A handbook of the theory and practice of medicine / by Frederick T. Roberts.
- Frederick Thomas Roberts
- Date:
- 1885
Licence: Public Domain Mark
Credit: A handbook of the theory and practice of medicine / by Frederick T. Roberts. Source: Wellcome Collection.
52/1050 page 34
![cannot sustain general batlis. It is in the treatment of renal dropsy tliat they are most valuable, and especially of acute cases. An occa- sional bath is also useful in preventing this form of dropsy. Diaphoretic medicines are often given, such as ipecacuanha, antimony, spirits of nitre, liquor ammoniae acetatis, or citrate of potash, but they afford little or no assistance from their diaphoretic action in the removal of dropsy. Jaborandi has proved serviceable in some cases. Watery ]jurgatives are frequently highly efficient in relieving dropsy, but care must be exercised in their administration, as they tend to weaken a patient. The most important are extract of elaterium (gr. ^ gradually increased to gr. |) ; jalap (9 i to 5 i) ; and cream of tartar (5 i to 3 ij) ; the last two form a very effective combination, as in tho compound jalap powder. They may be given two or three times a weeky or oftener if required. Dr. Matthew Hay has recommended the adminis- tration of a concentrated solution of a saline purgative, especially sul- phate of magnesia, in the treatment of certain cases of dropsy. It thus acts both on the intestines and the kidneys; and rapidly reduces the fluids of the blood. He has found this treatment more useful in general dropsies than in local dropsies ; and most beneficial in those depending on a stasis of the circulation, as cardiac dropsy. As requisite conditions he recommends that the patient should abstain from food for some hours pre- viously ; and that the salt should be administered along with the smallest possible quantity of water. Other strong purgatives are employed in treating dropsy, such as gamboge, veratrium, podophyllin, calomel, or croton oil, but these are much less admissible ordinarily, though some of them are occasionally serviceable. There can be no doubt that the effect of pills administered by certain quacks, which is sometimes really marvellous, is due to powerful purgatives Avhich they contain. Diuretics are most beneficial in some forms of dropsy. Those usually given are the nitrate, acetate, or citrate of potash or soda in full doses, freely diluted ; cream of tartar in small doses ; spirits of nitre ; infusion or tincture of digitalis, or the powdered leaf made up into pills with other ingredients; squill in the form of tincture or pill; spirits or in- fusion of juniper; infusion of fresh broom tops; or oil of turpentine. The balsam and resin of copaiba have been found efficacious in the treatment of ascites and other forms of dropsy. Caffein is also a valuable diuretic. The following pill is sometimes very efficacious in relieving dropsy, given about every other night:—R. Ext. elaterii, gr. J- to gr. ^ ; Pulv. scillj®, gr. -J to gr. i ; Pulv. digitalis, gr. ^ to gr. i ; Ext. hyoscyami, gr. IJ. M. fiat. pil. Another pill which has been much recommended consists of digitalis, squill, and blue-pill. Digitalis is also used as an external application, poultices of the leaves being placed over the abdomen, or fomentations of its infusion being employed. Gin or whisky freely diluted undoubtedly acts as an efficient diuretic in the treatment of some cases of dropsy. Blood-letting has been recommended under certain circumstances, with the view of unloading the vessels, and thus assisting the action of other remedies, but such treatment can rarely, if ever, be indicated. 4. Removal of the fluid by operation.—If dropsy cannot begot rid of in any other way, it is necessary to have recourse to certain opera- tions, and I believe that these are often delayed until too late a period, and ought in appropriate cases to be performed, not as last resources, but as curative measures. These operations include:—1. Faraceritesis or tapping of serous cavities, especially to be adopted in certain cases of](https://iiif.wellcomecollection.org/image/b20400111_0052.jp2/full/800%2C/0/default.jpg)
