MEDICINE. 
Sect. II'. Flatuosce, windy swellings. 
Genus I. Pneumatosis, a tense elastic swell- 
ing of the body, crepitating under the touch. 
Pneumatosis is constituted by a distension 
of the cellular membrane from air; it may 
arise without any evident cause, and in this 
case is denominated by Dr. Cullen the spon- 
taneous pneumatosis'; or the distending air 
may be introduced by means of an external 
wound, as of the thorax, in compound frac- 
ture of the ribs: sometimes elastic swellings 
of the whole bodyj follow, from the applica- 
tion of poison; and at others, pneumatosis 
appears as an attendant upon the hysteric 
disorder. 
The pathology of this disease, unless when 
it arises from wounds, is exceedingly ob- 
scure. 
M. M. Scarifications, compresses, tonics. 
- Genus II. Tympanites, a windy swelling of 
the abdomen, tense, elastic, painful, and at- 
tended by costiveness. 
Tympanitic swellings, both of the intes- 
tinal canal and of the cavity of the abdomen, 
often take place in conjunction with anasarca, 
or other disorders of debility, and frequently j 
arise from sedentary habits, hypochondriac 
ailments, and innutritious diet. 
M. M. Carminatives, emetics, tonics, and 
•a generous diet, with exercise. 
Tympanites is sometimes connected with 
obstructed menstruation, and in this case is 
■seldom. overcome but with the return ot the, 
menstrual discharge. 
Genus 111. Physomctra, an elastic swelling 
in the hypogastrium, consequent upon liatu- 
ient distension of the womb. 
“ Idris frequently deceives the barren fe- 
male with the hopes of pregnancy, till nature 
explains the mystery, and her expectations 
vanish in air.” 
Sect. III. Aquosa-y watery swellings. 
Dropsical enlargement is distinguished 
from pneumatosis by its being inelastic, or 
pitting from the pressure of the linger, and 
slowly recovering its former fulness. 
While considerable obscurity attends the 
nature and proxmiate cause of windy swell- 
ings, the theory of dropsical atfections is suffi- 
cientlv evident. Dropsy is a collection ot 
serous tluid, [either in the cellular membrane^ 
or in the cavities of the body. It is invariably 
occasioned by exhalation being dispropor-. 
tionute to absorption; this increase of exha- 
lation and diminution of absorption result 
from debility, which may be either direct or 
indirect; the latter follows increased action 
of the vessels, as in th* dropsy succeeding to 
intemperance ; the former arises out ot defi- 
cient excitement in the lymphatic system, 
us when an individual becomes dropsical 
from indolence, inactivity, mental depression, 
and poverty of diet. Partial dropsies, or 
anasarcous swellings of the cellular mem- 
brane, as well as effusions into cavities, may 
also originate from pressure on the veins,- in- 
dependently of original debility in the lym- 
phatic vessels, such pressure obstructing the 
tree reflux of blood through the. venous sys- 
tem, and by consequence occasioning a 
more than ordinary determination to the ex- 
halant arteries in the vicinity. Such are the 
dropsical accumulations which sometimes oc- 
cur in pregnancy, and which are relieved by 
delivery, in this manner likewise, that swell- 
ing o T the abdomen, constituting ascites, 
VOL. II. 
partly originates, when it is caused or attended 
by an obstructed circulation through the 
liv er, the blood in the vena porta: accumu- 
lating in an inordinate measure, and by con- 
sequence supplying the lymphatic vessels of 
the part with more than their due proportion 
of fluid. Lastly, without universal debility 
in the exhalant and absorbent vessels, drop- 
sical swellings may arise from inflammation, 
as is illustrated in* the anasarcous collections 
following erysipelas, in the hydrocele suc- 
ceeding to a blow on the testicle, in the drop- 
sy of the chest resulting from inflammation of 
the lungs, and in ascites following peritoneal 
inflammation. 
In whatever mode, and to whatever extent, 
dropsy may be occasioned, the accumula- 
tion of serous fluid by which it is constituted, 
always argues debility in the lymphatic ves- 
sels of the part in which this accumulation 
occurs. This debility, perhaps, is primarily 
and principally seated in the lymphatic ex- 
halants ; for we do not find hectic fever a 
characteristic of hydropic, as ir is of other af- 
fections, in which an original torpor of the 
absorbents is evidently the cause ot the mor- 
bid symptoms. Hectic only comes on in the 
last stages of dropsy, when the absorbents are 
worn out with constant exertion to absorb the 
effused fluid. 
