Excerpt from The Boston Medical and Surgical Journal, Vol. 97: July-December, 1877

These authors probably represent very fairly the views entertained in regard to the origin of bronchial respiration.. All assert that it may originate in the bronchi, with the exception of Guttman, who limits it too closely to the larynx. Careful observation shows that it may arise in the nose, lips, or throat, depending both upon the movements of these parts and the rapidity with which the current of air passes over them. When a similar sound has its source below the larynx it implies some abnormal condition of the parts by which vibrations are excited in the current of air, - such conditions, perhaps, as might be found in advanced catarrhal pneumonia, when the lung has been more or less extensively destroyed, but the requisites for its production are not found in simple consolidation or in effusions into the pleural cavity.

We must, however, admit that the sounds formed in or above the rima glottidis may be modified by the character of the passages or cavi ties which they enter, or that of the adjacent tissues. Dr. Langmaid, at the meeting where this matter was discussed, alluded to the fact that the bones of the head vibrate greatly, and stated that advantage was taken of this to get harmonic notes in which the trachea and bronchi took but little if any part. This seems to be only an example in the head of what is generally spoken of as consonance in the chest. For the production of the latter sound it is necessary that some change should take place in the pulmonary tissue, which increases its consistency either through disease or compression, so that the bronchi connected with it may respond more readily to and reinforce the waves of sound transmit ted from the larynx or parts above.

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