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( Originally Published 1921 )

Dropsy is an increase in the moisture of the tissues, or rather, in the spaces between the cells and fibres of the tissues. There is a natural and normal moisture in the tissues that keeps them pliable and bathes all the surface of the organs. Dropsy is an exaggeration of this moisture. Indeed, it is hard to make a distinction between swelling of the body and dropsy of the same part. Everybody has experienced a rapid accumulation of dropsy, such as causes a lump when one has been bitten by an insect; this, of course, quickly passes away, and is of no importance.

The dropsy that comes in heart disease is due to poor circulation which leads to an increase of the production of lymph by the walls of the blood vessels and its accumulation in the tissues. When dropsy is due to heart disease, it usually commences in the lowest parts of the body, so that the person notices first a little swelling of the feet. If not successfully treated, this increases until the legs are swollen, and gradually the upper parts of the body participate in the dropsy. A little swelling in itself does not give much trouble and is important only because it indicates the possibility of serious disease.

When dropsy becomes extended, it is a serious sign; and as time goes on, if the accumulation of fluid in the chest and abdomen increases, a person so affected is surely in a grave condition. In nearly all cases dropsy accumulates gradually and does not cause any sudden accident; but in the course of certain cases of heart disease, it may come on suddenly and affect the lungs. This is usually spoken of as oedema of the lungs, and is a serious, even frightful occurrence.

The treatment of dropsy is, of course, the treatment of the disease that causes it, except in certain instances where the accumulation is excessive; in these cases it may be necessary to draw off the fluid by tapping. This is, ordinarily, not a serious operation and, when the fluid is accumulating in some part of the body and is giving trouble, often affords great relief.

If a person is suddenly attacked with dropsy of the lungs, there is rapid, labored breathing, much rattling in the chest, and a sense of severe oppression. In such a case, while the physician is being summoned, the friends of the sufferer may help much by the administration of stimulants, whiskey being good, and by the application of mustard to the chest, followed by a hot poultice. The mustard application is made by mixing mustard with five parts of flour, moistening and spreading on a cloth. This is applied to the chest until the skin is reddened; then it is removed and a hot poultice is applied. The poultice should be made large enough to envelop the whole chest, and it should be put on very hot.

Equally valuable, sometimes even more so, is cupping the chest. To cup the chest ordinary thick tumblers are taken. They are rinsed out with alcohol, a few drops being left in the bottom ; then the alcohol is lighted by holding the glass over a candle, and while it is burning the glass is clapped against the side of the chest. Of course, the flame of the alcohol is immediately extinguished, but the cooling of the vapor makes a suction that draws the skin and flesh up into the glass, drawing the blood rap-idly to the surface. In this way, from four to eight tumblers may be spread over the chest and commonly great benefit quickly results.

When a person has shown a tendency to dropsy, it should always be an inducement to persistent efforts to conquer the conditions that caused it. Many heart patients escape dropsy until they have in some way suffered damage to their kidneys, kidney disease being, next to heart trouble, its commonest cause. The first attack of dropsy is seldom fatal and usually yields easily to suitable treatment.

The nursing of dropsical patients is always a difficult task for the nurse, who deserves corresponding credit when she is successful in making the patient comfortable and keeping up his courage. The diet should ordinarily be free from salt, because salt in the body always leads to retention of fluid for the reason that there must be fluid to keep it dissolved. A person who eats salt becomes thirsty because there is a demand for fluid to take care of the salt.

Dropsical patients ordinarily have weak kidneys kidneys deficient in their power of carrying off salt. The reduction of the amount of salt gives the kidneys a better chance to function and bring about a natural recovery from dropsy. Of course this process is slow, and the nurse must have patience and persistence that is the reason for this explanation.

My own belief is that most patients with heart disease can be so taken care of that they can escape the miseries pertaining to dropsy at the end .of its course. I have known patients with serious heart trouble, who, under the ministrations of a good nurse, have escaped dropsy tho constantly threatened.

A typical diet in dropsy is:

Breakfast One slice of toast, and one cup of tea with sugar and cream.

Dinner The lean of two chops or its equivalent, dry toast, and half an ounce of brandy or whiskey in two ounces of water.

Supper---As much dry toast as desired, and half an ounce of stimulant.

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