This report is based on an observation covering 155 cases of empyema resulting as a sequel of the 1,300 cases of pneumonia treated at the Camp Pike base hospital and reported in Major Arthur Small's1 paper. From the date of the organization of the hospital, all medical officers were instructed to examine pneumonia patients carefully with the idea of determining the presence of pus in the pleural cavity. To this end soldiers suffering with this disease were as a routine roentgenographed at the end of fourteen days after the onset, if the stage of convalescence was not well established at that date. Whenever roentgenoscopy disclosed possible signs of fluid in the pleural cavity, aspiration, under strict aseptic technic, was carried out. If as a result of this aspiration macroscopic pus was present, or the fluid examined in the laboratory showed pus organisms, surgical intervention was immediately instituted.
McKENNA H. OPERATION FOR EMPYEMA: A PRELIMINARY REPORT COVERING AN OBSERVATION ON ONE HUNDRED AND FIFTY-FIVE CASES. JAMA. 1918;71(9):743–745. doi:https://doi.org/10.1001/jama.1918.26020350016011c
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