(a) Commonly read manuals of clinical methods in medicine emphasize the need to listen to the intensity (or loudness) and quality (or character) of breath sounds on auscultation of chest(3). None of these even mention the term ‘air-entry’.

(b) Though technically, in a normal respiratory system examination the term ‘air-entry’ can be used interchangeably with breath sounds, but in pathological conditions one can not use ‘air entry’ as synonymous to breath sounds. It is elaborated in subsequent discussion.

(c) ‘Air entry’ is an interpretation reached by auscultating the chest for breath sounds. During physical examination one normally comments about the observations and find-ings, not interpretations and inferences.

(d) Auscultation of breath sounds is dependant on two variables – firstly, turbulent air-flow probably in the larger airways and secondly, journey of these sounds from their site of origin to the position of one’s stethoscope diaphragm(3). Obviously, any obstruction in airway passage resulting in decreased air entry will cause diminished intensity of breath sounds but vice versa is not true. Breath sounds may be absent or decreased in cases of pleural pathology (effusion, pneumothorax, thickening) or chest wall swelling. Is the ‘air entry’ in lungs diminished in these conditions? In very thin subjects breath sounds may be heard louder. Does it mean they have more ‘air entry’?

(e) An equally interesting clinical situation would arise when quality of breath sounds is altered, like in case of consolidation, cavity or broncho-pleural fistula. In these cases one finds bronchial breath sounds which are louder, more harsh and hollow compared to normal vesicular or puerile broncho-vesicular breath sounds in children. What can one comment about ‘air entry’ in these situations? It will be ridiculous to say that ‘air entry’ is increased in a consolidated lung.

(f ) Persistent efforts by the author to amend this misnomer at undergraduate and post graduate level have proved futile. It seems the term ‘air entry’ has insidiously, inadvertently and indiscriminately entered into the medical jargon allover the Indian subcontinent(1,2). And sadly, it is percolating down the memory lane of medical professionals uninhibited. Does it reflect rather casual approach in our medical teaching and attitude towards value and importance of a thorough and meticulous physical examination and case presentation? Is the zeal and zest to learn and use newer diagnostic technologies relegating the old, golden art of clinical skills to a back seat?