Dropsy of the Belly. Ascites.
THIS is a collection of water in the cavity of the belly; sometimes the fluid is outside of the peritoneum, and next to the muscles.
Symptoms. An enlargement of the belly, with a sense of distention and weight, particularly on the side on which the patient lies. Mrhen the collection of water is large, the.breathing becomes short and difficult, and the swelling is uniform over the whole abdomen.
In some instances the fluctuation of the water may be distinctly heard when the patient moves about, just as we may hear the water in a half filled barrel when it is rolled over. This sound of the fluid, when heard, distinguishes the complaint from pregnancy, and from the drumhead state of the bowels. This fluctuation may sometimes be produced by pressing upon one side of the belly while the patient is Standing or sitting, and striking the other side with the ends of the fingers of the other hand.
In some cases, there is loss of appetite, dry skin, costiveness, scanty urine, oppression of the chest, cough, colic pains, and variable pulse.
Causes. A frequent cause of this complaint is chronic inflammation of the serous membrane which lines the abdomen, I mean the peritoneum. It may also be produced by scarlet fever, fever and ague, disease of the heart, particularly dilation of the right cavities, and diseases of the liver, particularly the shriveled, hobnail condition of the liver, in short, whatever causes a pressure upon the portal veins, and obstructs the venous blood returning from the intestines.
Treatment. The remedies for this disease are mainly diuretics and purgatives. The bowels may sometimes be reduced in a few days from an enormous size, by medicines which excite the action of the kidneys. Digitalis combined with acetate of potash, etc. (130), forms an excellent preparation. The patient should have as a constant drink, a strong infusion made from two parts of haircap moss, and one each of juniper berries and dwarf elder bark; also an infusion of queen of the meadow.
The purgatives used in this complaint are those which produce watery stools. One of the best of these is elaterium. It will sometimes carry off the water with great rapidity; combined with some active cathartics (31), it will have all its good effects without the griping it is apt to occasion alone.
Cream of tartar, taken in large doses, every day, will sometimes do well. Epsom salts produces watery stools, and is a good remedy.
For promoting absorption of the fluid, the iodide of potassium, taken in from three to ten grain doses, three times a day, is a valuable medicine in many cases. The compound infusion of parsley is said to be still better.
The skin must receive careful attention. The alkaline sponge bath, with friction, will increase the transpiration of fluid through that organ. Exercise does much to keep up an active circulation, and to lessen dropsical effusions.
The strictest temperance, both in eating and drinking, must be observed. A light and nourishing diet, with water, tea, and the diuretics named above for drinks; beyond these the patient must not go.
A kneading and shampooing of the bowels once a day has an excellent effect; it gives activity to the circulation in obstructed veins. A bandage tied close around the bowels, and tightened as the water diminishes, has an effect upon the sluelish vessels similar to that of the laced stocking in varicose veins of the legs. It lessens the liability of a return of the complaint.
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