148 DISEASES OF THE LUNGS. 



which had a ver}^ offensive smell. It was allowed to flow 

 as long as it would without the admission of air through the 

 canula into the thorax. Eight quarts were drawn^ from 

 which the horse experienced more relief than from any 

 previous operation. Continue treatment. — 5th, Appetite 

 amended, and has lain down two or three times. Treat- 

 ment as before. — 7th, Improves gradually ; appetite 

 increases ; lies down frequently without seeming disturb- 

 ance. Treatment continued. — 12th, Feeds well, and rests 

 well. Continue remedies. — April 22d, Doing well. Mr. 

 Youatt saw the horse on the 19th June following: he was 

 then at work, and apparently well. 



Some important deductions are to be elicited from 

 these cases. They have been narrated in detail with a view 

 of, altogether, affording such a connected and faithful 

 history of hydrothorax, its progress, its varieties, its changes, 

 and the manner in which it has been cured by paracentesis, 

 as is to be surpassed only by actual observation of the cases 

 themselves. 



To PERFORM PARACENTESIS wc rcquirc a trocar, and one 

 longer and larger than surgeons use, who are very particular 

 about it being a fine trocar. The canula of the trocar I 

 have, measures four inches in length and five sixteenths of 

 an inch in diameter. That part of the thorax which is the 

 most dependent, the most conveniently come at, and where 

 no mischief can ensue from perforation, is to be chosen for 

 puncture. I have generally myself operated between the 

 eighth and ninth ribs, close to their cartilages. Mr. Dick 

 operates — at least Mr. Scriven did — between the eleventh 

 and twelfth ribs, about four or five inches above their 

 cartilages. The spot being determined on, the integument 

 is be drawn to one side, either by an assistant or with the 

 operator's left hand, and through it, in a state of tension, 

 is to be pushed, with a rotating motion, the point of the 

 trocar, keeping it obliquely directed, upwards and inwards, 

 as you proceed. Some make an incision through the skin 

 with a lancet first ; and I think it very advisable, on account 

 of the facility it gives to the introduction of the trocar. 



