One Passage for Food and Air

"We can thus, as I infer from Professor Owen's interesting description of these parts, understand the strange fact that every particle of food and drink which we swallow has to pass over the orifice of the trachea, with some risk of falling into the lungs, notwithstanding the beautiful contrivance by which the glottis is closed." — Charles Darwin, On the Origin of Species, 1859¹

"The species-specific anatomy that enables humans to produce the full range of quantal vowels, enhancing the robustness of speech, accounts for choking on food, which remains the fourth leading cause of accidental death in the United States." — Philip Lieberman, 2017²

Summary

The complaint is that air and food share the throat, so people choke, and that speech was bought with this flaw. The crossing itself is common to all mammals. What is human is a larynx that sits low in the adult neck. The cost is real but small, and it falls mostly on the old and the neurologically ill. Whether speech required the low larynx is disputed by the critics' own experts. Every built alternative that stops food reaching the airway costs something the human layout provides.

Who argues it. Darwin used the crossing as evidence that lungs came from a swim bladder, and praised the "beautiful contrivance" that closes the glottis.¹ Philip Lieberman says human speech anatomy "accounts for choking on food."² Nathan Lents says that with separate openings choking "would never happen."³ Jerry Coyne and Richard Dawkins do not use the argument.⁴
The anatomy. In every mammal the air and food paths cross in the pharynx.⁵ Infants and most mammals have a high larynx that gives a largely separate air route, yet still stop breathing for each swallow.⁶⁵ The human larynx starts high and descends.⁷ Lents has this backwards, and Creation Ministries International answered his error instead of the anatomy.
The cost. Choking killed 5,923 Americans in 2024, more than drowning and an eighth as many as falls.⁸ About three quarters were 65 or older.⁹ In one autopsy series 61% had a neurological or psychiatric disorder and 61% had missing teeth.¹⁰ Aspiration pneumonia kills about three times as many.¹¹
Speech. Lieberman says the vowels he credits are "not required for language."¹² Deer have a low larynx without speech, a macaque's vocal tract could make "an adequate range of speech sounds," and infants make contrasting vowels before the larynx descends.¹³¹⁴¹⁵ Speech did not strictly require the descent. Clearer speech may have.
The separated route. Surgeons build one when aspiration threatens life, and it works.¹⁶ It costs the voice and, in most patients, smell.¹⁷¹⁸ Animals with a sealed route breathe only through the nose; most healthy adults add the mouth past about 35 litres a minute.¹⁹ No layout beats the human one on every task, and no one has measured whether a high larynx would cut adult choking on solid food.
The replies. Jerry Bergman, David Menton and Evolution News name real functions and real trade-offs, but make errors of anatomy and arithmetic. The degeneration answer fits who dies, but not why the layout has no fail-safe.

Verdict: a real trade-off with a small, measured price. Speech is a fair reason for the layout, but the evidence that speech needed it is weaker than both sides assume.

Part 1: Who makes the argument

The parent article asks three things of any complaint: what the part is for, what limits it, and whether a feasible build does better.²⁰ This part states the complaint in its authors' words.

Darwin, 1859. Darwin did not call the crossing a flaw. He used it as a clue to history. Lungs, he argued, came from a swim bladder, and that ancestry lets us "understand the strange fact that every particle of food and drink which we swallow has to pass over the orifice of the trachea." In the same sentence he praised "the beautiful contrivance by which the glottis is closed."¹ His point covered every lung-breathing vertebrate, not humans alone.

Lieberman, 2017 and 2018. Lieberman, of Brown University's Department of Cognitive and Linguistic Sciences, has argued since a 1969 paper in Science that the human vocal tract is shaped for speech.¹⁴ He quotes Darwin's sentence and adds a human twist: "Because of this odd anatomy, which differs from that of all other mammals, choking on food remains the fourth leading cause of accidental death in the United States."¹² His technical version says the anatomy that makes the "quantal vowels" [i], [u] and [a] "accounts for choking on food."² This is the "speech bought with a fatal flaw" claim in its strongest scholarly form.

Olshansky, Carnes and Butler, 2001. Their redesigned human has a separated food and air passage. They conceded its costs in the caption: it "would disrupt breathing through the mouth and the ability to speak."²¹ In the text they wrote that "A simple rearrangement would have fixed that problem, albeit at the cost of severe trade-offs."²¹

Shubin, 2008. "Talking comes at a steep price: choking and sleep apnea are high on the list of problems we have to live with in order to be able to talk." He calls choking "Another trade-off of this design."²²

Dunn, 2010. Rob Dunn's Smithsonian list says the changes "leave falling food or water about a 50-50 chance of falling in the 'wrong tube.'"²³ No measurement is given.

Lents, 2018. Lents goes furthest. Separate structures "would make much more sense."³ "Nearly five thousand Americans choked to death in 2014 … If we had separate openings for air and food, this would never happen."³ He concedes that "all mammals can get foreign bodies lodged in their tracheae,"³ then says "In other apes, the larynx is substantially lower in the neck than ours" and speaks of "the gradual elevation of the voice box."³ Part 2 shows that this is the reverse of the anatomy.

Two things separate these authors. Darwin, Shubin, Lieberman and Olshansky's group call it a trade-off. Lents calls it a mistake. Only the second is a bad-design claim, and it is the one that needs a better build.

Part 2: The anatomy

The crossing is universal

The nose and mouth open into one chamber, the pharynx. The airway leaves it at the front, through the larynx, and the food path leaves it at the back, through the oesophagus. So air and food must cross. Rebecca German, A. W. Crompton and Allan Thexton state it for all mammals: "The anatomical pathways for inspired air and ingested food cross in the pharynx of mammals, implying that breathing and swallowing must be separated either in space or in time."⁵ Lieberman's "differs from that of all other mammals" is true of the adult human larynx's position. It is not true of the crossing, which is what Darwin described.

How the airway is protected

The epiglottis is only one layer. Koichiro Matsuo and Jeffrey Palmer of Johns Hopkins list the others. "The vocal folds close to seal the glottis … The hyoid bone and larynx are pulled upward and forward … This displacement tucks the larynx under the base of the tongue. The epiglottis tilts backward to seal the laryngeal vestibule."²⁴ The brain also switches breathing off: "The respiratory pause continues for 0.5 to 1.5 s during swallowing, and respiration usually resumes with expiration."²⁴ A cough is the last layer. "Aspiration of microscopic quantities also occurs in normal individuals."²⁴ The nerve that runs the larynx has its own article, The Recurrent Laryngeal Nerve.

