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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    protruding part was the colon. A second case is related by Sir Astley Cooper,* on the authority of Mr Bowles, and in this the right extremity of the stomach, the beginning of the duodenum, and part of the omentum, protruded into the right side of the chest, and were covered by a hernial sac formed by the perito- neum and the pleura. This man was also 50 years of age, and subject to asthmatic attacks, and died from excessive vomiting, after the exhibition of an emetic, as occurred in the case related by Riverius.j Another case, where the diaphragmatic hernia pro- truded through the interval on the right margin of the fibres aris- ing from the ensiform cartilage, is related by Professor Bignardi.:]: After a knowledge of the above cases, it could not be argued that, if the protrusion of the transverse arch of the colon, in the case Ave have detailed, had arisen from congenital deficiency in the diaphragm, it must have manifested itself before the reception of the wound, by some embarrassment of the respiratory function. The fact, moreover, that this protrusion must have existed from the time of the infliction of the wound up to his death, Avithout any marked impediment to the respiration, is obviously quite suf- ficient to invalidate any similar argument. 2. In the case we have related the protrusion of the colon through the diaphragm had occurred on the side of the chest, in which it is generally found in cases of deficient formation of the diaphragm. Of twenty-four recorded cases (not including the three last referred to,) which I have examined for this purpose, I find that in three only had the protrusion happened on the right side. One of these is the case of Riverius, already referred to ; another is one of the two cases mentioned by Dr Macauly,§ and one by Bonn.|| 3. The congenital deficiencies in the left side of the diaphragm, not only vary in extent, but also in position. In several of the recorded cases, the deficiency appears to have included the whole of the left side of the diaphragm, and in others it is merely stat- ed that the opening was on the left side. In two cases the open- ing was placed in the cordiform tendon, (case of Petit, and one of the cases of Weyland) ; in one it was stated to have been near the opening for the cava ascendens, (one of Vetter's cases) ; in Opus cit. p. 14. i Petit (opus cit.) relates the case of a man long subject to dyspnoea, and who had been treated for asthma, in whom the stomach, the colon, and the omentum were pushed up into the left side of the chest, and were enclosed in a sac formed by the diaphragm, peritoneum, and the pleura. See also Beclard's Supplement au Tr.iitu de Scarpa, p. 132, for two cases where the sac was formed by the pleura and peritoneum. $ Suir ernia diaphragmatica, 1827, as quoted by Laurence. $ Medical Observations and Inquiries, Vol. i. p. 20, London, 1763. II Descriptio Thesauri Ossiura Morbosorura Hoviani, No. 20'1, p. 69, as quoted by Laurence. «