A computer hardware-software system has been developed for extracting optical and digital mea-surements from chest x-rays and using these measurements to classify the severity of lung disease. The system consists of a digital image scanner and an optical system consisting of an x - y controller for film transportation and an RSI Fraunhofer diffraction pattern sampling unit. Initially the classification has been of opacity textural patterns associated with coal workers pneumoconiosis (CWP). However, the system appears to be expandable to all diseases described in the international standard which include lung disease, heart disease, and cancer with only software modification. Recently extensions to large opacity detection, measures of lung vascularity and lung and heart volume have been made. Results indicate classification accuracy rates for pneumoconioses comparable to visual readings of the films by expert radiologists, and significantly better than non-radiologist physicians who often read these films.