Early tapping, however, is never necessarily attended with 
A large dropsical collection: should never be discharged _ 
as fainting, and even death may ensue. This, however, may 
a great measure guarded against, by applying bandages tightly es 
equally over the whole abdomen. These should be drawn tighter as _ 
the contents are emptying, in order to support the bowels with an 
equal pressure. When this is properly done, almost any quantity of 
water that the abdomen may contain, may with safety bedrawnoff, 
These bandages should be continued several days after the ope- — 
Fation. | te 
The instruments for tapping generally used, are, the trocar, a 
a instrument, with a three-edged point; and the large seton— 
ncet. cae Pcie ie el ae. 
In performing the operation, the safest and best place seems to be 
at a point lying at nearly an equal distance between the navel and 
the centre of the spine of the haunch bone. No large blood vessels 
can be wounded here ; and the coverings of the belly in this place 
are somewhat fleshy, and heal more readily. None of the intestines 
can in this situation be readily injured; and when the patient is 
laid in a horizontal posture, which ought always to be the case, dur- 
ing the eperation, this point will be found to be more depending 
than any other. Ng aes Ree 
The place for the incision being determined on, it should be — 
marked, and the bandages applied to compress the abdomen, leaving 
an opening for the incision. _These bandages, or straps, should be 
confined with buckles, — they ward be drawn ie: epee. ar 
The patient being laid ina horizontal posture, with his elevated, — 
satis side lying over the side of the bed, the surgeon, if he use 
the trocar, will take it in his right hand; and fixing the head of the 
stilette in the palm of his hand, while his fore-finger directs the 
point of the instrument, he is now to push it forward till he finds 
that the end of the canula, or tube is entirely through the muscles, and 
lodged in the cavity of the abdomen. The stilette is now to be 
withdrawn and the tube allowed to remain as long as the discharge 
continues, care being taken to pull the bandage gradually tighter as 
the water flows off; or, ifthe patieht, notwithstanding this precaution, 
shall become languid, a total stop should be put to the discharge fox 
a few minutes. Ifa lancet is used, the incision should be carefully 
made, by repeated strokes, till the opening is sufficiently large and 
the matter flows freely ; asilver tube should then be introduced, with 
a perpendicular wing around it to prevent its slipping into the ab- 
domen, where it should be confined with adhesive plaster. , 
_ The discharge is sometimes stopped before the swelling is much 
diminished, by portions of the caul or intestines stopping up the end 
of the tube; this can easily be removed with a blunt probe. But 
this early cessation of the discharge may take place in consequence 
of the serum being collected in particular bags, having no commu- — 
‘3 
‘Stances, the tube must be withdrawn, and the wound being ¢ 
with a pledget of any simple ointment, the operation may ber 
iher immediately or.on the following day, on the ite 
men, or in the most depending part efit. 
_ by which only one of them is emptied: in such circum- 
