194 DISEASES OF THE LUNGS. 



from post-mortem gaseous emissions, the bowels become dis- 

 tended and forced against the diaphragm and abdominal 

 parietes to a degree to threaten bursting. I have seen the 

 recti muscles split and torn in this manner, as well as the 

 fasciculi of the diaphragm; and therefore, I repeat, it 

 requires, in this tympanitic state of the dead body, extreme 

 caution in pronouncing upon such lesions. 



Symptoms. — Cases have occurred in which nothing has 

 appeared to indicate disorder, and yet after death the 

 diaphragm has b6en discovered, ruptured. Other cases have 

 manifested such extraordinary agitation in the breathing 

 that the disease has appeared at once distinguished from all 

 others. This incongruity, probably, is to be accounted for 

 by the nature, direction, and extent of the lesion in the 

 muscle. On occasions, the disorder has so resembled broken- 

 wind that very good veterinarians have mistaken it for that 

 disease : hence one reason for the discrepancy of opinion 

 concerning the pathology of the latter. The respiration and 

 cough must furnish us with the main clue to the lesion: and 

 should symptoms of colic be present as well, we may suspect 

 that some abdominal viscus — intestine or omentum, or even 

 liver — has got into the rent in the diaphragm. Should 

 it become strangulated there, it will probably give rise to 

 symptoms such as indicate strangulated hernia elsewhere. 



The LESION, or rupture in the diaphragm, may occur 

 either in its fleshy or its tendinous portion : the former 

 appears to have been the most frequent seat of it, and in 

 particular in the vicinity of the ensiform cartilage. In one 

 case the muscle was split quite across. Tumefaction, red- 

 dening, infiltration of the lacerated edges, indicate that the 

 lesion is a recent one; absence of these signs, together with 

 smoothness and roundness of them, show that it is of some 

 standing. Jagged, bloody, unchanged edges, with con- 

 siderable distension of the abdominal viscera and parietes, 

 and this latter having taken place in the interval between 

 death and examination, will render it probable that the 

 rupture has happened post-mortem. 



The relation to broken- wind which this lesion bears. 



