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Article
August 15, 1908

THE APPLICATION OF THE BIER CUP IN THE TREATMENT OF RECENT EMPYEMAS.

JAMA. 1908;LI(7):572. doi:10.1001/jama.1908.25410070030002
Abstract

The many methods which have been proposed for the surgical treatment of empyema and the physical wrecks we find after this lesion, bear witness to the need for more effective treatment of pyothorax. The chest being a cavity under negative pressure, the normal equilibrium is upset the moment an incision is made for the relief of pus. This condition continues so long as drainage is maintained. A space remains and the lung is slow to expand. This consequently embarrasses Nature's effort at repair, for so long as pneumothorax exists, just so long may we expect a certain lack of lung expansion. The introduction and the presence of the drainage tube into the space also prevents free pulmonic expansion.

To overcome this embarrassment various suction and vacuum devices have been proposed and used, among these being the Van Hook vacuum bottle, which is attached to the patient by a long rubber

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