VII. Diluting drinks taken in such large quantities as to excite the action of the vessels by the stimulus of distention. This effect has been produced, sir George Baker informs us, by means of large draughts of simple water, and of cyder and water[44]. The influence of distention in promoting absorption is evident in the urinary and gall bladders, which frequently return their contents to the blood by the lymphatics, when they are unable to discharge them through their usual emunctories. Is it not probable that the distention produced by the large quantities of liquids which we are directed to administer after giving the foxglove, may have been the means of performing some of those cures of dropsies, which have been ascribed to that remedy?
VIII. Pressure. Bandages bound tightly around the belly and limbs, sometimes prevent the increase or return of dropsical swellings. The influence of pressure upon the action of the lymphatics appears in the absorption of bone which frequently follows the pressure of contiguous tumours, also in the absorption of flesh which follows the long pressure of certain parts of the body upon a sick bed.
IX. Frictions, either by means of a dry, or oiled hand, or with linen or flannel impregnated with volatile and other stimulating substances. I have found evident advantages from following the advice of Dr. Cullen, by rubbing the lower extremities upwards, and that only in the morning. I have been at a loss to account for the manner in which sweet oil acts, when applied to dropsical swellings. If it act by what is improperly called a sedative power upon the blood-vessels, it will be more proper in tonic than atonic dropsies; but if it act by closing the pores, and thereby preventing the absorption of moisture from the air, it will be very proper in the state of dropsy which is now under consideration. It is in this manner that Dr. Cullen supposes that sweet oil, when applied to the body, cures that state of diabetes in which nothing but insipid water is discharged from the bladder.
X. Heat, applied either separately or combined with moisture in the form of warm or vapour baths, has been often used with success in dropsies of too little action. Dampier, in his voyage round the world, was cured of a dropsy by means of a copious sweat, excited by burying himself in a bed of warm sand. Warm fomentations to the legs, rendered moderately stimulating by the addition of saline or aromatic substances, have often done service in the atonic dropsical swellings of the lower extremities.
XI. The cold bath. I can say nothing in favour of the efficacy of this remedy in dropsies, from my own experience. Its good effects seem to depend wholly on its increasing the excitability of the system to common stimuli, by the diminution of its excitement. If this be the case, I would ask, whether fear might not be employed for the same purpose, and thus become as useful in atonic, as it was formerly proved to be in tonic dropsies?
XII. Wounds, whether excited by cutting instruments or by fire, provided they excite inflammation and action in the arteries, frequently cure atonic dropsies. The good effects of inflammation and action in these cases, appear in the cure of hydrocele by means of the needle, or the caustic.
XIII. Exercise. This is probably as necessary in the atonic dropsy, as it is in the consumption, and should never be omitted when a patient is able to take it. The passive exercises of swinging, and riding in a carriage, are most proper in the lowest stage of the disease; but as soon as the patient's strength will admit of it, he should ride on horseback. A journey should be preferred, in this disease, to short excursions from home.
XIV. A recumbent posture of the body should always be advised during the intervals of exercise, when the swellings are seated in the lower extremities.
XV. Punctures in the legs and feet afford the same relief in general dropsy, accompanied with a weak action in the blood-vessels, that has been ascribed to them in dropsies of an opposite character.