In a recent publication1 on the subject of obstructive pulmonary atelectasis, two etiologic factors were described as being essential to its production, viz., bronchial obstruction and labored respiration or expiration against resistance. The latter of these two factors was contrary to the observations of Lee,2 Coryllos and Birnbaum3 and others,4 who had produced the condition experimentally with regularity, and who believed a quiet, shallow respiratory cycle to be one of the important factors in its etiology. This idea has been carried down from the time of Pasteur5 who, observing several cases of massive atelectasis associated with postdiphtheritic paralysis of the diaphragm, believed it due to a reduction in the depth of respiration.
When an attempt was made to reproduce the results of other investigators, the factor of straining respiration was accidently encountered and massive atelectasis produced with routine regularity in its presence.
That straining respiration
ADAMS WE, LIVINGSTONE HM. OBSTRUCTIVE PULMONARY ATELECTASIS: FURTHER STUDIES. Arch Surg. 1931;23(3):500–512. doi:10.1001/archsurg.1931.01160090145005
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