Four cases of aneurism of the arch of the aorta, and a case of diaphragmatic hernia / by John Reid.

  • Reid, John, 1809-1849.
Date:
[1840]
Catalogue details

Licence: Public Domain Mark

Credit: Four cases of aneurism of the arch of the aorta, and a case of diaphragmatic hernia / by John Reid. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    which passed partly through anotcli in the upper and right side of the sternum, and partly through the interval between the sternum, first rib, and clavicle. This opening admitted the passage of three finders, and communicated with the ancurismatic tumour, which had appeared externally. The walls of the external tumour were formed bv the anterior surface of the sternum, which was bare and rouo-h, by cellular tissue, and by the skin. A firm fibrinous and decolorized clot, about a quarter of an inch in thickness, occupied the apex of the external tumour, and by the edges of this the blood had escaped. The internal tumour was partly occupied by a large soft dark-coloured coagulum. The left ventricle of the heart was very considerably dilated and hypertrophied. The semilunar aor- tic valves were shortened, thickened along their margins, and were inadequate. Lungs contained some serum, and were not particu- larly pale, some coagulated blood in heart. Liver and intestines pale ; kidneys slightly granular. This aneurism, though large, produced no dyspnoea under mo- derate exertion, and no dysphagia, from the circumstance that it projected forwards and not backwards. It is much rarer for aneu- risms of the aorta to burst externally than what we would at first imagine. Some of the most experienced practitioners in this city have not witnessed such a case. Case V.—Case of Diaphragmatic Hernia produced'Jry a penetrating woicnd.—W. R. aged 45, a shoemaker, was admitted, on the 13th September ] 838, into the Infirmary, under the charge of Dr Shortt, about noon. He stated that he had been seized about 4 o'clock p.m. of the previous day with vomiting, succeed- ed by dyspnoea, and that the latter had continued to increase up to the time of his admission. He also stated, that for upwards of a year, lie had been subject to occasional severe pain in the left hypochondriacal region, and also to cough Avithout any expectora- tion. On admission he complained of great pain in the left hy- pochondrium, severe dyspnoea, with a depressed anxious expression of countenance; the pulse was intermittent, and so weak that it could not be reckoned. Extremities cold, and lips livid; per- cussion dull over the whole of the left side of the chest, and the respiratory murmur was there inaudible, while it was puerile on the right side. The sounds of the heart were only audible under the cartilages of the fourth, fifth, and sixth ribs on the right side. Had wine ordered, and sinapisms were applied to the chest and feet. Died in four hours after admission.* Sectio Cadaveris,16th September.—Heart healthy, but some- what displaced towards the right side. Right lung sound. The * The above account of his symptoms on admission was furnished bv Ur Alexander Wood.