Diseases of the chest and the principles of physical diagnosis . theriXoRRis AND Landis: Traus. Assoc. Am. Phys., 1913. DISEASES OF THE LUNGS 499 third of the cases it was not possible to determine the exciting is quite possible that in the case of an apparently primary abscess,the original source of the trouble was a latent and unrecognized the past few years attention has been directed to the frequencywith which a pulmonary abscess follows operations on the upper respira-tory tract and particularly after tonsilectomy. Manges^ and Claytor^have reported a number of ca
Diseases of the chest and the principles of physical diagnosis . theriXoRRis AND Landis: Traus. Assoc. Am. Phys., 1913. DISEASES OF THE LUNGS 499 third of the cases it was not possible to determine the exciting is quite possible that in the case of an apparently primary abscess,the original source of the trouble was a latent and unrecognized the past few years attention has been directed to the frequencywith which a pulmonary abscess follows operations on the upper respira-tory tract and particularly after tonsilectomy. Manges^ and Claytor^have reported a number of cases. Of 26 cases of abscess which followedoperations Wessler^ states that 21 fohowed a tonsillectomy. The pulmo-nary abscess may develop either as the result of a septic embolus, whichenters the circulation at the seat of the operation, or by direct inspirationof infected material during the period of anesthesia. Caseous foci in thetonsils seem to be especially dangerous and for this reason the tonsilsshould be removed with as little trauma as possible. 1 case. 1 ease 4 subdiaphrag-matic Fig. 311.—Location of abscess. Circles indicate site and size of abscess. A pulmonary abscess may be one of the sequels of a traumatic injuryto the chest, such as violent contusion of the chest wall, a fractured rib,or a penetrating gunshot or stab wound. In addition to the above-mentioned causes of single abscess, I havehad under observation two cases in which the abscess was caused by aforeign body—in one case a tooth and in the other a brass-headed importance of foreign bodies as an etiological factor of pulmonaryabscess is, as the result of X-ray examinations, bronchoscopy, and ofincreasingly frequent operative intervention becoming more a series of 25 cases Kltibs* reports 7 as being caused by a foreign bodyand Guirez^ has recorded 5. ^Amer. Jour, of Surgery, March, 1916.^International Clinics, Twenty-sixth Series, vol. ii, 1916.^ Amer. Jour. Roentgenology, April, 1
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