Appendix. - [$-;) 



for two or three days. The effecfl of this practice is evident ; 

 iiiflanimation may be brought on over the cavity ; fuppuration 

 will fucceecl, and the cafe will be converted into one of em- 

 pyema, with an opening in the cheil. The efreCls of keeping 

 in a canula in the abdomen v>rerc found, by the old furgeons, to 

 be fo bad, that the pradice was given up, even before the faint- 

 nefs, from drawing off the water at once, was fo well under- 

 ftood as to be capable of being prevented. In our patient, 

 fymptoms of inflammation from the canula were beginning 

 when it was withdrawn, and had it been kept in another day, 

 the inuammation would probably have become fo confiderable, 

 that it might have been expeded to produce the word confe- 

 quences. 



" The view v/ith which a canula is introduced and kept in, 

 is, to allow the water to run off only when we choofe it, and to 

 prevent air from getting into the cavity. The firfl intention it 

 does not anfwer ; as in our patient, though it was introduced 

 through the pleura when only a fmall perforation had been 

 made in it, fo that it might be clofely embraced, the water ooz- 

 ed out by its fides, and more was difcharged in this way than 

 by the canula itfelf. 



" Air is likewifc more apt to get into the cavity by the ca- 

 nula, than if the vv'-ater was difcharged without it. It is impof- 

 fible to flop it fo accurately and quickly with the finger or 

 cork, as to prevent the accefs of air, when there is little water 

 left, or when the lungs are not in a fituation to fill the cavity, 

 and efpecially when the patient is infpiring. This I found to 

 be the cafe, when I drew" off the lafl water by it. But before 

 I left the patient, I evacuated the air as completely as polfible, 

 by depreffmg that fide of the cheit during expiration. 



" From the ftrudure of the thorax, air is apt to be drawn in 

 by the external wound, and is again not eafily expelled. The 

 m.oft ready method of evacuating it, is by comprelfing that fide 



of 



A:connt of 

 W. Ha.iiiltoii. 



