North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826Various
History
North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826
Various
Medicine -- Periodicals
"Of the means to be employed to promote the absorption of the
water, under these or other circumstances of its accumulation
in the brain, little satisfactory can be said. The treatment
must be founded on the use of such means as shall avert the
risk of renewing an inflammation in the organ. To this end,
occasional blistering the head will be proper; the diet must be
spare, and the several secretions, particularly those of the
kidneys, must be cautiously promoted."
We next turn to the treatment of hydrothorax and ascites. As the
existence of hydrothorax in its early stage is difficult to ascertain,
and as what have been called premonitory symptoms are only those proper
to the mildest forms of the disease, and not of that condition of the
parts which gives rise to the effusion, the treatment is somewhat
difficult, and, in too many instances, our remedies are directed, not to
the disease itself, but to one of its effects. Faithful to his view of
the pathology of dropsy, Dr. A. remarks, that the plan of treatment to
be pursued at an early stage of symptomatic hydrothorax, must consist in
the use of those means which shall subdue the chronic excitement of the
serous membrane, as well as the chronic inflammation of the diseased
organ. To attain this end, the antiphlogistic and revulsive plans,
graduated to the age and strength of the patient, and to the violence of
the disease are recommended. In general the frequent application of
leeches are held by Dr. A. as preferable to venesection, unless the
patient be plethoric, and the disease arise from a local congestion
within the chest, which, according to him, is often a cause of serous
inflammation of the thoracic tissue, independently of any previous
disease. Dr. AYRE calls attention to the fact, that topical bleeding is
particularly adapted to correct that chronic inflammation of the serous
membranes, which causes an effusion from them, and which is neither the
result of any inflammatory excitement of the general system, nor of a
nature to produce it; and that when properly conducted, it has the
advantage of acting only slightly on the general system, and therefore
only slightly on the general strength, and very considerably on the
local disease. Together with leeches, blisters are to be used, and after
the chronic action existing in the serous membrane is subdued by these
means, a seton fixed in the integuments of the chest will be found of
great utility.
The same treatment will be found equally serviceable, not only to
correct the chronic excitement existing in the peritoneal membrane and
giving rise to ascites, but very commonly to cure or palliate the
visceral disease producing it. In respect to the very common practice
of resorting to mercury in this complaint, our author makes the
following judicious remarks.
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