r 
C 408 3 
Thomas Hines, aged 27, was admitted into -the 
hofpital on the 1 9 of December laft:, on account of 
a pain in his right fide, and cough ; which he had 
laboured under for three weeks. He was immedi- 
diately put under the phyficians care; but notwith- 
ftanding all proper methods ufed for his relief, his 
diforder increafed till the 13 of January following, 
when I was confulted. 
Upon inquiry, I found him afflicted with the fol- 
lowing fymptoms, a quick low pulfe, frequent cough, 
and difficulty of breathing ; which laft fymptom was 
greatly increafed upon lying on his left fide, or upon 
fitting upright. He appeared greatly emaciated, his 
countenance very pallid, or fallow. Upon farther 
inquiry, I found the right fide of the thorax fome- 
what enlarged; the integuments were vilibly thick- 
ened, but without the leaft difcoloration, or per- 
ceivable fluctuation. However, being perfuaded from 
the foregoing fymptoms, that there probably was an 
extravafated fluid underneath, I advifed the operation, 
which was accordingly done upon the fpot, in the 
following manner : 
The patient being conveniently feated, I made an 
incifion of about three inches long, with a knife, be- 
twixt the tenth, and eleventh rib, counting from 
above ; and at about four inches diftance from the 
'vertebra?. The direction of the incifion was agree- 
able to the courfe of the ribs ; and upon being made 
nearer to the fuperior edge of the eleventh rib, than 
to the inferior edge of the tenth rib, the intercoftal 
artery by that means efcaped being wounded. Upon 
dividing the intercoftal mufcles, very near twenty 
ounces of matter were difeharged, after which I 
introduced 
