Pulmonary Edema.


Synonyms:—Edema of the lungs; hydrops-pulmonum; dropsy of the lungs.

Definition:—A condition characterized by a serous effusion into the minute structure of the lungs, resulting in occlusion of the air vesicles and smaller .bronchioles.

Etiology:—The condition is usually secondary to pulmonary congestion. It also follows acute inflammation of the pulmonary structures and is present also as a sequel to chronic disease of the heart, Bright's disease, diabetes, chronic liver disorder and some forms of anemia. It may be present also in the last stages of protracted infectious disease and in chronic alcoholism.

Symptomatology:—With the infiltration of the serum and consequent encroachment upon the air cells there is pronounced difficulty in breathing, which may increase rapidly. Cyanosis appears early, with persistent, irritating cough; secretion is free, and the sputum is frothy and streaked with blood. It is so tenacious as to often obstruct the larynx, resulting in threatened suffocation. While the pulse is increased and becomes rapid and feeble, there is usually no elevation of the temperature, it being inclined rather to become sub-normal. As the condition increases, cyanosis develops, asphyxia occurs and death follows.

Diagnosis:—It may usually be distinguished by the presence of chronic conditions, from which it may develop. Inflammatory conditions will be accompanied by fever and hydrothorax will exhibit characteristic physical signs.

Prognosis:—If the condition follows in the line of the progress of general dropsy, especially if that condition depends upon disease of the heart, death may occur very suddenly; if it is an attendant of acute inflammatory conditions and its approach is announced by previous symptoms, or is anticipated, the treatment will correct the condition and prevent serious development.

Treatment:—The condition demands prompt treatment, with a full appreciation of its seriousness. Active derivative medication is sometimes demanded; a mild hydragogue cathartic, as magnesium sulphate, may be given, or mild doses of apocynum. This agent is especially adapted to this condition, as it antagonizes congestion, stimulates and strengthens the action of the heart, and promotes absorption or dissipation of the effusion. Bryonia will act in harmony with this remedy, and the two combined or alternated should produce the best of results in cases amenable to treatment.

Where the case is of sudden development and immediate asphyxia threatens, dry cups over the chest, both anteriorly and posteriorly, will postpone a serious result until other measures can be made effective. Phosphorus given in small doses will be of benefit also in this condition. Quebracho will temporarily relieve the difficulty of breathing, and in mild cases should produce permanent benefit.

The Eclectic Practice of Medicine with especial reference to the Treatment of Disease, 1910, was written by Finley Ellingwood, M.D.