Elements of the theory and practice of medicine ; designed for the use of students and junior practitioners / by George Gregory ... [etc.].

  • George Gregory
Date:
1835
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Licence: Public Domain Mark

Credit: Elements of the theory and practice of medicine ; designed for the use of students and junior practitioners / by George Gregory ... [etc.]. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    ^-^^ TREATMRNT (»F UHOPPY. [f'/flMQ. instances are not wanting of dropsy, connected witli mere functional disturbance of one or more organs, proving fatal, and leaving behind it no trace of morbid structure. Prognosis.—It follows from what has been said, that though a few cases of dro])sy are local, partial, temporary, and there- fore of no material imj)ortance, yet the greater number of them are extremely dangerous. The prognosis in general dropsy indeed should always be most strictly guarded, and for many reasons. It is, as we have seen, connected with states of thoracic and abdominal disorganization, over which we have no control. It indicates great severity of disease, and .shows that the whole system is deeply involved. It is often the strongest mark of a worn-out constitution, and of failure of the vis vitce. In all forms of dropsy there is a remarkable liability to relapse. The duration of the disease varies with many circumstances which it is impossible to enumerate, but which have all an important influence. There is an acute form of dropsy which has proved fatal in a few weeks, and there are instances on record of persons living for a long series of years labouring under a greater or less degree of it. Ascites is perhaps the most generally fatal of all the forms of dropsy, and certainly that over which medicine exerts the least power. It is hardly necessary to say, how much, in the successful issue of a drop- sical case, depends upon bringing it early under medical treat- ment, before the foundations of health are sapped, and the disease advanced to that point, where, from being one of func- tion, it becomes complicated with structural derangement. Treatment.—In the treatment of dropsy we are to aim, in the first place, at restoring a due state of the circulating system. Secondly, where this cannot be done, or while the measures for effecting it are in operation, we are to promote the temporary absorption of the effused fluid. Thirdly, where the powers of the system are inadequate either to the one or the other, re- course must be had, when practicable, to surgical aid. 1. The means of relief calculated to attain the first object vary of course with the kind of dropsy present. In the acute, plethoric, or arterial dropsy, we are to lower the tone of the arterial system, and to lessen the impetus of the circulatmg fluids upon the exhalant capillaries. For this purpose, it is sometimes necessary to have recourse to blood-letting, or to local depletion by cupping, or leeches. At other times this