Treatment.—­If there is effusion and few adhesions, cutting in and removing the fluid may help.  In other cases good nourishing diet with cod liver oil is best.

Ascites. (Hydroperitoneum.  Abdominal Dropsy).—­This is an accumulation of serous fluid in the peritoneal cavity.  It is but a symptom of disease.

Local Causes.—­Chronic peritonitis, obstruction of the portal (vein) circulation as in cirrhosis of the liver, cancer or other liver disease, from heart disease, tumors, as of the ovaries or enlarged spleen.  All these mentioned may produce this dropsy.

General Cause.—­Heart disease, chronic nephritis, chronic malaria, cancer, syphilis, etc.

Symptoms.—­Gradual increasing distention of the abdomen, causing sometimes a sense of weight, then difficulty of breathing from pressure.  The abdomen is distended, flattened at the sides unless it is very full.  The skin may be stretched tense, superficial veins are distended.  The navel may be flat or even protrude and around it the vessels may be greatly enlarged.  There is fluctuation when you tap sharply at one side, while holding your hand on the other side you feel a wavy feeling.

Physicians’ treatment for Ascites.—­First treat the disease causing it.  Sometimes it is necessary in order to prolong life to repeatedly tap the patient as in cirrhosis of the liver.  When it is caused by the heart or kidneys, give cathartics that carry away much liquid, hydragogue cathartics.  One dram of jalap at night followed by a big dose of salts before breakfast.  Cream of tartar and salts are good, equal parts.  Or cream of tartar alone, one to two drams, with lemon juice in water in repeated doses.  Digitalis and squill, of each one grain to cause great flow of urine.  Infusion of digitalis is also good to increase flow of urine, when the heart is the real cause of the ascites.  These treatments take the liquids away through the proper channels, the bowels and kidneys.

[136 Mothers’ remedies]

Ascites caused by an Ovarian Tumor.—­The tumor must be removed.  I am not in favor of indiscriminate operating, but operations often save lives.  I remember one case in which I very strongly urged the lady to have an operation performed.  It was a case of ascites, caused, as I was sure, by a tumor of the ovary.  The lady, as almost all people do,—­and I do not blame them for it,—­dreaded even the thought of an operation, but she was finally compelled to have an operation or die.  She filled so full that it was almost impossible for her to breathe.  She went away from home in terrible shape, almost out of breath, and returned home a well woman and has remained so.  Such cases formerly died.  But not all cases of ascites can be cured by an operation, it depends upon the cause.  In many cases all one can do is to doctor the cause, if that cannot be removed, make the patient’s remaining days as comfortable as possible.