The successful treatment of internal aneurism : illustrated by cases in hospital and private practice / by Jolliffe Tufnell.

  • Tufnell, Jolliffe.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: The successful treatment of internal aneurism : illustrated by cases in hospital and private practice / by Jolliffe Tufnell. Source: Wellcome Collection.

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    sallou', was admitted into the Herbert Ward upon the 14th of March of the present year, Avlth an aneurism of the abdominal aorta, of the size of an ordinary apple, situated below and to the left of the xiphoid cartilage of the sternum. The history given by the sufferer is, that he had always been accustomed to heavy work, and, for some years, to drink hard also, but not latterly. That towards the end of June, 18G3, he was employed in a stooping position, pitching up pipeclay from the hold of a ship, each lump of clay weighing 44 lbs. Whilst doing so he experienced pain in his back, but as he was working at this time a good deal in the wet, he fancied that it might be rheumatic, lie had, however, to discon- tinue his labour, and rest for a day or two; he then resumed it, and was employed at unloading iron. Shortly after he was attacked by seminal emissions, which occurred very frequently. His whole system became irritable and restless, and he could not sleep at night; whilst the pain in the back grew so severe that he had to give up work altogether. In January, 1864, he experienced a rigor, and immediately after- Avards noticed a beating in his belly. This abdominal pulsation gradually increased until his admission into hospital, when it was clearly visible to the eye, presenting to the left of the mesial line, inclining to the cartilages of the ribs upon the same side. Its impulse was considerable, and accompanied by a bruit de sovjfflet which, as nsual, Avas plainly audible to the ear when he lay recumbent, but Avas lost upon his standing erect. The heart and its valves Avere sound, and no thoracic aneurism Avas to be detected; but a second tumor, apparently pancreatic, could bo distinctly made out in the abdomen, a little below the aneurism proper. The pulse was, after exercise, when standing, 104, and in the sitting position, 84. After rest it was, in the standing position, 96, sitting, 80, but lying doAvn, only 66—the difference betAveen lying and standing being 30 beats per minute. I'he dorsal pain Avas very great, and the pulsation of the tumor to considerable as to be visible at the far end of the ward. Treatment Avas commenced upon the 23i-d of March. Upon the 4th of April the pain had so subsided as to be scarcely comphiincd cf, and upon the 3rd of .July, Avhcn he left the hospital, his condition Avas as follows : —His Aveight Avas lOst. Sibs., or l^lbs. heavier than before commencing the treatment upon the 23rdof Mai'ch, when he turned