The beginning of pulmonary function testing can best be dated to 1846 when John Hutchinson invented the spirometer. Although similar devices had been used by previous scientists he turned it into a precision instrument and approached the study of lung function systematically. His work inspired innumerable other researchers and inventors, and within a few years improved versions of his spirometer were appearing across Europe and America. By my count within twenty years there were at least four other methods for measuring expiratory volume (at least one of which is still in use) had been applied to a new generation of spirometers.
The initial focus of spirometry was entirely on exhaled volume and the use of spirometers for any other purpose did not begin to change until the 1930’s when the MVV test was proposed and formalized. During this time the accuracy of spirometers improved and many serious researchers laid the groundwork for our current understanding of pulmonary medicine and physiology. This was also a period of time in which what we now call quack medicine flourished. A quick glance in almost any of the newspapers or magazines of that time will show a variety of ads extolling the virtues of different medicines, treatments and devices, most of which now appear to be silly, ineffective or just plain dangerous. As much as we might like to ignore or belittle this sordid period in our medical history, the truth is that spirometers were also one of these quack medicine devices.