118 HYDROTHORAX. 



fluid by an operation ; thus relieving- the lungs from 

 oppression ; encouraging the return of strength by 

 enabling the compressed lungs to expand and arte- 

 rialize the blood. If, by the stillness at the bottom 

 of the chest, and by that stillness advancing upwards, 

 he is assured of the existence of effusion ; the practi- 

 tioner should have recourse to tapping the chest, and 

 evacuating the fluid. If he does this early, he will 

 secure the following very important advantage — the 

 lungs will sooner return to the discharge of their 

 proper function ; for the portion which has long been 

 compressed by the fluid, and rendered flaccid, very 

 slowly, or never, recovers its healthy action. 



The operation is simple in the hands of a skilful 

 surgeon, and to him it must be consigned. To him, 

 however, it may be hinted, that the che.st should after- 

 wards be frequently examined, by applying his ear to 

 the side ; that if fluid continues to be effused, and to 

 occupy the chest, it must be drawn off again. The 

 most desperate cases will thus be, occasionally, at least, 

 successfully combated. One of the reasons why this 

 operation has been so seldom successful is — because the 

 practitioner has contented himself with having once 

 evacuated the chest; and has not considered the dis- 

 position to effusion must remain until by good food, 

 kind nursing, and proper medicine the weakness left 

 by an acute disease has been destroyed. 



In man, however, when the effusion has once 

 commenced, it will continue in spite of all that can be 

 done; in the horse, should the animal apparently 

 recover, there is no disease after which he is so liable 

 to a relapse. The horse reviving from pneumonia 



