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The fundamental features of the pathology and physiology of acute empyema have been reviewed. The application of these principles in the treatment of acute empyema have been noted. The factors leading to the development of chronic empyema have been explained. Fifty cases of chronic empyema have been analyzed, particularly as to etiology.

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The consideration of postoperative pulmonary conditions is of necessity an important one. The fulminant course or the protracted convalescence that follows after such complications forces the question into a major position. This problem has been approached by many writers (Shultz, 1 Cutler, 2 Cleveland, 3 etc.) after they have gone over large numbers of hospital records and studied the cases listed under pulmonary complications. Carefully planned clinical studies directed toward this condition have been carried out by Whipple 4 and Elwyn. 5 Results of these various investigations have helped to clarify the problem in regard to many of the contributing factors in the production of postoperative pulmonary complications. The influence of preexisting pathologic changes, the seasonal variation and the relation of epidemics of infections of the upper respiratory tract to pulmonary complications have been commented on by Ravdin and Kern. 6 For a long time "ether pneumonia" and the effect

The occurrence of omental and intestinal adhesions after laparotomy has been a source of trouble ever since asepsis permitted the surgeon to open the peritoneum, and frequently these adhesions give rise to more acute symptoms than the condition for which the operation was done. At first adhesions were recognized only by the occurrence of intestinal obstruction, but later surgeons noted that a picture of dull, dragging pain or of partial obstruction after a laparotomy was the result of the presence of omental bands and intestinal adhesions. Many theories have arisen as to the etiologic factors concerned in the production of adhesions, although little experimental work has been done. Every surgeon is familiar with the protective action of omentum and of fibrinous exudate in the walling off of infection or perforation. Without this protective action, the mortality resulting from many procedures would be considerably greater than it is. It is only

The surgeon is frequently called on to perform operations on the extrahepatic bile passages without adequate knowledge of the extent of the hepatic lesion. Too often emphasis is placed on the disease of the gallbladder or common duct only, without estimating the associated hepatic damage. It has seemed to us that the extent of hepatic damage in all surgical lesions of the biliary apparatus should be determined, previous to operation, in the hope that some light might be thrown on the operative prognosis and the end-result. An accurate estimation of hepatic damage is complicated and complex because of the manifold functions of the liver. We have, therefore, confined ourselves in this study to an investigation of the pigment metabolism of the liver. We realize that this presents only one aspect of the subject, but we believe that if this function shows any alteration, in the absence of gross obstruction, it

The abdominal type of Hodgkin's disease is generally conceded to be the least prevalent of the internal forms of this malady, which may manifest itself as predominantly abdominal or mediastinal. In both of these types the disease may be either primary or secondary, the latter condition being more frequent. When abdominal symptoms are projected into the picture, they may render the making of a diagnosis exceedingly difficult. It is with the view of clarifying the disturbing situation which frequently arises under such circumstances that we desire to present what has impressed us as relatively the more common abdominal manifestations of the disease. The abdominal type of Hodgkin's disease may be either localized or generalized, acute or chronic. Of the abdominal organs, the retroperitoneal glands, especially the peripancreatic and the gastrohepatic, and the spleen and the liver are most frequently affected. Primary involvement of any of these structures is thought to

In the fall of 1925 I 1 ascertained the end-results of a small series of gallbladder operations and found that 84.4 per cent of the stone cases were apparently cured, whereas only 70 per cent of the noncalculous group were without symptoms. About the same time Whipple 2 found in a similar study that 89.4 per cent of the calculous cases and 76.6 per cent of the noncalculous cases were cured by cholecystectomy. The difference in the percentage of cure was almost identical in the two series. The liability of frequent recurrence of symptoms after operation on the noncalculous gallbladder has been long known, and in an early paper Stanton 3 found only 46 per cent of cures in a series of ninety-nine cases, in ninety-two of which cholecystostomy had been performed. But in 1914, W. J. Mayo 4 noted that simple drainage will not cure the majority of these