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SUMMARY An 846 g newborn survives critical apnea, pseudomonad pneumonia and stenosing tracheitis, and thrives during 3 months of exposure to 40% oxygen. When he dies unexpectedly during an excellent convalescence, his lungs show a surprisingly advanced centro‐lobular emphysema. The history excites skepticism about the clinical evaluation of “silent” lungs of newborns, and demonstrates how remarkable a disparity may exist between ventilatory function and morphological damage in newborns. The possibility for contributory etiological roles is discussed for oxygen therapy, tracheal obstruction and rapid growth, but not for pneumonia. The case recalls the disturbing increase in neonatal emphysema since 1960. Restricted use of the term, Wilson‐Mikity disease, is urged while generic use of the term, lobular emphysema, is condoned.

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