322 SUCCESSFUL PARACENTESIS THORACIS IN A HOUSE. 
racis was at once determined on, and performed as follows: — 
After counting the ribs from behind forward as far as the eleventh, 
a small incision was made through the integuments with a lancet, 
between the last-mentioned and the twelfth rib. The integu- 
ment being drawn aside, the trocar was introduced, about four or 
five inches above the cartilages of the ribs, close to the anterior 
margin of the posterior rib, in an oblique direction upwards, and 
rather forwards. On withdrawing the trochar from the canula, 
the fluid appeared in a full and copious stream, which was 
allowed to flow as long as possible without the admission of air 
through the canula into the thorax. Eight quarts were taken 
away, the canula was then withdrawn, and the skin allowed to 
return over the wound. The horse experienced great relief, and 
immediately began to breathe more quietly. The fluid on stand- 
ing to cool quickly coagulated. About three-fourths of it as- 
sumed the nature of fibrine, and the remainder was of a serous 
character. I then ordered the following ball to be given three 
times a day : sulph. ferri and resin, aa 3ij, camph. 5 j. 
30///. — He eats better, respiration is more natural, and the 
wound is closed. Treatment continued. 
31s/. — On auscultation some fluid being found to exist in the 
left cavity of the chest, paracentesis was performed on that side 
also, but scarcely a pint was abstracted. Treatment continued. 
Feb. 3 d . — The pulse increasing in frequency, the breathing 
more laborious, the appetite on the decline, and fluid again accu- 
mulating in the right cavity of the chest. The operation was 
once more performed on the right side, in the same intercostal 
space, and a little inferior to the former opening. Five quarts 
were obtained in a full stream, which again appeared to afford 
great relief. Continue treatment. 
13///. — The former symptoms have again returned, with consi- 
derable increase. The operation was again resorted to, and four 
quarts were abstracted ; after which a sudden prostration of 
strength, threatening fainting. The pulse was greatly reduced 
in strength and frequency ; but after a short time it returned to 
the former standard. Treatment continued. 
14 th . — Pulse harder and more frequent. Treatment continued, 
but with the addition of digitalis 3 j. 
L6//z. — Pulse rather softer, and diminished in frequency; appe- 
tite better, and respiration not so laborious. The digitalis omitted, 
but the iron, resin, and camphor still continued. 
21s/. — He is very restless ; abdominal respiration laborious. 
He frequently turns his head towards his sides, and occasionally 
gives a deep sigh. The pulse hurried, and very irregular; 
extremities cold ; in short, a train of symptoms was now ap- 
