Thoracentesis and its general results during twenty years of professional life : remarks made at a stated meeting of the New York Academy of Medicine, held April 7, 1870 (by invitation) / by Henry I. Bowditch.
- Bowditch, Henry I. (Henry Ingersoll), 1808-1892.
- Date:
- 1870
Licence: Public Domain Mark
Credit: Thoracentesis and its general results during twenty years of professional life : remarks made at a stated meeting of the New York Academy of Medicine, held April 7, 1870 (by invitation) / by Henry I. Bowditch. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
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![on the contrary, though better than before the operation, has had always a fistulous opening in the side, and fears are entertained that phthisis will eventually come on. The h>oy is now the picture of robust, rosy health. The girl, though better in health than before the operations, still bears ou her whole aspect the marks of long-continued disease. Allow me, in passing, to notice in the case of the little boy the natural language, so to speak, of the great relief usually arising from this operation. At the limes of the second and third opera- tions, it was that of the satisfaction felt by the little fellow at the thought that the operation was destined to relieve him. At my first operation he was very violent, and cried bitterly ; but as he gained so much comfort from it, he made not a whim]ier when he saw me prepared to operate a second time, and when his ■ flithar took him upon his knee, previously to the puncture. At the third operation he looked up at me with a most piteous yet confiding expression of face, and said : You will please hurt me as little as you can, won't you! I mention tliis tact in order to prove by the natural language of the child, that what adults ex- press in words and acts when they with avidity beg me to operate again, after having once ex|)erienced relief, so the youngest chil- dren show the same thought in a simpler style. I operated before the medical class (Feb. 2, 1866) on a very stout, burly Irisliman. He liad been ill six mouths, and the signs showed one ]>leural cavity apparently full. It had come on insidi- ously, the principal symptom being a gradually increasing dysp- noea. I tapped him ; for I deemed that the first thing to be done, as he had been so long ill. Only about a drachm of sei'ous ffuid ran out before applying the suction-pump, and not a drop more could I get with the instrument. Eviilentiy there was something obstructing it. Doing as I had done in one or more case.s, I re- versed the operation of the pump, and injected about an ounce of warm water. But it was too much for him in his nervous state to bear. The small extra pressure introduced into liis already disteixhd chest produced greatly increased dyspnoja. He became violently agitated—with some lividity of the lips—and roughly declared that he could not bear it. I instantly withdrew the trocar, and remarked to the class that T must operate higher np. These gentlemen wei'c looking on rather in wonder, and perhaps suppressed merriment, at the apparent failure of tiie operation I had praised so much. The man instantly said, I'll be d d if I will be murdered in this way. Let rae go. Leaving him to his meditations ami his mutterings, I turned to the class and said: Gentlemen, we have proof conclusive that this man's chest is full of a thin fluid. It is equally evident that thus far we have been foiled in getting it out. But ought we in duty to him to cease from our endeavor ? Decidedly not. Pro- bably some lymph lies down where I liave punctured ; and the only thing to be done is to put the instrument in higher up. That is what I propose to do; but the man, like a foolish child, under-](https://iiif.wellcomecollection.org/image/b21032737_0017.jp2/full/800%2C/0/default.jpg)
