The Archives of Internal Medicine, 1915, Vol. 15 (Classic Reprint)

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Excerpt from The Archives of Internal Medicine, 1915, Vol. 15This study of emphysema and asthma was undertaken with the idea that great changes in the dead space must occur when an emphysema tous patient suffered an asthmatic attack.It was suggested in a former publication on emphysema1 that the dead space was probably much enlarged in emphysema. If this were true then the dead Space of an emphysematous patient must undergo a great change during an attack of asthma. We have succeeded in get ting two emphysematous patients who had frequent attacks of asthma. After some persuasion, these patients learned to breathe through the Zuntz apparatus during asthmatic attacks. The asthma of both patients could always be relieved by subcutaneous injections of epinephrin. In this way we had numerous opportunities to compare the minute volume of air and the alveolar air of the emphysematous state with the asthmatic state. Much to our surprise we found the dead space, as measured by our method, varied little in the two conditions. Further more, we found the minute volume remained nearly the same, the con centration of carbon dioxid in the alveolar air was increased very little during the asthmatic attacks, but in Spite Of these slight variations in lung ventilation the patients commonly were cyanotic during the attacks of asthma and we could not account for cyanosis by any changes in the circulatory system.To produce cyanosis by impairment in the circulation, the evidences of stasis must be very great. Sufficient stasis may occur to cause air hunger, marked cardiac enlargement and pronounced stasis in the venous system as evidenced by widening of the jugular veins and hepatic enlargement, and, in spite of all these signs, cyanosis may not be apparent.About the PublisherForgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.comThis book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully, any imperfections that remain are intentionally left to preserve the state of such historical works.