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March 17, 1962


JAMA. 1962;179(11):893-894. doi:10.1001/jama.1962.03050110061017

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Chronic bronchitis is a term not much used in the United States until recently, but which is accepted in Europe to describe a disease characterized by chronic, almost daily, cough and frequent lower respiratory infections leading after many years to ventilatory insufficiency. In urban areas of Europe, and particularly Great Britain, it is considered a leading cause of death and is being recognized with increasing frequency in the United States. It is likely that multiple etiologic factors operate in the pathogenesis of this group of diseases; air pollution, smoking, allergy, heredity, and social class have been implicated by epidemiologic surveys.

A major factor, however, which is amenable to treatment, is chronic infection of the bronchi. There is now evidence that the major bronchi, normally sterile, continuously harbor a bacterial flora in chronic bronchitis with the 2 principal pathogens being Hemophilus influenzae and Diplococcus pneumoniae. Furthermore, the acute exacerbations of the

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