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Updated: May 10, 2025
The swelling is partly due to the increased amount of blood in the affected part and to the accumulation of leucocytes and proliferated tissue cells, but chiefly to the exudate in the connective tissue inflammatory œdema.
Although the patient's diet should be limited in bulk, and especially in amount of liquids, good nutrition should soon be given. Systemic weakness certainly tends to increase the exudate; systemic strength aids in absorption of the exudate.
The part affected is enormously increased in size, and causes inconvenience from its bulk and weight. In contrast to ordinary dropsy, there is no pitting on pressure, and the swelling does not disappear on elevation of the limb. The skin becomes rough and warty, and may hang down in pendulous folds. Blisters form on the surface and yield an abundant exudate of clear lymph.
If this is inadvisable, the organisms may be attacked by strong antiseptics, such as pure carbolic acid. Moist dressings favour the removal of bacteria by promoting the escape of the inflammatory exudate, in which they are washed out.
Following dry pericarditis or pericarditis with an exudate, especially when the exudate is fibrinous in character, the fibrous substance which is not absorbed or resorbed may develop into connective tissue, and the two pericardial surfaces become permanently grown together, causing the so-called adherent pericarditis.
He should not be allowed to sit up, either to eat or to attend to the calls of Nature. These rules are imperative, and when they are followed the pain is less, the heart beats less rapidly, is less hampered by pressure from whatever exudate may be present, and the adhesions which are liable to form will be less in amount and less serious for the future work of the heart.
If the heart is given all the rest possible during the acute phase of the disease, there will be less likelihood of the surfaces becoming so irritated that adhesions readily form. Anything which permits complete absorption and resorption of tile exudate will tend to prevent these hampering adhesions.
The inflammatory exudates become organized at the beginning of this stage, and the air can not enter the air cells. This period lasts several days. Resolution marks the beginning of recovery or convalescence. Toward the end of the second period, the inflammatory exudate in the air cells has begun to degenerate.
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