Hydatid disease of the lungs / by J. Davies Thomas.

  • Thomas, J. Davies (John Davies), 1844-1893.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Hydatid disease of the lungs / by J. Davies Thomas. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    sweats. The youth was considerably emaciated, and presented a decidedly phthisical appearance. On examining the chest, slight bulging was noticeable of all the interspaces on the right side in front, excepting the second and third near the sternum, and the maximum cardiac impulse was found to be in the left mammary line ; the right semi-circumference of the thorax was 14 inches, and the left 13^ inches. A tubular percussion- note was obtained in the first two right interspaces, but below that, there was toneless dulness, in the axilla the percussion-note was amphoric down to the level of the nipple, over the right back there was absolute dulness in the supra-spinous and upper half of the infra-spinous fossse, but below this, down to the seventh rib, and also in the inter-scapular region high pitched tubular resonance was obtained ; right base posteriorly, resonance normal. The whole of the Right Lung expands very deficiently, but more especially the upper lobe. On auscultation, the respiratory sounds in the right supra-clavicular region were divided, expiration being prolonged; below the clavicle there was cavernous breathing with increased vocal resonance, and also in the axilla, but less distinct at the posterior fold. In the right supra-spinous fossa, the breath sounds were weak and divided, in the infra-spinous region the inspiratory murmur was harsh, below the angle of the scapula the breathing was puerile. At the left apex harsh and prolonged expiration with moist rales was noted. The liver was not found to be displaced downwards. On February 8th, ether was administered, and I made a skin incision in the fifth interspace in the anterior axillary line, three inches outside and ^ inch above right nipple, and plunged a large trochar and canula into the lung, and then dilated the opening with Bigelow’s urethra dilator ; a considerable quantity of very fetid fluid came away, and afterwards the whole of the cyst ; there was considerable hajmorrhage at the time ; two large-sized drainage tubes were introduced into the cavity. The next day (February 9th) a good deal of glairy discharge was found in the dressing, ana the temperature was normal, but the patient had not slept well. On February 11th, the drainage tubes were removed, washed, and replaced, and it was found that a catheter went into the cavity to a depth of 4f inches, upwards and inwards. Since the operation, the cough had been much less, and patient only complained of a little soreness about the wound. From this date patient rapidly improved, and the temperature was sub- normal ; the cough disappeared, and the discharge from the wound became very slight. On February 18th one tube was left out. On February 25th, there was still a high-pitched tubular percussion- note on the right side down to the third rib, in the supra-clavicular fossa and