146 DISEASES OF THE LUNGS. 



of each 5ij, digitalis 3J, in ball, thrice a day. Clysters 

 occasionally; body and legs to be kept warm; mash and 

 gruel diet. — 10th, Much the same. Blister sides. Continue 

 ball, &c. — 11th, Pulse less full and intermittent; omit 

 digitalis ; continue other treatment. 



16th, Pulse increasing. Very restless, pawing litter, and 

 attempting to lie down, yet afraid to do so ; faeces thin and 

 foetid. V.S. three quarts, catechu 5ij, digitalis and opium 

 5ss each, night and morning. — 17th and 18th, Better. 

 Pulse 54 ; dung firmer ; appetite better. Nitre and emetic 

 tartar, of each ^ij, night and morning. — 22d, Very dull; 

 appetite impaired; pulse increased; purging and foetid 

 faeces. Catechu 5ij, opium 5j, chalk 5j, in gruel, thrice 

 a day. Starch injections. — 23d, Still purging ; appetite 

 worse ; becoming weak. Continue treatment, adding half 

 a bottle of port wine to each dose. — 25th, No better ; 

 losing flesh so rapidly as to extinguish all hope of recovery. 

 Give night and morning chalk §j, catechu and opium each 

 5J, Peruv. bark and gentian, of each 3ij.— 27th, Purging 

 subsiding. Appetite better. Discontinue the wine, but go 

 on with the medicine. — 28th, Purgation ceased. Appetite 

 better, but has now great difficulty of breathing. Auscul- 

 tation indicated great impediment in the right lung, and 

 percussion elicited a dull sound. This night, on relating 

 the case to Mr. Dick, he replied, from the account given, 

 the continued purging and rapid loss of flesh, he suspected 

 hydrothorax. — 29th, Mr. D. went to see him, and became 

 confirmed in his opinion. The eff'usion was chiefly on the 

 right side ; the left was nearly free. Paracentesis thoracis 

 was at once determined on. A small incision was made 

 with a lancet between the 11th and 12th ribs. The integu- 

 ments being drawn aside, the trocar was introduced about 

 four or five inches above the cartilages of the ribs, close to 

 the anterior margin of the posterior rib, in an oblique 

 direction, upwards and rather forwards. On withdrawing 

 the trocar, the fluid appeared in a full and copious stream, 

 which was allowed to flow as long as possible without the 

 admission of air through the canula into the thorax. Eight 



