the quantity of air inspired at each breath, but also on the number of inspirations- in a given time. If these two values be multiplied together we get what might be called the volume of respiration (Athmungsgrösse, Isidore Rosenthal, b. 1836), in contradistinction to depth of respiration and frequency of respiration. Various instruments have been devised to measure the volume of respiration, all more or less faulty for the reason that they compel respiration under somewhat abnormal conditions (Rosenthal, Gad, Peter Ludwig, Panum (1820-1885), Ewald Hering (b. 1834). From the data obtained we may conclude that the respiratory volume per minute in man is about 366 cub. in. (6000 cub. centim.). In connexion with this subject it may be stated that, after a single ordinary inspiration of hydrogen gas, 6-ro respiration's of ordinary air must occur before the expired air ceases to contain some trace of hydrogen.
Types of Respiration.—The visible characters of respiration in man vary considerably according to age and sex. In men, while there is a moderate degree of upheaval of the chest, there is a considerable although not preponderating degree of excursion of the abdominal walls. In women the chest movements are decidedly most marked, the excursion of the abdominal walls being comparatively small. Hence we may distinguish two types of respiration, the costal and the abdominal, according to the preponderance of movement of one or the other part of the body wall. In forced respiration the type is costal in both sexes, and so it is also in sleep. The cause of this difference between men and women has been variously ascribed (a) to constriction of the chest by corsets in women, (b) to a natural adaptation to the needs of child-bearing in women, and (c) to the greater relative flexibility of the ribs in women permitting a wider displacement under the action of the inspiratory muscles.
Certain Concomitants of Normal Respiration.—If the ear be placed against the chest wall during ordinary respiration we can hear with every inspiration a sighing or rustling sound, called "vesicular," which is probably caused by the expansion of the air vesicles; and with every expiration a sound of a much softer sighing character. In children the inspiratory rustle is sharper and more pronounced than in adults. If a stethoscope be placed over the trachea, bronchi or larynx, so that the sounds generated there may be separately communicated to the ear, there is heard a harsh to-and-fro sound during inspiration and expiration which has received the name of "bronchial."
In healthy breathing the mouth should be closed and the ingoing current should all pass through the nose. When this happens the nostrils become slightly expanded with each inspiration, probably by the action of the M. dilatatores naris. In some people this movement is hardly perceptible unless breathing be heavy or laboured. As the air passes at the back of the throat behind the soft palate it causes the velum to wave very gently in the current; this is a purely passive movement. If we look at the glottis or opening into the larynx during respiration, as we may readily do with the help of a small mirror held at the back of the throat, we may notice that the glottis is wide open during inspiration and that it becomes narrower by the approximation of the vocal chords during expiration. This alteration is produced by the action of the laryngeal muscles. Like the movements of the nostril, those of the larynx are almost imperceptible in some people during ordinary breathing, but are very well marked in all during forced respiration.
The Mechanics of Respiration.—The thorax is practically a closed box entirely filled by the lungs, heart and other structures contained within it. If we were to freeze a dead body until all its tissues were rigid, and then were to remove a portion of the chest wall, we should observe that every corner of the thorax is accurately filled by some portion or other of its contents. If we were to perform the same operation of removing a part of the chest wall in a body not first frozen we should find, on the other hand, that the contents of the thorax are not by any means in such circumstances bulky enough to fill up the space provided for them. If we were to measure the organs carefully we should find that those which are hollow and whose cavities communicate with the regions outside the thorax are all larger in the frozen corpse than in that which was not frozen. In other words, the organs in the thorax are distended somewhat in order that they may completely fill the chest cavity; and the nature of this curious and important condition may best be illustrated by the simple diagrams, figs. 7 and 8 (from Hermann's Physiologie des
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| Fig. 7. | Fig. 8. |
Menschen),—where t is the trachea, l the lung, v the auricle of the heart, k the ventricle, i an intercostal space with its flexible membranous covering. When the interior of the vessel is rendered vacuous by exhaustion through the tube o, the walls of the lungs and heart are expanded until the limits of the containing vessel are accurately filled, while all flexible portions of the walls of the vessel (corresponding to the intercostal membranes and the diaphragm of the thorax) are sucked inwards.
From this description it follows that the lungs, even when the thorax is most contracted, are constantly overs distended, and that, when the cause of this over-distension is removed, the lungs, being elastic, collapse. It further follows that if the thorax is dilated, the flexible hollow organs it contains must perforce be still more distended-a distension which in the case of the lungs is followed by an in drawing of air through the trachea in all cases where the trachea is open. Thus, as the act of respiration is primarily a dilatation of the thorax, the part played by the lungs is, as Galen knew, a purely passive one.
How is dilatation of the thorax effected? It has been pointed out that the rib-planes decline from the horizontal in two directions, viz. from behind forwards, and from the anteroposterior mesial plane outwards; a glance at fig. 9 will make this double sloping clear to the reader. It has, moreover, been explained that the diaphragm arches upwards into the thorax in such a manner that the lateral parts of the arch are vertical and in contact with the inner face of the thoracic walls. This being the structure of the thorax, the enlargement of its cavity is brought about (1) by raising the rib planes until they approach the horizontal, and (2) by depressing the diaphragm and making its rounded dome more cone-like in outline. A moment's consideration will show how these actions enlarge the boundaries of the-thorax. (a) When the postero-anterior slope of the rib-planes is diminished by the raising of the anterior ends of the ribs, the whole sternum is thrust upwards and forwards, and the antero-posterior diameter of the thorax is increased. (b) When the lateral slope of the rib-planes is diminished by the ribs being moved
