628 
A CASE OF TRAUMATIC EMPHYSEMA, 
PRODUCED BY FRACTURE OF A RIB, WITH LACERATION 
OF THE PLEURA AND LUNG. — FATAL TERMINATION. 
By Mr. VV. F. Karkeek, F.6., Truro. 
On the 13th of September, a grey mare, the property of 
William Daubuz, Esq., master of the F. B. Hunt, ridden by the 
whipper-in, in leaping a hedge, fell, and a piece of stick entered 
her chest, between the third and fourth rib, fracturing the third. 
The animal was immediately walked carefully home, the distance 
being between five and six miles. By the time she reached the 
stable, the whole cellular tissue of the surface of the body was 
infiltrated with air. It pervaded every part to an enormous and 
frightful extent, even to the eyelids, scrotum, and legs. The 
respiration was not much accelerated, nor did the animal appear 
to suffer much pain. She was immediately bled, until faintness 
was produced — a mild aperient given — the wound dressed, and a 
bandage applied. On the following day the pulse was consider- 
ably increased. Bleeding was again had recourse to, and some 
fever medicine given in the course of the day. Openings, also, 
were made with a lancet in different parts of the body, by which 
means the air was easily expelled, and with such force, that, at 
one time, a lighted candle that was held close to the orifice was 
nearly extinguished. This operation appeared to give the mare 
great relief; but still the pulse was quick and hard, and on the 
third day after the injury she was again bled. From this period 
the mare appeared to be gradually getting better. The emphysema 
was nearly gone, her appetite had partly returned, the pulse was 
ranging between 60 and 70, and the external wound had assumed 
a very healthy appearance. She continued in this state until 
the 20th instant, when a discharge of foetid bloody matter was 
seen to issue from the nostrils. The. discharge continued to in- 
crease, and on the 23d instant she died from suffocation, an im- 
mense quantity having burst out as it were instantaneously. 
In this case death was produced in consequence of the organic 
lesions in the lungs, the presence of air in the cellular structure 
being of secondary importance ; and I have been induced to 
place the case on record, to shew how easily emphysema can be 
relieved. On examination after death, the very rapid infiltration 
of air was partly accounted for. The mare must have suffered 
from some previous inflammatory attack of the lungs, as there 
was an adhesion, where the injury was sustained, between the 
surfaces of the pleura — thus establishing a continuity of tissue 
