(54) I-nStORr of the SOCIETY. 



the pleura much thicker than ii naturally is, owing to the ci- \^^"H"^,;°ton, 

 fev?ls of inflammation, and the prefTure of the v/ater, fo that a 

 timid operator, not aware of this circumfiance, (which is not 

 taken notice of), might defift, froin an idea of having met with 

 an adhefion, when he was really only halfway through the mem- 

 brane. In a cafe of hydrothorax I opened, I found the pleura 

 cojlnlis a fifth of an inch thick. I would then allow as much 

 water to run ofi^ as I thought proper, two afiiftants making fuch 

 a degree of preffure on the ribs of that fide as to prevent their 

 being raifed in breathing, during the time the fluid was dif~ 

 charged. After I had drawn ofi" fuch a quantity as flowed rea- 

 dily, and the patient could bear without faintnefs, I would bring 

 the loofe fldn over the hole in the pleura, and fix it there with 

 flips of emplaft. adhefiv. ; I would then lay the patient on the dif- 

 eafed fide, fo as to allow the water to ooze off by the wound, 

 while air would be prevented from getting in, by the fkin acft- 

 ing as a valve. If the patient grew faint, from the evacua,tion 

 being too quick, it could eafily be leffened, or flopped, by ma- 

 king him turn more and more towards his back, or oppofite 

 fide, fo as to make the hole in the pleura lefs a depending open- 

 ing ; or, by making preffure upon the fliin over the opening, 

 the difcharge might be completely flopped. If the lung was 

 not difeafed, as the water flowed off, it would be more and 

 more filled with air, and expanded. If it was fo much difeafed 

 as to be incapable of expanflon, by no mode of operation can 

 more water be drawn off than what diflended the cavity ; a 

 quantity muft be left equal to the want of enlargement of the 

 lung ; if we draw off more than this, air muft fupply its place ; 

 for we are not to imagine we can take away all the water, and 

 leave a vacuum. The wound will admit of the water oozing 

 long enough to evacuate all that fliould be taken away ; and it 

 will not be prevented from healing, fo as to endanger the pa- 

 tient, from the rifli of internal inflammation. If we find a 



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