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September 13, 1919


JAMA. 1919;73(11):839-840. doi:10.1001/jama.1919.02610370037014

Among the interesting developments in the field of surgical therapy in the past two years, few have exceeded that of empyema of the chest in the thoroughness of the study to which it has been subjected, and in the applicability of the results of such study to the problems of civil life. In the prewar days it had been accepted that the proper treatment of an accumulation of pus in the pleural cavity was free drainage by thoracotomy, with or without rib resection, and usually without irrigation, supplemented by the use of breathing exercises and mild calisthenics to encourage expansion of the lungs. A few surgeons attempted further to supplement thoracotomy by the use of a suction apparatus applied to the drainage tubes, but without sufficient success to encourage general adoption of this measure.

The objections to simple thoracotomy were in general twofold: 1. It permitted collapse of the lung

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