Introduction According to Laennec, it was Itard,7 in 1803, who first recognized pneumothorax as a pathological entity and gave it the name, although Riolan may have recognized it as early as the 17th century. Laennec himself,9 however, was the first to give an accurate and comprehensive clinical description of spontaneous pneumothorax and to appreciate its possible relationship to preexisting emphysema and bleb formation. In the last half of the 19th and the early part of the present century tuberculosis was considered to be the predominant cause of spontaneous pneumothorax. For example, Biach,1 in 1880, collected the cases of pneumothorax from three Viennese hospitals. Among 918 instances, 715, or about 80%, were ascribed to tuberculosis. But as early as 1819 Laennec9 described the finding of pneumothorax at autopsy without evidences of associated pulmonary tuberculosis. In 1856 McDowel12 reported the case of a young man who suffered "a