blood from the place of
rupture to the healthy parts of the circulation. He insisted that the
patients must rest, that they should take acid and astringent drinks,
that cold compresses should be placed upon the chest (our ice bags), and
that they should take only a liquid diet at most lukewarm, or, better,
if agreeable to them, cold. When the bleeding stopped, a milk cure was
very useful for the restoration of these patients to strength.

It is not surprising, then, to find that Alexander suggests a thoroughly
rational treatment for pleurisy. He recognizes this as an inflammation
of the membrane covering the ribs, and its symptoms are severe pain,
disturbance of breathing, and coughing. In certain cases there is severe
fever, and Alexander knows of purulent pleurisy, and the fact that when
pus is present the side on which it is is warmer than the other.
Pleurisy can be, he says, rather easily confounded with certain liver
affections, but there is a peculiar hardness of the pulse characteristic
of pleurisy, and there is no expectoration in liver cases, though it
also may be absent in many cases of pleurisy. Sufferers from liver
disease usually have a paler color than pleuritics. His treatment
consists in venesection, purgatives, and, when pus is formed, local
incision. He recommends the laying on of sponges dipped in warm water,
and the internal use of honey lemonade. Opium should not be used unless
the patient suffers from sleeplessness.

Some of the general principles of therapeutics that Alexander lays down
are very interesting, even from our modern standpoint. Trust should not
be placed in any single method of treatment. Every available means of
bringing relief to the patient should be tried. "The duty of the
physician is to cool what is hot, to warm what is cold, to dry what is
moist, and to moisten what is dry. He should look upon the patient as a
besieged city, and try to rescue him with every means that art and
science places at his command. The physician should be an inventor, and
think out new ways and means by which the cure of the patient's
affection and the relief of his symptoms may be brought about." The most
important factor in his therapeutics is diet. Watering-places and
various forms of mineral waters, as well as warm baths and sea baths,
are constantly recommended by him. He took strong ground against the use
of many drugs, and the rage for operating. The prophylaxis of disease is
in Alexander's opi