On August 15, an x-ray was made which showed the right chest filled with fluid to the fourth rib anteriorly. A needle was inserted between the seventh and eighth ribs laterally and ten cubic centimeters of clear amber fluid were withdrawn for diagnostic purposes. This proved to be sterile and a recession of all symptoms followed this aspiration, which would be expected.
However, on August 27, all symptoms recurred with equal severity and the chest was again aspirated, removing fifteen cubic centimeters of fluid which was followed by no improvement in symptoms.
On September 3, he received one dose of sulphur 1M which was followed by a recession of all symptoms and he was dismissed from the hospital on September 9. His recovery continued uneventfully at home and three months later he was reexamined and x-rayed. This showed marked improvement with slight fluid residue at the base of the right lung. In the meantime he had gained twenty pounds in weight and was employed as a truck driver on the state highway.
The stomach ulcer was treated with Smithies diet which consisted of frequent feedings of a diet high in carbohydrates and low in fats and proteins. The ulcer apparently healed and he was symptom free during the entire period of observation.
Final diagnosis was: perforated gastric ulcer followed by postoperative Infarcts of the right lower lobe of the lung, pleurisy and pleural effusion. A hernia resulted in the abdominal wound due to the breaking down of the tissues by the drainage discharge and the severe cough accompanying the chest complication.
