MEDICINE. 



countenance thla. idea, yet it most he acknowledged 

 he pathology of the disease is altogether obscure, 

 >t we have no direct facts to guide us in our 

 decision. One of the most remarkable symptoms in 

 Dropsy is the change which is effected in the state of 

 the urine; it ,- ..minished in quantity, and ii 



altered in its quality ; the proportion of the watery 

 part to the solid contents being considerably reduc- 

 ed, so aa to render it thick and high coloured, and to 

 eanse it to deposite as it cools, a copious sediment. In 

 ases of Dropsy the urine ha* been found to co- 

 i by the application of beet, proving that it con- 

 > a pui tion of albumen ; and as the presence of al- 

 i has been conceived to indicate a different con. 

 dition of the system from that which prevails in the 

 more ordinary kinds of Dropsies, considerable import- 

 ance baa been attached to this rirrwmstanre, both in a 

 pathological and a practical point of view. 



In attempting to cure Dropsy we an first to inquire 

 whether the disease be primary or simpteeaatir; and 

 if we conclude H to be only sjmptumahr, we an of 

 coarse to apply our remedies to the removal of the 

 final diataas. But when this cannot be accumplial 



or when we an not able to detect any primary 

 tion, we most direct our attention to the Dropsy itself; 



ami the two obvious indications will be to 



effused fluid and to prevent its 



effused fluid may be nmoved by 



ties which contain it, and tbne macfmtiicsliy 



ing it; but this seldom ' 



t iiapa 

 rary relief, aa while the same constitutional Jieaoastiusi 



MfOMtttDiM twtB sVptpfwaTat tn*tt It U flflViMQ HI InVWCf 



quantity than before, and that the general heahb is in- 

 jured by the operation. It must also be remarked, 



ias,wBt^ > Uw^canfclrymadT M *red^! 



^^^Mfl^B tllA ^MttfV^HM^MA ^&t* frMM ftlkA 4^^^kl^ 



i of the vital powers. e must therefore at- 

 tempt to remove the effused fluid through the inter, 

 ventien of internal rsmedits. ami of these the most ef. 

 fectsjal an each a* produce an increased art ten of some 

 of the excretory organs, especially the Jnseetmi 

 and the kidney. In consequence of that 

 neaion which subsists between ail parts of the 

 we find that if by any means we produce an 



ef this connexion we an scarcely able to ascertain, but 

 we are acquainted with the iffjtt. and we have fre- 

 quent opportunities of employing it with sdrant < . 



and diuretic* an the two rlasses of mcdksns^wfakh 

 an usually had recourse to for removing eollertione ef 

 serous fluids when effused into any of the cavities of 

 the body ; and it ia accordingly to these swbstauni*, 

 and especially to the letter, that we generally look for 

 tberonofr^ieec/aUdtwriptiewa. When we an 

 able to produce the desired tflect upon the kidney, we 

 indeed seldom fail in srrnmpnsaina oar purpose, bat 

 H unfortunately happens that then to no class of medi- 

 t is so uncertain and apparently so 



in their operation as diuretics. The naaj 



that have been employed for this purpow is very <___ 



doable, and they an so very different in their nature and 



to act upon the s 

 sanwatwctapon 



that we can scarcely conceiv, 

 une principle, or even to produce the 

 the body. Many of them indeed, H 

 an entirely inert, and hare ac- 



quired their reputation solely from some accidental 

 circumstance; but there are others of obvious activity, 

 although even of these it ia not easy to say in what 

 manner they act, or how substances of such different 

 qualities can all conduce to the same end. The medi- 

 cines that an nUimirl the roost efficacious diuretic* 

 an f quilU, digitalis, cream of tartar, and certain pre- 

 parations of mercury. Of' these the squill is the one 

 which is the most certain in its effects, and which 

 seems to be applicable to the greatest vsriety of cases, 

 so that unless then be some peculiarity in the consti. 

 tution, which prevents aa from administering the me- 

 dicine in proper quantity, or some structural disease 

 which counteracts it* operation, it seldom fails in in- 

 creasing the flow of urine. The vsrieties of Dropsy in 

 which, the squill is thought to be the most useful are 

 Aanasarca and Atcites. Digitalis is a medicine which 

 finnrim great power over the system, but which, al. 

 though occasionally very beneficial, manifests its dele- 

 terious sflecu, and become* decidedly injurious, if it 

 be employed improperly or in excessive quantity. 

 When we eeoaider the nature of the primary action of 

 squills and digitalis, we can scarcely suppose that they 

 operate upon the same principle, yet as we an not 

 able with any Jaffa* of precision to explain the nature 

 of their operation, we an decided almost entirely by i 



she expoftasscOi 



in determining u)>on the individual 

 for which they an each of them more peculiarly adapt- 

 ed. The variety of Dropsy called Hydrothorax, in 

 which the cavity of the chest is the seat of the disease, 

 ha* been generally conceived to be the one in which 

 digitalis is most serviceable ; and it is agreed that a 

 languid, or as it ia metaphorically termed, a relaxed 

 habit and a phlegmatic temperament, is better adapted 

 for the exhibition of this adirinii than a constitution 

 of an iBBHiitl description. The snpertartrate of pot- 

 ash ha* been epoken of by many respectable practi- 

 tioners a* a powerful diuretic; and then are ether 

 neutral salts, principally those into the composition of 

 which the lartarie and acetic acids enter, which src 

 generally supposed to possess the effect of promoting 

 the action of the kidney, but they an all of uncertain 

 operation. When they prove successful in increasing 

 the quantity of the urine, they commonly, at the same 

 tune, act as purgatives; and it may be questioned 

 they an to be considered as any thing more 

 culiar property of which 

 discharge from the* mu- 

 con* surface of the intestines, in which the urinary or- 

 gans may also partake. We have sufficient evidence 

 of the effect of mercury as a diuretic, but it may Actisa of 

 probably be nftiiid with man propriety to its opera- mercury. 

 tion as a general stimulant, than to any specific action 

 upon the Kidney : and this Quinism appear* to be coun- 



Med by the fact, that the use of mercury in Drop. 

 sy is prinaipalty as an adjuvant to other "'"tram, 

 for example to squills and digitalis. If the hypothesis 

 be not too mechanical, we may regard mercury as a 

 stimulant to all the secretory organs, probably in pro- 

 portion to their degree of vitality, or their connexion 

 with the circulating system ; but that its operation may 

 be more particularly directed to any one of them, by 

 being united with a medicine which acts specifically 

 upon the part : of this we have an illustration in what 

 we observe with respect to purgatives as well a* diure- 

 tic*. Perhaps the only case* in which we can con. 

 aider mercury aa having any direct effect in the re- 

 moval of Dropsy, is when the disease depend* upon 

 the enlargement of some glandular part, either by the 



