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T. G. Richardson, M.D.
JAMA. 1883;I(2):46-48. doi:10.1001/jama.1883.02390020014001b.
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[Read before the American Surgical Association at its late annual meeting in Cincinnati, May 31st, 1883.]

Chronic suppurative pleuritis with an imperfect fistulous outlet, either external or bronchial, is not an uncommon result of gun-shot or other penetrating wounds of the thoracic cavity; and it is no secret that the resources of surgery have not heretofore offered much encouragement to the unfortunate sufferers. In the majority of such cases there is contraction traction or sinking in of the injured side, a constant discharge of fetid pus, persistent cough, irritative or septic fevers, and more or less rapid exhaustion of strength, terminating usually in death within a few months, or a year or two at the farthest.

Two main difficulties are encountered in the treatment of such cases: 1st, imperfect drainage, upon the correction of which the life of the patient depends; and, 2nd, permanent separation of the lung from the


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