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History of Respiratory Gas Exchange

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Abstract

As early as the 6th century B.C. the Greeks speculated on a substance pneuma that meant breath or soul, and they argued that this was essential for life. An important figure in the 2nd century A.D. was Galen whose school developed an elaborate cardiopulmonary system that influenced scientific thinking for 1400 years. A key concept was that blood was mixed with pneuma from the lung in the left ventricle thus forming vital spirit. It was also believed that blood flowed from the right to the left ventricle of the heart through pores in the interventricular septum but this view was challenged first by the Arab physician Ibn al‐Nafis in the 13th century and later by Michael Servetus in the 16th century. The 17th century saw an enormous burgeoning of knowledge about the respiratory gases. First Torricelli explained the origin of atmospheric pressure, and then a group of physiologists in Oxford clarified the properties of inspired gas that were necessary for life. This culminated in the work of Lavoisier who first clearly elucidated the nature of the respiratory gases, oxygen, carbon dioxide and nitrogen. At that time it was thought that oxygen was consumed in the lung itself, and the fact that the actual metabolism took place in peripheral tissues proved to be a very elusive concept. It was not until the late 19th century that the issue was finally settled by Pflüger. In the early 20th century there was a colorful controversy about whether oxygen was secreted by the lung. During and shortly after World War II, momentous strides were made on the understanding of pulmonary gas exchange, particularly the role of ventilation‐perfusion inequality. A critical development in the 1960s was the introduction of blood gas electrodes, and these have transformed the management of patients with severe lung disease. © 2011 American Physiological Society. Compr Physiol 1:1509‐1523, 2011.

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Figure 1. Figure 1.

The cardiopulmonary system according to the school of Galen. This dominated physiological thinking for some 1400 years. From .

Figure 2. Figure 2.

Michael Servetus (1511‐1553), who described the pulmonary transit of blood in a theological treatise. However, he was burnt at the stake for heresy, as can be seen at the top of the engraving.

Figure 3. Figure 3.

Marcello Malpighi (1628‐1694), who was the first person to describe the pulmonary capillaries and the alveoli. He described these in the frog lung, which he was able to examine with the recently invented microscope.

Figure 4. Figure 4.

Evangelista Torricelli (1608‐1647), who invented the mercury barometer and was the first person to understand the pressure of the atmosphere.

Figure 5. Figure 5.

Robert Boyle (1627‐1691), who invented the air pump with Robert Hooke (1635‐1703). Boyle described the inverse relationship between the pressure and volume of a gas at constant temperature, now known as Boyle's law.

Figure 6. Figure 6.

Joseph Priestley (1733‐1804), who was the first person to report the isolation of oxygen.

Figure 7. Figure 7.

Antoine Laurent Lavoisier (1743‐1794) with his wife, who was his laboratory assistant. He was the first person to understand the nature of the three respiratory gases, oxygen, carbon dioxide, and nitrogen.

Figure 8. Figure 8.

Paul Bert (1833‐1886), who was first person to understand that the physiological effects of gases such as oxygen depend on their partial pressure.

Figure 9. Figure 9.

John Scott Haldane (1860‐1936), who made many contributions to our understanding of respiratory gas exchange, although he championed oxygen secretion by the lung.

Figure 10. Figure 10.

August Krogh (1874‐1949) and his wife, Marie Krogh (1874‐1943). August made many contributions including disproving oxygen secretion by the lung. Marie introduced the use of carbon monoxide to measure the diffusion properties of the lungs.

Figure 11. Figure 11.

From left to right, Arthur Otis (1913‐2008), Hermann Rahn (1912‐1998), and Wallace Fenn (1893‐1971). They were responsible for many new insights into respiratory gas exchange, especially the role of ventilation‐perfusion inequality.



Figure 1.

The cardiopulmonary system according to the school of Galen. This dominated physiological thinking for some 1400 years. From .



Figure 2.

Michael Servetus (1511‐1553), who described the pulmonary transit of blood in a theological treatise. However, he was burnt at the stake for heresy, as can be seen at the top of the engraving.



Figure 3.

Marcello Malpighi (1628‐1694), who was the first person to describe the pulmonary capillaries and the alveoli. He described these in the frog lung, which he was able to examine with the recently invented microscope.



Figure 4.

Evangelista Torricelli (1608‐1647), who invented the mercury barometer and was the first person to understand the pressure of the atmosphere.



Figure 5.

Robert Boyle (1627‐1691), who invented the air pump with Robert Hooke (1635‐1703). Boyle described the inverse relationship between the pressure and volume of a gas at constant temperature, now known as Boyle's law.



Figure 6.

Joseph Priestley (1733‐1804), who was the first person to report the isolation of oxygen.



Figure 7.

Antoine Laurent Lavoisier (1743‐1794) with his wife, who was his laboratory assistant. He was the first person to understand the nature of the three respiratory gases, oxygen, carbon dioxide, and nitrogen.



Figure 8.

Paul Bert (1833‐1886), who was first person to understand that the physiological effects of gases such as oxygen depend on their partial pressure.



Figure 9.

John Scott Haldane (1860‐1936), who made many contributions to our understanding of respiratory gas exchange, although he championed oxygen secretion by the lung.



Figure 10.

August Krogh (1874‐1949) and his wife, Marie Krogh (1874‐1943). August made many contributions including disproving oxygen secretion by the lung. Marie introduced the use of carbon monoxide to measure the diffusion properties of the lungs.



Figure 11.

From left to right, Arthur Otis (1913‐2008), Hermann Rahn (1912‐1998), and Wallace Fenn (1893‐1971). They were responsible for many new insights into respiratory gas exchange, especially the role of ventilation‐perfusion inequality.

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John B. West. History of Respiratory Gas Exchange. Compr Physiol 2011, 1: 1509-1523. doi: 10.1002/cphy.c091006