The respiratory disability associated with the later stages of wounds of the thorax incurred during war is a real problem. Infection is primarily responsible for the disability in the majority of cases; however, organization of blood within the pleural cavity unattended by sepsis is not uncommon and often leads to an even greater degree of respiratory invalidism. Favorable experiences in the surgical management of the latter condition by decortication of the lung has prompted this communication. The trend of treatment of acute traumatic hemothorax in this war has been conservative.1 In the forward zones of combat modern methods of preventing and relieving shock are efficiently executed, thus saving many lives. Respiratory distress is readily recognized and relieved by aspiration of blood without replacement with air. In the forward higher echelons the pleural cavity is emptied of the bloody effusion as soon as possible by repeated aspiration without replacement with