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2.  Oesophageal Speech 
British Medical Journal  1952;2(4795):1177-1178.
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PMCID: PMC2021945  PMID: 12997683
12.  Steady-state Diffusing Capacity Determined by a Simplified Method 
Thorax  1962;17(4):302-307.
PMCID: PMC1018715  PMID: 13928849
14.  Hyperventilation in Carbon-monoxide Poisoning 
British Medical Journal  1962;2(5303):511-512.
PMCID: PMC1925878  PMID: 14463254
15.  Clinical, Bronchographic, Radiological, and Physiological Observations in Ten Cases of Asbestosis 
Ten cases of asbestosis (eight male, two female), aged 45-65 years have been kept under observation for periods of up to eight years. Bronchiectasis was demonstrated bronchographically in six cases. Clubbing of the fingers and coarse crepitations appeared to be signs of bronchiectasis rather than of uncomplicated asbestosis. It is suggested that the prevalence of bronchiectasis is higher than has been reported previously because the patients survived longer. The radiological findings are tabulated and compared with previous descriptions. In these subjects there was no relationship between radiological and clinical state. Nine patients eventually showed clinical deterioration and it often proceeded rapidly. The radiograph however, usually remained unaltered.
Pulmonary function tests, including diffusing capacity, arterial blood analysis and estimation of mechanical properties of the lung, were carried out in these 10 cases, and in 11 asbestos workers (aged 35-64 years) without radiological abnormality. The steady state diffusing capacity for carbon monoxide (Dco) at rest was lower in asbestosis than in the control subjects. The pulmonary compliance was remarkably low in asbestosis and related fairly closely to the vital capacity. The maximum voluntary ventilation was also low and was related to increased pulmonary resistance but it cannot be said whether this is in the airways or in the lung tissue. Indirect evidence of inequalities of ventilation/perfusion ratio was obtained in most cases. There is no convincing evidence that pulmonary fibrosis occurs without radiological abnormality, but a defect of diffusion may occur. There is no test of pulmonary function which is diagnostic, but a low pulmonary compliance, especially if combined with a low diffusing capacity, is confirmatory.
It is suggested that the demonstration of a progressive decline in vital capacity, or in diffusing capacity, may enable a diagnosis of asbestosis to be made before radiological abnormality has appeared, but this point has not been proved.
PMCID: PMC1038059
16.  The Mechanical Properties of the Lung in Pneumoconiosis of Coal-miners* 
To assess changes in the mechanical properties of the lungs in pneumoconiosis, the “elastance” (coefficient of elastic resistance, the reciprocal of compliance) of the lung and resistance of the airways were measured by the method of Mead and Whittenberger (1953) in 97 coal-miners and 17 men who had never worked underground. Ages ranged from 24 to 57. The work done on the lung was measured in 66 of these subjects, and the maximum voluntary ventilation (M.V.V.) was measured in all. The subjects were obtained by random selection from hospital out-patients and by random selection from a radiological survey of over 5,000 coal-miners. The M.V.V. was reduced in coal-miners with progressive massive fibrosis (P.M.F.), and in those without pneumoconiosis, but was not significantly reduced in simple pneumoconiosis. Elastance of the lung was unaltered in young miners but was slightly, and significantly, increased in all elderly faceworkers whatever the radiological category. This change appeared to be due to long years of work underground rather than to the radiological abnormality of pneumoconiosis. This slight change in the pulmonary elastance cannot be the cause of the reduction in M.V.V., since the two are unrelated. Inspiratory resistance was normal in all coal-miners, suggesting that pneumoconiosis is not associated with any fixed distortion of the airways. The non-elastic work of breathing, however, was frequently above normal and this suggests that bronchial obstruction develops rather commonly during expiration. This change appears to be the cause of reduction of M.V.V. in the majority of cases, as a negative correlation between M.V.V. and non-elastic work was established. Mean non-elastic work was not, however, unduly high in those radiological groups in which a significant reduction of M.V.V. was recorded. It is suggested that this discrepancy may be due to excessive frictional resistance in the chest wall of miners with P.M.F. and those with no radiological abnormality. The findings are consistent with the hypothesis that emphysema is abnormally common in elderly coal-miners, and that it, rather than pneumoconiosis, is the cause of their reduced ventilatory ability.
PMCID: PMC1037907  PMID: 13651559

Results 1-16 (16)