The treatment of ascites is seldom perfectly successful. The great
extent of the peritoneum, the number and importance of the viscera with
which it is connected, and of the absorbent glands which it encloses,
the number and weakness of the veins which transmit their blood to the
portal vessels, and the absence of valves, in some measure account for
the frequent accumulation of fluid in this cavity. It appears in both
sexes from the usual causes of inflammatory disease. Unwholesome diet,
the drastic operation of purgatives, external injuries, the suppression
of accustomed secretions and discharges, all are exciting causes of
dropsy.
The animal has suffered materially from mange, which has been apparently
cured: the itchiness and eruption altogether disappear, but many weeks
do not elapse ere ascites begins to be seen, and the abdomen is
gradually distended with fluid. When this appears in young and healthy
animals, it may be conquered; but when there has been previous disease
of almost any kind, comparatively few patients permanently recover.
Irritability of the stomach, and a small and accelerated pulse, are
unfavourable. If the operation of tapping has taken place, at all times
there is danger; but, if there is a thick, brown, albuminous or fetid
discharge, it is very unlikely that any permanent advantage will result
from the operation.
We will introduce a few cases as they occur in our clinical records.
'November 7th, 1821'.--A spaniel, nine years old, had been, during four
months, alternately asthmatic or mangy, or both. Within the last few
days she had apparently increased in size. I was sent for. The first
touch of the abdomen betrayed considerable fluctuation. She likewise had
piles, sore and swelled. I ordered an alterative ball to be given
morning and night.
'8th'. One of the balls has been given, and two doses of castor oil; but
no effect has been produced. An injection was administered.
'9th'. A small evacuation of water has been produced, and the bowels
have been slightly opened. Give a dose of the castor-oil mixture.
'10th'. The obstruction has been removed; the enlargement is somewhat
diminished; much water has passed. Give an alterative ball every
morning.
'14th'. The alteratives have been continued, and there is a slow but
evident decrease of the abdomen.
'18th'. I cannot detect any effusion in the abdomen. Give a pill every
alternate day for a fortnight. At the expiration of this period the dog
was apparently well.
'April 23d', 1822.--A terrier, ten years old, had cough and mange, which
ceased. The belly for the first time began to enlarge, and on feeling
the dog considerable fluctuation was evident. He would not eat, but he
drank immoderately. Give daily a ball consisting of tonic and physic
mist., with powdered digitalis and tartrate of iron.
'May 6th'.--He is in better spirits, feeds tolerably well, but is rather
increased in size. Give daily a ball of tartrate of iron, digitalis,
ginger, and a grain of calomel.
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