PARACENTESIS THORACIS. 293 



and tense ; it was laborious as well as frequent. His inspira- 

 tion was short and almost instantaneous, and ended with that 

 catch in the throat which is produced by shutting the glottis ; 

 after this he strained to expire for a moment without any 

 noise, then suddenly opening the glottis, he forced out his 

 breath with a sort of groan, and in a hurry, and then quickly 

 inspired again; so that his endeavour seemed to be to keep 

 his lungs always full, inspiration succeeded expiration as fast 

 as possible. He said his. difficulty of breathing was owing to 

 an oppression or tightness across his breast, near the pit of the 

 stomach. He had a little cough, which exasperated his pain, 

 and brought up blood and phlegm from his lungs. Scarifi- 

 cations were made, which relieved him; the emphysema sub- 

 sided; his breathing became more and more easy, and he 

 recovered. 



In Mr. Cheston's case, the man had received a blow on the 

 chest. He had a constant cough, bringing up, after many in- 

 effectual efforts, a frothy discharge lightly tinctured with blood; 

 he seemed to be in the greatest agonies, and under a constant 

 appearance of suffocation. His pulse was irregular, and some- 

 times scarcely to be felt; his face livid; and when he was 

 sensible, which was only now and then, he complained of a 

 pain in his head. On passing a bandage round his chest, 

 with a proper compress to prevent the discharge of air into the 

 cellular membrane, and to confine the motion of the thorax, 

 the patient cried out that he could by no means suffer it, and 

 that if it were bound so tight, he should burst. A strong com- 

 pression by the hand alone affected him in the same manner. 

 Scarifications were made to let out the air from the cellular 

 membrane; and these closing, others were made. Notwith- 

 standing bleeding, repeated scarifications, and other means, his 

 sense of suffocation and difficulty of breathing increased. On 

 the fourth day the air no longer got into the cellular mem- 

 brane ; when on a sudden inclining his head backwards, as it 

 were for the admission of more air than usual, his breathing 

 became more difficult and interrupted, he turned wholly in- 

 sensible, and soon after died. 



M. Littre, M. Mery, and Mr. Cheston opened the bodies 

 of their several patients after death. 



M. Littre in his, besides a wound of the lungs and a frac- 



