Penicillin in acute suppurations of the lung.

Acute suppurations of the lung have been always one of the hardest problems which the specialist is called to confront due to the peculiar circumstances of the condition. Drainage of the abscesses through the bronchus, when its patency is maintained, has been the hope for a spontaneous healing in all cases and in this expectancy, several weeks and months usually elapsed thus delaying surgical intervention which is always feared as very hazardous. The use of some measures such as postural drainage, intravenous injections of several substances as sodium bonzoate, ethyl alcohol, creosote derivatives, vaccination, arsenical compounds, etc., were considered justified until recently and a number of healings were attributed to every one of the procedures tried, although most of these measures could not resist the test of a critical study. Most probably the good results of some drugs should be credited to spontaneous healing through bronchial drainage. When the group of sulfa drugs appeared, renewed hopes led to the trial of these drugs in pulmonary abscesses and after some experience was gathered the consensus of the specialists was not entirely favorable and the surgical approach, which calls for the artificial drainage of every purulent collection, held its position. Therefore, a large number of suppuratlons were surgically treated once reasonable time had been given to test the effectiveness of the sulfa drugs. With the advent of penicillin, again all of us started trying the new drug for these suppurations, with the hope of avoiding surgical treatment and its risks. The early experience with penicillin, however, was not very satisfactory, for those who reported the first results from the use of the drug according to the pattern employed for other diseases. Again, the principle of draining any collections of pus was holding its position and most of the early observers advised not to delay the operation. Particularly, there were reported failures when dealing with abscesses caused by anaerobic germs of the fetid type. Little hope was left for the use of penicillin in this