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.

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    cliest, the serum will inevitably soon turn into pus. Cut tlieie is no perinauent opening made by the exploring trocar. 7th. We may e.\cite]ileurisy by pricking the pleuia. This is an ignis fatuus of some theoriser, not in the least founded in fact. 8th. We 7nay injui'e the intercostal nerve or artery. So Ave may, but I have never seen any evidence of having done so in at least 248 * operations. 9th. The instrument is imperfect. It won't always act; it docs not always draw. All these objections are commonly not met with in case a man before each operation thoroughly arranges the instrument, and tries it, and knows that it is in perfect order. He will be foiled often if he do not use these precautions. The question is often asked, Where shall we puncture ? If I can, I always operate in the back between the eighth or nintli, or ninth and tenth ribs, below the scapula, on a line with its lower angle. I auscultate tlie healtliy side, and always tap at least two inches above the lowest point at which the murmur can be heard. Gen- erally, I think, between tlie eighth and ninth rib is the best sj)ot. HOW SHOULD WE OPERATE ? !J[akc no incision of the skin, do not try to make any valvular opening, but, guided by the forefinger of the left liand pressed deeply into the intercostal space, plunge quickly and freely in. Be sure to go in quickhj and deep enough^ to get fairly into the fluid. I thank you, gentlemen, for the courtesy which lias allowed me to ajipear before J'ou, and for the kind attention with wliich you have received these desultory remarks. * April 11—250 at present date.