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Show Conclusion of flu: Firsi Pin-2‘. Conclusion 9‘ flit First Part. "6 body : be ofthrce kinds. The first is, where there is a general dcbility in the. s of the ar- this is felt most in the lower extremities or legs; the extremitie the tcrics are so relaxed, that they permit the thinner fluids to escape into cavities of the cellular membrane, whilst the lymphatic vessels, having lost their tone, do not take up these fluids. Cases of this kind are frequently met with in young people from temporary debility, who have undergone some tedious and dangerous disease, as after fever. From this they frequent- ly recover; but it isa very bad symptom in old age, accompanied with asthma, as it is most probable that the visible dropsy of the legs is then accompanied with an invisible one, or water in the chest. Women fro- qiiently bear this swelling of the legs longer than men, even for years, without any danger. Some men have sustained it for twelve years, With. out the least decrease of their general health. I have seen the integiiinents of the ankles hanging over the shoes for months, and yet the patient has perfectly recovered. The second species of dropsy is very common, and is tl at which arises in consequence of previous inflammation of a cavity; and may take place in any habit of body. If an inflammation arise in a cavity, it may terminate in a number of different ways: one of these ways is by an increased secretion of the fluid of surfaces. A man receives a blow on the testicle; inflammation takes place, and the consequence is frequently a hydrocele, or dropsy of the tunica vaginalis. A child's brain inflames, and this inflammation ends at last in hydro- cephalus, or collection of water in the brain. I'lcurisy frequently tct: miiiates in hydrothorax, or collection of water in the chest. I have often taken away forty or sixty pints of water, which had accumulated in the cavity of the abdomen, in the few days the peritoneal inflammation had lasted, during the usual species of the child-bed fever. This is to be considered as the substituting a less dangerous disease for another. Perito- neal inflammation kills often in three days, but ascites may last twenty years. When the arteries of the part have once got a habit of increasing their secretions, they commonly go on for a long time. The lymphatics may, in some cases, absorb their usual quantity of the fluid of surfaccs; but, as the fluid secreted by the arteries Often far exceeds the quantity which they absorb "flaw" urnmwvimw"-‘W>WWI W 1 17 absorb, the dropsy is still kept tip; or, the lymphatics may be so altered by the inflammation, as not to absorb a sufficient quantity. The third species of dropsy is that which arises front some obstruction to the return of the venous blood to the heart. This may happen from the blood of the veiia portarum being obstructed in its course to the heart by a schirrous liver; ascitcs, or dropsy of the abdomen, may be the consequenco. It may happen from inflammatory adhesions of the sub- stance of the lungs retarding the passage of the blood of the pulmonary artery through that viscus. In either case, the venous blood is obstructed in its passage to the heart; the arteries find a greater resistance to their throwing their blood into the veins, and are obliged to relieve themselves by an increased secretion from their exhalents, and thus most probably dropsy is produced in the cavities to which they belong; for when the ob- struction is tended some at the same morning, in removed, the dropsy disappears-In a case which I atyears ago, the patient had dropsical swellings of his legs, time had a hoarsencss which had lasted for two years. One stooping to buckle his shoes, he burst a blood-vessel in his lungs, and from this accident lost about two pounds of blood; both the hoarseness and the swelling of the legs gradually went off, and he conti- niicd well for two years after. A boy, nine years of age, had for some months dropsical sivcllings of the lower extremities; at first the pulse was strong and frequent, and the heart gave the aneiirisnial stroke: I said there was some great disease in the chest. After his death, I was permitted to open the body; the right ventricle of the heart was twice as large, and twice as thick, as the left ventricle; just the reverse of what is natural. The reason of this, I found, was a laminated coagulum of blood, about the. size of a small cherry, at_ tached by a peduncle to the beginning of the pulmonary artery, and nearly blocking up its cavity. A married gentleman, about 35, became suddenly melancholy, com- plained amongst other things of being lately gradually unman‘d, his legs began to swell, his urine became scanty and turbid, and he could not go up stairs without losing his breath. I suspected water in the chest; in three months he died. I opened the body, there was water in the chest, but there |
