490 OPEEATIONS ON THE KESPIEATOBY APPAEATUS. 



quantity of fluid, the nut F is closed and E is opened. In the 

 funnel D, the diluted tiactm-e of iodine is poured and carried iato 

 the chest as slowly as the operator thinks proper, where it mixes 

 with the remaining portion of the fluid. "Wien the injection re- 

 turns in the instrument to a level with the Httle piece of glass C, 

 the nut E is closed, and the instrument removed, thus guarding 

 entirely against the introduction of air into the chest. 



In respect to the quantity of fluid that can be safely removed 

 at once, there are varying opinions. Some practitioners hold that 

 the cavity ought to be entirely emptied, or, at least, so far as the 

 location of the j)uncture allows, while others favor the method of 

 discharging the contents by installments. 



According to St. Cyr, who has experimented very extensively 

 in this matter, the removal of a small quantity is followed by a 

 negative result, the fluid forming again in a very short time ; whUe, 

 on the other hand, if the entire accumulation is taken away at one 

 time, amounting, perhaps, to forty or fifty quarts, it must be at 

 the hazard of encountering, as supervening disorders, syncope, 

 rupture of the pulmonary vesicles, congestions, or splenic or hep- 

 atic hemorrhages, with an ultimate fatal termination. 



The question thus remains unsolved, and if recoveries have 

 been recorded by Lafosse, Jr., Strauss, Massot, Bar and others, 

 failures have followed the operation in the hands of Gohier, 

 PUger, Bassi, Dieterichs, Prudhomme, St. Cyr, etc. Pelle and 

 SeweU have obtained recoveries when removing aU the fluid at 

 once. Our ovrai experience has been negative in the cases in which 

 we have observed both conditions — that of partial, and, as weU, 

 that of the entire removal of the fluid. 



Supplementing the operation with medicinal injections of 

 some sort has been recommended. Hertwig has used astringent 

 solutions ; Leblanc, Bouley and Prudhomme have favored the use 

 of tincture of iodine, and the following prescriptions, used in 

 human surgery, are recommended by Peuch and Toussaint : 



Weak /Solution— -^—Tinct. of iodine, 10 parts; iodide of 

 potass., 1 part ; distilled water, 100 parts. 



This is flrst used, but, if it fails, the following is injected : 



Strong Solution~^—T:inct of iodine, 30 parts; iodide of 

 potass., 4 parts ; distilled water, 100 parts. 



The general treatment recommended for those forms of dis- 

 eases in which these liquid accumulations originate, must be per- 



