A new approach to pulmonary emphysema.

One of the unsolved problems of pulmonary disease is the complex entity of pulmonary emphysema. There is as yet no uniform acceptance of the aetiology of the illness. Therapy mainly consists of attempts to palliate certain factors in the illness rather than specifically to treat causative agents and stop the progress of the disease. The following major problems are presented by the disease. First, can we define a reasonable aetiology? How does the disease progress, and what factors are involved in such progression ? What are the earlier stages ofpulmonary emphysema and how are they to be recognized? How can one discover localized areas of increased intrapulmonary pressure ? What therapeutic methods are available relative to the disease, and what are their value ? if surgery is used, what special anaesthesia-operative and post-operative-considerations are there ? To try to answer some of these questions we have carried out a clinical study of 294 patients suffering from varying stages and degrees of pulmonary emphysema.