Sec. 25. This species of encysted dropsy is not without difficulty
distinguishable from an ascites; and yet it is necessary to
distinguish them, because the two diseases require different treatment
and because the probality of a cure is much greater in one than in the
other.
Sec. 26. The ovarium dropsy is generally slow in its progress; for a
considerable time the patient though somewhat emaciated, does not lose
the appearance of health, and the urine flows in the usual quantity.
It is seldom that the practitioner is called in early enough to
distinguish by the feel on which side the cyst originated, and the
patients do not attend to that circumstance themselves. They generally
menstruate regularly in the incipient state of the disease, and it is
not until the pressure from the sac becomes very great, that the
urinary secretion diminishes. In this species of dropsy, the patients,
upon being questioned, acknowledge even from a pretty early date,
pains in the upper and inner parts of the thighs, similar to those
which women experience in a state of pregnancy. These pains are for a
length of time greater in one thigh than in the other, and I believe
it will be found that the disease originated on that side.
Sec. 27. The ovarium dropsy defies the power of medicine. It admits of
relief, and sometimes of a cure, by tapping. I submit to the
consideration of practitioners, how far we may hope to cure this
disease by a seton or a caustic.--In the LXIst case the patient was
too much reduced, and the disease too far advanced to allow of a cure
by any method; but it teaches us that a caustic may be used with
safety.
Sec. 28. When tapping becomes necessary, I always advise the adoption of
the waistcoat bandage or belt, invented by the late very justly
celebrated Dr. Monro, and described in the first volume of the Medical
Essays. I also enjoin my patients to wear this bandage afterwards,
from a persuasion that it retards the return of the disease. The
proper use of bandage, when the disorder first discovers itself,
certainly contributes much to prevent its increase.
OVARIUM DROPSY with ANASARCA.
Sec. 29. The anasarca does not appear until the encysted dropsy is very
far advanced. It is then probably caused by weakness and pressure. The
Digitalis removes it for a time.