. International record of medicine . al cavity as soonas possible. It has always been found that after the re-moval of the pus the temperature lias immediately fallen Sept. 24, 1892.] POORE: OPERATIOXS FOR EMPYEMA. 349 aud the appetite improved. Ether has always been used,but, in cases of great prostration, only enough to blunt sen-sibility, the drainage-tube being inserted as rapidly as pos-sible, leaving any further proceeding until the patient wasstronger. The opening has always been made in the post-axillaryline, between the seventh and eighth or eighth and ninthribs. In only two cases has
. International record of medicine . al cavity as soonas possible. It has always been found that after the re-moval of the pus the temperature lias immediately fallen Sept. 24, 1892.] POORE: OPERATIOXS FOR EMPYEMA. 349 aud the appetite improved. Ether has always been used,but, in cases of great prostration, only enough to blunt sen-sibility, the drainage-tube being inserted as rapidly as pos-sible, leaving any further proceeding until the patient wasstronger. The opening has always been made in the post-axillaryline, between the seventh and eighth or eighth and ninthribs. In only two cases has the cavity been washed out, andin these the contents of the abscess were foetid at the timeof operation. In one case later the cavity was washed outwitli pyoctanin to stop suppuration ; it seemed to act accident has ever happened. It has been the rule inold cases to remove a segment of two ribs, in order toafford ample room for the drainage-tube. In cases whereit was not done at first it has been called for at a later The reason for this is that, although there may be plentyof room while the chest is filled with pus, as soon as it isevacuated either the lung must expand or the ribs fall inand the space left by the pus tend to be obliterated. Inold cases the lung is bound down by quite firm adhesionsand can not expand rapidly, so the ribs fall in, and thedrainage-tube is either (forced out or is pinched and ceasesto act as a drain. In one case the ribs overlapped one an-other, so that a portion of the whole width of the ribs hadto be removed. In two cases Estliinders operation has been performed ;in one, three or four inches of the fourth, fifth, sixth, andseventh ribs were removed ; in the other, four or five inchesof the fourth, fifth, sixth, seventh, and eighth. The firstpatient died from amyloid degeneration; the second recov-ered. Ten patients have been seen and examined since theirdischarge from the hospital. In eight the lung is fullyexpanded ; there is no
Size: 1422px × 1757px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1860, booksubjectmedicine, bookyear186
