Morphine for Pulmonary Edema

To the Editor.— In Dr. Weldon J. Walker's article on "Treatment of Heart Failure" in the June 3 issue ofThe Journal(228:1276, 1974), the use of morphine in the treatment of acute pulmonary edema is not mentioned. While Dr. Walker does state that the patient's anxiety should be controlled, he relegates this to No. 8 in a list of ten measures to be taken in the treatment of acute pulmonary edema. It is generally recognized that the first step in treating a patient with acute pulmonary edema is an adequate dose of morphine. This not only relieves anxiety but also ameliorates his dyspnea and fear of impending death. I shall always remember a young man with kyphoscoliosis and heart failure who was admitted for the first time to the ward service of a large teaching hospital where I was the attending physician. The house staff informed me the next