506 



asphyxia is especially dangerous on account of the risk of blood- 

 l^oisoning after an oj^eration of tracheotomy. 



Metastasis to the viscera, or from the legs to the head, is a most 

 serious complication, while metastasis from the head or otlier ^ov- 

 tions to the holly and legs is favorable, as removing, for a moment at 

 least, all danger of immediate death. The prognosis is otherwise 

 based on the complications, their extent and their individual gravity, 

 existing, as they do here, in an alreadj^ debilitated subject. 



Treatment. — The treatment of anasarca may have been as variable 

 as are the lesions. The Indications are at once shown by the altera- 

 tions and mechanism of the disease, which we have just studied. 

 These are: 



(1) Regulation of the disordered circulation of the blood and 

 strengthening of the vaso-motor system. 



(2) Promotion of absori)tion of the colloid mass, which has infil- 

 trated the tissues. This, of course, is based upon oxidization in order 

 to metamorphose the exudation into absorbable crystalloids. 



(3) Prevention of metastasis, which is the most frequent fatal 

 termination of this trouble, if not directly by a?dema of the lung or 

 enteritis, indirectly by further weakening the already debilitated 

 system. 



(i) The immediate treatment of the complications, each, p^r se, 

 asphj-xia and gangrene, being the two which most frequently call for 

 active interference. 



These indications call for constitutional and local' remedies. 



Blood-letting would at first seem totally contra-indicated, but in 

 certain cases it acts like a charm. Debilitated, as an animal usually 

 is when attacked by anasarca, we have yet seen that one of the great 

 predisposing causes is the plethoric habit. The current of blood, like 

 a swollen river after a spring storm, can be thrown from its usual 

 course by the slightest side channel. The use of bleeding requires 

 the acute i:)erception of the practitioner to be put upon the alert to 

 regulate it. Not only the present condition, but the ijrevious state of 

 health, and the probable future hygienic and medical care must be 

 taken into consideration. Given a case that will admit of bleeding, 

 the quantit}' to be taken is always a minimum one, and it is to be 

 regulated by the effect upon the pulse during the bleeding. 



With the weakened walls of the vessels but a little lessening of 

 the pressure will ijroduce a vacuum, when compared with the con- 

 dition found in an ordinary blood-vessel system, with normal elas- 

 tic walls. Bleeding is only permissible at the outset of the disease 

 when the tumors are still isolated. When the tumefaction has coal- 

 esced all the blood is required to oxidize the mass of effused colloid 

 matter. 



Hygiene now comes into play as the most imj)brtant factor. Oats, 

 oat and hay tea, milk, eggs, anything which the stomach or rectum 



