Outlines of practice : a handbook of the prognosis and treatment of disease, with formulae / by Samuel Fenwick.

  • Fenwick, Samuel, 1821-1902.
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: Outlines of practice : a handbook of the prognosis and treatment of disease, with formulae / by Samuel Fenwick. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    48/402
    arm, leeched, and blistered, on account of a spitting of blood supposed to arise from the lungs. The most careful examina- tion of the chest failed to detect any pulmonary disease, but on opening the mouth the cause was at once apparent. A fungoid projection of the gum was seen arising from a decayed tooth, and the forceps at once relieved her of the bleeding that the active treatment she had undergone only tended to increase. Where the hemorrhage results from congestion of any organ produced by a disease of the heart or liver, the treatment must be directed to relieve the obstructed circulation. An altered condition of the blood, on the contrary, requires mineral or vegetable astringents to counteract its tendency to transude through the vascular walls. Whenever it is possible you should trust rather to local than general astringents, as they lose much of their efficiency when they have to traverse the circulation before reaching the affected structure. B. It used to be the custom to bleed in all severe haemor- rhages, on the idea that coagulation of the blood at the injured part would be favored by it. This is now seldom practiced, be- cause a slight haemorrhage does not require it, whilst a severe loss of blood of itself sufficiently depresses the action of the heart. In certain cases, as in some hepatic disorders, it may be necessary to deplete the vascular system by saline aperients, but the same objection exists against their use as in some cases of acute inflammation, viz., that their action disturbs the bodily rest which it is so necessary to enforce. As a general rule, your treatment must be directed to the part from which the bleeding takes place, and you should seek either to constrict the walls of the vessels or to favor the coag- ulation of the blood. The use of ice is one of the most power- ful means at your disposal. A bladder or india-rubber bag filled with fragments of it should be placed over the affected organ, and the ice renewed as often as is necessary. Tannic acid or perchloride of iron may be used locally where the