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the oid school. What other means has he to conquer acute maladies with. Seize

upon the lancet, leeches, and calomel, and his main sources are cut off. Thank God, Homeopathy has tracod a safer road.

I will not enter into minutiæ. Suffice it to say, that Broussais's loech practice has bled thousands into the grave.

How great the authority of Broussais once was, is well know?). It is now on the wane. *

Local bleeding, I am well awarè, is much recommended in inflammatory discases of children.

It is generally understood that tho great irritability of children inclincs them to those maladies which make the application of lecches essential.

I am not favorably disposed to the theory of irritation, and therefore am neither friendly to the lancet nor to the leeches.

it has fallen to my lot, says Professor Dunglison, to witness some alarming cases of exhaustion, especially in children, where leeches have been applied. In two

*The following statistic table will confirm the assertion of the diminished success of the Broussaisian doctrines. In 1823, France still exported leeches io the number of more than a million. After this, she exhausted not only her own supply, but also that of England, Germany, and Hungary, and has even drawn them from Moldavia and Wallachias

Import.

Export. . 1820

1,157,920 1823. ...320 000.

..1,188,855 1827 -33,634,494.

190,950 1833 . 41,654,300.

.868,650 1834. .. ..21,885,465.

...868,650 I should like to see a calculation of the pills used in the United States for one year only,

cases, indeed, the result was fatal. In both cases, due

wwuum of blood was lost before the cause of the sinking was discovered ; and in one of them overy attempt to arrest the flow of blood failed. These cases are rare, but they constitute objections to the use of leeches, which do not apply to cupping (?) (we doubt that cupping can fill up the place of leeching) the flow from the wounds made by the scarificator being readily arrested.

When leeches are applied to soft parts, -for example, to the abdomen, it is truly astonishing (!) how much blood sometimes is detracted; praticularly when a poultico is applied over the bites, and the patient is kept warm in bed. This is more likely to occur in children than in adults. On this account, leeches should never be applied : late at night on children. (The advice is a good one; but in cases of urgency, neglect will kill the little patient, and the allopathic physician has no better means at hand than leeches.)

Blisters, Setons, Cauteries, Ointments. The great extent of the tegumentary membrane, the manifold functions which it performs, render it an im. portant consideration in relation to health, and in disease.

Studied under tho two-fold point of view of conforma. tion and structure, the tegumentary membranes of the outer surface, and of the inner passages of the body, have characters which are common almost in their whole extent.

T2

234

THEORY AND PRACTICE

moastvo,

The groater number of the exanthemous inflammation,

mottles

atr., Igava Ranens *\ -*. divisions of the togumontary membranes simultaneously. The runnings of the eyes, the nasal, laryngeal and tracheal catharrhal affection of measles corresponds to the exanthema of the skin, which characterizes the diseases on the general surfaco, and the matter secreted by the bronchi presents a poculiar character in relation with the species of inflammation which is going on. In scarlatina, the mucous of the mouth and pharynx, almost always,--and that of the stomach and intestines, occasionally, presents a dotted redness altogether analogous to that which is observed upon the surface of the skin. The eruption in this disease is followed by desquammation of the cuticle, and the mucous membranes, furnished with an epithelium, cast this pellicle off in a precisely similar manner,

The observation of Heberardt have shown that the skin may become changed into a mucous membrane, and this, in its turn, into external integument, under certain circumstancos. In fact, when any portion of the outer surface of the body is, for a long time, subtracted from the influence of the atmosphere, as during the treatment of certain fractures, when the leg is kept for many weeks bent upon the thigh, and, the intugements of the femoral and crural portion in the region of the twist of the knee are

*1 reatise on the Diseases of the skin, by P. Rayer, M. D,

tHeberard, memoire sur l'analogie qui existe entre les systemes muquent Ol dermoide.

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maintained in contact; and in the folds of the skin of very luoty infants. WA SAA that the cutieule softens and disappears, and that the surface of the skin ends by secreting mucous exactly like a mucous membrane. On the other hand, we know that in old cases of prolapsus of the uterus, and of the anus, the mucous membranes of the intestines become thickened and dry, and by degrees acquire every appearance of the skin. From this hasty sketch of the internal and external integuments of the body, it is easy to perceive that they bear a great analogy to one another. Observation has taught us, (says Beclard*), that a healthy state of the skin coincides with that of the mucous membrane, Persons of a delicate whitish skin are very apt to suffer under morbid secretions of the skin and mucous membranes, and on many other diseases which affect both membranes at the same time.

Even Hippocrates know that an increased secretion of the mucous membranes proceeds from a diminished cutaneous secretion.

Every one knows that a checked perspiration, or other morbid impression on the surface of the body, will lead to diseases of the lungs, stomach, intestines, kidneys, bladder, etc.

Females ought to be particularly careful, being more liable to inveterate maladies through improper treatment of the skin.

*Etemons d'anatomie generale, par A. P. Beclard.

The intimate connection, sympathetic relation, or contact between external and internal parts. The great sensihilityand susceptibility of the skin to inimical impressions, it seems to me has never been duly appreciated by the practitioners of the old school. Were it otherwise, it could not have escaped their notice, that this hodge podge business of plastering, blistering, cauterisation, removing or repelling itch, or other cutaneous inaladies, by irritating ointment, can have no other but an injurious tendency to the system.

In the fullest conviction of the truth of this assertion, I will quote the following examples.

The inflammation of the skin, (says Prof. Dunglison,) caused by vesicants, is occasionally attended with fatal consequences. It is of the erysipelatous kind, and under particular circumstances--as regards age, condition of the system, etc., the inflammation eventuates in gangreno and doath.

In very young children, great irritation is apt to be induced by blisters; and if the child be labouring under any eruption of the skin,-such, for instance, as is present in measles or scarlet, the inflammation

may

terminate unhappily. We can hardly imagine an occurrence more disagreeable to the philanthropist, than that of a patient dying in consequence of the application of an agent from which he expects a curo, or at least a mitigation of the symptoms. Great caution is therefore necessary in the use of these agents in very early life, especially in the

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