The Wilmingtonian., 1883-06-23

disease, CdFutOC, Irom kiunoy uisSase, Tctus'
All these are of the passive order. We have
also a form of dropsy peculiar to women,
and known as oud1ida, while yet another
variety of a far milder type is found in
young women under certain irregular con-
ditions of the healthy functions of life.
When the watery matter is effnsed into
the abdominal cavity, causing the body to
swell up sometimes to an extraordinary ex-
tent, the disease is known as ascites or alb
dominal dropsy. This is most commonly a
result of disease of the liver, particularly
that form known as cirrhosis, hobnaied or
drunkard's liver. When the water collects
chiefly in the legs, and arms the disease is
termed anasdrca OF dropsy of the cellular
tissue, and is most commonly associated
with some affection of the valves of the
dropsy manifesting itself locally; and af
fecting but a small portion of the body, Gas
the face OF the feet) is called edemd. This
is frequently observed in the face in the
early stages of Brights disease, and in the
feet in the last stage of consumption. The
swollen condition of the under eyelids OF
drunkards after debauch is slight mani
festation of GdemG
The effects of the effusion of watery mat
ter into any part of the system are generally
so obvious as to attract the attention of the
most ignorant, and even of the patient him
self. 1t is important however not only to
ascertain that dropsy actually exists but to
locate its cause for in this way alone can we
hope to effect cure.
A dropsical accumulation is readily dis
tnguished from fatty one by its property
of "pitting" on pressure with the finger
over the part. Thus If a linn is seen to be
swollen without previous violence or injury,
, it may be Immediately settled whether the
+ swelling is due to dropsy. If the finger is
pressed on it, no pain if felt; this is in itself
f valuable indication. But we also find
/ that the imprint made by the pressure
remains, often for several minutes after the
; finger has been removed. This is conclu-
, sive proof that the case is one of dropsy.
. Inquiry will then generally elliott that the
patient has been previously suffering from
Q some trouble with his kidneys or heart
; most commonly we shall hear of Brights
D disease or rheumatic fever. The prognosis
: in either case is very grave. Few dropscal
g patients recover under such circumstances
i though life may be prolonged for months OF
o even years.
o When the watery accumulation is in the
t abdomen it is liable to be compounded with
other conditions of by no means 80 serious
/ a character. Large collections of wind in
: the intestines have been frequently mistal
t ell for dropsy, so have fatty accumulations
/, and tumors.
# But to the skilled practitioner of medicin,
y there is but little likelihood Of error i
: the fingers of one hand are placed agains
3 one side, of a dropsical abdomen and thu
It opposite side of the swelling rubbed gently
e with the finger ofthe other hand, motion
I. like that of wave of water can be felt.
d is characteristic, and like nothing but itself
II Another sigh is that when the patient il
& seated and the fingers gently rubbed owe
d the abdomen, the part filed with waite
rs gives dull sound, while the upper portio
+, gives resonance as if drum were struck
If whence the term tympdnitic which medica
men apply to it. The cause of this is tina
ss the intcstines, which generally contain air
s. float on the dropsical accumulation, and W
a have first the conditions noticed in strikin
Q. with a stick tub half full of water.
~ Mention has been made of the operatio
r. of tapping for the dropsy. In this cas-
as the watery accumulation in the abdomen
as removed by making an incision low dow
ed toward the groin and inserting a drainag
he tube through which tho water dribbles OF
Formerly the operation frequently prove
of fatal, the patient sinking suddenly from tt
X withdrawal of the pressure of the water,
1t which the great organs above had accon
ne modated themselves. In modern practice Il
no abdomen is tightly bandaged as the fluid
re- Withdrawn so as to give the great visce
as the needful support. At the best howeve
as tapping is but a last resource, and only ju
n tifiable when the accumulation is so gre
IRE as to threaten the patient with suffocatio
ny The rational treatment of the dropsic
ne ,,o4;oo+ 10 o., ~, a,,r+ tba ,apooyal Of tho