Respiratory Physiology: People and Ideas (review)

Respiratory physiology is a broad church. It encompasses studies as diverse as gas transport across pleural membranes; the nervous control of sneezing; and the applied physiology of altitude acclimatization. Historians of respiratory physiology have been well served recently: Wiltz Wagner and E. Kenneth Weir’s edited volume The Pulmonary Circulation and Gas Exchange (1994), Bodil Schmidt-Nielsen’s biography of her parents, August and Marie Krogh: Lives in Science (1995), and John West’s earlier edited collection High Altitude Physiology: Benchmark Papers in Human Physiology (1981) are some of the more notable contributions to have come from practitioners themselves. The present volume extends and supplements those works, with a collection of historical essays contributed by past or present practitioners from around the world.

Ewald Weibel’s introductory chapter on the structural basis of lung function provides the morphological framework for the following sections, on gas exchange and blood flow; on the mechanics of respiration; and on regulatory aspects of ventilation. A final chapter by Marsh Tenney valiantly attempts the near-impossible task of providing a succinct history of comparative respiratory physiology, focusing on vertebrate studies.

As can be expected from such a wide ambit, the result is of mixed quality. The authors seem to have approached their tasks in one of two ways—either a broad review of the field, or a personal account of their own careers and contributions. On the whole, it is the latter approach that is more successful and that is of particular interest to the professional historian, providing insights, information, context, and contributions not readily available elsewhere. John Clements recognizes the importance of this mode, declaring his intention “to present . . . ideas, people, and vignettes . . . that will soon be lost to view” (p. 208). His chapter on his and others’ work on surfactant is a model, describing the early “monastic era” in the laboratory and the emergence of the “secular phase” (p. 225) when the clinical implications of surfactant in saving newborn babies with respiratory distress syndrome became obvious.

This is not to say that the “survey” approach is useless: Robert Fitzgerald and Sukhamay Lahiri’s history of chemoreception, and John West’s account of pulmonary blood flow and gas exchange, are both ambitious, scholarly studies that provide important critiques of their subjects.

The book is attractively illustrated (I particularly enjoyed the muzzled caiman crocodile on p. 363). The full bibliographies provide ready guides to the more specialized scientific and clinical literature, but the work is of wider interest to historians of science and medicine, beyond those concerned just with respiratory physiology. Several papers dwell either explicitly or implicitly upon the significance of advances in equipment and techniques—whether these be directly in the area of respiratory physiology (e.g., Ludwig’s blood gas pump, Krogh’s microtonometer, the Riley bubble method) or in fields such as the neurophysiological advances made by E. D. Adrian and Yvnge Zotterman in recording from single nerve fibers. Scientific controversies make their appearance: one such is the well-known dispute between Christian Bohr and John Haldane on the one hand, and Bohr’s pupil August Krogh on the other, as to whether oxygen and carbon dioxide were actively secreted by the lung or whether gas exchange was by diffusion. Also included is a less-well-known debate, that between Peter Macklem and Jere Mead on the role of the diaphragm in breathing, recounted in Macklem’s chapter on respiratory muscle physiology and touched on in Mead’s chapter on the lung and chest wall mechanics.

This is the latest volume in the People and Ideas (originally Men and Ideas) series published by the American Physiological Society, a list that includes, inter alia, volumes on endocrinology, membrane transport, and renal transport. The high standard of these books, and their accessibility to both historians and scientists, are tributes to the Society’s efforts to record and explore physiological history. Respiratory Physiology is a worthy addition to the collection.