252 CHAPTER 28. 



CHAPTER 28. 



DROPSICAL SWELLINGS. 



509. Nature of Droj^sical Swellings. 510. Seat. 511. Causes of Soft 

 Dropsical Swellings. 512. Ca^lses of Inflammatory Dropsical SioelUngs. 

 513. Treatment. f>\4<. Direct removal of the Fluid. h\h. Indirect removal 

 of the Fluid. 516. Removal of the causes. 517. Swelled legs. 



509, Nature of Dropsical Swellings. 



The Swellings, recognised as Dropsical, consist of an abnormal quan- 

 tity of fluid derived from the blood by percolation of its watery parts 

 through the coats of the vessels. The effused fluid consists of seruni with 

 a very slight quantity of albumen and wholly free from any admixture 

 of blood or coagulable lymph. 



Dropsical Swellings are of two kinds, namely, those which result from 

 venous obstruction or debility, and those which result from inflammation. 



The first named are soft and free from heat or tenderness, they pit on 

 pressure and sometimes temporarily disappear either entirely or in a 

 great degree on the application of friction, combined with pressure. 

 The lattel- are hard, hot, highly sensitive, and often pulsate strongly. 



510. Seat. 



These watery effusions may collect in any of the closed cavities of the 

 body or in any of the loose permeable structures. They bear various 

 names, according to the cavity in which they occur. 



They are most common in the legs, constituting the disease known as 

 (Edema of the legs; in the peritoneal sac, constituting water on the 

 belly, otherwise called Ascites ; or generally under the skin of the belly, 

 sheath, legs, and other dependent parts, being then recognised as Ana- 

 sarca or general dropsy. Not unfrequently they occur in the chest, as 

 Hydrothorax or Hydrops pericardii; and more rarely in the ventricles 

 of the brain and in the spinal cord as Hydrocephalus, or in the testicle 

 as Hydrocele. 



511. Causes of Soft Dropsical Swellings. 



The effusion of serum which produces the soft pitting swelling may 

 result from a diminished and retarded, or from a retarded though not 

 diminished state of the circulation; or it may result from a poor im- 

 poverished condition of the blood ; or all these causes, or some of them 

 may exist in combination. 



These, however, though the immediate causes, are themselves the 

 result of other affections. Want of tone in the circulation often arises 

 from disease of the heart. If the heart is weak, it is unable to propel 

 the blood onwards as rapidly as it is returned to it by the veins. Hence 