Infants and most mammals

Jeffrey Laitman and Joy Reidenberg describe the usual mammal: a larynx "positioned high in the neck. This permits an intranarial larynx to be present and creates largely separate respiratory and digestive routes. While infant humans retain this basic mammalian pattern, developmental descent of the larynx considerably alters this configuration."²⁵ In the infant, "The epiglottis touches the back of the soft palate so that the larynx is open to the nasopharynx." As the neck lengthens, "The contact of the soft palate and epiglottis is lost … This change in human development contributes to the development of speech. However, the pharynx becomes part of both the food way and the airway."²⁴

"Largely" matters. Liquid flows around the high larynx in channels on each side, but a baby still cannot breathe through a swallow. John Koenig, Alan Davies and Bradley Thach recorded 13 bottle-fed infants. Each swallow brought "a period of airway closure lasting 530 +/- 9.8 (SE) ms," and breathing stopped altogether as swallows approached 1.4 a second.⁶ German's piglets were the same: "there was always a period of apnea associated with the swallow." And after weaning a mammal's solid food passes "over the larynx."⁵ Lieberman's popular line that cats and dogs "can lap up water while breathing"¹² is true only between swallows.

Which way the larynx moves

Takeshi Nishimura's MRI work settles the direction. "The hyoid bone and larynx in human neonates are positioned as high as in other mammals. However, during postnatal life, they descend."⁷ Chimpanzee larynges "also descend during infancy, as in human infants," though less.²⁶ Lents's "In other apes, the larynx is substantially lower in the neck than ours" is backwards.³ The adult human larynx is the low one.

Low larynges in animals that do not talk

Fitch and David Reby found that red and fallow deer carry the larynx low at rest, "similar to that in humans, and, during roaring, red-deer stags lower the larynx even further, to the sternum."¹³ Lions and tigers can pull the larynx back 20 to 23 cm, and the koala's appears to rest "near the sternum."¹³ Their conclusion: "laryngeal descent occurs in species that lack speech," so a low larynx has "non-phonetic functions."¹³ They propose one: a longer vocal tract makes the caller sound bigger, as the second drop of boys' larynges at puberty does without adding to "the phonetic abilities of teenage boys."¹³

Part 3: What the crossing costs

The count

The National Safety Council's 2024 figures, from the national death records, give:

Cause, United States, 2024	Deaths	Per 100,000
Falls	47,026	not given
Choking on food or other objects	5,923	1.74
Drowning	4,201	1.24

The council says choking rates were "quite low for most ages" and "Rates rose rapidly beginning at about age 71."⁸⁸

The hub article, and Eric's notes before it, quote lifetime odds for "Choking on food" of 1 in 2,367 (and, in the notes, an older 1 in 4,404).²⁷ The 1 in 2,367 is correct but counts only deaths coded as food. Most food choking in the elderly is coded as "other objects": of 16,531 choking deaths at 65 and over in 2009 to 2013, 3,113 were coded as food and 12,614 as other objects.²⁸ Wen-Shan Wu and colleagues note that forensic studies find "many of deaths been classified as ICD-10 code W80 were in actually involving food."²⁸ Counting all choking, the lifetime odds are nearer 1 in 700.²⁹ That is still about eight times smaller than the odds of dying in a fall (1 in 89).

Per swallow the risk is tiny. Bergman gives "about 1,000" swallows a day.³⁰ On that figure the United States makes about 124 trillion swallows a year, and one in about 21 billion ends in death.³¹

Who dies

About three quarters of choking deaths are at 65 or older, more than 4,100 a year, according to an Associated Press summary of federal statistics.⁹ Ellen Kramarow and colleagues at the National Center for Health Statistics found the food-choking deaths of older people most strongly tied to "dementia (including Alzheimer's disease), Parkinson's disease and pneumonitis."³² Wu's group added schizophrenia, oral cancer, stroke and larynx cancer.²⁸

Autopsy series show the rest. In Adelaide from 1993 to 2002, Roger Wick, John Gilbert and Roger Byard found 43 adult deaths from food choking. Half died in nursing homes. "Twenty-seven of the victims (61%) had histories of neurological or psychiatric disorders," 61% had few or no teeth, and 19 had alcohol or psychotropic drugs in the blood.¹⁰ In Vienna, Andrea Berzlanovich and colleagues found that younger victims "choked significantly more often on large pieces of foreign material" and had more alcohol in the blood.³³ Working-age deaths have fallen since the Heimlich manoeuvre spread in the 1970s, while deaths at 65 and over have not.³⁴

No source found counts the sober, healthy adults with their own teeth who choke to death. The series above suggest they are a minority of a minority. Small children are the other group at risk: choking "is one of the leading causes of unintentional death for infants,"³⁵ though their larynges are still high. Infants choke on toys and small objects as well as food, so this does not show that a high larynx fails to protect. It does show that a high larynx is not enough.

The larger cost: aspiration

Choking is the fast failure. The slow one is aspiration pneumonia, when food, drink, saliva or stomach contents reach the lungs. Tejas Gupte and colleagues counted "an average of 17,616 deaths per year" with aspiration pneumonia as the underlying cause in 1999 to 2017, three quarters of them at 75 or older.¹¹ That is about three times the choking toll, and it also depends on the shared passage. It is also a veterinary disease, and no source compares its rate across layouts.

Part 4: Did speech buy it?

Lieberman's case is precise. In the adult, half the tongue lies flat in the mouth and half stands upright in the throat, meeting at about a right angle. That shape, he argues, makes the vowels of "see," "do" and "ma," which are "relatively insensitive to small errors in tongue placement." It forms over the first years of life as the tongue descends, "pulling the larynx down with it."² He is careful about what this buys. The vowels "buffer speech against misinterpretation" and are "not required for language."¹² He also concluded that Neandertals "could talk, albeit with less clarity than modern humans."² So even the strongest advocate of the theory claims clarity, not speech itself.

Three lines of evidence cut the link further.

Monkey vocal tracts. Fitch, Bart de Boer, Neil Mathur and Asif Ghazanfar filmed living macaques by X-ray and modelled their vocal tracts. "We demonstrate that the macaque vocal tract could easily produce an adequate range of speech sounds to support spoken language." They concluded that "Macaques have a speech-ready vocal tract but lack a speech-ready brain."¹⁴ Lieberman replied that their model still lacked [i] and [u]. Fitch's group conceded they "never observed monkeys doing so," and doubted that "[i] (or any other vowel) plays a necessary role in spoken language."³⁶
Infants. Boë and colleagues report that "infants at 20 weeks produce contrasting vowels when imitating adult /i a u/," and that children make adult-like vowels "well before developmental LD" (laryngeal descent).¹⁵ Their review concludes that "laryngeal descent is not required to produce contrasting formant patterns."¹⁵ Boë's own vocal-tract model was attacked by de Boer and Fitch in 2010, as Lieberman points out, so this is one party in a live dispute.
Deer. A permanently low larynx exists in animals that do not speak (Part 2), so descent can serve other ends.

The fair reading is this. Speech did not strictly require the low larynx. The clearest human vowels may need the adult tongue shape, and that shape needs the larynx low. The dispute is between a clarity gain (Lieberman) and a gain too small to matter (Fitch, Boë). Nobody on either side has measured how much clarity is at stake in real conversation.

