Clinical lectures delivered in Steevens' Hospital : with observations on practical medicine. Vol. 1 / by Sir Henry Marsh ; edited by J. Stannus Hughes.

  • Marsh Henry, Sir, 1790-1860.
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures delivered in Steevens' Hospital : with observations on practical medicine. Vol. 1 / by Sir Henry Marsh ; edited by J. Stannus Hughes. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    On the Sth of October, when seen by Sir ITenrj' ilarsh, every well-miirked physical sign of effusion into the left pleural cavity existed ; dilatation of the left side to the extent of an inch and a half bcjyond the right side; general oedema of left side, partly towards the inferior portion, and on the mammary region there were marked fulness and extreme tenderness un the slightest pressure. This circum- stance, with the presence of obstinate diarrhoea, which had produced considerable debility, led to the postjjone- uient of the operation, in expectation that the contained fluid would point. Moreover, ordinary signs of hectic were persistent for some time. October 13th: Pulnwnary distress became more urgent; sudden supervention of most severe dyspnoea ; sensation of impending suffocation ; severe and constant cough, with frothy and colourless expectoration. These symptoms were suddenly relieved by an immense discharge of puru- lent matter, which gushed forth from the mouth.* * In the May number of the Duhlhi Quarterlt/ Journal of Medical Sciences for 18-tO, the late Dr. George Greene, in his observations on empyema, makes some admu-ably practical and original remarks on profuse purulent expectoration some- times met with in these cases, and which from its character, both as to quantity and quality, might lead to the supposition that it depended on an abscess in the Imig or on a fistulous communication established between a bronchial tube and the matter contained in the plem-al cavity. Dr. Greene, after detailino- some highly interesting cases in point, then enters as follows on an explanation as to the cause of this profuse and purulent expectoration, and its changes after the operation of paracentesis thoracis:— «It will be observed in all these cases, that a very remark- able diminution of the expectoration, and an aheration ni its character, immediately ensued, after a free external outlet