Vladimir Nabokov

NABOKV-L post 0013805, Mon, 30 Oct 2006 10:43:28 +0530

Subject
Re: Edsel Ford and conjuring nebulae in two lungs
Date
Body
Matthew Roth wrote:
>2. In lines 615-616, Shade is describing "the exile, the old man / Dying in
a motel" and says: >"He suffocates and conjures in two tongues / The nebulae
dilating in his lungs." My >questions: Does "two tongues" refer to
languages? Medically speaking, what are nebulae >and how do they dilate in
the lungs? What does it mean to "conjure" them?

This has pretty much been covered, but there are no nebulae in the lungs -
the closest anatomically are alveoli, which do dilate and contract on
inspiration and expiration respectively, and the closest phonetically would
be nebulisers, which are devices used to administer drugs to the lungs - I'm
unsure as to when these entered general use, but my guess would be that they
were in common use at the time of writing.

The likeliest explanation is, as Matthew has already said, that it's a
reference to the radiographic appearance of disease on X-ray. Plain
tuberculosis, however, doesn't resemble a nebula on an X-ray film - the
classical presentation is cavitating lesions (or nothing!). The only thing
that does resemble a nebula is miliary tuberculosis, which gives a pattern
of lots of tiny dots in the lung fields which is virtually pathognomic. So
we can be actually very specific about the illness in question.

On reading this thread, it occurred to me that miliary TB can, like the
ordinary form, spread throughout the body (where it has a similar speckled
appearance on gross histology at post-mortem, although lacking the black
"cosmos" background of the X-ray). About a quarter of those with miliary TB
also get tuberculous meningitis - which might link in to the recent lemnisci
/ tubular sclerosis discussion, and be a possible explanation for Shade's
neurological symptoms.

Nick.

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