Chronic Bilateral Basal Pulmonary Fibrosis

It is realized that lesions casting similar shadows by x-ray may be quite different when microscopically examined. Also, comparable tissue changes may result from various causes. With failure of the self-cleansing mechanism of the lung fibroblastic proliferation and replacement can occur whether the substance retained is congestive or infectious in nature, metabolic in origin, or derived from inhaled particles. The cleansing function of ciliary action, bronchial peristalsis and cough is considered to be absent in normal terminal bronchioles. Alveolar cleansing is by lymphatic drainage and phagocytosis. The ultimate lymph channel from the lung is stated by Drinker to be of small caliber with the mechanical effect of a bottle neck. Exudation in excess of absorption can occur with ease.

Pending additional knowledge regarding idiopathic basal pulmonary fibrosis, the therapy attempted has been to arrest further progress of the disease by the prevention and treatment of recurrent respiratory infections which are frequent, for the symptomatic relief of ineffective cough; and to control alveolar exudation. One consistent feature in the group studied has been age with its increased tissue vulnerability. In a population of increasing age it is probable this condition will be seen more frequently, recognized more easily and ultimately treated more effectively.