A handbook of local therapeutics / edited by Harrison Allen.

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of local therapeutics / edited by Harrison Allen. Source: Wellcome Collection.

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    exhaustive article on the subject, in von Ziemssen's Therapeutics, makes the following statement: - What I have seen of it (bleeding) has been . incapable of leaving any doubt in my mind that this treatment is seldom and perhaps never imperative. It is far different from local depletion Two forms are yet in vogue, viz., leeching, and scarification with cupping Leeching.—TX-i^ use of leeches is indicated when it is desired to ab- stract blood from localities which, from their position, or from excessive tenderness, makes it difficult to be operated upon by the knife. In order to imitate as near as is practicable the conditions under which these ani- mals secure their food, the skin over the selected locality should be care- fully cleansed, especially should all traces of soap be removed, and of such pungent medicaments as turpentine, liniments, etc., otherwise the animals will refuse to bite. A little blood or milk smeared upon the skin will often induce leeches to take hold. Medicinal leeches are of two kinds, the Swedish and American. The former are much the more power- ful and, at least in the treatment of adults, are, as a rule, preferred. Each abstracts from one-half ounce to an ounce of blood. The American leech is one-sixth the strength of the European. Where a number of leeches are to be applied, as over the abdomen in nervous persons, where each bite causes alarm, the leeches may be placed in a half tumbler of cold water, and by an adroit movement the tumbler may be inverted on the part and the leeches will attach themselves rapidly; the water maybe drained away and caught in a pledget of absorbent cotton. It is not uncommon for leech bites to continue bleeding. This bleeding may be controlled by pressure, Monsel's solution on cotton, styptic cotton, or, if these fail, by the application of the actual cautery. Leeches should not be applied where the skin is delicate or loose, as on the eyelids or scrotum. They are often employed with great advantage in the early stage of Peri- TONiTis. The application of a dozen Swedish leeches over the distended and tender abdomen, followed by hot poultices, will frequently be fol- lowed by the most happy results. In Acute Synovitis of the knee joint, accompanied by much pain and throbbing, the application of half a dozen leeches will often be of service, and will assist in cutting short an attack which, under ordinary circumstances, might be of long duration. In Prostatitis, accompanied by pain and throbbing, the application of a few leeches to the perineum, in conjunction with other remedies, is often productive of good results. It has been advised by some authorities to apply the leeches to the anterior wall of the rectum, but this requires unusual skill in dealing with these animals. Cupping.—This mode of securing a local loss of blood is now rarely used, and since, in order to make it efficient, it involves a previous scarifi- cation of the skin, the reader is referred for its consideration to works on minor surgery.