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November 23, 1957


JAMA. 1957;165(12):1568. doi:10.1001/jama.1957.02980300048011

IN 1876 there was published a description of the peculiar breathing noticed in some patients with meningitis.1 The words in which Biot recorded his observations have been translated as follows: "This irregularity of the respiratory movements is not periodic, sometimes slow, sometimes rapid, sometimes superficial, sometimes deep, but without any constant relation of succession between the two types, with pauses following irregular intervals, preceded and often followed by a sigh more or less prolonged."2 The verbal description was accompanied by tracings which are reproduced in Major's textbook; they clearly show the inequality of the individual respiratory movements and the impossibility of predicting when the next inspiration will occur and what it will be like.

This condition is of both theoretical and practical importance. Physiologically it indicates a profound disorganization of the mechanisms that control respiration. Practically, in the days before the invention of respirators, it was an ominous