Part 5: Is a separated route available?

Olshansky's group drew a separated throat but did not say how it would work. Three real versions exist. Each can be priced on the tasks the human throat performs.

Layout	Where it is found	Food into the airway	Breathing while swallowing	Mouth breathing	Speech through the mouth	Smell
Low larynx, shared pharynx	Adult humans	Possible; about 5,900 US deaths a year	No	Yes	Yes	Yes
High larynx, seal can be undone	Most mammals, human infants	Liquids go round the larynx; solids pass over it	No, a pause at every swallow	Only by breaking the seal	Disputed	Yes
High larynx, seal permanent	Toothed whales	Food passes beside the larynx	Can swallow and echolocate at once	No	No; sound made in the nasal passages	Not applicable
Surgical full separation	Laryngectomy, laryngotracheal separation	Impossible	Yes, through a neck stoma	No	Lost, unless a prosthesis is fitted	Mostly lost

Sources for the rows: German and Koenig for the high larynx;⁶⁵ Reidenberg and Laitman for toothed whales;³⁷ Lindeman, Hilgers and Bonte for surgery.¹⁶¹⁷¹⁸

Full separation works, and it is used. Roger Lindeman described patients for whom "even the cuffed tracheostomy tubes of new and improved design do not adequately prevent aspiration."¹⁶ He joined the windpipe to the oesophagus and gave the patient a neck opening to breathe through. "Aspiration was totally and dependably controlled."¹⁶ The price is the voice. Katrien Bonte and colleagues write that these operations "nearly all result in the loss of phonation," and voice prostheses succeeded in 15 of their 35 patients.¹⁸ Smell goes too, because air no longer flows through the nose. Of 44 laryngectomy patients studied by Frans Hilgers and colleagues, 33 were "nonsmellers." Training restored smell in 15 of them.¹⁷ Surgeons choose this trade only when aspiration threatens life, which is itself a measure of its price.

A permanent seal costs the mouth. Toothed whales have a larynx that "may be permanently intranarial, held in place by the palatopharyngeal sphincter."³⁷ They breathe only through the blowhole and make their sounds in the nasal passages. Horses are "an obligate nasal breather," and even their seal needs muscle: failure of the palatal muscles has been "implicated in the pathogenesis of dorsal displacement of the soft palate," a disorder of racehorses.³⁸ People use the mouth route. In Veli Niinimaa's study, 20 of 30 healthy adults switched to mouth-and-nose breathing at about 35 litres a minute, and four breathed that way habitually. Only five stayed on the nose alone.¹⁹ Bergman makes the same point: the shared pharynx lets "the mouth and nose to alternate as breathing ports," which matters "whenever the nose is plugged, as when suffering from a cold."³⁰

A separable seal is the live option, and it is unmeasured. Most mammals can undo the seal to pant or call. A human with a high, separable larynx would keep mouth breathing and, on Fitch's evidence, most of speech. Two facts limit the gain. Solid food, the kind that kills by choking, passes over the larynx even in high-larynx mammals. And no study has measured how often apes or monkeys choke on solid food. The size of the benefit is unknown.

So no layout beats the human one on every task. Full separation wins on safety and loses voice, smell and mouth breathing. The permanent seal loses the mouth. The separable seal may lose some clarity and gains an unknown amount of safety. Olshansky's group saw this when they wrote that the fix would come "at the cost of severe trade-offs."²¹

Part 6: The design replies

Jerry Bergman (Creation Ministries International, 2008). "The pharynx serves as a single passage for three systems—the respiratory, digestive and communicative—for many very good reasons. A major one is, unlike other primates, our airway and esophagus intersect. This can cause choking, but allows speech."³⁰ He adds that lung mucus "is moved up out of the lungs by cilia and is then swallowed."³⁰ For the failures: "In the vast majority of cases problems only arise with a misuse or degeneration in the system … this is expected within the biblical model, as the Fall has produced degeneration."³⁰ He says the only real test is "a scientific comparison of two groups," and that critics "have not proposed the details or any evidence of a functional better design."³⁰³⁰

Priced. The three-systems point is right, and Part 5 bears it out. "Unlike other primates, our airway and esophagus intersect" is wrong: they intersect in every mammal.⁵ What differs is the height of the larynx. Mucus clearance works in high-larynx mammals too, so it does not favour the low larynx over a high one. Bergman's two-group comparison already exists in part: laryngectomy patients. It shows the separated design wins on aspiration and loses on voice and smell. The misuse-and-degeneration point matches the autopsy data (Part 3).

Don Batten and Tas Walker (Creation Ministries International, 2018). "Well, yes of course; if our larynx was lower in our neck we might be less prone to choke, but we could not talk."³⁹ Priced. This answers Lents's reversed anatomy. The adult human larynx is already the lower one, and a lower larynx means more exposure, not less. The corrected claim, that a higher larynx might choke less but speak less clearly, is Lieberman's trade-off and is defensible. As written, the sentence is wrong.

David Menton (Answers in Genesis, 2020). The problem "is easily solved by a rather simple surgery called a tracheotomy … you will be unable to talk after this procedure."⁴⁰ Priced. A tracheotomy does not separate the passages. Lindeman's point was that tracheostomy tubes fail to stop aspiration.¹⁶ The operations that separate them are laryngectomy and laryngotracheal separation. Menton's conclusion survives the correction: those operations do cost the voice.¹⁸

Evolution News (Discovery Institute, 2018). The site accepts Lieberman's trade-off: "The design does come with an increased chance of choking, but it's also something that allows us to speak as we do." It calls the throat "more like a trade-off than a botch."⁴¹ To put the risk "in perspective" it says 5,051 choking deaths in 2015 work out "to 0.0018 percent of all deaths in the United States."⁴¹ Priced. The United States registered 2,712,630 deaths in 2015.⁴² 5,051 of them is 0.19 percent, about one death in 540. The site printed the fraction as a percentage and understated the share a hundredfold.⁴³ The trade-off framing is sound; the number is not.

The Institute for Creation Research. No ICR article on choking was found. Brian Thomas wrote in 2008 that the human larynx, "in contrast to apes, is uniquely suited for varied and subtle speech capacities."⁴⁴ That rests on Lieberman's disputed premise. Randy Guliuzza's general rule is that "There is absolutely no need from the outset to ever concede that anything on creatures is poorly designed."⁴⁵ A skeptical reader will count that as refusing to test.

Where the replies are weakest. Batten and Walker state the degeneration answer plainly: "Degeneration with old age is not a design fault."³⁹ It explains who dies: people with dementia, stroke, Parkinson's disease, missing teeth or alcohol in the blood. It does not explain why the layout depends on a working nervous system with no fail-safe. A fully separated route keeps working when the nerves fail; that is why surgeons build it. The design reply has to say that the fail-safe costs too much for the healthy majority. Part 5 supports that, but no creationist source makes the argument with numbers.

