Pulmonary Abscess.
When from severe, persistent inflammation pus forms in any portion of the lung structure, with the consequent destruction of the tissue, the condition known as abscess of the lung occurs. Large abscesses are not common, but not infrequently small abscesses in one or more portions of the lung structure may occur at the same time. Or pus corpuscles may become infiltrated into the bronchi, blood vessels, or interstitial tissue. These may diffuse themselves through an entire lobe, or there may be a restricting fibrous wall, enclosing the purulent fluid. The pus may penetrate into the bronchioles and be expectorated through the bronchial tubes, evacuating the entire abscess, or it may perforate the pleura and fill the pleural sac.
Symptomatology:—The hectic fever, slight cough and increasing feebleness are similar to the same conditions existing in other subacute diseases of the lungs. The physical signs, the results of an exploratory puncture, or the presence of pus cells in the expectoration, are indisputable evidences. The symptoms are so similar to those of purulent bronchitis, or bronchiectasis, that the diagnosis is sometimes difficult. In all protracted cases of inflammatory disease in the chest the physician should keep the possibility of septic infection ever in mind and should recognize the characteristic symptoms immediately they appear.
Treatment:—If the presence of pus in considerable quantity near the surface of the lung can be positively determined an opening should be made through the chest wall and through the pleura, with possibly resection of a portion of a rib, and the purulent fluid should be thoroughly evacuated. The use of the same remedies advised in the treatment of gangrene of the lungs will result in good in these cases. The same thorough course of. tonics and restoratives must also be prescribed. Judicious exercise, with deep inspiration, must be carefully carried out during the latter stages of convalescence. If there is any pulmonary condition, in which alcoholic stimulation is admissible, it is in the treatment of gangrene or abscess of the lungs. The use of internal antiseptics and antiseptic inhalations is also important.
