Clinical Cardiopulmonary Physiology [antikvár]

Foreword The Impact of Cardiopulmonary Physiology on Clinical Chest Medicine By BURGESS L. GORDON, M.D. President and William J. Mullen Professor of Medicine, The Woman's Medical College of Pennsylvania; Philadelphia, Pennsylvania. Consultant in Internal Medicine and Chest Diseases, Veterans Administration Hospital; Formerly Clinical Professor of Medicine and Physician-in-Chief, Barton Memorial and White Haven Divisions, Jefferson Medical College and Hospital; Formerly Physician to the Pennsylvania Hospital, Philadelphia, Pennsylvania. A STIRRING EVOLUTION has occurred in the development and course of cardiopulmonary infections. Featured is the lowered incidence of tuberculosis, pneumonia, diphtheria, syphilis and rheumatic fever, with a marked reduction in the mortality rates. Timely diagnoses and chemotherapy hold the rightful claim for controlling these dread infections; and thoracic surgery has come forward with new technics to deal with chronic, localized pulmonary processes and valvular defects of the heart. The newly won laurels in the prevention and treatment of cardiopulmonary conditions are somewhat overshadowed by the increasing frequency of degenerative diseases of the heart and lungs. In fact, man is living longer due to his escape from the acute infections, only to fall prey to a wide variety of functional disturbances. Witness the mounting cases of emphysema, pulmonary fibrosis, pneumoconiosis, chronic pleurisy, displaced mediastinum, bronchiectasis, obstructions of the bronchi, atelectasis, cystic disease of the lungs, impairment of the pulmonary circulation, coronary disease of the heart and cor pulmonale. The comphcations tend to mask the antecedent disease, while unexplained bouts of dyspnea, cough and expectoration continue to harass the patient. Unfortunately, function impairment is not always recognized until the disturbances have become extensive and even hopelessly estabhshed. Disabhng cardiopulmonary conditions pose important problems for the general practitioner, internist and surgeon, both for the evaluation of disability and the control of manifestations. No longer are the physical examination, roentgenogram and routine laboratory procedures considered adequate and critical; medicine is turning inquiringly to function testing and dynamic treatment. For example, the rounded type -of chest was once regarded a satisfactory criterion for the diagnosis of emphysema; the roentgenograms of anthracite coal miners with massive nodulations were considered as unmistakable signs of disabling pneumoconiosis; bronchiectasis with associated atelectasis was viewed as a contraindication to surgery; and cardiac conditions, notably valvular defects, were thought beyond the realm of radical treatment. But with the benefits of physiologic testing it is apparent that the barrel-shaped chest may not accurately represent the