(From Hydrops 4325water,) hyderos; a dropsy.

In reality there is but one kind of this disease, for all the various dropsies differ only in their seat. As this circumstance suggests a variety of practice, we have distinctly considered the peculiar circumstances under each head, and shall now add only a few general remarks.

All dropsies are chronical diseases from debilitated fibres; but this debility may be general or particular. It is, however, always attended with an accumulation of serosity, either in the whole of the cellular texture, or in particular cavities. In the anasarca the water is clear and limpid, but in the ascites often more thick and gelatinous, or sometimes mixed with hydatids or coagulated lymph.

Each age and sex is liable to this disorder; but generally it happens to men advanced in years, and to women after child bearing; those who live in low wet situations; whose life is sedentary, and who have indulged in spirituous liquors.

The general or immediate causes of all dropsies are increased exhalation or diminished absorption. The former, in anasarca, is, according to Dr. Hunter, owing to transudation. This, however, makes little difference in the present view of the subject; and it is useless to engage in an examination of the distinction, as it will not apply to any practical improvement.

Increased exhalation often arises from an interruption to the return of the venous blood; and this interruption may arise from diseases of the right ventricle of the heart, or its valves, from an upright posture, when the force of gravity opposes the return; scirrhi, or other obstructions in the liver or spleen; polypous concretions in the veins; aneurisms in the arteries; abscesses; scirrhi or steatoms in the neighbourhood of the arteries or the veins; the gravid uterus, etc.

A general debility and laxity of the whole system are a common cause of increased exhalation, and dropsies are, in this way, occasioned by repelled eruptions or suppressed evacuations; by general causes of debility, as palsy, long fevers, excessive evacuations, and intemperance.

A preternatural quantity of watery fluids taken into the system, or absorbed by the skin, has been considered as a cause of dropsy; and a preternatural tenuity of the blood from saline acrimony has been said to produce the same effect. Each, however, is, we believe, rare. re easily disposes of the superabundant fluids, if the secretions are free; but when suppressed, as in cold watery situations, by an ischuria renalis, etc. dropsy will probably follow.

A rupture of the thoracic duct, of the lacteals or lymphatics of the kidneys, ureters, or vesica urinaria, may produce dropsy; but these causes are peculiarly rare. Hydatids, on the contrary, we suspect to frequently induce this disease.

Absorption may be diminished from loss of tone in the absorbing extremities of the lymphatics, and by obstructions to the passage of the absorbed fluids in their course. See Lacteals and Lymphatics.

These causes of dropsy, though separately stated for the sake of distinction, are frequently combined; and we must confess that the great outline will not admit of practical application. Our chief object is to evacuate the water by increasing the secretions, while we support the general tone of the system by a warm cordial diet, cordial and tonic medicines, which do not possess too great a degree of astringency. The bitters called aperient are, in general, best adapted for this purpose. The general evacuants we have noticed in the articles of Anasarca and Ascites, q. v. Wc shall now add the means of obviating some of the more troublesome symptoms.

Dropsies are not quickly fatal, except when produced by polypus concretions in the heart or pulmonary vessels; a scirrhous liver; tumefied mesenteric glands; a scirrhous or otherwise disordered uterus. Bleeding of the nose, ulcers, or gangrene, appearing in any part, are highly dangerous. Great thirst, the upper parts greatly extenuated, febrile horror with external heat, an erysipelas on the legs, livid streaks or spots on the skin, are among the most dangerous symptoms.

Thirst. - We see no reason for the rigid abstinence so often enjoined: the patient may, in general, drink in proportion to his inclination. Acid liquors, as cycler, or in want of it vinegar imperial, with a small proportion of the spirit of juniper, or rhenish wine and water, may be allowed; and thirst is often prevented by holding nitre in the mouth.

Difficulty of breathing. - In this case the loss of a few ounces of blood has been recommended; but though a momentary relief is thus obtained, the injury will be considerable. The safest method is, if possible, to obtain relief by expectoration; and for this purpose a mixture of the gum ammoniac with the acetum scillae may be repeated as the occasion requires. The infusion of garlic is often useful, and the asafoetida relieves the dyspnoea when it is connected, as is often the case, with flatus in the stomach, occasioning hysteric affections. In this situation also a warm plaster or liniment, with a large proportion of opium, may be applied to the pit of the stomach.

Spasms often arise in particular parts, especially about the chest, frequently awaking the patient out of a sound refreshing sleep. In such cases opium, with camphor, is the only effectual remedy; and even in hydro-thorax, when the dyspnoea is considerable, is often a safe remedy. It is only contraindicated when there is a considerable and apparently necessary discharge from the mucous glands of the bronchiae.

Vomiting is relieved often by the chalk julep, with a slight warm opiate, or by a saline draught in the act of effervescence.

Purging requires regulation only, for it is often a salutary discharge.

See Hoffmann, Boerhaave, Lister, and Lysons, on this disease; Le Dran's Operations; London Medical Transactions, vol. ii.; Cullen's First Lines, vol. iv.; Monro on Dropsy.