Birth and development of respiratory medicine at Universit de Montral: From phthisiology to respiratory medicine

The authors relate the history of respiratory medicine in the network of hospitals treating adult patients and affiliated to the Universite de Montreal in the 20th century. The Institut Bruchesi, the Hopital du Sacre-C oe ur and the professors of the Faculty of Medicine of Universite de Montreal played a founding role in the organization of health care and teaching of phthisiology. They were active actors in the slow transition from phthisiology to pneumology from 1940 onward. The successive founding of the Hopital sanatorium Rosemont and of Institut Lavoisier in 1950 represent the key landing steps of research on other respiratory diseases besides tuberculosis. From 1960 to 1970, phthisiology evolved to pneumology: through the development of respiratory physiology; the public health concerns regarding the impact of smoking, causing chronic obstructive pulmonary disease and lung cancer; the changing status of sanatoria that became general hospitals; the increased frequency of asthma, sleep apnea and occupational lung disease; and the therapeutic breakthroughs offered by oxygen therapy, rehabilitation and lung transplant. The practice of pneumology is greatly influenced by medical imaging as well as the interventionist and multidisciplinary approach in a network of hospitals with a resolutely academic intention. Cet article presente l'histoire de la medecine respiratoire dans le reseau des hopitaux traitant des patients adultes et affilies a l'Universite de Montreal au 20ieme siecle. L'Institut Bruchesi, l'Hopital du Sacre-C oe ur et les professeurs de la Faculte de medecine de l'Universite de Montreal ont joue un role fondateur dans l'organisation des soins et de l'enseignement de la phtisiologie. Il montre la lente transition de la phtisiologie vers les premieres orientations liees a la pneumologie a partir des annees 1940. Les creations successives de l'Hopital sanatorium Rosemont et de l'Institut Lavoisier en 1950 constituent des moments cles de l'emergence des premieres recherches sur les maladies respiratoires autres que la tuberculose. A partir de la decennie 1960-1970, la phtisiologie evolue vers la pneumologie: par les developpements en physiologie respiratoire; les preoccupations de la sante publique rattachees au tabagisme, comme cause des maladies pulmonaires obstructives chroniques et des cancers bronchiques; la mutation des sanatoriums en hopitaux generaux; l'augmentation de la frequence de l'asthme, des apnees du sommeil et des maladies respiratoires professionnelles; et des approches therapeutiques de l'oxygenotherapie, de la readaptation et des greffes pulmonaires. La pratique de la pneumologie est tres influencee par l'imagerie radiologique, l'approche dite interventioniste et une approche multidisciplinaire dans un reseau d'hopitaux a statut resolument universitaire.