Pulmonary Abscess.

Synonyms.—Abscess of the Lungs; Suppurative Pneumonitis.

Definition.—A collection of pus in the lung, accompanied by degeneration of tissue.

Etiology.—Abscess of the lung is due to septic infection, following inflammation. It may follow lobar or lobular pneumonia. It is prone to follow aspiration or deglutition pneumonia, where septic conditions of nose and throat exist. Chronic tuberculosis is also accompanied frequently by abscess of the lung.

Embolic or metastatic abscesses are usually multiple, and are due to septic material carried to the lung through the circulation, as from malignant endocarditis, pyemia, pyonephrosis, and like conditions.

They may be due to perforations from without, and the lodgement of foreign bodies, such as bullets, this being common during the war. It may also be caused by abscesses of other parts, as of the liver, spleen, or to carcinoma.

Pathology.—The abscess may involve one or more lobules or engage almost an entire lobe. The favorite location is the lower lobes, and the right more frequently than the left. They are generally situated at the anterior portion of the lung, and when in contact with the pleura give rise to purulent pleurisy by direct infection. When the abscesses are small, they may be scattered throughout the entire lung.

Symptoms.—The symptoms are not characteristic. The fever is of a septic type, with chill and night-sweats. Cavity signs are usually noted. There is cough, with expectoration of fetid pus, in which shreds of broken-down lung-tissue may be seen. The symptoms of the primary disease should also be taken into consideration.

Prognosis.—The prognosis should be guarded. Where the previous health has been good and the environments are first-class, the outlook is hopeful, especially when following acute diseases. The chronic form is less favorable.

Treatment.—The treatment will be antiseptic and reconstructive. Calcium sulphide should be given four times a day. Echinacea may be employed to correct septic processes. Iron, quinia, and strychnia as a reconstructive, may be of much benefit.

The patient should reside in a climate where he may be much in the open air and sunshine, good, nutritious, and easily digested food furnished, and the secreting organs kept in good condition.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.