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JAMA. 1918;71(25):2062-2068. doi:10.1001/jama.1918.26020510008010a.
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The death rate from many hundred cases of empyema occurring in the United States Army during the winter of 1917-1918 was very high. The average mortality reported from the various camps was 30.2 per cent. Many camps reported between 45 and 60 per cent., and one camp reported a mortality of 84 per cent. in eighty-five cases.1 Most of the deaths reported followed virulent Streptococcus hemolyticus infection. Whether or not this high death rate was due to the virulence of the infection or the treatment, it is evident that there are great possibilities for improvement in methods of treatment.

During the past seven months I have had the opportunity to observe seventy cases of empyema in the Walter Reed General Hospital, Washington, D. C., and as a result of this experience have adopted a method of treatment that is submitted as an improvement on the usual procedures. The chief


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