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Osler Centenary Papers: Management of pleural infection: Osler’s final illness and recent advances
  1. Prudence Gregory1,
  2. Najib M Rahman2,
  3. Y C Gary Lee1,3
  1. 1 Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  2. 2 Oxford Centre for Respiratory Medicine, University of Oxford, Oxford, UK
  3. 3 School of Medicine & Centre for Respiratory Health, University of Western Australia, Perth, Western Australia, Australia
  1. Correspondence to Prof Y C Gary Lee, Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, WA 6009, Australia; gary.lee{at}


Sir William Osler’s great work and achievements are extensively documented. Less well known is his prolonged battle with postinfluenza pneumonia, lung abscess and pleural infection that eventually led to his demise. At the age of 70, he was a victim of the global Spanish influenza epidemic, and subsequently developed pneumonia. In the era before antibiotics, he received supportive care and opium for symptom control. The infection extended to the pleura and he required repeated thoracentesis which failed to halt his deterioration. He proceeded to open surgical drainage involving rib resection. Unfortunately, he died shortly after the operation from massive pleuropulmonary haemorrhage. In this article, we review the events leading up to Osler’s death and contrast his care 100 years ago with contemporary state-of-the-art management in pleural infection.

  • pleural infection
  • empyema
  • pneumonia
  • surgery
  • tissue plasminogen activator
  • deoxyribonuclease

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  • Funding YCGL is a Medical Research Future Fund Next Generation Practitioner Fellow of Australia and has received project grant funding from the NHMRC, New South Wales Dust Diseases Authority, Sir Charles Gairdner Research Advisory Committee, Institute for Respiratory Health, Cancer Australia and Cancer Council of Western Australia. NMR is funded by the Oxford National Institute for Health Research Biomedical Research Centre.

  • Competing interests YCGL and NMR have served as advisors for Lung Therapeutic Inc. NMR serves as a consultant to Rocket Medical UK.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.