_October_ 7th. Mr. F----, a little man, with a spine and thorax
greatly deformed; for more than a year past had complained of
difficult respiration, and a sense of fulness about his stomach; these
complaints increasing, his abdomen gradually enlarged, and a
fluctuation in it became perceptible. He had no anasarca, no
appearance of diseased viscera, and no great paucity of urine. Purges
and diuretics of different kinds affording him no relief, my
assistance was desired. After trying squill medicines without effect,
he was ordered to take Pulv. fol. Digital. in small doses. These
producing no sensible effect, the doses were gradually increased until
nausea was excited; but there was no alteration in the quantity of
urine, and consequently no relief to his complaints. I then advised
tapping, but he would not hear of it; however, the distress occasioned
by the increasing fulness of his belly at length compelled him to
submit to the operation on the 20th of _November_. It was necessary to
draw off the water again upon the following days:
_December_ the 8th.
-- -- 27th.
1780. _February_ the 4th.
-- -- 23d.
_March_ the 9th.
During the intervals, no method I could think of was omitted to
prevent the return of the disease, but nothing seemed to avail. In the
operation of _February_ 23d, his strength was so much reduced, that
the water was not entirely removed; and on the 9th of March, before
his belly was half emptied, notwithstanding the most judicious
application of bandage, his debility was so great, that it was judged
prudent to stop. After being placed in bed, the faintness and sickness
continued; severe rigors ensued, and violent vomiting; these
vomitings continued through the night, and in the intervals he lay in
a state nearly approaching to syncope. The next day I found him with
nearly the same symptoms, but remarked that the quantity of fluid he
had thrown up was very much more than what he had taken, and that his
abdomen was considerably fallen; in the course of two or three days
more, he discharged the whole of the effused fluid; his strength and
appetite gradually returned, and he was in all respects much better
than he had been before the last operation.
Some time afterwards, his belly began to fill again, and he again
applied to me; upon an accurate examination, I judged the quantity of
fluid might then be about four or five quarts. Nature had pointed out
the true method of cure in this case; I therefore ordered him to bed,
and directed ipecacoanha vomits to be given night and morning: in two
or three days the whole of the water was removed by vomiting, for he
never purged, nor was the quantity of his urine increased; his
appetite and strength gradually returned; he never had any further
relapse, and is now an active healthy man. I must leave the reader to
make his own reflections on this singular case.
1780.