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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    Chap. 7.] it is associated with a degree of anasarca, and sometimes also with hydrothorax. The quantity of water collected m the belly is often enormous, amounting in some instances to upwards of a hundred pints. It is curious to observe how little inconve- nience this occasions to the viscera among which it floats. The functions of the stomach and bowels are performed in most cases of ascites with tolerable regularity. The disease may occur in either sex, and at any age ; but like the other forms of dropsy, it is cliiefly to be met with in advanced life. Causes.—The causes of ascites may be reduced to the following heads. It is, in the first place, a sequel of peritonaeal inflammation, both acute and chronic, diffused and circum- scribed. This form of ascites is accompanied with tenderness in some part of the abdomen, more especially in the right hypochondrium. It arises, in the second place, from diseased conditions of the solid glandular structures of the abdomen— the liver, spleen, and pancreas. In by far the larger propor- tion of cases the liver is the organ afffected. On dissection it appears enlarged, schirrhous, tuberculated, or studded with hydatids. It is a commonly received opinion, that the dropsy which attends diseased liver is referrible to the difficulty with which the blood is transmitted through the vena port^, and its consequent stagnation, or congestion in the capillaries. This notion is in some measure confirmed by the enlargement which is always more or less observable at the same time in the superficial veins of the abdomen. Something more, however, is probably necessary to constitute a dropsical tendency. It would be impossible, otherwise, to explain why ascites should be so common an attendant on ulcerated stomach and bowels, and such chronic disorganizations as denote a general decay of the whole frame. The constitutional origin of ascites is ren- dered still more evident by its arising in so many cases from causes exterior to the abdomen, such as produce dropsy generally, more especially structural diseases of the heart. Treatment.—The treatment of ascites must of course to a certain degree vary with the cause which gives rise to it. When it depends upon organic disease of the abdominal viscera, it is nearly beyond the reach of art. When it occurs along with extensive anasarca, it denotes so great an extent of constitutional disturbance as almost to preclude the hope of permanent recovery. That form of ascites which partakes of 2 T