1824.] Proceedings of Philosophical Societies. 383 



Article XIII. 



Proceedings of Philosophical Societies. 



ROYAL SOCIETY. 



March 4 (continued). — " Some further particulars of a case of 

 Pneuinato-thorax ; by J. Davy, MD. FRS." 



Dr. Davy's hopes of the favourable termination of the case of 

 Pneumato-thorax, in which tapping was resorted to, as described 

 in the Appendix to his paper in the Philosophical Transactions 

 for 1823,* had proved fallacious ; — the patient had died ; and the 

 object of the present paper was briefly to detail the progress of 

 his disorder, and to give the examination of the air found in the 

 chest. 



About a month after the date at which the history of 

 the case in the Philosophical Transactions terminates, hydro- 

 thorax supervened, and it was likewise found that air was 

 collected in the left cavity of the chest. A consultation being 

 held upon the case, a second operation was determined on. Dr. 

 Davy having experienced inconvenience in penetrating the in- 

 tercostal space, adopted the method of perforating a rib, men- 

 tioned by Hippocrates. Part of the fifth rib was accordingly 

 laid bare by the scalpel, then bored through by a carpenter's 

 auger, and the pleura penetrated by a trocar : about fourteen 

 ounces of clear fluid were obtained, containing albumen, and 

 a little sub-carbonate of soda, but no free carbonic acid ; the 

 succeeding portions, however, were more and more purulent, 

 and contained gas. The total quantity of fluid thus obtained 

 in the course of six weeks amounted to twenty pints. By means 

 of a trocar and bladder air was obtained from the aperture at 

 three several times ; and being examined by lime water and 

 phosphorus was found to consist of from 88 to 90 per cent, of 

 azote, 2 to 4 carbonic acid, and 3 to 5 oxygen. The patient 

 was at first much relieved by the operation, and seemed to be 

 recovering : but he eventually became worse, and died ; evi- 

 dently from the mere effects of the disorder. 



On the examination of the body after death six ounces of 

 pus were found in the right pleura ; the right lung at first ap- 

 peared healthy, but upon minute examination a number of gra- 

 nular transparent tubercles were found disseminated through it. 

 The left lung was much condensed, so that it could not be 

 inflated by blowing with a pair of double bellows attached to 

 the trachea; it Communicated with the pleura by two small 

 openings. The heart was displaced, having been thrown to 

 the right side, obliquely on the spine. The body having been 

 opened in a bath, 170 cubic inches of gas were collected from 

 it, containing 16 per cent, of carbonic acid, and a little oxygen ; 



* See our latt number, J>, 302. 



