Blood letting in a case of epilepsy complicated with acute cerebral congestion

Dr W Campbell relates an interesting case of a maid servant who fell downstairs with a child in her arms, and was supposed to be hysterical from fear. He found her suffering from violent convulsions, recovering every few minutes. She was unconscious, respiration appearing to be suspended; eyes shut, with dilated pupils; face much suffused; pulse very frequent and full.

Concluding that  she was suffering from acute congestion of the brain, perhaps originating in the powerful nervous impression, and having ascertained that she had been in this condition for two hours, despite the application of cold to the head and other restoratives, Dr Campbell decided to try blood letting.

From 10 to 12 ounces were abstracted, and the patient then began to look about her in a bewildered way, whilst the convulsions ceased, and the breathing was audibly performed.

The flow of blood was temporarily arrested; but as the convulsions did not recur, and she became more and more conscious, the arm was bound up. The pulse speedily fell from 135 to 100, and speedy convalescence ensued.

Medical Times and Gazette, October 8, 1870

Treatment of sunstroke by venesection

Mr Salter, of Tolleshunt D’Arcy, records an interesting case of a lad, aged 16, who on one of the hottest days of July 1869 was suddenly affected with sunstroke.

Half an hour after the seizure he was lying on the ground insensible, wriggling in convulsions like an eel.  The muscles of the trunk, neck, and legs were rigid, the countenance suffused, the eye directed backwards and fixed, the breathing snatchy and stertorous. The pupils were much contracted, the conjunctivae injected, the teeth firmly clenched together. The temperature of the body was abnormally high.

The heart beat tumultuously, and the throbbing of the carotids was very energetic.  At the wrist the character of the pulse was small, quick, sharp and wiry; there was a lack of volume, not of propelling force.

After watching him carefully for some time, during which his symptoms increased in severity, Mr Salter determined to bleed him, and several ounces of blood were taken without delay. The effect was most striking. The convulsions were quickly relieved, and gradually ceased as the blood continued to flow; the pulse became slower and fuller, the breathing less laboured, and the venous engorgement of the face subsided, the pupils relaxed a little, and by the time the arm had been bound up, he lay out in a heavy, oppressed sleep. He was now put to bed. Cold applications were made to the head, and warmth offered to the feet. A dose of castor-oil, with small but frequent doses of brandy and beef-tea, speedily led to recovery, and in two days he went home.

Medical Times and Gazette, August 27, 1870