Phenix gazette. [volume] (Alexandria [D.C.]) 1825-1833, 1825-05-17
IFoy the Phenip Gasette.l

humanity, and greatly oblige many OF your
readers. The facts established by this article
of the evil effects of indscrimnate and repeat
ed bleeding, cannot be too strongly enforced
upon the mind of every practising physician
The writer's of this paper appear to have We
~ inst view of thesubject, and seem to wish,
that every person to whom the lives and health
of VERSIONS are committed, should give the
subject proper attention. MEplCoS'
A very interesting case OF DEATH by
hamilton from spontaneous haemorr-
hage, which suggests some important
reflections. has been recorded by Mr..
Bonnar. A man, aged 81, OF spare
habit, lost, by epistaxis, about three
mounds OF blood. This took place "a
bout the last of August. Yin about ten
DAYS afterwards, as soon as he mad re-
covered his former strength, the bleed
;np required, and continued to do so
till the third of October, when he died. y
The quantity of blood which he lost
was carefully measured by the attend
ants, and was calculated to be upwards
Of thir,y-iye pounds. On examination
after death, the heart and larger YES
sells were found nearly destitute OF
blood. On carefully removing the
ethmoid bone by sewing on each side
Of it, and cutting away the external
parts of the nose. so as to have full
view of its cavity, nothing particular
could be observed. There was no col
lection of coagulated blood; but the
mucous membrane seemed to be consi-
derably thickened more than it usually
is" This fact shows the correctness
of the observation of Laennec respect
ing haemorrhage from the lungs, VIZ:
that the bleeding does not generally a
rise from the evasion or rupture of
small vessel, but from the surface Of
the air cells. Indeed haemorrhage
from the nose and from the branchia!
ramifcations may naturally be expect
ed to possess similar character, when
we consider the identity of surface, and
the relation of function between the
parts from which it is poured out.
In the history Of this case some facts
of considerable importance must be no.
ted, and they ought to be kept in re-
collection during the employment Of
large depletion. "ro the very last the
muscular strength of the patient re-
manned tolerably good. Almost i'm
mediately before death, he could raise
himself in bed; and had it not been for
the oppressive and most painful sick
ness, he would have been capable of a
very considerable degree OF exertlon, at
Il time whennot many ounces OF blood
were circulating in his system" CAT
ter every one of the attacks, the pulse
rose considerably in strength and fire.
uuency. The blood was, in each in
stance, very soon coagulated, but show
ed none Of the buffy coat"
The rising of the pulse after excess
sive bleeding, has been remarked by
many of the best informed Psychologists;
but to the experienced observer, this
excessive action of the arterial system
has particular character, which he
can more readily recognize than des-
cribe. 1t appears, in some measure,
to arise from the vital action of the YES
sells upon their contents, and from the
mode i'll which they accommodate their
calibre to the quantity of blood circu-
lating through them; thus preserving,
(by this action, while their nervous in
fluence is not diminished by any other
sedative influence, as in fever, sc, a
continued supply of blood to support
or to excite the hearts contraction. y
knowledge of the phenomena resulting
from excessive losses ofblood, ought to
teach us that an excited state of arte-
rial pulsation is by no means proof OF
the necessity of depletory measures.
I'm conncxion with the above observations,
the following passage from DR.. Lucas, on the
subject of the circulation, will be read with
peculiar interest, and although apparently
physiological, it will appear to those who re-
feet, more practical than any isolated dog
ma, or single therapeutical precept, because
it conveys an important principle from which
much sound practice may be deduced'"
DR. Lucas conceives arterial action as partly
referable to the mechanical property of the
elastic tunc of the artery, and partly to the
contractile power of its muscular fbres.l
"To bring the elastic principle into
action, for the support of the circula-
ton, with all the effect of which it is
capable, it is necessary that the arteries
should be in state Of forced disten-
ton; by which means a steady and per
manent eXertion of the elastic force will
be kept up for the propulsion of the
blood. That such is actually the state
of these vessels during life and health,
is proved by their admeasurement,
which is found TO exceed considerably
that to which the elastic structure re-
duces them after death. 1t must, in
deed, be evident, that unless more or
less of forced distortion of the vessels