. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. oved,the absorption of the rest may follow rapidly. A daily saline cathartic is given; the patient is kept quiet andallowed a nutritious and easily assimilable diet. The administrationof salicylate of sodiimi may hasten absorption, especiallv in cases inwhich there is a rheumatic history. If there is pain or a harassingcough, small doses of codeine should be given. Eiiip!/enia.~-Vs\m\ the presence of pus in the chest is once estab-lished, it is imperati\e that it be evacuated with the leas
. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. oved,the absorption of the rest may follow rapidly. A daily saline cathartic is given; the patient is kept quiet andallowed a nutritious and easily assimilable diet. The administrationof salicylate of sodiimi may hasten absorption, especiallv in cases inwhich there is a rheumatic history. If there is pain or a harassingcough, small doses of codeine should be given. Eiiip!/enia.~-Vs\m\ the presence of pus in the chest is once estab-lished, it is imperati\e that it be evacuated with the least possibledelay. In infants and children it is not advisable to temporize byfirst performing aspiration. Retention of even a limited quantitV DISEASES OF THE PLEURA 645 of purulent exudate in the pleural cavity not only leads to emaciationand physical weakness as a result of continued fever, but generalsepsis may also result. Aspiration is not efficient, and is today prac-tically abandoned as a mode of treatment. The physician may eitherincise the intercostal space or resect a rib to obtain Fig. 166.—Empyema, site of incision in line with the angle of the scapula. Simple incision in the injtercostal space is efficient in many casesof empyema occurring in the first eighteen months of life. In thesefrail patients excision of the rib has been sometimes accompaniedby discouraging results. The greatest number of deaths after any operative procedure forthe relief of empyema occur in children under the age of eighteenmonths. The strength of the patient should be supported as much aspossible. A general anesthetic is not necessary for patients under 646 DISEASES OF THE RESPIRATORY SYSTEM this age. Bronchitis and pneumonia very frequently result fromthe general use of anesthetics in young patients. Local anesthesiais all that is needed. Ethyl chloride in tubes is efficient. The sur-face of the chest is carefully cleansed with soap and water, alcohol,ether, and sublimate. An
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