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
Catalogue details

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.

    21/96 (page 13)
    and in a few weeks Vie was beyond my attendance, and in six was at business in Boston, in spite of my requests lor caution. He felt so well that he seemed unable to listen to cautions. He has continued well since. I am sure, Mr. President, that you, and those of the Academy who know me, will believe that in detailing these iaets I am not falsifying. Gentlemen, they are solemn and true statements, and as such should command your attention. Fourth.—I icould use the operation to prolong life and relieve suffering temporarily., even if there he no hopie of tdtimate cure. The two following eases illustrate this :—A physician, a^t. 70, liad organic disease of the stomach and parts adjacent, and intei- current with it, and probably consequent thereupon, was an ettii- sion into the right pleura, causing at times frequently recurring dyspnoea. On this gentleman I operated eight times during less than one month. He experienced so much comfort from it that he called it his luxury, said that for twenty-four hours after thoracentesis was performed he was lapi)ed in Elysium. On one occasion he requested me to jierform it, but having operated only a very few days ])reviously, I siiggcsled waiting at least twenty- lour hours, and when I visited him the following day he addressed me earnestly, in liict solemnly adjured me never again to refuse to operate when the jiatient, from previous experience, dt-manded it. I shall not soon forget that apjieal from the really dying man. The following illustrates the same. The natural language of relief was the only means we had of knowing of the comfort the operation gave. A young woman, a teacher, became epileptic, and when I saw her her mind seemed almost wholly lost. She was lying in bed* partially propped up, but perpetually writhing and moaning as if in great suffering, but utterly unable to give intelligent answers. On auscultation we found signs of a large effusion into one pleura. I operated, not for the hope of cure, but simply' to relieve her. One quart of pus was drawn. The poor patient lay down tran- quilly and slept easily, and, strange as it may seem, even the mind seemed to recover somewhat from its piostration. She knew more what was going on around her, and expressed in many natural w.ays the real comfort we had given hei'. There was no attempt at reaccumulation, and at the autopsy, about a month af- terw.irds, we found recent adhesions only, no fluid remaining. Fifth.—/ think ire shall hereafter operate on acute cases of common pleurisy which do not early yield to remedies after a few weeks of treatment. The question will often arise, I think, hereafter, whether, after treating a case for a few weeks and no attempt at absoiption takes place, we should not try really the abortive treatment liy ac- tually removing the fluid, and allowing the lung to expand. Ex- perience has not as yet decided at what period of the early time of the disease we may puncture. But I cannot see any valid reason for continuing any active treatment more than one, two,