Dropsy

Dropsy is a disease resulting from an abundance of matter. Its cause is cold matter foreign to the body, which penetrates into the spaces between the particles of the organs and swells there. It penetrates either into all external organs or into hollow places in those areas where food and juices are affected. There are three types of dropsy: “dropsy of meat”, the cause of which is watery, mucous matter, spreading along with the blood throughout the organs, “skin dropsy”, the cause of which is watery matter pouring into the space of the lower cavity and into the places adjacent to it, and “ dropsy tympanum", which is caused by wind matter spreading in the same areas.

In relation to dropsy, there are general reasons and laws, as well as special reasons and laws for each type of dropsy. Dropsy does not happen if there is no liver disease - special or due to complicity, although it also happens that the liver gets sick, but dropsy does not occur. The causes of dropsy, in general, are either special, associated with the liver, or due to complicity. Of the special causes, the closest and most general is weakness of hepatic digestion; this seems to be the connecting cause of this disease. As for the previous causes, these are all liver diseases associated with nature, and diseases of the instrument, such as small size, blockages, tumors hot, cold, wet and loose, which block the mouth of the vessel that attracts nutrients, as well as hardening of the membrane surrounding the liver. The causes associated with nature are either hot causes - most of them cause dropsy through dryness, or cooling causes, and they all exert their effect by dissipating the innate heat gradually, or extinguishing it at once. By “dissipation” I mean here a phenomenon well known among doctors, namely, that innate warmth sometimes dissipates little by little or dies out at once; both occur from hot or cold, for example, from drinking cold water on an empty stomach or after a bath, exercise and copulation. This also happens for moisturizing or drying reasons - after taking medications that melt the juices, or due to excessive bowel movements through perspiration, excretion of urine, laxity, as well as with ulceration of the intestines, menstrual cleansing and bleeding from the kidneys. The most harmful of these emptyings is the removal of blood.

As for the diseases of the instrument, the paragraph devoted to each of them stated how they lead to dropsy. Regarding the causes of dropsy by complicity, it occurs either with the participation of the liver with the whole body, when the blood in it becomes very hot or very cold due to some circumstance, or due to the coldness of the stomach and a disorder of its nature, especially if the disorder of nature causes diarrhea. Or this happens due to a reason related to the vessels of the mesentery, or due to complicity with the spleen due to its large size or due to the hard, soft or hot tumors present in it.

Dropsy also occurs due to significant excretion of black bile. Its excess causes exhaustion and cooling of the liver, spreading the force of black bile moving towards the liver, and brings its harmful effect to the liver, just as it brings black bile to the brain and causes obsessions. A large size of the spleen leads to dropsy and weakening of the liver for two reasons, firstly, because it draws a lot of juices from the liver and takes away its strength, and secondly, it exhausts the strength of the liver by confrontation and prevents it from generating good blood . Sometimes dropsy arises from the complicity of the kidneys, due to the coldness of the kidneys and especially due to their warmth, and also from blockages or hardening in the kidneys, due to which they do not involve aqueous humor, although there is no disease in the kidneys themselves. Sometimes dropsy occurs for a reason depending on the intestines and their diseases, especially the jejunum due to its proximity to the liver; It also happens due to disease of the bladder, uterus, lungs and abdominal obstruction. Not every time dropsy occurs in association with the kidneys, the cause is their nature. No, this sometimes happens due to blockages or tumors in them, when the kidneys do not attract aqueous humor. The situation is the same when dropsy occurs due to the complicity of the intestines: this does not always happen only as a result of a change in the condition of the intestines in relation to the basic qualities; no, the reason for this is sometimes pain in the intestines, pain and abrasions, as well as severe pain, etc., because this weakens the liver. Dropsy with the participation of the uterus also does not depend on its qualities, but occurs due to pain in the uterus and retention of cleansing in it. Often, dropsy occurs due to involvement with the anus due to retention of blood in the kidney cones; the same applies to the other organs mentioned. The organs of fecal ejection are most often involved in the disease of the concave part of the liver, and the urinary and respiratory organs are most often involved in the disease of the convex part. The involvement that most often leads to dropsy is the involvement of the liver with the kidneys, jejunum, spleen, mesentery and stomach. Says one of the doctors: "Dropsy sometimes arises from tumors that form in empty places, especially from cold tumors due to a disorder of nature extending to the liver and causing harm, or from black gall blood, which often lingers in these places and forms obstructions in the region adjacent to the liver, penetrating there and causing bloody diarrhea; in the first case, this leads to dropsy after persistent pain in the lumbar region, hardly dissipated by medicine or stool." However, this reasoning is not flawless.

