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
Unlike what occurs in hydrothorax and hydrocephalus, the effusion in the
present form of dropsy is of inconsiderable importance, compared to the
visceral disease which is its remote cause. When, however, the
accumulation becomes very considerable, the pressure of the fluid may
affect the organs, and more particularly the peritoneal lining, which
from the irritation induced in it, may take on a higher grade of
inflammation, terminating in effusion of coagulable lymph or pus, and in
death. The necessity which arises of tapping, where the effusion is very
considerable, proves sometimes a farther cause, perhaps, of aggravating
the disease of the affected viscus, and either of renewing or extending
the hydropic excitement, or of converting it into a higher or more
destructive form of inflammation.
By most writers on dropsy, anasarca has been maintained to originate, in
all instances, in debility, and to be curable only by a tonic and
invigorating plan. It is true that some writers, especially among the
ancients, (for we can hardly class PORTAL among the moderns,) have
spoken of the disease as arising occasionally from a plethoric state of
the circulation, and enforced the necessity, under these circumstances,
of venesection. This view of the pathology of anasarca, although leading
in many instances to a successful practice, was, however, vague and
often unsatisfactory. To the late Dr. RUSH, and to Dr. PARRY, much
credit is certainly due for their labours on this subject; but so far as
we are informed, it was not until within a few years, that the subject
was cleared of part of the obscurity in which is was involved, and that
the disease, at least the active sort, has been referred to an
irritation of the cellular tissue. Following up this opinion, and
generalizing still more than the French pathologists, our author asserts
that anasarca invariably consists in an inflammation of the cellular
membrane of the body, with a serous effusion as its result. The
accumulation, he continues, may be either idiopathic or symptomatic, and
either general or local; occurring only under two forms, the one being
of greater intensity that the other. In general, the disease derives all
its importance from the nature of the remote cause.
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