Intrathoracic aneurysm / by F. de Havilland Hall.

  • Hall, Francis de Havilland.
Date:
1913
Catalogue details

Licence: In copyright

Credit: Intrathoracic aneurysm / by F. de Havilland Hall. Source: Wellcome Collection.

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

    17/98 (page 13)
    IB In considering the effects produced by pressure of the growing aneurysm, it must be remembered that pain may be the only symptom to direct attention to the insidious malady, which is fraught with such terrible consequences to its victims. Deep-seated and persistent pain in the chest and back is most commonly due either to aneurysm or to a malignant growth, and it will sometimes puzzle even an experienced physician to decide with which of these two conditions he has to deal. The advice given by Sir Thomas Watson —that Nestor of medicine—whose lectures, I am afraid, are seldom read in these scientific days, should be Hept in mind: '' When an adult person makes constant complaint of certain morbid feelings in a part, the proba- bility is that he has something the matter, and we must investigate the case with what helps we can get. Fortu- nately since his days science has placed in our hands resources for investigation of which he could never have dreamt. A patient who has persistent pain in the chest which cannot be assigned to any definite cause should be X-rayed, and this method of examination will usually suffice to clear up the diagnosis. The pain resulting from pressure of the aneurysmal sac upon the vertebras is frequently of an agonising character, so that the iinfortunate sufferer is at times tempted to put an end to his misery. Yet, on the other hand, we m^y come across cases in which the aneurysm in its onward march has eaten through the ribs, and appeared as an external tumour on the surface of the chest, though the patient may deny that at any time he has experienced pain—certainly not severe pain. I am at loss to explain the reason for this great difference, but that it exists I am sure. Dr. Sutton gives a notable example of such a case : '' There was a man lying in the ward with a big pulsating mass which I thought was an aneurysm, and the largeness of the pulsation made me suspect that the aneurysm had burst. I thought that the inexperience of the clerk might prevent his getting at the history rightly, so I took the notes myself. ' I was well,' said the patient, ' till a few weeks ago, when I was jammed by a cart against a load of bricks.' But an aneurysm had eroded his vertebree for months and months, and the accident