Search

The successful treatment of empyema depends on the recognition of the basic pathology of the condition. In the treatment of a collection of pus elsewhere in the body, simple incision and the establishment and maintenance of adequate drainage suffices in most cases to effect a cure. But in the chest cavity a different condition exists. When the pleural sac is opened for the drainage of pus, the normal negative pressure is immediately changed to atmospheric pressure (15 pounds to the square inch), the elastic lung collapses, the respiratory and circulatory embarrassment of the patient is increased instead of lessened, and a condition results which is the very thing to be avoided. To put it in the simplest form, it is adding a complication instead of ameliorating or aiding the condition. The indications for the most successful treatment of this condition are obvious: the establishment of adequate drainage coincident with the