Patterns of Disturbed Lung Function in Patients with Chronic Obstructive Vesicular Emphysema

Emphysema has been defined as a condition in which the alveoli of the lungs are dilated and their walls overdistended (Christie, 1952). In the classification most widely used, emphysema is divided into four groups: (1) Chronic obstructive vesicular emphysema; (2) senile or atrophic emphysema; (3) acute vesicular emphysema; and (4) localized or compensatory emphysema. Senile emphysema is often unassociated with symptoms, acute vesicular emphysema is a relatively rare and transient phenomenon, while in compensatory emphysema the primary condition often overshadows the changes attributable to emphysema. The great majority of patients presenting with emphysema in clinical practice must therefore be placed in the first category of chronic obstructive vesicular emphysema. Yet, when these patients come to necropsy, the pathological changes characteristic of this form of the disease are not always found. This was so in nine of Cabot's (1927) 12 patients diagnosed in life as emphysema, whereas only seven of 153