In 1820 the first edition of the Manual of Briand and Brosson was published.
A murderer from behind, or from that side the hand of which the victim would use, may inflict a wound in the same situation and direction as a suicidal one.
If the asphyxia is interrupted before this stage, the spots do not appear.
The emphysemais sometimes observed shortly before death, but it attains its maximum development after death, when it may spread rapidly over the greater part of the body.
Emphysema of the subcutaneous, subperitoneal, and other loose areolar tissue of the body is a rare but remarkable result of the perforation of gastric ulcer.
In the case which he has reported in full interstitial and subserous emphysema could be traced from the ulcer ("Luft im Blute," Deutsches Arch.
Perforation into the trachea is indicated by expectoration of food or drink; perforation into the great vessels, by haematemesis, usually fatal; and perforation into the mediastinum, by emphysema and purulent cellulitis.
Hydrothorax, sero-fibrinous pleurisy, and emphysema may develop either with or without cancerous invasion of the pleura.
Demarquay (Essai de Pneumatologie medicale, Paris, 1866) deserve the credit of first calling general attention to the occurrence of subcutaneous emphysema after rupture of the digestive tract.
Persons suffering from valvular diseases of the heart, emphysema of the lungs, or cirrhosis of the liver are strongly predisposed to diseases of the stomach.
Perforation is indicated by sudden collapse and by emphysema from swallowed air.
Subcutaneous emphysemamay precede the formation of the fistula.
The following writers have each reported a case of emphysema following the perforation of gastric ulcers: Cruveilhier, Anat.
The skin is sometimes divided, but more frequently the pleura and lungs are torn by the spiculæ projecting internally; hence effusion into the chest, and emphysemaof the subcutaneous cellular tissue near the fracture, take place.
When there is no wound of the integument, emphysema of the forehead and eyebrows has resulted from disruption of the bones that compose this cavity, or others connected with the nostrils.
Emphysema is apt to occur in consequence, and may prove troublesome; the cellular tissue of the neck becomes filled, so as to interfere with free respiration, and the infiltration of air extends over the face and chest.
If the emphysema is slight, and confined to the neighbourhood of the injured part, farther extrication is prevented by the timely and accurate application of a bandage; the air already in the cellular tissue speedily disappears.
Complications may arise, the strength may fail, the secretions may become too abundant, and asphyxia may ensue; emphysema may show itself, or catarrhal pneumonia may gradually supervene.
There may be, as in emphysema of the lung, a diminished respiratory and vascular surface, yet evidences of fatty infiltration, particularly of the liver, are wanting.
There were no external signs of the injury with the exception of the emphysema following rupture of the lung.
By this time the emphysemahad extended to the scrotum.
The man continued to improve rapidly, the emphysema disappeared on the seventh day, and eighteen days after the reception of the wound he was discharged.
In interstitial emphysema the air is infiltrated into the connective tissue beneath the pleura and between the pulmonary air-cells.
Another view, known as the nutritive theory, maintains thatemphysema depends essentially on a primary nutritive change in the walls of the air-vesicles.
The main element in the treatment of emphysema consists in attention to the general condition of the health, and in the avoidance of all causes likely to aggravate the disease or induce its complications.
Surgical emphysema signifies the effusion of air into the general connective tissues of the body.
The chief symptom in this complaint is shortness of breath, more or less constant but greatly aggravated by exertion, and by attacks of bronchitis, to which persons suffering from emphysema appear to be specially liable.
Whooping-cough is well known as the exciting cause of emphysema in many persons.
Of pulmonary emphysema there are two forms, true vesicular and interstitial (or interlobular).
Peanut kernels and watermelon seeds and, rarely, other foreign bodies in the bronchi produce obstructive emphysema of the invaded side.
Emphysema unaccompanied by pyogenic processes usually requires no treatment, though an occasional case may require punctures of the skin to liberate the air.
Rupture of the cervical esophagus is usually followed by cervical emphysema and cervical abscess, both of which often burrow into the mediastinum along the fascial layers of the neck.
On the free side a compensatoryemphysema is present.
Gaseous emphysemais present in some cases, and denotes a dangerous infection.
Compression stenosis of the trachea associated with pulmonary emphysema accounts for the dyspnea during attacks of coughing.