The worst kind of dropsy is that which occurs during a hot illness. Some people believe that “meat dropsy” is worse than others, because the damage covers the entire liver, all the vessels of the body and meat, so that the third digestion completely stops, but there are also doctors who believe that it is easier than others and even easier than drum However, it is more likely that waterskin dropsy is the most severe of all. In addition, there is a type of “meat dropsy” that is lighter than all other types of dropsy, and there is also a very malignant one; this is judged by taking into account the reasons that plunge the patient into dropsy.

From the obvious state of affairs and from what experience most often shows, it follows that all varieties of “meat dropsy” are milder than others, and it does not necessarily follow that the liver is as weak in this case as in other types of this disease. The person most at risk from dropsy is a person whose natural nature is hot and dry; people with a nature opposite to this suffer from dropsy only when they have great illnesses. Dropsy resulting from hardening of the spleen is much safer than that caused by hardening of the liver; one can even hope to cure such a disease. Often the dropsy matter rises so high that it causes asthma, shortness of breath and cough; this indicates the proximity of death, which occurs within three days. Sometimes the breathing changes due to the pressure of matter, and not due to moisture; it's more secure. Sometimes in such patients, as death approaches, ulcers form in the mouth and on the gums due to malignant vapors, and at the end of the disease, ulcers sometimes appear throughout the body due to a disorder of the nature of the blood. They say that if something similar comes out in a dropsy's stool, it foretells his death. If a person experiences dropsy, and he already suffers from melancholy, then the melancholy dissipates, since dropsy moisturizes his nature.

Know that relief from dropsy is destructive. When a person has dropsy, the first thing to do is to recognize what exactly is swollen: the pubis, legs, back, kidney area, lower back, or some intestines; the state of his nature should also be known in relation to softness or dryness: if the nature is dry, it is better than if it is soft, especially with dropsy starting from the waist and kidneys; if dropsy begins from the lower back, then the nature is often soft, since the liquid parts of the nutrients return to the intestines. Dryness of nature with dropsy starting from the front is observed more often. It is also necessary to recognize the condition of the lower abdomen and pubis: whether they are dry or fleshy: fleshiness indicates strength and the ability to endure laxity. It is also necessary to see whether the scrotum is involved in the swelling or not: if the scrotum is involved in the swelling, then one can be afraid of fluid leaking out, and leakage causes sexual impotence and malignant, difficult-to-treat ulcers.

Causes of waterskin dropsy, except for reasons of complicity. The connecting reason for it is that aqueous humor becomes excessive and does not come out from the side where there is an outlet for it. It, of necessity, comes back and accumulates in places other than where it should necessarily accumulate; this occurs either by seepage, or by the separation of steam, which, being locked up, turns into water, or it occurs due to the abundance of matter, or from the strong expelling action of nature, which, obeying an imperious necessity, drives the moisture through the passages for excess into the abdominal cavity and into the cavity where the intestines are located. Most often, moisture stops between the omentum and the inner lining of the abdominal walls and penetrates into the omentum, unless the omentum is corroded.

You already know that the expelling action of nature sometimes causes pus to penetrate even into the bones, not to mention other organs. This occurs either as a result of a rupture of one of the passages prepared for nutrients into the liver - then moisture seeps out and accumulates near these passages without entering the liver - or it happens in this way, as one of the first ancient scientists said and then repeated, attributing it to himself , another, later doctor. He argued that there is a return of moisture through the mouths of the vessels that went to the navel of the unborn fetus and the fetus received nutrition from them, as well as through the mouths of the vessels that went to the navel, from which the fetus’s urine comes out. After all, a child in the womb urinates through the navel, and a newborn, until his umbilical cord is cut, also urinates through the navel, and when exit in this direction becomes impossible, the urine is directed into the bladder. And so, if blockages and the help of expelling forces from other sides force moisture to do this, it passes through these vessels until it reaches their mouths. If moisture does not find a passage to the navel, then the vessels spread out towards the stomach, open and the stomach becomes very wide compared to how it was originally created. And the passages located near the bulge are compressed: they are narrow, narrower than those located near the depression. It is not far from probable that the removal of aqueous humor from the abdomen occurs along these directions and paths, and that drugs draw it from the abdomen into the liver and then into the intestines.

