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616 EXTRACTION OF TEETH.

nient slioiild be boguii before extra('tin<>;. This is done by thoroughly
building up the system by a course of" hygienic and tonic treatment.
The cause of bleeding in cases where the hemorrhagic diathesis exists
is but imperfectly understood ; the blood may be so defibrinated that it
has lost the power of coagulation and so will not form a clot, or the
muscular coats of the vessels have lost their tonicity, either through
general debility or the lack of energy in the vasomotor nervous system,
which prevents their contracting so as to close the lumen. Certainly
the walls of the capillaries permit free transudation of the blood.
In good health the proper coagulation and the contraction of the blood-
vessels will stop the hemorrhage even when an artery of consider-
able size is lacerated, especially if the flow be held in abeyance by arti-
ficial means for a short time. It is when the blood will not coagulate
and the vessels fail to contract that a thorough systemic treatment must
be given. This lack of normal function on the part of the blood and
vessels may arise from various diseases, and in order to judiciously
treat a patient exhibiting the hemorrhagic diathesis a thorough exam-
ination must be made and such treatment given as the diagnosis indi-
cates. Among the most common causes of hemorrhage are anemia,
syphilis, ]uirpura, tuberculosis, and a generally impaired vitality, rarely
an over-acting heart ; the passive hyperemia attendant upon a weak
heart is a potent fjictor requiring a course of preliminary treatment.
Specific and special diseases must of course receive the treatment
peculiar to these conditions. On general principles the following tonics
are advisable : Quassia, cinchona and its alkaloids, iron in its various
forms, sulfuric and hydrochloric acids, arsenic, phosphorus, nux vomica
and its alkaloid strychnin. With these general tonics various hemo-
statics can be given, such as alum, tannic acid, ergot, erigeron Cana-
densis, and gallic acid. Very frequently the digestive organs require
special medication, when such remedies as pepsin, pancreatin, hydro-
chloric acid, and bismuth subnitrate are indicated.
The following prescriptions have proved to be very excellent in
their special province.
As general tonics :
I^i. Strychniffi sulphatis,
Acidi arsenosi, ««. gr.
j ;
Quinise sulphatis, gr. xxx
;
Ferri suljihatis exsiccat., gr. xv.
M. et ft. pilula3 No. xxx.
S. One immediately after each meal.
^. Elixir ferri, quinia? et strychnise, foiv.
S. Teaspoonful four times daily.