DROPSY OF THE PERITONEUM ASCITES. 64:9 



may form, must be steadily poulticed and opened early. Like treat- 

 ment and the use of iodine externally and internally are indicated in 

 chronic peritonitis. 



In regard to the symptomatic indications, an early cyanosis, and 

 still more excessive dyspnoea, if accompanied by symptoms of oedema 

 of the lungs, requires venesection. It is true, this only temporarily 

 removes the danger to life ; but we know of no other remedy to fulfil 

 this urgent indication. The administration of oil of turpentine, long 

 since recommended in England, benefits the cause of the dyspnoea, the 

 tympanites, just as little as the absorbents and other remedies, by 

 which it has been attempted to carry gases off from the intestines. 

 The introduction of a small trocar into the abdomen, to draw off the 

 gas, should be avoided, as we may attain just as much by the introduc- 

 tion of a tube through the rectum (Bamberger). The vomiting is 

 most benefited by swallowing small pieces of ice. Even the mildest 

 eccoprotics should not be used for the constipation until the inflamma- 

 tion has ceased ; generally, opium is as useless as the astringents in the 

 diarrhoea depending on the oedema of the mucous membrane. In pro- 

 tracted cases, where there seems to be danger from the consumption 

 caused by the fever, we should give sulphate of quinine in large doses, 

 small quantities of wine, and a nutritious and easily-digested diet. 



CHAPTEK II. 



DROPSY OF THE PERITONEUM ASCITES. 



ETIOLOGY. Dropsy of the peritonaeum ascites is a transudation 

 into the abdominal cavity, resembling the normal transudations of the 

 body. The circumstances under which ascites develops are the same as 

 those under which increase of the transudations occurs elsewhere, and 

 may either be referred to increased lateral pressure in the vessels, or 

 to a diminished amount of albumen in the blood, or, lastly, to a degen 

 eration of the peritonaeum : 



1. Ascites is very often one symptom of general dropsy, whethe 

 this depend on obstruction to the flow of blood from the veins, by dis 

 ease of the heart and lungs, or on degeneration of the kidneys, of the* 

 spleen, or any other disease inducing poverty of the blood. In all 

 these cases the ascites is usually one of the last in the series of dropsi- 

 cal symptoms, and does not occur till dropsical effusions in the sub- 

 cutaneous tissue (anasarca) of the extremities, face, etc., have existed 

 for some time. 



2. In other cases, the ascites is the result of a congestion confined 