Objections and responses

"Choking kills thousands. A designer would have prevented it." About 5,900 Americans a year die this way, most of them old and ill.⁹⁸ The only layout proven to prevent it removes the voice and most of the sense of smell.¹⁷¹⁸ A critic has to show a layout that keeps those and still prevents choking.
"Other animals do not choke, because their passages are separate." Their passages cross too, and they stop breathing to swallow.⁵⁵ No rate of fatal choking in wild apes or monkeys was found. The claim is untested, not false.
"Speech required the descended larynx, so the cost was the price of language." Lieberman himself says the key vowels are "not required for language."¹² Fitch and Boë find vowel contrast without descent.¹⁴¹⁵ The honest claim is "clearer speech," and its size is disputed.
"If speech did not need the descent, the design reply collapses." So does the story that speech drove the descent; both sides leaned on Lieberman. What remains for the design side is the mouth route and whatever clarity the adult tract adds, a weaker defence than "speech."
"The Fall explains choking." It fits the data on who dies better than it fits most bad-design cases.¹⁰ It does not explain the layout itself, and choking in toddlers is not degeneration.³⁵

Issues and unanswered questions

The benefit of a high larynx for adults is unmeasured. No study found compares fatal choking on solid food in high-larynx primates with humans. Without it, neither side can price the separable-seal option.
The United States age table was not read. The National Safety Council's age-by-age figures sit in a Tableau chart that refused download, and CDC WONDER blocked automated queries. The three-quarters share rests on an Associated Press summary and agrees with Wu's 3,300 a year at 65 and over in 2009 to 2013.²⁸
Healthy adults are not counted anywhere. The autopsy series are small (273 in Vienna, 44 in Adelaide).³³¹⁰ Death certificates also miss some choking, which may be recorded as heart attack.²⁸
Several sources were read only as abstracts (Kramarow, Wick, Berzlanovich, Gupte, Lindeman, Bonte, Hilgers), and the speech dispute between Lieberman, Fitch and Boë is unresolved.
Aspiration pneumonia costs about three times the choking toll. How much of it a different layout would avoid is unknown.
The young-earth side has no numbers here. No creationist source weighs the cost of choking against the benefits of the layout, and the most-read replies contain errors of anatomy and arithmetic.

Verdict

The crossing of air and food is common to all mammals and was praised by Darwin as a "beautiful contrivance." What is peculiar to adult humans is the low larynx, and it adds a real cost: about 5,900 American deaths a year from choking and a share of the larger toll from aspiration. The cost falls mostly on the old and the neurologically impaired. Lieberman's claim that speech bought it is overstated even by his own words, because the vowels he credits are "not required for language." A low larynx is best defended as a trade for clearer speech and a mouth route for breathing, not for speech itself. No built alternative beats the human layout on every task. Full separation, the only one proven to stop choking, costs the voice and smell. The design replies are right about the trade-off and wrong about several facts. Their weakest point is the lack of a fail-safe when the nervous system fails, and no creationist has priced it.

