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September 27, 1965

Emphysema: Several Factors May Cloud Diagnosis

JAMA. 1965;193(13):24-32. doi:10.1001/jama.1965.03090130076038

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Emphysema can be defined only in morphologic terms, according to E. Osborne Coates, MD, Division of Pulmonary Diseases, Henry Ford Hospital, Detroit.

The amount of actual destruction of lung tissue is the criterion. But emphysema is only one of three conditions which may produce diffuse airway obstruction, the others being bronchial asthma and chronic bronchitis. Clinical observation cannot clearly define morphologic emphysema, Dr. Coates noted. All that can be said is that the person has chronic obstructive lung disease —with symptoms and signs of emphysema or bronchitis or asthma. Each condition overlaps the others.

Both emphysema and asthma are characterized by shortness of breath on exertion; bronchitis consists of chronic cough productive of sputum. Emphysema, clinically, produces shortness of breath on exertion, usually occurs in men over 40 years of age, and may or may not be accompanied by cough and sputum. Bronchitis can do the same without necessarily destroying

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