284 DISEASES OF THE PLEURA. 



him of drink. I have seen other cases, where this treatment failed, as, 

 contrary to all reason, the patient was allowed a copious supply of 

 wine on certain days. An attempt may also be made to excite reab- 

 sorption by the outward and inward administration of iodine, which 

 has a well-known reputation as an absorbent. I have seen such re- 

 markably rapid absorption take place under the internal use of syrup 

 fend iodidi ( 3 ij) with syrup simplic. ( ij), a teaspoonful being taken 

 every two hours, in conjunction with the external application of a 

 weak compound solution of iodine (iodini. 3 ss, potass, iodid. 3 ij, aquse 

 destil. ij), upon the affected side of the chest, that I cannot help re- 

 garding the beneficial action of this prescription as probable, although 

 I do not regard it as proved. 



Considering our slender ability to excite or even to hasten reab- 

 sorption of pleuritic effusions by means of internal medication, the dis- 

 covery that their evacuation by surgical means is attended by much 

 less danger than was formerly supposed, and the frequent and early 

 practice of such operations in cases of pleurisy with effusion, must be 

 considered an important advance in therapeutics. Every additional 

 day, during which the lung is exposed to pressure, and time is allowed 

 for cells to multiply in the exudation, the chances of complete recovery 

 diminish, and the danger of a fatal termination increase. It is to 

 be hoped that the experience of Kussmaul, Hartels, and Ziemssen, 

 will promote the introduction of paracentesis thoracis, both in cases 

 of empyema and of serofibrinous effusion. Indications for the proced- 

 ure of tapping and its various details are given in the hand-books 

 of surgery. 4 



CHAPTER II. 



HYDROTHORAX. 



ETIOLOGY. Hydrothorax is not the result of an exudation, but of 

 a dropsical transudation into the pleural sac. In most instances its 

 source is easily traceable to one or other of the well-known condi- 

 tions under which pathological transudations arise, namely, increase of 

 the lateral pressure within the veins, and decrease in the amount of 

 albumen in the serum of the blood, the so-called dropsical crasis. 



" Water on the chest," which, to the minds of the laity, is one of 

 the most formidable of maladies, in which view the older pathologists 

 participated, is never an independent and primary affection, but is 

 always secondary, being the result of some morbid process, which has 

 given rise to the conditions necessary for the production of a patho- 

 logical transudation. Hydrothorax, therefore, no more deserves the 

 name of a disease than does dropsy of the subcutaneous tissue, or 

 dropsical effusions into other large cavities of the body. It is merel v 



