134 



DISEASES OF THE BESPIBATOBY OBOANS. 



Diuretics and cardiac stimulants have only an indirect influence 

 on the accumulations, and when the exudate is gradually absorbed 

 we can hardly credit these drugs with accomplishing the results, as 

 the exudate is usually re-absorbed when the acute inflammatory 

 stage of the diseases has passed. The best method of treatment is 

 the removal of the secretion by surgical means — that is, to punc- 

 ture the chest-wall. This operation is not at all dangerous in the 

 dog, and is generally successful unless the adhesions are too 

 thick. 



The operation must be performed where there is a very large 

 exudate and the dull sound can be heard over the entire lung; 

 where there is oedema of the lung; in intense dyspnoea caused 

 by the pressure of the exudate; and where there is deficient reab- 

 sorption, as is seen when the fever has entirely disappeared and 

 the fluid does not show any signs of becoming reabsorbed. 



Puncture of the cavity of the chest : The trocar used in this operation is 

 an ordinary sized trocar, seen in Fig. 38, or, if we wish to make first an 

 exploring puncture, we use the needle of the 

 ordinary hypodermatic syringe. The needle, after 

 having been disinfected, is introduced into the 

 lower third of the wall of the chest, between the 

 fifth and ninth rib, the patient being in a stand- 

 ing position. The entrance of air into the thoracic 

 cavity must be avoided, and to prevent this we 

 must use a trocar that has a faucet, or else when 

 the flow of fluid becomes stopped at any time from 

 some obstruction at the end of the trocar it is well 

 to put the finger over the end of the opening to 

 prevent the air from being sucked into the cavity. 

 It is well to empty the cavity slowly and never 

 entirely, as the affected pleurae come in contact 

 with each other and rub, often causing acute 

 hemorrhage. After withdrawing the trocar it is 

 well to paint the opening with some iodoform 

 collodion. 



Fig. 3S. 



Trocars for puncture ot 

 the thorax. 



When the fluid obtained is purulent, it 

 generally requires several punctures to empty 

 the cavity. The animal should have a nutritive but easily digested 

 diet — soup, beef-tea, lean meat; and when the fever is high, anti- 

 pyrine in doses of 0.5 to 2.0, according to the size of the dog. 



