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 second and fifth volumes of the _Archives Generales de Medecine_,
Dr. BOUILLAUD has related many cases of partial and general dropsy,
which undoubtedly originated in obstruction to the venous circulation,
from adhesion of the parietes of the principal veins. It is true that
Dr. A. is compelled to admit this among the causes of dropsy; but
faithful to his theory, he supposed the supervention of an arterial
reaction resulting in an effusion of serum. It does not appear to us,
however, that this arterial reaction is admissible in all cases of the
sort, and we prefer on the whole the explanation of the mechanism of the
effusion, originally given, by DONALD MONRO, and lately by Drs.
BOUILLAUD and BROUSSAIS, who refer it to an obstruction in the venous
circulation and to a consequent deficient venous absorption. By
admitting this explanation, it is readily perceived, that we admit a
passive dropsy, and we think the view well exemplified by a case which
occurred last summer. The individual had recently recovered from a
violent attack of disease, and was left much debilitated. Induced by
this circumstance to travel to the north, he had occasion to notice that
when seated long in a stage with his feet depending on the veins
compressed, oedema invariably came on, and that it as invariably went
off the next day if he did not ride. This occurred so often as to lead
us to think there could not always be an arterial reaction occasioning
the effusion, and that this effect arose from the mere obstruction to
the venous circulation.
In making these remarks we are not actuated by the desire of detracting
from the merits of Dr. A.'s views of the pathology of dropsy; convinced
as we are, that the great majority of cases of the disease, which are
thought by many physicians to arise from debility, do not owe their
origin to this condition of the system, but to an increased excitement
of the membranes or cellular tissue. Were it otherwise, how could we
account for the fact, that dropsy is generally _local_, whilst the
_debility_ to which it is in most instances referred, is general?
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