This section is from the book "Smith's Family Physician", by William Henry Smith. See also: Natural Physician's Healing Therapies: Proven Remedies that Medical Doctors Don't Know.
Sir Thomas Watson says: "It has been said, and said with much truth, that Dropsy is rather a symptom of disease, than a disease of itself, and it has been affirmed that it would be more philosophical and scientific to treat of the original malady upon which the effusion or accumulation depends; to erase dropsy from the list of substantive diseases, and to place it in the catalogue of mere symptoms.
"But this, to my mind, is a very mistaken view of the matter. For, first, it is oftentimes uncertain, while the patient is yet alive, what or where the primary disease may be; and even after death we sometimes can discover no organic change that would satisfactorily account for the effusion. Practically speaking, in such cases, the Dropsy is the disease and the sole object of our treatment. And, secondly, Dropsy is in fact, to a medical eye,in all cases, something more than an effect or symptom of disease. The imprisoned liquid is often a cause of various other symptoms; embarrassing, by its pressure, important functions, and even extinguishing life. The removal of the Dropsy (although its original cause, of which it was a symptom, may remain behind, untouched, to be again productive of effusion under circumstances favorable to the operation)-the removal of the Dropsy will often restore a person to comparative comfort, or even to what, so far as his sensations, and powers, and belief are concerned, is, to him, for the time, a state of health.
This disease is marked by a tense swelling of the abdomen, accompanied by an evident fluctuation.
Dropsy may arise from various causes. It may occur in either sex, and at any age, but it is chiefly to be met with in persons advanced in life. It is often preceded by loss of appetite, sluggishness, inactivity, dryness of the skin, oppression at the chest, cough, diminution of the natural discharges of urine, and costiveness. Shortly after the appearance of these symptoms, a swelling is perceived in the lower part of the belly, which extends gradually, and keeps on increasing, until the whole abdomen becomes at length swelled and tense.
The distention and sense of weight, although considerable, vary somewhat according to the posture of the body, the weight being felt the most in that side on which the patient lies, while at the same time the distention becomes somewhat less on the opposite side.
As the collection of water becomes more considerable, amounting in some cases to eighty or a hundred pints, the difficulty of breathing is much increased, the countenance exhibits a pale or bloated appearance, an immoderate thirst arises, the skin is dry and parched, and the urine is very scanty, thick, high-coloured, and deposits a reddish sediment; the functions of the stomach and bowels are generally performed with tolerable regularity. The pulse is variable, being sometimes faster, and at other times slower than natural.
Ascites or Dropsy of the belly means the accumulation of serous liquid in the general cavity of the abdomen: while Ovarian Dropsy consists in a collection of fluid in one or more cells within the Ovary; or in a serous bag connected with the uterine appendages.
In ascites the enlargement is uniform and symmetrical, in respect of the two sides of the body. When the patient lies on her back the flanks bulge outwards, or hang over, from the weight and lateral pressure of the fluid. This increased breadth of the trunk is not observable in the case of an Ovarian tumour or pregnancy.
When we are able to trace the early history of Ovarian Dropsy, we find, in most instances, that the abdominal tumour was first perceived on one side; but when the enlargement of the abdomen is great, the distinction between Ascites and Ovarian Dropsy, drawn from the shape of the swelling, fails, as then the Ovarian tumour distends the abdomen, if not uniformly, yet nearly or quite as much on one side as on the other.
It is observable in true Ascites that there are almost always manifest indications of constitutional suffering and disturbance; a sallow complexion; debility; emaciation. The morbid accumulation results from disease in some organ, of which the functions cannot be impaired without injury to the whole system.
Ovarian Dropsy, on the other hand, may last long and be extreme in degree, while the general health is scarcely affected. The very bulk and weight of the swelling produce, indeed, much inconvenience and discomfort; but, in other respects, the patient often remains in fair, and even in good health. This appears to be owing to the circumstance that the ovary is not directly necessary to the life or well-being of the individual, but is merely subservient, for a limited time, to the purpose of reproduction.
Encysted Dropsy, in the abdomen, is not always Ovarian Dropsy. Omental Dropsy; the omental cavity alone being full of liquid; Cysts containing a considerable quantity of a clear thin liquid, and connected with the liver, are common. Probably these are in all cases the growth of hydatids. Dropsy of the Fallopian tubes, Dropsy of the Uterus, large serous cysts in the Kidney, constitute other forms of abdominal encysted Dropsy. Such states must be discovered by their own particular circumstances. None of them are very common.
Chronic Ascites is sometimes the result of acute inflammation of the peritoneum. In such cases the abdomen is usually uneasy, and tender under pressure; or at any rate more than commonly sensitive. Whereas when Ascites is passive as well as chronic, you may make the requisite examination without causing any distress to the patient.
The actual condition of the dropsical Ovary is subject to much variety. Sometimes there is but one cyst; and this may be no bigger than a pea; or it may be large enough to contain many gallons Its walls may be as thin and flexible as those of the healthy urinary bladder, or they may be firm, and half an inch or more in thickness. It may spring from a small pedicle, and lie free, and otherwise unattached in the cavity of the peritoneum; or may adhere, partially or at all points, to the contiguous surfaces: or it may be tied and tethered by bands of coagulable lymph.