288 Unpublished communication to the writer, 1882.
In 1815, Blondel practised puncture of the chest with a bistoury. Gendrin performed the same operation in acute pleurisy in 1831, but with only bad results. Townsend289 (1833) acknowledged that the operation had fallen into disuse, as much from uncertainty of diagnosis as from any experience of its general danger. He gives the results of Thomas Davies's operations—8 out of 10 successful cases in empyema, with 9 fatal cases in pneumothorax with effusion (probably tubercular), and 3 fatal cases in hydrothorax. Davies used a grooved needle to determine the presence of the liquid, its quality, and the thickness of the walls. After the operation his practice was to inject a weak solution of chloride of lime, which he found to have the effect of diminishing the discharge and correcting its character. Crompton290 (1834) had 3 successful cases out of 10.
289 Cyc. Prac. Med., vol. ii. p. 43.
290 Ibid., vol. iii. p. 400.
Robert Law291 pronounced paracentesis more successful in chronic than in acute pleurisy. Townsend doubts whether the admission of air was hurtful; he quotes Nysten and Spies's experiment, showing that air introduced into healthy pleuræ was invariably absorbed in a few days.
291 Ibid., 1834.
Townsend292 and Law, as well as C. I. B. Williams,293 speak of the different kinds of syringes that have been proposed to draw off the fluids.294 Dupuytren proposed (1814) the introduction of a small canula with a very flexible substance at its outward extremity, such as the bladder of some domestic animal, which would allow fluid to escape, and at the same time would oppose the entrance of air into the chest. Becker (1834) published a work in which he investigated the nature of the false membranes in pleurisy, and showed that the access of air did not produce unpleasant results. He reported 2 successful cases out of 3 of operation.
292 Ibid.
293 Library of Pract. Med., 1841.
294 Boyson, Thèse de Paris, 1814.