On a case of death from hæmorrhage into the pericardium, as a result of rupture of one of three true and circumscribed aneurysms of the coronary artery of the heart : with observations on aneurysm or aneurysmal dilatation as a result of embolism or thrombosis.

  • Ogle, John W. (John William), 1824-1905.
Date:
[cbetween 1800 and 1899?]
Catalogue details

Licence: Public Domain Mark

Credit: On a case of death from hæmorrhage into the pericardium, as a result of rupture of one of three true and circumscribed aneurysms of the coronary artery of the heart : with observations on aneurysm or aneurysmal dilatation as a result of embolism or thrombosis. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    and that the deviation from its ordinary physical condition was probably the result of the extensive pleural adhesions which existed. Another apparent discrepancy between physical conditions observed during life and post-mortem results, may be noticed in the case of the kidneys; for whereas the right kidney was coarse and congested, and contained in its substance an extravasation of blood and two old-standing discoloured blocks of fibrinous deposit, yet the urine, on examination, was found to contain no albumen or blood-casts w^hen the patient was admitted, though some crystals of hse- matine were found in it.* Directly I saw the patient, his history, and the fact of the occurrence of the sudden pain in the arm, followed, as it was, by equally sudden and un- expected loss of power in the limb (the wrist and hand being dropped), along with the existence of the swell- ing in the lower part of the arm, made me suspect that it was a case of sudden plugging of an artery and pressure upon neighbouring nerves, though of course I could have had no idea of the presence of aneurysm of the coronary arteries. That pressure on the nerves of the arm had ex- isted was indeed proved to be the case, though it is impos- sible to say whether the affection of the nerves of the arm was owing to the pressure of an aneurysm or to that of blood effused into the neighbouring textures,! or to both com- bined. The establishment of this pressure was no doubt contemporary with the sudden pain and the loss of power in the limb which occurred six wrecks before admission; but possibly in his previous illness (two years before admission) there may have been a slight amount of this pressure (pro- * We are quite conversant with cases in which urine contains no appre- ciable amount of albumen, but in which blood-discs may be discovered nevertheless by the microscope, f That blood extravasated into textures around nerves may by pressure affect those nerves, was illustrated by a case which occurred in St. George's Hospital in January 1866, and was related by my colleague Dr. Dickinson to the Pathological Society. The patient—an intemperate man—suffered from purpura. A tumour formed suddenly in the thigh, and another in the lower part of one arm on the inner side, at a part corresponding to that affected in my patient: and in connection with this latter, numbness of the little finger and outer side of the third finger was experienced ; after death (which was from meniDgitis) the tumour of the arm was found to consist of altered blood so embedded in the biceps muscle as to press decidedly on the ulnar nerve.