Clinical Management of Chronic Obstructive Pulmonary Disease [antikvár]

INTRODUCTION Quite rightly, the "princeps" descriptions of bronchodilation and emphysema are attributed to Rene Laennec. However, the origins of these descriptions are not well known. Most of the patients in his service had tuberculosis, but eventually a group of six household servants also came into his care. Of these, two died, even though only in their 40s. One, a maid, provided a basis for the description of bronchodilation; the other, Mr. Chopinét, a coachman of a private carriage, was suffering from emphysema. In his personal notes, Laennec wrote, "The disease that I call [bronchodilation and emphysema] are not well known and have not been described by anyone. The anatomical changes [that they cause] that I want to describe in these chapters seem not so far to have attracted the attention of the anatomists, or even that of the practicing physicians." Today more than 180 years later, emphysema and chronic obstructive pulmonary disease (COPD) have been extensively described by the anatomists, and practicing physicians are giving considerable attention to these diseases. In his Foreword to this volume, Gordon Snider gives an exquisite panoramic view of not only what we have learned, but also where our challenges lie. The middle of the twentieth century saw a surge of interest in emphysema, chronic bronchitis, and COPD. The last term, COPD, lumps together a number of anatomically distinct entities but it serves the purpose very well. There was a time when these entities were distinguished by their physiological appearance ("pink puffers" and "blue bloaters"), but this is no longer in fashion.