Hippocrates gives a tolerably correct account of the causes and treatment of dropsy. The varieties of the disease described by him are dropsy from the drinking of cold water, from disease of the liver, and from disease of the spleen. He further states that it is frequently the consequence of protracted fevers, diarrhœa, dysentery, and quartan fevers (de Aer. &c.) He mentions a species of dropsy which he calls the dry (Aph. iv, 11), which has been generally referred to tympanitis. See Littré (t. iv, 416.) In certain cases attended with dyspnœa he recommends venesection; and Galen in his Commentary states that these cases are, when the disease is preceded by suppression of the hemorrhoidal or menstrual discharges, or is connected with plethora. But no one, he says, ventures to bleed in tympanites or ascites. Hence Avicenna and most of the ancient authorities forbid venesection in dropsy, except under the circumstances mentioned by Galen. Galen says, indeed, in his work (de Venesect. ad Erasistrat.) that he had sometimes cured dropsy by bleeding; but it is not to be understood that he approved of it as a common practice. In short, he was no Sangrado, but had anticipated Blackall. One of his hydragogue potions is composed of cantharides. (De Reg. in Morb. Acut.) Hippocrates recommends us to perform paracentesis thoracis in the side at the third rib from the last. He also approves of paracentesis abdominis in cases of ascites; and directs us to burn the region of the liver, when that viscus is affected. He further approves of free scarifications of the testicles and thighs. He has described hydrops uteri, or hydrometra, a case which, although of rare occurrence, is occasionally met with. See Van Swieten (Comment. 1224); Vesalius (de Fabrica Hum. v, 9); Monro (Works), and Dr. A. T. Thomson (Paper in the Med. Chir. Trans. xiii, 1.)
Galen gives a long list of external and internal remedies for dropsical complaints. (Sec. Loc. ix.) Ox-dung mentioned by our author was a common remedy in ancient times, according to Galen. Diogenes Laertius relates that the celebrated Heraclitus died lying in a bed of it. Upon the authority of Antonius Musa, Galen recommends a cataplasm containing elaterium, stavesacre, and hyssop. He recommends a vinous preparation of elder. Pliny particularly commends this medicine in dropsy, and most of the ancient authorities make mention of its diuretic properties. Galen says that the liver is affected in all cases of dropsy. (De Locis, v, 6.) In like manner Stephanus, the commentator on Hippocrates, states that in all cases of dropsy the liver is affected, either primarily or sympathetically. Hippocrates refers one species of dropsy to disease of the parts situated in the loins, by which Galen and Stephanus agree that he means the jejunum, mesaraic veins and kidneys. (Ed. Dietz. 139.)
Celsus describes three varieties of dropsy, namely, ascites, anasarca, and tympanites. He enjoins restriction as to food and drink, and recommends walking, friction, and sudorifics, such as heated sand and warm baths. He gives a long list of diuretics, as iris, valerian, saffron, cinnamon, &c. In tympanites he recommends emetics, cupping the belly, rubbing it with rubefacients, and applying sinapisms to it, or burning eschars on it with heated irons. In anasarca he recommends scarifications at the inner part of the leg, squills in a linctus, and the like. He approves of tapping in ascites.
Aretæus describes the symptoms of dropsy with great accuracy and elegance. He says it is a most unseemly disease, from which few recover, and those more by the aid of the gods than of art. He treats of the three varieties already mentioned, and also makes mention of hydatids. Hydatids, by the way, are described also by Galen (Comm. ad Aphor. vii, 55), and Rhases (Cont. vii). He remarks that it is wonderful how much the patient in dropsy flatters himself with hopes of recovery, more than in many other diseases far less dangerous. He states that there are partial dropsies, such as of the head, lungs, liver, spleen, and uterus. He mentions among the exciting causes of the disease the drinking of cold water, flatulent food, and the insect buprestis (meloe vesicatoria L.)
From a passage in Plutarch, it would appear that certain forms of dropsy had at one time been thought infectious. (De Serâ Num. Vind.)
Dioscorides and Ruffus praise elaterium as a hydragogue in dropsy. In the ‘Euporista,’ baked squills and oxymel are particularly commended, with various cataplasms externally.
Cælius Aurelianus states fully the causes of dropsy, such as cachexia, protracted fevers, hardness of the liver, spleen, peritoneum, or uterus; dyspnœa, cæliac affection, dysentery, retention of the hemorrhoidal or menstrual discharges, abstinence, an unseasonable draught of water, especially of salt water, the abuse of medicines, and so forth. He maintains, however, that the disease is the same, from whatever cause it arises. The common symptoms of all its varieties are said by him to be swelling, torpor, difficult breathing, disturbed sleep, thirst, diminished urine, and sometimes latent fever. He informs us that Erasistratus in his dissections generally found the liver indurated. His external applications are very similar to those of our author. He particularly commends a vinous tincture of squills as a hydragogue. He approves highly of paracentesis, and has answered all the objections which had been made to the operation. He mentions that Asclepiades practised scarifications at the ankles.
The ordinary cases of dropsy are well stated by Serenus Samonicus in the following lines:
“Corrupti jecoris vitio, vel splenis acervo,
Crescit hydrops, aut cum siccatæ febre medullæ,