Nearly all physicians have come to recognize that the presence of pus in the pleural cavity is generally a definite indication for immediate operation, and a large percentage of rapid recoveries and complete cures has become the rule in such cases. We recently noticed a method1 that has been successfully used by Dr. E. Fletcher Ingals in these cases, and which is available to the general practitioner without surgical assistance. In the great majority of cases this conservative operation is all that is required and cases go on readily to recovery.
Neglected cases are still occasionally met, however, in which the purulent exudate has been allowed to compress the lung for so long a time that the visceral pleura has become so much thickened and so inelastic that expansion of the lung is impossible, even after evacuation of the pus. Operation offers the only method of successfully dealing with