Empyema is essentially a condition in which the normal physiologic processes of the lung and pleura on the affected side or sides are altered, impaired or suspended. These are replaced in part by defensive processes, namely, the emigration of leukocytes in response to the presence of pathogenic bacteria or foreign bodies the outflow of lymph to dilute toxins and to fill spaces that were potential spaces only, in the normal organ; an increase in the blood vessels for nourishment and repair of the affected part; and roundcell infiltration to establish a direct barrier to the advance of bacterial infection and an indirect barrier to the spread of infection by immobilizing the motor mechanism through plugging its cellular spaces and lymphatic channels. This, in fact, is an inflammatory process with exactly the same characteristics as an inflammatory process in any other part of the body. Therefore, any plan for the treatment
GREEN JR. PHYSIOLOGY OF RESPIRATION IN TREATMENT OF WAR WOUNDS OF CHEST AND EMPYEMA. JAMA. 1919;72(19):1356–1361. doi:10.1001/jama.1919.02610190018008
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