No Room to Doubt the Propriety of Blood-Letting

in about Warren

To the Publishers of the Boston Evening-Post.

As Life and Health are the basis of all possible enjoyment, and disease every day threatens both, it is no wonder the professors of the art of medicine seem of such importance to mankind, especially when considered that the means of life in their hands if misapplied work quite contrary effects than were either expected or intended.  Hence the quick circulation of a report thro’ the largest city of any notable event respecting the death or recovery of any one under the care of a person whose character is yet unsettled with the people.

That the public should have the utmost satisfaction in such case, none (that can afford it) will deny.  Whenever then it is publicly said that a new Doctor has killed a patient, and broad hints given of his unsuccessful treatment of others, justice to himself and country entitles him to a public vindication.

I being a sufferer and conscious not only of innocence but merit in the case alledged against me, beg leave to give the public a fair relation of the facts, with some obvious reflections on them, and let every one concerned judge for themselves.

A young married woman in this town, from great fatigue, &c. fell into a Pulmonary Phthisis or Consumption of the Lungs, with a very troublesome and fatiguing cough, and fever rising irregularly, sometimes to inflam[m]ation, one Lobe of the Lungs seemed more affected than the other, a[nd] the matter greatly crude and tenacious in both.  I began to treat her with cooling mild attenuants to ripen and expectorate the matter; but by the third or fourth day of my attendance the fever rose to an uncommon height, and a purple redness of the face, laboring of the pulse and respiration, insupportable pain in the side, and other like symptoms, left no room to doubt the propriety of blood-letting, which was administred to the arm of the most affected side, and by intervals 6 or 8 ounces taken away.  Emolients, coolers and gentle anodynes were given, notwithstanding which a considerable haemorrhage from the Lungs happened next day; and sometime after repeating my visit I found the Gentleman who had formerly attended her had called, seen the blood, enquired who had taken it, and being informed, condemned the practice, saying he had never heard of bleeding in consumptions, and so terrified the patient that she gave up all thoughts of life, and to my knowledge took no more medicines. – Would only add, that from the first I signified to her nurse that her case was desperate and scarce the least hope of recovery, nor do I believe the accuser had other sentiments.

The woman in a few days dying, I was every day obliged with the information of my killing her by bleeding, as a matter of just exultation over a mountebank that pretended a secret for the cure of all diseases. –

Being thus accused of killing, and no other means blamed than the bleeding, it may be worth while to enquire a little whether the accuser’s never hearing of bleeding in a consumption be sufficient to fix the charge, or e contra whether it may not betray a want of knowledge in the accuser.

The causes of a Phthisis Pulmonalis (says the incomparable Boerha[a]ve, Aphorisra 1198) may be referred to that disposition of body by which persons are first liable to an haemoptysis and then to an ulcer of the eroded part.

If a disposition to an haemoptysis or flowing of blood from vessels burst in the Lungs is never to treated with bleeding: Quere, What is?

[Dr.] Pitcairn says, B. II. §11.  Since herein fear is left the stagnant blood should produce an inflamation, an abscess and an ulcer, a vein is to be opened unless the patient has been sunk too much in his strength already by evacuations. –

Morton says, In the first, when the patient is afflicted with a continual cough, especially in the night time, the defluxion on the Lungs is to be stopped by bleeding.”

Sydenham says, After other mild trials if the cough yields not, especially if attended with fever, it would be trifling to trust to pectorals, inasmuch as it must be cured by bleeding and purging.  Swan’s Syd. p. 664. and again professedly treating consumptions, says, The cure must be attempted 1st by lessening the cause of the defluxion on the Lungs by bleeding – and again repeats it p. 671.

Cheyne says (Cure of diseases of body and mind p. 142) that gentle partial and regular Phlebotomies are the most general and effectual, and expeditious operations in the cure of chronic diseases – p. 143 that hectics and consumptions in their first stages may be effectually prevented and cured by such partial phlebotomies.

Celsus says the cure of a violent recent pain is bleeding.

Butler and Haller on Blood-letting say, But whatever be the cause, or wherever the seat of inflam[m]ation is supposed to be, revulsive bleeding is always useful.

Pringle Diseases of the Army Part III. Chap. 3. says the disease being of an [i]nflamatory nature, bleeding is the chief remedy – further when the patient complains of pains in his sides, constriction of breast, or hot and restless nights, I have trusted to small but repeated bleedings, &c. – The quantity of blood drawn was from 4 to 7 oz. – I have found nothing diminish the hectic heats so much as small bleedings and a cooling diet – and much more to the same purpose.–

Monro on ditto, p. 124 says, when the patient complains of a pain and tightness of the breast, it was always necessary to take away more or less blood; and further says in p. 125, if the patient was not relieved by it, it was absolutely necessary to bleed a second time.  Still further, p. 131, the opening a vein and taking away from 4 to 8 oz. of blood when the pain of the breast was troublesome, or the patient hot and restless gave the greatest relief of any thing he had tried, and that repeated bleedings were so far from wasting the patient’s strength that they seem rather to prevent their being exhausted so fast as it would otherwise have been by allaying the force of the hectic fever – to strenthen which, quotes Mead’s Monita Medica & Edinburgh Essays, Vol. IV. art. 28.

Langrish in the cure of hectic fevers says, When the vessels are distended and inflamation arises, attended with excruciating pain, nothing will relieve but bleeding – No. 502, thus hectic fevers when they arise from inflamed viscera are to be treated as common inflamatory fevers till the heat, full pulse, darting throbbing pains & all symptoms of inflamation are abated – For since suppuration is the consequence chiefly to be dreaded and prevented, the first and general indication is to hinder the tumified glands from aposthemating. –

Robinson says, in a disposition to haemorrhage, to make a revulsion bleeding in either arm will be highly proper. –

Barry says the same, and for the cure of an haemoptoe orders bleeding till the disunited vessels are almost collapsed and thence contracted. –

Under the article bleeding, Dict. Arts, &c. is said, some make no scruple of bleeding in consumptions every other day for several weeks together. – And,

Benjamin Marten, (than whom none has made closer observation) says, in a consumption nothing is more common than a frequent succession of inflamatory tumors, at the access of each of which a violent intention of all the symptoms may be perceived, and that bleeding is indispensible in each such condition. –

And if these be not authorities enough & worth the accuser’s or his master’s perusal, we may perhaps (if need be) find more by the time his ignorance of bleeding brings the practice into general discredit. –

After all I would have no person presume on all these authorities to bleed or do much else in such dangerous diseases without a thorough knowledge of the circumstantial indications – All I wish is that when meddling ignorance intrudes on the improvement of the most important science, wherein the lives of thousands are concerned, that it may be ever exposed to the contempt it justly merits.

I am the Public’s humble Servant,

Boston, 16th April 1767.                                                                                 Tho. Young.

Source: Boston Evening-Post, April 20, 1767, Issue 1648, Page 4

Discussion: Dr. Thomas Young, believing himself maligned in public, defends his treatment of a patient. Despite, or as his accuser apparently alleged, because of Young’s treatments, the patient died. The cause was pulmonary phthisis, most probably tuberculosis in modern terms. Thomas Young, a self-trained physician of the sort scorned by university or apprentice-trained physicians, assumes a learned tone. He quotes freely a number of contemporary medical texts.

Could this dispute morph into a politically tinged, months-long free for all, stoked by rival newspaper editors? Check back for future installments for the unlikely course of this disagreement.

Previous post:

Next post: