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Modern Treatment: Treatment of Obstructive Pulmonary Emphysema and Treatment of Lymphedema.

Arch Intern Med. 1970;125(5):902. doi:10.1001/archinte.1970.00310050140036.
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The excellent patho-physiologic-therapeutic correlations that have come to characterize this series are maintained in this edition.

The first section is concerned with obstructive pulmonary insufficiency including chronic obstructive airway disease (COAD) and asthma, plus sequelae (cor pulmonale and respiratory alkalosis and acidosis). One might comment on the dearth of information about low flow (Venturi tube) oxygen (24% to 28%) in severe COAD (as popularized by Campbell), and the absence of discussion about portable oxygen delivery systems for ambulation of COAD patients (as advised by Petty).

Part 2 deals with lymphedema. Therapy of idiopathic lymphedema is directed at fluid removal (elevation, elastic stockings, diuretics) before organizing fibrosis occurs. Treatment of secondary lymphedema (obstruction due to recurring lymphangitis, neoplastic lymph node involvement after mastectomy) is directed at elimination of obstruction whenever possible, and then persistent mechanical manipulation (elevation, massage, exercise, elastic support, and diuretics). A concluding section describes surgical procedures (excision,


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