Sources

1.
Darwin, Charles. On the Origin of Species by Means of Natural Selection. John Murray. 1859. First edition. Public domain. Read from the Darwin Online transcription F373 in the source library, which carries the printed page markers; the passage falls between the markers for pages 191 and 192.
1. 1a.
  Page 191: “We can thus, as I infer from Professor Owen's interesting description of these parts, understand the strange fact that every particle of food and drink which we swallow has to pass over the orifice of the trachea, with some risk of falling into the lungs, notwithstanding the beautiful contrivance by which the glottis is closed.” ↩ ↩ ↩
2.
Lieberman, Philip. “Comment on “Monkey vocal tracts are speech-ready”.” Science Advances 3(7):e1700442. 2017. Lieberman was in the Department of Cognitive and Linguistic Sciences, Brown University. CC BY-NC. Read from the PMC copy; cited by section. Mirror: PMC
1. 2a.
  Section Introduction: “the “quantal” vowels [i], [u], and [a] (the vowels of the words “see,” “do,” and “ma”)”. Section Quantal vowels and vocal tract anatomy: “In human adults, half of the tongue, its “horizontal” segment, SVTh, rests in the mouth, whereas its vertical segment, SVTv, rests in the pharynx within the neck. The horizontal and vertical segments meet at an approximate right angle”. “At the same time, quantal vowels are relatively insensitive to small errors in tongue placement.” “Through a gradual remodeling process over the course of the first 6 to 8 years of life, probably regulated by species-specific epigenetic factors, the human skull is remodeled and the human tongue changes its shape, descending into the pharynx as the neck lengthens, pulling the larynx down with it.” ↩
2. 2b.
  Section Introduction: “we concluded that Neandertals had brains that could learn and execute the complex motor acts involved in talking and hence had language and could talk, albeit with less clarity than modern humans.” ↩
3. 2c.
  Section Conclusion: “The species-specific anatomy that enables humans to produce the full range of quantal vowels, enhancing the robustness of speech, accounts for choking on food, which remains the fourth leading cause of accidental death in the United States (15).” His reference 15 is Daniel E. Lieberman, The Evolution of the Human Head (2011), pp. 281–339. ↩ ↩ ↩
3.
Lents, Nathan H. Human Errors: A Panorama of Our Glitches, from Pointless Bones to Broken Genes. Houghton Mifflin Harcourt. 2018. Lents is a biology professor at John Jay College, City University of New York. Copyright. Print-disabled archive.org copy read with bin/iapdsearch.py; not stored. Body pages = leaf − 20 by the item's page map, confirmed by the index entries "choking, 19" and "lithopedion, 116"; introduction pages from its running heads (leaf 15 = xi). Mirror: Archive.org
1. 3a.
  Page 18: “Having totally separate anatomical structures for digestion and respiration would make much more sense in terms of hygiene, immune defense, and the general maintenance of these very different systems”. ↩
2. 3b.
  Page 19: “Nearly five thousand Americans choked to death in 2014, the majority of them choking on food. If we had separate openings for air and food, this would never happen.” ↩ ↩
3. 3c.
  Page 19: “Even though all mammals can get foreign bodies lodged in their tracheae, humans are particularly prone to choking because of some very recent evolutionary changes in our species’ neck anatomy.” ↩
4. 3d.
  Page 19: “In other apes, the larynx is substantially lower in the neck than ours.” Page 20: “Most scientists believe that the larynx has migrated high in the neck of the modern human to enhance vocalizations.” “it was one of a variety of vocalizations that were made possible by the gradual elevation of the voice box.” ↩ ↩
4.
A search of the print-disabled archive.org copies of Coyne's Why Evolution Is True (2009, whyevolutionistr00coyn) and Dawkins's The Greatest Show on Earth (2009, greatestshowonea00dawk) for "choke" and "choking" returned no matches on 27 September 2026. ↩
5.
German, Rebecca Z. et al. “The coordination and interaction between respiration and deglutition in young pigs.” Journal of Comparative Physiology A 182(4):539–547. 1998. Read from the PubMed abstract.
1. 5a.
  Section Abstract: “The anatomical pathways for inspired air and ingested food cross in the pharynx of mammals, implying that breathing and swallowing must be separated either in space or in time.” ↩ ↩ ↩ ↩
2. 5b.
  Section Abstract: “Despite the high morphological position of the larynx in young mammals, allowing liquid to pass in food channels lateral to the larynx, respiration and swallowing are not wholly independent events. Although, when suckling on a veterinary teat, the swallows occurred at various points in the respiratory cycle, there was always a period of apnea associated with the swallow.” “associated with passage of a solid bolus over the larynx”. ↩ ↩ ↩ ↩
6.
Koenig, John S. et al. “Coordination of breathing, sucking, and swallowing during bottle feedings in human infants.” Journal of Applied Physiology 69(5):1623–1629. 1990. Read from the PubMed abstract. Eight term and five preterm healthy infants.
1. 6a.
  Section Abstract: “Minute ventilation during bottle feedings was inversely related to swallow frequency, with elimination of ventilation as the swallowing frequency approached 1.4/s. Swallows were associated with a 600-ms period of decreased respiratory initiation and with a period of airway closure lasting 530 +/- 9.8 (SE) ms.” ↩ ↩ ↩
7.
Nishimura, Takeshi. “Developmental changes in the shape of the supralaryngeal vocal tract in chimpanzees.” American Journal of Physical Anthropology 126(2):193–204. 2005. Read from the PubMed abstract.
1. 7a.
  Section Abstract: “The hyoid bone and larynx in human neonates are positioned as high as in other mammals. However, during postnatal life, they descend relative to the hard palate more rapidly compared with the horizontal growth of the oral cavity.” ↩ ↩
8.
National Safety Council. “Deaths by Age and Cause – Data Details.” Injury Facts. 2026. 2024 data. The live site refused download; read from the Wayback copy. The age-by-age table is an embedded chart that could not be downloaded. Mirror: Archive.org
1. 8a.
  Section The six leading causes of death caused by unintentional injury in 2024: “Choking: 5,923 deaths”. “Average rate of 1.74 deaths per 100,000 population”. “Death rates due to choking on inhaled or ingested food or other objects were quite low for most ages”. “Rates rose rapidly beginning at about age 71”. The page numbers choking "#3" a second time; by count it is fourth, after poisoning, falls and motor-vehicle crashes. ↩ ↩ ↩ ↩ ↩
2. 8b.
  Section The six leading causes of death caused by unintentional injury in 2024: “Falls: 47,026 deaths”. “Drowning: 4,201 deaths”. “Average rate of 1.24 deaths per 100,000 population”. ↩ ↩
9.
The Associated Press. “More elderly Americans are choking to death. Are these devices the answer?” NBC News. Jul 14, 2025. News report citing "federal health statistics" without a table; used only for the age share. Copyright.
1. 9a.
  “Each year, choking claims the lives of more than 4,100 Americans who are 65 or older. It’s the most vulnerable age group, accounting for about three-quarters of U.S. choking deaths, according to federal health statistics.” ↩ ↩ ↩
10.
Wick, Roger et al. “Café coronary syndrome-fatal choking on food: an autopsy approach.” Journal of Clinical Forensic Medicine 13(3):135–138. 2006. Forensic Science SA, Adelaide, 1993–2002. Read from the PubMed abstract.
1. 10a.
  Section Abstract: “Forty-four cases were identified (M;F=21:23), with one infant (11 mths) and 43 adults (30-96 yrs; mean 68.9 yrs), with a preponderance of victims (57%) aged between 71 and 90 yrs. Deaths occurred in nursing homes (N=22) cases, at home (N=11) and in restaurants (N=4). Twenty-seven of the victims (61%) had histories of neurological or psychiatric disorders”. “Twenty-seven cases (61%) were described as either edentulous or having significant numbers of teeth missing. Toxicological evaluation of blood revealed alcohol and a variety of psychotropic prescription medications in 19 cases.” ↩ ↩ ↩ ↩
