lOO SMITHSONIAN MISCELLANEOUS COLLECTIONS VOL. 63 



into the pleural cavity of nitrogen gas, or atmospheric air, so as to 

 compress the lung and prevent as nearly as possible all motion. The 

 credit for devising this operation and first performing it, belongs to 

 Forlanini, but it v^as first practiced in America by Dr. John B. 

 Murphy,' of Chicago, and has been repeatedly used by many others 

 in Europe and America, including the late Dr. Henry P. Lbomis,* 

 Dr. Cleaveland Floyd and Dr. Samuel Robinson, of Boston, Dr. L. 

 Brauer, Prof. T. Beneke, of Hamburg, Dr. H. L. Barnes and Dr. 

 F. T. Fulton, of Rhode Island. 



ARTIFICIAL PNEUMOTHORAX 



Prof. Theodore Beneke, of Hamburg, says' that Forlanini con- 

 ceived the idea of placing the affected lung at rest by artificial 

 pneumothorax as early as 1882 ; he put it in practice in 1888 ; Brauer 

 and Ad. Schmidt performed it in 1906. Murphy seems to have 

 developed his operation without any knowledge of Forlanini's work. 

 The operation has been performed in Germany, according to Beneke, 

 by hundreds of physicians on several thousand patients. The opera- 

 tion is meeting with great favor in America." 



The clinical observation that the occurrence of pleuritic effusion 

 in tuberculous cases was followed by an arrest of the symptoms of 

 the primary disease if the effusion were left undisturbed; and, 

 further, the unfavorable results which follow tapping in other cases, 

 or when later adopted in cases of quiescent during the presence of 

 the effusion led to this method of artificially producing immobility. 

 Pleuritic effusion is intimately connected with pulmonary tuberculo- 

 sis in a majority of cases and, if not purulent, should probably be 

 left undisturbed. 



Loomis followed Murphy's technique, using a special apparatus 

 for the injection of pure nitrogen gas by means of which from fifty 



'John B. Murphy: The Surgery of the Lungs (Journ. Amer. Med. Ass., 

 1898). Also Surgical Clinics of Dr. John B. Murphy, December, 1913. W. B. 

 Saunders Co., Phila. ; also Interstate Medical Journ., March, 1914. 



^ Henry P. Loomis: Some Personal Observations on the Effects of Intra- 

 pleural Injections of Nitrogen Gas in Tuberculosis (Trans. Amer. Climat. 

 Ass., 1900; Med. Record, Sept. 29, 1900). 



This method was first proposed by Prof. Carlo Forlanini, of Pavia, Italy, 

 at the International Medical Congress, Rome, 1894. 



' Ueber den kunstlichen Pneumothorax, " Tuberculosis." Berlin, Nov., 1913. 



" See article by Dunham and Rockhill, with discussion by C. L. Minor, 

 Journ. Amer. Med. Ass., Sept. 13, 1913. 



