Case of chronic empyema treated successfully by paracentesis / by A. Peddie.

  • Peddie Alexander, 1810-1907.
Date:
[1850]
Catalogue details

Licence: Public Domain Mark

Credit: Case of chronic empyema treated successfully by paracentesis / by A. Peddie. 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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    CASE OF CHRONIC EMPYEMA TREATED SUCCESSFULLY BY PARACENTESIS. By A. PEDDIE, M.D., F.R.C.P., PHYSICIAN TO THE MINTO HOUSE HOSPITAL AND DISPENSARY, EDINBURGH. [FROM THE MONTHLY JOURNAL OF MEDICAL SCIENCE, FOR AUGUST 1850.] ■ Robert Neilson, aged 26, picture-frame maker, near Denny, was admitted to Minto House Hospital on the 27th October 1846, being recommended by Dr Ali- son to Professor Syme for the operation of paracentesis thoracis. He stated that, while in Dublin in the beginning of January of the same year, after complaining for some weeks of slight cough, he was suddenly affected with what he understood to be a pleurisy of the left side. For this he was cupped, repeatedly blistered, took mercury and hydrodate of potass, and was sent back to Scotland in the end of February, very weak and much distressed in breathing. In the month of June he was advised to sea-bathing, which he tried without benefit for two months. Various practitioners in the country were consulted, and the general opinion appeared to have been, that he was affected with a hardness of the lungs, which blistering and time only could remove. On admission his general symptoms were,—very considerable debility, great breathlessness, and palpitation on the slightest exertion, and these to a dis- tressing degree, accompanied with cough when attempting to lie on the right side. His nights were very restless, but not feverish; his pulse was 80—of ordinary character, the tongue clean, the appetite good, and the bowels regu- lar. The external aspect of the chest to the eye, as well as measurement, showed a decided enlargement of the left side, considerable filling up under the clavicle, and great bulging of the inferior and lateral parts, which was particu- larly apparent when viewed from behind. The intercostal spaces generally were completely filled up, and almost prominent in the lateral region ; and in- spiratory efforts, although very conspicuous in the right, produced no expan- sive movements in the left side. There was also slight fulness in the upper part of the abdomen. Percussion over the side was universally dull, but espe- cially stone-like beneath the mammary region; and not the slightest feeling of vocal vibration was communicated to the hand. Auscultation gave a weak but rough and somewhat bronchial respiration above and immediately below the clavicle. It became less audible as the mammary region was approached, where, and underneath, it was entirely absent. It was also very faintly heard in the upper and back part of the axilla ; and, posteriorly, from the shoulder to the lowest part of the thorax, and to an extent of about four finger breadths SUTHERLAND AND KNOX, GEORGE STREET, EDINBURGH.