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Dropsy Treatment with Scarifier and Trocar, Page 2

Description of Dropsy Fluid Build-Up or Ascites

"Scarce any Disease is attended with more certain Signs than this. We know that a Dropsy is beginning when voiding less Urine than usual, the Belly swells by slow Degrees by the gathering of the Serosities which distill into it: When the Patient is laid on his Back, his Belly is equally extended; but if he lies on one Side, the Water then is making to the under Side, there forms a great Purse by its own Weight and Bulk, and upon any small Motion is heard to float in the Cavity, as in a Vessel half full: The Scrotum afterwards becomes tumefied [swollen] by part of the serous Liquor [fluid] which distills into it from the Belly; the Yard [penis] and Lips of the Matrix [I believe he means the skin surrounding the opening at the tip of the penis, but I'm not certain] are swelled with the same; the Thighs, the Legs and Feet, by their low situation, determine the Humours to run towards them, and those Parts increased in Bulk in an extraordinary manner by the Affluence of these Waters. It must be observed here, that the Tumefaction [swelling] of the inferior extreme Parts always proceeds in Anasarca [swelling caused by wind], and succeeds in Ascites [swelling caused by fluid], this ending with what the other began." (Dionis, p. 76)

Treatment by Medicines

"The Waters are forced out two ways, either insensibly or sensibly, that is, either by Pharmacy or Chirurgery

The Medicaments furnished by Pharmacy are of two sorts: They are either such as are externally, or such as are internally applied.

The former must be strong Desiccatives. Fabricus relates to have seen very good Effects result from a large Spunge moistened in Lime-water, and applied to the Belly. Galen advises the Patient to plunge himself stark naked into a Sack of Corn, because, says he, the Peasants, to swell their Corn, and tender it more weighty [in order to get more money for it when selling it], throw into it Bottles of Water which slowly drain out, from whence the Consequence seem'd to him just that it the Corn had the Virtue imperceptibly to attract the Water through the Bottles, it might draw out that which was contain'd in the Belly: He further adds, that in Egypt dropsical Patients were cured by exposing their Bellies to the Sun, or laying them in Sand before heated by the Beams of that Flauer.

The Remedies taken internally are so very numerous, that 'twould be impossible for me to recite them all: They are such as, stimulating the Urine, force it to the Reins, and by their incisive and poinant Particles, tend to open a Way for their Passage: These Medicaments are called Aperitives, or Diuretics; the strongest of which are the Salts of Millipedes or Hoglice, Rue, Mugwort or Artemisia, Tartar, Juniper, and the Sal Polychrestrum.
...
"If then, after the Use of them, the Disease increase, Recourse must be had to Chirurgery, which proposes to us two Methods, one of opening the Belly, and the other of making Scarifications [small incisions] only in some other Parts as the Scrotum, the Thighs, the Legs, or Feet." (Dionis, p. 77-8)

Treatment of Dropsy by Scarification

Scarification of a man's legs, From Prosperi
Alpini, De Medicinæ Ægyptiocum, p. 198 These Scarifications are made on the Cods [scrotum], and sometimes on the Yard [penis] or Lips of the Matrix, when those Parts are so swelled that it seems impossible to force the Water through any other Passages than small Wounds through which it distills in Drops, decreasing apparently the swelling of the Part, in proportion to their Evactuation. We are also obliged to practise them on the Thighs, Legs and Feet near the Ancles, or on the Instep, in order to discharge, or force those Parts to disgorge what appears to us transparent, like Bottles full of Water. Nature is not always so patient, as to wait this Chirurgical Assistance; for these Parts frequently of themselves tumefy by the abundance of Serosities with which they are filled, which by breaking they void; when this happens the Patient seems relieved, but it really does but prolong his Misery.
...
There are not particular Places assigned where Scarifications ought to be made, but the most proper are the most transparent; and where the Tumour threatens to break, if a Passage be not immediately provided for it, Fabricius pretends to be nearer the Mark, when he tells us,
Scarification Tools: A - Folding fleam set (for making incisions,
B - Individual fleams/lancets, C - Bleeding stick for driving fleams into skin,
D - 10 blade spring-operated fleam That he cauterizes the Leg to open a Passage for these Waters, and by that Means facilitates their Evacuation.

Tho' Scarification seems less cruel than piercing the Belly, for my part I yet prefer Punction on several Considerations; the first of which is, that in order to reap the Advantage which we may promise our selves from this Operation, it ought not to be deferred 'till the lower Extremities are sufficiently tumefied to admit of Scarification; the second is, that by Punction more Water is voided in a quarter of an Hour, than in eight Days by Scarification, and consequently the Patient is more expeditiously relieved; The third is, that the Water irrigating the Muscles and Membranes of all these Organs, Scarification so relaxes the Fibres, as to leave a Weakness, which is seldome cured: And the fourth is, that all Dropsies end with the Sphacelus [gangrene], which never fails, soon or late, to happen to the Place where any of these Overtures are made by Scarification." (Dionis, p. 78-9) Next>>

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