Enlargement of the Air Cells. Emphysema.
This disease consist, in enlargement of the air cells, the obliteration of their vessels, and the wasting of their wars.
Physical Signs. Thumping upon the chest gives a clearer and louder sound than natural~ one which is tympanitic, or drum head like.
The murmur of the ingoing breath is diminished both in duration. and intensity, of the outgoing breath, it is increased.
Dry, crepitant rattle attends the ingoing breath only; occasionally, sibilous rattle.
General Symptoms. Habitual shortness of breath, and very great difficulty of breathing, occurring in paroxysms, which cause the patient to rush to the open window for air.
There is generally a cough, and the matter raised is frothy, liquid, and mucous, or watery.
The face has a peculiar dusky color, and the countenance an anxious, melancholy expression. The nostrils are thick, and the lower lip full. The muscles of the neck are large, and the gait of the patient is stooping. The strength is wasted in proportion to the difficulty of breathing.
Emphysema tends to produce disease of the heart, Bright's disease, and venous congestions in the head.
Observations. The tympanitic sound is caused by the increased amount of air in the cells.
The air cells have lost their elasticity, the air, in a great degree, remains in them, not passing in and out, hence the absence of the vesicular murmur.
The crepitant rattle attends the ingoing breath only, and is supposed to arise from the expansion of the lungs which are in a drier state than natural. It has been compared to the sound produced by blowing into a dried bladder.
Treatment. To whatever extent the air cells are destroyed, to that extent, of course, the disease is incurable. It may, however, be palliated and relieved to a great extent.
Generally, bronchitis exists in connection with emphysema; and when this is found to be the case, the remedies for that disease must be employed. (370) often is curative.
The inhalation of tincture of stramonium, in one or two teaspoonful doses, the same as the alterative inhalant is used, will be useful.
To be taken internally, an excellent preparation may be made by uniting one dram of ethereal tincture of lobelia with two drams of tincture of ipecac, and two ounces of ammoniac mixture. The dose is one or two tablespoonfuls. Half grain to grain doses of extract of cannabis indica are excellent to relieve the difficulty of breathing.
The diet must be very carefully regulated, as overindulgence at the table aggravates the symptoms.
Change of air is often highly beneficial; but it is impossible to predict its effect beforehand in each individual case.
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