Intermittent Fevers, uncomplicated with cerebral affections, or with inflammation of some important viscera, rarely, if ever, require the use of the lancet; when, however, these complications are either present originally, or arise during the progress of the attack, abstraction of blood is indicated, but this may often be equally, if not more advantageously, effected by leeches or cupping than by general blood-letting. The practice originally proposed by Dr. Mackintosh, of bleeding in the cold stage, has met with supporters in Twining and other good authorities; but, on the other hand, it has been found repeatedly to fail, and has now justly been abandoned. 3002. In Small-pox, Measles, and Exanthemata generally, when uncomplicated, no necessity whatever exists for the use of the lancet. An airy room, mild diaphoretics, an occasional aperient, and sponging the body with cold or tepid vinegar and water, is generally sufficient. When complications, especially of the lungs, supervene, the question of blood-letting arises; but, in the majority of cases, all that is required is better effected by leeches than by the lancet. In Scarlatina Anginosa, leeching the throat often affords great local relief. 3003. In Puerperal Fever, Puerperal Peritonitis, &c, it is diffi-cult to form a correct estimate of the value of blood-letting, its applicability, or indeed its admissibility, depends upon the peculiar character of the epidemic, and the state of the patient: in some cases it has proved the sheet anchor, whilst in others it has appeared useless, if not decidedly injurious. For many years past, observes Dr. Churchill,t it has been found either inadmissible or injurious in the cases we have had in Dublin. The type of the disease, and the state of the patient, not only prohibited the use of the lancet, but indicated very clearly the necessity of a line of treatment very different, if not the opposite. In all cases, moreover, when bleeding is admissible, the period of its beneficial use is very limited; after the first twelve or twenty-four hours, little benefit appears to accrue from it. Having premised thus much, we may mention the treatment which ordinarily has proved successful. If the pulse be firm, a large quantity of blood may be taken from the arm. Dr. Gordon recommends from twenty to twenty-four ounces at the beginning, and repeated, if necessary. Dr. Ashwell considers Dr. M. Hall's method of placing the patient upright, and bleeding to incipient syncope, of great value in puerperal Peritonitis. Should any circumstances forbid a repetition of the venAe-section, a number of leeches (from sixty to a hundred - Campbell) may be applied to the abdomen; and when these fall off, the abdomen should be fomented, or covered with a light bran poultice. The fomentation or poultice may be repeated, at intervals, as it has a very soothing effect. After this, Mercury, Opium, and Antimony, variously combined, form appropriate internal remedies. (Churchill.)

* Dis. of India, 1860, p. 123.

Midwifery, p. 588.