We have hitherto spoken indiscriminately 
of dropsy of cavities, and of dropsy in the cel- 
lular membrane: these, however, although 
they often exist conjointly, require to be dis- 
tinguished ; for instance, an accumulation of 
water in the thorax may be confined to the 
cellular texture of these organs, and form the 
disease properly distinguished by the deno- 
mination of anasarca pulmonum; or it may he 
diffused in the cavity of the chest, and con- 
stitute the true hydrops pectoris, or hydro- 
thorax. The former generally arises from an 
universal torpor of the lymphatic system, 
and is almost constantly connected with hy- 
dropic swellings of other parts, particularly 
the ancles and legs ; the latter often originates 
as a local disease, as.fr&m an inflammation of 
the pleura, and is sometimes confined entirely 
to the chest. 
Genus I. Anasarca. General dropsy. 
Dropsy of the cellular membrane im- 
mediately under the skin appears prin- 
cipally in tl^ lower extremities, on ac- 
count" of the depending situation of these 
members, and the universal connection be- 
tween the cells of whic h the membrane is 
constituted ; and party on account of the de- 
ficiency in lymphatic excitement, from which 
it originates, being more conspicuous in 
those Vessels which are the furthest removed 
from the centre of the circulation. Anasarca, 
as it arises from exhausted excitability in the 
lymphatic vessels, is always a disorder indi- 
cating much danger. 
M. M. Those stimuli which are found to 
exert their influence on the absorbent vessels, 
particularly steel, digitalis, calomel. Diure- 
tics, such as squills, juniper, nitrous at her, 
cantharides, chrvstals of tartar, and nitre. 
Emetics and cathartics are less proper in 
anasarca than in dropsy of cavities. The phy- 
sician must be especially careful while eva- 
cuating the fluid by means of diuretics, to 
support ( he* general excitement, in order to 
prevent its reaccumulation ; from want of so- 
licitous attention to this particular, the wa- 
ters, after an apparent eura of anasarca, often 
15-3 
again collect to an increasing extent. Punc- 
tures and scarifications of the extremities are 
seldom advisable, on account of the prevail- 
ing debility and tendency to gangrene. 
Vile sparing use of liquids is generally pro- 
per in dropsy; instances, however, have been 
known of copious draughts of water produ- 
cing a termination of the complaint. 
Genus If. Hydrocephalus, dropsy of the 
brain. See Infancy. 
Genus HI. Hydrorachitis, dropsical tu- 
mour in the spine. See Surgery. 
Genus IV. Hydrothorax, dropsy of the 
chest. 
Symptoms. Difficulty of breathing, espe- 
cially in a horizontal position, paleness of 
countenance, starting in sleep, palpitation of 
the heart, numbness of the arms, especially 
when elevated, and in the advanced stages of 
the malady an evident fluctuation of water in 
the cavity of the chest. The hydrothorax, 
or hydrops pectoris 1 , “is distinguished from 
the anasarca pulmonum, as the patient in (In- 
former cannot lie down half a minute; in the 
latter, the difficulty of breathing, which oc- 
casions him to rise up, comes on more gradu- 
ally; as the transition of the lymph in the cel- 
lular membrane, from one part to another of 
it, is slower than that of the elfused lymph in 
the cavity of the chest.” (Darwin.) We have 
already said, that in the anasarca pulmonum 
the disease is often attended with swelled 
legs. Dr. Darwin suspects that even this 
species of dropsy of the chest is in the greater 
number of instances a disease merely of the 
cellular membrane of the part, not of a 
general torpor of the lymphatic system, and 
that the legs do not swell (ill the patient, from 
the protraction of the local malady, becomes 
universally weak. We often, however, meet 
with ascitic and anasarcous swellings com- 
mencing in the extremities, which, in their 
course towards a fatal termination, rise up 
into the chest, and in this manner occasion 
the pulmonic affection. Here the general 
paralysis of the lymphatics precedes the pri- 
mary disorder of the thorax. 
Causes. Where the universal has preceded 
the local affection, the malady is most fre- 
quently to be traced to intemperance in the 
use of fermented and spirituous liquors. The 
most usual source of genuine hydrothorax, or 
hydrops pectoris, is t lie sudden application of 
cold, while the body is in a state of perspira- 
tion and debility, from previous heat and ex- 
ercise. Young people, during perspiration 
and fatigue from dancing, “ if they drink 
•freely of cold lemonade or water are apt to 
bring on a dropsy of the chest.” (Townsend.) 
M. M. Digitalis in considerable doses is 
especially indicated in dropsy of the chest, 
and its effects are more visible as well as 
more certain in the anasarca pulmonum than 
in the hydrops pectoris, because this medi- 
cine influences powerfully the whole extent 
of the absorbent system. Squill, in combina- 
tion with ca'omel, for the hydrops pectoris ; 
and if the cellular membrane he anasarcous, 
connect steel with both the above medicines. 
Chrystals of tartar, especially in the anasarca 
pulmonum. Diuretics of other kinds, the 
same as in general anasarca. Opium. In 
hydrothorax, or dropsy of the chest, without 
anasarca, paracentesis, or puncture in t! e 
side. “ It is sometimes impossible even to 
relieve lire dropsy of intemperance; and the 
