Edward James, AEt. 21. Admitted _March_ 20th, 1784. Complained of great
difficulty of breathing, pain in his head, and tightness about the
stomach, with a trifling swelling of his legs. Ordered pil. scillit.
[Symbol: scruple]i. ter de die. On the third day his legs much more
swelled, his breathing more difficult, and in every respect worse; his
pulse very small and quick, complained when he turned in bed, of
something like water rolling from one side of the thorax to the other.
A remarkable blueness about the mouth and eyes, and purged considerably
from the pil. scill. Ordered to omit the pills and to take
[Symbol: ounce]i. of infus. Digitalis every eight hours; the proportion
[Symbol: dram]iss. to eight ounces of water and [Symbol: ounce]i. of
aq. n. m. sp.--7th Day, The infusion had neither purged, nor vomited
him: he only complained once or twice of giddiness. His belly was now
very hard, rather black on the right side the navel, and his legs
amazingly swelled. Ordered a bolus with rhubarb and calomel, to be
taken in the morning, and [Symbol: ounce]ii. julep salin. cum tinct.
canthar. gutt. forty ter die.--12th Day, nearly in the same state,
except his breathing which was somewhat more difficult, being now
obliged to have his head considerably raised. Persistat--From this day
to the 32d day he became hourly worse. His belly which at first was
only hard, now evidently contained a large quantity of water, his legs
were more swelled, and a large sphacelated sore appeared upon each
outer ancle. Respiration was so much obstructed, that he was obliged
to sit quite upright to prevent suffocation. He made very little
water, not more than eight ounces in a day and a night, and was much
emaciated. Ordered his purging bolus again, and [Symbol: ounce]ii. of
a mixture with sal diuretic, [Symbol: ounce]ss. to [Symbol: ounce]xii.
three times in a day, and a poultice with ale grounds to his legs.
54th day. To this period there was not the least probability of his
existing; his legs and thighs were one continued blubber, his thorax
quite flat, and his belly so large that it measured within one inch as
much as a woman's in this Hospital the day she was tapped, and from
whom twenty seven pounds of coagulable lymph were taken. He made about
three ounces of water in twenty-four hours: his penis and scrotum were
astonishingly swelled, and no discharge from the sores upon his legs.
Ordered to take a pill with two grains of powdered Foxglove night and
morning. For a few days no sensible effect, but about the 60th day he
complained of being continually giddy, and had some little pain in his
stomach. He now made much more water, and dared to sleep. His appetite
which through the whole of his illness had been very bad, was also
better. 66th day. Breathing very much relieved, the quantity of water
he made was three chamber pots full in a day and a night, each pot
containing two quarts and four ounces, moderately full. Ordered to
continue his pills, and his legs which were very flabby, to be rolled.
69th day. His belly nearly reduced to its natural size, still made a
prodigious quantity of water, his appetite very good, habit of body
rather lax, and his complexion ruddy. On the 2d of _June_, being still
rather weak, he was ordered decoct. cort. [Symbol: ounce]ii. ter de
die; and on the 12th was discharged from this Hospital perfectly
cured.