After evacuation of the pus in cases of empyema, the huge suppurating cavity that remains must be obliterated. In cases in which the lung, though compressed against the spine or mediastinum, is not yet held in its false position by strong adhesions or by thick deposits of organized new material, aseptic opening and plentiful gauze dressings are sufficient. These dressings act as a valve as well as a protection from infection, and they absorb discharge. Air or gas present in the pleural cavity with every cough, indeed with every expiration, is expelled little by little into the gauze covering the orifice of the wound, while this mass of gauze applies itself too firmly to the chest to permit entrance of air from without, and there is produced within the thorax a tendency to a vacuum, a negative pressure, which sucks the collapsed lung out toward the chest wall.
CHEESMAN WS. EMPYEMA TREATED BY PERTHES' METHOD.. JAMA. 1905;XLIV(20):1611–1613. doi:10.1001/jama.1905.92500470039003
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