on air found in the pleura, &c 511 
and 9th ribs, having previously divided the integuments and 
the intercostal muscles with a scalpel. On withdrawing the 
stillette a little air rushed out, and was collected in the 
bladder, but not in the quantity that I expected ; it did not 
exceed five cubic inches ; and on examination it was found 
to consist of azote, and a little carbonic acid. 
Conceiving that the operation had failed in consequence 
of adhesions in the part of the pleura punctured, and, en- 
couraged by the composition of the air collected, and the 
slight relief which the patient experienced, a repetition of the 
operation was decided on, and performed the next day. 
The chest was perforated just below the left papilla. Now, 
on withdrawing the stillette into the bladder, a large quan- 
tity of air rushed out and distended the bladder ; and on 
separating the bladder from the cannula (by cutting it off, 
after having secured the air in the former by a tight liga- 
ture,) air from the chest continued for several seconds to 
rush out with violence, as if from a blow-pipe. When the 
rushing of air ceased, and it was found that air began to pass 
in on inspiration, the cannula was withdrawn, and the wound 
was closed by adhesive plaster. 
The patient experienced sudden and great relief, exceed- 
ing his power to express. Since the operation he has con- 
tinued to improve, and now, June 17, he is as well as, or 
better, than when first admitted into the hospital ; his appe- 
tite is good, his cough little troublesome ; he can lie on the 
left side, which he was unable to do for many months prior 
to the operation ; both wounds are healed ; and the left side 
of the chest is diminished considerably in volume, and is 
much less tense and tympanitic. Though the heart still beats 
