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
It is in such cases that recoveries take place under almost any plan of
treatment, and that bark and other tonics have been found beneficial.
Their utility, however, in these cases is very limited, consisting only
in aiding the removal of the effects of the disease, and keeping up the
strength of the system, whilst the absorbents perform their function,
and remove the fluid. Dr. A. recommends, in these cases, puncturing and
bandages; but he very justly adds, that they must not be employed,
whenever there remains any inflammation in the parts, as they would then
tend to aggravate it.
"To oedematous swellings, in which the serous local
inflammation, whether symptomatic or idiopathic, still
subsists, I am accustomed to direct the application of leeches
and cold evaporating lotions, observing not to commence the use
of the latter, until twelve hours after the leeches have been
used, that inflammation may not be produced in the wound."
"When anasarca arises from a general excited state of the
system, as denoted by the pulse, and by the serous quality of
the urine, venesection becomes necessary, combined with the use
of leeches, applied to the extremities, or to those parts of
the body, in which the serous tissues are most affected, along
with the active use of the general means already alluded to."
In anasarca, an error is sometimes committed, especially by young
practitioners, of estimating the degree of danger, and the necessity for
active treatment, by the single consideration of the extent of the
oedematous swelling. This, however, should be guarded against, as the
swelling may be very considerable, and the disease subsided, or of
little consequence; whilst, in other instances, the reverse may be the
case. In the first instance, where the disease is not seen early, the
treatment must sometimes be limited to those means which promote the
absorption of the water, and neither venesection nor leeches will be
required. In such cases, the practitioner must be guided by the state of
the pulse and urine; the presence or absence of vascular excitement; the
history given of the case up to the period when visited, and
particularly by the progress of the swelling.
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