Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung condition characterized by persistent airflow limitation, making breathing increasingly difficult. Though the chronic symptoms of COPD have afflicted humans for centuries, the specific recognition and classification of the disease complex under its modern name is a relatively recent development. Understanding when COPD was discovered requires tracing the evolution of medical thought from simple clinical observation to precise pathological and physiological definition.
Early Clinical Observations of Chronic Lung Disease
Descriptions of chronic cough and breathlessness date back to ancient medical texts, often grouped under broader terms like “catarrh.” In the 17th and 18th centuries, physicians recorded observations aligning more closely with COPD. For instance, T. Bonet described “voluminous lungs” in 1679, and Giovanni Morgagni noted lungs “turgid particularly from air” in 1769.
The first clear descriptions of chronic bronchitis appeared in 1808, focusing on the clinical presentation of a persistent, productive cough. Without tools to visualize lung damage, these chronic respiratory issues were frequently confused with diseases like asthma or tuberculosis.
19th-Century Pathological Identification
The 19th century shifted focus toward understanding the structural basis of chronic lung disease. René Laennec, who invented the stethoscope in 1816, linked clinical sounds to post-mortem anatomy. In his 1821 treatise, Laennec described lungs that failed to collapse during autopsy, suggesting excessive air inflation, which he termed “emphysema.”
Carl Rokitansky furthered this anatomical understanding between 1840 and 1870 by perfecting the systematic autopsy. Rokitansky established the micropathology of pulmonary emphysema, detailing the abnormal enlargement of air spaces within the lung. Concurrently, chronic bronchitis was clinically defined as a separate, symptom-based entity marked by a chronic productive cough lasting for at least three months per year for two consecutive years.
Formal Definition and Coining the Term COPD
Merging chronic bronchitis and emphysema into a single disease complex became necessary due to their shared risk factors, primarily cigarette smoking, and overlapping clinical presentation. This unification began in 1959 with the landmark Ciba Guest Symposium in London, which sought to standardize the terminology and classification of chronic pulmonary emphysema and related conditions. The symposium defined the component parts of the disease.
In 1962, the American Thoracic Society (ATS) Committee on Diagnostic Standards published its own definitions, which further contributed to harmonizing the understanding of the disease. The specific acronym, Chronic Obstructive Pulmonary Disease (COPD), is widely credited to William Briscoe, who used the term at the 9th Aspen Emphysema Conference around 1964 or 1965. The use of COPD rapidly gained traction and was widely adopted by the American Thoracic Society in the mid-1960s to represent the combined, irreversible airflow limitation caused by a mix of chronic bronchitis and emphysema.
Establishing Global Diagnostic Standards
Once the term COPD was standardized, the focus shifted toward objective diagnosis. Although the spirometer, a device for measuring lung function, was invented in 1846 by John Hutchinson, it was not universally applied to COPD diagnosis until later. Spirometry became recognized as the definitive tool for assessing airflow limitation, the defining physiological characteristic of the disease.
The modern framework for standardized diagnosis and management was solidified with the launch of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in 1997. GOLD created universal guidelines that established the post-bronchodilator forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) ratio of less than 0.7 as the spirometric threshold required to confirm a diagnosis of COPD.