TRAUMATIC EMPHYSEMA. 169 
(Godbille). In tympanitis, if one punctures the caecum in horses or | 
the rumen in cattle, as also in accidental wounds of those cavities, gases, 
which they contain, penetrate sometimes into the subcutaneous con- 
nective tissue and produce a more or less extensive emphysema. 
Subcutaneous emphysema may exist without a wound of the skin or 
of the superior respiratory organs. In’cattle, it quite frequently coexists 
with pulmonary emphysema, sometimes with echinococcosis or other 
pulmonary lesions. Then, generally, it begins at the superior part on 
the neck ; ordinarily, not very apparent at the outset, palpation is 
necessary to detect it. Then it spreads towards the posterior regions, 
following the dorso-lumbar line. 
Sometimes subcutaneous emphysema shows itself upon animals 
which are not affected with pulmonary lesions and in which the skin is 
free from the perforation of cestri. This form is ordinarily observed 
upon animals which have made a long journey on foot. Cattle dealers 
say that over-walking, fatigue, and blows are the cause of it. The 
gaseous infiltration starts almost always at the loins, extending after- 
wards to the back and the withers. Lafosse admitted that under the 
influence of a trouble in the cutaneous respiration, these gases (oxygen, 
carbonic acid, nitrogen) were ‘‘ thrown into the cellular tissue by the 
capillaries.” Bouley had to make a fissure in the rectum with a punc- 
turing foreign body to produce it. A gaseous elaboration of microbian 
origin has also been cited as cause. 
The slight gravity of traumatic subcutaneous emphysema is recognized 
by numerous observations. The action of the air upon the cellular 
tissue is almost without danger, and that of gases issuing from intestinal 
sources is not to be feared, unless they carry with them, in the con- 
nective tissue surrounding the wound, a certain quantity of liquid mat- 
ter noxious on account of the microbes it contains. 
The treatment is the very simplest. Traumatic emphysema due to 
atmospheric air should be treated by methodic pressures made upon the 
tumefaction, from the periphery towards the wound, to expel the air 
which has penetrated the tissues. If the cutaneous wound is small, it 
should be obliterated with a plaster of collodion. Large wounds of the 
axilla and of the groin should be partially closed with a suture and the 
patient should be kept at rest. With large penetrating wounds of the 
trachea, when the air reaches the connective tissue through the wound 
of the mucous membrane it is necessary to enlarge the cutaneous solu- 
tion of continuity, whose small size is, ordinarily, the cause of the 
emphysema. In these first varieties of the affection, no puncture or 
scarification of the crepitating zone is to be made. When emphysema 
is produced by gases from intestinal cavities, the cutaneous wound must 
be enlarged, methodic pressures must be made on the swelling, and if 
the inflammation of the peritraumatic zone indicates the presence, in 