11.
Gupte, Tejas et al. “Mortality from Aspiration Pneumonia: Incidence, Trends, and Risk Factors.” Dysphagia 37(6):1493–1500. 2022. Read from the PubMed abstract.
1. 11a.
  Section Abstract: “Aspiration pneumonia was reported as the underlying cause of death in 334,712 deaths or an average of 17,616 deaths per year (30.1% of the total aspiration pneumonia-associated deaths). Individuals 75 years old or older accounted for 76.0% of aspiration pneumonia deaths”. ↩ ↩
12.
Lieberman, Philip. “Why Human Speech Is Special.” The Scientist. Jul 1, 2018. Copyright. Page saved to the source library; the article text sits in the page's structured data.
1. 12a.
  Section The evolution of the human vocal tract: “Because of this odd anatomy, which differs from that of all other mammals, choking on food remains the fourth leading cause of accidental death in the United States.” ↩
2. 12b.
  Section The evolution of the human vocal tract: “As infants suckle, they raise the larynx to form a sealed passage from the nose to the lungs, allowing them to breathe while liquid flows around the larynx. Most mammalian species retain this morphology throughout life, which explains why cats or dogs can lap up water while breathing.” ↩
3. 12c.
  “These quantal vowels produce frequency peaks analogous to saturated colors, are more distinct than other vowels, and are resistant to small errors in tongue placement.” “Thus, while not required for language, these vowel sounds buffer speech against misinterpretation.” A reference numeral, 5, follows "placement." in the original. ↩ ↩ ↩
13.
Fitch, W. Tecumseh, and David Reby. “The descended larynx is not uniquely human.” Proceedings of the Royal Society of London B 268:1669–1675. 2001. Read from the scanned PDF on PMC; pages from the PDF, one page per printed page (PDF page 1 = 1669). Mirror: PMC
1. 13a.
  Page 1669: “The resting position of the larynx in males of these species is similar to that in humans, and, during roaring, red-deer stags lower the larynx even further, to the sternum. These findings indicate that laryngeal descent is not uniquely human and has evolved at least twice in independent lineages.” ↩ ↩
2. 13b.
  Page 1673: “roaring cats (lions, tigers, etc., genus Panthera), which have long been known to possess an extremely elastic stylohyoid ligament, allowing the larynx to be retracted 20–23cm”. “In koalas (Phascolarctos cinereus) the resting position of the larynx appears from published figures to be near the sternum”. ↩
3. 13c.
  Page 1674: “First, the fact that laryngeal descent occurs in species that lack speech clearly indicates the existence of non-phonetic functions of a lowered larynx (whatever those functions might be).” ↩
4. 13d.
  Page 1674: “While this pubertal descent of the larynx does not increase the phonetic abilities of teenage boys, it does increase their vocal-tract lengths and lower their formant frequencies”. ↩
14.
Fitch, W. Tecumseh et al. “Monkey vocal tracts are speech-ready.” Science Advances 2(12):e1600723. 2016. CC BY-NC. Read from the PMC copy. Mirror: PMC
1. 14a.
  Section Introduction: “This hypothesis is widely accepted today, largely due to a seminal 1969 Science paper by Lieberman et al. (6), which used a computer program to explore the phonetic capability of a rhesus macaque and, by extension, other nonhuman primates.” ↩
2. 14b.
  Section Abstract: “We demonstrate that the macaque vocal tract could easily produce an adequate range of speech sounds to support spoken language, showing that previous techniques based on postmortem samples drastically underestimated primate vocal capabilities.” “Macaques have a speech-ready vocal tract but lack a speech-ready brain to control it.” ↩ ↩ ↩
15.
Boë, Louis-Jean et al. “Which way to the dawn of speech?: Reanalyzing half a century of debates and data in light of speech science.” Science Advances 5(12):eaaw3916. 2019. CC BY-NC. Read from the PMC copy; cited by section. Mirror: PMC
1. 15a.
  Section Abstract: “First, even among primates, laryngeal descent is not uniquely human. Second, laryngeal descent is not required to produce contrasting formant patterns in vocalizations. Third, living nonhuman primates produce vocalizations with contrasting formant patterns.” ↩ ↩
2. 15b.
  Section VT growth and acoustic normalization: “Notably, Kuhl and Meltzoff (137) show that infants at 20 weeks produce contrasting vowels when imitating adult /i a u/.” “These studies show that infants and children achieve contrasting, and even adult-like, productions starting well before developmental LD, even while their pharyngeal cavity is less than half its adult length.” ↩ ↩
16.
Lindeman, Roger C. “Diverting the paralyzed larynx: a reversible procedure for intractable aspiration.” The Laryngoscope 85(1):157–180. 1975. Read from the PubMed abstract.
1. 16a.
  Section Abstract: “In some patients, even the cuffed tracheostomy tubes of new and improved design do not adequately prevent aspiration over an extended time intervel, as evidenced by repeated bouts of aspiration pneumonia despite these cuffed tubes and despite optimal intensive care.” ↩ ↩
2. 16b.
  Section Abstract: “Such an anastomosis with concomitant tracheostomy allows aspiration of saliva and even food to occur through the malfunctioning larynx but diverts it back into the esophagus through the tracheo-esophageal anastomosis.” “Aspiration was totally and dependably controlled, and no further chest complications occurred.” ↩ ↩ ↩
17.
Hilgers, Frans J. M. et al. “Rehabilitation of olfaction after laryngectomy by means of a nasal airflow-inducing maneuver: the “polite yawning” technique.” Archives of Otolaryngology–Head & Neck Surgery 126(6):726–732. 2000. Read from the PubMed abstract.
1. 17a.
  Section Abstract: “Forty-four patients who underwent laryngectomy”. “Fifteen of the 33 patients in the pretreatment nonsmeller category converted to smellers, for a success rate of 46% (P<.001).” ↩ ↩ ↩ ↩
18.
Bonte, Katrien et al. “Secondary Voice Restoration After Laryngotracheal Separation (LTS) for Dysphagia with Intractable Aspiration.” Dysphagia 30(6):695–701. 2015. Read from the PubMed abstract.
1. 18a.
  Section Abstract: “The basic surgical principle is to separate the alimentary and respiratory tracts through a variety of procedures which, unfortunately, nearly all result in the loss of phonation, with the exception of total laryngectomy (TL) which includes the placement of an indwelling voice prosthesis.” “Placement of an indwelling voice prosthesis during a second operation was successful in 15 patients”. ↩ ↩ ↩ ↩ ↩
19.
Niinimaa, Veli et al. “The switching point from nasal to oronasal breathing.” Respiration Physiology 42(1):61–71. 1980. Read from the PubMed abstract, whose ventilation unit has lost its "l": the switching point is in litres per minute.
1. 19a.
  Section Abstract: “Twenty of the 30 subjects (normal augmenters) switched from nasal to oronasal breathing at submaximal exercise of 105.0 W (SD = 30.1), four subjects (mouth breathers) breathed habitually oronasally, five subjects (nose breathers) persistently breathed through the nose only”. “In normal augmenters, the onset of oronasal breathing (VE 35.3 +/- 10.81 . min-1) was quite consistent individually”. ↩ ↩
20.
The parent article, The Human Body Under Criticism, Part 2, applies the three questions of Arguments from Bad Design, Part 2: state the task and the cost, compare a feasible alternative, and price the trade-off. ↩
21.
