Medicine: Miller on Lungs

Three weeks ago Publisher Charles C. Thomas of Springfield, Ill. issued 1,500 copies of a small monograph called The Lung by Anatomist William Snow Miller of the University of Wisconsin. Price was $7.50. The issue was sold out in a fortnight and last week zealous doctors offered as high as $50 for a copy. This rare situation in the history of medical publishing was attributable to the fact that in the history of medicine there had never before appeared so thoroughgoing a study of the human lung. Dr. Miller’s 20g-page monograph—including an affectionate dedication to his wife who was once his student—took its place overnight beside such classics as William Harvey’s Motion of the Heart & Blood, Rudolf Virchow’s Cellular Pathology. Some well and lesser known facts covered by The Lung:

¶The lungs are two irregular conical shaped organs occupying the chest. At birth and for three weeks thereafter they are white. Gradually they darken to yellowish grey or reddish grey in the adult. People who live in smoky cities like St. Louis (TIME, Feb. 22) have their lungs marbled with black and blue lines from particles of soot. Coal miners’ lungs are black, copper miners’ are blue.

¶Men’s lungs are bigger than women’s. Their weights range from 2 lb. (women) to 3 lb. (men). At full inspiration the lungs contain about 5 qt. of air. At every normal breath 1 pt. of air goes in & out of the lungs.

¶Air enters each lung through a bronchus, which branches from the windpipe (trachea). A bronchus subdivides successively into bronchioles, air ducts (ductuli alveolares), air pockets (atria), lobules. Lobules bulge with many air sacs (acini) which look like clusters of grapes. Walls of the lobules adjoin walls of capillaries in which the pulmonary veins and pulmonary arteries terminate. The pulmonary arteries bring dark blood loaded with carbon dioxide from the body’s tissues to the lobules. The lobules treat the blood with fresh oxygen, leaving it pure and crimson.

¶Bronchial pneumonia results from inflammation of the bronchi and bronchioles. It is less dangerous than lobar pneumonia which clogs the lobules and prevents carbon dioxide from getting out of the blood, oxygen from getting in.

Anatomists and physicians have known a good deal of all this since 1628, when William Harvey published his De Motu Cordis. But enough remained unknown to cause Dr. Miller 47 years of research. It was he who discovered the lungs’ atria. He proved that the significant unit of lung architecture is the lobule. He systematized the whole lung anatomy, rationalized its physiology. He anatomized the tubercle of Ghon, the spot in the lung from which certain cases of pulmonary tuberculosis develop in children. He guided a former assistant, Professor Olof Larsell of the University of Oregon, in mapping the nerves of the lungs. Despite all this, Dr. Miller humbly and urgently begins his monograph: “There remain many problems to be solved.” For instance, does oxygen diffuse directly into the blood stream, or do the lungs first do something to oxygen to make it fit for the blood? How do filtrable viruses get through the respiratory system to cause diseases like measles?

The Man. William Snow Miller looks like General Custer. William Harvey looked like Shakespeare. Otherwise the two anatomists resemble one another astonishingly. A friend of Harvey described him as short, bright-eyed, quick, alert, choleric, often fingering the handle of his dagger. A friend of Dr. Miller describes him as “a chipper, cheerful, deaf little man, almost military in preciseness and persistence; as high-tempered as he is patient and potent; just, exacting, and opinionated.”

For many years Dr. Snow was the only faculty M. D. at the University of Wisconsin, where he went to teach vertebrate anatomy in 1892. In 1907 he and the late Dr. Charles Russell Bardeen organized the University’s medical school. In 1924 Dr. Miller retired as professor emeritus of anatomy. He still spends four hours every morning in his laboratory at the University. Afternoons he pecks away at a typewriter in his home library, preparing lessons on the history of medicine for practicing physicians to study. He was a pioneer in 1909 in the postgraduate teaching of medical history.