(so) HISrORT of ihe S C I E T T. 



Account of large qiianLii;y tliiis evacuated, it will prove the lung of that 



\v. Hamiiion. jz^^ j.^^ ^^ founcl ; as, air being entirely excluded, the cavity 

 muft be filled up by that alone, after the vv^ater is diicharged. If 

 little runs ofF, it is probably one of thefe cafes where the lung 

 is fo much indurated as to be for ever incapable of performing 

 its function. In the firll cafe, the patient may derive benefit 

 from the operation; the difeafe may be prevented from recur- 

 ring. In the other we have done him no hurt ; he will breathe 

 more eafily as long as the oozing continues, by taking away the 

 redundant Vv\ater, but, as this cannot be kept up long, he muft 

 at iail be left to his fate. 



" Laying the patient on the difeafed fide after the operation 

 muft be of fervicc, as it both allows the w^ater to run ofr, and it 

 prevents hinri from enlarging that fide of the cheft, and thus 

 limning a riftc of drawing in air by the wound. When a canula 

 is kept in, this is impracticable ; the patient cannot be laid 

 much towards that fide without the canula prefting on the bed- 

 clothes. In the manner I have propofed, the operation will, I 

 think, be more fafcly performed, and might therefore be oftener 

 tried. 



" V/kat I have faid applies only to hydrothorax. In em- 

 pyema an opening muft be kept in the cheft, to difcharge the 

 matter as it forms. The tw^o difeafes certainly require different 

 furgical treatment. In the firft, inflammation has not come on, 

 and is to be guarded againft In the other, the collection of 

 matter is the effect of it, and its being regularly difcharged will, 

 if any thing can, abate it. I fhould therefore follow Mr Bell's 

 plan* in this, though I would differ from it in the other; and 

 as the fteps of the operation in thefe two cafes would be the 

 fame, except leaving in the canula in empyema, we may attempt 



it 



* The canula recommended by Mr BiiLL^has no l!p or margin round the opening. 

 By fiich an addition it has a hold of the parts round the opening, and can be kept 

 much Headier. 



