ASCITES. 483 



Prognosis. The prognosis is grave, though it must not be regarded 

 as necessarily fatal. In cases resulting from genital diseases, and in 

 localised chronic peritonitis resulting from persistent, but not excessive, 

 mechanical violence, complete and perfect recovery may occur. 



On the other hand, in cases of chronic lesions of the liver, kidneys, 

 heart, etc., and in tuberculosis, carcinoma, etc., recovery cannot be 

 expected. 



Treatment. Treatment should be directed towards combatting the 

 chronic inflammation. With this object resort may be had, when neces- 

 sary, to persistent stimulation of the sides of the abdomen, mild blisters 

 and mustard plasters, or friction with turpentine. 



The food should be easy of digestion, and of first-rate quality. The 

 most useful drugs comprise mild, unirritating diuretics, general stimu- 

 lants, and tonics. 



Animals affected with incurable lesions should not be treated. 



ASCITES, 



True ascites consists in dropsy of the peritoneum, unaccompanied by 

 inflammation of that membrane, or by the presence of infectious micro- 

 organisms in the transuded liquid. Properly speaking, it is not a morbid 

 entity, but only a symptom common to several very complex diseases. 



Causation. The diseases which produce it may be set forth under 

 five principal heads : — 



(1.) Cardiac affections in general, particularly chronic lesions of the 

 heart, interfering with venous circulation, and causing prolonged stasis 

 of blood in an organ or tissue. 



(2.) Pericarditis due to foreign bodies, and the various forms of 

 pseudo-pericarditis, i.e., lesions in the neighbourhood of the heart, 

 causing compression of that organ and of its vessels. 



(B.) Generally speaking, all lesions which interfere with the return 

 circulation, particularly lesions of the liver (distomatosis, echinococcosis, 

 and interstitial hepatitis). These produce compression of the portal 

 vein or other obstacle to circulation, and the transudation is exclusively 

 localised in the abdominal cavity. The connective tissue does not 

 become infiltrated. 



(4.) Diseases of the kidneys (nephritis, pyelo-nephritis), which 

 secondarily produce cardiac disturbance. 



(5.) Gestation, which causes compression of certain digestive viscera, 

 and of certain veins of the pelvic cavity. 



Ascites was formerly regarded as always forming a complication 

 either of anaemia or of hydrsemia. We now know that the primary 

 cause of these three collections of symptoms (ascites, anaemia, and 



II 2 



