Edema of the feet oozing fluid
Dropsy ("watery edema ") - the accumulation of fluid in tissues or cavities and organs of the body.
The accumulated moisture is formed from liquidcomponents of blood and lymph. which, due to special, abnormal conditions go out (sweat) out of the vessels, do not enter the further circulation and accumulate in the tissues of the body. Water penetration of tissues can be observed either in limited areas, or be common and touch almost all parts of the body. Depending on the prevalence of the process, W is divided into: general hydrops universalis, and local; the latter, in turn, are divided into separate forms, looking at the place of defeat, having their own special names, are: swelling of the skin and subcutaneous tissue - anasarca, hyposarca; abdominal B. - ascites; accumulation of fluid in the thoracic cavity, in the pleural sac - hydrothorax; in the cardiac bag - hydropericardium; in the cavities and ventricles of the brain - hydrocephales, etc.
The causes of hydrocele formation are the mainway: 1) in mechanical conditions, preventing the complete removal of venous blood and lymph from the tissues; so, for example. when pressure is applied to any part of the body, limbs, superficial veins may be narrowed in the lumen, and deeper located arteries will continue to deliver blood to the tissues; due to such conditions, the lymphatic fluid entering the tissues will not enter the veins that have a difficult outflow of blood, but accumulate between the cells and the fibers of the tissue, and there will be swelling. Common edema, which develops in diseases of the heart, has the same mechanical origin; it is usually observed with such heartaches, when the correct flow of venous blood into the right heart is broken; for example, in the absence of a tricuspid valve and, successively, when the valves of the bivalve are insufficient, and when, owing to the decline in cardiac activity, the weakening of the force of the heart contractions, the equilibrium between the entry into the tissue of the liquid lymph and its reverse absorption is disturbed. Dropsy and edema from mechanical causes are usually called "stagnant", or "passive"; secondly) from changes in the composition of blood or lymph and changes in the walls of blood vessels; The latter, in turn, takes place at mostwith blood disease and eating disorders of tissue cells. These changes cause the intensive leakage through the walls of capillary vessels of liquid parts of blood, the so-called "cachectic" or "hydremic" dropsy. They are observed when the blood is poor in protein, with watery blood and poor blood with its shaped elements, with specific changes in blood and blood vessels in diseases of the kidneys (Bright's form), in swamp disease (malaria), scing (scorbutus), malnutrition ), etc. (in contrast to the dropsy of mechanical origin, or passive, these hydrocephalus are called "active") and in-3-x) under influence of nervous system disorders, peripheral or central, - the so-called"neuropathic edema." To this kind of dropsy include "paralytic edema," local or general, developing after paralysis from various lesions of the brain or spinal cord; "neuralgic edema" - with nervous or neuralgic pains; edema with traumatic injuries of nerve trunks, "hysterical swelling," blisters of urticaria (articaria), appearing in some individuals when various tastes or medicinal substances are introduced into the stomach, etc. (Prof. VV Podvysotsky, "Fundamentals of General Pathology ", St. Petersburg, 1891, page 187). The cause of the neuropathic edema lies, it is believed, in the disorder of the innervation of the vessels or, more precisely, in the spasmodic contraction of the veins (Unna).
Distribution B. on groups is more theoretical; in practice, the moments that cause V. are often complex, which causes the existence of "mixed forms" of dropsy (Prof. Yu.T. Chudnovsky, "Protocols of General Russian Physicians", St. Petersburg, 1879. p. 109). The elucidation and recognition of the main cause of such B. in each individual case is of great clinical importance for the treatment and prediction of the outcome of the disease. From true watermarks it is necessary to distinguish inflammatory fluid effusions caused by inflammatory processes in tissues and organs (see Inflammation) and also the so-called "false dropsy". The latter are formed in separate organs and glands from the excessive accumulation of liquid branches (secretions) in them, due to the difficulty or cessation of their exit from constriction or complete infection of the excretory ducts; for example, dropsy of the renal pelvis (hydronephrosis) in case of ureteral infection, fluid accumulation in the lacrimal sac, - in the fallopian tubes with the fusion of their walls (hydrosalpinx), etc. False hydrocephalus are usually cyst-like tumorous tumors filled with fluid.
Anatomical changes in tissues with dropsyare expressed first of all by the disconnection of fibers and cells by the accumulating liquid and subsequent turbid swelling and fatty degeneration. As for the appearance of edematous parts, their shape changes: they become soft, slightly elastic; at pressure with a finger on the swollen skin a depression is formed, which does not smooth out for a long time; they increase in volume, sometimes so significantly that adjacent organs are displaced; functions of edematous organs are violated until complete cessation, what causes secondary disorders.
