from lying down. Is generally more to one side than another; does not flow from side to side as in abdominal dropsy. THE TREATMENT Should be varied from that above given, as purgatives and diuretics do not do so much good, and we have still more to rely on tapping and compression and external blisters with mercurial unctions. When the accumulation takes place in the tunica albuginia testis, it forms what we call This is known by an enlargement of the peritoneal surface of the testicle and the filling up with water of the tunica albuginia. It is distinguished or diagnosed from hernia scroti. hæmatocele, enlarged testicle, or orchitis, by its soft transparent nature and by its not affecting the general health of of the patient. The treatment alone is surgical as all internal remedies are useless and even injurious. The water is let out by a canular and either a seton put in or the spirits of wine or tincture of iodine is injected, and then the testicle is bandaged with adhesive strips. I prefer the seton in old and bad cases, the tincture of iodine injections in recent and mild ones. TREATMENT OF DROPSY FROM MALARIAL DISEASES. This form of dropsy is always complicated with enlarged spleen and indurated liver,-yellow, sallow skin, and is by far the most common form of dropsy I have seen and had to treat, and is the most amenable to treatment when judiciously administered, almost every case can be cured. TREATMENT. I usually commence by giving the following proportions once or twice each day, and following with quinine according to circumstances. If patient has fever, I always give quinine after the purgative in large doses. For an adult I give R.-Hydr. chl. mitis, xx. grs. Antimonii et potassæ tartratis, ii. grs. Me. F chartas, No. ii, One in the morning and the other at night. If it debilitates or purges too much, I only give one dose in the morning and the quinine at ten o'clock. R.-Quinæ sulphatis, xx. grs. Me. P. chartas, No. 4. One every three hours or two powders, if chill is expected before twelve, one at ten, the other at twelve. I continue this from day to day, if the patients strength holds out, and they will generally gain strenght under this treatment. Where the spleen is much enlarged I apply blister after blister over the enlargement. Where the liver is specially involved by enlargement or induration, I also blister over its tender surface. I afterwards bandage with roller bandage and apply mercural ointment over the abdomen covered by oil silk. Having thus reduced the dropsy, I give daily the following: R.-Ext. taraxicı, xx. grs. S.-One three times schnapps to drink. Quinæ et ferri. citratis, xxiv. grs. a day. I also allow my patient Holland gin or Most cases will soon be cured by this plan, but many may be cured by much milder means; and where there is no complication from malarial causes but if the dropsy is produced from some of the exanthemata I give the following: R.-Potassæ et soda tartratis, 1 oz. Jalapi pulveris, xx. grs. Me. F. chartis, No. 2. S.-One, moring and night, to be continued from day to day until patient is relieved. I have also used in these cases preparations of quinine with juniper berries. The oil of juniper and oil of cubebs in chloroform thus:- R.-Olei. juniperis, Olei cubebis aa. i. drach. Chloroformi, i. oz. S.-Give ten to twenty drops three times a day. This is an admirable prescription and does not debilitate or weaken the constitution. This, with a few drops of quinine and iron, will cure most cases produced by measles, scarlatina, small-pox or erysipelas, but the body should be kept warm and the skin clean. The tinct. of iron, digitalis and jalapi may be given with great benefit thus: : digitalis S.-Thirty drops three times a day. This may be administered in a drach. of gin or in an infusion of buchu or senna if the bowels are not well open. Where the dropsy is dependent upon and caused by secondary syphilis, I give the following: R.--Potassa iodidi, vi. drach. Hydr. chl. corrosivæ, ii. grs. S.-Give tablespoonful three times a day. This, with generous diet and exercise in the open air, will usually relieve in a few weeks, and the change for the better may be seen in a few days. If these cases are too feeble to bear the mercury, I give them cicuta and extract of belladonna thus: R.-Potassæ iodidi. vi, drach. Ext. cicutæ, xx. grs. Syrupi Sarsaparillæ, i. pt. Tablespoonful three times a day two hours before each meal. Before closing this piece I cannot refrain from mentioning the use of alkaloids of leontadin, leptandrin, podophillen, jalapin, hydrastin, xanthroxylin, alnuin, elaterin, thus: Give at once. R.-Elaterin, i gr. Jalapin, gr. Potassæ bitartratis, i. oz. Which is spoken so lightly of by the Eclectic doctors. I believe they are beneficial and preferable to the old tinctures and extracts, and that they keep better in our Southern climate, are more easily carried in the saddle-bags, more easily taken by our patients, and these, together, are no ordinary advantages. |