. The principles and practice of surgery. fluid themoment the patient experiences a feeling of stricture or serious incon- 1 Eemarks on Thoracentesis before the New York Academy of Medicine, April 7,1870, by Henry I. Bowditch, PARACENTESIS THORACIS. 701 venience. In the opinion of Dr. Flint, the operation is admissiblewhenever the pleural cavity remains filled with liquid after a brief trialof the measures designed to promote absorption; and the operationshould not be delayed whenever the liquid accumulation is sufficientto involve danger or distressing dyspnoea. As to the supposed dan-ge
. The principles and practice of surgery. fluid themoment the patient experiences a feeling of stricture or serious incon- 1 Eemarks on Thoracentesis before the New York Academy of Medicine, April 7,1870, by Henry I. Bowditch, PARACENTESIS THORACIS. 701 venience. In the opinion of Dr. Flint, the operation is admissiblewhenever the pleural cavity remains filled with liquid after a brief trialof the measures designed to promote absorption; and the operationshould not be delayed whenever the liquid accumulation is sufficientto involve danger or distressing dyspnoea. As to the supposed dan-ger of wounding the intercostal arteries, the lungs, heart, diaphragm,etc.; it exists only when the previous auscultation has not been care-fully made, or the instrument is in the hands of an unskilful instrument employed by Dr. Bowditch consists of a small trocarand canula, with or without a stop-cock. Dr. Flint has improved theapparatus by the addition of a flexible and adjustable tube, providedwith a suction-bag. Fig. Flints apparatus for Thoracentesis. The point of election for the introduction of the trocar is on theback, between the eighth and ninth ribs, below the scapula, and on aline with its lower angle. Guided by the index-finger of the left hand,pressed deeply into the intercostal space, the instrument—without anyprevious incision of the skin—is plunged quickly into the pleuralcavity. The trocar is then withdrawn, and the tube attached; thefluid being removed by the expansion of the India-rubber bag, after itscompression with the hand. The instrument should always be suppliedwith a stop-cock, to be used after withdrawing the trocar and whileadjusting the tube, and whenever, in the subsequent steps of the opera-tion, it may be necessary to suspend temporarily the evacuation of thefluid. The instrument being withdrawn, the wound closes spon-taneously. Thoracentesis in Pyothorax.—Pyothorax resulting from gunshotand other traumatic injuries, has a
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