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April 1934


Author Affiliations

From the Department of Surgery, College of Medicine, University of Iowa.

Arch Surg. 1934;28(4):684-705. doi:10.1001/archsurg.1934.01170160070003

About ninety years ago Rokitansky1 observed a marked inconspicuousness of pulmonary tuberculosis in passively congested lungs. He asserted that diseases of the heart and of the blood vessels producing passive congestion of the lungs are a preventive of phthisis. How these observations led Bier to introduce as a therapeutic measure the artificially produced passive hyperemia that now bears his name is a matter of history.

Since the reports of Rokitansky, many able clinicians have been impressed by the favorable influence on tuberculosis of cardiac or pulmonary diseases which invoke passive congestion. They likewise have been impressed by the unfavorable influence of diseases which are associated with hyperventilation of the lungs. Among those who have made definite comment on these phenomena are Osler, Weiss,2 Walsh,3 Fishberg,4 Hoffmann,5 Brügelmann and Sewall.6 Certain pathologic states, such as mitral stenosis and cardiac decompensation, are definitely associated with chronic

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