Chronic Bronchitis? Pulmonary Emphysema?

Chronic bronchitis is a very common disease in England; many articles and monographs concerning it have appeared there in the last decade.^1-3The condition is responsible for a high morbidity and mortality in Great Britain, while in the United States this diagnosis is seldom associated with severe and progressive respiratory illness, although the reported incidence of pulmonary emphysema continues to rise. Does this discrepancy represent a real national difference in incidence of disease or is the problem one of definition? It becomes apparent from comparative vital statistics that bronchitis in Great Britain is much more common than emphysema and bronchitis combined in the United States. Since emphysema is not included in British statistics, it must fall within their category of chronic bronchitis. Discussion about nomenclature is often nonproductive, unless the terms involved apply to genuine clinical differences.⁴ How can chronic bronchitis be separated from pulmonary emphysema? A clear