Obstructive emphysema is an increasing medical problem which challenges the physician of the present era. More than 14 million persons in the United States are affected with some form of disease obstructing the airway. Although improved recognition of obstructive emphysema and fewer errors in its diagnosis have come about within the past ten years, full appreciation of basic principles of treatment is often wanting.
In the United States, deaths from chronic pulmonary emphysema have more than quadrupled in the last ten years. Approximately 5 deaths per 100,000 persons are due to obstructive emphysema. Even more apparent is the morbidity due to the disease.
The greatest effort must be directed toward prevention and cure of this disease. Therapeutic measures should be instituted before serious complications result. The most adverse influence upon the prognosis of emphysema is the development of right-heart failure and secondary polycythemia.1 Every effort of therapy, therefore, should