ABSTRACT
It would be fair to say that chronic obstructive pulmonary disease (COPD) is a disease entity that, at the time of writing, is enjoying a renaissance of interest. It is also true to say that this condition has not received the attention in the past that it has deserved. There are many reasons for this. It has proved very difficult to compose a definition of the syndrome that encompasses the disease in a single sentence or even a single paragraph. It has even proved quite difficult to define the syndrome completely. Most definitions link COPD to the closely related syndrome of asthma. It is seen as asthma’s recalcitrant alter ego: irreversible rather than reversible, presenting in elderly rather than young patients and difficult to manage, with the result that patients block beds in hospitals and compete unfavourably for intensive care, compared with community-based asthmatics who come to hospital only when there is a failure in management. In short, something of a nuisance.
