On the Treatment of Ascites by Diuretics Applied Externally

1850 Boston Medical and Surgical Journal  
Some years ago, a short paper appeared in a French periodical, on tho treatment of ascites by means of digitalis and squill applied outwardly in the form of liniment ; and three cases were given, illustrating the diuretic and curative effects of this treatment, after failure by means of diuretics administered in (he usual way, as well as by powerful purgatives. At the time, I had under my charge a boy, 10 years of age, who had labored under simple ascites-that is, without any oedema, even in
more » ... oedema, even in the limbs-for a period of five or six months, during which the effusion had slowly and steadily increased, notwithstanding the employment of brisk purgatives, various powerful diuretics, and mercurial action. There was great difficulty in referring this affection to any particular organic disease ; but, on the whole, a previous chronic peritonitis was suspected to be the cause. When he came under my care, purgatives and diuretics internally were again tried, and especially digitalis and squill, but with no better success than before. On the contrary, the enlargement and tension of the belly became gradually very great, so that the boy was confined in a great measure to bed. The French suggestion came, therefore, most opportunely. A mixture of equal parts tincture of digitalis, tincture of squill, and tincture of soap, was rubbed freely and diligently into the skin of the belly morning and evening. At an early period-so early, if I do not mistake, as tho beginning of the third day-the urine began for the first time to increase; by-and-hy a copious flow was established ; the ascites quickly subsided, and in about fourteen days entirely disappeared ; the boy at the same time gained flesh and strength under the use of simple bitters and chalybeates, and ere long his health was completely restored. When I last heard of him, four or five years afterwards, he continued well and strong. The same treatment was tried afterwards in several cases, more or less similar to this, but fora lime with invariable disappointment. In all, however, the more ordinary measures had previously been exhausted to no purpose ; and in most of them decided organic disease of some abdominal organ was ascertained to be the cause of the effusion. At length
doi:10.1056/nejm185012250432101 fatcat:l22rqzcq7veclisebchpwpiye4