The source of this connecting cause lies either in the separating force, or in the separated matter, or in the ducts. As regards the cause of the separating force, the action of separation is common to the expelling force of the liver and to the attracting force of the kidneys. If both of these forces or one of them weaken or there is a blockage in the passages, and especially if a solid tumor has formed in the kidneys, then the aqueous humor is not separated, the body does not accept it and the ducts do not tolerate it; then one of the causes of waterskin dropsy necessarily arises. Therefore, dropsy often occurs due to weakness or disease of the kidneys alone. And the reason inherent in the separated matter is that there is a lot of aqueous moisture, more than what the force can divide, or it is not well digested. There is a lot of aqueous moisture due to drinking plenty of water, and this happens with strong, overwhelming thirst, if the nature of the liver causes thirst or it arises for another reason. Or it happens due to blockages in which no significant amount of fluid is drawn into the liver, and thirst continues despite drinking plenty of fluids. This also happens because the water itself does not help with thirst, because it is hot, not cold, or has some thirst-inducing quality: saltiness, the properties of bavrak, or something else. As for causes of another kind, if the wet nutrient is not digested evenly, the body or liver accepts part of the wet nutrient and does not accept the other part, and it fills the ducts. Sometimes this leads to one of the mentioned causes: dropsy of the wineskin, if the watery matter prevails, or dropsy of the drum, if the windy matter prevails; this happens during the second digestion of food.

The reason, depending on the ducts, is that tumors and obstructions are formed in the ducts, preventing the aqueous humor from following its paths and passing in the proper direction; they delay it and even divert it to other paths outside the ducts. If nature itself expels the moisture of dropsy from a dropsy patient, this is a sign of salvation. In most cases, if the dropsy is punctured, the swelling occurs again within three days, and most often this happens from the winds. Hippocrates says: “When a person has a lot of mucus between the abdominal barrier and the stomach, which causes him pain, then if it flows through the vessels into the bladder, his illness goes away.” Galen says: “Or rather, the mucus descends to the pubis, but not towards the bladder. And how can it ooze into the bladder, since it is mucus, and not liquid watery moisture.” And I say: it is not far from probable that the mucus dissolves and becomes liquid, and it is quite possible that it rushes in some direction by the will of nature and by necessity, or that in other directions there is an impeding cause; Thus, pus from the chest rushes through the vena cava to the bladder. After all, such penetration is by no means more surprising than the penetration of pus into the bones of the chest. As for the statement of one of the doctors that Hippocrates sometimes means aqueous humor by mucus, such an assumption is far from probable and there is no need for it. It happens that the stomach swells, as with dropsy in a person who has ulcers in the intestines, and then perforation of the intestines occurs, but the patient does not die until he dies from another cause, and the bloating occurs because feces pour into his stomach, and the stomach increases. However, in my opinion, although some doctors say this, it seems to be far from the truth. Death occurs earlier than this, especially if the rupture occurs in the upper intestines.

Causes of "meat dropsy", except for reasons of complicity. The previous cause of this is the disorder of the third digestion and the transition of nutrients into something damp and slimy; the blood then does not adhere to the body naturally due to its bad quality. Sometimes the previous cause is the second digestion or the first digestion, or the spoilage of what is eaten, or the sliminess of nutrients. If the digestive, retaining and separating force in the liver weakens or the attracting force in the organs increases, and the digestive force in them weakens, then such dropsy occurs. Most often it occurs from cold in the liver itself or due to complicity, even if there are no tumors or blockages retaining the nutrient. This type of dropsy often occurs due to the coldness of the blood vessels and diseases that arise in them or blockages that form from ingesting viscous food, clay, and the like. Sometimes this happens because the vessels are taken over by the chill of the cold air, which has a strong effect on them, and sometimes this happens as a result of the heat, which causes the body and juices to melt. If a blockage occurs, due to which the purulent molten juice cannot be directed to the kidney area, it disperses in the body; most often this happens suddenly.

