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June 1971

Pathology of Chronic Bronchitis and Emphysema.

Arch Intern Med. 1971;127(6):1140. doi:10.1001/archinte.1971.00310180156027

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This text includes the most artistic set of illustrations yet published on the pathology of emphysema. Beyond these highly skilled reproductions of pathological anatomy, Heard presents a carefully reasoned and logical classification of pulmonary emphysema. His classification has several things to recommend it. First, it is founded on an historical base, reverting to the terminology introduced by Laennec 150 years ago. Second, it is simpler than the classification recently proposed by Lynne Reid. The simplification results from a restriction to morphology without concern for clinical or physiological types. This avoids the principal drawback of the Reid classification, a duplication of categories for those with, and those without, airways obstruction.

The text has at least one major and one minor shortcoming. The major deficiency is failure to present rigid criteria for the clear distinction between panacinar and centrilobular emphysema in all cases. It seems unfortunate that most illustrations of panlobular emphysema

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