Until 1968, most patient care and research in pulmonary medicine by the faculty of the Columbia-Presbyterian Medical Center was carried out in the Columbia Division at Bellevue Hospital where Drs. André Cournand and Dickinson Richards developed the Cardiopulmonary Laboratory during the 1930's and won the Nobel Prize in 1956. Their initial efforts produced what has since become the standard methodology for characterizing respiratory function. They then proceeded to explore normal physiology and the abnormalities generated by disease. The defining abnormalities of chronic airway disease and of diffuse diseases of the lung interstitium (as well as their impact respiratory gas exchange and on the pulmonary circulation and right heart) were described in collaboration with Drs. R.M. Harvey, M.I. Ferrer, W.A. Briscoe, H.W. Fritts and their fellows. Innovations in the management of respiratory failure were introduced that have since become standard therapies. The technique of lung morphometry was developed by Drs. D. Gomez and E. Weibel.

The Bellevue Laboratory closed in 1968 and its members moved to The Presbyterian Hospital campus. The training of clinical and research fellows was continued in the tradition established at Bellevue Hospital. In 1973, the Pulmonary Division was constituted formally under the direction of Dr. Harvey and staffed by the Bellevue group (who became known as "the Bellevue Mafia"). Studies of the chemical control of the pulmonary circulation and of the vasomotor induction of pulmonary hypertension in airway disease; of methods for characterizing changes in pulmonary vascular resistance; and of the hemodynamics of interstitial diseases were conducted by Dr. Y. Enson. The demonstration, sequencing and localization of angiotension converting enzyme (the first such characterization of a membrane-bound enzyme) was performed by Dr. P.R.B. Caldwell. Dr. D.F. Rochester examined diaphragmatic work, oxygen consumption and blood flow and developed the concept of respiratory muscle fatigue. Dr. N. Braun examined respiratory function in neuromuscular disease. Dr. R. Cole elucidated the role of myoglobin in oxygen transport to and utilization by skeletal muscle. Vasomotion in shunt pathways produced by resorption atelectasis, as well as its control, was examined by Dr. H. Thomas.

Dr. Caldwell was appointed director of the Division in 1985 upon the retirement of Dr. Harvey. The techniques and methodologies of cell and molecular biology came to occupy a more prominent role in the Division's activities. Dr. Enson, together with Dr. L. Schulman, continued his studies of control of the perfusion of shunt pathways in animal models of oleic acid pulmonary edema and granulomatous lung disease with emphasis on the role of prostanoids. Dr. P. Simonelli examined the molecular biology of adenovirus and of the human immunodeficiency virus with emphasis on the pathogenesis of pulmonary infection. An AIDS/TB service was established for patient management with responsibility for direction shared by the Pulmonary and Infectious Disease Divisions. Investigations of phagocytosis by pulmonary macrophages with concentration on signal transduction and protein-protein interactions were initiated by Dr. S. Greenberg. Dr. E. DiMango initiated studies of lung inflammation seen in Pseudomonas airway infection in cystic fibrosis. Dr. DiMango is also responsible for bridging between the pediatric and adult programs for the management of cystic fibrosis. A program of lung and heart-lung transplantation has been developed under the medical direction of Dr. L. Schulman in collaboration with Drs. C. McGregor and P. Simonelli. This group is examining the cell biology of acute and chronic lung rejection and improved methods of immunosuppression. After Dr. Caldwell's retirement in 1996, Dr. Y. Enson became acting Division Chief.

Dr. Paul Rothman was recruited to assume direction of an expanded Division of Pulmonary, Allergy & Critical Care Medicine on July 1, 1997. This appointment marked the beginning of a major effort to expand the clinical and basic research programs of the division. Dr. Rothman's research is centered on cytokine signaling and the role of cytokines in lymphocyte development. Dr. Rothman opened the Laboratory of Allergy and Inflammatory Lung Diseases to study airway inflammation and oncogenesis. In addition to Dr. Rothman's research group, Dr. Steven Greenberg continues his studies of signaling involved in macrophage phagocytosis. On June 1, 1998, Dr. Neil Schluger joined the Division as Chief of Clinical Pulmonary Medicine. In addition to his responsibilities for all clinical aspects of the program, Dr. Schluger will continue his research into the human host response in tuberculosis infection and disease. Dr. Charles Powell was recruited to the division from Boston University and has initiated a program of investigation in lung cancer, focused on using molecular techniques to study the development and progression of malignant lesions. A program of basic and clinical research in asthma is entered around the newly created Edsall-Wood Asthma Center. Dr. Rachel Miller is studying mechanisms of allergen sensitization in asthma, and Dr. Emily DiMango is conducting a number of clinical trials of new therapeutic agents. Dr. Byron Thomashow developed and serves as the medical director of the JoAnne LeBuhn Lung Failure Center. Through this center, the division participates in the NIH-sponsored National Emphysema Therapy Trial, the NIH-sponsored study of lung volume reduction surgery as a treatment for emphysema. Most recently, Dr. Ivor Douglas has been recruited from the University of Chicago to serve as Chief of Critical Care Medicine within the division. He will initiate a research program in mechanisms of inflammation in acute lung injury. Dr. Raphael Clynes has been recruited from the Rockefeller University to study the role of Fc receptors in inflammation. Dr. Robert Basner has been recruited from the University of Illinois as director of Sleep Medicine and Research in the division.