A Case of Chest Injury Exposing Pleural Cavity and Lung

space near the mid-axillary line. The pleural cavity was exposed. Air was rushing in and out with respiration, with a peculiar hissing sound, and the dome of the diaphragm and the lower margin of the lung were seen moving up and down with expiration and inspiration. There was no subcutaneous emphysema. No blood could be seen in the pleural cavity. The margins of the wound were freely excised including the torn pleural margins. During the excision of the pleural tissues, respiration suddenly stopped, probably because of pleural shock. Respiration restarted under ordinary artificial respiration. To combat further pleural shock, morphine hydrochlor gr. ? was injected intramuscularly with atropine sulphate gr. 1/150. No further respiratory trouble occurred. Sulphapyridine powder was introduced into the pleural cavity, and sprinkled in the excised wound. Two tension sutures were introduced. The wound was closed by three layers of buried catgut sutures securing pleural, muscular and subcutaneous tissue margins. A gauze dressing