RUPTURE OF THE DIAPHRAGM. 193 



its left curvature, and the diaphragm lacerated through the 

 fleshy part of its right side. The diaphragmatic lesion had 

 given vent to no hemorrhage, nor were the lacerated edges 

 at all tumid. The divided fibres vrere irregular, collected 

 into unequal parcels, and their colour the same as that of 

 the other parts, 



I leave these cases to the consideration of my reader and 

 the test of future observation. Whether they be or be not 

 proofs sufficient of the fact they are intended to demon- 

 strate, they have at least this value : they will serve to 

 caution us against hasty and inconsiderate decisions on 

 occasions when we meet with rupture of the diaphragm in 

 the dead body, and are not altogether satisfied about the 

 symptoms during life having been such as to indicate it. 



The DEDUCTIONS to be drawn from the foregoing and 

 other analogous cases, are, that rupture of the diaphragm is 

 by no means unlikely to follow acts of extraordinary ex- 

 ertion, efi*orts of any kind, and particularly upon a full 

 stomach, or rather when the bowels are distended with green 

 or other food likely to generate gas. A fast gallop, strain- 

 ing draught, a heavy fall or blow upon the side, violent fits 

 of coughing, even the throes of parturition, have all proved 

 the occasion of it. The diaphragm, being in itself the 

 ordinary and principal respiratory agent, any act said to 

 " break the wind" of a horse, seems quite as likely to pro- 

 duce laceration of it as rupture of the air-cells ; a circum- 

 stance which, connected with the resemblance in the 

 symptoms of the two lesions, will very well account for such 

 cases of broken-wind as are said to consist in ruptured 

 diaphragm ; though, in truth, they are not broken-wind : 

 at least not the disease which in our pathology answers to 

 that name. While the whole body is in action or con- 

 vulsed, the diaphragm, as D'Arboval has pertinently ob- 

 served, becomes the point d^appui of the muscular system, in 

 which state of contractile resistance, its fibres must especially 

 be liable to be rent. Coupled with these causes of rupture, 

 we must not forget what has been known to happen — and 

 what may often happen in such cases — after death, when, 



II. 13 



