Derenne J P, Debru A, Grassino A E, Whitelaw W A
Service de Pneumologie, Hôpital de la Pitié-Salpétrière, Paris, France.
Eur Respir J. 1995 Jan;8(1):154-60. doi: 10.1183/09031936.95.08010154.
Galen (129-200 AD) produced a large written output which was to remain one of the major basis of clinical medicine for centuries. His contribution to respiration, reported in his own books and in those of Oribasius, was that of a chest physician and of an experimental physiologist. He described in minute details how to perform a remarkable series of experiments by which he demonstrated the anatomy and function of the respiratory muscles. He described the actions of the diaphragm and how it moves the rib cage, in a series of spinal chord sections and muscle denervations. He investigated the passive or active nature of expiration and made fine observations of lung movements through the exposed pleural space. He described the interaction between the lungs and chest wall and developed the concept of interaction between ribcage and abdominal muscles in maintaining the position of the diaphragm, showing a clear understanding of the principle that the diaphragm can move upward during an isovolume manoeuvre as long as the ribcage is allowed to expand. A skillful clinician, Galen applied his theories of the analysis of problems at the bedside, particularly in patients affected with dyspnoea which he attributed to respiratory muscle dysfunction.
盖伦（公元129 - 200年）著述颇丰，其著作在数个世纪里一直是临床医学的主要基础之一。他在自己的著作以及奥里巴西乌斯的著作中所阐述的对呼吸的贡献，兼具胸科医生和实验生理学家的视角。他详细描述了如何进行一系列卓越的实验，通过这些实验展示了呼吸肌的解剖结构和功能。他在一系列脊髓横切和肌肉去神经支配实验中，描述了膈肌的作用以及它如何移动胸廓。他研究了呼气的被动或主动性质，并通过暴露的胸膜腔对肺部运动进行了细致观察。他描述了肺与胸壁之间的相互作用，并提出了胸廓与腹部肌肉在维持膈肌位置方面相互作用的概念，清楚地理解了这样一个原理：只要胸廓能够扩张，在等容操作期间膈肌就可以向上移动。作为一名技艺娴熟的临床医生，盖伦将他的问题分析理论应用于床边，特别是在那些他认为患有因呼吸肌功能障碍导致呼吸困难的患者身上。
