Page:Encyclopædia Britannica, Ninth Edition, v. 8.djvu/190

180  uses αὐτοκράτωρ as his formal, and βασιλεύς as the popular. On the revival of the in the  by  in, the  (at ﬁrst in the form imperator, or imperator Augustus, afterwards Romanorum imperator Augustus) was taken by him and by his , , and  , heads of the , down till the  of the emperor  in. The had, however, grown up in the earlier  (about the time of the emperor, –) that although the emperor was chosen in  (at ﬁrst by the , afterwards by a small body of ), and entitled from the moment of his  to be  in  by the , he could not use the  of emperor until that  had actually taken place. The, therefore, though he exercised, as soon as chosen, full imperial powers both in  and , called himself merely “ of the ” (Romanorum rex semper Augustus) until he had received the   in the. In, being refused a passage to  by the , obtained from  a  permitting him to style himself emperor elect (imperator electus, erwählter Kaiser). This was taken by   and all  emperors, immediately upon their  in ; and it was until  their strict  designation, and was always employed by them in s and other ofﬁcial s. The  “elect” was, however, omitted even in formal s when the  was addressed, or was spoken of in the. According to, there was and could be only one emperor in the, the direct of , who represented the unity of  and of the  people on its temporal side as the  did on its ual. Hence during those ages the and   did not admit in principle, though they sometimes recognized in fact, the  of the emperor who reigned at ; and the  in like manner denied the existence of an emperor in the, and maintained that the heads of the  were merely  intruders. In spite, however, of the universal acceptance of the above mentioned, the  of emperor was one which other s seem to have hankered after. In  of, in the pride of his  over the , assumed the style of Hispanicæ imperator, but was forced by the remonstrances of the emperor  to abandon it. In the it was again assumed by  of, but not by any of his. In the  s frequently used the term basileus, and sometimes also imperator, partly from a desire to imitate the  of the , partly in order to claim a  over the minor s and s of the  corresponding to that which the emperor was held to have over  generally (see Freeman, Norman Conquest, vol.i., Appendix, who however attaches too much importance to this  use). In comparatively modern times, the of emperor has been taken by the s of (, about, his predecessors at  having been called s of, and the title of Czar or Tsar being apparently a   for , not related to ),  ( in ,  in ),  ,  ,  ( 31, ),  in respect of the. who have reigned in, a certain who ) became  of  after the  against , and the   during his short tenure of power in , also called themselves emperors; and modern usage applies the term to various semi- , such as the  of  and . It can, therefore, hardly be said that the  has at present any deﬁnite descriptive force, such as it had in the , although its associations are chiefly with , and it is vaguely supposed to imply a sort of precedence over . In the cases of , , and  in respect of , it may perhaps be taken to denote that general over-lordship which their s exercise over minor s and over their various , and which is distinct from their position as  of one or more particular  or s, the  being also  of , as the  is  of , and the   of.

1em (undefined)  EMPHYSEMA (from ἐμφυσάω, to inflate), in medicine, means an abnormal presence of air in certain parts of the body. In its restricted sense, however, it is generally employed to designate a peculiar affection of the lungs, of which there are two forms. In one of these there is over-distension of the air-cells of these organs (see ), and in parts destruction of their walls, giving rise to the formation of large sacs, from the rupture and running together of a number of contiguous air-vesicles. This is termed vesicular emphysema. In the other form the air is inﬁltrated into the connective tissue beneath the pleura and between the pulmonary air-cells, constituting what is known as interlobular emphysema.

The former variety is by far the more common, and appears to be capable of being produced by various causes, the chief of which are the following:— 1. Where a portion of the lung has become wasted, or its vesicular structure permanently obliterated by disease, without corresponding falling in of the chest wall, the neighbouring air vesicles or some of them undergo dilatation to ﬁll the vacuum. 2. In some cases of bronchitis, where numbers of the smaller bronchial tubes become obstructed, the air in the pulmonary vesicles remains imprisoned, the force of expiration being insufﬁcient to expel it; while, on the other hand, the stronger force of inspiration being adequate to overcome the resistance, the air-cells tend to become more and more distended, and permanent alterations in their structure, including emphysema, are the result. 3. Emphysema also arises from exertion involving violent expiratory efforts, during which the glottis is constricted, as in paroxysms of coughing, in straining, and in lifting heavy weights. Hooping cough is well known as the exciting cause of emphysema in many persons. In whatever manner produced, this disease gives rise to important morbid changes in the affected portions of the lungs, especially the loss of the natural elasticity of the air-cells, and likewise the destruction of many of the pulmonary capillary blood-vessels, and the diminution of aerating surface for the blood. As a consequence of these, other changes are apt to arise affecting related organs, more particularly the heart and the venous system generally, one of the most frequent results of which is the occurrence of dropsy. The chief symptom in this complaint is shortness of breathing, 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. The respiration is of similar character to that already described in the case of asthma. In severe forms of the disease the patient comes to acquire a peculiar