The Case of an Extraordinary Dropsy, Communicated in a Letter from Tho. Short, M. D. to C. Mortimer, M. D. Sec. R. S.

of this, was sufficient to refer us to the whole System or Furniture of the Heavens. But I am afraid I become tedious. I am Your Illustrious Society's, and your most obedient, Findern, July 8. 1742. humble Servant, E. Latham. IV. The Case of an Extraordinary Dropsy, communicated in a Letter from Tho. Short, M.D. to C. Mortimer, M.D. Sec. R.S. Sheffield, Aug. 2. 1742. SIR, The following Case being somewhat uncommon, perhaps it may not be wholly unworthy of your Notice. Last January I was called to visit a young Woman of Thirty Years of Age, who about Seven Years ago, had like a severe Fit of the Stone in her Left Kidney, with all the common Symptoms of a Stone, but by some Means recovered again. Three Years ago she had another Fit, but got better in a few Days; though she mostly complained of a dull Pain in that Place ever after. When I saw her, I found her Menstrues had been very irregular and small since her last Paroxysm, and totally obstructed since September; her Pulse very small and quick, her Countenance pale and languid; a Pain at the Pit of her Stomach, towards the the Spleen, besides that in the Kidney; her whole Stomach and Belly full, and somewhat swelled, but harder on the Left Side than the Right; a Fluctuation of Water or Matter among the Abdominal Muscles, and the Peritoneum very hard under it: The Right Side was full, and softer. She had no Appetite, little Sleep, a small Cough, a little Thirst, slight Fever, and much Pain. I ordered her some laxative, aperient, attenuating, diuretic Pills, with an antihydric stomachic Mixture, the Country Air, and daily moderate Riding. She pursued this Method a few Weeks with some Advantage, but not so much as she expected and desired. Then she took the Advice of another Physician, to no better Purpose. In April I was consulted again by her. Her Flesh was now much shrunk, the Belly fuller, Pulse quicker, Pain the same, Urine scanty, but pale, Appetite languid. I prescribed other things to the same Purpose as above, but with no better Success. In June I put her on drinking Nevil-Holt Water (which last Year had cured Three of Dropsies, which was all had used it for that Purpose) and riding: Upon this she made Water freely, slept tolerably well, had a better Appetite, less Pain, and much cheerfuller; but the Swelling of the Belly was still the same. Always on turning her in Bed, she heard and felt a Jolting and Fluctuating of Water in the Belly: This put her on being tapped, not doubting but she would recover then. Next Day I was sent for to see the Water drawn off, July 23. but to my Surprize, on the Perforation, between Three and Four Pints of very thick, roupy, mixt Matter came away; some was Matter, some a thick white Slime, but the greatest Part was a thick thick reddish-brown Liquor, like Liver mashed with a little Water: It could not get through the Canula, without often clearing it with a Goose-quill. After this came near Six Pints of clear Water or Serum, as in a Dropsy. She seemed much easier then, all the Afternoon and Night; next Forenoon not so easy, though she came down Stairs to Dinner. Quickly after it, she was most severely and violently seized with such excruciating Pain all down the Left Side to the Foot, as threw her into the most profuse Sweat, often Faintings, Vomitings, &c. At Four o’Clock, she wholly lost both Sense and Motion of that Thigh and Leg; at Five she was insensible, and at Six she died, July 24th. Next Day the Body was opened before me, when a monstrous Tumour on the Left Side of the Belly shewed itself, and a large Bag of Water on the Right Side appeared, which Two filled the whole Cavity. The Abdominal Muscles on the Left Side were very large, flabby, bloated, and a livid pale. The Peritoneum uncommonly hard, thick and scirrhus; the Liver and Spleen both much emaciated; the first not above Two Pound, the last about Two or Three Ounces; the Stomach and Intestines, from the Cardia to the Anus, full of small, hard, white, scirrhous Knots, like small Peas, or Hailstones; the Intestines of a dusky yellow Colour: The Remains of the Omentum were mortified: The Kidneys were found: The Pancreas very small and yellow. The Tumour on the Left Side (which was the Ovarium) being cut up, some Pints of the same Matter as was first drawn off in Tapping, run out: It was divided into innumerable Cells, full of different Matter, some as above; some white, thick Slime, some fatty, some purulent, &c. The Partitions between the Cells very strong, cartilaginous in the Middle, so as to resist the Knife; like muscular Flesh below and above this Cartilage, so was each Cell. The whole Ovarium, before it was first broke, might weigh about Twenty Pound Weight. The Bag of Water on the Right Side, was the other Ovarium, wherein was nothing but like a large Ox Bladder, containing Nine or Ten Pints of Water; like a Bladder at the lower End, and rising up like a crooked Horn at the other End; the Skin was very thin and smooth. The Vesica urinaria and Uterus were both found. From the above-mentioned Account you will see, 1st, That here was a triple Dropsy, viz. One intermuscular on the Left Side of the Abdomen; One in the Cavity of the Belly; One, and the largest of all, in the Right Ovarium. 2dly, As I have before observed the like in some others, in much the same Condition; in barren Women, and stale Maids, Tapping should be very cautiously undertaken: Especially when the whole Belly is not equally distended, and not a free Fluctuation of the Water heard and observed from Side to Side, as the Sick turn in Bed; but especially if there was, or is, a sensible Difference to be felt in the Hardness or Softness of the Parts of the Belly, before it is distended monstrously. I am, SIR, Your most humble Servant, Tho. Short. V. Part