Organs of Voice and Respiration

Organs of Voice and Respiration

The TRACHEA, or Rough Artery, by some call’d the PIPE or CANE of the Lungs, is a Channel which descends from the Jaws to the Lungs, and enters them with several Branches, through which the inspir’d Air is suckt in, and the same Air expir’d, is breath’d out again with the Scrous Vapours and Steams, for the Refrigeration and Ventilaton of the Vital Blood, and the Production of Voice and Sounds’.

Ysbrand van Diemerbroeck, The Anatomy of Human Bodies … translated by
William Salmon (London, 1689), p. 366.[1]

 Giambattista Morgagni, Adversaria anatomica omnia (Leiden, 1723), Tabula prima: image of tongue, trachea and larynx.

Giambattista Morgagni (1682–1771), whose illustration of the tongue is visible in the illustration above, was noted for his illustration of the ‘ossicles of the larynx’. Morgagni was professor of Padua for much of the eighteenth century and he was very influential, particularly in the area of anatomical pathology. Worth owned two texts by him: Adversaria anatomica omnia (Leiden, 1723) and In Aur. Corn. Celsum et Q. Ser. Samonicum epistolae (The Hague, 1724).

Giulio Cesare Casseri, De vocis auditusque organis historia anatomica singulari fide methodo ac industria concinnata tractativus duobus explicata ac variis iconibus aere excusis illustrata …  (Ferrara, 1601), Tabula XV.

De vocis auditusque organis historia anatomica singulari fide methodo ac industria concinnata tractativus duobus explicata ac variis iconibus aere excusis illustrata …  (Ferrara, 1601) was the first textbook to be printed by Giulio Cesare Casseri (fl, 1552–1616), a famous anatomist at the University of Padua in the sixteenth century. The publication brought together two treatises by Casseri, one on voice production and the other on the organs of hearing. Its 34 anatomical plates were of a very high standard. Nearly two thirds of the plates were devoted to the organs of the voice, and the rest focused on the ear. As Żytkowski and Walocha note, Casseri’s work on the voice broke new ground: he provided a precise description of the organs of the voice, not only in humans, but also in other animals, such as pigs, cattle and cats, making ‘one of the most ambitious and detailed reports in the field of comparative anatomy that arose at the turn of the 16th and 17th centuries’.[2] In this image, the main part of the illustration shows the larynx, heart and the lungs. As Żytkowski and Walocha state, in order to create sounds, the respiratory system and the larynx must work together.[3] The first to assert this vital relationship was none other than Vesalius. [4]

The Lungs

‘Life and respiration are complementary. There is nothing living which does not breathe nor anything which breathing which does not live.’

William Harvey (1653)

William Harvey (1578–1657) regarded the lungs (Greek: pneumones) as synonymous with life or spirit (pneuma), and as such he declared them the most important organ in the body in his Lectures on the Whole of Anatomy (1653), contradicting Galen who ascribed that level of importance to the liver. Like his predecessors, Harvey described the lungs as having five lobes in total, three on the right lung and two on the left, to account for the placement of the heart, in a concave section of the lower lobe of the left lung called the cardiac notch.

The formation of the lobes of the lungs is defined by their fissures (grooves). The right lung has two fissures, the horizontal and the oblique, separating into upper, middle, and lower lobe, while the left lung has a horizontal fissure between its upper and lower lobes. Scottish anatomist and physician Daniel John Cunningham (1850–1909) writes in his seminal Textbook of Anatomy (Edinburgh, 1902):

‘Variations in the pulmonary fissures are fairly common. Thus, it sometimes happens that the middle lobe of the right lung is imperfectly cut off from the lobus superior. Supernumerary fissures also are not infrequent, and in this way the left lung may be cut into three lobes, and the right lung into four or even more lobes’. [5]

The specimen below shows such an occurrence in a pair of lungs of a juvenile. This variation is called a lingular lobe, derived form the term lingula (Latin; little tongue) – what is only a tongue-like projection in the middle of the typical left lung anatomy. In this case the accessory oblique fissure defines a well-developed supernumerary lobe. Cases of anatomical variations in the lungs may complicate patient treatments and surgeries such as transplantation.

Pair of preserved lungs of a juvenile. These lungs show an unusual anatomical variation of three lobes on each lung. Typically, only the right lung has three lobes. Prepared by Dr. Daniel John Cunningham, late 19th century. Courtesy of the Old Anatomy Museum, School of Medicine, Trinity College Dublin.

Cunningham regarded anatomical variations in the context of Darwin’s theories of evolution. In his essay ‘On the Significance of Anatomical Variations’ published in 1898, he writes: ‘Some of these variations may lead to little or no result; others which tend to adapt the individual more perfectly to its environment are strengthened and perhaps perpetuated by natural selection’. [6]

Text: Dr Elizabethanne Boran, Librarian of the Edward Worth Library, and Ms Evi Numen, the Curator of the Old Anatomy Museum, Trinity College Dublin.

Sources

Cunningham, Daniel J., ‘The Significance of Anatomical Variations’, Journal of Anatomy and Physiology, 33, Pt. 1 (1898), 1-9.

Housman, Brian, et al., ‘Giulio Cesare Casseri (c. 1552–1616): The servant who became an anatomist’, Clinical Anatomy, 27 (2014), 675–80.

Van Diemerbroeck, Ysbrand, The Anatomy of Human Bodies .. translated by William Salmon (London, 1689).

Wysocki, Michael et al., ‘Iulius Casserius: revolutionary anatomist, teacher and pioneer of the sixteenth and seventeenth century’, Anat. Sci. Int., 91 (2016), 217–225.

Żytkowski, Andrzej and Jerzy Walocha, ‘Anatomical studies on larynx and voice production in historical perspective’, Polia Medica Cracoviensia, LX, no 3 (2020), 85–98.

[1] This English translation is not in the Worth Library. Worth had a 1679 Latin edition of this work.

[2] Żytkowski, Andrzej and Jerzy Walocha, ‘Anatomical studies on larynx and voice production in historical perspective’, Polia Medica Cracoviensia, LX, no. 3 (2020), 94.

[3] Ibid., 85.

[4] Brinkman, R. J., and J. J. Hage. ‘Andreas Vesalius’ 500th Anniversary: Initial Integral Understanding of Voice Production,’ [In eng]. J Voice 31, no. 1 (Jan 2017): 124.e11-24.e19.

[5] Cunningham, Daniel J., Text-book of Anatomy (Edinburgh; London : Pentland, 1902).

[6] Cunningham, Daniel J., ‘The Significance of Anatomical Variations’, Journal of Anatomy and Physiology,  33, Pt. 1 (1898), 1-9.

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