Excerpt from On the Curative Effects of the Abstraction of Blood: With Rules for Employing Both Local and General Blood-Letting in the Treatment of Diseases
This observation applies in a particular manner to those diseases for which medicine possesses what is called a specific remedy. In treating these diseases, much depends on the state of general health in the individual before such specific medicines are administered. From want of such care, how often do we hear of the different preparations of mercury, bark, and iron, disagreeing with particular patients? In almost every instance this will be found to arise from some part of the alimentary canal being in a deranged state, which state ought to have been corrected previous to administering the specific remedy. The most useful medicines often fall into disrepute from want of such attention, whilst under other circumstances the dose must be changed, as well as the form of administering it. I do not mean to affirm that there are no individuals with whom particular medicines disagree. On the contrary, there are persons in whom cinchona, mercury, iron, and even milder drugs, as rhubarb, senna, and many saline medicines, have a decidedly pernicious effect. Such instances, however, are only to be considered as exceptions.
Diseases, I have already remarked, assume an infinite variety of character, not only in persons of different ages and constitutions, but also in people living in different districts of a country, and in different ranks of society. The limited observations, therefore, which are made on the treatment of patients in the wards of an hospital, have often had the imputation of being incorrect from the same remedies having been used with very different effects in other classes of the community. I have often heard medical men, whose practice has been confined to one class of persons, such as soldiers or sailors, and who have acquired great expertness and skill in treating that particular class - I have often heard such practitioners remark, how different were the systems which they found it necessary to pursue when they were called on to treat the diseases of other classes of individuals, particularly those of women and children, and such of the poor as are habituated to intemperance, and irregular habits of life.
I cannot dwell too strongly on the importance of this subject, as I think it may be distinctly traced that many errors in the treatment of diseases have arisen from one set of practitioners being accustomed to act with greater energy than is necessary, and following indiscriminately a particular system, and another who, from seldom seeing the more violent forms of disease, practise with timidity and indecision.
These observations, while they may be applied to the use of any remedy, are yet particularly applicable to that now under consideration, as there is no means more generally used, and more decided in its effects, than the abstraction of blood; and yet there is no point on which you will find greater diversity of opinion, and fewer distinct rules laid down, both as regards the circumstances and extent to which it should be employed.
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