When I use a word: Dropsy
Authors: J. Aronson
Journal: BMJ (2003)

Dropsy, familiar to all doctors as an outdated term for a variety of conditions associated with the accumulation of fluid, is still in use. The word is an abbreviated form of the word hydropsy, perhaps because of elision with the definite article followed by metanalysis: “the hydropsy” became “th' idropsy” and then “the dropsy.” Dropsy, in Greek ο υδρωψ, comes from the word for water, υδωρ (hudor), from which we get words such as hydrocele and dehydration.

In addition to υδρωψ ανα ςαρκα (anasarca) and υποςαρκα (hyposarca), extensive forms of dropsy, Hippocrates described dry dropsy, ουδρω ξηροσ (gaseous distension of the belly) and emphysematous dropsy, ο υδρωψ μeτ' eμφυςηματων. Galen referred to τυμπανιασ υδρωψ, or drum-like distension of the belly, due to either ascites or tympanites (distension of the belly by gas rather than liquid, a term still sometimes used by vets), and for which Pliny recommended hellebore (which contains cardiac glycosides). And Galen called diabetes υδρωψ eισ αμιδα (piss-pot dropsy).

However, the term later came to be used for many different forms of fluid accumulation:



Dropsy of the legs, which we now call peripheral oedema


Hydrops abdominis (ascites)


Hydrops amnii (hydramnios)


Hydrops pectoris (pleural effusion)


Hydrops pericardii (pericardial effusion)


Meningeal hydrops (hydrocephalus)


Ovarium dropsy (ovarian cyst).




When I searched for dropsy and hydrops in Medline I got over 3600 hits. Most of them (about 60%) were to do with hydrops fetalis, which is usually due to rhesus disease, but which can also be caused by haemoglobin Bart's. Endolymphatic hydrops, hydrops labyrinthi, and cochlear hydrops accounted for about 25%, not surprisingly, since they are other names for Meniere's disease. Gallbladder dropsy accounted for 4.5%, and corneal hydrops (presumably not to be confused with eyedrops) for 1.7%. Hydrops was sometimes used to refer to a joint effusion, and there were a few cases of hydrops tubae profluens (intermittent hydrosalpinx), which causes apparent incontinence after hysterectomy, when a blocked Fallopian tube swells, bursts, and drains into the vagina.

An interesting condition known as epidemic dropsy, which is seen mostly in India but which has also been reported in Mauritius, Fiji, South Africa, and Nepal (see Journal of Tropical Pediatrics 1999;45:8-13), accounted for 1.5% of my Medline hits. It is caused by the ingestion of mustard oil or ghee adulterated with oil from the seeds of Argemone mexicana (the Mexican poppy), which contain a toxin called sanguinarine, so called because it was first identified in Sanguinaria canadensis, the blood-root. Epidemic dropsy presents with gastrointestinal symptoms a week or so before the onset of pitting oedema of the legs, fever, and darkening of the skin, often with local erythema and tenderness. Perianal itching is common, and myocarditis and congestive cardiac failure can occur. Other features include anaemia, hepatomegaly, pneumonia, ascites, glaucoma, alopecia, and sarcoid-like skin changes.

Of words beginning with hydro- listed in the Oxford English Dictionary, hydrotic is the odd one out, being a misspelling for hidrotic, which comes from another Greek word ιδρωσ (hidros), meaning sweat. The Greek word υδωρ came from the Indo-European root AUE, which also eventually gave rise to such diverse words as hydra, urology, undulate, and water itself. On the other hand, ιδρωσ came from the root SUEID, which gave sudorific, exude, sauna, and, of course, sweat. But this is not an unusual error to make—confusing sweat with water.