1876 – Biot studied patients with Cheyne–Stokes respiration at l’Hôtel-Dieu de Paris. In a 16-year old male with tuberculous meningitis he observed a previously undescribed pattern of breathing which he termed ‘rhythme meningitique‘.
He found the breathing pattern to be irregular and rapid, with rhythmical pauses lasting 10–30 s; and with alternating periods of apnoea and tachypnoea. The pattern was completely irregular and lacked the ‘crescendo–decrescendo’ cycles of Cheyne–Stokes breathing.
Biot original footnote 1876
“We stated in the previous pages that the various authors who wrote about Cheyne–Stokes respiration had mentioned it in tuberculous meningitis. We have observed the case of a 16‐year‐old young man. We collected several pneumographic graphs. These graphs are conspicuously different from those that we saw in fig I, especially in that before and after the pause there is no respiratory movement that gradually decrease and increase; but, a respiration that is deep, dyspnoeic, like a big sigh from the patient during those moments. On the other hand Trousseau, whose astute observation cannot be doubted, noted in his Clinique (part II, page 240), that periodic irregularity of breathing is a sign of tuberculous meningitis; but the reading of this paragraph shows that it is not Cheyne–Stokes. Without wanting to come to a definitive conclusion, it seems that in meningitis it is not really the true type of Cheyne–Stokes respiration, but close to this type and more regular. It is an issue that should be the subject of future study.”
Biot concluded that this breathing pattern should be considered separately and not as a variant of Cheyne–Stokes breathing and recorded the first ‘Biot respiration pattern‘.
1904 – Hofbauer introduced the term to the German literature as ‘Das Biotische Atmen‘ as part of the differential diagnosis for shortness of breath.
1911 – Lewis Conner introduced the term to the English literature. Conner observed seven patients with Biot respiration, six of whom had meningitis [Am J Med Sci 1911]
- Camille Biot (1850 – 1918)
- John Cheyne (1777–1836)
- William Stokes (1804–1878)
- Lewis A Conner (1867-1950)
- Ataxic breathing
- Biot C. Contribution a l’etude du phenomene respiratoire de Cheyne‐Stokes. Lyon médical. 1876;23:517-528
- Biot C. Étude clinique et expérimentale sur la respiration de Cheyne-Stokes. 1878
- Hofbauer L. Semiologie und differential diagnosis der verschiedenen arten von kurzatmigkeit auf grund der atemkurve. 1904 [25–28].
- Conner L. Biot’s breathing. Am J Med Sci 1911;141:350–360
- Wijdicks EF. Biot’s breathing. J Neurol Neurosurg Psychiatry. 2007;78(5):512-513. [PMC2117832]
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