Relaxation is often very useful in “dropsy of the flesh,” when the nature tries to expel the watery excess through natural and unnatural passages, but sometimes the nature is too weak for expulsion, and sometimes the unnatural penetration of the excess into the passages through the mentioned paths takes place before the expelling force of the nature takes possession of them. . Sometimes the passages do not accept the excess, and often the expelling force drives these excesses towards the liver, because they are watery and homogeneous with what usually rushes to the liver. And so, if the liver and the organs adjacent to it do not accept these excesses due to weakness or abundance of matter, or because the whole body does not accept them due to a blockage or other obstacle, they wander between the two expelling forces.

Hippocrates says: “If a person’s liver fills with water, and then this water breaks into the inner lining of the abdominal walls, then his stomach becomes full and he dies.” Says Galen: “He means by this the numerous blisters which form on the outer side of the liver and take up water.  When they burst and there are many of them, the water enters the space of the abdominal cavity, but rarely penetrates into the omentum, unless the omentum has been corroded by this side." He says: “This water is similar to the water of dropsy. Sometimes a person falls ill with dropsy, but does not die; on the contrary, he lives and water comes out of him, either by nature or thanks to treatment. It is not impossible that such a patient also survives.”

But I think that he will die, because such water is more malignant in its substance; it deteriorates in the abdominal cavity and destroys the patient with its vapor, especially since such a person has a damaged membrane surrounding the liver.

Causes of tympanic hydrocele. The most common cause of tympanic hydrocele is damage to the primary digestion due to weakening of strength or due to immaturity of matter. If the matter has not been thoroughly digested, but weak heat has already had some insignificant effect on it and the body does not accept it and throws it away, then the first thing it turns into is something vapor-like and wind-like. Sometimes these juices are juices that surround the region of the stomach and intestines, and often they cause constant pain, for low heat produces a weak dissolution in them, which turns them into winds, especially if the stomach is wet and cold and the juices are not prepared for digestion in the liver; then, in the liver there is also some heat, striving to digest something that is not yet predisposed to digestion. Often this disease also occurs due to strong extraneous heat in the stomach and liver. This heat rushes towards the moist nutrients and fluids of the body, before they are possessed by the digestive force emanating from the innate heat, and has an unnatural effect on them, dissolving them and turning them into winds even before digestion.

Dry tympanic dropsy can also be caused by weakness of primary digestion and weakness of heat, or the force of heat taking over nutrients and not giving them time to digest, or dropsy occurs due to bad food. Sometimes during pestilence and many other acute diseases, the abdomen swells, which becomes like a drum, and if you hit it with your hand, a drumming sound is heard in it. This is a very bad sign.

General signs. All types of dropsy are accompanied by damage to the complexion; with splenic hydrops it is greenish and blackish. With any dropsy there is swelling of the legs due to the weakness of the innate heat and fluid or vapor content of the blood, as well as swelling of the eyes and swelling of other limbs. Dropsy of all types does not occur without excruciating thirst and shortness of breath; most often it is accompanied by a decrease in the urge to eat due to a large urge to drink; the exception is some cases of dropsy due to coldness of the liver and especially from drinking cold water at the wrong time. With any dropsy, and especially with waterskin, and then with “dropsy of meat”, the urine becomes scanty and most often turns red, since there is little of it and all the dye collects in it, which disperses in copious urine. This also happens due to the small separation of bloody moisture and red bile from the urine; therefore, due to the redness and coloration of the urine, one should not assume that dropsy is hot. Dropsies often have warm fevers and often develop pimples that burst and release a yellow fluid. Diarrhea often occurs with “meat dropsy” and tympanic dropsy.

