CASES OF PARACENTESIS THORACIS, WITH OBSERVATIONS

MOST persons connected with public practice have, 1 think, observed that cases out of the ordinary course generally occur in sets, or in quick succession to each other; that, after some weeks, or even months have elapsed, without any case of poisoning, for example, having occurred in the wards, two, three, or more cases, may be admitted in a single week, etc. Thus, it has lately happened at Guy's, that, though " cheloid" disease was little known or not recognised little more than a year and a half ago, we have since that time had admitted five or six instances of the complaint. Thus, as another example, though no case of cut throat had previously been admitted for six months into Guy's, we lately had three cases in about four days admitted into one ward, and another, two or three weeks afterwards, into another ward. I think it desirable to mention this coincidence, lest, because I have not lately adverted to it, the profession should assume that I have given up my advocacy of, or have resigned my confidencc in, the operation of paracenttesis thoracis; whereas the fact is, that the following cases only have occurred under my observation, so far as I am able to recollect, within the time comprised in their history. It is not my intention here to enter into any discussion as to the general propriety or the safety, undecer propeiprecautions, of the operation; of the mode in which Mr. Cock and I recommend it to be performed; or of the plan of procedure to be adopted after its performance; as I conceive these questions have been fairly laid before the profession in various papers published in the Guy's Ilospital Reports and the Mfedical Gazette.* My simple object in the present communication is to lay before the profession a few cases in which the operation was performed, and to indicate thereby the simplicity, and, under proper precautions, the harmlessnessjuoad its immediate effects-of the operation, and the temporary relief obtained thereby in cases wherein no permanent benefit could be reasonably expected by any mode of treatment, and in which even temporary relief from excessive distress could be obtained by no other means with which I am acquainted, without an infinitely greater expenditure of power, anxiety, and pain, and also with, after all, very problematical results indeed. The cases are as follow: CASE I. PLEURITIc EFrUSION; PARACENTESis THORACIS; RELIEF; RAPID CURE. (From Notes by MIr. G. N. CHIEEK.) J. P., aged 26, by trade a gunmakui, and rosiding in Whitechapel, was admitted into Stephen ward (No. 19) on March 1st, 1854, under the care of Dr. Babington. He was unmarried; his parents were yet alive; and he had eight brothers and sisters, all of whom were healthy. He stated that he was never very strong, or in robust health; but that, for the last four years, he had been occasionally liable to shortness of breath, but not to such a degree as to compel him to desist from his occupation. His present disease commenced about a fortnight before admission, when he was attacked with a very severe, sharp, and stabbing pain in the right side, accompanied with rgors and general febrile symptoms. He kept his bed for four days, and then went to consult Dr. Habershon, by whose advice he was much relieved; but he was subseuently induced to apply for admission into the hospital. We then complained of pain in the chest, especially between the shoulders, and beneath the sternum. He had very dight dyspnoea, but a frequent and painful cough; the pue was small, compressible, and 100 in number; the skin