170 DISEASES OF THE LUNGS. 



again, when only one side is affected, there is another 

 source of error : we may mistake the sound side, as being 

 less sonorous, for the diseased one; but this is soon 

 rectified by auscultation. 



" There is a constant cough returning in fits, usually dry, 

 or accompanied by a viscid, transparent expectoration. When 

 the emphysema is of long standing and extensive, the inter- 

 costal spaces become expanded, and the thorax is rendered 

 prominent, and rounded on one or both sides, according as 

 the affection is single or double. 



" In all the points occupied by the emphysema the 

 murmur of respiration is very weak, or altogether sup- 

 pressed. During full inspirations, and sometimes during 

 expiration, we have a ' rale sibilant,^ resembling the sound 

 of a small valve, or a ' rale sonore,' imitating the cooing of 

 a dove. The contrast between this marked resonance of 

 the thorax, and the feebleness or total abstinence of the 

 respiratory murmur, constitutes the distinctive character of 

 this disease.^^ 



Surely, these remarks are not only applicable, but cannot 

 fail to prove of very great service to us in our examinations 

 of cases of broken-wind, supposed to consist in emphy- 

 sematous lungs. 



Are there other proximate causes of broken-wind? 

 We are hardly advanced enough in our inquiry to answer 

 this question. French authorities give us nervous influence, 

 pulmonary inflammations, lesions of the heart, and lesions of 

 the diaphragm. 



Professor Sewell was of opinion that broken-wind con- 

 sisted in structural or functional derangement, and conse- 

 quent loss of power, of the muscular fibres traversing the 

 trachea and encircling the bronchial tubes, in some portion 

 or the whole of their course. 



Professor Dick, in company with Mr. Hallen, V.S. 

 6th Dragoons, examined a mare after death who had for 

 years been affected with broken- wind, and could discover no 

 apparent lesion which could by possibility bear on the com- 

 plaint. Was this nervous broken-wind? 



