Obstructive Pulmonary Disease Testing in Hospital Patients1

As a part of the growing awareness of the syndrome of diffuse pulmonary ventilatory obstruction, numerous studies of the epidemiology of this disease have been carried out, particularly in the industrial countries of the northern temperate zone. Numerous problems have arisen, particularly in regard to selection of appropriate physiologic tools for the determination of ventilatory obstruction and also in interpretation of obtained data. As an illustrative example, the methods and findings of one of these studies will be presented and discussed in comparison with previously reported studies. Because of increasing evidence that a diffuse obstructive pulmonary syndrome plays a major role in the diagnosis and care of patients in a tuberculosis hospital (1, 2), a study of the incidence of this syndrome was undertaken (3, 4), utilizing the measurement of maximal expiratory flow by the "Puffmeter" of Goldsmith (5). The results of this investigation are published elsewhere" and may be summarized as follows: