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INTRODUCTION

Clinical, scientific, and technologic aspects of medicine have evolved over more than 2000 years, and the study of lung function and pulmonary diseases has been an integral part of its growth and development*. About 3 centuries ago, progress toward scientific medicine accelerated markedly, and it has continued to gain speed ever since. In the 17th century, research and experimentation began to tilt clinical medicine toward the exact sciences; by the 18th century, pathology had become an integral part of clinical medicine, and clinical–pathologic correlations succeeded empiricism, dogmatism, and metaphysics. The age of the great clinicians dawned in Europe in the early 19th century, when autopsies became legal and socially acceptable, and when physicians who cared for patients actually performed the autopsies.

The road to our current understanding and practice of pulmonary medicine and science has been somewhat convoluted.1–3 However, it is possible to retrace the scientific trail by examining iconic figures and addressing milestones (Table 1-1). This chapter traces the course of scientific pulmonary medicine over the last two millennia. By necessity, what follows constitutes a limited overview of selected aspects of the history of the field, including alveolar–capillary gas exchange, lung volumes, mechanics of breathing, control of breathing, ventilation–perfusion relationships, and scientific advancements impacting clinical medicine, including chest imaging, lung transplantation, bronchoscopic techniques, and advances in critical care. Indeed, much of the content of the book addresses the many advances in respiratory disorders achieved over the last 50 years.

TABLE 1-1Landmark Figures in the Evolution of Modern Pulmonary Medicine

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