The operative treatment of intra-thoracic effusion / by Norman Porritt.

  • Porritt, Norman, 1858-
Date:
[1883?]
Catalogue details

Licence: Public Domain Mark

Credit: The operative treatment of intra-thoracic effusion / by Norman Porritt. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    complication of paracentesis to be next alluded to, viz:—Syncope. Its useful effects in cardiac dyspnoea are known and appreciated, but I think no one has yet pointed out its value in the treatment of similar symptoms and cough, the result of letting out fluid from the chest. In every case, an immediate refuge must not be sought in the relief afforded by drugs ; as the cough, though temporarily annoying and painful, is a sign of healthy action, as well as the means of after good. And if the sudden congestion of the expanding lung be remembered, the administration of opiates, which tend to make that condition more lasting, is contra-indicated. However, in a severe case five minims of the Tinctura Opii may be advantageously combined with half a fluid drachm of Spt. vEth. Sulph. Co. diluted with half-an-ounce of water. Bow- ditch* observes, when writing of the features of 270 cases, I have not been obliged to use opiates except once Of twice to check extravagant cough ; I should never check a mild one as it is usually the healthful sign of expansion of the lung. An elastic bandage applied firmly round the lower part of the chest is a safe and often effectual means of checking the cough. Dyspnoea is one of the indications that the quantity of fluid with- drawn must not be increased, and is a sign of more import and demands more attention than the cough. Its value as such will be reserved for discussion at a later stage. Surgical Emphysema after Paracentesis. Unless the pleura contain air, it is difficult to conceive that extravasation of air into the cellular tissue should occur, except an imperfect physical examination allow puncture of an adherent lung, or a rash operator wound a compressed lung by incautious manipulations. I have never met with the accident. It is more apt to follow incision than paracentesis of the chest, and modern improvements adopted in the instruments used * Bowditch. Practitioner, vol. i, 1873, p. 194.