Account of a case of empyema, which recovered after repeated punctures of the pleural sac / [Theophilus Thompson].

  • Theophilus Thompson
Date:
1844
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Licence: Public Domain Mark

Credit: Account of a case of empyema, which recovered after repeated punctures of the pleural sac / [Theophilus Thompson]. Source: Wellcome Collection.

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    in vain; and probably that medicine will generally prove useless, and even injurious, when pus in any considerable quantity is effused into the pleural sac. Iodine and other remedies are not likely to be more efficacious ; and, therefore, whenever there are clear evidences of such effusion interfering with re¬ spiration and nutrition, the operation should be promptly performed. When the fluid effused is serum, the whole quan¬ tity, although amounting, as in a case described by Dr. Archer,# even to eleven pints, may possibly be removed at once, without detriment; but as the present case was considered one of true em¬ pyema or pyothorax, with the lung probably con¬ densed, it was thought safer to remove only a portion of the matter at one time, and to repeat the operation as occasion might require—a precaution strongly recommended by the experience of Du- puytren. We left no canula in the wound after the opera¬ tion ; believing that, in such cases, the admission of air, especially if long continued, has a very in¬ jurious tendency. In an instructive example, which Dr. Stroud has related,! the use of a canula was followed, in about a week, by a change of the secre¬ tion from serum to pus, which, after a few days, assumed a very foetid character, and the patient, although young, and otherwise not in hopeless * Transactions of King’s and Queen’s Coll, of Physicians, vol. i. f Medical Quarterly Review, vol. i. p. 184.