PLETH 011A (Gr. "fullness" or "excess"), designates a general excess of blood in.the system. It may arise either from too much blood being made, or from too little being expended. The persons who become plethoric are usually those in thorough health, who eat heartily and digest readily, but who do not take sufficient bodily exercise, and do not duly attend to the action of excreting organs. With them the process of blood making is always on the increase, and the vessels become more and more filled, as is seen in the red face, distended veins, and full pulse. The heart is excited and over worked, and hence palpitation, shortness of breath, and probably a sleepy feeling. may arise; but these symptoms, instead of acting as a warning, too often cause the abandon ment of all exercise, by which the morbid condition is aggravated. The state of plethora thus gradually induced 'may be extreme without any functions materially failing, and yet the subject is on the verge of some dangerous malady, such as apoplexy, or struct ural disease of the heart or great vessels, or of the lungs, kidneys, or liver.
Plethora is said to be sthenie when the strength and irritability of the muscular fibers (especially of the heart and arteries) are fully or excessively developed. This form com monly affects the young and active, and those of sa ngnineous nature. The blood is rich in red cells and fihrine; and there is a tendency to general febrile excitement, active hem orrhages, fluxes. and inflammation. A natural cure is thus often effected by the super vention of an attack of bleeding from the nostrils or from piles, or mucous or bilious diarrhea. The plethora is said to be aRthenie (Gr. a, not, and asthenos, strength) when there is a deficiency of contractility and tone in the muscular fiber. In this case, the
heart and vessels, instead of being excited (as in sthenie plethora) by the augmented qnantIty of blood, are oppressed by its load, and cannot duly expel their accumulated contents. The face is purple instead of red; the extremities cold, and the excreting organs sluggish. This form affects persons weakened by age, excesses, or previous disease.. It tends to produce congestions and passive hemorrhages, fluxes. and dropsies; and if continued, structural changes, such as dilatation of the heart, enlarged liver, varicose veins, etc.
In sthenie plethora, blood-letting is the first remedy, and this, with the continued use of aperient medicine and a sparing diet, is often sufficient to complete the cure. if these means fail, recourse thust be lied to antillionials, salines, digitalis, and sometimes mer cury or colchicum. In the asthenie form, Dr. Williams (to whose article on plethora." in his Principles q• •Medicine, we refer our readers for further details) observes that " the continued use of alterative aperients and diuretics, such as mild inereurials, with rhubarb, aloes, or septet, salines and taraxactun, nitric acid, iodide of potassium, etc., may prepare the way for various tonics, such as calumba, hark, and iron." Ile also recommends the use of the Cheltenham, Leamington, and Llandriudod waters; first the saline, which are aperient and diuretic; and afterward the chalybeate, wit felt, although tonic, usually contain enough of saline matter to keep the secretions free. Foci I may lie taken more freely than in the sthenic form; and in both varieties, as much exer cise in the open air should be taken as can be borne without causing exhaustion.