ANASARCA, OR DROPSY OF THE SKIN. 417 



chosen for the opening should be upon the hnea alba, mid- 

 way between the umbilicus and the sheath : in the mare, 

 between the umbiHcus and pubes. This point should be 

 chosen for the puncture, which ought to be made directly 

 upwards ; and both this and the former operation must be 

 conducted and treated upon similar principles, with the ex- 

 ception, that in ascites the whole of the fluid may be evacu- 

 ated at once, and allowed further to drain off, by the simple 

 application of a linen bandage. Should any prospect of 

 benefit be derived, endeavour to prevent a recurrence by 

 strengthening the general habit. 



CHAPTER VIII. 



DISEASED COLLECTIONS OF FLUID WITHIN THE CELLULAR 

 MEMBRANE. 



ANASARCA, OR DROPSY OF THE SKIN. 



Anasarca^ (Edema, and Water Farcy. — We need make no 

 distinction between these terms, particularly the two first. 

 As generally accepted, oedema carries probably rather a 

 more local definition with it ; thus we say an oedema- 

 tous swelling : but anasarca is more frequently used to 

 designate an extensive dropsy of the cellular membrane. 

 Both, however, have the same origin, and are accompanied 

 by the same symptoms. It differs from ascites principally 

 in its external seat, which is sometimes partial and some- 

 times general. It also appears under different forms, as it 

 has different origins ; and its terminations are also under the 

 influence of these circumstances. A debility of the ab- 

 sorbent system is usually observed in the spring and autumn. 

 There is, however, some general atony of the whole system, 

 and the oedema disappears as the constitution establishes 

 itself. At other times anasarca and oedema appear as ac- 

 companiments or sequelae to acute diseases that have dis- 

 turbed the functions generally, in the which case the 

 absorbents become irritated ; or to the oedema is added 

 tumefied lymphatics. 



E e 



