Note 107 — Chapter IX · OF THE INFLUENCE OF THE DEATH OF THE LUNGS, OVER THE GENERAL DEATH OF THE BODY.

This fact, frequently confirmed in my experiments, is not always the same in man. We often see emphysema produced by violent efforts of respiration, efforts which have forced into the cellular organ the air contained in the lungs. Now, if the passage of the air in the blood preceded or even accompanied its introduction into the neighbouring cells of the bronchia, all these cases of emphysema would be necessarily fatal, and even in a sudden manner, since, from what has been said before, the contact of the air on the brain, to which the circulation would carry it, would inevitably interrupt the functions of this organ.

Yet we see that emphysema is often cured, or does not produce death for a length of time.[108] I saw, at the Hotel Dieu, an air tumour, suddenly appear in the axilla, from the violent efforts of the patient to prevent respiration, whilst Desault reduced an old luxation. In a few days this tumour disappeared without producing any inconvenience. We find, in the Memoirs of the Academy of Surgery and in Treatises on Operations, various examples of emphysema produced by powerful agitations of the thorax, and in consequence of the introduction of a foreign body into the wind-pipe; emphysema, with which the patients have lived many days, and from which even they have recovered.

There is then no doubt, that often in man the air passes from the lungs into the cellular texture, without entering the arterial system. My experiments on animals have not been exactly analogous to what happens from the introduction of a foreign body, when a part of the air enters and goes out. It is then probable that from a cause precisely similar would arise also the same effect in animals.

And vice versa, the passage of the air in the blood-vessels sometimes takes place in man, without the infiltration of the cellular organ; then the death is sudden.

A fisherman, subject to colick, was suddenly seized with it in his boat; the abdomen swelled, the respiration became painful and the patient died almost instantaneously. Morgagni opened the body the next day, and found the vessels full of air. Pechlin also says he saw a man die suddenly in great distress and with a hurried respiration, and he afterwards found a large quantity of air in the heart and in the large vessels.

I have dissected many bodies, in which, before death there had been a sanguineous congestion in the exterior capillary system of the face, the neck and even of the thorax. This system exhibited a remarkable engorgement and lividity in all its parts, and I have found in opening the arteries and veins, in those of the neck and head especially, a frothy blood, mixed with bubbles of air. I learnt that one of these subjects died suddenly with a convulsive affection of the pectoral muscles; I have no information respecting the others. Besides, all who have had much to do with dissecting rooms, must have seen bodies of this kind, which very soon become putrid and emit an insupportable odour. They have observed also that the air in the vessels existed previous to the putrefaction.

I suspect that in all these cases death has been produced by the sudden passage of air from the lungs into the blood, which has afterwards carried it to the brain; nearly like what I have said takes place, when, in a living animal, we force much air towards the lungs, and thus drive this fluid into the vascular system.

By considering these phenomena in connexion with the remarks presented above on death from the injection of air into the veins, the opinion I have advanced, will I think, be admitted, and it is besides the opinion of many other physicians. Many experiments have already been made on the dead body relative to this point. Morgagni has presented them in detail; but it is on the living that we must observe the passage of the air into the blood in order to deduce consequences which shall bear on the subject on which we are treating. We know in fact what is the influence of death on the permeability of the parts.