OF THE
DROPSIE.
The Second Distemper which I shall consider as subject to these Measures, is one Species of the Dropsie; that is, the Anasarcous Kind, from which likewise I except those, which are attended with a hard Liver, or a remarkable Obstruction of some of the Viscera.
This kind of Dropsie, thus circumstantiated, does at first View, seem not to need the Assistance of any extraordinary means to help towards a Cure, it being the most Curable of all Dropsies; and we have daily Instances of its giving way to Common Medicines, nevertheless there are such exceptions in this most Favourable Case, as give trouble enough to a Physician sometimes, and requires more than usual Application; as for Instance; sometimes a Person happens to be brought so low by an Unseasonable Purge, that afterwards Diureticks and Corroboratives will have no effect upon him, but the Case becomes deplorable, without the Rupture of any Lympheducts or other the like Difficulty.
Secondly, when People decline in Years, there are some extraordinary means requisite to make the Remedies exert themselves with like Success, as they do in Younger Persons.
Thirdly, in Hysterick Women it is difficult to carry off the load of Water by common means, without some such Method as I shall hereafter mention; because their Spirits are so low, that they can bear no considerable Evacuation.
Fourthly, when a Dropsie comes upon an Asthmatick Person, there are particular Difficulties arise, and the singular Advantages of constant and gentle Exercise in this Case are universally known.
These four different Circumstances of this Distemper, may suffice to shew that I have Colour enough for my calling in the Gymnastick Method into this Case, and ’tis the first of the Exceptions, I mean the ill Effects, which sometimes follow upon the Use of Purgatives, which have chiefly occasion’d me to inquire, whether we ought in this plain Case, thus circumstantiated to halt between two Opinions, between Purgatives and Diureticks, without endeavouring to establish a certain Praxis upon Just Foundations.
There are none will deny, but Diureticks are the most proper and natural Remedies in this Case, if they would always succeed, because directed to the proper Emunctory, the Kidneys, and because they can go hand in hand, with the Corroborative Medicines to be given at the same time; I take it for granted therefore, that whenever Purgatives are us’d in this Case, it is because the Diureticks don’t take quick enough, or in order to carry off the load of Serum, that the Diureticks may the sooner display their good effects, because it will be alledg’d that the Serum becomes so Ropy and Glutinous in the Passages and Capillary Parts, that the Diuretick cannot always act upon it. But tho’ this is granted, it will not suffice to warrant the Use of the stronger Purgatives, because their manner of Acting cannot agree with this Distemper, and because those difficulties objected, may be overcome by other means.
First, the very Nature of strong Purgers, makes against this Case, it seems very preposterous, to have recourse to such Deleterious Drugs, to those Mortis Catapultæ (as Ludovicus calls the Esula’s and such like Purgatives) in Order to the Restoring an impoverish’d Blood; if they acted only by Stimulating the Intestines, something might be said; but since it is indisputable that they pass into the Blood, and act powerfully upon it, there is no doubt to be made, but they fuze and divide it, and break its Globules, and consequently make as much Water as they carry off, which is the very Reason why Sweating is laid aside, and Salivation, tho’ they both seem so proper to carry off Watery Humours; I know it may be alledg’d in Defence of these Medicaments, that the 36th and 37th Aphorisms, of the Second Section seem to imply, that a Sick Person would receive less Harm from ’em, than one that is in Health; but yet this will not excuse their Use in our Case, because tho’ the Viscousness of the Serum, may blunt the Particles of those Drugs for a time, and hinder ’em from working so quickly, yet when once they are throughly imbib’d, and begin to exert their Force, they ravage the very Principles of Life, and can by no means be fit for a Person in so low a condition. But admit that the Water is carry’d off by these means, the Blood will be left as poor at least as it was before the Dropsie first appear’d; and then how can we be sure the Waters will not rise again? Suppose an Anasarca follows upon an Hæmorrhage, which is very common, and you draw off the Water by Purging; will not the Person be just in Statu quo, upon supposition that the Medicines in their working did not impair Nature? but that is not to be granted, because it is impossible to suppose, that such Drastick Medicines, should not prey upon Nature, even while they are assisting her; and can we be assur’d that the Blood will not run into the same Colliquation it did before? Besides, may there not be some reason to suspect that the very quantity of the Serum, supposing it is not too Turgid indeed, may sometimes be serviceable, to the promoting the activity of the Diuretick, even as we find in the true Ascites, it is of some use in the Cavity of those Persons, because they often can’t spare it, without certain Ruine? We don’t know how much the confidence of the Fluid may conduce to the keeping its homogeneous Particles combin’d, and we ought to be very tender of doing any thing, that might tend to dissolve the Crassamentum, the Globules, which are as it were the very Semen Sanguinis (if I may so speak); for how far Nature would endure such measures, before the Sanguification would be totally subverted, would require a Dissertation, longer than my Scope will permit; but that this is sometimes done is not improbable, and I take this to be the Case of a Young Fellow I knew, who falling into a slight Dropsie, goes to an Empirick somewhere about White-Chappel, from whom he had a Dose of Pills, which gave him about 30 Stools, which sunk him so much that his Nails turn’d black, and he died in two or three days time; Here ’tis very likely the Signification was entirely extinct, and the Blood chang’d into a Preternatural Fluid, and all by the great Power of these Deleterious Drugs; and tho’ ’tis likely the Quack did not know the proper Dose of his Medicines, yet one would think, this was no more than what might be expected from Ten Grains of Elaterium, which yet has been allow’d by an Eminent Writer.