60 
THOUGHTS ON BROKEN WIND. 
air having got outside its proper contractile conduit, cannot 
readily return, but remains there : this happens, perhaps, in many 
places, until a considerable portion of lung may be in this state ; 
and as the portions so affected have lost their natural condition 
of compressibility and capability of oxygenizing the blood, and 
withal are more porous and voluminous, the sounder parts are 
called on to do more than in health ; and, the diseased portions 
having caused the lungs to be considerably increased in volume, 
the natural means to affect the act of expiration fails in accom¬ 
plishing it, and, of necessity, the abdominal muscles are brought 
in as powerful auxiliaries. This is the view I take of it, so that 
I consider emphysema, when it exists, to be an effect of the 
original disease, and to become a cause, secondarily, of the diffi¬ 
culty of expiration. After all the symptoms of broken wind 
are fully established, the same cause would still be in operation, 
viz. the cough, to break down the air-cells, in addition to the 
powerful efforts of the abdominal muscles, which, although of 
necessity called into play in expiration, yet seem also to be 
affected spasmodically. An exactly similar action takes place 
with respect to cough producing emphysema in the lungs of 
children, as in whooping cough; and sometimes, in people who 
play much upon wind instruments, a similar appearance is 
manifested. 
Another way in which broken wind has been attempted to be 
accounted for is due to our worthy Professor Sewell. He con¬ 
siders that an atrophied condition of the transverse muscle of the 
trachea, and the enveloping and lining membranes of the 
bronchi, has ensued, either as an effect of chronic bronchitis or 
the product of some peculiar sympathetic diseased action, 
arising probably out of an affection of the stomach ; and as these 
tubes, which were mainly instrumental in expiration, have lost 
their natural contractile power, the abdominal muscles were natu- 
ally called into play to assist the expiratory effort, thus pro¬ 
ducing the appearance called broken wind; and that, therefore, 
we might or might not have emphysema as an effect. The 
probability would be, that, in the weakened state of the walls of 
the air-cells, such an effect would take place : at the same time, 
broken wind might exist without it. In support of this, we 
know that in broken wind the lungs are usually paler and spe¬ 
cifically lighter than in health, and that the lining membrane 
of the trachea and of the bronchi is likewise extremely pale. 
The theory deserves our careful consideration, as coming from 
so high a quarter, and as appearing to carry much weight with 
it: to say the least of it, it is possible it may be not an infre¬ 
quent mode in which broken wind is produced. 
Since writing the last remarks, a number of the London 
