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July 15, 1893

THE MEDICAL ASPECTS OF EMPYEMA.Read before the Section on Practice of Medicine at the Annual Meeting of the American Medical Association.

JAMA. 1893;XXI(3):67-78. doi:10.1001/jama.1893.02420550001001

It has been the writer's fortune within the past three years to encounter, both in hospital service and consultation, a number of cases of purulent pleurisy following or complicating croupous pneumonia. In most instances the onset was so insidious or the symptoms so obscure and misleading that the recognition of the empyema was a surprise. Moreover, the symptomatology did not answer to the text book description. Generally the case was considered one of pneumonia with delayed or incomplete resolution. In all instances there were certain characters, both of the effusion and also of the symptoms, which impressed themselves strongly on the writer's mind, and he was led to believe purulent pleuritis is more frequently overlooked than need be. It seemed to him also, that this want of recognition was due to incorrect notions as to the etiology, symptomatology, diagnosis and prognosis of the disease, rather than to treatment, or in