ON PARACENTESIS THORACIS. 
183 
now ordered to be given every four hours, and two drachms of 
nitrate of potass night and morning. 
The medicine was continued every four hours until the 18th of 
August. No difficulty of breathing occurred, and he went on 
improving in every respect. At the date just mentioned, I 
turned him out to grass for three or four hours daily, and con¬ 
tinued the medicine three times a day till the 30th of August, 
and for a week afterw'ards only once a day. 
On the 24th October he returned to his duty, and has been in 
perfect health ever since. 
I attribute my success in the three cases which I have just 
detailed to the early performance of the operation, and the liberal 
use of tonics, which while they invigorated the system had no 
tendency to hurry the circulation. These, it will be observed, 
were exhibited both before and after the operation; and J cannot 
too strongly impress upon my brethren the propriety of following 
the same course. In most of my unsuccessful cases, dissection 
shewed that the lungs and pleura were so much diseased that 
recovery was impossible. In other cases, however, I must attri¬ 
bute my w^ant of success to my not exhibiting the tonic medicine 
as I have just recommended. By strengthening the system in 
general, we give tone to the part which the previous inflamma¬ 
tion had weakened; and when the fluid is drawn off, there is 
much less risk of its again collecting. An unsuccessful case, in 
consequence of not exhibiting tonics, occurred to me three years 
ago. A valuable horse belonging to my commanding officer. 
Colonel Townsend, which had always previously enjoyed excel¬ 
lent health, was attacked with inflammation of the lungs. He 
was only bled once, and the disease terminated in hydrothorax. 
I operated on him three times on both sides. Fifteen quarts 
were abstracted the first time, eight the second, and two the 
last. He survived the first operation thirty days. A review of 
the whole case, coupled with the appearances presented after 
death, has convinced me that an early and steady exhibition of 
tonics would, in all probability, have saved him. 
[We regard these as exceedingly valuable cases, and thank Mr. 
Black for them. With his opinion on the advantage of the 
early performance of the operation, and the efficacy of tonics, 
we cordially agree.—Y.] 
