There is reason to believe that empyema of the chest was recognized by the ancients and that the Egyptians and Chinese suggested surgical drainage after empyema necessitatis had developed. The results of treatment of empyema must have been poor even as late as 1835, when Dupuytren, the most eminent French surgeon of his day, refused operation on himself for empyema, saying that he would "rather die by the hand of God than with the aid of a physician." Until the early part of the nineteenth century it appears that treatment was directed toward drainage in the chronic stage rather than in the acute. Sporadically a method was suggested which tended to attack the disease in its acute stage, but because of the appalling mortality, the relatively poor results and the apparent magnitude of the surgical procedure, the method found few who would try it and even fewer who would advocate