Thoracentesis: an old story and some new sources

Section snippets

Two late 18th century manuscripts

Both of the manuscripts we feature here were written by students hearing the lectures of famous authors, but whose advice on thoracentesis is previously unknown. They are fascinating not only for expanding our understanding of these two important figures but because they provide precise descriptions of the site and technique of thoracic drainage just before auscultation, which would provide the means for locating the pathological change. Student lecture notes could have served as a sort of

Discussion

This Spotlight suggests that until the 18th century, doctors carried out thoracentesis largely in accordance with Hippocrates' recommendations to make the incision low in the chest. The question arose as to whether the approach should be anterior or posterior. We can see that at least two reputed doctors with considerable anatomical knowledge, Astruc and Bichat, raised the question of the drainage technique, with particular reference to the surgical approach. Astruc went further in describing