The lesion in many cases of so-called typical abscess of the lung has been found to be gangrene. Instead of a grayish area of suppuration without appreciable odor, the lesion is ragged, brownish or greenish and penetratingly foul-smelling. The sputum in these cases is foul smelling, grayish brown or grayish green and contains characteristic oral spirochetes, fusiform bacilli and vibrios. In cases of abscess, on the other hand, it is whitish yellow, mucopurulent or purulent, without appreciable odor and contains pyogenic organisms, usually staphylococci.
As patients with pulmonary gangrene do not respond well to the treatment for abscess but are frequently cured by arsphenamine therapy,1 the differentiation between these two diseases is imperative.
Anatomically, the pulmonary abscesses observed were of two types:
The embolic type of abscess, which involves a number of lobes, is multiple and relatively small, is associated with areas of suppuration elsewhere in the body, and