E 2 44 1 
his ftomach, he was feized with violent and long con- 
tinued vomitings. Thefe, though at length they were 
quieted, left his cheft very fore. From this time his 
cough became troublelome, as did remarkably his 
fhortnefs of breath upon the leafl motion, attended 
with the feveral circumflances above defcribed. 
From confidering the hiftory of this difeafe, and 
comparing it with the appearance of the lungs after 
death, I cannot but be of opinion, that the violent 
efforts to vomit occafioned primarily both the em- 
phyfema, and the varices of the pulmonary vein. 
This opinion, I flatter myfelf, will not, to perfons 
well vei led in the animal (Economy, feem ill founded, 
when they reflect how forcibly the lungs are prefled 
in violent efforts to vomit, both by the mulcles fub- 
fervient to refpiration and the abdominal mufcles, 
as well as by the contents of the abdomen itfelf. 
And it is wonderful, when the texture of the lungs 
is confidercd, that accidents of this kind do not much 
oftener happen, not only in vehement Teachings to 
vomit, but in violent coughs, pains of childbirth, 
lifting great weights, and other preternatural exertions 
of flrength. 
When once the extremities of the bronchia 
and the veficular fubftance have given way, the 
mifehiefs are eafily forefeen. The air getting loofe 
into the fubflance of the lungs cannot be parted 
with in exfpiration ; it confequently is retained there, 
and the fpace it occupies prevents as much of the 
' external air being received into the lungs as its own 
quantity. As, from their inceflant motion, injuries 
to the lungs are not eafily removed, when once a 
rupture is made, every fit of coughing or other vio- 
lent exertion extravafates more air. Hence the rup- 
ture 
