Empyema, with treatment : with discussion on thoracic surgery, American Surgical Association, Philadelphia, Pa., June 3-5, 1909 / by Albert Vander Veer.

  • Vander Veer, A. (Albert), 1841-1929.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Empyema, with treatment : with discussion on thoracic surgery, American Surgical Association, Philadelphia, Pa., June 3-5, 1909 / by Albert Vander Veer. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    12/35 page 10
    and abscess about right shoulder. Two weeks later empyema presented and trocar used, with introduction of drainage tube in right pleural cavity. Knee and shoulder improved, but drainage from side not satisfactory. July 3, 1908, two ribs were thoroughly resected, and an abscess containing about 500 c.c. of purulent fluid escaped. Drainage continued very profuse. From this time on patient improved rapidly and has made a splendid recovery. That repeated cases of pneumonia often deceive the general practitioner, regarding the complication of empyema, and as to the possibility- of tuberculosis being present, is, in my mind, a fact. I have sometimes witnessed a very earnest discussion, on consul- tation, as to whether the case was one of simple plastic pleurisy, one of chronic consolidation, or one of true empyema, and I have no doubt in my mind that there are many cases of pneumonia associated with pleurisy in which an unexpected condition of empyema creeps in and is present without being recognized as promptly as it should be by the family physician. The following case, one of many, is of some value in illustrating this point: Mr. J. W., aged forty-five years, farmer by occupation. May 8, 1908, suffered from pain in right side, and in June had an attack of pneumonia, same side. This was followed by attacks of cough- ing and pain on inspiration. Cough paroxysmal, which had persisted since onset, usually occurring during morning hours, at which time patient expectorated freely, coughing up profuse secretion, described as resembling oyster juice, with sweetish taste, but free from odor. At times he had expectorated a quart of this material, and not infrequently a pint or more. During attacks pain was present on right side of chest. Had lost in weight and strength. No history of night sweats; otherwise history negative. There was much discussion as to the case being one of tuberculosis, or consolidation from pneumonia, possibly plastic pleurisy, but with no admission as to empyema being present. Blood count did not show a leukocytosis above 6250. Frequent examination of the sputum showed an enormous amount of pus cells, but no tuberculosis. June 14 1908, I believed the patient was suffering from empyema, and did a thorough resection of the fifth and sixth
    digitised image 1
    digitised image 2
    digitised image 3