Larson and Barman (1965) described 2 kindreds, and Hole and Wasserman (1965) reported one, with multiple cases of chronic obstructive pulmonary disease (emphysema, chronic bronchitis, or both). A correlation with smoking was suggested. Knudson (1979) pointed out that ... Larson and Barman (1965) described 2 kindreds, and Hole and Wasserman (1965) reported one, with multiple cases of chronic obstructive pulmonary disease (emphysema, chronic bronchitis, or both). A correlation with smoking was suggested. Knudson (1979) pointed out that James Jackson, Jr. (1810-1834), son of one of the founders of the New England Journal of Medicine, discovered the familial factor in emphysema while studying with Louis in Paris. Jackson observed that 18 of 28 patients with pulmonary emphysema had at least 1 parent with the disease. Familial factors over and above alpha-1-antitrypsin deficiency (613490) are likely.