Disordered Pulmonary Function

Introduction The remarkable advances in pulmonary physiology during the last decade have provided new techniques with which to analyse the complex disorders present in lung disease. The increased precision of these new methods has led to the appearance of symbols, equations, graphs and the frightening paraphernalia of mathematics. The main aim of this article is to show how these measurements have improved our understanding of emphysema by discussing the data obtained from one patient who has been extensively studied. Although the various disorders have been separated into groups for the purposes of discussion it is important to realize that they are all interrelated. A complete assessment of emphysema (or any other lung disease) requires many measurements. However, as so often happens, improved physiological knowledge has led to improved ability to interpret clinical evidence. Therefore, at the end, I have suggested a simple scheme for the evaluation of emphysema making use of clinical information and tests most of which are so simple as to be within the capabilities of any reasonably equipped hospital. In the various tables and illustrations reasonable normal values for a man of 60 years have been given for comparison. No technical details are given in the text. For the further elucidation of the underlying pulmonary physiology reference should be made to 'The Lung' (Comroe, Forster, Dubois, Briscoe and Carlsen, I955). References are only given to aspects of the subject not covered in that work.