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
"In the case of the liver, which is commonly considered, when
in a scirrhous or enlarged state, to be the seat of these
mechanical obstructions, and thus, to be the cause of abdominal
dropsy, we have no satisfactory instance yet shown to us, of
any such precise condition of that organ. There are, indeed,
numerous instances of abdominal dropsies, in those labouring
under a scirrhous or enlarged state of the liver; but there are
also, numerous examples of such states of the liver, as well as
of the spleen and other organs, without any such effusion; and
in many cases, when such effusion has taken place, it has been
carried off by the natural passages or by tapping, without any
return of the dropsy; and yet, without any visible change in
the structural condition of the liver."
Dr. A. further remarks, that if the cause were mechanical and existed in
the liver, the effect should be constant; which, however, is not the
case. Besides, were this mechanical cause necessary, how could we
account for the appearance of abdominal dropsy, where there is no
disease of the liver, or in other cavities, where no mechanical cause is
asserted to be present, and where the remedies by which the cure is
effected, have no relation to such causes? Again, if the discharge
depended upon a mechanical cause, the water should in every case be of a
uniform fluidity, and the progress of its accumulation likewise uniform;
so that the operation of tapping should have no tendency to induce a
more rapid refilling of the cavity. Yet, the contrary of all this is a
subject of daily observation. In addition to this, Dr. A. calls the
attention to the fact, that in experiments, in which obstruction has
been artificially made, by tying the vena cava for example, the
experimenter has committed an error, in reasoning from the lower animal
to man--assuming, that as ascites had arisen in dogs, it would in like
manner have occurred in human subjects.
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