Modern medicine may have sent the death rattle the way of milk fever, the vapors, consumption and other layman’s terms for the ills of our ancestors.
Many pulmonary diseases that can cause noisy labored breathing before death are not the major killers they were before antibiotics.
And the kind of breathing distress that would cause a death rattle would now probably call for insertion of a breathing tube, at least in a hospital.
There is a medical term, agonal respiration, for any irregularity of breathing, sometimes deep and sometimes shallow, just before death, but for most people there is no noise.
If there is a sound before death, it is probably one of three kinds of respiratory noise.
First, a person slipping into an unconscious state cannot clear secretions from around the larynx, vocal cords and trachea, so the passage of air may make a staccato wheeze or rattle, mostly on expiration.
This was commonly called the death rattle.
But pulmonary diseases that cause such secretions, like tuberculosis and pneumonia, are now treatable, so that people are more likely to die of something else, like a heart attack or stroke.
A second airway noise, stridor, is a harsh whistle that comes on breathing in when the larynx is narrowed by swelling.
Finally, the terms rales or rhonchi describe crackling sounds that occur mostly on inspiration, either because of fluid in the lung tissue itself or because of the snapping open of alveoli, or small air sacs.