Water fluid, impregnating tissues, tothe composition is very close to the blood plasma. contains all of its liquid, soluble constituents (only in a slightly smaller amount), the content of salts is almost the same as in blood, and the protein substances, conversely, are much smaller, especially in the water fluid in chronic inflammation of the kidneys (Bright's form), in diseases heart, cachexia, etc. at which the protein content in the aqueous liquid is less than 1%. The watery liquid is more often transparent and colorless, but sometimes yellowish or reddish from the admixture of blood and cloudy from the presence of white blood balls, purulent bodies or fat. Its reaction is alkaline; specific gravity is lower than the specific weight of blood. Dropsy can not be considered an independent form of the disease, but there is an effect or symptom of other disorders. Water phenomena, complicating various diseases, are not of the same form and intensity, but have their own characteristics. Thus, in case of heart diseases, edema is first noticed on the legs, on the ankles, and slowly rises upward; later all hands, shoulders and face swell. When heart water dries from the blood vessels, as if due to its gravity, it descends and accumulates in the lower parts of the body. With dropsy of kidney origin and with some cachectic swelling is first seen on the face, then there is dropsy of the skin and subcutaneous tissue (anasarca), common to the whole body. Often, chronic kidney damage causes an increase in the heart (cardiac hypertrophy) with a sequential circulatory disorder, and a combination of kidney and heart diseases appears that reflects the form of dropsy. If the flow of blood flowing through the portal vein due to liver disease or vein compression by any tumor or from any other cause, the fluid flows into one abdominal cavity - ascites. The causes that impede the movement of blood through the portal vein are usually very persistent, and why the ventral B. is in most cases a prolonged course and reaches enormous dimensions; In the abdomen, sometimes up to 20 liters of fluid accumulated. To the abdominal dropsy, the swelling of the legs may re-join due to the fact that the fluid accumulated in the stomach presses on the veins, and then cachexia may develop from a malnutrition. which is the cause of the general B. Vodians of nervous origin are often observed on one half of the body, for example, with half paralysis; or on one arm, leg, etc., with the defeat of individual nerve trunks. The treatment of dropsy is directly dependent on the causes that cause them; destruction of the latter or, at least, weakening of them - these are the first basic indications of therapy of dropsy. Edema of the water, developing in diseases of the heart, usually pass relatively soon with increased cardiac activity and reduced stagnation in the venous system; cardiac remedies aimed at restoring blood circulation compensation, such as digitalis, adonis vernalis, convolaria majalis, caffeine, etc., are at the same time and means against B. Abdominal V. dependent on movement blood in the portal vein, in most cases, can not be subjected to radical therapy, since the causes of such a difficulty usually lie deep - in persistent changes in the hepatic tissue, in the development of tumors that press on vessels, etc., which often can not be eliminated. General V. with kidney disease passes when restoring the correct function of the latter, with the improvement of the painful process in the walls of the vessels, with the restoration of the normal blood composition. Water drops from cachexia and nerve lesions also require therapy directed against the main suffering. In addition to radical therapy, palliative measures are also applied to the treatment of dropsy, which are aimed at limiting the accumulation of fluid that are necessary when the accumulation of water becomes excessive, disrupts the activities of various organs and threatens life. These measures include, first of all, all the techniques that raise the total energy of the body and help him to fight the abnormal conditions caused by the painful process. This example of self-defense of the body we see in the development of collateral circulation in general. With a large accumulation of fluid in the abdominal cavity, due to a significant difficulty in the outflow of blood through the portal vein, collateral, additional blood circulation also develops. and the function of the portal vein is assumed by the vascular branches embedded in the abdominal walls and belonging to the common vein system.
Then, the accumulation of fluid in the body canlimit, reducing the amount of water in the food (dryness) or increasing the moisture from the body later, urine, excrement, why sweats and sweats are used. diuretic, permeable.
If there is a large accumulation of fluid in the body or inseparate cavities are used and simple mechanical release. For the release of fluid with the general dropsy, injections or cuts are made primarily on the legs, through which the liquid also oozes. In the cuts are inserted sometimes ducts, metal or rubber. With this kind of operation, it is necessary to strictly observe the purity and disinfection of them; contamination of wounds leads to the appearance of phlegmonous and even erysipelatous inflammation. The release of fluid can be done on the same patient many times, and there have been cases when it gave a push to a lasting recovery. Accumulated liquid in some cavity is sometimes poured out and arbitrarily, with occasional rupture of the walls; Thus, an arbitrary outflow of fluid in abdominal edema was observed through the navel. through the intestines, etc .; such a flow of fluid can be useful, but sometimes it is very dangerous when the fluid flows into other organs, for example. in the lungs with puffy dropsy (pleural sack).
A. Lipsky. Water drop in animals. In general, the development of the disease in animals is the same andis caused by the same reasons as in humans. In some species of animals, B. is relatively rare, for example. in horses, which is explained by the closer to nature nature of these animals; on the contrary, in indoor dogs, which are not kept under normal conditions, it occurs as often as in humans. Sometimes the general dropsy takes on the character of a general disease and reaches the size of the enzootic (see this sl.). This is usually due to inadequate maintenance of animals; Thus, the general disease of dropsy was observed repeatedly among workers of oxen and horses in those farms where livestock feed on remains of sugar beet production, containing a huge amount of water, very often up to 95%, with the remaining 5% of dry matter containing only 1 /2 % of nitrogenous nutrient. Interestingly, the cows. receiving the same food, but having a natural runoff excessively perceived in the water feed through the mammary gland, do not get waterborne. In addition, B. was observed among sheep at grazing on bad marshy peatland pastures and among cattle with exclusive feeding by a bard. B. in animals is also often not an independent disease, but only a sign accompanying some other disease, for example. with hepatic-helminthic disease of sheep, tuberculosis of cattle, etc.
Corpses of animals that died from the common B. amaze with their anemia and pale color of meat. The same pallor of coloring in living animals can be seen on the unpainted skin and mucous membranes of the eyes, nose and mouth. Meat of animals killed in the period of perfectly developed dropsy is tasteless, and therefore in some states or not at all is allowed for sale, or is sold only under special conditions. The cure of this disease is possible only if the content of animals is changed.
Article from the Encyclopedic Dictionary of Brockhaus and Efron