366 Pulmonic Interstitial Emphysema 



that he has given a more detailed account of the technique in another place,"^ 

 and further that "This route was devised for the purpose of inducing an arti- 

 ficial anterior pneumomediastinum, which permits in selected cases a more 

 precise diagnosis of conditions arising in this region and of pericardial and 

 pcricardio-sternal adhesions. It is evident that when air under tension is col- 

 lected in the anterior mediastinimi it should be easy to relieve the pressure 

 through this route, as there is no difficulty in penetrating into this region in 

 the normal individual." 



Much has been written on the entry of air into the mediastinum and pleural 

 cavity from wounds of the neck and chest. One of the most recent of these 

 discussions is that of Neffson"" who analyzed a series of cases of tension pneumo- 

 thorax and mediastinal emphysema occurring after tracheotomy. He admits, 

 however, that the mediastinal emphysema may arise in some of these cases from 

 a PIE originating as described in this paper, from rupture of alveoli into the 

 pulmonary interstitial tissue. 



REFERENCES 



1. Macklin, C. C: in Problems of Ageing, ed. by E. V. Cowchy (2d ed.; Baltimore: 1942), ch. 9. 



2. Barrie, H. J.: Lancet 238:996, 1940. 



3. Gumbiner, B., and Cutler, M. M.: Amei. Jl. Diseases Childr. 61:650, 1941; also Jl. Amer. 



Med. Assn. 117:2050, 1941. 



4. Hamman, L.: Tins. Assn. Amer. Physns. 52:311, 1937. 



5. Hamman, L.: Bull. Johns Hopkins Hosp. 64: 1, 1939. 



6. McGuire, J., and Bean, W. B.: Amer. Jl. Med. Scis. 197:502, 1939. 



7. Smith, A. B., and Bo\vser, J. F.: Radiology 38:314, 1942. 



8. Styron, C. W.: New England Med. Jl. 225:908, 1941. 

 g. Wolff , B. P.: .\nn. Internal Med. 13:1250, 1940. 



10. Ehrlich, D. E., and Schomer, A.: Radiology 30:471, 1938. 



1 1. Macklin, C. C: Brit. Med. Jl. 11:994, 1937. 



12. Berkley, H. K., and Coffen, T. H.: Jl. Amer. Med. -Assn. 72:535, 1919. 



13. Lister, W. A.: Lancet 214:1225, 1928. 



14. Macklin, C. C: Anat. Recrd. 24:119, 1922. 



15. Macklin, C. C: Amer. Jl. Anat. 35:303, 1925. 



16. Macklin, C. C: Med. Recrd. 143:89, 1936. 



17. Macklin, C. C, and Andrus, P. M.: Anat. Recrd. 45:231, 1930. 



18. Macklin, C. C: Physiol. Revs. 9:1, 1929. 



19. Macklin, C. C: Archs. Surg. 19:1212, 1929. 



20. Macklin, C. C: Amer. Rev. Tuberc. 25:393, 1932. 



21. Macklin, C. C: Tubercle 14:16,69, 1932. 



22. Macklin, C. C: Archs. Internal Med. 64:913, 1939. 



23. Macklin, C. C: Med. Recrd. 150:5, 1939. 



24. Macklin, C. C: Jl. Michigan State Med. Soc. 39:756, 1940. 



25. Macklin, C. C: Proc. & Trns. Roy. Soc. Canada (s.3:sect.V) 34:69, 1940. 



26. Bourne, G.: Brit. Med. Jl. 11:313, 1940. 



27. Scott, A. M.: Lancet 232: 1327, 1937. 



28. Jessup, P. M.: Archs. Surg. 23:760, 1931. 



29. Macklin, C. C: Canad. Med. Assn. Jl. 36:414, 1937. 



30. Ballon, H. C, and Francis, B. P.: Archs. Surg. 19:1627, 1929. 



31. Fisher, J. H., and Macklin, C. C: Amer. Jl. Diseases Childr. 60: 102, 1940. 



