History of respiratory mechanics prior to World War II

The history of respiratory mechanics is reviewed over a period of some 2,500 years from the ancient Greeks to World War II. A cardinal early figure was Galen (130-199 AD) who made remarkably perceptive statements on the diaphragm and the anatomy of the phrenic nerves. The polymath Leonardo da Vinci (1452-1519) contributed observations on pulmonary mechanics including the pleural space and bronchial airflow that still make good reading. Vesalius (1514-1564) produced magnificent illustrations of the lung, ribcage, and diaphragm. In the 17th century, the Oxford School including Boyle, Hooke, Lower, and Mayow were responsible for many contributions on mechanical functions including the intercostal muscles and the pleura. Hales (1677-1761) calculated the size and surface area of the alveoli, the time spent by the blood in the pulmonary capillaries, and intrathoracic pressures. Poiseuille (1799-1869) carried out classical studies of fluid mechanics including one of the first demonstrations of flow limitation in collapsible vessels. The culmination of the pre-World War II period was the outstanding contributions of Rohrer (1888-1926) and his two Swiss countrymen, Wirz (1896-1978) and von Neergaard (1887-1947). Rohrer developed the first comprehensive, quantitative treatment of respiratory mechanics in the space of 10 years including an analysis of flow in airways, and the pressure-volume behavior of the respiratory system. von Neergaard performed landmark studies on the effects of surface tension on pressure-volume behavior. Progress over the 2,500 years was slow and erratic at times, but by 1940 the stage was set for the spectacular developments of the next 70 years.