414 HYDROTHORAX, OR DROPSY OF THE CHEST. 



atmospheric air mashing into the lungs, can be detected, set 

 it down that the fluid has not readied so high. As soon 

 as the judgment is determined, perform an operation in 

 the manner detailed below. 



The operation of paracentesis thoracis, or of tapping the 

 chest, consists in first making a slight opening through the 

 integuments ; when the skin is to be pulled on one side, 

 and the trochar inserted. The situation for making the 

 opening is near to the anterior edge of the ninth rib, but 

 not too low down, for fear of harming important structures. 

 The skin being drawn aside the canula armed is to be 

 thrust in, and gently pushed forward, till all opposition is 

 mastered ; then withdraw the stillet, and push the blunt 

 tube onward. Sometimes the sides of the chest are covered 

 with pus and coagulated fibrine, which prevent the fluid 

 from rushing forth. A probe, therefore, may be introduced, 

 and moved quietly about to remove the obstruction. Fluid is 

 thus drawn off'; but supposing it to be present upon both 

 sides, there is some dispute as to how much, or the manner 

 in which it ought to be abstracted. If all be taken at once, 

 nature sinks under the operation ; therefore it is best to 

 take a third from each side, using care that the amount 

 draw^i from both sides renders them equal as to what re- 

 mains. " Then giving the horse the best of provender, and 

 the animal having perfectly recovered its tranquillity, repeat 

 the operation at the expiration of eight hours ; this time 

 inserting the trochar lower down, and in another eight hours 

 draw off' the remainder of the water. The trochar, in this 

 last operation, must be inserted very gently, and care be 

 taken that the stillet be withdrawn immediately upon the 

 sides being pierced. 



No fear need be entertained about making these nume- 

 rous holes in the horse's sides. No damage will be done, 

 even though the practitioner should encounter a dry tap, 

 or though no fluid should be found within the chest. The 

 subsequent treatment is to give the most powerful tonic 

 medicines, and the most decidedly nourishing food. Car- 

 rots and roots may be allowed, but all grasses must be 

 strictly prohibited. Linseed may be mixed with the food, 

 and ground beans are especially beneficial. Medicine, how^- 

 ever, must not be forgotten. All astringent substances 



