590 PRACTICE OF PHYSIC. 



for ought we know, are incurable, such as a polypus of the heart, 

 near the heart, or in .the sinus of the brain ; the several topical 

 affections which I have hinted at in the heart and lungs ; fur- 

 ther, those which depend upon some affection of the vessels lead- 

 ing from the brain ; all the dropsies depending on scirrhosities 

 of the liver or any of the abdominal viscera, which have gone 

 the length of producing the atony which has induced the dropsy ; 

 and more positively the dropsies of the lower belly from com- 

 pression of the vena cava, from rupture of the lymphatics, or 

 from small encysted dropsies. I would judge the same effect 

 to arise from obstruction in the course of the lymphatics, such as 

 in the mesentery. The causes being here incurable, the dropsies 

 produced by them are so also. 



u Other cases may be considered as ambiguous, as for in- 

 stance, those depending on a relaxation of the exhalents. If 

 this occurs to a considerable -degree, the dropsy may be incurable. 

 But when we find relaxation from temporary causes and without 

 topical affection, we may often consider the disease as curable : 

 and we hold the same language with regard to those cases which 

 arise from great hsemorrhagies, or long continued evacuations of 

 any kind ; if these have not gone the length of weakening the 

 assimulating powers, we may expect the crasis of the blood re- 

 stored, and the dropsy cured. 



" If, in the last place, this disease depends upon suppressed 

 evacuations or some other diseases, which are only temporary, 

 then we may suppose the dropsy to be removable like its cause. 



" It is very necessary to attend to these distinctions in cases 

 of dropsy, both with a view to the attempts which we may make 

 in practice, and more frequently to excuse ourselves by a pro- 

 per prognostic, and to prevent our judging rashly of medicines 

 and their efficacy, when we happen to have employed them only 

 in the incurable cases." 



MDCLXVII. Having thus explained the general causes of 

 dropsy, I should proceed, in the next place, to mention the sev- 

 eral parts of the body in which serous collections take place, 

 and so to mark the different species of dropsy ; but I do. not 

 think it necessary for me to enter into any minute detail upon 

 this subject. In many cases these collections are not to be as- 

 certained by any external symptoms, and therefore cannot be 



