American Materia Medica, Therapeutics and Pharmacognosy

The Removal of Dropsical Accumulations.
In the treatment of dropsy I am convinced that the physiological
processes involved have been misunderstood and therefore often wrongly
treated. Failures have been attributed to the remedy, when they have
been due to its improper administration. That this is too often the case in
the use of remedies for other conditions, I am assured.
To illustrate: Cathartics are administered for their hydrogogue action in
dropsy, either to directly reduce the quantity of the fluid within the
tissues or to reduce the quantity of serum directly from the blood and
thus induce a reabsorption, perhaps, of the serum which has been
diffused outside the capillaries throughout the tissues.
It is well known that apocynum, elaterium, and hair cap moss, when given
in proper dosage, will so influence the process of absorption that the
diffused serum will be taken back through the medium of the capillaries,
into the circulation and the dropsy will disappear without any active
hydrogogue or diuretic action.
I first made this observation in 1882, of the action of hair cap moss. Both
my own observations and those of other more recent writers will confirm
this influence as being possible from the use of apocynum, elaterium,
magnesium sulphate in small and frequently repeated doses, and one or
two other remedies to a limited extent. Whether the remedy acts through
its direct influence upon the heart, and the circulation of the blood, or
upon the secretory or excretory glands of the intestinal canal, as
elaterium is supposed to act, or upon both these processes, as apocynum
acts, or primarily upon the kidneys, there is no doubt in my mind that an
influence is exercised upon the blood pressure-upon arterial tension and
perhaps also upon the specific gravity of the blood which influences
absorption and the osmotic processes, promoting a reabsorption of the
diffused serum into the capillaries without any apparent loss of fluid by
increased intestinal, renal, or other eliminative action.
If it were possible to know how this reabsorption could be always
induced, it would be of great advantage, as it at once restores the
quantity of fluid to the circulation, and prevents the prostration and
debilitation of the patient, present, often after the removal of so great a
quantity of fluid, which sometimes results in the death of the patient,
before the influence of restoratives can be administered. I regret that I
Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 44