ander Benedictus, made a favorable diagnosis
of wounds made in the fleshy portions of the diaphragm, but despaired
of those in the tendinous portions. Bertrand, Fabricius Hildanus, la
Motte, Ravaton, Valentini, and Glandorp, record instances of recovery
from wounds of the diaphragm.

There are some peculiar causes of diaphragmatic injuries on record,
laughter, prolonged vomiting, excessive eating, etc., being mentioned.
On the other hand, in his "Essay on Laughter (du Ris)," Joubert quotes
a case in which involuntary laughter was caused by a wound of the
diaphragm; the laughter mentioned in this instance was probably caused
by convulsive movements of the diaphragm, due to some unknown
irritation of the phrenic nerve. Bremuse gives an account of a man who
literally split his diaphragm in two by the ingestion of four plates of
potato soup, numerous cups of tea and milk, followed by a large dose of
sodium bicarbonate to aid digestion. After this meal his stomach
swelled to an enormous extent and tore the diaphragm on the right side,
causing immediate death.

The diaphragm may be ruptured by external violence (a fall on the chest
or abdomen), or by violent squeezing (railroad accidents, etc.), or
according to Ashhurst, by spasmodic contraction of the part itself. If
the injury is unaccompanied by lesion of the abdominal or thoracic
viscera, the prognosis is not so unfavorable as might be supposed.
Unless the laceration is extremely small, protrusion of the stomach or
some other viscera into the thoracic cavity will almost invariably
result, constituting the condition known as internal or diaphragmatic
hernia. Pare relates the case of a Captain who was shot through the
fleshy portion of the diaphragm, and though the wound was apparently
healed, the patient complained of a colicky pain. Eight months
afterward the patient died in a violent paroxysm of this pain. At the
postmortem by Guillemeau, a man of great eminence and a pupil of Pare,
a part of the colon was found in the thorax, having passed through a
wound in the diaphragm. Gooch saw a similar case, but no history of the
injury could be obtained. Bausch mentions a case in which the omentum,
stomach, and pancreas were found in the thoracic cavity, having
protruded through an extensive opening in the diaphragm. Muys, Bonnet,
Blancard, Schenck, Sennert, Fantoni, and Godefroy record instances in
which, after rupture of the diaphragm, the viscera have been found in
the t