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November 27, 1948


Author Affiliations

Washington, D. C.

From the George Washington University School of Medicine, Department of Surgery, Washington, D. C.

JAMA. 1948;138(13):943-946. doi:10.1001/jama.1948.02900130007003

Empyema of the thorax has become a rare disease. This is particularly true of the postpneumococcic variety and applies to other pleural abscesses resulting from trauma and other causes. A few years ago it was a well known lesion with a significant mortality rate and troublesome morbidity and the source of controversial opinions on details of treatment. Students of medicine were warned of the frequency of complicating empyema following pneumonia, and residents dreaded the management of drainage tubes and suction apparatus. Today it is possible and probably likely that young surgeons might not have the opportunity to study an old-fashioned case of empyema of the thorax during an extended training period.

The first dramatic reduction in the incidence of postpneumococcic empyema followed the almost universal use of the sulfonamide drugs for pneumonia. For example, in 1,250 patients with pneumonia treated with the sulfonamide drugs, Dowling1 reported an incidence of