Passive Pulmonary Congestion
Definition:—A pulmonary congestion, which occurs secondarily to other conditions and which may have existed for a long time. This condition exists as a result of some obstruction which prevents the proper return of the blood into the left side of the heart. The most common cause is probably mitral disease. It may occur also from the pressure of an abnormal growth, and also results occasionally from asphyxia.
A form of congestion, known as hypostatic congestion, occurs in the dependent portions of the lungs, where there has been feeble action of the heart, in chronic disease with much debility, especially in the aged, and also where long-continued fevers have induced great debility; also where, from paralysis, tuberculosis or chronic rheumatic arthritis, the patient has been permitted or obliged to long occupy the same position. This is sometimes known as hypostatic pneumonia, or pulmonary splenization.
Symptoms:—The condition is of slow development, in marked distinction to acute hyperemia; there is some cyanosis, first of the lips and subsequently of the face; usually there is no marked difficulty of breathing, but the patient is inclined to breath with the mouth open. There is an increase in the rapidity of the respiration also, but the character of the pulse depends much upon the underlying condition. Physical examination shows the absence of the respiratory murmur, increasing consolidation, and later, bronchial breathing, with mucus rales.
Treatment:—The position of the patient should be frequently changed, the original position not being resumed for a long time. The medicinal treatment must be adapted to the cause of the disease. Usually minute doses of belladonna, frequently repeated, even in the most feeble patients, will be of service. Small, frequent portions of the infusion of capsicum will produce excellent results. Cactus grandiflora will render service also, and avena sativa if there is paralysis; well selected tonics and restoratives will be demanded. Usually the underlying conditions are incurable, and a permanent influence from medicine cannot be expected.