Olshansky, S. Jay et al. “If Humans Were Built to Last.” Evolution: A Scientific American Reader, 347–354. University of Chicago Press. 2006. Reprints Scientific American 284(3):50–55, March 2001 (Crossref DOI 10.1038/scientificamerican0301-50); the 2001 magazine pages were not read. Copyright. Print-disabled archive.org copy read with bin/iapdsearch.py; not stored. Printed page = leaf − 10, anchored by running heads on leaves 358, 359, 362, 363 and 364. Mirror: Archive.org
1. 21a.
  Page 352: “Would help food and drink to bypass the windpipe more effectively. This design would need refining, though, because it would disrupt breathing through the mouth and the ability to speak”. Figure caption for the separated food and air passage. ↩
2. 21b.
  Page 354: “Suboptimal design of the upper respiratory and digestive systems makes choking another risk for older people. A simple rearrangement would have fixed that problem, albeit at the cost of severe trade-offs.” ↩ ↩
22.
Shubin, Neil. Your Inner Fish: A Journey into the 3.5-Billion-Year History of the Human Body. Pantheon Books. 2008. Copyright. Print-disabled archive.org copy read with bin/iapdsearch.py; not stored. Page 189 anchored by the running head "THE MEANING OF IT ALL 189" on leaf 203 and by the book's index entry "choking, 189". Mirror: Archive.org
1. 22a.
  Page 189: “Talking comes at a steep price: choking and sleep apnea are high on the list of problems we have to live with in order to be able to talk.” “Another trade-off of this design is choking. Our mouth leads both to the trachea, through which we breathe, and to our esophagus, so we use the same passage to swallow, breathe, and talk.” The OCR splits "esophagus" across a line break. ↩
23.
Dunn, Rob. “The Top Ten Daily Consequences of Having Evolved.” Smithsonian.com. Nov 19, 2010. Copyright. Page saved to the source library.
1. 23a.
  Section 5. Choking: “Together these changes leave falling food or water about a 50-50 chance of falling in the “wrong tube.” As a consequence, in those moments in which the epiglottis does not have time to cover the trachea, we choke.” ↩
24.
Matsuo, Koichiro, and Jeffrey B. Palmer. “Anatomy and physiology of feeding and swallowing: normal and abnormal.” Physical Medicine and Rehabilitation Clinics of North America 19(4):691–707. 2008. Read from the PMC author manuscript; cited by section. Mirror: PMC
1. 24a.
  Section Development of anatomy: “The epiglottis touches the back of the soft palate so that the larynx is open to the nasopharynx, but this airway is separated from the oral cavity by a soft tissue barrier (Fig. 2).” “The contact of the soft palate and epiglottis is lost, and the the pharynx becomes longer vertically. This change in human development contributes to the development of speech. However, the pharynx becomes part of both the food way and the airway (Fig. 2). This makes us vulnerable for aspiration.” ↩
2. 24b.
  Section Pharyngeal stage: “The vocal folds close to seal the glottis (space between the vocal folds) and the arytenoids tilt forward to contact the epiglottic base prior to opening of the UES.” “The hyoid bone and larynx are pulled upward and forward by contraction of the suprahyoid muscles and thyrohyoid muscle. This displacement tucks the larynx under the base of the tongue. The epiglottis tilts backward to seal the laryngeal vestibule.” ↩
3. 24c.
  Section Coordination among Eating, Swallowing and Breathing: “The respiratory pause continues for 0.5 to 1.5 s during swallowing, and respiration usually resumes with expiration.” ↩
4. 24d.
  Section Airway protection – penetration/aspiration: “Laryngeal penetration is sometimes observed in normal individuals. Aspiration of microscopic quantities also occurs in normal individuals.” ↩
25.
Laitman, Jeffrey T., and Joy S. Reidenberg. “Specializations of the human upper respiratory and upper digestive systems as seen through comparative and developmental anatomy.” Dysphagia 8(4):318–325. 1993. Read from the PubMed abstract.
1. 25a.
  Section Abstract: “Most mammals, such as our closest relatives the nonhuman primates, exhibit a larynx positioned high in the neck. This permits an intranarial larynx to be present and creates largely separate respiratory and digestive routes. While infant humans retain this basic mammalian pattern, developmental descent of the larynx considerably alters this configuration.” ↩
26.
Nishimura, Takeshi et al. “Descent of the larynx in chimpanzee infants.” Proceedings of the National Academy of Sciences 100(12):6930–6933. 2003. Read from the PubMed abstract. Mirror: PMC
1. 26a.
  Section Abstract: “The human larynx descends during infancy and the early juvenile periods, and this greatly contributes to the morphological foundations of speech development.” “We used magnetic resonance imaging to study the development of three living chimpanzees and found that their larynges also descend during infancy, as in human infants.” ↩
27.
National Safety Council. “Odds of Dying (2024 Data).” Injury Facts. 2026. The live site refused download; read from the Wayback copy. The table's source line reads "National Safety Council estimates based on data from National Center for Health Statistics—Mortality Data for 2024". Mirror: Archive.org
1. 27a.
  Tables Lifetime odds of death for selected causes, United States, 2024: “Choking on food 1 in 2,367”. “Drowning 1 in 1,025”. “Fall 1 in 89”. ↩ ↩
28.
Wu, Wen-Shan et al. “Associations between chronic diseases and choking deaths among older adults in the USA: a cross-sectional study using multiple cause mortality data from 2009 to 2013.” BMJ Open 5(11):e009464. 2015. CC BY-NC. Read from the PMC copy. Mirror: PMC
1. 28a.
  Table 1: “Overall choking (W78–W80) 16531”. “Inhalation and ingestion of food causing obstruction of respiratory tract (W79) 3113”. “Inhalation and ingestion of other objects causing obstruction of respiratory tract (W80) 12614”. Underlying-cause column, deaths at 65 and over, 2009–2013, from CDC WONDER. 16,531 over five years is about 3,300 a year. ↩ ↩
2. 28b.
  Section Discussion: “according to previous forensic studies,16–20 many of deaths been classified as ICD-10 code W80 were in actually involving food.” ↩
3. 28c.
  Section Abstract: “Schizophrenia, Parkinson's disease, Alzheimer's disease and oral cancer are four chronic diseases that had significant associations with both overall and food-related choking. Stroke, larynx cancer and mood (affective) disorders had significant associations with overall choking, but not with food-related choking.” ↩
4. 28d.
  Section Discussion: “Many sudden and unexpected deaths occurring during meals because of accidental occlusion of the airway by swallowed food might have been incorrectly attributed to acute myocardial infarction (ie, café coronary), resulting in the under-reporting of choking deaths.” ↩
29.
Our derivation, from one National Safety Council year. The council's lifetime odds are inversely proportional to the number of deaths. Drowning, 4,201 deaths, has lifetime odds of 1 in 1,025²⁷⁸, so all choking, 5,923 deaths⁸, gives 1,025 × 4,201 ÷ 5,923 ≈ 1 in 727. The same scaling puts the food-coded deaths behind "1 in 2,367" at about 1,800 a year. ↩
30.
Bergman, Jerry. “Is the human pharynx poorly designed?” Journal of Creation 22(1):41–43. Apr 2008. Read from the creation.com web version of 15 April 2009, which has no page numbers. Copyright.
1. 30a.
  “The pharynx serves as a single passage for three systems—the respiratory, digestive and communicative—for many very good reasons. A major one is, unlike other primates, our airway and esophagus intersect. This can cause choking, but allows speech.” ↩
2. 30b.
  “In the vast majority of cases problems only arise with a misuse or degeneration in the system. This cannot be used as evidence of bad design because good original design takes into account neither unwise usage of the design nor subsequent degeneration of the system. Rather, this is expected within the biblical model, as the Fall has produced degeneration and was caused by (and produced more) unwise choices!” ↩
3. 30c.
