An Account of a Successful Opeation for the Hydrops Pectoris, by William Moreland, Surgeon at Greenwich; Communicated by W. Watson, M. D. F. R. S.

XXXVIII. An Account of a successful Operation for the Hydrops Pectoris, by William Moreland, Surgeon at Greenwich; communicated by W. Watson, M.D. F.R.S. Read Dec. 18, 1766. As very few instances are to be met with in medical or chirurgical writers, of the successful opening of the thorax in the dropsy of the breast; the following person's case, who was preserved by it in the most imminent danger of death, may encourage others under similar circumstances to perform the operation, which has hitherto been very rarely attempted. Anne Harmsworth of Crooms Hill, Greenwich, of a thin, hectic habit of body, and subject to defluxions on the breast, about the latter end of the year 1760, complained of a smart, shooting pain in her right side, which somewhat affected her breast. Her evacuations by stool and urine were by no means deficient, nor was there any remarkable appearance on the part affected. A blister was applied, and oily medicines given, which relieved her in a few days, yet not so entirely but that she had returns of the pain at different times, though not sufficient to make her apply for advice, till November 1762, when she was feized with a much greater degree of the same kind of pain, attended with difficulty of respiration, a sense of weight on on the diaphragm, and a quick pulse, with a little more heat than usual. On the 18th of December, I saw her, for the first time, with Mr. Mills, a surgeon at Greenwich, when she related to me the above complaints, now much augmented, having a sense of fulness in that side (which was ready to burst, as she termed it) and an evident fluctuation in the right cavity of the thorax. But her left side was free from complaint. She made very little urine, and that limpid. The expectorant medicines (blister and cathartic) were administered without the least relief; her symptoms gradually increasing. On the 1st of January 1763, she could breathe in no other situation than that of the thorax brought forward to the knees, in which posture she continued till the 30th of January, when finding the ribs elevated exceedingly, and the right side of the thorax uniformly distended, with every other reason tending to confirm the notion of a fluid's being lodged there: we, in company with Mr. William Sharp (whose opinion we had, this day, requested) proposed the operation to her, which the present pressure of her disease, and the little probability of her living long in that state, determined her to consent to. I, then, in presence of Mr. William Sharp, surgeon to St. Bartholemew's, and Mr. Mills, made an incision, about four inches long, between the sixth and seventh ribs, (reckoning upwards) and about half way between the spine and sternum into the cavity of the thorax, and discharged from thence seven pints of limpid serum. Immediately the difficulty of breathing was removed, but a faintness succeeding seemed to endanger her her for a short time, occasioned more by the sudden removal of the pressure from the lungs, than any other inconvenience from the operation, the loss of blood being very inconsiderable. From this time to the next morning, the urine was secreted and discharged to the quantity of three pints more than she had drank. On the first dressing, the next day, there issued about a spoonfull of serum, but none afterwards: and though she remained weak and faint for several days, yet she had no other inconvenience, from the time of the operation to that of the cicatrization of the wound, which was compleated in less than a month; the wound having been dressed superficially the whole time. It may be remarked, that, though, at the time of the operation, she was two months gone with child, she nevertheless compleated her pregnancy, and is now in as good a state as she had enjoyed for many years before. XXXIX. A Letter