In Acute Inflammation of the Heart and its Membranes, blood-letting was formerly regarded as indispensable; but the practice in this, as in other acute inflammations, has undergone considerable modifications. Dr. Taylor,* after extensive experience, draws the following deductions as to the value of blood-letting in Pericarditis: -
1. The duration of Pericarditis increases in proportion as the time is longer between the commencement of the disease and the first bleeding. 2. The duration of cases bled after the first four days is greater by one-half than of those bled within the first four days from the invasion of the disease. 3. The influence of bleeding is more marked in cases in which it is copiously and repeatedly, as well as early, practised, than in those in which blood is drawn less frequently, and more sparingly. 4. Pericarditis is never extinguished by one bleeding, however early, or however copiously practised. 5. Occasionally Pericarditis is suspended for a limited time, the suspension, in every instance, being immediately consequent upon the local abstraction of blood. 6. It is probable that renal has a longer duration than rheumatic Pericarditis. 7. Blood-letting must be less copious, and is more frequently inadmissible, in renal than in rheumatic Pericarditis. 8. Blood-letting probably lessens the mortality, inasmuch as it lessens the duration of Pericarditis. 9. The abstraction of blood by venAesection, cupping, or leeches, almost invariably relieves the pain at once, but not permanently. There is no reason to suppose that any one form of bleeding relieves pain more effectually than another. 10. Blood-letting never lessens the frequency of the pulse, except when there are signs of the inflammation having abated. 11. The tendency to syncope in some cases of Pericarditis renders it necessary to be very careful in abstracting blood by venAesection. 12. Free venAesection for Pericarditis does not always prevent the subsequent appearance of serious inflammation in other internal organs.