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
Dr. A. discovers a further evidence of the relation which dropsy bears
to diseases of local excitement, in the effects it produces on the
general system. Thus, during the continued effusion of serum in
anasarca, there is sometimes a large quantity absorbed and carried out
of the body; by which a regular draught is made upon the nutrient
principles of the blood, which must naturally create effects like those
arising from the continued discharge of pus from a suppurating surface.
In both cases the local disease, when extensive and of long duration,
will necessarily occasion an exhaustion of the vital powers, by which
that condition of the system termed cachexy will be induced.
"The exhausted or cachectical state, therefore, of the system,
which has been so variously accounted for, and so frequently
assigned as a principal cause of both local and general dropsy,
is a direct consequence of the agency of some power diminishing
the vital strength at its source; and in the case of a chronic
and long continued serous inflammation, it will proceed from
the daily abduction from the circulation of a portion of its
vital fluid: and whether it be pus or serum that is drawn from
the body; or whether it be from any permanent failure in the
supplies of nutriment to it, the effect will be the same, as if
a certain quantity of blood was daily abstracted from the
system."
Dr. A. continues to remark that, under these circumstances, a
suppurating surface will readily become gangrenous, from any cause
temporarily exciting it, and that, in like manner, a higher
inflammation may sometimes supervene upon an oedematous limb, as in
the former case, and terminate in gangrene.
"Hence, therefore, the tendency of dropsical parts to fall into
gangrene, and which has been urged, as an argument, in proof of
debility being the cause of the serous effusion, is only what
is common to other forms of local inflammation, under a similar
condition of the body."
From the view he has adopted of the nature of dropsy, Dr. AYRE thinks
that the excitement of the parts, giving rise to the effusion, may be
either 1st. Sub-acute or chronic. 2nd. Symptomatic or idiopathic. In
other words, that it may arise from a local disease, or from the common
causes of inflammation; and that these causes may be either general or
particular. 3d. That the serous inflammation may be either local or
general, giving rise to a general or local effusion.
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