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October 1960

Research on the Effect of Blood-Letting in Several Inflammatory Maladies: Translation of an Article by Pierre-Charles-Alexander Louis (Arch. gen. Méd. 321-336, 1835), with Introduction

Author Affiliations

Richmond, Va.; Jackson, Miss.

Arch Intern Med. 1960;106(4):571-579. doi:10.1001/archinte.1960.03820040109009

The determination of the relative merits of various therapeutic measures, or the de- termination of the efficiency of any one of these compared to the course of the untreated disease, has been one of the recurrent problems of medicine. The Hippocratic injunction "first do no harm" is often forgotten in the pressure to give a pill or to perform some maneuver or operation. The determination of therapeutic efficiency requires some accuracy of diagnosis, lest real benefit to the patient be balanced by harmful reactions.

The French school of physicians of the early 19th century made important advances in diagnostic ability by careful clinicopatho-logic correlation. Pierre-Charles-Alexandre Louis (1787-1872) participated in these advances. When enough progress had been made in diagnosis, he was able to ask a therapeutic question, "How good is blood-letting in inflammatory disease?" In the following article he made one of the first attempts to decide methodically and scientifically