Definition:—A condition in which air has found its way into the pulmonary interstitial tissue from rupture of the air cells. More correctly this definition applies to that form of emphysema known as interlobular. The term vesicular emphysema is applied to that form of the disease in which there is a dilatation of the air vesicles or a rupture of the vesicular walls permitting the coalescence of a number of cells, forming bladder-like air spaces or air sacs.
The interlobular form is sometimes known as interstitial or intervesicular emphysema. Vesicular emphysema is divided by some writers into three sub-classes—the hypertrophic, or large-lunged form; the atrophic or senile emphysema, and compensatory emphysema, which form is induced by the inability of the lung cells in proximity to the diseased area because of some obstruction or from compression, to expand properly.
The interstitial form is always acute. The compensatory form may be either acute or chronic, while the hypertrophic and atrophic forms are always chronic. This condition changes the contour of the chest, increasing its size and inducing from projection forward the so-called barrel-shaped chest.
Etiology:—The condition depends essentially upon an underlying constitutional depravity, from which the tissues lack vital tone and lose their characteristic elasticity. The immediate cause may be a muscular strain or a direct blow to the chest walls.
Treatment:—There is no specific method of cure for this disease. Occasionally, benefit is obtained from the use of ammonium chlorid, or from a carefully selected iodid. Specific bronchial symptoms may demand belladonna, bryonia, sticta, sanguinaria or lobelia. The patient should reside in a dry climate.