It is very important to note that, as discovered by Manges, the differential emphysema occurs at the end of expiration and the plate must be exposed at that time, before inspiration starts.
Emphysema of the scalp sometimes results when the fracture passes through the mastoid cells.
If the mucous membrane of the air-passage or the apex of the lung and its investing pleura is torn, emphysema of the connective tissue may develop and spread widely over the body.
Subcutaneous emphysema is not a common symptom; when it occurs, it is usually due to the patient forcing air into the connective tissue while blowing his nose.
When the medial wall is fractured and the nasal fossa opened into, epistaxis and emphysema of the orbit are constant symptoms.
When the nasal fossæ or the air sinuses are opened into, the patient should be warned against blowing his nose, as this is liable to induce or increase emphysema of the orbit or lids.
Emphysema of the scalp may follow fractures implicating any of the air sinuses of the skull, the air infiltrating the loose cellular tissue between the pericranium and the aponeurosis, and on palpation yielding a characteristic crepitation.
Implication of the frontal sinus may be followed by emphysema of the orbit and lids, and if there is infection by suppurative complications.
When the external wound is small, there may be a considerable degree of emphysema of the cellular tissue.
It is probable that emphysema is more likely to occur if there is any obstruction to breathing through the mouth after the operation, such as may be caused by the falling back of the remaining part of the tongue.
In some cases the surgical emphysema is so considerable as to involve the side of the neck and face, and indeed has been known to necessitate the performance of laryngotomy.
Occasionally the os planum is perforated, resulting in emphysema of the eyelids or an ecchymosis like a ‘black eye’.
O'Dwyer started from the observation that those suffering from emphysema seldom develop true pneumonia.
And he hoped {356} to prevent the progress of the disease, or to abort it in its inception, by producing artificial emphysema for the time being.
The lungs were in the same condition of congestion and emphysema in strangulation, suffocation, and hanging.
Tardieu found patches ofemphysema due to rupture of the surface air-vesicles, giving the surface of the lung the appearance of a layer of white false membrane.
Summer heat and shallow or stagnant water hasten the development of putrid gas and subcutaneous emphysema which bring the cadaver to the surface, and that, too, sometimes in spite of precautions taken to insure the submersion.
Acute emphysema of the portion of lung not obstructed may follow its forcible distention.
Emphysema is generally present in the cellular tissues, but this latter symptom may also occur at times with non-penetrating wounds of the chest.
Later emphysema often develops throughout the tissues of the neck, and there is great danger of œdema of the larynx.
Where there is an excess of air in the chest cavity, as in emphysema or in pneumothorax, the percussion sound becomes abnormally loud and clear.
Emphysema of the skin is not a true disease of the skin, but it is mentioned as a pathological condition.
Emphysema is a rupture of the minute air vesicles of the lung substance, and may be either interlobular or vesicular.
Loss of voice, frequent cough, bloody sputa, slight emphysema at the wound of entrance, and nausea, were the leading symptoms.
Emphysema is not common in penetrating gunshot wounds, but occasionally happens.
Where old, chronic bronchitis with emphysema exists there is frequently marked dilatation of the right side of the heart, in which case a patient should by all means avoid Colorado.
There was not the slightest emphysema of the eyelids or of the skin about the eyes.
Next day the skin swelling and the conjunctivalemphysema had disappeared.
In the second case the wide development of emphysema was prevented by the early introduction of a tracheotomy tube.
When brought into the advanced Base hospital on the third day, there were signs of blood in the left pleura, cellular emphysema over the right side of the chest, and signs of collapse of the right lung.
Redness of skin and swelling below level of wound, and cellular emphysema above.
Thirty six hours later there was very free hæmorrhage into the right posterior triangle, emphysema at the episternal notch, dysphagia, and complete obliteration of the cardiac area of dulness.
Emphysema and considerable blood extravasation developed in the posterior triangle of the neck, also loss of power in the musculo-spiral distribution, but no anæsthesia.
On the third day the dyspnoea was more troublesome and emphysema began to develop in the neck.
Emphysema must also be passed over with the single remark that it is a very common accompaniment both of vascular and cardiac degenerations.
