THE HISTORY OF THE STUDY OF PULMONARY EMPHYSEMA AS A NOSOLOGICAL FORM (A LITERATURE REVIEW)

Abstract

The issue of the nosology of pulmonary emphysema in adults was uncertain for a long time. According to all international and Ukrainian clinical guidelines and majority of scientific search systems, pulmonary emphysema is considered within the chronic obstructive pulmonary disease (COPD). However, in the International Statistical Classification of Diseases and Related Health Care Problems (ICD), pulmonary emphysema was put into a section separate from COPD. The aim of this study was to follow the history of pulmonary emphysema research in terms of its nosological affiliation according to the literature data. The first publications on pathological inflation of the lungs were dated back to 1679 and 1769. In 1821 the term "pulmonary emphysema" was introduced. In the 19th century emphysema was associated with asthma and bronchitis. In the first internationally recognized classification of diseases in 1900, emphysema was associated with asthma. In the period from 1909 till 1948, pulmonary emphysema was classified as a separate nosological form. In the middle of the last century the practitioners from different countries equally used the terms chronic bronchitis, or asthma or emphysema ("British bronchitis" and "American emphysema"). The grounds of the modern understanding of pulmonary emphysema were created in 1958, when CIBA Guest Symposium experts noted that emphysema was a lung condition characterized by an abnormal increase in the size of the air spaces distal to the terminal bronchioles due to dilatation or destruction of their walls and it is morphological concept. Due to the variety of clinical and pathological syndromes, emphysema could not be considered as a separate entity with homogeneous clinical, radiological or functional signs, therefore, according to CIBA Guest Symposium, it was not possible to use the term "emphysema" as the name of the disease. Today, pulmonary emphysema is defined as the destruction of the gas exchange surfaces of the lungs (alveoli), being a pathological concept that describes only one of several structural disorders in patients with COPD. In asthma patients, from the nosological point of view, the presence of pulmonary emphysema indicates an overlap with COPD in one patient. Key words: pulmonary emphysema, chronic obstructive pulmonary disease, nosology, history of medicine.