At the operation he
had removed the diseased area at the apex of the right lung,
together with sound tissue for two cm. in every direction.
Tuffier stated that the result of his operation had been
perfectly successful and the patient had shown no suspicious
symptoms since.
Rupture of the Lung Without Fracture.--It is quite possible for
the lung to be ruptured by external violence without fracture of
the ribs; there are several such cases on record. The mechanism
of this rare and fatal form of injury has been very aptly
described by Gosselin as due to a sudden pressure exerted on the
thoracic wall at the moment of full inspiration, there being a
spasm of the glottis or obstruction of the larynx, in consequence
of which the lung bursts. An extravasation of air occurs,
resulting in the development of emphysema, pneumothorax, etc.
Subsequently pleurisy, pneumonia, or even pus in the pleural
cavity often result. Hemoptysis is a possible, but not a marked
symptom. The mechanism is identical with that of the bursting of
an inflated paper bag when struck by the hand. Other observers
discard this theory of M. Gosselin and claim that the rupture is
due to direct pressure, as in the cases in which the heart is
ruptured without fracture of the ribs.
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