CASES OF PARACENTESIS THORACIS, WITH OBSERVATIONS
Authors: H. M. Hughes
Journal: BMJ (1855)

MOST persons connected with public practice have, 1 think, observed that cases out of the ordinary course gene- rally occur in sets, or in quick succession to each other; that, after some weeks, or even months have elapsed, with- out 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 recog- nised little more than a year and a half ago, we have since that time had admitted five or six instances of the com- plaint.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 men- tion this coincidence, lest, because I have not lately ad- verted 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 ob- servation, 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 propei-pre- cautions, of the operation; of the mode in which Mr. Cock and I recommend it to be performed; or of the plan of pro- cedure 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 harmlessness -juoad 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 ac- quainted, without an infinitely greater expenditure of power, anxiety, and pain, and also with, after all, very pro- blematical results indeed.The cases are as follow: CASE I. PLEURITIc EFrUSION; PARACENTESis THORA- CIS; RELIEF; RAPID CURE. (From Notes by MIr.G. N.CHIEEK.)J. P., aged 26, by trade a gunmakui, and ro- siding in Whitechapel, was admitted into Stephen ward (No. 19) on March 1st, 1854, under the care of Dr. Babing- ton.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 occa- sionally liable to shortness of breath, but not to such a de- gree as to compel him to desist from his occupation.His present disease commenced about a fortnight before ad- mission, when he was attacked with a very severe, sharp, and stabbing pain in the right side, accompanied with