The treatment of severe and refractory edema of the lower extremities has occupied the attention of physicians for many centuries. The celebrated Roman philosopher Celsus,1of the first century A. D., in a chapter on De Hydropicis, called attention to the beneficial effects of a low fluid intake as well as to the increased elimination of fluid by excessive sweating; but in addition to these measures it is of considerable interest to find the following recommendation given by him for the treatment of dropsy: Above all an incision ought to be made, of almost four fingerbreadths, on the inner side [of the leg], from which much fluid may drain for several days. Although even today this original recommendation of Celsus is occasionally resorted to, more appropriate measures are now available. Great progress has been made during the last fifty years in the direction of a better understanding of cardiac
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