30 Centralblatt f. Chir., No. 42, 1882.
| FIG. 55. |
| From a case of Kolaczek's, in which the resection of the third to the sixth ribs, with a portion of the sternum, was practised for the removal of an enchondroma. Diagram exhibits the aperture in the thoracic wall which permitted the exposure of the pericardium. Pneumothorax occurred, but patient recovered (Deutsches Archiv für klinische Medicin, Bd. xxx. 1882). |
Paracentesis must sometimes be practised to relieve accumulation of fluid in the pleural sacs in instances in which dyspnoea is serious, and life may be prolonged by repeatedly practising this operation. Reflex laryngeal irritation, or paroxysmal dyspnoea with stridulous breathing, requires the use of inhalations or atomization of antispasmodics, and among the most useful of these are ether and chloroform. This group of neural symptoms can sometimes be markedly palliated by hypodermic use of morphia with atropia. But too often the symptoms are caused by actual pressure, and not by nerve-irritation, and this mode of treatment is futile, and therefore these measures should be employed with caution.
Sleeplessness, cough, bronchial or other pulmonary complications, must be managed upon general principles. The local pains may be met by local treatment, such as mustard sinapisms or soothing lotions; even blisters may secure temporary relief. The digestive system should be carefully studied, and assimilable and appropriate food should be selected. In lymphadenoma combinations of iodine with arsenic, as in Donovan's solution, may be tried, but, unfortunately, the utmost aid from present resources consists in a palliative and expectant policy.
DISEASES OF THE BLOOD AND BLOOD-GLANDULAR SYSTEM.
BY WILLIAM OSLER, M.D.