Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung condition characterized by persistent airflow limitation, which makes breathing increasingly difficult. The journey to the formal identification of this widespread ailment was not a single event but a centuries-long process of anatomical observation, clinical description, and finally, medical consensus. Understanding when COPD was “discovered” means tracing the evolution of medical thought that brought together two separate diseases under one umbrella definition.
Early Recognition of Symptoms
The earliest medical texts contained only non-specific observations of chronic respiratory distress. As far back as 1679, the Swiss physician Théophile Bonet described the lungs of a deceased individual as “voluminous.” A century later, in 1769, the Italian anatomist Giovanni Morgagni also reported on cases involving “turgid” lungs, suggesting an early recognition of what would later be understood as emphysema.
These initial observations were limited to post-mortem descriptions of anatomical abnormalities without a clear clinical correlation or cause. The focus shifted in 1814 when British physician Charles Badham provided a more formal clinical description, identifying chronic bronchitis as a disabling condition marked by a persistent cough and excessive mucus, which he referred to using the ancient term “catarrh.” Although these figures identified parts of the eventual syndrome, their work represented observations of clinical signs and changes in lung structure, not the diagnosis of a distinct, specific disease complex.
Defining the Separate Conditions
Significant progress was made throughout the 19th century as medical techniques allowed for the distinction and formal description of the two core pathologies. This period saw physicians begin to separate the clinical entity of chronic bronchitis from the anatomical changes of emphysema. Emphysema, defined by the irreversible enlargement and destruction of the air sacs (alveoli), was recognized pathologically as a condition involving the permanent overinflation of lung tissue.
Concurrently, chronic bronchitis was clinically defined as a condition involving a persistent, productive cough—specifically, one lasting at least three months of the year for two consecutive years. While it was noted as early as 1837 that emphysema was a frequent complication of bronchitis, the two conditions were treated as separate diagnostic entities for decades. The medical community focused on distinguishing the clinical signs of mucus-producing airway inflammation from the structural damage that led to the permanent air-trapping within the lungs.
The Consolidation and Coining of COPD
The modern understanding and formal coining of the term came in the mid-20th century, driven by the realization that chronic bronchitis and emphysema frequently co-existed and shared common risk factors, primarily cigarette smoking. This need for a unified nomenclature was formally addressed during a pivotal meeting known as the Ciba Guest Symposium in 1959. At this symposium, international experts worked to standardize the terminology, definitions, and classification of chronic pulmonary emphysema and related conditions.
Following the Ciba meeting, the American Thoracic Society (ATS) further cemented the definitions of chronic bronchitis and emphysema in 1962, emphasizing their shared association with chronic airflow obstruction. The actual term “Chronic Obstructive Pulmonary Disease” (COPD) was first used by Dr. William Briscoe at the 9th Aspen Emphysema Conference in June 1965. This new umbrella term was quickly adopted to represent the spectrum of progressive and irreversible airflow limitation. By 1966, the term COPD was widely accepted, reconciling the different terminologies used by British and American physicians.
Modern Diagnostic Evolution
Following the formal coining of the term, the medical focus shifted toward standardized, objective measurement for diagnosis and severity assessment. Spirometry, a test that measures the volume and speed of air a person can exhale, became the globally accepted standard for confirming the presence of COPD. The foundation for this objective testing was laid earlier, in 1947, with the introduction of timed vital capacity measurement, which assessed airflow limitation.
Today, the diagnosis of COPD requires the demonstration of persistent airflow limitation, specifically a post-bronchodilator ratio of the forced expiratory volume in one second (\(\text{FEV}_1\)) to the forced vital capacity (\(\text{FVC}\)) of less than \(0.70\). Once the diagnosis is confirmed by spirometry, international guidelines, such as those published by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), are used to classify the disease severity. These guidelines use the \(\text{FEV}_1\) value to grade the severity of the airflow obstruction, allowing for consistent treatment and prognosis worldwide.