriately through the medium of the blood vessels, on which the organic nervous system is every where profusely distributed, the one accompanying the other throughout the frame. Thus intimately interwoven, they experience reciprocative changes, and generate a common influence. The vital organs, as well as their subordinate parts, in the more perfect animals, being applied by both those systems,— the most rudimental type and essential requisites of organization, and actuated by their common influence, are thereby enabled to perform their destined functions, the superadded or peculiar organization of each organ being the instrument which, thus actuated, performs specific affairs in the economy.

It results from this:-1st, that we are not justified in considering changes in the states of vascular action, or in the relation subsisting between the vessels and the quantity

or quality of the fluids circulating in them, apart from the condition of the organic nervous system, which is thus intimately connected by structure and function, both with them and all vital organs. 2d, that changes in the vascular.. system are very often induced by impressions made primarily upon the organic nervous system. And 3d, that, upon tracing the procession of morbid phenomena, the first impression made by the exciting cause, and earliest change from the healthy state, will be found in the func tions of this system of nerves, in perhaps the larger proportion of cases, etc., and the secreting and assimilating functions being very soon afterwards disordered.

Within a few years past, says Dr. Pancost, the in fallible existence of either acute or chronic inflammation in nearly all derangements of the system, has become more problematic, and the attention of physicians has been much turned towards the part which the nerves play in the production of diseases. The respective publications of Messrs. Teule and Tate, with which the public has lately been favoured, have produced much good (?) by oxemplifying, in the strongest manner, the visceral disorders which may be maintained by focal irritation, or inflammation in the different masses of the nervous system,, and.. especially in the spinal marrow.

Having now before us the results of multiplied experiments on the nervous system, which, as none can doubt,

*A treatise on the structure, functions, and diseases of the human sympa. thetic nerve, by Lobstein, translated from the Latin, with notes, by Joseph Pancost, M. D.

must be regarded as the main spring of health and dis

ease.

It is surprising that even the most enlightened of the profession still persist to hold forth error as truth, trotting along like merchants of Bristol*-a dangerous road, when a better way is opened before them.

Most of our eminent men confess that medicine, as it is, is but a mass of crude amorphous materials. "Medicine," says Dr. Cowan, the author of Dr. Louis' numerical system, (!)" for many evident reasons, has been, and continues to be, the victim of varied and contradictory hypotheses.

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Abercrombie says: A considerable number of medical doctrines will come out, on examination, in rather an unsatisfactory manner, and yet even those very men (so strong is habit) slide on slippery ways which they wish. others to avoid, and commit the same error they pointed

out.

It is not so very far out of the way, when a modern writer says, "that man is but a bundle of habits.”

Bleeding, impartiality constrains me to say, cannot always be dispensed with, especially in inflammations of the lungs and heart; but in most cases we fear that nervous irritation is mistaken for inflammation, in which bleeding and purging very often destroys life.

Formerly the merchants of Bristol had no place for meeting but the street, open to every variety of weather. An exchange was erected for them, with convenient piazzas, but so rivetted were they to their accustomed place, that, in order to dislodge them, the magistrates were forced to break up the pavement, and to render the place a heap of rough stones, »

The morbid effects of large depletions has been well illustrated by the experiments of Dr. Seeds, Dr. M. Hall, and Mr. Piorry. Copeland says-There are two impor tant considerations which should not be overlooked in practice, viz: that in many diseases apparently attended. with excitement, we shall meet with cases in which the actual quantity of blood in the body is much less than úsual; and in various others, blood letting will often not be borne, although seemingly indicated, and although the quantity of blood in the frame be not lessened. In illus tration of the former of these, I may state, that many years ago, I had an opportunity of remarking minutely the appearances on dissection of a man of middle age, and somewhat fat, who had complained of an acute and painful disease, obviously functional, for which he had been blooded only twice on successive days, and on neither occasion to above thirty ounces; and yet the symptoms of excessive loss of blood appeared, from which he died in twenty-four hours after the second depletion.* The most careful examination could detect no organic change, excepting the remarkably bloodless and pale state of the. viseera. Even the brain was less vascular than usual. That in various diseases, unattended by diminution of the circulating fluid, depletion will produce marked symptoms of depression and sinking, owing to the state of

*1 recollect the case of a lady of about forty-five years of age, on the continent of Europe, who was bled for shortness of breathing, when scarcely ten ounces of blood had been taken, she fainted and expired. Such cases are of rare occurrence, still they may happen: they should teach us to be cautious.

the vital powers being insufficient to accommodate the vessels, by their tonic or vital contraction to the reduced bulk of the blood, is well known-c. g. Adynamic fevers, erysipelas, and puerperal fevers, in which, as well as in puerperal mania, and various other acute diseases, large vascular depletion is often most injurious.

The morbid effects of large depletions will necessarily vary with the nature of the disease in which they are employed. When carried too far, in cases of excitement, whore the nervous or vital power is not depressed, and the blood itself rich or healthy, reaction generally follows each large depletion, and thus often exacerbates or brings back the disease for which it was employed, and which had been relieved by the primary effects of the evacuation. This is more remarkably the case in acute inflammations of the internal viscora, particularly of the brain, or its membranes. Thus, every observing practitioner must often have noticed, that a large depletion, when carried to deliquium, will have entirely removed the symptoms of acute inflammation when the patient has recovered consciousness; and that he expresses the utmost relief. But it generally happens, that the inordinate depression-the very full syncope that is thought essential to the securing of advantage from the depletion,-is followed by an equally excessive degree of vascular reaction with which

*

2

*No organ bears blood letting better than the lungs, with others, as that of the brain, stomach, intestines. I have often noticed the patient fall in a state of sinking or collapse, when but a small quantity of blood was taken.-Edit.