Even a casual observation of the cases of empyema which have appeared in the Base Hospital at Camp Upton during the past winter and spring shows that we are dealing for the most part with an altogether different type of this disease from that to which we are accustomed. The very early appearance of this complication in the course of pneumonia, its unusual bacteriology and the very high mortality which accompanies it, even under favorable conditions, are the most striking and important variations. Closer study indicates a different train of symptoms, certain alterations in physical signs and a modified pathologic picture; while operative procedures, which, when resorted to in ordinary empyemas give almost uniformly good results, have in this epidemic been attended by so high a death rate as to cause both physician and surgeon to question seriously their advisability, value and type.
In view of these deviations from the