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Many years ago, pulmonary physiology and pathophysiology were central to practice, training and research in respiratory medicine. Many of the ‘big names’ in respiratory medicine were experts in pulmonary physiology. A quick canter through the ‘further reading’ section of my old, 1985, third edition of John West’s ‘Respiratory Physiology—the essentials’ reveals names such as JE (John) Cotes, NB (Neil) Pride, EJM (Moran) Campbell, doyens of respiratory medicine in their time, but now probably unfamiliar to the young respiratory physicians of today. And I remember attending amazingly erudite lectures given by the revered David Dennison at the Brompton Hospital, when I was a senior registrar there. In modern respiratory medicine training, however, pulmonary physiology competes with so many other—potentially more interesting (?)—topics that it often receives relatively scant attention. This may be in part due to the disease-oriented approach to the practice of medicine today. However, as many readers will know, patients usually don’t present with a disease label. Even today, the majority of patients presenting to the general respiratory clinic come with the non-specific symptoms of breathlessness, cough and chest pain, along with a plea from their General Practitioner, to ‘sort them out.’ In this context, I would argue that an understanding of respiratory physiology/pathophysiology and of lung function testing …
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