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Introduction

The current level of clinical, scientific, and technologic sophistication of medicine has evolved over more than 2000 years. From the inception of medicine, pulmonary medicine has been an integral part of its growth and development. About 300 years 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 early in the 19th century, when autopsies became legally permissible 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.13 Progress has been punctuated by delays, detours, and reversals. However, it is possible to retrace the scientific trail by examining iconic figures and addressing milestones in drawing the map (Table 1-1). This chapter uses these milestones to trace 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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