490 OPEBATIONS ON THE KESPIEATOKY APPARATUS. 



quantity of fluid, the nut F is closed and E is opened. In the 

 funnel D, the diluted tincture of iodine is j)oured and carried into 

 the chest as slowly as the operator thinks proper, where it mixes 

 with the remaiaing portion of the fluid. "When the injection re- 

 turns in the instrument to a level with the little piece of glass C, 

 the nut E is closed, and the instrument removed, thus guarding- 

 entirely against the introduction of air into the chest. 



In resi^ect to the quantity of fluid that can be safely removed 

 at once, there are varying opinions. Some practitioners hold that 

 the cavity ought to be entirely emj)tied, or, at least, so far as the 

 location of the punctiu'e allows, while others favor the method of 

 discharging the contents by installments. 



According to St. Cjr, who has exj^erimented very extensively 

 in this matter, the removal of a small quantity is followed by a 

 negative result, the fluid forming again in a very short time ; while, 

 on the other hand, if the entire accumulation is taken away at one 

 time, amounting, perhaj)s, to forty or fifty quarts, it must be at 

 the hazard of encountering, as supervening disorders, syncope, 

 rupture of the j^ulmonary vesicles, congestions, or splenic or hep- 

 atic hemorrhages, with an ultimate fatal termination. 



The question thus remains unsolved, and if recoveries have 

 been recorded by Lafosse, Jr., Strauss, Massot, Bar and others, 

 failures have followed the operation in the hands of Gohier, 

 Pilger, Bassi, Dieterichs, Prudhomme, St. Cyr, etc. Pelle and 

 Sewell have obtained recoveries when removing all the fluid at 

 once. Our own experience has been negative in the cases in which 

 we have observed both conditions — that of partial, and, as weU, 

 that of the entire removal of the fluid. 



Supplementing the operation with medicinal injections of 

 some sort has been recommended. Hertwig has used astringent 

 solutions ; Leblanc, Bouley and Prudhomme have favored the use 

 of tincture of iodine, and the following prescriptions, used in 

 human surgery, are recommended by Peuch and Toussaint : 



Weak Solution — 3 — Tinct. of iodine, 10 parts; iodide of 

 potass., 1 part ; distilled water, 100 parts. 



This is first used, but, if it fails, the following is injected : 



Strong Solution — 5 — Tinct. of iodine, 30 parts; iodide of 

 potass., 4 parts ; distilled water, 100 parts. 



The general treatment recommended for those foi'ms of dis- 

 eases in which these hqoid accumulations originate, must be per- 



