HYDROPERICARDIUM. 



Definition. Dropsy of the pericardial sac. 



Causes. This is an effusion occurring, passively, independently 

 of inflammation, and like other oedemas may come from an excess 

 of water in the blood (ansemia, hydrosemia), or from nephritis, 

 hepatitis, obstruction to the pulmonary or pleural circulation, 

 (pulmonary sclerosis, cancer, tuberculosis, actinomycosis), insuf- 

 ciency of the left auriculo-ventricular valves, or parasitisms (dis- 

 tomatosis, lung worms, intestinal worms. ) 



Lesions. The pericardial fluid is considerable in amount, clear 

 or straw-colored, and contains a little albumen, and traces of 

 fibrinogen and salts. The paucity of the two latter engredients 

 distinguishes it from the effusion of pericarditis. 



Symptoms. These are the objective symptoms of pericarditis 

 with effusion, but without the attendant fever, or the pain on 

 pressure or percussion. It is not preceded by a cardiac friction 

 sound. There are dyspnoea, rapid pulse and breathing, easily 

 roused by slight exertion, a tendency to palpitation, irregular 

 rhythm of the heart, excessive area of flatness on percussion 

 showing a conical outline with the apex below, a low, mufiled or 

 distant character of the heart sounds, and it may be a venous 

 pulse in the lower end of the jugulars. 



Treatment. Correct the primary disease on which the dropsy 

 is dependent. Then solicit the absorption of the effused liquid 

 by diuretics, digitalis and deobstruents (pilocarpin). Blisters to 

 the region of the heart will often favor absorption, and may be 

 repeated when the effect of the first have ceased. All other 

 measures failing, tapping may be resorted to, but this will be 

 ineffectual while the primary disease-factor persists. 



460 



