Dropsy of the Cells. General Dropsy. Anasarea.
JUST under the skin is a membrane composed chiefly of cell called the cellular membrane. When a considerable part or the whole of these cells are filled with a watery fluid, we call the complaint anasarea, or cell dropsy. If, besides this, there is a collection of water in the large cavities, we give it the name of general dropsy.
Symptoms. The disease generally begins with a swelling around the ankle and leg, which is more visible at night after standing and walking, and is less perceptible in the morning in consequence of the horizontal position of the night. To the touch of another person, dropsical feet and legs feel a little colder than natural; and when hard pressed with the finger, a pit will be sunk in the flesh, which remains some time before it fills up. As the disease advances, the skin of the legs becomes smooth, shining, and sometimes even cracks open to let out the water. The limbs, and indeed the whole person, become stiff, heavy, and clumsy.
As the disease advances, and ascends to the belly and chest, there is shortness of breath, a sense of suffocation on moving or lying down, a tightness and distress across the epigastrium, thirst, dryness of skin, wakefulness, loss of appetite, scanty and deep colored urine, and a slow fever.
Cause. General dropsy is caused by whatever weakens the general system, and by such circumstances as obstruct the circulation in the veins. The most frequent causes, therefore, are certain diseases of the heart and kidneys.
Explanation. Modern physiology has demonstrated that the veins do a certain part of the work of absorption. The serous membranes which line the larger cavities of the body exhale watery fluid enough, and no more than enough, to keep them moist, and cause the organs within to play smoothly upon their surface. If the fluid were not taken away as fast as it is poured out, the cavity, being a shut sac, would become full, and we should have dropsy. It is the office of the veins to absorb this fluid and convey it away in the general current of the blood.
This is the method of their doing it: The walls of the veins are so constructed as to permit watery fluids to pass through them, either in or out. When they are comparatively empty, or only moderately full, fluids on the outside pass in, and mingle with the contents. This is called endosmosis. When they are very full, the watery portion of the blood will filter through, and pass out. , This is called exosmosis.
Now, if the reader will think a little, he will easily see that if the veins are barely full enough not to allow any fluid to pass in, the natural exhalations of the shut sacs would bring on dropsy; but if the veins are so full as to cause water to flow out, then the dropsical accumulation will be still more rapid.
Diuretin in 20grain doses dissolved in water and taken five or six times a day may prove serviceable in both this disease and the one on the preceding page.
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