14d PHILOSOPHICAL TKANSACTIONS. [aBTNO I764. 



little room was left for fresh air in inspiration; the lungs, from the emphysema, 

 and from the diseased state of the pulmonary vein, filling almost the whole cavity 

 of the thorax. This not only occasioned an enormous defect in the quantity of 

 air in inspiration necessary to the purposes of life, but, by the preternatural com- 

 pression, the motion of the blood was retarded in the lungs, more especially in 

 their smaller vessels. This affected not only the serous extravasation in the cyst 

 before-mentioned, but occasioned those general obstructions in the blood vessels 

 of the lungs which brought on the sphacelated appearance; and finally, by the 

 increase of the complaint, was the cause of death. This extraordinary disten- 

 sion of the lungs also accounted for the heart being of a more compressed figure 

 than is usually seen. 



In the present instance, an asthma was occasioned by 2 causes, either of which 

 has hitherto been scarcely considered as conducing to it; the one an emphysema, 

 and the other a varicose affection of the pulmonary vein. Had the causes of 

 this disease been as perfectly known during the life of the patient, as since his 

 death the case would not have admitted of a cure; as there was no method of 

 discharging the extravasated air from the lungs, neither could any medical pro- 

 cess alter or amend the varicose state of the pulmonary vein. 



Such a state of lungs, as that just now described, in an otherwise healthy 

 young man, could not, Dr. W. was persuaded, happen but from some very 

 powerful cause; and, on inquiry, he was informed, that about the beginning of 

 October, not 2 months before his death, from something which had greatly of- 

 fended his stomach, he was seized with violent and long continued vomitings. 

 These, though at length they were quieted, left his chest very sore. From this 

 time his cough became troublesome, as did remarkably his shortness of breath 

 on the least motion, attended with the several circumstances above described. 

 From considering the history of this disease, and comparing it with the appear- 

 ance of the lungs after death, he could not but be of opinion, that the violent 

 efforts to vomit occasioned primarily both the emphysema, and the varices of the 

 pulmonary vein. This opinion, he flattered himself, would not, to persons well 

 versed in the animal economy, seem ill founded, when they reflected how for- 

 cibly the lungs are pressed in violent efforts to vomit, both by the muscles sub- 

 servient to respiration and the abdominal muscles, as well as by the contents of 

 the abdomen itself. And it is wonderful, when the texture of the lungs is con- 

 sidered, that accidents of this kind do not much oftener happen, not only in 

 vehement retchings to vomit, but in violent coughs, pains of childbirth, lifting 

 great weights, and other preternatural exertions of strength. 



When once the extremities of the bronchia and the vesicular substance have 

 given way, the mischiefs are easily foreseen. The air getting loose into the sub- 

 stance of the lungs cannot be parted with in expiration; it consequently is re- 