When dropsy begins due to a tumor in the liver, the nature becomes constricted, the feet become swollen and there is a cough without phlegm; tumors form in the right and left sides, which disappear and reappear; most often this happens with waterskin dropsy. And if dropsy begins from the groins and lower back, then swelling begins from the feet and there is prolonged diarrhea, but the swelling does not resolve and the water is not removed. With dropsy, the cause of which is hot, signs of heat are observed: burning, thirst, yellow complexion, bitterness in the mouth, severe dryness of the body, decreased urge to eat, as well as yellow and green vomiting. The burning sensation of urine increases at the end of the disease, as it is very hot. If dropsy is of such a kind that the juices melt a lot and rush out not along both natural paths, then this is indicated by an abundance of yellow bile and signs of melting of the juices; this is preceded by the appearance of feces and urine in the form of slop and purulent; it begins in the groin and lower back area. The same is true for any dropsy that occurs due to acute illnesses. As for dropsy, the cause of which is cold, its symptoms are the opposite of this. Sometimes the urge to eat becomes very intense, as happens with a cold stomach; then, when the coldness of nature becomes excessive, he falls.

Dropsy, the cause of which is a solid tumor, is recognized by the signs of such a tumor and the accompanying diarrhea, as well as by the weakness of the urge to eat. If the cause of dropsy is a hot tumor, then it begins from the liver; With it, the nature is locked up and there are all the signs inherent in a hot tumor. A greenish complexion and previous diseases of the spleen indicate splenic hydrops; Sometimes the appetite does not decrease. If the cause is rooted in the kidneys, then appetite also does not fall immediately and not to the same extent as it does with hepatic dropsy. Such dropsy is preceded by kidney diseases, tumors and ulcers in them.

Signs of waterskin dropsy. Waterskin dropsy is accompanied by a feeling of heaviness in the abdomen; when you hit the stomach, there is no noise, but if you move the patient, you hear the sound of churning water in the stomach; the same thing happens when the patient turns over from side to side. When you feel your stomach, it feels like you are touching a waterskin filled with liquid, rather than an inflated waterskin. With this disease, the members of the body do not get fat and their volume does not increase, as with “water dropsy”; on the contrary, they seem to melt and the shine of moist, stretched skin is visible on the surface of the abdomen. Sometimes the penis swells and testicular hydrocele occurs. The pulse of such a person is small, frequent, tending to hardness with some tension due to the tension of the membranes; sometimes at the end of the disease, it tends to become soft due to the abundance of moisture. If waterskin dropsickness occurs suddenly after a stone has passed from the liver in the absence of obvious causes of liver disease, then know that one of the ureteral ducts in the kidneys has ruptured.

Signs of "meat dropsy". With it, swelling of the entire body is observed, as happens with the body of a deceased person; all members, especially the face, tend to become full, but not to lose weight. If you press your finger anywhere on the body, the finger leaves a depression. In the abdomen there is no such swelling and splashing or edema with protrusion of the navel and drumming sound, which occurs in the abdomen with waterskin and with tympanic dropsy. In most cases, "meat dropsy" is accompanied by diarrhea when the nature is soft and white; The pulse is wavy, wide, and soft. They say that if there is flabbiness in the face or body or left arm of a person and itching in the nose occurs at the beginning of this phenomenon, then he dies on the second or third day.

Signs of tympanic hydrocele. With tympanic dropsy, the navel protrudes strongly outward and there is no such heaviness as occurs with waterskin dropsy. On the contrary, sometimes there is such a tension in the abdomen that is not present with waterskin dropsy, and it even becomes like a stretched string. With tympanic dropsy, there is no such thickening of the limbs as with “dropsy of the flesh”; on the contrary, the limbs begin to dry out. If you hit a patient's stomach with your hand, you hear a sound similar to the sound of a waterskin inflated with air, but not a waterskin filled with water. The patient constantly wants to burp, and he feels relief after belching and the release of winds. His pulse is longer than that of other dropsy, and not weak, because tympanic dropsy is not as debilitating due to any quality of nature or the heaviness of the water, as waterskin dropsy. In most cases, the pulse is fast, frequent, tending to be tense and hard. With tympanic hydrocele, there is no such swelling of the legs as with other types of hydrocele.

