British Cardiology 1900–50

Fleming, Peter

doi:10.1007/978-1-4471-0773-6_1

Cited by 1 publication

(2 citation statements)

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“…The term heart failure was not then in common usage; in his textbook, Osler used it only in connection with diphtheria and typhoid. 8,17 Observe, however, that Osler described symptoms and signs of acute heart failure in the first five of these indications: chronic valvular heart disease, arteriosclerosis, cardiac hypertrophy and dilatation, pulmonary edema, and emphysema with "great engorgement of the veins." In cerebral hemorrhage, Osler's rationale was "to reduce the arterial pressure."…”

Section: Osler's Recommendations For Bloodlettingmentioning

confidence: 99%

“…16 This was roughly the equivalent of "heart failure," a term that did not come into wide use until the 20th century. 17 Phlebotomy for acute heart failure, and especially for pulmonary edema, is eminently reasonable from a 21st-century perspective as a way to reduce blood volume should potent diuretics be unavailable. 18 Thereafter, recommendations for bloodletting rapidly fell off for most conditions that did not involve "cardiopulmonary congestion.…”

Section: Introductionmentioning

confidence: 99%

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New observations support William Osler’s rationale for systemic bloodletting

Bryan

2019

Baylor University Medical Center Proceedings

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Bloodletting has been called William Osler's "blind spot," especially with respect to pneumonia. Also puzzling has been his endorsement of bleeding in selected cases of heatstroke. Recent clinical observations on pneumonia and, to a lesser extent, heatstroke lend support to Osler's rationale for bloodletting in these conditions. A 21st-century rationale now exists for all eight indications for systemic bloodletting listed by Osler in the first edition of his textbook, The Principles and Practice of Medicine (1892): treatment of acute heart failure (seven of the eight indications) or rapid lowering of blood pressure (in subarachnoid hemorrhage accompanied by severe hypertension). These observations support the narrative that during Osler's lifetime, bloodletting became more "rational" largely on the basis of cumulative clinical experience.

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Section: Osler's Recommendations For Bloodlettingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%