  “The only way to scientifically prove a system is better is to do a scientific comparison of two groups, one group that uses each system. This experiment will never be done as it would require major surgery and likely would create serious health problems.” ↩
4. 30d.
  “Darwinists who criticize the existing system have not proposed the details or any evidence of a functional better design.” ↩
5. 30e.
  “Humans swallow about 1,000 times a day or 27,375,000 times in an average lifespan.” No source is given for the figure. ↩ ↩
6. 30f.
  “The pharynx structure permits the mouth and nose to alternate as breathing ports—a feature that is critical whenever the nose is plugged, as when suffering from a cold, or the mouth is blocked, such as when it contains food.” ↩
7. 30g.
  “The mucus is moved up out of the lungs by cilia and is then swallowed.” ↩
31.
Our arithmetic, for scale only. The council's 5,923 deaths at 1.74 per 100,000 imply a population of about 340 million.⁸ At Bergman's 1,000 swallows a day³⁰, that is 340 million × 1,000 × 365 ≈ 1.24 × 10¹⁴ swallows a year, or one death per 2.1 × 10¹⁰ swallows. The swallow rate is Bergman's and unsourced; halving it doubles the risk per swallow. ↩
32.
Kramarow, Ellen et al. “Food-related choking deaths among the elderly.” Injury Prevention 20(3):200–203. 2014. The authors are at the National Center for Health Statistics. Read from the PubMed abstract; the full text was behind a publisher wall.
1. 32a.
  Section Abstract: “During 2007-2010 in the USA, 2214 deaths among people aged ≥65 were attributed to choking on food. The death rate for this cause is higher among the elderly than among any other age group.” “three causes-dementia (including Alzheimer's disease), Parkinson's disease and pneumonitis-are most strongly associated with deaths from choking on food among older people.” ↩
33.
Berzlanovich, Andrea M. et al. “Foreign body asphyxia: a preventable cause of death in the elderly.” American Journal of Preventive Medicine 28(1):65–69. 2005. Institute of Forensic Medicine, Vienna, 1984–2001. Read from the PubMed abstract.
1. 33a.
  Section Abstract: “In the study period, 273 adults died of food/foreign body asphyxia, 73% of them out of the hospital and 27% in hospitals.” “In contrast, younger individuals choked significantly more often on large pieces of foreign material (p <0.002) and showed a significantly higher rate of blood alcohol concentration (p <0.001).” ↩ ↩
34.
Turner, C. M. et al. “Trends in Choking-Related Deaths After Introduction of the Heimlich Maneuver.” The Laryngoscope. 2026. Read from the PubMed abstract.
1. 34a.
  Section Abstract: “Among individuals aged 15-64, choking mortality increased from 1970 to 1975 (APC +2.45%) then declined significantly from 1975 to 1985 (APC -5.15%) and continued to decrease through 2021.” “Among adults ≥ 65 years, no sustained mortality reduction was observed”. ↩
35.
National Safety Council. “Choking.” National Safety Council. 2026. Read from the Wayback copy. Mirror: Archive.org
1. 35a.
  “Choking is one of the leading causes of unintentional death for infants, who require a different rescue procedure than adults.” ↩ ↩
36.
Fitch, W. Tecumseh et al. “Response to Lieberman on “Monkey vocal tracts are speech-ready”.” Science Advances 3(7):e1701859. 2017. CC BY-NC. Read from the PMC copy. Mirror: PMC
1. 36a.
  “First, contra Lieberman, we did not show that “the monkey vocal tract cannot produce” these vowels—only that we never observed monkeys doing so.” “Second, we are skeptical that [i] (or any other vowel) plays a necessary role in spoken language.” ↩
37.
Reidenberg, Joy S., and Jeffrey T. Laitman. “Position of the larynx in Odontoceti (toothed whales).” The Anatomical Record 218(1):98–106. 1987. Read from the PubMed abstract. Seventeen specimens of nine genera.
1. 37a.
  Section Abstract: “Whereas the larynx of most terrestrial mammals is separable from the nasopharynx, that of the odontocetes studied may be permanently intranarial, held in place by the palatopharyngeal sphincter. Laryngeal position may affect their vocal abilities, allowing odontocetes to simultaneously swallow and echolocate.” ↩ ↩
38.
Holcombe, Susan J. et al. “Electromyographic activity of the palatinus and palatopharyngeus muscles in exercising horses.” Equine Veterinary Journal 39(5):451–455. 2007. Read from the PubMed abstract.
1. 38a.
  Section Abstract: “dysfunction of these muscles has been implicated in the pathogenesis of dorsal displacement of the soft palate.” “The predominant expiratory activity of these muscles may be associated with specific muscle function related to exercise or distinct upper airway phenomena of an obligate nasal breather, such as the horse.” ↩
39.
Batten, Don, and Tas Walker. “Is the human body badly designed?” Creation Ministries International. Aug 31, 2018. Updated 22 September 2025. Copyright.
1. 39a.
  “Well, yes of course; if our larynx was lower in our neck we might be less prone to choke, but we could not talk; now that would be a good idea, eh? The constraint of being designed to talk limits what is possible.” ↩
2. 39b.
  “Degeneration with old age is not a design fault (prostate problems in some men are a case in question). Nothing lasts forever. Nor is malfunction due to disease (e.g., sinus problems). None of these bad things were part of the original design but are a consequence of the Fall of man.” ↩
40.
Ham, Ken. “Is the Human Body a Bad Design?” Answers in Genesis. Jun 4, 2020. A Ken Ham blog post that quotes the anatomist David Menton at length, answering the Norwegian biologist Glenn-Peter Sætre. The quotations cited here are Menton's. Copyright.
1. 40a.
  Section Humans are so poorly constructed, it is even dangerous to eat!: “Fortunately for the evolutionists, this is a problem easily solved by a rather simple surgery called a tracheotomy.” “But discuss this with your surgeon before you undergo this surgical “improvement” because you will be unable to talk after this procedure.” ↩
41.
Evolution News. “Oral Cavity’s Supposedly “Lousy” Design Is a Key to Human Speech.” Evolution News. Jul 5, 2018. Published by the Discovery Institute under the byline "Science & Culture"; the site now calls itself Science and Culture Today. Copyright.
1. 41a.
  “The design does come with an increased chance of choking, but it’s also something that allows us to speak as we do.” “That having been said, the design of the human oral cavity looks more like a trade-off than a botch.” ↩
2. 41b.
  “But to put things in perspective, according to the National Safety Council, “5,051 people…died from choking in 2015,” which works out to 0.0018 percent of all deaths in the United States, and of those “2,848 were older than 74.”” ↩ ↩
42.
Xu, Jiaquan et al. “Mortality in the United States, 2015.” NCHS Data Brief (267). Dec 2016. Public domain. The CDC site refused download; read from the Wayback copy. Mirror: Archive.org
1. 42a.
  Section Summary: “In 2015, a total of 2,712,630 resident deaths were registered in the United States—86,212 more deaths than in 2014.” PDF page 5. ↩ ↩
43.
5,051 ÷ 2,712,630 = 0.00186, which is 0.19 percent, or about 1 in 537.⁴²⁴¹ ↩
44.
Thomas, Brian. “A Vocal Vestigial Organ?” Institute for Creation Research. Jul 25, 2008. Creation Science Update. Copyright.
1. 44a.
  “In humans they are well integrated into the larynx which, in contrast to apes, is uniquely suited for varied and subtle speech capacities.” “Likewise, the human voice apparatus, which alone contains the biological machinery necessary for human speech, represents a generous gift from God.” ↩
45.
Guliuzza, Randy J. “Major Evolutionary Blunders: The 'Poor Design' of Our Recurrent Laryngeal Nerve.” Acts & Facts 45(4). Mar 31, 2016. Institute for Creation Research. Guliuzza is a registered professional engineer and a physician. Copyright.
1. 45a.
  “There is absolutely no need from the outset to ever concede that anything on creatures is poorly designed. In reality, creatures in their prime normally exhibit breathtaking fit and finish.” ↩