Treatment of "learning disorder". The doctor looks to see whether there are various bile juices in the body of such patients, and if there are, then he causes relief, for example, with bitter iyaraj: it removes excesses without removing innate fluids; if it is known that their juices are thick and viscous, then they are given a laxative from iyaraj with coloquint or a laxative that includes sabur, coloquint, polypodium, agaric and scammonium resin. The number of components is determined by the expected degree of liquid or thickness of the juices, as well as the strength or weakness of the body. Sometimes one is even forced to resort to remedies such as harbak if other medications do not help cleanse the body and remove the viscous excess. In this case, you should loosen it carefully and give the medicine in several doses. Whenever it seems that matter has accumulated, do not let it become established and repeat the emptying. In this case, it is necessary to take into account the condition of the patient’s stomach so that he is not harmed by laxatives.

Laxatives for such patients are scented with raw scarlet wood and similar substances, but if their powers are great, then do not think too much about it and purify with iyaraj in sufficient quantity. In general, it is necessary that the treatment regimen prevent the formation of excess, which is achieved by gentle frequent emptying, and one should, as far as possible, refrain from bloodletting. If bloodletting cannot be avoided due to the body being overfilled with blood, then proceed with it with caution, removing the blood in parts over three or four days. Bloodletting is most needed if the cause of the disease is blood retention during kidney or menstruation. Then it is best to first perform a bowel movement with blood purifying agents, for example, iyaraj or something similar, and then, if this is already unavoidable, it is enough to take a little blood. In most cases, such patients require emptying with means that remove juices from the bottom and open blockages, and then with diuretics, which also open blockages. Dissolving enemas, which dissolve fluids and remove them from below, are very useful.

After such patients have had a bowel movement, the best treatment for them is moderate physical exercise, reducing water intake and bathing in water with the properties of bavrac, in sulfur water and in alum water; they should stay close to the sea and hot springs. As for the fresh water bath, it is harmful to them, unless they use a dry bath and do not sweat from its hot air. If such patients resort to vomiting before eating, then this is an excellent method of treatment for them; At the beginning of the disease, vomiting should be induced with radish soaked in sikanjubin, and at the end with harbak. Physicians should take charge of drying the water as much as possible and opening the blockages; in medicinal dressings and in drinking medicines, drying, thinning and fragrant substances should be used, such as sumbul, Chinese cinnamon and Ceylon cinnamon; thinning medicines are wormwood, lovage, sapling, nettle seed, dubrovnik, round aristolochia and squeezed sapling juice, centaury, wolf's bast leaves; Opopanax and bladder cherry help due to their special properties.

The medicinal dressings for such patients include sulfur, squeezed mad cucumber juice, wolf bast root and leaves, soda, iris ash, sea foam; These medicines and others like them are suitable for rubbing in a bath. Maybikh, handikun, liquid fragrant wine in small quantities, as well as iris wine are useful for them; One of the remedies that helps them a lot is wine made from wormwood, given on an empty stomach. Of the varieties of medicinal porridge, especially after cleansing, teryak, mithridate, medicine from turmeric, from lakka, kalkalanaj from seeds help; They are often given milk and camel urine to drink, mainly when the patient’s body is hard and strong, especially if the “digestion disorder” becomes chronic and almost turns into dropsy. Sometimes they give you two uqiyas of camel urine with shikanjubin in an amount of up to half a bowl or more, as well as shikanjubin in goat urine. Sometimes it is better to mix yellow myrobalans with urine if the patient’s juices are liquid and yellow-billed. Among the poultices, applying a poultice on the stomach and liver with sumbul, Ceylon cinnamon and medicines similar to these two, as well as using a bandage of such medicines with maysusan and similar substances, helps. Patients are constantly rubbed into the stomach with something like bavrac or sulfur with well-known hot oils. As for bandages, a plaster with a roller and quince helps them, and if the disease is persistent, then the patient is smeared with cow feces and goat feces.

As for the diet of a person suffering from a “digestion disorder,” he is fed food that is tasty and strengthens the nature, such as turach, partridges and broth made from them, zirbaj, strongly flavored with cloves, Ceylon cinnamon, saffron and mastic, as well as sour gravies. Among the fruits, sweet pomegranate is suitable for them; Quince in small quantities is also not harmful. You should also add to their food, for example, mustard, leek, garlic and whatever goes their way, but do not add too much of it all.