Four years ago my interest in the subject of large pulmonary abscesses was greatly stimulated when the question arose as to the advantages of draining a necrotic right upper lobe in the anterior axillary line instead of more posteriorly.
A man, aged 32, a cook, had been very ill with a rapidly progressing and destructive pneumonia. When first seen he was propped up in bed under an oxygen tent, excited, dyspneic, pale, perspiring and nauseated from the foul odor of sputum. Roentgenograms (fig. 1) showed that the abscess was extensive, but fortunately the liquefying process had not perforated the oblique or horizontal fissures. In the semisitting position, in which the patient was most comfortable, it was evident that drainage anteriorly would be most dependent. Under local anesthesia a section of the fifth rib was removed in the anterior axillary line and soft rubber tubes were placed on the
BIRD CE. THE TREATMENT OF LARGE PULMONARY ABSCESSES. JAMA. 1936;107(16):1288–1292. doi:10.1001/jama.1936.02770420026007
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